The use of systematic reviews in the design of randomized controlled trials of acupuncture: a systematic review

摘要

Purpose: One of the major purposes of systematic reviewis to guide future randomized studies to resolve current conflictsor address uncertainty in clinical practice. Concerns havebeen raised regardingwaste in research due to inadequate useof existing evidence for designing future research. We aimedto investigate how systematic reviews have been used in thedesign of randomized trials of acupuncture.Methods: Protocols for randomized trials of acupuncturewith trial registration number published from January 2008to April 2013 were searched through four English databases(EMBASE, MEDLINE, CENTRAL and AMED). Full-list of referencetitles in included study protocolswas screened to identifycited systematic reviews.Results: Thirty-eight protocols that referenced a total of108 systematic reviews were eligible. Thirty-seven protocols(97%) cited at least one review (median value of 3). Reviewswere predominantly used for identifying current evidence levelsof diseases/conditions or available treatments in 36 of 37review-cited protocols (95%). Other areas of use included justificationof study interventions and comparisons (n=13; 34%),estimation of the difference to detect or margin of equivalence(n=2; 5%), formulation of acupuncture details (n=2; 5%), estimationof the control group event rate (n=2; 5%), selection ordefinition of outcome (n=6; 16%), collection and analyses ofadverse events (n=3; 8%), duration of follow-up (n=0; 0%) andother areas that were not directly related to the design of therespective protocol (n=7; 18%). Eighteen of 37 protocols (49%)cited systematic reviews to inform at least one aspect of thedesign of the trial.Conclusion: Most protocols used systematic reviews for thepurpose of background description and only about a half ofthem cited systematic reviews to inform the design. Adequateuse of systematic reviews is needed to design future acupuncturetrials in context of the existing evidence and to avoidunnecessary redundancy of research.