Table 3.
Characteristics of Systematic Reviews that Included Meta-Analyses Comparing Manual and Electrical Acupuncture Trial Outcomes
| Research question: “Is there any evidence that electrical stimulation of acupuncture points results in significantly distinct clinical outcomes when compared to manual stimulation?” | |||||||
|---|---|---|---|---|---|---|---|
| Databases and dates: MEDLINE and AcuTrials, January 1, 2000–December 31, 2012 | |||||||
| Search strings: PubMed: “electroacupuncture” AND “acupuncture”; AcuTrials: “Acupuncture vs. acupuncture AND electroacupuncture” | |||||||
| Inclusion criteria: Reviews that reported pooling of data in a meta-analysis in which comparisons were made between outcomes associated with MA and EA. Reviews listed only as abstracts or protocols, previous reviews by the same researchers, reviews of interventions that did not use acupuncture needling, and reviews in the form of editorials or commentaries were excluded. | |||||||
| Study, year | Condition | Design, relevant trials | Trials with MA | Trials with EA | Comparison analyzed | Results | Comments |
| Direct comparisons | |||||||
| Manheimer et al., 201070 | Osteoarthritis | Meta-analysis, 9 trials | 4 trials, 1215 patients | 5 trials, 614 patients | Comparing effect sizes as SMDs in single analysis with test of interaction | Effect size of MA trials: SMD, −0.11 (95% CI, −0.29 to −0.11); EA trials: SMD, 0.50 (95% CI, −0.81 to −0.20); p for interaction=0.042) | EA superior to MA |
| Indirect comparisons | |||||||
| White et al., 201171 | Smoking cessation | Meta-analysis, 14 trials | All 14 trials,a 2206 patients | 4 trials, 462 patients | Separately comparing vs. sham control using RRs | MA vs sham MA: RR, 1.18 (95% CI, 1.03–1.34); EA vs sham EA: RR, 1.17 (95% CI, 0.89–1.54) | Difference not directly evaluated, but EA vs. sham statistically significant |
| Lu et al., 200772 | Chemotherapy-induced leukopenia | Meta-analysis, 10 trials | All 7 trials, 270 patients | 3 trials, 169 patients | Comparing WMD for leucocyte increase vs. control | Leukocyte increase in those trials with EA: WMD, 1.863 (95% CI,1.096–2.629); p=0.041; no increase for MA | Significant leukocyte increase in the 3 EA trials |
| Smith et al., 201073 | Depression | Meta-analysis, 5 trials | 3 trials, 175 patients | 2 trials, 117 patients | Separately comparing vs. SSRIs using SMDs | MA vs. SSRI: SMD, −0.02 (95% CI, −0.33 to 0.28); EA vs SSRI: SMD, 0.07 (95% CI, −0.38 to 0.53) | Difference not directly evaluated; neither comparison statistically significant |
| Cho et al., 200974 | Obesity | Meta-analysis | 2 trials, 43 patients | 2 trials, 53 patients | Separately comparing vs. lifestyle control, using RRs | MA vs lifestyle control: mean difference, 2.16 (95% CI, 0.47–3.84); EA vs lifestyle control: mean difference, 1.20 (95% CI, −0.65 to 3.05) | Difference not directly evaluated, MA vs. lifestyle control statistically significant |
| Lee et al., 200975 | Schizophrenia | Meta-analysis, 7 trials | All 7 trials,a 457 patients | 5 trials, 365 patients | Separately comparing with adjunctive drug vs. drug alone, using RRs | MA+drug vs. drug: RR, 1.15 (95% CI, 1.04–1.28); EA+drug vs drug: RR, 1.19 (95% CI, 1.00–1.43) | Difference not directly evaluated, both comparisons statistically significant |
| Langhorst et al., 201076 | Fibromyalgia | Meta-analysis, 7 trials | 5 trials, 175 patients | 2 trials, 104 patients | Separately comparing effect sizes vs. control using SMDs | MA vs. control SMD, −0.19 (95% CI, −0.52 to −0.14); EA vs. controls: SMD, 0.43 (95% CI, −0.81 to −0.04) | Difference not directly evaluated, but EA vs. sham statistically significant (p<0.03) |
a
Trials include those with MA and EA, with data on number of trials and number of patients not separated out.
SMD, standardized mean difference; CI, confidence interval; RR, risk ratios; WMD, weighted mean difference; SSRI, selective serotonin reuptake inhibitor.