The quality of reporting in randomized controlled trials of acupuncture for knee osteoarthritis: A cross-sectional survey

Overall Reporting Quality of Randomized Controlled Trials of Acupuncture for Knee Osteoarthritis: A Systematic Review

Objective

To evaluate the reporting quality of randomized controlled trials (RCT) of acupuncture for knee osteoarthritis and explore factors associated with the reporting.

Study Design and Setting

Eight databases were searched from inception to August 2024 to assess the quality of acupuncture for knee osteoarthritis RCTs based on the CONSORT, the STRICTA, and the CONSORT-Outcomes. We performed regression analyses on pre-specified study characteristics to explore factors associated with reporting quality.

Results

One hundred and seventy-four RCTs were evaluated by 69 items from 3 checklists. Seventeen of 37 items on the CONSORT were under-reported (reported in less than 20% of RCTs), and the weakest reported item was why the trial ended or was stopped (0%). Four of 17 items on the STRICTA were under-reported, and the weakest reported item was the number of needle insertions per subject per session (9.2%). Eight of 17 items on the CONSORT-Outcomes were under-reported, and the weakest reported item was identifying any outcomes that were not pre-specified in a trial registry or trial protocol (0.6%). RCT locations include countries other than China, published in English, or funded were more likely to have better reporting.

Conclusion

RCTs of acupuncture for knee osteoarthritis need to focus more on reporting details of acupuncture interventions, the reporting of protocol amendment, and the complete reporting of outcome-related content. Journals should encourage authors to adhere strictly to reporting guidelines, which is necessary to improve the quality of reporting, which is very important for Chinese journals.

The quality of reporting in case reports of permanent neonatal diabetes mellitus: a cross-sectional study

BACKGROUND

Although randomized trials and systematic reviews provide the best evidence to guide medical practice, many permanent neonatal diabetes mellitus (PNDM) studies have been published as case reports. However, the quality of these studies has not been assessed. The purpose of this study was to assess the extent to which the current case reports for PNDM comply with the Case Report (CARE) guidelines and to explore variables associated with the reporting.

METHOD

Six English and four Chinese databases were searched from their inception to December 2022 for PNDM case reports. The 23 items CARE checklist was used to measure reporting quality. Primary outcome was the adherence rate of each CARE item and second outcome was total reporting score for each included PNDM case report. Linear and logistic regression analyses were used to examine the connection between five pre-specified predictor variables and the reporting quality. The predictor variables were impact factor of the published journal (<3.4 vs. ≥3.4, categorized according to the median), funding (yes vs. no), language (English vs. other language), published journal type (general vs. special) and year of publication (>2013 vs. ≤ 2013).

RESULT

In total, 105 PNDM case reports were included in this study. None of the 105 PNDM case reports fulfilled all 23 items of the CARE checklist. The response rate of 11 items were under 50%, including prognostic characteristics presentation (0%), patient perspective interpretation (0%), diagnostic challenges statement (2.9%), clinical course summary (21.0%), diagnostic reasoning statement (22.9%), title identification (24.8%), case presentation (33.3%), disease history description (34.3%), strengths and limitations explanation (41.0%), informed consent statement (45.7%), and lesson elucidation (47.6%). This study identified that the PNDM case reports published in higher impact factor journals were statistically associated with a higher reporting quality.

CONCLUSION

The reporting of case reports for PNDM is generally poor. As a result, this information may be misleading to providers, and the clinical applications may be detrimental to patient care. To improve reporting quality, journals should encourage strict adherence to the CARE guidelines.

How about the RCTs' quality of acupuncture treatment for female urinary incontinence in recent 20 years? A report quality assessment

PURPOSE

To evaluate the quality of randomized controlled trials (RCTs) of acupuncture on female urinary incontinence (UI).

METHODS

We searched for related RCTs of acupuncture on female UI from seven databases (PubMed, Embase, Cochrane library, Web of Science, Medline, ClinicalKey, and Clinical trials). We applied CONSORT (2010 year) and STRICTA criteria to evaluate the relevant factors of included RCTs. Two trained researchers scored independently, and concordance was assessed by Cohen's к-statistic. The median and interquartile range summarized the CONSORT and STRICTA scores of the included studies. In addition, two independent sample t tests were used to assess the differences in the study quality between the 2000-2010 and the 2011-2022 years.

RESULTS

A total of 25 RCTs were finally included, and the scores were consistent between different assessors. The average CONSORT score was 10.50 (IQR 9.0-15.0) (total score was 25.0). Overall, the studies generally included scientific background (24/25, 96%), inclusion and exclusion criteria (24/25, 96%), outcome indicators (24/25, 96%), randomization methods (21/25, 84%), generalizability (19/25, 76%), and financial support (15/25, 60%). Most lacked sample size calculation (5/25, 20%), type of randomization (5/25, 20%), blinding (6/25, 24%), case screening period and follow-up (4/25, 16%), and study registration (6/25, 24%), etc. The average STRICTA score was 3.380 (IQR 3.02-3.95) (total score was 6.0). There had a lack of education on treatment methods for patients (3/25, 12%) and the qualification of acupuncturists (6/25, 24%).

CONCLUSION

The overall quality of RCTs on acupuncture treatment of female UI was suboptimal. It is still necessary to improve the research methods, especially the application of random methods, blinding, the interpretation of treatment, and the identification qualification of acupuncturists.

Intervention reporting and dissemination of information for the management of hand osteoarthritis

INTRODUCTION

A variety of exercise programs are recognized to be effective for the management of hand osteoarthritis (HOA). It is important to report the essential elements of these exercise programs for clinicians to replicate properly and facilitate their implementation with individuals who suffers from HOA, especially if they are found to be effective programs.

PURPOSE OF THE STUDY

The objective of this article was to assess content reporting using three exercise reporting standardized assessment tools among exercise interventions randomized controlled trials (RCTs) involving individuals with HOA.

STUDY DESIGN

A descriptive study was used.

METHODS

Two pairs of trained assessors independently identified, selected, and scored the reporting quality of the exercise programs of RCTs on the management of HOA using three standardized assessment tools: the Consensus on Exercise Reporting Template (CERT) checklist, Consensus on Therapeutic Exercise Training (CONTENT) scale, and Template for Intervention Description and Replication (TIDieR) checklist to review the quality of reporting of 11 RCTs included in a recent Ottawa Panel guideline.

RESULTS

Based on consensus reached by two different pairs of reviewers and an arbitrator, the mean total scores for the 11 included exercise programs were reported as follows: the mean total score for the CERT, CONTENT, and TIDieR was 10.58/19 ± 4.34, 3.27/9 ± 1.90, and 5.92/12 ± 2.54, respectively. The overall Pearson's Correlation (r) between the methodological quality and intervention reporting was 0.86, 0.71, and 0.54 for moderate-to-high RCTs and 0.47, 0.79, and 0.42 for fair-to-poor methodological quality for the CERT checklist, CONTENT scale, and TIDieR checklist, respectively.

CONCLUSIONS

The intervention reporting in the management of HOA is poor among low-, moderate-, and high-quality clinical trials. The least reported information was intervention parameters related to behavior change. Improving reporting is recommended to ensure replication of effective exercise programs to enhance quality of life of individuals with HOA.

Do acupuncture trials have lower risk of bias over the last five decades? A methodological study of 4 715 randomized controlled trials

Objective

To evaluate the change of the risk of bias (RoB) of acupuncture randomized controlled trials (RCTs) in the past five decades.

Methods

Multiple databases were searched. We included RCTs identified from systematic reviews (SRs) on acupuncture. General characteristics and RoB judgment for each domain were extracted. The proportions of RCTs at high and unclear RoB were calculated and the changes were examined by the Mann-Kendall test.

Results

We included 368 SRs including 4 715 RCTs. The rates of RCTs at unclear RoB were the highest in allocation concealment (63%), and at the lowest in incomplete outcome data (35%); in the last five decades, statistically significant reductions were found for random sequence generation (P < 0.001) and selective reporting (P = 0.01), and increases for blinding of participants and personnel (P < 0.001), blinding of outcome assessment (P < 0.001) and incomplete outcome data (P = 0.04). For the proportions of RCTs at high RoB, blinding of participants and personnel (47%) and blinding of outcome assessment (35%) were the poorest domains; there were no significant differences in changes for all domains.

Conclusions

Although improvements concerning unclear risk were observed for random sequence generation and selective reporting, major issues remain for allocation concealment and blinding. It is imperative to use valid randomization, specify how it is conducted, and try to test for selection bias and the success of masking by using the Berger Exner test.

Isometric exercise, acupuncture, and magnet therapy for knee osteoarthritis: randomized clinical trial

Introduction: Knee osteoarthritis is a common disease, particularly in the elderly population. Degenerative disorders of the cartilage cause pain and stiffness in the knee joint. As a result, patients frequently experience limitation in their daily activities. Purpose: To compare the effects of exercise, acupuncture, and magnet therapy on symptoms and physical function among middle-aged and elderly people with knee osteoarthritis. Materials and methods: We carried out a parallel three-arm randomized clinical trial in an outpatient clinic of the Department of Physical Medicine and Rehabilitation at a University Hospital. In total, 60 female patients of age ≥ 40 years with chronic knee osteoarthritis were randomly allocated to one of three groups of isometric exercise, acupuncture, and magnet therapy. The primary outcome measure was subjective pain rated according to the Visual Analog Scale. We also used the Western Ontario McMaster Universities Osteoarthritis Index for assessing and monitoring the symptoms of knee osteoarthritis in order to evaluate the efficacy of the interventions. An isometric exercise program was prescribed, consisting of three sessions per week for six weeks. Participants in the acupuncture group received three treatment sessions per week for six weeks, each lasting for 30 minutes. For pulsed electro-magnetic field therapy, a total of three 30-minute sessions per week for a period of 6 weeks were administered to each patient. Results: There were no statistically significant differences between the study groups in terms of the outcome measures (all p values > 0.05). However, within-group analyses showed that there were significant differences regarding the clinical outcomes in each group (all p values < 0.05). Conclusion: All three therapeutic modalities are effective and could be used as the first line of treatment for knee osteoarthritis. Moreover, it should be noted that the favorable outcomes remained at least two months after treatment concluded.

Assessing the reporting quality in randomized controlled trials of acupuncture for postherpetic neuralgia using the CONSORT statement and STRICTA guidelines

Background

This study evaluates the reporting quality of randomized controlled trials (RCTs) on acupuncture use for the treatment of postherpetic neuralgia and explores related factors.

Methods

The following six databases PubMed, Embase, Cochrane Library, VIP, CNKI, and SinoMed, were systematically searched from their inception to December 2018. RCTs using acupuncture as an intervention for postherpetic neuralgia were selected and incorporated in this study. The reporting quality was assessed based on the CONSORT statement and the STRICTA guidelines. Regression analyses were also conducted on pre-specified study characteristics searching for factors associated with reporting quality.

Results

A total of 137 RCTs were included in this study. The CONSORT based median OQS was 12 (minimum 3, maximum 29). Of the items comprised in the statement, ten were sufficiently reported (reported in over 70% of trials). The remaining fifty-five items were poorly reported (reported by fewer than 5% of trials). The STRICTA based median OQS was 9 (minimum 2, maximum 15). The results showed that eight of the comprised items were well reported (reported in over 70% of trials), and only three were incompletely reported (reported in fewer than 20% of trials). Based on the CONSORT statement related analysis, a post-2010 publication (β coefficient 2.394, 95% confidence interval [CI] 1.168–3.620) and funding (β coefficient 4.456, 95% CI: 3.009–5.903) represented independent and significant predictors of a high overall reporting quality. However, only a funding source (β coefficient 1.305, 95% CI 0.219–2.391) was associated with an increased OQS based on STRICTA analysis.

Conclusion

The findings indicated that RCTs on acupuncture for PHN generally had a sub-optimal reporting quality, a situation that improved for those published after 2010 or with funding sources. Therefore, rigorous adherence to the CONSORT statement and the STRICTA guidelines should be emphasized in future studies.

A systematic review of quality of reporting in registered intimate partner violence studies: where can we improve?

BACKGROUND

Reporting quality is paramount when presenting clinical findings in published research to ensure that we have the highest quality of evidence. Poorly reported clinical findings can result in a number of potential pitfalls, including confusion of the methodology used or selective reporting of study results. There are guidelines and checklists that aim to standardize the way in which studies are reported in the literature to ensure transparency. The use of these reporting guidelines may aid in the appropriate reporting of research, which is of increased importance in highly complex fields like intimate partner violence (IPV). The primary objective of this systematic review is to assess the reporting quality of published IPV studies using the CONSORT and STROBE checklists.

METHODS

We performed a systematic review of three large study registries for IPV studies. Of the completed studies, we sought full text publications and used reporting checklists to assess the quality of reporting.

RESULTS

Of the 42 randomized controlled trials, the mean score on the CONSORT checklist was 63.5% (23.5/37 items, SD 4.7 items). There were also 12 pilot trials in this systematic review, which scored a mean of 49.3% (19.7/40 items; SD 3.3 items) on the CONSORT extension for pilot trials. We included 12 observational studies which scored a mean of 56.1% (18.5/33 items; SD: 4.1 items).

CONCLUSIONS

We identified an opportunity to improve reporting quality by encouraging adherence to reporting guidelines. There should be a particular focus on ensuring that pilot studies report pilot-specific items. All researchers have a responsibility to ensure commitment to high quality reporting to ensure transparency in IPV studies.