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Gang WJ, Xiu WC, Shi LJ, Zhou Q, Jiao RM, Yang JW, Shi XS, Sun XY, Zeng Z, Witt CM, Thabane L, Song P, Yang LH, Guyatt G, Jing XH, Zhang YQ. Factors Associated with the Magnitude Of acUpuncture treatment effectS (FAMOUS): a meta-epidemiological study of acupuncture randomised controlled trials. BMJ Open 2022; 12:e060237. [PMID: 36038176 PMCID: PMC9438103 DOI: 10.1136/bmjopen-2021-060237] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To identify factors and assess to what extent they impact the magnitude of the treatment effect of acupuncture therapies across therapeutic areas. DATA SOURCE Medline, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang Database, VIP Database, and China Biology Medicine disc, between 2015 and 2019. STUDY SELECTION The inclusion criteria were trials with a total number of randomised patients larger than 100, at least one patient-important outcome and one of two sets of comparisons. DATA ANALYSIS The potential independent variables were identified by reviewing relevant literature and consulting with experts. We conducted meta-regression analyses with standardised mean difference (SMD) as effect estimate for the dependent variable. The analyses included univariable meta-regression and multivariable meta-regression using a three-level robust mixed model. RESULTS 1304 effect estimates from 584 acupuncture randomised controlled trials (RCTs) were analysed. The multivariable analyses contained 15 independent variables . In the multivariable analysis, the following produced larger treatment effects of large magnitude (>0.4): quality of life (difference of adjusted SMDs 0.51, 95% CI 0.24 to 0.77), or pain (0.48, 95% CI 0.27 to 0.69), or function (0.41, 95% CI 0.21 to 0.61) vs major events. The following produced larger treatment effects of moderate magnitude (0.2-0.4): single-centred vs multicentred RCTs (0.38, 95% CI 0.10 to 0.66); penetration acupuncture vs non-penetration types of acupuncture (0.34, 95% CI 0.15 to 0.53); non-pain symptoms vs major events (0.32, 95% CI 0.12 to 0.52). The following produced larger treatment effects of small magnitude (<0.2): high vs low frequency treatment sessions (0.19, 95% CI 0.03 to 0.35); pain vs non-pain symptoms (0.16, 95% CI 0.04 to 0.27); unreported vs reported funding (0.12, 95% CI 0 to 0.25). CONCLUSION Patients, clinicians and policy-makers should consider penetrating over non-penetrating acupuncture and more frequent treatment sessions when feasible and acceptable. When designing future acupuncture RCTs, trialists should consider factors that impact acupuncture treatment effects.
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Affiliation(s)
- Wei-Juan Gang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
- China Centre for Evidence-Based Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Wen-Cui Xiu
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
- China Centre for Evidence-Based Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lan-Jun Shi
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
- China Centre for Evidence-Based Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qi Zhou
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Rui-Min Jiao
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
- China Centre for Evidence-Based Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ji-Wei Yang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
- China Centre for Evidence-Based Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiao-Shuang Shi
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
- China Centre for Evidence-Based Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiao-Yue Sun
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
- China Centre for Evidence-Based Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhao Zeng
- Library of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Claudia M Witt
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Lehana Thabane
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Ping Song
- China Academy of Chinese Medical Sciences, Beijing, China
| | - Long-Hui Yang
- China Academy of Chinese Medical Sciences, Beijing, China
| | - Gordon Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Xiang-Hong Jing
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
- China Centre for Evidence-Based Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yu-Qing Zhang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Nottingham Ningbo GRADE Centre, University of Nottingham Ningbo China, Ningbo, China
- CEBIM (Center for Evidence Based Integrative Medicine)-Clarity Collaboration, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Su Q, Zou D, Gai N, Li H, Kuang Z, Ni X. Traditional Chinese Medicine for Post-stroke Sleep Disorders: The Evidence Mapping of Clinical Studies. Front Psychiatry 2022; 13:865630. [PMID: 35782438 PMCID: PMC9240765 DOI: 10.3389/fpsyt.2022.865630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 05/18/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND PURPOSE Recently, there are a number of clinical studies on traditional Chinese medicine (TCM) for post-stroke sleep disorders (PSSDs). This study aimed to map the current clinical studies and identify gaps to inform future study agendas. METHODS PubMed, Embase, Cochrane Library, and Chinese databases, including SinoMed, CNKI, and Wanfang, were searched for clinical studies on PSSDs treated with TCM from their inception to September 2021. Evidence sources, number of studies, types of PSSDs, intervention categories, effectiveness, and quality assessment were graphically displayed. RESULTS The evidence map involved 810 clinical studies, of which the earliest report was dated back to 1993, and an advanced growth of the whole evidence was observed in 2012. Randomized controlled trials (RCTs) were the most common type of study design (78.15%), and post-stroke insomnia was the most common type of sleep disorders (65.80%). The benefits of Chinese herbal medicine (CHM) and acupuncture therapies for post-stroke insomnia have been widely reported in RCTs (81.60% and 75.38%, respectively). However, the benefits of CHM interventions were assessed using a global approach rather than being based on a specific formula, and the highest level of evidence supporting the effectiveness of acupuncture therapies was of low methodological quality. In addition, evidence from primary studies was insufficient in the areas of TCM for post-stroke sleep-related breathing disorders (SBDs) and Chinese mind-body exercises for post-stroke insomnia. CONCLUSIONS PSSDs treated with TCM have been widely assessed in clinical studies. For better evidence translation, clinical trials on specific CHM interventions and high-quality systematic reviews on acupuncture for post-stroke insomnia should be conducted. For a better solution to clinical questions, TCM on SBDs after stroke and the benefits of Chinese mind-body exercises for post-stroke insomnia should be explored in future clinical studies.
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Affiliation(s)
- Qing Su
- The Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Danmei Zou
- The Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Nuo Gai
- The Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Huishan Li
- The Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhuoran Kuang
- The Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Xiaojia Ni
- The Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
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Silver JA, Yeung JC, Almutawa D, Szwimer R, Nguyen LHP. Evaluating Strength of Evidence of Pediatric Otolaryngology Research Literature: A 20-Year Review. Laryngoscope 2021; 132:1869-1876. [PMID: 34784065 DOI: 10.1002/lary.29945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/19/2021] [Accepted: 11/05/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS Quantity and quality of Otolaryngology-Head and Neck Surgery (OTL-HNS) research are increasing, yet patterns within Pediatric OTL-HNS publications are unknown. This study examines trends in the level of evidence of pediatric OTL-HNS articles over a 20-year period to quantify the growth and characterize contributing factors. STUDY DESIGN Review article. METHODS A retrospective review was conducted on 12 peer-reviewed OTL-HNS journals at three time-points: 1996, 2006, and 2016. Pediatric-specific OTL-HNS journals were selected; all were among the top 10 highest impact factor journals, with one pediatric-specific and one Canadian journal. Publication details, author characteristics, and study focus were collected. Papers were classified based on the Oxford Centre for Evidence-Based Medicine Levels of Evidence by two independent reviewers. RESULTS Of the 1,733 articles reviewed, 727 met inclusion criteria. A greater absolute number of pediatric OTL-HNS articles were published over the years studied: from 95 in 1996 to 359 in 2016 (P < .001). As well, the absolute number of high-quality studies has increased over the study period, from 28 articles in 1996 to 100 articles in 2016. However, the relative percentage of high-quality papers remained stable between 27.9% and 32.2% with an average of 29.7% (P = .89). Higher impact factor journals did not tend to publish higher-quality pediatric OTL-HNS articles (P = .48). CONCLUSIONS Over the past 20 years, there is no appreciable improvement in the proportion of high-quality publications in pediatric OTL-HNS; however, there is an overall greater number of high-quality papers within OTL-HNS literature. These findings likely relate to challenges of research within pediatric surgical specialties. LEVEL OF EVIDENCE NA Laryngoscope, 2021.
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Affiliation(s)
- Jennifer A Silver
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Québec, Canada
| | - Jeffrey C Yeung
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Québec, Canada
| | - Deema Almutawa
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Québec, Canada
| | - Rachel Szwimer
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Lily H P Nguyen
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Québec, Canada
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Weng TL, Chu FY, Cheng BR, Chen TJ. The element of family medicine in the mega journal of the family medicine specialty: A bibliometric analysis of the journal, Chinese General Practice. Medicine (Baltimore) 2021; 100:e24891. [PMID: 33725846 PMCID: PMC7969253 DOI: 10.1097/md.0000000000024891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 02/03/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND With the evolving specialization of modern medicine, family medicine (FM), also known as general practice, is relatively late in being recognized as a formal specialty in most countries of the world. Because many non-FM specialists were recruited into the new specialty in the early stages of FM specialization, the contents of FM specialty journals might, to an extent, reflect the development of the FM specialization. METHODS In this study, the voluminous journal, Chinese General Practice, which is regarded as the most representative specialty journal, was chosen and analyzed to illustrate the current situation of FM in China. A total of 878 articles, relating to the journal, Chinese General Practice in 2018, were retrieved from the publisher's web site and the original articles were categorized into FM- and non-FM- related articles by 3 board-certified FM doctors. Furthermore, the first authors, as well as the institutions and regions where the first authors worked, and their related specialties, were also analyzed. RESULTS Of the 634 original articles, 252 (39.7%) articles were FM related. Only 41 FM-related articles were written by authors working at FM departments: 3 at community health service centers, 29 at hospitals, and 9 at universities. Of the 382 non-FM related articles, 159 articles dealt with the topic of internal medicine, followed by traditional Chinese medicine (36), obstetrics and gynecology (28), neurology (27), pediatrics (27), and surgery (21). CONCLUSION In conclusion, FM publications in China in the study year, as exemplified by Chinese General Practice, were mostly contributed by non-FM authors dealing with non-FM topics. A transition to more FM-oriented development might be anticipated in the near future.
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Affiliation(s)
- Tzu-Ling Weng
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei
| | - Feng-Yuan Chu
- Department of Family Medicine, Taipei Veterans General Hospital, Yuanshan & Su-Ao Branch, Yilan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Bo-Ren Cheng
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei
- Department of Family Medicine, Taipei Veterans General Hospital, Yuanshan & Su-Ao Branch, Yilan
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