Acupuncture and dry-needling for low back pain (Review)

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Table 1. Criteria for the Risk of Bias Assessment (Continued) F. Was the outcome assessor blinded to the intervention? F. The reviewer determines if enough information about the blinding is given in order to score a “yes.” G. Were cointerventions avoided or similar? G. Cointerventions should either be avoided in the trial design or similar between the index and control groups H. Was the compliance acceptable in all groups? H. The reviewer determines if the compliance to the interventions is acceptable, based on the reported intensity, duration, number and frequency of sessions for both the index intervention and control intervention(s) I. Was the drop-out rate described and acceptable? I. The number of participants who were included in the study but did not complete the observation period or were not included in the analysis must be described and reasons given. If the percentage of withdrawals and drop-outs does not exceed 20% for immediate and short-term follow-ups, 30% for intermediate and long-term follow-ups and does not lead to substantial bias a “yes” is scored J. Was the timing of the outcome assessment in all groups similar? J. Timing of outcome assessment should be identical for all intervention groups and for all important outcome assessments K. Did the analysis include an intention-to-treat analysis? K. All randomized patients are reported/analyzed in the group they were allocated to by randomization for the most important moments of effect measurement (minus missing values) irrespective of noncompliance and cointerventions Table 2. Methodological quality assessment Study A and B C D, E and F G H I J K Comments, flaws, etc Araki 2001 Y and Y Y Y, N, Y Y Y Y Y Y Score=10 and no serious flaws (High) Carlsson 2001 Y and Y DK Y, N, Y DK DK Y (1 month) ; N (3 and 6 months) Y Y Score=7 at 1 month (follow-up= 100%), Score=6 at 3 and 6 months (follow-up=64% and 54% respectively) (High) Ceccherelli 2002 Cherkin 2001 Y and DK Y DK, N, Y DK DK Y Y Y Score=6. No serious flaws. (High) Y and DK Y N, N, Y Y Y Y Y Y Score=8. No serious flaws (High) Coan 1980 Y and Y DK N, N, N DK N N N N Score=2 (Low) Acupuncture and dry-needling for low back pain (Review) Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 116
Table 2. Methodological quality assessment (Continued) Ding 1998 DK and N DK Y, N, N DK DK Y Y N Score=3 (Low). Main outcome is very subjective. Edelist 1976 DK DK and DK Y, N, Y DK Y DK DK DK Score=3 (Low). Main outcome is a subjective measure. Methods poorly described Garvey 1989 Y and DK DK Y, N, Y Y Y Y Y Y Score=8. No serious flaws (High) . Baseline characteristics are not shown. Groups are very different in size Giles 1999 DK and Y DK N, N, Y DK N N Y N Fatal flaw= 52% drop out during treatment period in the acupuncture group Giles 2003 Y and Y Y N, N, DK Y DK N Y Y Score=6. 39% drop out at 9-weeks (Low). No adjustment for multiple comparisons Grant 1999 Gunn 1980 Y and Y N N, N, Y Y DK Y Y N Fatal flaw= baseline differences in main outcome measures. VAS (range 0-200) at baseline in acup group was 140 and in the TENS group was 101 N and DK DK N, N, DK DK DK Y N N Score=1 (Low). Allocation by alternation and not concealed. No mention of blinded assessments. We don’t have baseline values for pain. Co-interventions were allowed and not standardized or monitored. No ITT: this is not a big problem for the 12-week follow-up, but maybe for the longer term follow-up He 1997 DK and N Y Y, N, N DK DK N Y DK Score=3 (Low). No information about allocation of patients. No description of lost patients Inoue 2000 Inoue 2001 Y and Y DK Y,N, Y Y Y Y Y Y Score=9 (High). We believe there were no losses because the followup was shortly after the single session Y and Y DK Y,N,Y Y Y Y Y Y Score=9 (High). We believe there were no losses because the followup was shortly after the single ses- Acupuncture and dry-needling for low back pain (Review) Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 117
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Acupuncture and dry-needling for lo
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Analysis 5.2. Comparison 5 acupunct
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[Intervention Review] Acupuncture a
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traditional meridian acupuncture po
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of experts in acupuncture treatment
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ack pain. The average improvement i
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Figure 2. Acupuncture compared to a
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245 patients who received acupunctu
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Although the conclusions showed som
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R E F E R E N C E S References to s
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Wu 1991 {published data only} Wu YC
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treatments by traditional acupunctu
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Araki 2001 (Continued) Conclusion:
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Ceccherelli 2002 Methods Participan
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Cherkin 2001 (Continued) or acupunc
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Ding 1998 Methods Participants Inte
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Garvey 1989 Methods Participants In
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Giles 1999 Methods Participants Int
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Giles 2003 Methods Participants Int
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Grant 1999 Methods Participants Int
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Gunn 1980 (Continued) varied) Costs
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Inoue 2000 (Continued) Notes Langua
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Kerr 2003 (Continued) For results,
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Kurosu 1979(b) Methods Participants
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Lehmann 1986 (Continued) Conclusion
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Li 1997 (Continued) Interventions O
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MacDonald 1983 (Continued) Language
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Meng 2003 (Continued) 12.7 Conclusi
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Sakai 1998 (Continued) 2) Oral medi
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Takeda 2001 (Continued) Mean age: 2
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Tsukayama 2002 Methods Participants
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Wang 1996 Methods Participants Inte
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Yeung 2003 Methods Participants Int
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(Continued) Kinoshita 1981 Koike 19
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Page 97 and 98: Analysis 5.10. sick leave Compariso
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Page 103 and 104: pain and function (adjusted for bas
Page 105 and 106: Review: Analysis 7.2. Comparison 7
Page 109 and 110: Analysis 10.3. Comparison 10 acupun
Page 113 and 114: improvement (Continued) Li 1997 Imp
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Page 129 and 130: Table 5. Adequacy of acupuncture (C
Page 131 and 132: Table 5. Adequacy of acupuncture (C
Page 133 and 134: 20 factorial$.ti,ab. (2463) 21 foll
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