scholarly journals A Critical Overview of Systematic Reviews and Meta-Analyses on Acupuncture for Poststroke Insomnia

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Jinke Huang ◽  
Manli Wu ◽  
Simin Liang ◽  
Xiaohui Qin ◽  
Min Shen ◽  
...  

Objectives. Acupuncture has increasingly been used for insomnia relief after stroke. We aimed to evaluate the methodological quality and summarize the evidence regarding the effectiveness of acupuncture for poststroke insomnia (PSI) from systematic reviews/meta-analyses (SRs/MAs). Methods. Eight databases were searched from inception through August 23, 2020. SRs/MAs on acupuncture treatment for PSI were included. Methodological quality assessment was performed using Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), and evidence quality assessment was performed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Results. Six SRs/MAs on acupuncture treatment for PSI were included. The AMSTAR-2 showed that the methodological quality of all included SRs/MAs was rated as critically low. According to the evaluation results of GRADE, 38.9% (7/18) of outcomes were rated as very low-quality evidence, 22.2% (4/18) were low-quality evidence, and 8.9% (7/18) were moderate-quality evidence. Descriptive analysis results showed that acupuncture was an effective treatment modality for PSI. Conclusions. All included reviews indicated that acupuncture was more effective than the control group for the treatment of PSI, but the credibility of the results is limited owing to the generally low methodological and evidence quality of the included SRs/MAs. More high-quality evidence is needed to determine whether acupuncture is more effective than other treatments.

2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Jinke Huang ◽  
Min Shen ◽  
Xiaohui Qin ◽  
Weichi Guo ◽  
Hui Li

Objectives. Because current evidence regarding the effectiveness of acupuncture for a tension-type headache (TTH) is controversial, we evaluated the reliability of the methodological quality and outcome measures of systematic reviews/meta-analyses (SRs/MAs) on acupuncture for TTH. Methods. We conducted a comprehensive literature search for SRs/MAs in major databases from the database’s inception to September 2019. The Methodological Quality of Systematic Reviews 2 (AMSTAR-2) and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) assessments were used to assess the methodological quality of the included reviews and the quality of evidence, respectively. Results. Eight reviews were included in the analysis. The AMSTAR-2 assessment results showed that the methodological quality of all included reviews was critically low. Thirty-six outcome measures were included in these reviews. The GRADE results showed that 25 (25/36, 69.4%) outcomes provided low- or very low-quality evidence, four (4/36, 11.1%) provided moderate-quality evidence, and seven (7/36, 19.4%) provided high-quality evidence. Descriptive analysis results showed that acupuncture treatment for TTH reduced headache frequency and severity. Conclusions. Acupuncture appears to be an effective treatment modality for TTH, but the credibility of the results is limited owing to the generally low methodological quality and evidence quality in the included SRs/MAs.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Jinke Huang ◽  
Yanlu Wang ◽  
Suihe Huang ◽  
Xiaohui Qin ◽  
Fang Yan ◽  
...  

Objectives. Shenfu Injection (SFI) was widely used in the treatment of heart failure (HF) in China. A plethora of systematic reviews/meta-analyses (SRs/MAs) has been conducted in this research area, although with scattered results. The purpose of this overview was to conduct a comprehensive review to summarize and critically evaluate the existing evidence. Methods. Digital databases were searched for SRs/MAs up to January 28, 2021. Two authors independently screened the reviews and assessed the methodological quality of included SRs/MAs using Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2). Quality of evidence for outcomes evaluated within the reviews was appraised with the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE). Results. Thirteen SRs/MAs met the inclusion criteria. Based on AMSTAR-2, the quality of all SRs/MAs was critically low, because all of them have more than one critical domains that were unmet. Based on GRADE, the evidence quality of 24 outcome measures was low or very low, 27 outcome measures was moderate, and none outcome measure was high. Descriptive analysis showed that SFI was an effective and safe method for HF. Conclusions. The use of SFI for the treatment of HF may be clinically effective and safe. However, this conclusion must be interpreted cautiously due to the generally low methodological quality and low evidence quality of the included SRs/MAs. More rigorously designed SRs/MAs and RCTs with high methodological quality are necessary for further proof.


2021 ◽  
Vol 12 ◽  
Author(s):  
Jie Zhang ◽  
Qianying Yu ◽  
Li Peng ◽  
Yuesi Qin ◽  
Mingyi Jing ◽  
...  

Background: In recent years, systematic reviews/meta-analyses (SRs/MAs) of Chinese herbal medicine (CHM) for psoriasis have continuously emerged. Their methods and evidence quality, however, are yet to be evaluated, and whether their conclusions can provide clinicians with reliable evidence is still debatable.Objectives: This overview aims to evaluate the methodological quality, risk of bias, and reporting quality of relevant SRs/MAs, as well as the current evidence of CHM for treating psoriasis.Methods: We searched nine electronic databases from their respective time of establishment to January 20, 2021, as well as the reference lists of the included SRs/MAs, protocol registries, and gray literature. Two reviewers independently used the following: A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2, Risk of Bias in Systematic Reviews (ROBIS), the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), and Grades of Recommendations, Assessment, Development and Evaluation (GRADE) to evaluate the methodological quality, risk of bias, reporting quality, and evidence quality of the included SRs/MAs.Results: This review included 14 SRs/MAs involving 45 outcomes, of which 12 (85.71%) SRs/MAs had a very low quality evaluated by AMSTAR 2 and 7 (50.00%) SRs/MAs had a high risk of bias assessed by ROBIS. The protocol and registration and funding statements were the major reporting flaws according to the PRISMA checklist. The evaluation with the GRADE system demonstrated no outcome of high-quality evidence, and inconsistent efficacy evaluations were found in this overview. Only 15 (33.33%) outcomes were moderate-quality evidence, supporting the claim that CHM plus Western medicine (WM) was superior to WM. Generally low quality of evidence showed no difference in the incidence of adverse events between the combined therapy and WM. However, the conclusion that CHM was superior to WM cannot be drawn due to the inconsistent results.Conclusion: Despite that CHM has the potential benefit and safety in the adjuvant treatment of psoriasis, the conclusion should be treated with caution because of the generally low quality of methodology and evidence. In the future, high-quality randomized controlled trials (RCTs) should be carried out, and the quality of relevant SRs should also be improved to promote their clinical application.


2021 ◽  
Vol 8 ◽  
Author(s):  
Min Shen ◽  
Jinke Huang ◽  
Tao Qiu

Background: To systematically appraise and synthesize evidence, we conducted an overview of systematic reviews/meta-analyses (SRs/MAs) on acupuncture for stable angina pectoris (SAP).Methods: Eight databases were searched for SRs/MAs of acupuncture on SAP. The methodological quality, reporting quality, and evidence quality were evaluated by Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, respectively.Results: A total of seven published SRs/MAs met the inclusion criteria. According to the evaluation results of AMSTAR-2, two studies were considered as of moderate quality; the remaining five were considered as of very low quality. According to the evaluation results of the PRISMA checklist, only one study reported the checklist in its entirety, while others had reporting deficiencies. According to GRADE, a total of 18 outcome indicators extracted from the included studies were evaluated. The evidence quality was very low in three, low in three, moderate in eight, and high in four.Conclusion: Acupuncture may be beneficial for SAP from the currently published evidence. However, this conclusion must be interpreted cautiously due to the generally low methodological quality, reporting quality, and evidence quality of the included studies. More rigorous, more standardized and comprehensive SRs/MAs are needed to provide strong evidence for convincing conclusions.


2021 ◽  
Vol 8 ◽  
Author(s):  
Jinke Huang ◽  
Xiaohui Qin ◽  
Min Shen ◽  
Yanjuan Xu ◽  
Yong Huang

Background: Tai chi (TC) is a popular form of exercise among adults with chronic heart failure (CHF), yet services are greatly underutilized. The aim of the current study was to identify and summarize the existing evidence and to systematically determine the clinical effectiveness of Tai Chi in the management of CHF using a systematic overview.Methods: Both English and Chinese databases were searched for systematic reviews (SRs)/meta-analyses (MAs) on TC for CHF from their inception to June 2020. The methodological quality, reporting quality, and risk of bias of SRs/MAs were assessed using Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, and Risk of Bias in Systematic reviews (ROBIS), respectively. The evidence quality of outcome measures was assessed by the Grades of Recommendations, Assessment, Development and Evaluation (GRADE).Results: Six SRs/MAs using a quantitative synthesis to assess various outcomes of TC in CHF were included in this overview. The methodological quality, reporting quality and risk of bias of the SRs/MAs and the evidence quality of the outcome measures are generally unsatisfactory. The limitations of the past SRs/MAs included the lack of either the protocol or registration, the list of excluded studies, and the computational details of meta-analysis were inadequately reported. The critical problems were that qualitative data synthesis relied on trials with small sample sizes and critical low quality.Conclusions: TC may be a promising complementary treatment for CHF. However, further rigorous and comprehensive SRs/MAs and RCTs are required to provide robust evidence for definitive conclusions.


2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Jinke Huang ◽  
Mengxiong Lu ◽  
Yijun Zheng ◽  
Jinxin Ma ◽  
Xiangxue Ma ◽  
...  

Objectives. To systematically collate, appraise, and synthesize the current evidence on acupuncture for irritable bowel syndrome (IBS). Methods. Systematic reviews (SRs)/meta-analyses (MAs) of acupuncture for IBS were searched in eight databases. For quality evaluation of the enrolled studies, Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) was used for methodological quality, Preferred Reporting Item for Systematic Reviews and Meta-Analyses (PRISMA) for reporting quality, and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) for evidence quality. Results. Ten studies were included in our review. According to AMSTAR-2, only one study met all the criteria and was rated as high methodological quality, and the rest were rated as low or very low methodological quality. According to the PRISMA checklist, most of the items were fully reported, with the exception of Q5 (protocol and registration), Q8 (search), and Q27 (funding). With the GRADE system, no outcome measure was rated as high quality. Conclusions. Acupuncture may be a promising therapy for IBS. However, this conclusion must be treated with caution since the quality of SRs/MAs providing evidence is generally low.


2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Jinke Huang ◽  
Min Shen ◽  
Xiaohui Qin ◽  
Yong Huang

Objectives. The effectiveness of auricular acupuncture (AA) for insomnia is far from uniform. The aim of this overview was to summarize and critically evaluate the evidence from systematic reviews (SRs)/meta-analysis (MAs) and provide an overall verdict about the therapeutic value of AA for insomnia. Methods. A search of relevant literature for SRs/MAs was performed on major medical databases. The methodological quality was assessed using the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2) and the evidence quality was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Results. Seven SRs/MAs were deemed eligible for the present overview. According to the evaluation results of AMSTAR-2, the methodological quality of all included SRs/MAs was critically low. Consistent methodological deficiencies were item 2 (the lack of a protocol), item 4 (the lack of a specific search strategy), item 7 (the lack of a list of excluded studies), and item 15 (the lack of an assessment of publication bias). For GRADE, of the 17 outcomes, only 1 (5.9%) was rated of high-quality, 4 (23.5%) were rated of moderate-quality, and the remaining 12 (70.6%) were rated of low-or critically low-quality. Descriptive analysis of the outcomes reveals a positive effect of AA for insomnia. Conclusions. AA may be beneficial for insomnia, but the evidence is plagued by important limitations, e.g., the poor quality of SRs/MAs and primary studies.


2020 ◽  
Vol 2020 ◽  
pp. 1-15
Author(s):  
Jun Yang ◽  
Jun Xiong ◽  
Ting Yuan ◽  
Xue Wang ◽  
Yunfeng Jiang ◽  
...  

Background. Acupuncture and moxibustion have been accepted as treatment options for primary dysmenorrhea (PD). So far, several systematic reviews (SRs) and meta-analyses (MAs) have reported on the efficacy and safety of acupuncture and moxibustion in treating PD. Objectives. The aim of this study was to critically summarize the evidence from relevant SRs and MAs reporting on the efficacy and safety of acupuncture and moxibustion in treatment of PD. Materials and Methods. Seven electronic databases, including Cochrane Database of Systematic Reviews, EMBASE, PubMed, SinoMed, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), and Wanfang database, were systematically searched. SRs or MAs about acupuncture for PD published up to May 2019 were included in the analysis. More than two authors independently assessed the quality of the evidence by AMSTAR2, PRISMA, PRISMA-A, and GRADE approach. Results. A total of 28 SRs and MAs, 281 original studies, reporting on 26,459 female patients were analyzed. The majority of the SRs were of moderate reporting quality and poor methodological quality. Moderate-quality evidence suggested that acupuncture and moxibustion were more effective compared to indomethacin or Fenbid in treating PD. Low-quality evidence suggested that, compared to NSAIDs, acupuncture and moxibustion could relieve pain with less adverse effects. Conclusion. Acupuncture and moxibustion seem to be effective and safe approaches in treatment of PD; yet, the methodological quality of most of the studies and the quality of evidence were low. Thus, additional studies are required to further confirm these results.


2021 ◽  
Author(s):  
Yaqin Lu ◽  
Yonggui Ge ◽  
Wanqiang Chen ◽  
Wenting Xing ◽  
Lushan Wei ◽  
...  

Abstract Background: An increasing number of systematic reviews (SRs) and meta-analyses (MAs) of clinical trials have begun to investigate the effects of virtual reality (VR) in patients with Parkinson disease (PD). The aim of this overview of was to systematically summarize the current best evidence for the effectiveness of VR therapy for the rehabilitation of people with PD.Methods: We searched SRs/MAs based on randomized controlled trials (RCTs) for relevant literature in PubMed, Embase and Cochrane library databases from inception to December 5, 2020. The methodological quality of included SRs/MAs was evaluated with the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), and the evidence quality of outcome measures with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Results: A total of nine SRs/MAs were included. The evaluation with AMSTAR-2 showed that all included SRs/MAs but one were rated as low or critically low quality studies. The GRADE criteria revealed 19 studies with very-low-quality evidences, 20 with low-quality evidences, 8 with moderate-quality evidences, and 1 with high-quality evidence. Effectiveness evaluation showed that VR therapy had greater improvement of stride length compared with control groups. However, there were inconsistent results (better or similar effects) regarding to gait speed, gait ability, balance, global motor function, activities of daily living, quality of life, postural control, cognitive function, and neuropsychiatric symptoms.Conclusions: VR therapy appears to be a promising and effective treatment for PD, but there is still a lack of high-quality evidence. In the future, rigorous-designed, high-quality RCTs with larger sample sizes are needed to further verify the effectiveness of VR therapy in the treatment of PD.


2020 ◽  
Vol 12 ◽  
Author(s):  
Jinke Huang ◽  
Min Shen ◽  
Xiaohui Qin ◽  
Manli Wu ◽  
Simin Liang ◽  
...  

Background: Acupuncture may be an effective complementary treatment for Alzheimer's disease (AD). The aim of this study was to summarize the evidence provided by systematic reviews (SRs)/meta-analyses (MAs) on the effect of acupuncture on AD.Methods: Eight electronic databases were searched from their inception until October 19, 2020. The methodological quality, reporting quality, and risk of bias of the included SRs were assessed by the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the Risk of Bias in Systematic Reviews (ROBIS) tool, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Moreover, the evidence quality of the outcome measures was assessed by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE).Results: Eleven SRs/MAs met all inclusion criteria. According to the results of the AMSTAR-2, all included reviews were rated critically as being of low quality. With PRISMA, the reporting checklist was relatively complete, but some reporting weaknesses remained in the topics of the protocol and registration, search strategy, risk of bias, additional analyses, and funding. Based on the ROBIS tool, only two SRs/MAs had a low risk of bias. With the GRADE system, no high-quality evidence was found, and only seven outcomes provided moderate-quality evidence. Among the downgraded factors, the risk of bias within the original trials was ranked first, followed by inconsistency, imprecision, and publication bias.Conclusions: Acupuncture is a promising complementary treatment for AD. However, due to the low quality of the SRs/MAs supporting these results, high-quality studies with rigorous study designs and larger samples are needed before widespread recommendations can be made.


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