Summary of findings 3.
| Acupuncture compared with wait‐list control for chronic neck pain | ||||||
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Patient or population: patients with chronic neck pain (pain for more than 90 days) Settings: primary care newspaper advertisement or recruited through participating physicians Intervention: acupuncture Comparison: wait‐list control | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | Number of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Wait‐list control | Acupuncture | |||||
| Pain intensity (VAS) short term | Mean pain intensity across control groups was 5 points on a 0 to 10 scale |
Mean pain intensity in intervention groups was 4 points on a 0 to 10 scale | ‐‐ | 30 (1 study) |
⊕⊕⊕⊝ Moderate Limitations: 0 Inconsistency: 0 Indirectness: ‐1 Imprecision: 0 Other: 0 |
One trial with low risk of bias showed a small reduction in pain. Moderate evidence supporting acupuncture is helpful |
| Disability (neck and pain disability scale) short term | Mean disability across control groups was 6 points on a 0 to 100 scale | Mean disability in intervention groups was 29 points on a 0 to 100 scale |
‐‐ | 3451 (1 study) |
⊕⊕⊕⊝ Moderate Limitations: 0 Inconsistency: 0 Indirectness: ‐1 Imprecision: 0 Other: 0 |
One large study with low risk of bias favoured acupuncture |
| Quality of life (SF‐36 mental score) short term | Mean quality of life score across control groups was 1 point on a 0 to 10 scale | Mean quality of life score in intervention groups was 4 points on a 0 to 10 scale |
‐‐ | 3451 (1 study) |
N/A | One large study showed no statistically significant findings in favour of acupuncture |
| *The basis for the assumed risk (e.g. median control group risk across studies) is provided in footnotes. The corresponding risk (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; RR: risk ratio | ||||||
| Adverse effects were reported in 14 studies and included increased pain, bruising, fainting, worsening of symptoms, local swelling and dizziness. No life‐threatening adverse effects were noted by these studies Cost of care was calculated in 1 study, which found that acupuncture treatment was cost‐effective GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate Very low quality: We are very uncertain about the estimate | ||||||