British Medical Journal: How to Improve the Evidence Base of Acupuncture

Key messages


· A large number of systematic reviews of acupuncture exist which are overall methodologically rigorous

· Clinical practice and health policy underuse beneficial acupuncture therapies for which rigorous systematic reviews have documented high or moderate certainty evidence

· Acupuncture funding and research need to focus on conditions for which acupuncture therapies have had substantial beneficial effects but for which evidence is of low certainty

· A coordinated multistakeholder effort to generate acupuncture evidence and support its implementation will enable a more evidence-based approach to practice and research


Current findings


Acupuncture showed a moderate or large effect with moderate or high certainty evidence in eight diseases or conditions: improvement in functional communication of patients with post-stroke aphasia; relief of neck and shoulder pain; relief of myofascial pain; relief of fibromyalgia related pain; relief of non-specific lower back pain; increased lactation success rate within 24 hours of delivery; reduction in the severity of vascular dementia symptoms; and improvement of allergic rhinitis nasal symptoms.


Fig 1. Number of systematic reviews of acupuncture published between 2000 and 2020


Summary recommendations to increase use of acupuncture systematic reviews

Incorporate acupuncture evidence into decision making within health systems


Given the many systematic review summarizing acupuncture evidence identified in The BMJ acupuncture collection, international, regional, and national organizations and health systems should initiate, support, and develop more acupuncture evidence informed decision making.

Build a joint research production effort

Knowledge users, funding agencies, and researchers should set joint research agendas to accelerate the generation, updating, evaluation, and release of evidence to provide a basis for the application of acupuncture.

Digitize and disseminate evidence on acupuncture to facilitate access

A digitized repository should be created with evidence matrices that map systematic reviews of acupuncture and disseminate (eg, through social media, subscriptions, and emails) tailored messages derived from systematic reviews to help patients, clinicians, and policy makers access evidence on acupuncture.

Enable the use of existing evidence in health system decision making

Linkages and exchange between researchers, clinicians, and policy makers should be encouraged to help expand the use of existing acupuncture evidence, especially in areas in which acupuncture therapy shows moderate or large effects supported by moderate or high certainty evidence. The GRADE evidence to decision framework enables transparent and structured evidence informed health system decisions.

Align knowledge gaps and research with funding priorities

Researchers and granting agencies should focus on areas where acupuncture has shown large effects supported with low or very low certainty evidence (areas of high potential) and avoid research and funding in areas where moderate or high certainty evidence has proven the benefit of interventions.


Reference:

Evidence on acupuncture therapies is underused in clinical practice and health policy. BMJ 2022; 376 doi: : https://doi.org/10.1136/bmj-2021-067475

https://www.bmj.com/content/376/bmj-2021-067475

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