Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, acupmed2018011671
[Online ahead of print]

Acupuncture in Sham Device Controlled Trials May Not Be as Effective as Acupuncture in the Real World: A Preliminary Network Meta-Analysis of Studies of Acupuncture for Hot Flashes in Menopausal Women

Acupuncture in Sham Device Controlled Trials May Not Be as Effective as Acupuncture in the Real World: A Preliminary Network Meta-Analysis of Studies of Acupuncture for Hot Flashes in Menopausal Women

Tae-Hun Kim et al. Acupunct Med.


Background: Randomised controlled trials of acupuncture performed using sham interventions to control for the placebo effect have mostly used two types of sham techniques: techniques with minimal insertion of acupuncture needles with no additional stimulation (shallow needling control) and techniques with sham acupuncture devices that do not penetrate the skin (sham device control). To achieve successful blinding, sham device controlled acupuncture trials also use the acupuncture base unit in the verum acupuncture group, but in the shallow needling control trials this is not necessary for the verum acupuncture treatment.

Objective: In this study, we analysed the estimated comparative effectiveness of these two verum acupuncture modalities in studies of acupuncture for menopausal hot flashes that used two types of sham control treatments.

Methods: We conducted a network meta-analysis that included randomised controlled trials of acupuncture for hot flashes. Electronic databases, including Medline, Embase, Cochrane Library and AMED, were searched through March 2017. Data were extracted using a predefined data extraction tool by two independent reviewers. The risk of bias was assessed using the Cochrane risk of bias tool for randomised controlled trials. A five-node network meta-analysis was conducted based on the frequentist framework.

Results: Eight studies were included in this review. From the network meta-analysis, we found that verum acupuncture in the shallow needling controlled trials was more effective than verum acupuncture in the sham device controlled trials (SMD -7.27, 95% CI-9.11 to -5.43). Significant heterogeneity and inconsistency were not observed among the included studies or the comparisons.

Conclusions: From this preliminary analysis, we found that different types of verum acupuncture may have different effect sizes with respect to the severity of menopausal hot flashes.

Keywords: acupuncture; network meta-analysis; shallow needling; sham device; verum acupuncture.

Similar articles

  • Acupuncture for Acute Stroke
    M Xu et al. Cochrane Database Syst Rev 3, CD003317. PMID 29607495. - Review
    This updated review indicates that apparently improved outcomes with acupuncture in acute stroke are confounded by the risk of bias related to use of open controls. Adver …
  • Acupuncture for Menopausal Hot Flushes
    S Dodin et al. Cochrane Database Syst Rev 2013 (7), CD007410. PMID 23897589. - Review
    We found insufficient evidence to determine whether acupuncture is effective for controlling menopausal vasomotor symptoms. When we compared acupuncture with sham acupunc …
  • Verum Versus Sham Manual Acupuncture for Migraine: A Systematic Review of Randomised Controlled Trials
    Y Yang et al. Acupunct Med 34 (2), 76-83. PMID 26718001. - Review
    Current clinical evidence suggests that verum acupuncture is superior to sham acupuncture in migraine, reflected by a higher total effective rate and decreased recurrence …
  • Acupuncture for Symptomatic Gastroparesis
    KH Kim et al. Cochrane Database Syst Rev 12 (12), CD009676. PMID 30560568. - Meta-Analysis
    There is very low-certainty evidence for a short-term benefit with acupuncture alone or acupuncture combined with gastrokinetic drugs compared with the drug alone, in ter …
  • A Randomized Trial of Acupuncture for Vasomotor Symptoms in Post-Menopausal Women
    L Venzke et al. Complement Ther Med 18 (2), 59-66. PMID 20430288. - Randomized Controlled Trial
    This study showed that both shallow needling and verum acupuncture were effective treatments of post-menopausal vasomotor symptoms. Study subjects were not able to distin …

LinkOut - more resources