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Lu W, Giobbie-Hurder A, Tanasijevic A, Kassis SB, Park SH, Jeong YJ, Shin IH, Yao C, Jung HJ, Zhu Z, Bao C, Bao T, Yang E, Bierer BE, Ligibel JA. Acupuncture for hot flashes in hormone receptor-positive breast cancer: A pooled analysis of individual patient data from parallel randomized trials. Cancer 2024; 130:3219-3228. [PMID: 38924035 DOI: 10.1002/cncr.35374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 04/10/2024] [Accepted: 04/15/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Hot flashes are a common side effect of endocrine therapy (ET) that contribute to poor quality of life and decreased treatment adherence. METHODS Patients with breast cancer wo were receiving ET and experiencing hot flashes were enrolled through three parallel, randomized trials conducted in the United States, China, and South Korea. Participants were randomized to either immediate acupuncture (IA) or delayed acupuncture control (DAC). IA participants received 20 acupuncture sessions over 10 weeks, whereas DAC participants received usual care, then crossed over to acupuncture with a reduced intensity. The primary end point was a change in score on the endocrine symptom subscale of the Functional Assessment of Cancer Therapy (FACT)-Endocrine Symptoms between baseline and week 10. Secondary end points included the hot flash score and the FACT-Breast score. A planned pooled analysis of individual patient data was performed using longitudinal mixed models. RESULTS In total, 158 women with stage 0-III breast cancer were randomized (United States, n = 78; China, n = 40; South Korea, n = 40). At week 10, IA participants reported statistically significant improvements in the endocrine symptom subscale score (mean change ± standard error: 5.1 ± 0.9 vs. 0.2 ± 1.0; p = .0003), the hot flash score (-5.3 ± 0.9 vs. -1.4 ± 0.9; p < .003), and the FACT-Breast total score (8.0 ± 1.6 vs. -0.01 ± 1.6; p = .0005) compared with DAC participants. The effect of the acupuncture intervention differed by site (p = .005). CONCLUSIONS Acupuncture led to statistically and clinically meaningful improvements in hot flashes, endocrine symptoms, and breast cancer-specific quality of life in women undergoing ET for breast cancer in the United States, China, and South Korea.
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Affiliation(s)
- Weidong Lu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Anita Giobbie-Hurder
- Division of Biostatistics, Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Anna Tanasijevic
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Sylvia Baedorf Kassis
- The Multi-Regional Clinical Trials Center of Brigham and Women's Hospital and Harvard, Boston, Massachusetts, USA
| | - Sung Hwan Park
- Department of Surgery, Daegu Catholic University, School of Medicine, Daegu, Republic of Korea
| | - Young Ju Jeong
- Department of Surgery, Daegu Catholic University, School of Medicine, Daegu, Republic of Korea
| | - Im Hee Shin
- Department of Medical Statistics and Informatics, Daegu Catholic University, School of Medicine, Daegu, Republic of Korea
| | - Chang Yao
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Hyun Jung Jung
- Department of Diagnostics, College of Korean Medicine, Daegu Haany University, Daegu, Republic of Korea
| | - Zhiyuan Zhu
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Chao Bao
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Ting Bao
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - EunMee Yang
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Barbara E Bierer
- The Multi-Regional Clinical Trials Center of Brigham and Women's Hospital and Harvard, Boston, Massachusetts, USA
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Jennifer A Ligibel
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
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Xiong Z, Ma P, Zhang H, Liu C, Liu B, Liu Z, Yan S. Placebo response to sham electroacupuncture in patients with chronic functional constipation: A secondary analysis. Neurogastroenterol Motil 2024; 36:e14770. [PMID: 38361038 DOI: 10.1111/nmo.14770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 01/30/2024] [Accepted: 02/08/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Chronic severe functional constipation is a common disease that requires novel and effective treatment strategies. Acupuncture might constitute a promising therapeutic approach for chronic constipation, but it reportedly engenders an enhanced placebo response. Herein, we aimed to determine the magnitude of the placebo responses to electroacupuncture for constipation and identify its influencing factors. METHODS In this secondary analysis of a multicenter randomized trial, patients were randomized to a sham electroacupuncture group, which was administered for 8 weeks in 24 sessions of superficial needling at nonacupoints. The placebo response rates were assessed using three responder criteria: ≥3 complete spontaneous bowel movements per week (CSBMs/week), overall CSBM, and sustained CSBM. Logistic regression with backward selection method was employed to identify the potential factors that affected the placebo response. KEY RESULTS Overall, 539 patients were included in the study. The placebo response rate was 10.58%, 9.46%, and 9.09% according to the three aforementioned criteria, respectively. Those who exhibited more CSBMs/week at baseline were more likely to respond to sham electroacupuncture. Among patients with more than one CSBM per week at baseline, the response rates for achieving the criteria of ≥3 CSBMs per week, overall CSBM, and sustained CSBM were 25.40%, 30.16%, and 22.22%. CONCLUSIONS AND INFERENCE Electroacupuncture did not demonstrate a large placebo response in functional constipation treatment. The number of CSBMs at baseline may be a moderator of the placebo response to sham electroacupuncture. Thus, superficial needling sham acupuncture may be considered an ideal sham control for clinical trials of chronic constipation.
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Affiliation(s)
- Zhiyi Xiong
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Peihong Ma
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Haoran Zhang
- College of Preschool Education, Beijing Youth Politics College, Beijing, China
| | - Cunzhi Liu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Baoyan Liu
- China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhishun Liu
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Shiyan Yan
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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Duan Y, Zhao P, Liu S, Deng Y, Xu Z, Xiong L, Chen Z, Zhu W, Wu S, Yu L. Reporting and influencing factors of patient-reported outcomes in acupuncture randomised controlled trials: a cross-sectional study protocol. BMJ Open 2024; 14:e079218. [PMID: 38326262 PMCID: PMC10860004 DOI: 10.1136/bmjopen-2023-079218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/17/2024] [Indexed: 02/09/2024] Open
Abstract
INTRODUCTION Patient-reported outcomes (PROs) are health reports that come directly from the patients themselves and represented the experience and insights of the patient's perspective on the impact of the intervention. PROs were increasingly emphasised in acupuncture randomised controlled trials (RCTs). However, the reporting quality of PROs in acupuncture RCTs has not been investigated to date. Therefore, we constructed this study to reveal the basic characteristics and reporting quality of PROs in acupuncture RCTs, and explore the relationship between concealment, blinding and RROs. We hope our findings can provide guidance for the reporting standards and future development of PROs in acupuncture RCTs in reverse. METHODS AND ANALYSIS RCTs using acupuncture treatment as the intervention and PROs as primary outcomes or secondary outcomes will be systematically searched through seven databases MEDLINE, EMBASE, CENTRAL, CBM, CNKI, Wanfang and VIP between 1 January 2012 and 15 October 2022. The basic characteristics, concealment, blinding design and the characteristics of PROs in included RCTs will be summarised. The reporting quality of PROs will be assessed based on the CONSORT PRO extension. Logistic analysis will be performed to identify the association between concealment, blinding and RROs. ETHICS AND DISSEMINATION Ethical approval is not required for this study. This protocol has been registered in Open Science Framework (OSF) Registries. The findings of this study will be submitted to a peer-reviewed academic journal.
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Affiliation(s)
- Yuting Duan
- Sleep Research Institute of Chinese Medicine, The Affiliated TCM Hospital of Guangzhou Medical University, Guangzhou, China
- Evidence-based Medicine Center, The Affiliated TCM Hospital of Guangzhou Medical University, Guangzhou, China
| | - Pinge Zhao
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shujuan Liu
- The Affiliated TCM Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuening Deng
- The Affiliated TCM Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhirui Xu
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Linghui Xiong
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zewei Chen
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Weifeng Zhu
- The Affiliated TCM Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shengwei Wu
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lin Yu
- The Affiliated TCM Hospital of Guangzhou Medical University, Guangzhou, China
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Wang H, Lei X, Ma D, Zhao Z, Wang A, Du G, Zhang J, Wang F, Guo J. Efficacy of acupuncture for psychogenic erectile dysfunction: a randomized, sham-controlled trial. Basic Clin Androl 2023; 33:40. [PMID: 38124064 PMCID: PMC10734192 DOI: 10.1186/s12610-023-00215-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 11/25/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Psychogenic erectile dysfunction (pED) is a common sexual dysfunction often accompanied by psychosomatic factors. Its treatment includes oral medications, psychotherapy, and behavioral therapy. Acupuncture's effect on erectile function in pED patients remains to be investigated. This randomized study evaluated the effects of acupuncture and sham acupuncture in pED patients. Altogether, 66 men with pED were randomized to the acupuncture (n = 33) or sham acupuncture group (n = 33). Both groups have a 6-week treatment with 18 sessions. Primary outcome was the International Index of Erectile Function-5 (IIEF-5) at 6 weeks. Secondary outcomes were IIEF-5 (weeks 2, 4, and 10), erection hardness score (EHS), sexual encounter profile-2 (SEP-2), SEP-3, self-rating anxiety scale (SAS), and self-rating depression scale (SDS). RESULTS Among the 66 participants, 64 completed the outcome measurements at week 10. Both acupuncture and sham acupuncture groups had improved IIEF-5 and EHS and decreased SAS and SDS post-treatment (p < 0.05). The acupuncture group had significantly better improvement in IIEF-5, EHS, and SEP-3 and significantly reduced SAS and SDS than the sham acupuncture group (p < 0.05). The improvement in SEP-2 post-treatment was not significantly different between the two groups (p > 0.05). There were no serious adverse events. CONCLUSIONS The 6-week acupuncture treatment significantly improved the erectile capacity and psychosomatic status of pED patients. TRIAL REGISTRATION ChiCTR2200064345 (Chinese Clinical Trial Registry) ( https://www.chictr.org.cn/showproj.html?proj=174873 ).
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Affiliation(s)
- Hao Wang
- Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Xulu Lei
- Department of Preventive Care Center, Beijing Fengtai Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Dongyue Ma
- Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Ziwei Zhao
- Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Anmin Wang
- Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Guanchao Du
- Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiwei Zhang
- Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Fu Wang
- Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China.
| | - Jun Guo
- Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China.
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Sun C, Xiong Z, Sun C, Liu T, Liu X, Zhang Q, Liu B, Yan S, Liu C. Placebo response in sham-acupuncture-controlled trials for migraine: A systematic review and meta-analysis. Complement Ther Clin Pract 2023; 53:101800. [PMID: 37793307 DOI: 10.1016/j.ctcp.2023.101800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 09/09/2023] [Accepted: 09/21/2023] [Indexed: 10/06/2023]
Abstract
AIM To understand the placebo response of acupuncture and its effect on migraine and optimize the design of future acupuncture clinical trials on migraine treatment. METHODS Randomized controlled trials with sham acupuncture as a control in migraine treatment were searched in four English databases from inception to September 1, 2022. The primary outcome was placebo response rate. Secondary outcomes were migraine symptoms, emotional condition, and quality of life. Factors associated with placebo response were also explored. Results were combined using risk difference (RD) or standardized mean difference (SMD) and 95% confidence interval (CI) with a random effects model. RESULTS The final analysis included 21 studies involving 1177 patients. The pooled response rate of sham acupuncture was 0.34 (RD, 95% CI 0.23-0.45, I2 89.8%). The results (SMD [95% CI]) showed significant improvements in migraine symptoms (pain intensity -0.56 [-0.73 to -0.38], and episode conditions -0.55 [-0.75 to -0.35]); emotional condition (anxiety scale -0.49 [-0.90 to -0.08] and depression scale -0.21 [-0.40 to -0.03]); and quality of life on the Migraine-Specific Quality-of-Life Questionnaire (restrictive 0.78 [0.61-0.95]; preventive 0.52 [0.35-0.68]; and emotional 0.45 [0.28-0.62]) and on the Medical Outcomes Study Short-Form (physical 0.48 [0.34-0.62] and mental 0.21 [0.02-0.41]). Only acupuncture treatment frequency had a significant impact on the placebo response rate (RD 0.49 vs. 0.14; p = 0.00). CONCLUSIONS The effect sizes for placebo response of sham acupuncture varied across migraine treatment trials. Further studies should routinely consider adjusting for a more complete set of treatment factors.
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Affiliation(s)
- Chengyi Sun
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Zhiyi Xiong
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Chongyang Sun
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Tinglan Liu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaoyu Liu
- School of Acupuncture-Moxibustion and Tuina, Tianjin University of Chinese Medicine, Tianjin, China
| | - Qinhong Zhang
- Department of Tuina, Acupuncture and Moxibustion, Shenzhen Jiuwei Chinese Medicine Clinic, Shenzhen, China
| | - Baoyan Liu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Shiyan Yan
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China; International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China.
| | - Cunzhi Liu
- International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
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Liu T, Yu CP. How Do Expectations Modulate Pain? A Motivational Perspective. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023; 18:1508-1519. [PMID: 37369088 DOI: 10.1177/17456916231178701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Expectations can profoundly modulate pain experience, during which the periaqueductal gray (PAG) plays a pivotal role. In this article, we focus on motivationally evoked neural activations in cortical and brainstem regions both before and during stimulus administration, as has been demonstrated by experimental studies on pain-modulatory effects of expectations, in the hope of unraveling how the PAG is involved in descending and ascending nociceptive processes. This motivational perspective on expectancy effects on the perception of noxious stimuli sheds new light on psychological and neuronal substrates of pain and its modulation, thus having important research and clinical implications.
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Affiliation(s)
- Tao Liu
- The Second Teaching Hospital, University of Jilin
| | - Cui-Ping Yu
- Department of Basic Medicine, Changchun Medical College
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Xiong ZY, Liu XY, Ma PH, Sun CY, Sun CY, Liu TL, Liu BY, Liu CZ, Yan SY. Placebo Response among Different Types of Sham Acupuncture for Low Back Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Chin J Integr Med 2023; 29:941-950. [PMID: 37580465 DOI: 10.1007/s11655-023-3608-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND Low back pain (LBP) is a prevalent and debilitating condition that poses a significant burden on healthcare systems. Acupuncture has been proposed as a promising intervention for LBP, but the evidence supporting its specific effect is insufficient, and the use of sham acupuncture as a control in clinical trials presents challenges due to variations in sham acupuncture techniques and the magnitude of the placebo effect. OBJECTIVE To investigate the magnitude of the placebo response of sham acupuncture in trials of acupuncture for nonspecific LBP, and to assess whether different types of sham acupuncture are associated with different responses. METHODS Four databases including PubMed, EMBASE, MEDLINE, and the Cochrane Library were searched through April 15, 2023, and randomized controlled trials (RCTs) were included if they randomized patients with LBP to receive acupuncture or sham acupuncture intervention. The main outcomes included the placebo response in pain intensity, back-specific function and quality of life. Placebo response was defined as the change in these outcome measures from baseline to the end of treatment. Random-effects models were used to synthesize the results, standardized mean differences (SMDs, Hedges'g) were applied to estimate the effect size. RESULTS A total of 18 RCTs with 3,321 patients were included. Sham acupuncture showed a noteworthy pooled placebo response in pain intensity in patients with LBP [SMD -1.43, 95% confidence interval (CI) -1.95 to -0.91, I2=89%]. A significant placebo response was also shown in back-specific functional status (SMD -0.49, 95% CI -0.70 to -0.29, I2=73%), but not in quality of life (SMD 0.34, 95% CI -0.20 to 0.88, I2=84%). Trials in which the sham acupuncture penetrated the skin or performed with regular needles had a significantly higher placebo response in pain intensity reduction, but other factors such as the location of sham acupuncture did not have a significant impact on the placebo response. CONCLUSIONS Sham acupuncture is associated with a large placebo response in pain intensity among patients with LBP. Researchers should also be aware that the types of sham acupuncture applied may potentially impact the evaluation of the efficacy of acupuncture. Nonetheless, considering the nature of placebo response, the effect of other contextual factors cannot be ruled out in this study. (PROSPERO registration No. CRD42022304416).
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Affiliation(s)
- Zhi-Yi Xiong
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Xiao-Yu Liu
- School of Acupuncture-Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Pei-Hong Ma
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Chong-Yang Sun
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Cheng-Yi Sun
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Ting-Lan Liu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Bao-Yan Liu
- China Academy of Chinese Medical Sciences, Beijing, 100007, China
| | - Cun-Zhi Liu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Shi-Yan Yan
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China.
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Lee YS, Kim SY, Lee H, Chae Y, Lee MS. ACURATE: A guide for reporting sham controls in trials using acupuncture. J Evid Based Med 2023; 16:82-90. [PMID: 36959765 DOI: 10.1111/jebm.12524] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 03/06/2023] [Indexed: 03/25/2023]
Abstract
OBJECTIVE To promote better reporting quality regarding sham acupuncture in clinical trials for a precise appraisal of the adequacy of the sham acupuncture procedure. METHODS A three-stage online Delphi survey was conducted to a group of experts. Items with higher than 80% consensus from the initial checklist were selected as the final candidates. Further discussion among the working group was convened to preclude potential redundancy among the items. RESULTS A total of 23 experts out of 35 (66%) responded to the Delphi process. The final checklist consists of 23 items in six categories: type of sham acupuncture, details of sham acupuncture manipulation, location of sham acupuncture, treatment regimen, practitioner, and protocol and settings. CONCLUSION This paper presents the Acupuncture Controls gUideline for Reporting humAn Trials and Experiments (ACURATE) checklist, an extension of The Consolidated Standards for Reporting of Trials (CONSORT) and to be used along with STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) when sham acupuncture needles are used in the study. This checklist focuses on a clear depiction of sham needling procedures to enhance replicability and enable a precise appraisal. We encourage researchers to use ACURATE in trials and reviews involving sham acupuncture to assist reporting sham acupuncture procedures and the related components.
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Affiliation(s)
- Ye-Seul Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Song-Yi Kim
- Department of Anatomy and Acupoint, College of Korean Medicine, Gachon University, Seongnam, Republic of Korea
| | - Hyangsook Lee
- Department of Science in Korean Medicine, College of Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Younbyoung Chae
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Myeong Soo Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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Li YJ, Leong II, Fan JQ, Yan MY, Liu X, Lu WJ, Chen YY, Tan WQ, Wang YT, Zhuang LX. Efficacy of acupuncture for the treatment of Parkinson's disease-related constipation (PDC): A randomized controlled trial. Front Neurosci 2023; 17:1126080. [PMID: 36866329 PMCID: PMC9972583 DOI: 10.3389/fnins.2023.1126080] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 01/30/2023] [Indexed: 02/16/2023] Open
Abstract
Objective To evaluate the efficacy of acupuncture in treating Parkinson's disease-related constipation (PDC). Materials and methods This was a randomized, controlled trial in which patients, outcome assessors, and statisticians were all blinded. Seventy-eight eligible patients were randomly assigned to either the manual acupuncture (MA) or sham acupuncture (SA) groups and received 12 sessions of treatment over a 4-week period. Following treatment, patients were monitored until the eighth week. The primary outcome was the change in weekly complete spontaneous bowel movements (CSBMs) from baseline after treatment and follow-up. The Constipation Symptom and Efficacy Assessment Scale (CSEAS), the Patient-Assessment of Constipation Quality of Life questionnaire (PAC-QOL), and the Unified Parkinson's Disease Rating Scale (UPDRS) were used as secondary outcomes. Results In the intention-to-treat analysis, 78 patients with PDC were included, with 71 completing the 4-week intervention and 4-week follow-up. When compared to the SA group, weekly CSBMs were significantly increased after treatment with the MA group (P < 0.001). Weekly CSBMs in the MA group were 3.36 [standard deviation (SD) 1.44] at baseline and increased to 4.62 (SD, 1.84) after treatment (week 4). The SA group's weekly CSBMs were 3.10 (SD, 1.45) at baseline and 3.03 (SD, 1.25) after treatment, with no significant change from baseline. The effect on weekly CSBMs improvement in the MA group lasted through the follow-up period (P < 0.001). Conclusion Acupuncture was found to be effective and safe in treating PDC in this study, and the treatment effect lasted up to 4 weeks. Clinical trial registration http://www.chictr.org.cn/index.aspx, identifier ChiCTR2200059979.
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Affiliation(s)
- Ying-Jia Li
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ian-I Leong
- The First Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jing-Qi Fan
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ming-Yue Yan
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xin Liu
- The First Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wei-Jing Lu
- The First Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuan-Yuan Chen
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wei-Qiang Tan
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yu-Ting Wang
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Li-Xing Zhuang
- Department of Acupuncture and Moxibustion, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China,*Correspondence: Li-Xing Zhuang,
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Warren A. An integrative approach to dementia care. FRONTIERS IN AGING 2023; 4:1143408. [PMID: 36873742 PMCID: PMC9978191 DOI: 10.3389/fragi.2023.1143408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 02/08/2023] [Indexed: 02/18/2023]
Abstract
As the aging population continues to increase, Alzheimer's disease and related dementias are becoming a global health crisis. The burdens experienced by the person living with dementia, their caregivers, healthcare, and society persist unabated. Persons with dementia represent an important population in need of a tenable care plan. Caregivers need the tools with which to properly care for these persons and to mitigate their own stress response. A viable healthcare model utilizing integrated approaches to care for persons with dementia is in overwhelming demand. While much research is focused on a cure, it is equally important to address the difficulties faced by those currently affected. One approach is to incorporate interventions to increase quality of life within the caregiver-patient dyad via a comprehensive integrative model. Improving daily life of the persons with dementia, along with their caregivers and loved ones may aid in attenuating the pervasive psychological and physical impacts of this disease. A focus on interventions that provide neural and physical stimulation may facilitate quality of life in this regard. The subjective experience of this disease is challenging to capture. The relationship between neurocognitive stimulation and quality of life is at least, in part, therefore still uncertain. This narrative review aims to explore the efficacy and evidence-base of an integrative approach to dementia care in facilitating optimal cognition and quality of life outcomes. These approaches will be reviewed alongside person-centered care that is fundamental to integrative medicine, including exercise; music; art and creativity; nutrition; psychosocial engagement; memory training; and acupuncture.
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Affiliation(s)
- Alison Warren
- DAOM, MSHS (Master of science in health sciences), Department of Clinical Research and Leadership, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
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Acupuncture for hot flashes in hormone receptor-positive breast cancer, a coordinated multinational study: Rationale and design of the study protocol. Contemp Clin Trials 2022; 121:106885. [PMID: 35998768 DOI: 10.1016/j.cct.2022.106885] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 07/30/2022] [Accepted: 08/12/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Acupuncture has been reported to reduce hot flashes in patients with breast cancer undergoing adjuvant hormonal therapy. Although hot flashes are common, the prevalence varies among cultures, races, and ethnicities; the efficacy of acupuncture across cultures has not been investigated. METHODS This is a coordinated multinational study, including three parallel randomized trials with a planned analysis of individual patient data, to test the effectiveness of acupuncture on hot flash-related symptoms in hormone receptor-positive breast cancer patients on adjuvant endocrine therapy. Using a standardized acupuncture protocol (total across all three studies of n = 80) versus usual care (total n = 80), symptoms are assessed using changes in the Endocrine Symptom Subscale of Functional Assessment of Cancer Therapy-Endocrine Symptoms. Secondary outcomes include hot flash severity, quality of life, and sleep quality. Differences in response to acupuncture between participants in the three countries will also be explored. DISCUSSION Here we describe the design of a protocol for a coordinated multinational study, with attention to the complex considerations in developing a multinational research effort testing a non-pharmacologic intervention. This protocol and approach provide guidance for future efforts to evaluate and test non-pharmacologic interventions across multinational populations. TRIAL REGISTRATION clinicaltrials.gov (Identifier: NCT00797732, registered on December 21, 2018), Chinese Clinical Trial Registry (ChiCTR2100045888), and The Clinical Research Information Service (CRIS) of Korea (Registration number: KCT0003618).
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Lee YS, Kim SY, Kim M, Kim M, Won J, Lee H, Lee MS, Chae Y. Reporting quality of sham needles used as controls in acupuncture trials: a methodological evaluation. Chin Med 2022; 17:64. [PMID: 35637519 PMCID: PMC9153153 DOI: 10.1186/s13020-022-00608-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 04/10/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The description of controls is important in acupuncture clinical trials to interpret its effectiveness without fallacy. This paper aims to evaluate the reporting quality of acupuncture studies on the characteristics of sham needles. STUDY DESIGN AND SETTING Using a checklist developed from previously published reporting guidelines, the distribution of reported items and changes of reporting rates over time were investigated. Two-way ANOVA and linear regression were conducted. RESULTS Original articles of RCTs of any design involving sham needles as controls were eligible for assessment. 117 trials from three 2-year time periods between 2009 and 2018 were included. Seven items out of 25 were reported in more than 50% of the studies. While significant differences of reporting scores among categories were observed, there were no significant differences among time periods; no significant improvement was observed over time. CONCLUSIONS Low reporting qualities of sham needles used in acupuncture studies may influence how researchers understand the effectiveness of acupuncture. This study evaluated previous publications from 2009 to 2018 and found that reporting qualities on sham needles did not improve over time. Further studies are required to validate the items used in this study to endorse better reporting of controls in acupuncture trials.
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Affiliation(s)
- Ye-Seul Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Song-Yi Kim
- Department of Anatomy and Acupoint, College of Korean Medicine, Gachon University, Seongnam, Republic of Korea
| | - Mariah Kim
- Department of Internal Medicine, Korean Medicine Hospital of Pusan National University, Yangsan, South Korea
| | - Minseo Kim
- Department of Anatomy and Acupoint, College of Korean Medicine, Gachon University, Seongnam, Republic of Korea
| | - Jiyoon Won
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Hyangsook Lee
- Department of Science in Korean Medicine, College of Korean Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Myeong Soo Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Younbyoung Chae
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul, Republic of Korea.
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Liu J, Song G, Huang Y, Lv C, Wang Y, Wu D, Sun C, Jing M, Yu Y. Placebo Response Rates in Acupuncture Therapy Trials for Functional Dyspepsia: A Systematic Review and Meta-Analysis. J Clin Gastroenterol 2022; 56:299-310. [PMID: 35180148 PMCID: PMC8900996 DOI: 10.1097/mcg.0000000000001679] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 12/01/2021] [Indexed: 01/30/2023]
Abstract
BACKGROUND Functional dyspepsia (FD) is a functional digestive disease with limited management selection. Previous studies revealed that acupuncture therapy is effective for FD. However, because sham controls were not implemented in most clinical trials following acupuncture therapy, it is difficult to differentiate overall treatment responses from placebo. This study aims to quantify placebo responses in clinical trials in which FD patients received sham manual acupuncture (MA) and sham electroacupuncture (EA). MATERIALS AND METHODS Randomized controlled trials of MA and EA for FD patients were searched in PubMed, Web of Science, Cochrane Library, and Embase databases, as well as 4 Chinese language databases from inception to January 2021. RevMan 5.20 software was used for pooled analysis of symptom scores and quality of life. The symptom scores were combined using standard mean difference (SMD) or weighted mean difference (WMD) with a 95% confidence interval (CI). The quality of included studies was tested using modified Jadad scale and Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) checklist. Egger's test, Begg's test, and sensitivity analyses were conducted using Stata 11.0 statistical software. The protocol of this study is registered in PROSPERO as CRD42021233858. RESULTS After screening, the current systematic review included 13 randomized controlled trials, of which 8 studies were used in the meta-analysis. Regarding subjective outcomes, the combined effect of sham MA on FD symptoms was [SMD=-0.42, 95% CI (-0.72, -0.12); P=0.005], whereas sham EA treatment was [SMD=-0.54, 95% CI (-0.81, -0.27); P<0.001]. The combined effect on FD quality of life of post-sham MA group was [SMD=-0.32, 95% CI (-0.52, -0.12); P=0.002]. With regard to objective outcomes, the combined effect of sham EA on dominant frequency was [WMD=-0.11, 95% CI (-0.30, -0.08); P=0.24], while the combined effect of sham EA on dominant power was [WMD=-3.35, 95% CI (-8.04, 1.35); P=0.16]. CONCLUSIONS Sham MA and sham EA remarkably improve symptoms and quality of life scores of FD without influencing objective outcomes, highlighting the significance of sham controls in acupuncture therapy clinical trials.
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Affiliation(s)
- Jie Liu
- Department of Gastroenterology
| | - Gengqing Song
- Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH
| | | | | | - Ying Wang
- South District of Endoscopic Center, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Dandan Wu
- South District of Endoscopic Center, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Chenyu Sun
- Internal Medicine, AMITA Health Saint Joseph Hospital Chicago, Chicago, IL
| | - Meng Jing
- Dunedin Public Hospital, Southern District Health Board, Dunedin, New Zealand
| | - Yue Yu
- Department of Gastroenterology
- South District of Endoscopic Center, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
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Wulff-Burchfield E. Supportive and Palliative Care for Genitourinary Malignancies. Urol Oncol 2022. [DOI: 10.1007/978-3-030-89891-5_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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15
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Leopold SS. A Conversation with … Ted J. Kaptchuk, Expert in Placebo Effects. Clin Orthop Relat Res 2021; 479:1645-1650. [PMID: 33979308 PMCID: PMC8277290 DOI: 10.1097/corr.0000000000001824] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 01/31/2023]
Affiliation(s)
- Seth S Leopold
- Editor-In-Chief, Clinical Orthopaedics and Related Research® , Philadelphia, PA, USA
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