Research On The Quality Of Systematic Reviews And Randomized Controlled Trials Of Acupuncture And Cognition Of Reporting Guideline

Background China’s own needs for innovation-oriented country construction calls for the innovation and development of Traditional Chinese Medicine (TCM). Based on the rationale of Meridian theory, theoretical system of TCM theory is different from that of western medicine.The increasing number of systematic reviews/meta-analysis (SRs/MAs) and randomized controlled trials (RCTs) in Chinese and international journals, what are their methodological and reporting quality? Has the information in clinical evidence on acupuncture met the needs of clinician on acupuncture? Questions like these are all worthy of further study, which has important significance for researches and practices in the field of TCM.Objective1) To evaluate the quality of SRs/MAs and the reporting characteristic of their included randomized controlled trials (RCTs) of acupuncture.2) To investigate the cognition of relevant reporting guideline for researchers and the requirement of the acupuncture-specific information for clinician of acupuncture.3) To discuss the bottle-neck problems that has limited its innovation and development of acupuncture, possible measures for the improvements of the quality of clinical studies of acupuncture and knowledge translation.Methods1) Evidence-based Practice conception and strategies;2) Systematic review;3) Scientific combination of qualitative and quantitative research methods.4) Use of questionnaires. Research questions were formulated by using the PICOS method. Relevant SRs/MAs were comprehensively collected in Chinese and English databases through internet searching. The quality of methodology was assessed by developing a systematic review. Reporting quality was assessed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklists and checklists for SRs/MAs on acupuncture-specific information. We assessed the reporting quality of included RCTs of acupuncture by using the checklist of Consolidated Standards of Reporting Trials (CONSORT) and Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA). We also designed questionnaires which were later taken by researchers and clinician of acupuncture. The content of questionnaires was mainly on "the cognition of Preferred Reporting Items for Systematic Reviews and Meta-Analyses" and "the requirement of reporting information of clinical evidence of acupuncture". Finally, data were analyzed via SPSS software.Results1) A total number of327SRs/MAs of Acupuncture&Moxibustion and their included363RCTs were identified in this study, which showed that their reporting quality was poor. The Cochrane "risk of bias" tool has not been used in all SRs/MAs of acupuncture since2009. Even whenthe ROB tool was used, reporting of relevant information was still incomplete. Scores of the PRISMA showed a significant difference among the SRs/MAs in CSRs, international journals and Chinese journals. Scores of the PRISMA of CSRs are higher than those in Chinese journals and international journals. There was significant difference (P=0.000) in scores of the information of acupuncture characteristic among the CSRs, Chinese journals and International Journals. Their scores of information of acupuncture characteristics in CSRs were the highest, while scores in Chinese journals were the lowest (P=0.000). Scores of the PRISMA and the information of acupuncture characteristic of SRs/MAs in SCI journals were higher than those in non-SCI journals (P=0.000). As for the included363Chinese’s and English RCTs of acupuncture, scores of CONSORT of RCTs in2006-2010were higher in English than in Chinese (P=0.000). However, scores of STRICTA in2006-2010in English RCTs were similar to these in Chinese RCTs (P=0.440). Compared with these in2001-2005, scores of CONSORT in2006-2010were significantly higher than in both English and Chinese RCTs (Chinese:P=0.011; English: P=0.001). Besides, scores of STRICTA in both English and Chinese RCTs in2006-2010were similar to RCTs in2001-2010(Chinese:P=0.853; English:P=0.317).2) Few interviewers knew PRISMA statement and their content well. Although there was a high requirement of acupuncture-specific information from clinician of acupuncture. The reporting and requirement information of clinical evidence has not met the need of clinician on acupuncture.3) Suggestions for policy on the quality of clinical evidence and knowledge translation include a gradually development of following factors:Research projects, standard establishment, training transformation, afte-effect evaluation, site inspection and acceptance, promotion after consensus, validation expansion, after-effect evaluationand continuous improvement.Conclusions This study showed that the quality of SRs/MAs and reporting quality of their included RCTs of acupuncture were very poor. Meanwhile, it is hard for readers to understand and assess the validity, reliability and practicality of results due to poor reporting quality. The fact that only a few people in China know the PRISMAS statement and the reporting information can not meet the need of clinician on acupuncture. So researchers should pay more attention to scientifical design, scrupulous implementation and comprehensive reporting. We should learn and use those reporting guideline to improve the quality of SRs/MAs and RCTs on acupuncture, to develop a reporting guideline based on acupuncture practice, which can then be used for clinical practice and provide a reference for evidence-based on clinical decision making.