Dataset Information

Is acupuncture effective for knee osteoarthritis? A protocol for a systematic review and meta-analysis.

ABSTRACT:

Introduction

Knee osteoarthritis (KOA) is one of the leading causes of disability. The effectiveness of acupuncture for treating KOA remains controversial. This protocol describes the method of a systematic review and meta-analysis evaluating the effectiveness and safety of acupuncture for treating KOA.

Methods and analysis

Four English databases (PubMed, Embase, Cochrane Library databases and Web of Science) and four Chinese databases (China National Knowledge Infrastructure, Chinese Biomedical Literature Database, VIP Database for Chinese Technical Periodicals, and Wanfang) will be searched from the database inception to 1 September 2021. All randomised controlled trials related to acupuncture for KOA will be included. Extracted data will include publication details, basic information, demographic data, intervention details and patient outcomes. The primary outcome will be pain intensity. Risk of bias will be assessed using the Cochrane Collaboration's tool for assessing risk of bias. Article selection, data extraction and risk of bias assessment will be performed in duplicate by two independent reviewers. If the meta-analysis is precluded, we will conduct a descriptive synthesis using a best-evidence synthesis approach. The strength of recommendations and quality of evidence will be assessed using the Grading of Recommendations Assessment Development and Evaluation working group methodology.

Ethics and dissemination

Ethics approval is not required because individual patient data are not included. This protocol was registered in the international Prospective Register of Systematic Reviews on 25 February 2021. The systematic review and meta-analysis will be submitted for publication in a peer-reviewed journal. The findings will also be disseminated through conference presentations.

Trial registration number

CRD42021232177.

SUBMITTER: Liu CY

PROVIDER: S-EPMC8753400 | biostudies-literature | 2022 Jan

REPOSITORIES: biostudies-literature

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Publications

Is acupuncture effective for knee osteoarthritis? A protocol for a systematic review and meta-analysis.

Liu Chuan-Yang CY Tu Jian-Feng JF Lee Myeong Soo MS Qi Ling-Yu LY Yu Fang-Ting FT Yan Shi-Yan SY Li Jin-Ling JL Lin Lu-Lu LL Hao Xiao-Wan XW Su Xin-Tong XT Yang Jing-Wen JW Wang Li-Qiong LQ

BMJ open 20220111 1

<h4>Introduction</h4>Knee osteoarthritis (KOA) is one of the leading causes of disability. The effectiveness of acupuncture for treating KOA remains controversial. This protocol describes the method of a systematic review and meta-analysis evaluating the effectiveness and safety of acupuncture for treating KOA.<h4>Methods and analysis</h4>Four English databases (PubMed, Embase, Cochrane Library databases and Web of Science) and four Chinese databases (China National Knowledge Infrastructure, Chi ...[more]

PMID: 35017242

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Project description:BackgroundKnee osteoarthritis is a common clinical disease with frequent occurrence. More and more studies have shown that external therapies such as acupuncture and massage are beneficial to the treatment of knee osteoarthritis.ObjectiveThe purpose of this systematic review and meta-analysis of randomized controlled trials (RCTS) was to evaluate the efficacy and safety of acupuncture and massage combined with treatment of KOA and to provide some reference for clinical treatment of KOA.MethodsNetwork meta-analysis was used to evaluate the efficacy of acupuncture combined with massage in the treatment of knee osteoarthritis. PubMed, Cochrane Library, Web of Science, Embase, Chinese Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), VIP, and Wanfang were searched by computer for randomized controlled trials on acupuncture combined with massage in the treatment of knee osteoarthritis. All researchers independently screened the literature, extracted data, and evaluated quality, and studies that met the quality criteria were analyzed using Stata16.0 software.ResultsA total of 3076 articles were retrieved, and finally, 49 studies involving 10 acupuncture combined with massage methods were included. The total sample size was 4458, including 2182 in the experimental group and 2276 in the control group. The results of network meta-analysis showed the following: in terms of effective rate, the optimal first three interventions were floating needle+massage, needle knife+massage, and silver needle+massage; in terms of reducing VAS score, the optimal first three interventions were common acupuncture+massage, needle knife+massage, and warm needle+massage; in terms of improving total Lysholm index score, the optimal first three interventions were silver needle+massage, electroacupuncture+massage, and needle knife+massage; in terms of reducing total WOMAC score, the optimal first three interventions were silver needle+massage, electrothermal needle+massage, and common acupuncture+massage; in terms of reducing WOMAC stiffness score, the optimal first three interventions were warm needle+massage, silver needle+massage, and common acupuncture+massage; and in terms of reducing WOMAC joint function score, the optimal first three interventions were silver needle+massage, warm needle+massage, and common acupuncture+massage.ConclusionThe results showed that acupuncture combined with massage could improve the clinical therapeutic effect of patients with knee osteoarthritis. Limited by the quality of the included studies, the conclusions obtained still need to be further validated.

Project description:ObjectivesAlthough many trials have assessed the effect of acupuncture on knee osteoarthritis (KOA), its efficacy remains controversial. Sham acupuncture techniques are regarded as representative control interventions in acupuncture trials and sometimes incorporate the use of sham devices (base units) to support a non-penetrating needle. To achieve successful blinding, these trials also use acupuncture base units in the verum acupuncture group. Base units are not used in real-world clinical settings. We aimed to assess the effect sizes of verum and sham acupuncture for KOA in sham-controlled trials with or without base units.MethodsA total of 10 electronic databases for randomized controlled trials (RCTs) comparing the efficacy of verum manual acupuncture and sham acupuncture for the treatment of KOA were searched for articles published before April 12, 2022. The primary outcome was pain intensity, and the secondary outcomes included physical function. The first assessment after the end of treatment was chosen for analysis. Effect sizes are reported as standardized mean differences (SMDs) with 95% confidence intervals (95% CIs). The risk of bias was assessed using the Cochrane risk of bias tool, and publication bias was evaluated using a funnel plot and Egger's test. The quality of evidence for estimates was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach.ResultsFifteen RCTs were included. There was generally a low risk of bias except for the difficulty in blinding acupuncture therapists (performance bias). Compared to verum acupuncture in sham-controlled trials using base units, verum acupuncture in sham-controlled trials without base units was more effective for improving pain (SMD -0.56, 95% CI -1.09 to -0.03) and function (SMD -0.73, 95% CI -1.36 to -0.10) in KOA. The quality of evidence for network estimates was moderate to low due to the risk of bias and imprecision.ConclusionThese findings suggest that verum acupuncture in different types of sham-controlled trials has different effect sizes for KOA. Because base units are not used in clinical settings, the results of verum acupuncture in sham-controlled trials with base units need to be interpreted carefully.Systematic review registrationhttps://www.researchregistry.com/browse-the-registry#registryofsystematicreviewsmeta-analyses/registryofsystematicreviewsmeta-analysesdetails/6269f962606c5e001fd8790c/, identifier reviewregistry1351.

Project description:ObjectiveTo evaluate the effectiveness and safety of viscosupplementation for pain and function in patients with knee osteoarthritis.DesignSystematic review and meta-analysis of randomised trials.Data sourcesSearches were conducted of Medline, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases from inception to 11 September 2021. Unpublished trials were identified from the grey literature and trial registries.Eligibility criteria for study selectionRandomised trials comparing viscosupplementation with placebo or no intervention for knee osteoarthritis treatment.Main outcome measuresThe prespecified primary outcome was pain intensity. Secondary outcomes were function and serious adverse events. Pain and function were analysed as standardised mean differences (SMDs). The prespecified minimal clinically important between group difference was -0.37 SMD. Serious adverse events were analysed as relative risks.MethodsTwo reviewers independently extracted relevant data and assessed the risk of bias of trials using the Cochrane risk of bias tool. The predefined main analysis was based only on large, placebo controlled trials with ≥100 participants per group. Summary results were obtained through a random effects meta-analysis model. Cumulative meta-analysis and trial sequential analysis under a random effects model were also performed.Results169 trials provided data on 21 163 randomised participants. Evidence of small study effects and publication biases was observed for pain and function (Egger's tests with P<0.001 and asymmetric funnel plots). Twenty four large, placebo controlled trials (8997 randomised participants) included in the main analysis of pain indicated that viscosupplementation was associated with a small reduction in pain intensity compared with placebo (SMD -0.08, 95% confidence interval -0.15 to -0.02), with the lower bound of the 95% confidence interval excluding the minimal clinically important between group difference. This effect corresponds to a difference in pain scores of -2.0 mm (95% confidence interval -3.8 to -0.5 mm) on a 100 mm visual analogue scale. Trial sequential analysis for pain indicated that since 2009 there has been conclusive evidence of clinical equivalence between viscosupplementation and placebo. Similar conclusions were obtained for function. Based on 15 large, placebo controlled trials on 6462 randomised participants, viscosupplementation was associated with a statistically significant higher risk of serious adverse events than placebo (relative risk 1.49, 95% confidence interval 1.12 to 1.98).ConclusionStrong conclusive evidence indicates that viscosupplementation leads to a small reduction in knee osteoarthritis pain compared with placebo, but the difference is less than the minimal clinically important between group difference. Strong conclusive evidence indicates that viscosupplementation is also associated with an increased risk of serious adverse events compared with placebo. The findings do not support broad use of viscosupplementation for the treatment of knee osteoarthritis.Systematic review registrationPROSPERO CRD42021236894.

Project description:BackgroundOsteoarthritis is the most common degenerative joint disease. It is associated with significant socioeconomic burden and poor quality of life, mainly due to knee osteoarthritis (KOA), and related total knee arthroplasty (TKA). Since early detection method and disease-modifying drug is lacking, the key of KOA treatment is shifting to disease prevention and progression slowing. The prognostic prediction models are called for to guide clinical decision-making. The aim of our review is to identify and characterize reported multivariable prognostic models for KOA about three clinical concerns: (1) the risk of developing KOA in the general population, (2) the risk of receiving TKA in KOA patients, and (3) the outcome of TKA in KOA patients who plan to receive TKA.MethodsThe electronic datasets (PubMed, Embase, the Cochrane Library, Web of Science, Scopus, SportDiscus, and CINAHL) and gray literature sources (OpenGrey, British Library Inside, ProQuest Dissertations & Theses Global, and BIOSIS preview) will be searched from their inception onwards. Title and abstract screening and full-text review will be accomplished by two independent reviewers. The multivariable prognostic models that concern on (1) the risk of developing KOA in the general population, (2) the risk of receiving TKA in KOA patients, and (3) the outcome of TKA in KOA patients who plan to receive TKA will be included. Data extraction instrument and critical appraisal instrument will be developed before formal assessment and will be modified during a training phase in advance. Study reporting transparency, methodological quality, and risk of bias will be assessed according to the TRIPOD statement, CHARMS checklist, and PROBAST tool, respectively. Prognostic prediction models will be summarized qualitatively. Quantitative metrics on the predictive performance of these models will be synthesized with meta-analyses if appropriate.DiscussionOur systematic review will collate evidence from prognostic prediction models that can be used through the whole process of KOA. The review may identify models which are capable of allowing personalized preventative and therapeutic interventions to be precisely targeted at those individuals who are at the highest risk. To accomplish the prediction models to cross the translational gaps between an exploratory research method and a valued addition to precision medicine workflows, research recommendations relating to model development, validation, or impact assessment will be made.Systematic review registrationPROSPERO CRD42020203543.

Dataset Information

Is acupuncture effective for knee osteoarthritis? A protocol for a systematic review and meta-analysis.

Introduction

Methods and analysis

Ethics and dissemination

Trial registration number

Publications

Is acupuncture effective for knee osteoarthritis? A protocol for a systematic review and meta-analysis.

Similar Datasets

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