Shin 2009.

Methods	Randomised, non‐blinded, parallel 2‐arms trial
Participants	Country: Korea Site: the laboratory of Ewha Woman's University College of Nursing Recruitment: 185 women were recruited through a posted advertisement placed in a university hospital, of these 30 volunteers were enrolled and randomly divided into three groups (Hand Acupuncture Therapy, Hand Moxibustion Therapy, control group) of 10 each. There were respectively 7, 8, 7 volunteers in each group completed. Hand acupuncture group versus control group were included in this review. Inclusion: women aged 20 to 35 years meeting ICD‐10 criteria for PMS. Exclusion: 1. menstrual irregularity (fewer than 20 days or more than 36 days) in the previous 3 months; 2. pregnancy or breastfeeding; hysterectomy; 3. oral contraceptive use in the previous 3 months; antidepressant, benzodiazepine, or psychotropic drug use; 4. diagnosed with thyroid disorder; and a history of depression or anxiety disorder.
Interventions	Screening: three menstrual cycles were screened prior to intervention using the Menstrual Symptom Severity Scale and used as baseline data. Intervention group: hand acupuncture therapy: (n = 10) Treatments were applied to the basic female corresponding hyuls on the Im Ki Mek of both hands: A5, A6, A8, A12, A16, A18; Liver Ki Mek N18; and Spleen Ki Mek F6, Needles were inserted into either hand at an approximate penetration depth of less than 1 mm. After needle insertion, the women were instructed to keep their hands still for 15 minutes. Control group: no treatment control group. (n = 10) Women did not receive any treatment but were contacted at the time of follow‐up assessment. Duration: 10 sessions for 4 weeks Timing of administration: 10 times treatments in the 4‐week period, once every 3 days at Ewha University Medical Center. Summary measures: score change of severity of menstrual symptoms between the first pretreatment luteal phase (5 days prior to menses) and the first post‐treatment luteal phase (5 days prior to menses)
Outcomes	The Menstrual Symptom Severity developed by Mitchell, Woods, and Lentz (1992)
Notes	NICMAN score: 19 Funding: not reported Conflict of Interest: not reported Date study was conducted: not reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: “ Women were randomly divided into three groups (i.e., HAT, HMT, control) of 10 each” (pg 175). Method of randomisation not reported.
Allocation concealment (selection bias)	Unclear risk	Not reported
Blinding of participants and personnel (performance bias) All outcomes	High risk	No blinding possible due to no treatment control group. Likely to affect outcome.
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Not reported
Incomplete outcome data (attrition bias) All outcomes	High risk	14 women completed (7 in the HAT group, and 7 in the control group). During the intervention phase, 6 women withdrew for a variety of reasons (e.g., work schedule, personal plans, wedding, school, vacation, and so forth).
Selective reporting (reporting bias)	Unclear risk	No protocol published
Other bias	Low risk	None noted