Evidence map›Paper›PMID 40689021›Full record

ReviewIntegrative medicine research2025

Cochrane reviews of acupuncture are dated, do not account for the specific effects of sham controls and likely underestimate the efficacy of acupuncture therapy.

Arya Nielsen, L Susan Wieland

Abstract readReview
In one paragraph

Review in Integrative medicine research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Reply to Borst et al.: Acupuncture and the placebo effect.Proceedings of the National Academy of Sciences of the United States of America · 2026
    Article
  3. Review
  4. What's the science behind acupuncture?Proceedings of the National Academy of Sciences of the United States of America · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Arya NielsenIcahn School of Medicine at Mount Sinai, Department of Family Medicine & Community Health, NY, NY, USA.
L Susan WielandDepartment of Biochemistry and Cellular & Molecular Biology, Division of Integrative Physiology, Georgetown School of Medicine, Washington D.C., USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Because Cochrane reviews represent a quality standard for systematic reviews, we sought to clarify to what extent Cochrane reviews of acupuncture characterize the potential and problematic specific effects of sham acupuncture. Methods: We imported records of Cochrane acupuncture reviews into Covidence and independently selected reviews with at least one included study comparing manual acupuncture to sham acupuncture. Dual data extraction for eligible reviews included review author expertise, evaluation of intervention adequacy, use of STRICTA guidelines, characterization of sham methods, and whether specific effects of sham were discussed relative to needle penetration, point selection or use of a sham device. Results: Of the 56 reviews with acupuncture in the title, 16 were ineligible. Of the 40 included reviews, 28 were published in or before 2018. Most reviews had an author with acupuncture trial expertise; however, assessment of intervention adequacy was rarely conducted, STRICTA guidelines were rarely utilized, and reporting of sham acupuncture methods was commonly either missing or lacking rigor. While 20/40 reviews acknowledged the controversy regarding sham as an active and therefore inadequate control, no reviews incorporated this into their conclusions. Conclusion: Most Cochrane reviews of acupuncture therapy are dated and are also not current relative to the science of acupuncture biomechanism and the impact of 'active' sham arms. The handling of sham controls, combined with a lack of evaluation of verum intervention adequacy, contravenes a clear research standard and indicates that the efficacy of acupuncture is likely underestimated in Cochrane reviews.

Indexed as

Acupuncture therapyCochrane systematic reviewsSpecific effects of sham controls

Identifiers

PMID40689021
PMCPMC12271578

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.