Table 2.
Certainty of evidence in included systematic review with GRADE approach.
| First author (year) [ref] | Outcomes | Study design | Number of studies (Total sample size) | Effect (95% CI) | p-value | Certainty of evidence |
|---|---|---|---|---|---|---|
| Feng (2019) (25) | Total effective rate | WA vs. WM | 8 (582) | OR 4.10 [2.51, 6.71] | < 0.00001 | Low |
| Guo (2018) (26) | Total treatment effect | WA vs. WM | 11 (925) | OR 4.54 [3.02, 6.82] | < 0.00001 | Low |
| WOMAC total | WA vs. WM | 2 (150) | SMD -0.68 [-1.02, -0.35] | < 0.00001 | Very low | |
| Lu (2015) (27) | Total effective rate | WA vs. WM | 8 (811) | RR 1.37 [1.27, 1.48] | < 0.0001 | Very low |
| Total effective rate (long term) | WA vs. WM | 2 (175) | RR 1.16 [1.04, 1.29] | = 0.008 | Very low | |
| Total effective rate (short term) | WA vs. WM | 4 (339) | RR 2.31 [1.57, 3.41] | < 0.00001 | Low | |
| Adverse events | WA vs. WM | 2 (176) | RR 0.20 [0.05, 0.75] | = 0.02 | Low | |
| Kong (2019) (28) | Total treatment effect | WA+WM vs. WM | 16 (1445) | OR 4.20 [2.80, 6.32] | < 0.00001 | Moderate |
| Pain (VAS) | WA+WM vs. WM | 11 (979) | MD -1.53 [-1.96, -1.11] | < 0.00001 | Very low | |
| LKSS | WA+WM vs. WM | 8 (753) | MD 19.7 [13.76, 25.18] | < 0.00001 | Very low | |
| WOMAC total | WA+WM vs. WM | 3 (312) | MD -10.25 [-15.61, -4.90] | 0.0002 | Very low | |
| Cao (2019) (29)) | Total effective rate | WA+WM vs. WM | 9 (786) | RR 1.16 [1.10, 1.22] | < 0.00001 | Moderate |
| Jun (2022) (12) | Total treatment effect | WA vs. WM (Drug) | 24 (2278) | RR 1.22 [1.17, 1.27] | < 0.001 | Low |
| WA vs. WM (Injection) | 5 (465) | RR 0.99 [0.91, 1.09] | NS | Low | ||
| WA + WM (Drug) vs. WM (Drug) | 8 (646) | RR 1.27 [1.18, 1.35] | < 0.001 | Very Low | ||
| WA + WM (Injection) vs. WM (Injection) | 25 (2238) | RR 1.1.5 [1.11, 1.19] | < 0.001 | Low | ||
| Pain | WA vs. WM (Drug) | 10 (874) | SMD -2.65 [-3.92, -1.38] | = 0.01 | Very low | |
| WA vs. WM (Injection) | 8 (726) | SMD -0.01 [-0.57, 0.55] | NS | Very low | ||
| WA + WM (Drug) vs. WM (Drug) | 2 (168) | SMD -5.85 [-7.84, -3.85] | < 0.001 | Very low | ||
| WA + WM (Injection) vs. WM (Injection) | 19 (1795) | SMD -1.68[ -2.07, -1.29] | < 0.001 | Very low | ||
| Function | WA vs. WM (Drug) | 13 (1354) | SMD -1.79 [-2.31, -1.26] | < 0.001 | Very low | |
| WA vs. WM (Injection) | 6 (547) | SMD -0.6 [-1.59, 0.39] | NS | Very low | ||
| WA + WM (Drug) vs. WM (Drug) | 4 (364) | SMD -1.45 [-3.11, 0.22] | < 0.001 | Very low | ||
| WA + WM (Injection) vs. WM (Injection) | 22 (2012) | SMD -1.40 [-1.72, -1.08] | < 0.001 | Very low | ||
| Jiang (2019) (30) | Total treatment rate | WA+WM vs. WM | 20 (1719) | OR 4.45 [3.12, 6.35] | < 0.00001 | Moderate |
| Chen (2019) (31) | Pain (VAS) | WA + other therapies vs. all type therapies | 5 (450) | WMD -2.20 [-3.34, -1.06] | < 0.05 | Very low |
| WOMAC total | WA + other therapies vs. all type therapies | 5 (418) | WMD -0.67 [-1.27, -0.07] | < 0.05 | Very low | |
| Huang (2021) (32) | Total effective rate | WA vs. all type therapies | 17 (1109) | OR 3.41 [2.27, 5.13] | < 0.00001 | Moderate |
| Pain (VAS) | WA vs. all type therapies | 10 (663) | MD -0.93 [-1.20, -0.67] | < 0.00001 | Low | |
| WA vs. AT | 4 (232) | MD -1.23 [-1.62, -0.84] | < 0.00001 | Very low | ||
| WA vs. EA | 2 (130) | MD -0.63 [-1.09, -0.17] | = 0.007 | Low | ||
| WA vs. Moxa | 3 (233) | MD -0.80 [-0.90, -0.70] | < 0.00001 | Low | ||
| WA vs. WM | 1 (68) | MD -1.30 [-2.00, -0.60] | = 0.0003 | Low | ||
| WOMAC | WA vs. all type therapies | 6 (430) | MD -8.91 [-12.58, -5.23] | < 0.00001 | Low | |
| WA vs. AT | 2 (172) | MD -14.11 [-20.89, -7.33] | < 0.0001 | Very low | ||
| WA vs. EA | 2 (130) | MD -4.42 [-15.27, 6.44] | NS | Very low | ||
| WA vs. WM | 2 (128) | MD -8.29 [ -9.50, -7.08] | < 0.0001 | Low | ||
| Luo (2019) (33) | Total treatment effect | WA vs. all type therapies | 10 (819) | OR 5.22 [3.45, 7.89] | < 0.00001 | Low |
| Jin (2022) (34) | Total effective rate | WA vs. TCM | 8 (795) | RR 1.18 [1.06, 1.33] | = 0.0004 | Low |
| Daily activities | WA vs. TCM | 2 (129) | MD -4.31 [-10.90, 2.28] | NS | Low | |
| Pain (VAS) | WA vs. TCM | 6 (427) | MD -1.06 [-1.61, -0.51] | = 0.0002 | Very low | |
| WOMAC | WA vs. TCM | 6 (427) | MD -6.93 [ -12.14, -1.72] | = 0.009 | Low | |
| Li (2021) (35) | Total effective rate | WA vs. AT | 10 (872) | OR 3.44 [2.25, 5.27] | < 0.00001 | Moderate |
| WA vs. EA | 8 (643) | OR 0.91 [0.58, 1.43] | NS | Low | ||
| Pain (VAS) | WA vs. AT | 3 (178) | MD -1.40 [-1.83, 0.96] | < 0.00001 | Low | |
| WA vs. EA | 5 (374) | MD 0.82 [-0.08, 1.72] | NS | Very low | ||
| WOMAC | WA vs. EA | 4 (279) | MD 0.98 [-1.76, 3.71] | NS | Very low | |
| LKSS | WA vs. AT | 2 (114) | MD 17.36 [13.40, 21.32] | < 0.00001 | Low | |
| Zhang (2018) (36) | Total effective rate | WA vs. TCM | 12 (1176) | RR 1.04 [1.00, 1.08] | = 0.06 | Very low |
| Pain (VAS) | WA vs. TCM | 7 (563) | SMD -0.48 [-1.26, 0.30] | NS | Very low | |
| LKSS | WA vs. AT | 4 (359) | SMD -1.68 [-2.03, -1.32] | < 0.001 | Low | |
| WOMAC total | WM vs. EA | 4 (299) | SMD 0.69 [0.46, 0.92] | NS | Very low | |
| Ou (2018) (37) | Total effective rate | WA vs. AT | 7 (530) | OR 5.07 [2.85, 9.04] | < 0.00001 | Low |
| Wu (2016) (38) | Total effective rate | WA vs. EA | 11(772) | OR 1.21 [0.81, 1.80] | NS | Very low |
| Pain (VAS) | WA vs. EA | 5 (339) | SMD 0.25 [-0.11, 0.61] | NS | Very low | |
| WOMAC | WA vs. EA | 4 (279) | SMD 0.08 [-0.15, 0.32] | NS | Very low |
AT, acupuncture; GRADE, Grades of Recommendations, Assessment, Development, and Evaluation; LKSS, Lysholm Knee Score Scale; MD, mean difference; Moxa moxibustion; OR, odd ratio; ROB, risk of bias; RR, risk ratio; SMD, standard mean difference; TCM, traditional Chinese medicine; VAS, visual analog scale; WA, warm needle acupuncture.