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. 2018 Mar 16;2018(3):CD008208. doi: 10.1002/14651858.CD008208.pub4

Summary of findings 2.

Cranial electrotherapy stimulation (CES) compared with sham for chronic pain

CES compared with sham for chronic pain
Patient or population: adults with chronic pain
Settings: laboratory/ clinic
Intervention: active CES
Comparison: sham CES
Outcomes Effect size Relative effect
(average % improvement (reduction) in pain (95% CIs) in relation to post‐treatment score from sham group)*
*Where 95%CIs do not cross the line of no effect.
No of participants (studies) Quality of the evidence (GRADE)
Pain intensity (0 to < 1 week postintervention)
measured using visual analogue scales or numerical rating scales
SMD ‐0.24 (‐0.48 to 0.01) 270 (5) ⊕⊕⊝⊝ low1
Disability (0 to < 1 week postintervention)
measured using self‐reported disability/pain interference scales
No data available No data available No data available No data available
Quality of life (0 to < 1 week postintervention)
measured using Fibromyalgia Impact Questionnaire
MD ‐25.05 (‐37.82 to ‐12.28) 36 (1) ⊕⊝⊝⊝ very low2
CI: confidence interval; CES: cranial electrotherapy stimulation; MD: mean difference; SMD: standardised mean difference
GRADE Working Group grades of evidence
High quality: we are very confident that the true effect lies close to that of the estimate of the effect;
Moderate quality: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of effect, but there is a possibility that it is substantially different;
Low quality: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect;
Very low quality: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect.

1Downgraded once for study limitations due to high or unclear risk of bias and once for imprecision due to low participant numbers. 2Downgraded once for study limitations due to high or unclear risk of bias, once for inconsistency (single study) and once for imprecision due to low participant numbers.