Summary of findings 5. Summary of findings: needle acupuncture versus valproate.
| Needle acupuncture compared with valproate for epilepsy | ||||||
|
Patient or population: participants with epilepsy (one included study only recruited children with absence epilepsy while another included study recruited both children and adults with generalised epilepsy) Settings: hospital inpatients and outpatients Intervention: needle acupuncture Comparison: valproate | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| valproate | needle acupuncture | |||||
|
Seizure freedom (follow‐up: 3 months to 1 year) |
136 per 1000 | 238 per 1000 (126 to 445) | RR 1.75 (0.93 to 3.27) | 180 (2) | ⊕⊕⊝⊝ lowa | |
|
50% or greater reduction in seizure frequency (follow‐up: 3 months to 1 year) |
556 per 1000 | 734 per 1000 (583 to 923) | RR 1.32 (1.05 to 1.66) | 180 (2) | ⊕⊕⊝⊝ lowa | |
|
Post‐treatment quality of life (QOLIE‐31 score, which has a range of 0‐200, with higher score indicates better quality of life) (follow‐up: 3 months) |
The mean post‐treatment quality of life across control groups ranged from 170.22 to 172.6 points. | The mean post‐treatment quality of life in the intervention group was 12.04 points higher (4.05 points higher to 20.03 points higher). | 100 (1) |
⊕⊕⊝⊝ lowa | ||
|
Frequency of adverse effects ‐ dizziness (follow‐up: 3 months) |
160 per 1000 | 181 per 1000 (75 to 429) | RR 1.13 (0.47 to 2.68) | 100 (1) |
⊕⊕⊝⊝ lowa | |
|
Frequency of adverse effects ‐ malaise (follow‐up: 3 months) |
233 per 1000 | 161 per 1000 (76 to 343) | RR 0.69 (0.33 to 1.47) | 100 (1) |
⊕⊕⊝⊝ lowa | |
|
Frequency of adverse effects ‐ nausea (follow‐up: 3 months) |
140 per 1000 | 20 per 1000 (2 to 157) | RR 0.14 (0.02 to 1.12) | 100 (1) |
⊕⊕⊝⊝ lowa | |
|
Frequency of adverse effects ‐ sleepiness (follow‐up: 3 months) |
119 per 1000 | 71 per 1000 (17 to 284) | RR 0.60 (0.15 to 2.38) | 100 (1) |
⊕⊕⊝⊝ lowa | |
| *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.