Liang 2009

Methods	RCT Number analysed/randomised: 53/54 Intention‐to‐treat: NA Power analysis: NR Funding source: NR
Participants	Chronic neck disorder associated with degenerative changes ‐ cervical spondylosis Participant recruitment: Guangdong Provincial Hospital of TCM
Interventions	INDEX TREATMENT Routine acupuncture Treated with routine acupuncture at GV 14, Ex‐HN 15 and SI 15 with 40 mm long needles (diameter of 0.30 mm). Needles were retained for 20 minutes after Deqi was achieved COMPARISON TREATMENT Sham acupuncture Sham acupuncture. Needled at 1 cm lateral to Ex‐HN 15 and SI 15 (needles were 40 mm long with a diameter of 0.22 mm). Needles were retained for 20 minutes CO‐INTERVENTION Infrared radiation as adjuvant treatment, comparable between index and control groups Treatment schedule: Treatment consisted of 9 sessions, applied 3 times a week (every other day) over a period of 3 weeks No follow‐up
Outcomes	QUALITY OF LIFE: Northwick Park Neck Pain Questionnaire (up to 100, low score = better) Baseline mean: routine acupuncture 35.32, sham acupuncture 31.96 End of study mean: routine acupuncture 19.16, sham acupuncture 23.76 Absolute benefit: routine acupuncture 16.16, sham acupuncture 8.2 Reported results: Both groups showed improvement SMD ‐0.39 (95% CI random ‐0.77 to ‐0.00) immediate post treatment 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 described
Allocation concealment (selection bias)	Unclear risk	Not described
Blinding (performance bias and detection bias) All outcomes ‐ patient?	Unclear risk	Not described
Blinding (performance bias and detection bias) All outcomes ‐ care provider?	Unclear risk	Not described
Blinding (performance bias and detection bias) All outcomes ‐ outcome assessor?	Unclear risk	Not described
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	As described
Selective reporting (reporting bias)	Low risk	None reported
Similarity of baseline characteristics	Unclear risk	Not described
Co‐interventions avoided or similar?	Unclear risk	Not described
Compliance acceptable?	Unclear risk	Not described
Similar timing of outcome assessment?	Low risk	Similar at baseline and 3 weeks
Fatal Flaw	High risk	Reporting flaws