Table 1.

Adverse events associated with auricular therapy reported in case reports.

Study and setting	Age (gender)	Reason for AT	Type of AT (method and duration)	Practitioner	Selected acupoints	AEs and severity	Outcomes	Causality*
Ye, 2014 [22], Chinese PLA General Hospital, Beijing, China	48 (female)	Constipation	Method: auricular acupressure using auricular plaster with vaccaria seeds Duration: not reported	Physician	Shenmen, kidney, liver, spleen, stomach, temple, subcortex, forehead, occiput	Event(s): dizziness Severity: not reported	Recovery after removing taped seeds	Probable/likely
Yu and Xie, 2010 [23], Teda Hospital, Tianjin, China	41 (male)	Lumbar muscle strain	Method: auricular acupressure using auricular plaster with vaccaria seeds Duration: three days per treatment, 4 treatments in total (12 days)	Physician	Heart, liver, spleen, occiput, shenmen, sympathetic	Event(s): somnolence Severity: not reported	Recovery after removing taped seeds	Probable/likely
Huo et al., 2000 [24], Chinese PLA 546 Hospital, Xinjiang, China	43 (male)	Dilated cardiomyopathy	Method: auricular acupressure using auricular plaster with vaccaria seeds Duration: three days per treatment, 5 treatments in total (15 days)	Not reported	Heart, liver, lung, shenmen, spleen, sympathetic, occiput	Event(s): somnolence Severity: not reported	Recovery after removing taped seeds	Probable/likely
Ma, 1992 [25], Ningyang TCM Hospital, Shandong, China	58 (female)	Chronic diarrhea	Method: auricular acupressure using auricular plaster with vaccaria seeds Duration: 30 minutes	Not reported	Large intestine, small intestine, shenmen, liver, sympathetic, spleen	Event(s): abdominal pain Severity: severe	Recovery after removing taped seeds	Possible

AT: auricular therapy, AE: adverse event, PLA: People's Liberation Army, and TCM: traditional Chinese medicine.

^*The WHO-Uppsala Monitoring Centre (UMC) System for Standardized Case Causality Assessment: certain—a plausible time relationship that adverse events clearly occurred after receiving AT and disappeared after withdrawal, and these events could not be explained by other health problems or interventions; probable/likely—a reasonable time relationship that the onset of symptoms was most likely related to AT and that was unlikely attributed to other health problems or interventions; possible—a reasonable time relationship that the onset of symptoms was most likely related to AT but that could also be explained by other health problems or interventions, and the information at withdrawal was lacking or unclear; unlikely—there was an improbable time relationship between AT and the adverse event; conditional/unclassified—event occurred but more data were essential for a proper causality assessment; unassessable/unclassifiable—an adverse event was suggested by a report but cannot be judged due to insufficient or contradictory information.