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A Meta-Analysis of Randomized Controlled Trials

Edzard Ernst, MD, PhD, FRCP(Edin); Adrian R. White, MD

Arch Intern Med. 1998;158:2235-2241.

Background  Acupuncture is commonly used to treat back pain, but there is no published meta-analysis of trials of its effectiveness for this condition.

Objective  To perform a meta-analysis of trials of acupuncture for the treatment of back pain.

Methods  A systematic literature search was conducted to retrieve all randomized controlled trials of any form of acupuncture for any type of back pain in humans. The adequacy of the acupuncture treatment was assessed by consulting 6 experienced acupuncturists. The main outcome measure for the meta-analysis was numbers of patients whose symptoms were improved at the end of treatment.

Results  Twelve studies were included, of which 9 presented data suitable for meta-analysis. The odds ratio of improvement with acupuncture compared with control intervention was 2.30 (95% confidence interval, 1.28-4.13). For sham-controlled, evaluator-blinded studies, the odds ratio was 1.37 (95% confidence interval, 0.84-2.25).

Conclusion  Acupuncture was shown to be superior to various control interventions, although there is insufficient evidence to state whether it is superior to placebo.

From the Department of Complementary Medicine, Postgraduate Medical School, University of Exeter, Exeter, England.

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