He 2005

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 but no voltage CO‐INTERVENTION Reported, see 'Risk of bias' Treatment schedule: 3 times/wk 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 at immediate post Absolute benefit: acupuncture 42, placebo 12 Reported results: statistically significant favouring acupuncture at immediate post and 3 year follow‐up SMD ‐3.17 (95% CI random ‐4.44 to ‐1.90) immediate post treatment SMD ‐1.75 (95% CI random ‐3.01 to ‐0.49) at 6 months SMD ‐3.33 (95% CI random ‐4.78 to ‐1.88) 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)	Unclear risk	Not reported adequately
Allocation concealment (selection bias)	Unclear risk	Not reported
Blinding (performance bias and detection bias) All outcomes ‐ patient?	High risk	Interventions perceivably different
Blinding (performance bias and detection bias) All outcomes ‐ care provider?	High risk	Not possible
Blinding (performance bias and detection bias) All outcomes ‐ outcome assessor?	High risk	Participant as outcome assessor not blinded
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?	Unclear risk	Not reported
Selective reporting (reporting bias)	Unclear risk	No protocol
Similarity of baseline characteristics	Low risk	Reported to be similar
Co‐interventions avoided or similar?	Low risk	Reported to be similar
Compliance acceptable?	Low risk	Each participant received 3 treatments/wk to a total of 10
Similar timing of outcome assessment?	Low risk	All assessed at 6 months and 3 years
Fatal Flaw	Low risk	Acceptable