Table 4. The overall evidence quality for outcome measure.

Group	N	Participants		Absolute effect [95%CI]	Certainty assessment					Certainty	Importance
		I	C		Risk of bias	Inconsistency	Indirectness	Imprecision	Other considerations
Acupuncture vs. Usual care	Time to First Flatus
	15	580	582	SMD-1.14 [-1.54, -0.73]	Seriousa	Seriousa	No	No	No	Low	Critical
	Time to First Defecation
	12	488	492	SMD-1.31 [-1.88, -0.74]	Seriousa	Seriousa	No	No	No	Low	Critical
	Time to Bowel Sounds Recovery
	10	401	399	SMD-1.57 [-2.14, -1.01]	Seriousa	Seriousa	No	No	No	Low	Critical
	Length of hospital stay
	8	303	302	MD-1.68 [-2.55, -0.80]	No	Seriousa	No	No	No	Moderate	Importance
Acupuncture vs. Sham acupuncture	Time to First Flatus
	4	162	164	SMD-0.81 [-1.40, -0.23]	Seriousa	Seriousa	No	Seriousc	No	Very Low	Critical
	Time to First Defecation
	3	132	134	SMD-0.34 [-0.58, -0.10]	Seriousa	No	No	Seriousc	No	Low	Critical
	Time to Bowel Sounds Recovery
	3	107	109	SMD-1.03 [-1.14, -0.43]	Seriousa	Seriousa	No	Seriousc	No	Very Low	Critical
	Length of hospital stay
	3	104	105	MD-0.99 [-0.26, 0.08]	No	Seriousa	No	Seriousc	No	Low	Importance

Abbreviations: N, No. of studies; I, intervention; C, control; CI, confidence interval; MD, mean difference; SMD, standard mean difference.

a. Downgraded due to serious risk of bias: high risk of performance bias and unclear risk of selection bias and detection bias.

b. Downgraded due to substantial heterogeneity.

c. Downgraded due to small sample size.