Table 4.
GRADE Quality of Evidence Assessment for Acupuncture on Symptom Management of Postoperative Side Effects of Breast Cancer.
| Quality
assessment |
Summary of finding
table |
Quality | Importance | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| No. of patients |
Effect |
||||||||||
| Outcome/no. of studies | Design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | Acupuncture | Control | Relative (95% CI) absolute | ||
| Hot flashes (n = 6) | Randomized trials | Seriousa | Not seriousb | No serious indirectness | Seriousc | None | 299 | 269 | MD = 0.28 (0.45-0.11) | Low | Important |
| Fatigue (n = 4) | Randomized trials | No serious risk of bias | Not seriousb | No serious indirectness | No serious | None | 92 | 85 | MD = 0.06 (1.03-0.92) | Moderate | Important |
| Pain (n = 5) | Randomized trials | Serious | Not serious | No serious indirectness | Seriousc | None | 188 | 131 | MD = 0.98 (0.41-213) | Low | Important |
| Stiffness (n = 4) | Randomized trials | No serious risk of bias | Not serious | No serious indirectness | Seriousc | None | 170 | 116 | MD = 0.62 (0.54-0.76) | Low | Important |
| Kupperman index (n = 5) | Randomized trials | No serious risk of bias | Not serious | No serious indirectness | Seriousd | None | 83 | 74 | MD = 0.21 (0.83-0.4) | Low | Imporatant |
| Physical well-being (n = 7) | Randomized trials | No serious risk of bias | Seriousb | No serious indirectness | Seriousc | None | 305 | 271 | MD = 0.07 (0.4-0.24) | Low | Important |
| TNF (n = 2) | Randomized trials | No serious risk of bias | Not serious | No serious indirectness | Seriousc | None | 33 | 33 | MD = 0.64 (1.83-0.53) | Low | Important |
| IL-1 (n = 2) | Randomized trials | No serious risk of bias | No serious | No serious indirectness | Seriousc | None | 33 | 33 | MD = 0.15 (1.36-1.65) | Low | Important |
Abbreviations: GRADE, grading of recommendations assessment, development, and evaluation; CI, confidence interval; MD, mean differences; TNF, tumor necrosis factor; IL-1, interleukin-1; RCT, randomized controlled trial..
a
RCTs did not mention or not use the blinding method and randomized grouping.
b
Evidence of significant interstudy heterogeneity.
c
Confidence in estimates of effect is poor; RCTs do not calculate the number for optimal information size, and small sample size.
d
Similarity of point estimates, extent of overlap of CIs is poor.