He 2004

Methods	RCT Number analysed/randomised: 24/24 Intention‐to‐treat: NR Power analysis: NR Funding source: NR
Participants	Chronic neck pain Participant recruitment: selected from 5 large companies in Oslo by the company's occupational physician, Norway
Interventions	INDEX TREATMENT Acupuncture 16 body points, 6 ear points, electrostimulation COMPARISON TREATMENT Placebo 10 to 14 mm distal to real points or 4 to 6 mm for ear points; electrostimulation set up but no voltage CO‐INTERVENTION Reported, see 'Risk of bias' Treatment schedule: 3 times per week, over 3 to 4 weeks, for a total of 10 treatments, with each session averaging 45 minutes in duration Duration of follow‐up: immediate post treatment, 6 months, 3 years
Outcomes	PAIN INTENSITY (0 to 100 VAS scale) Baseline mean: acupuncture 57, placebo 48 End of study mean: acupuncture 15, placebo 36 immediate post treatment Absolute benefit: acupuncture 42, placebo 12 Reported results: statistically significant favouring acupuncture at immediate post and 6 month follow‐up SMD ‐3.17 (95% CI random ‐4.44 to ‐1.90) immediate post treatment SMD ‐1.54 (95% CI random ‐2.47 to ‐0.61) at 6 months SMD ‐2.72 (95% CI random ‐3.89 to ‐1.56) at 3 years Drop‐outs: none Adverse effects: NR Costs of care: NR
Notes	‐‐
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Randomisation by draw with replacement
Allocation concealment (selection bias)	Unclear risk	Not reported
Blinding (performance bias and detection bias) All outcomes ‐ patient?	Low risk	Described in report
Blinding (performance bias and detection bias) All outcomes ‐ care provider?	High risk	Not possible
Blinding (performance bias and detection bias) All outcomes ‐ outcome assessor?	Low risk	Described in report
Incomplete outcome data (attrition bias) All outcomes ‐ Drop out rate acceptable?	Low risk	No drop‐outs
Incomplete outcome data (attrition bias) All outcomes ‐ Analyzed in the group to which they were allocated?	Low risk	All participants randomised were analysed, described in report
Selective reporting (reporting bias)	Unclear risk	No protocol
Similarity of baseline characteristics	High risk	Not similar with respect to PPT and duration of symptoms; also headache baseline information not provided
Co‐interventions avoided or similar?	High risk	21% of the intervention group and 50% of the control group received other treatment
Compliance acceptable?	Low risk	All participants completed all 10 treatments
Similar timing of outcome assessment?	Low risk	All assessed immediate post, 6 months, 3 years
Fatal Flaw	Low risk	Acceptable