Summary of findings 4. Summary of findings: needle acupuncture versus phenytoin.

Needle acupuncture compared with phenytoin for epilepsy
Patient or population: participants with epilepsy Settings: hospital outpatients (one included study recruited outpatients only, the other included study did not specify the patient settings) Intervention: needle acupuncture Comparison: phenytoin
Outcomes	Illustrative comparative risks* (95% CI)		Relative effect (95% CI)	No of Participants (studies)	Quality of the evidence (GRADE)	Comments
	Assumed risk	Corresponding risk
	phenytoin	needle acupuncture
50% or greater reduction in seizure frequency (follow‐up: 6 months)	700 per 1000	1000 per 1000 (322 to 1000)	RR 1.43 (0.46 to 4.44)	150 (2)	⊕⊕⊝⊝ lowa
Adverse effects (follow‐up: 6 months)	See comment	See comment	Not estimable	120 (2)	See comment	The included study did not report adverse effects.
*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk Ratio.
GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.

a. Evidence from RCT downgraded by two levels because of high risk of bias in study design and imprecise result.