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Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis
Individual patient data meta-analysis of 39 high-quality RCTs (20,827 patients) finds acupuncture superior to sham and to no-acupuncture control for musculoskeletal pain, osteoarthritis, chronic headache, and shoulder pain, with effects persisting at one year with modest attenuation.
Design
- IPD MA update through 31 Dec 2015
- Trials: 39 RCTs with unambiguous allocation concealment, 20,827 patients total
- Indications: non-specific musculoskeletal pain, osteoarthritis, chronic headache, shoulder pain
- Comparators: sham acupuncture and no acupuncture controls
Headline effects (abstract)
- Acupuncture superior to sham and to no acupuncture for each indication (P < 0.001)
- Standardised mean differences ~0.2 vs sham and ~0.5 vs no acupuncture (pain scales)
- Persistence: at 1 year, treatment effects ~15% smaller than immediately post course
Evidence hygiene
- Sham type modulates effect (penetrating sham shows smaller gaps vs real acupuncture).
- Clinical significance of 0.2 SMD vs sham remains debated—read GRADE-style discussions in the paper.
Publication
Vickers AJ, Vertosick EA, Lewith G, et al. J Pain. 2018 May;19(5):455-474. PMID 29198932.
Outcomes
- Effect Size (Cohen's d / SMD)-0.5d (Cohen's d)
- Effect Size (Cohen's d / SMD)-0.2d (Cohen's d)