Table 1.
Reference | Year | Meta-analysis | Intervention | Comparator groups | Types of included studies | Number of studies Number of patients |
Risk of bias assessment? Grade of Recommendation? |
Safety (AE/SAE) |
---|---|---|---|---|---|---|---|---|
CAM interventions in general | ||||||||
Baranowsky et al. [50] | 2009 | No | CAM therapies as defined by the NIH, with the exception of dietary, nutritional, herbal, and hormonal supplements | Any | RCT | 24; 1466 | Adapted instrument | Not assessed; not reported |
De Silva et al. [51] | 2010 | No | CAM therapies (oral or topical application) | Placebo or other treatments | RCT | 7; 267 | Jadad scale | Minor AE No SAE |
Holdcraft et al. [52] |
2003 | No | CAM therapies according to NIH scheme | Any | RCT, non-RCT | 22; 1091 | Consort rating system | Not assessed; not reported |
Terhorst et al. [53] | 2011 | Yes | CAM therapies according to NIH scheme | Any | RCTs | 60; 2897 | Adapted GRADE system (random sequence generation and allocation concealment; incomplete outcome data; selective reporting; other) | Not assessed; not reported |
| ||||||||
Exercise-based CAM | ||||||||
Chan et al. [54] | 2012 | No | Qigong | Any | RCT, CT | 4; 251 | Jadad scale | Not assessed; not reported |
Langhorst et al. [55] |
2013 | Yes | Meditative movement therapies (yoga, qigong, tai chi) | Any control | RCT | 7; 362 | Randomization, allocation concealment, blinding of outcome assessment, adequacy of data analysis (intention-to-treat analysis) | 3.1% AE No SAE |
Lauche et al. [56] | 2013 | Yes | Qigong | Any control | RCT | 7; 395 | Cochrane risk of bias assessment; GRADE | Minor AE No SAE |
Mist et al. [57] | 2013 | Yes | Complementary and alternative exercise | Any | Any | 16; 832 | Jadad score | No SAE |
| ||||||||
Manipulative therapies | ||||||||
Ernst [58] | 2009 | No | Chiropractic treatment | Any | RCT | 4; 108 | Jadad score | Not assessed; not reported |
Kalichman [59] | 2010 | No | Massage therapy | Any | Any, with an emphasis on RCTs | 8; 235 | None | Not assessed; not reported |
Schneider et al. [60] | 2009 | No | Chiropractic treatment | Any | RCTs, systematic reviews, meta-analyses, guidelines consensus documents, RCTs, clinical trials, case reports, case-control studies, surveys | 8 systematic reviews, 3 meta-analyses, 5 practice guidelines, 44 RCTs, 17 clinical trials, 17 case reports, 2 case-control studies, 2 surveys | Oxford rating scale; Scottish Intercollegiate Guidelines Network evidence rating checklist | Not assessed; not reported |
| ||||||||
Mind/Body interventions | ||||||||
Bernardy et al. [61] |
2011 | Yes | Hypnosis, guided imagery | Any | CT; quasi-RCT; RCT | 6; 239 | Scale for rating the quality of psychological trials in pain [40] | Minor AE No SAE |
Glombiewski et al. [62] |
2013 | Yes | EMG and EEG biofeedback | Any | RCT | 7; 321 | Randomization, allocation concealment, blinding of outcome assessor, adequate data analysis, intention-to-treat analysis | Minor AE No SAE |
Hadhazy et al. [63] |
2000 | No | Mind-Body therapies (education, cognitive therapy, movement therapy, dance, meditation, relaxation, hypnosis, guided imagery, biofeedback) | Any | RCT, quasi-RCT | 13; 802 | Jadad criteria | No AE reported |
Kozasa et al. [64] | 2012 | No | Meditation-based interventions | Any | RCT | 4; 449 | Jadad score | Not assessed; not reported |
Lauche et al. [65] | 2013 | Yes | Mindfulness-based stress reduction (MBSR) | Any control | CT; RCT | 6; 674 | Cochrane risk of bias assessment; GRADE | No AE/SAE reported |
| ||||||||
Acupuncture | ||||||||
Deare et al. [66] | 2013 | Yes | Acupuncture (invasive acupuncture only) as standalone or adjunct | Any (nonacupuncture treatments, placebo, sham-acupuncture) | RCT | 9; 395 | Cochrane risk of bias assessment | 0–53% AE No SAE |
Langhorst et al. [67] | 2010 | Yes | Acupuncture | Sham-acupuncture, simulated acupuncture | RCT, quasi-RCT | 7; 385 | van Tulder score | 3–70% AE No SAE |
Martin-Sanchez et al. [68] |
2009 | Yes | Acupuncture | Sham-acupuncture | RCT | 6; 323 | None | Not assessed; not reported |
Mayhew and Ernst [69] |
2007 | No | Acupuncture | Any | RCT | 5; 316 | Jadad score | Not assessed; not reported |
| ||||||||
Balneotherapy/hydrotherapy | ||||||||
Fraioli et al. [70] | 2013 | No | Spa therapy | Unclear | RCTs, observational studies | 7; 303 | Value of the international journals that published these researches, the number of patients included in the studies, the methods used to study the patients, and the possibility of exclusion of more frequent studies bias | Not assessed; not reported |
Langhorst et al. [71] | 2009 | Yes | Hydrotherapy | Any | RCT | 13; 446 | van Tulder score | Not assessed; not reported |
McVeigh et al. [72] |
2008 | No | Hydrotherapy | Any | RCT | 10; 571 | van Tulder score | Not assessed; not reported |
| ||||||||
Phytotherapy | ||||||||
de Souza Nascimento et al. [73] |
2013 | No | Medicinal plants or related natural products | Placebo, other drugs | RCTs | 8; 475 | Jadad score | Minor AE No SAE |
| ||||||||
Homeopathy | ||||||||
Perry et al. [74] | 2010 | No | Homeopathy | Any | RCTs | 4; 163 | Jadad score; recommendations from the Cochrane Handbook | Not assessed; not reported |
AE: adverse event; CAM: complementary and alternative medicine; CONSORT: Consolidated Standards of Reporting Trials; CT: controlled trial; GRADE: Grading of Recommendations Assessment, Development, and Evaluation; RCT: randomized controlled trial; SAE: serious adverse event.