Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
Italian National Institute of Health, Rome, Italy.
BMC Complement Med Ther. 2020 Oct 14;20(1):307. doi: 10.1186/s12906-020-03099-9.
Many systematic reviews of clinical trials on acupuncture were performed within the Cochrane Collaboration, the evidence-based medicine (EBM) most recognized organization. Objective of the article was to systematically collect and identify systematic reviews of acupuncture published in the Cochrane Library and assess their quality from a methodological perspective.
A comprehensive literature search was performed in the Cochrane Database of Systematic Reviews to identify the reviews of acupuncture conducted until June 2019. The methodological quality of the included reviews was assessed using the AMSTAR 2 checklist, an evaluation tool for systematic reviews.
Out of a total of 126 eligible reviews, 50 systematic reviews were included. According to the AMSTAR 2, 52% of Cochrane Systematic Reviews (CSRs) were of low quality, due to the presence of one or more weaknesses in at least one of the domains defined as critical for the methodological quality assessment. The less satisfied critical domain was inadequate investigation and discussion of publication bias. Declaration of potential sources of conflict of interest, and funding of the authors of the review and of the included studies were other important weaknesses.
The main methodological flaws in the included CSRs were related to topics of relatively new concern in the conduction of systematic reviews of the literature. However, both, lack of attention about retrieval of negative studies, and statements about conflict of interests are crucial point for the evaluation of therapeutic interventions according to EBM methodology.
许多针对针灸的临床试验系统评价都是在循证医学（EBM）最认可的 Cochrane 协作组织内部进行的。本文的目的是系统地收集和识别 Cochrane 图书馆中发表的针灸系统评价，并从方法学的角度评估其质量。
在 Cochrane 系统评价数据库中进行了全面的文献检索，以确定截至 2019 年 6 月进行的针灸系统评价。使用 AMSTAR 2 检查表评估纳入的系统评价的方法学质量，这是一种用于系统评价的评估工具。
在总共 126 篇合格的综述中，有 50 篇系统综述被纳入。根据 AMSTAR 2，52%的 Cochrane 系统评价（CSRs）质量较低，因为在定义为评估方法学质量的关键领域之一中至少存在一个或多个弱点。不太满意的关键领域是对发表偏倚的调查和讨论不足。潜在利益冲突的声明，以及综述作者和纳入研究的资金来源也是其他重要的弱点。
纳入的 CSR 中的主要方法学缺陷与文献系统评价中相对较新的关注主题有关。然而，缺乏对检索阴性研究的关注以及关于利益冲突的声明，根据循证医学方法，这些都是评估治疗干预的关键要点。
