Risk of bias assessments and reporting quality of systematic reviews and randomized controlled trials examining acupuncture for depression: An overview and meta-epidemiology study
Correction(s) for this article
-
Corrigendum
- Volume 13Issue 3Journal of Evidence-Based Medicine
- pages: 249-249
- First Published online: July 17, 2020
Shanxia Luo
Department of Mental Health Center, West China Hospital of Sichuan University, Chengdu, P.R. China
Search for more papers by this authorYoulin Long
Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, P.R. China
Search for more papers by this authorWenzhe Xiao
West China School of Public Health, Sichuan University, Chengdu, P.R. China
Search for more papers by this authorXin Wang
School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, P.R. China
Search for more papers by this authorRui Chen
School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, P.R. China
Search for more papers by this authorQiong Guo
Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, P.R. China
Search for more papers by this authorJia Liu
West China School of Medicine, Sichuan University, Chengdu, P.R. China
Search for more papers by this authorRuochen Shao
School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, P.R. China
Search for more papers by this authorLiang Du
Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, P.R. China
Search for more papers by this authorCorresponding Author
Min Chen
Department of Traditional Chinese Medicine, The Third People's Hospital of Chengdu, Chengdu, P.R. China
Correspondence
Min Chen, Department of Traditional Chinese Medicine, The Third People's Hospital of Chengdu, No. 82, Qinglong Street, Chengdu, Sichuan 610031, China.
Email: [email protected]
Search for more papers by this authorShanxia Luo
Department of Mental Health Center, West China Hospital of Sichuan University, Chengdu, P.R. China
Search for more papers by this authorYoulin Long
Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, P.R. China
Search for more papers by this authorWenzhe Xiao
West China School of Public Health, Sichuan University, Chengdu, P.R. China
Search for more papers by this authorXin Wang
School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, P.R. China
Search for more papers by this authorRui Chen
School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, P.R. China
Search for more papers by this authorQiong Guo
Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, P.R. China
Search for more papers by this authorJia Liu
West China School of Medicine, Sichuan University, Chengdu, P.R. China
Search for more papers by this authorRuochen Shao
School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, P.R. China
Search for more papers by this authorLiang Du
Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, P.R. China
Search for more papers by this authorCorresponding Author
Min Chen
Department of Traditional Chinese Medicine, The Third People's Hospital of Chengdu, Chengdu, P.R. China
Correspondence
Min Chen, Department of Traditional Chinese Medicine, The Third People's Hospital of Chengdu, No. 82, Qinglong Street, Chengdu, Sichuan 610031, China.
Email: [email protected]
Search for more papers by this authorFunding information:
This work was supported by the National Natural Science Foundation of China (Numbers: 81873197, 81403276); and the Key Program of Sichuan Provincial Science and Technology Department, China (Number: 2019YFS0194).
Abstract
Objectives
To assess the use of risk of bias (ROB) assessment tools and the reporting quality of ROB assessment results in systematic reviews (SRs) of acupuncture for depression, as well as to evaluate the ROB of depression-related randomized controlled trials (RCT).
Methods
Embase, Medline, Chinese Journal Full-Text Database (CJFD), VIP Chinese Technology Periodical Database, and WanFang Data Resource System of Digital Periodicals were searched from their inception to 24 November 2017. SRs of RCTs concerning acupuncture on depression were included. General characteristics and the information related to risk of bias in SRs were extracted. A descriptive analysis was used.
Results
Thirty-nine SRs were included. Of these, two (5%) did not perform a ROB assessment, 18.9% did not report the ROB assessment results, and 62.2% did not report the assessment results of each ROB item. Text descriptions and tables were commonly used in reporting forms. Only 32.4% of SRs reported support for judgment. The reporting rate of ROB assessment results was low in all items (13.5%-35.1%). Regarding RCTs, 59.7% used adequate randomization methods, 13.1% performed adequate allocation concealment, 12.5% performed adequate blinding of participants and personnel, 27.3% performed adequate blinding of the assessment outcomes, and 41.5% and 49.3% had a low ROB in terms of incomplete outcome data and selective outcome reporting, respectively.
Conclusion
For the SRs of acupuncture for depression, the selection of ROB assessment tools needs to be optimized. The reporting quality is poor, and the overall ROB of RCTs is high. Therefore, the results may not be reliable.
CONFLICT OF INTEREST
None.
Supporting Information
| Filename | Description |
|---|---|
| jebm12372-sup-0001-SuppMat.docx18.9 KB | APPENDIX 1 Search strategies for systematic review on acupuncture for depression |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
REFERENCES
- 1Fredriksen KJ, Schoeyen HK, Johannessen JO, Walby FA, Davidson L, Schaufel MA. Psychotic depression and suicidal behavior. Psychiatry. 2017; 80(1): 17–29.
- 2GBD Data Visualizations. http://www.healthdata.org/gbd/data-visualizations (accessed 19 May 2019).
- 3Prince M, Patel V, Saxena S, et al. No health without mental health. Lancet. 2007; 370(9590): 859–877.
- 4Ruhe HG, Huyser J, Swinkels JA, Schene AH. Switching antidepressants after a first selective serotonin reuptake inhibitor in major depressive disorder: a systematic review. J Clin Psychiatry. 2006; 67(12): 1836–1855.
- 5Arroll B, Macgillivray S, Ogston S, et al. Efficacy and tolerability of tricyclic antidepressants and SSRIs compared with placebo for treatment of depression in primary care: a meta-analysis. Ann Fam Med. 2005; 3(5): 449–456.
- 6Baghai TC, Möller HJ, Rupprecht R. Recent progress in pharmacological and non-pharmacological treatment options of major depression. Curr Pharm Des. 2006; 12(4): 503–515.
- 7 World Health Organization. Management of Mental Disorders, 4th ed. Sydney: WHO Collaborating Centre for Evidence in Mental Health Policy; 2004.
- 8Keller MB, McCullough JP, Klein DN, Arnow B, Dunner DL, Gelenberg AJ. A comparison of nefazodone, the cognitive behavioral-analysis system of psychotherapy, and their combination for the treatment of chronic depression. N Engl J Med. 2000; 342(20): 1462–1470.
- 9Stub T, Alraek T, Liu J. Acupuncture treatment for depression-a systematic review and meta-analysis. Euro J Integr Med. 2011; 3(4): e253–e64.
- 10Chan YY, Lo WY, Yang SN, Chen YH, Lin JG. The benefit of combined acupuncture and antidepressant medication for depression: a systematic review and meta-analysis. J Affect Disord. 2015; 176: 106–117.
- 11Wang H, Qi H, Wang BS, et al. Is acupuncture beneficial in depression: a meta-analysis of 8 randomized controlled trials? J Affect Disord. 2008; 111(2–3): 125–134.
- 12Zhang ZJ, Chen HY, Yip KC, Ng R, Wong VT. The effectiveness and safety of acupuncture therapy in depressive disorders: systematic review and meta-analysis. J Affect Disord. 2010; 124(1–2): 9–21.
- 13Spitzer RL, Endicott J, Robins E. Research Diagnostic Criteria (RDC) for a selected group of functional disorders, 3rd ed. New York, NY: Biometric Research, 1977.
- 14 World Health Organisation. The ICD-10 Classification of Mental and Behavioural Disorders. Diagnostic Criteria for Research. Geneva: World Health Organisation, 1993.
- 15 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, DC: American Psychiatric Association; 1994.
- 16 Chinese Psychiatric Society. The Chinese Classification of Mental Disorders [CCMD-3], 3rd ed. Shandong: Shandong Publishing House of Science and Technology; 2001.
- 17He J, Du L, Liu G, et al. Quality assessment of reporting of randomization, allocation concealment, and blinding in traditional Chinese medicine RCTs: a review of 3159 RCTs identified from 260 systematic reviews. Trials. 2011; 12: 122.
- 18Pang Y, Shi J. Clinical effect of acupuncture on postpartun depression:a meta-analysis. J Liaon Univ Trad Chin Med. 2016; 18(7): 8–10.
- 19Zhang GC, Hang YF, Zhu XP, Fu WB. Effectiveness of acupuncture and moxibustion for post-stroke depression: a meta-analysis. J New Chin Med. 2011; 43(2): 127–129.
- 20Bian XK, Fu LX, Zuo XH, Shen X. Acupuncture versus medicine for depression in China: a systematic review. J Clin Acupunct Moxibust. 2011; 27(8): 59–62.
- 21Chang P. Systematic evaluation on treatment of depression after stroke by acupuncture. Clin J Chin Med. 2014; 6(30): 120–122.
- 22Fan L, Fu WB, Xu NG, Liu JH, Ou AH, Wang YW. Meta-analysis of randomized controlled trials on acupuncture and moxibustion treating depression. Chin J Gerontol. 2010; 30(18): 2561–2563.
- 23Huang GX. Systematic evaluation and meta-analysis of clinical efficacy of acupuncture vs different western medicines for the treatment of post-stroke depression. GuangZhou: Guangzhou University of Chinese Medicine, 2017.
- 24Li B, Du YH, Li D, Wang X, Li HS, Jia LY. Research on the optimal intervention mode of acupuncture treatment on major depressive disorder base on meta analysis and multiple objectives decision making. Chin J Trad Chin Med Pharm. 2014; 29(3): 923–926.
- 25Li B, Du YH, Liu Q. Study to evaluate efficacy, intervention-level of acupuncture therapy based on meta-analysis of ordinal data: major depressive disorder. Tianj J Trad Chin Med. 2016; 33(3): 135–138.
- 26Li XH. Systematic reviews of acupuncture treatment for stroke depression. GuangZhou: Nanfang Medical University, 2012.
- 27Li XH, Chen JQ, Hu YN, Wang HT. Acupuncture combined with western medicine versus western medicine for patients with post-stroke depression: a meta-analysis. Shaan J Trad Chin Med. 2012; 33(9): 1263–1267.
- 28Lin YL. Bibliometrics and meta analysis of onelectroacupuncture treatment of depression. GuangZhou: Guangzhou University of Chinese Medicine, 2015.
- 29Liu MJ, Liu ZC, Xu B, Cai JW. Meta analysis of acupuncture treatment of type 2 diabetes mellitus and depression clinical research. J Zhej Chin Med Univ. 2016; 40(1): 54–59.
- 30Kan FX. Effectiveness of acupuncture versus fluoxetine for post-stroke depression: a systematic review. ChengDu: Chengdu University of Traditional Chinese Medicine, 2014.
- 31Song HT, Wu Z, Zhang RX. Acupuncture at du meridian for depression: a meta-analysis. Int Med Health Guidance News. 2017; 23(2): 250–253.
- 32Sun YL, Chen SB, Gao Y, Xiong J. Acupuncture versus western medicine for depression in China: a systematic review. Chin J Evid-Based Med. 2008; 8(5): 340–345.
- 33Wang L, Chi QB. Electro-acupuncture for depression: a systematic review of randomized controlled trials. Shang J Acupunct Moxibust. 2008; 27(3): 36–38.
- 34Wang L, Sun DW, Zou W, Zhang JY. Systematic evaluation of therapeutic effect and safety of acupuncture for treatment of depression. Chin Acupunct Moxibust. 2008; 28(5): 381–386.
- 35Xiong J, Du YH, Liu JL, et al. Acupuncture versus western medicine for depression neurosis: a systematic review. Chin J Evid-Based Med. 2009; 9(9): 969–975.
- 36Xiong J, Du YH, Liu JL, et al. Acupuncture versus western medicine for post stroke depression: a systematic review. Journal Evid-Based Med. 2010; 10(3): 179–185, 92.
- 37Yin MM, Xiao W. Effectiveness of acupuncture for post-stroke depression: a meta-analysis. Asia-Pacific Trad Med. 2016; 12(2): 71–72.
- 38Zhang JB, Ren L, Sun YL. Meta-analysis on acupuncture for treatment of depression in patients of poststroke. Chin Acupunct Moxibust. 2009; 29(7): 599–602.
- 39Zhong BL, Huang YQ, Li HJ. The effectiveness and safety of acupuncture for depression: a systematic assessment. Chin Mental Health J. 2008; 22(9): 641–647.
- 40Li B, Du YH, Wang X, Li HS, Li D, Jia LY. Meta analysis and analytic hierarchy process-based intervention strategy research of acupuncture for primary depressive disorder. [in Chinese]. Zhongguo Zhen Jiu. 2013; 33(5): 463–467.
- 41Wang S, Zhang J, Chen J, et al. Early filiform needle acupuncture for poststroke depression: a meta-analysis of 17 randomized controlled clinical trials. Neural Regen Res. 2014; 9(7): 773–784.
- 42Leo RJ. A systematic review of randomized controlled trials of acupuncture in the treatment of depression. J Affect Disord. 2007; 97(1-3): 13–22.
- 43Sniezek DP, Siddiqui IJ. Acupuncture for treating anxiety and depression in women: a clinical systematic review. Med Acupunct. 2013; 25(3): 164–172.
- 44Li ZF, Wu Q, Fu WB, Chen JY. Systematic review on effectiveness and safety of acupuncturemoxibustion for perimenopausal depression. Chin J Trad Chin Med Pharm. 2014; 29(5): 1746–1752.
- 45Dong B, Chen Z, Yin X, et al. The efficacy of acupuncture for treating depression-related insomnia compared with a control group: a systematic review and meta-analysis. BioMed Res Int. 2017; 2017:9614810.
- 46Fan L, Fu W, Xu N, Liu J, Ou A, Wang Y. Meta-analysis of 20 clinical, randomized, controlled trials of acupuncture for depression. Neural Regen Res. 2010; 5(24): 1862–1869.
- 47Wang JF, Tan LJ, Mei QX, Zheng QH, Yang SB, Mei ZG. Meta analysis on acupuncture for postpartum depression. World J Acupunct—Moxibust. 2017; 27(1): 28–34.
- 48Zhang W, Sun JH, Gao Y, et al. System review on treating post-stroke depression with acupuncture. World J Acupunct—Moxibust. 2014; 24(2): 52–59.
10.1016/S1003-5257(14)60026-X Google Scholar
- 49Mukaino Y, Park J, White A, Ernst E. The effectiveness of acupuncture for depression—a systematic review of randomised controlled trials. Acupunct Med. 2005; 23: 70–76.
- 50Zhang GC, Fu WB, Xu NG, et al. Meta analysis of the curative effect of acupuncture on post-stroke depression. J Trad Chin Med. 2012; 32: 6–11.
- 51Smith CA, Hay PP, MacPherson H. Acupuncture for depression. Cochrane Database Syst Rev. 2010; 20(1):CD004046.
- 52Xu Y. A cumulative meta-analysis study of comparing the efficacy of the treatment of post stroke depression by acupuncture and western medicine. GuangZhou: Guangzhou University of Chinese Medicine, 2014.
- 53Whiting P, Savović J, Higgins JP, et al. ROBIS: a new tool to assess risk of bias in systematic reviews was developed. J Clin Epidemiol. 2016; 69: 225–234.
- 54Higgines JPT, Green S. Cochrane handbook for systematic reviews of interventions 4.2.6 [updated September 2006]. The Cochrane Library. Chichester, UK: John Wiley & Sons, Ltd; 2006. Issue 4.
- 55Higgins JP, Altman DG, Gotzsche PC, et al. The cochrane collaboration's tool for assessing risk of bias in randomised trials. BMJ. 2011; 343:d5928.
- 56Savovic J, Jones HE, Altman DG, et al. Influence of reported study design characteristics on intervention effect estimates from randomized, controlled trials. Ann Intern Med. 2012; 157(6): 429–438.
