18 sessions over 6 weeks
12 weeks
No
Appendix 8: CASP Critical Appraisal
Macklin et al., 2006 | Flachskampf et al., 2007 | Yin et al., 2007 | Kim et al., 2012 | Zheng et al., 2016 | Zheng et al., 2018 | |
Did the trial address a clearly-focused issue? | Yes – the effect of acupuncture on hypertension | Yes – the effect of acupuncture on hypertension | Yes – the effect of acupuncture on hypertension | Yes – the effect of acupuncture on hypertension in relation to the circadian rhythm | Yes – the effect of acupuncture on hypertension in relation to brain electrical activity | Yes – the effect of acupuncture on hypertension |
Was the assignment of patients to treatments random-ised? | Yes – process of randomisation not specified | Yes – process of randomisation not specified | Yes – process of randomisation not specified | Yes – through a manual process of randomisation | Yes – process of randomisation not specified | Yes – through an electronic process of randomisation |
Were all of the patients who entered the trial properly accounted for at its conclusion? | Yes – as per flowchart (p.840) | Yes – as per flowchart (p.3124) | Yes – as per flowchart (p.1149) | Yes – as per flowchart (p.919) | Yes – as per flowchart (p.3) | Yes – as per flowchart (p.415) |
Were patients and study personnel ‘blind’ to treatment? | No | No | No | No | No | No |
Were the groups similar at the start of the trial? | Yes – most participants identified as ‘White’, but there were no other significant differences | Yes – there were no significant differences between the groups at baseline | Yes – there were no significant differences between the groups at baseline | Yes – there were no significant differences between the groups at baseline | Yes – there were no significant differences between the groups at baseline | Yes – there were no significant differences between the groups at baseline |
Aside from the experi-mental intervention, were the groups treated equally? | Yes | Yes | Yes | Yes | Yes | Yes |
How large was the treatment effect? | Measured to the nearest 0.1 mmHg | Measured to the nearest 0.1 mmHg | Measured to the nearest 0.01 mmHg | Measured to the nearest 0.0+1 mmHg | Measured to the nearest 0.01 mmHg | Measured to the nearest 0.1 mmHg |
How precise was the estimate of the treatment effect? | Precise: measured using p-values with confidence intervals | Precise: measured using p-values with confidence intervals | Precise: measured using p-values with confidence intervals | Precise: measured using p-values with confidence intervals | Precise: measured using p-values | Precise: measured using p-values with confidence intervals |
Can the results be applied to the local population, or in your context? | Yes – showed active acupuncture is no more effective than sham acupuncture for reducing systolic or diastolic BP | Yes – showed active acupuncture is more effective than sham acupuncture for reducing systolic or diastolic BP. However, the effects of the acupuncture are notsustained | Yes – showed active acupuncture is more effective than sham acupuncture for reducing BP | Yes – showed active acupuncture may be more effective than sham acupuncture for reducing nighttime diastolic BP only | Yes – showed active acupuncture may be more effective than sham acupuncture for reducing systolic BP only | Yes – showed active acupuncture is more effective than sham acupuncture for reducing BP |
Were all clinically-important outcomes considered? | Yes – age, race, gender, baseline BP, history of anti-hypertensive medication use, obesity, primary TCM diagnosis | Uncertain – there was a focus on baseline BP only | Uncertain – the potential confounders controlled for in analysis (if any) were not specified | Uncertain – the potential confounders controlled for in analysis (if any) were not specified | Uncertain – the potential confounders controlled for in analysis (if any) were not specified | Uncertain – the potential confounders controlled for in analysis (if any) were not specified |
Are the benefits worth the harms and costs? | Two patients in the active acu |
