Systematic reviews of complementary therapies - an annotated bibliography. Part 1: Acupuncture
1 Centre for Complementary Medicine Research, Department of Internal Medicine II, Technische Universität, München, Kaiserstr. 9, 80801 München, Germany
2 Institute for Social Medicine & Epidemiology, Charité Hospital, Humboldt University, Berlin, Germany
3 Memorial Sloan-Kettering Cancer Center, New York, USA
4 Consortial Center for Chiropractic Research, Davenport, Iowa, USA
5 NHS Centre for Reviews & Dissemination, University of York, UK
6 Department of Epidemiology, Maastricht University, The Netherlands
7 Division of Complementary Medicine, Department of Family Medicine, University of Maryland School of Medicine, USA
BMC Complementary and Alternative Medicine 2001, 1:3 doi:10.1186/1472-6882-1-3Published: 16 July 2001
Complementary therapies are widespread but controversial. We aim to provide a comprehensive collection and a summary of systematic reviews of clinical trials in three major complementary therapies (acupuncture, herbal medicine, homeopathy). This article is dealing with acupuncture. Potentially relevant reviews were searched through the register of the Cochrane Complementary Medicine Field, the Cochrane Library, Medline, and bibliographies of articles and books. To be included articles had to review prospective clinical trials of acupuncture; had to describe review methods explicitly; had to be published; and had to focus on treatment effects. Information on conditions, interventions, methods, results and conclusions was extracted using a pretested form and summarized descriptively.
From a total of 48 potentially relevant reviews preselected in a screeening process 39 met the inclusion criteria. 22 were on various pain syndromes or rheumatic diseases. Other topics addressed by more than one review were addiction, nausea, asthma and tinnitus. Almost unanimously the reviews state that acupuncture trials include too few patients. Often included trials are heterogeneous regarding patients, interventions and outcome measures, are considered to have insufficient quality and contradictory results. Convincing evidence is available only for postoperative nausea, for which acupuncture appears to be of benefit, and smoking cessation, where acupuncture is no more effective than sham acupuncture.
A large number of systematic reviews on acupuncture exists. What is most obvious from these reviews is the need for (the funding of) well-designed, larger clinical trials.