Exercise: The analgesic effect of acupuncture

Madsen, Gøtzsche, and Hróbjartsson reported a systematic review of randomised clinical trials of acupuncture treatment for pain, with acupuncture, placebo acupuncture, and no acupuncture groups.

They identified trials as shown in the following table:

Characteristics of trials

Trial	Clinical problem	Trial size—No randomised (No; % dropouts)	Blinding	Concealment of allocation	Pain scale	Treatment duration (No of sessions)*
Melchart	Tension headache	270 (30; 11%)	Patients	Centralised telephone randomisation	Rating scale (1-10)	8 weeks (12); evaluation at 12 weeks
Linde	Migraine	302 (20; 7%)	Patients	Centralised telephone randomisation	Rating scale (0-10)	8 weeks (12); evaluation at 12 weeks
Scharf	Osteoarthritis	1039 (57; 5%)	Patients	Central randomisation	WOMAC (0-10)	6 weeks (10); evaluation at 13 weeks
Witt	Osteoarthritis	300 (14; 5%;)	Patients	Centralised telephone randomisation	WOMAC (0-10)	8 weeks (12)
Foster	Osteoarthritis	352 (19; 5%)	Patients	Central telephone randomisation	WOMAC (0-10)	3 weeks (6); evaluation at 6 weeks
Brinkhaus	Low back pain	301 (17; 6%)	Patients	Centralised telephone randomisation	VAS (0-100 mm)	8 weeks (12)
Molsberger	Low back pain	186 (12; 6%)	Patients	Central telephone randomisation	VAS (0-100 mm)	4 weeks (12)
Leibing	Low back pain	150 (36; 24%)	Patients	Unclear	VAS change (0-10 cm)	12 weeks (20)
Wang	Postoperative pain	101 (unclear)	Patients	Unclear	VAS (0-100 mm)	1 day (1)
Lin	Postoperative pain	100 (unclear)	Patients	Unclear	VAS (0-100 mm)	1 day (1)
Fanti	Colonoscopy	30 (unclear)	Unclear	Unclear	Rating scale	(1-5) 1 day (1)
Sprott	Fibromyalgia	30 (unclear)	Unclear	Unclear	VAS (0-10)	3 weeks (6)
Kotani	Scar pain	70 (unclear)	Unclear	Sequentially sealed opaque envelopes	VAS (0-10 cm)	4 weeks (20)
VAS=visual analogue scale; WOMAC=Western Ontario and McMaster Universities pain subscale. * Timing of evaluation is identical to treatment duration if not otherwise specified.

Question 1: Is there any evidence of clinical heterogeneity between these trials?

Check suggested answer 1.

Question 2: What kind of variable are the outcomes in these trials?

Check suggested answer 2.

Question 3: How could the results of these trials be combined in a meta-analysis?

Check suggested answer 3.

Figure 1 shows the results of the comparison of acupuncture and sham acupuncture:

Figure 1. Comparison of acupuncture with sham acupuncture for control of pain

D

Question 4: What kind of graph is Figure 4?

Check suggested answer 4.

Question 5: Is there evidence of statistical heterogeneity?

Check suggested answer 5.

Question 6: What conclusions could we draw about the effect of acupuncture on pain?

Check suggested answer 6.

Reference

To Systematic Reviews index.

To Martin Bland's M.Sc. index.

To Martin Bland's home page.

This page maintained by Martin Bland.
Last updated: 16 February, 2009.

Back to top.