Summary of findings 5. Acupuncture compared with psychological therapy for depression.
| Acupuncture compared with psychological therapy for depression | ||||||
| Patient or population: clinical diagnosis of depression Setting: community Intervention: acupuncture Comparison: psychological therapy | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | No. of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with psychological therapy | Risk with acupuncture | |||||
| Severity of depression at the end of treatment as measured by self‐rated depression scores (lower score indicates less severe depression) | SMD 0.5 lower (1.33 lower to 0.33 higher) | ‐ | 497 (2 RCTs) | ⊕⊕⊝⊝ LOWa,b | As a rule of thumb, 0.2 SMD represents a small difference, 0.5 moderate, and 0.8 large. | |
| Adverse events measured during study treatment | Study population | RR 0.62 (0.29 to 1.33) | 453 (1 RCT) | ⊕⊕⊝⊝ LOWc,d | ||
| 86 per 1000 | 53 per 1000 (25 to 115) | |||||
| Quality of life (physical) | ‐ | ‐ | ‐ | No studies reported on this outcome. | ‐ | Cannot estimate the effect of acupuncture as no studies reported on this outcome |
| Quality of life (emotional) | ‐ | ‐ | ‐ | No studies reported on this outcome. | ‐ | Cannot estimate the effect of acupuncture as no studies reported on this outcome |
| *The risk in the intervention group (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; RCTs: randomised controlled trials; RR: risk ratio; SMD: standardised mean difference. | ||||||
| GRADE Working Group grades of evidence. High quality: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect. Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect. | ||||||
aDowngraded one level for serious risk of bias; both included trials have high risk of performance bias. bDowngraded one level owing to substantial heterogeneity (I2 = 85%, Tau2 = 0.31, P = 0.01). cDowngraded one level for imprecision as only a single study reported on this rare outcome.
dDowngraded one level owing to high risk of performance bias.