Acupuncture for post-stroke depression: a systematic review and meta-analysis

Table 2 Quality of evidence of included reviews according to GRADE

Certainty Assessment							No. of Patients
No. of Studies	Reference No.	Risk of Bias	Inconsistency	Indirectness	Imprecision	Publication Bias	Treatment Group	Control Group	Effect (95% CL)	Certainty
Acupuncture/EA (+placebo) compared to antidepressants (+sham acupuncture)
HAM-D₁₇
5	[25, 30, 33, 34, 37]	serious ^a	serious ^b	not serious	serious ^c	none	130	127	MD −0.43 (−1.61, 0.75)	⨁◯◯◯VERY LOW
HAM-D₂₄
2	[24, 27]	serious ^a	serious ^d	not serious	very serious ^c	none	60	60	MD −3.09 (− 10.81, 4.63)	⨁◯◯◯VERY LOW
HAM-D
4	[29, 31, 32, 36]	serious ^a	serious ^e	not serious	not serious	none	225	269	MD − 1.55 (−4.36, 1.26)	⨁⨁◯◯LOW
Adverse events
5	[29,30,31, 34, 37]	serious ^a	not serious	serious ^f	serious ^c	none	4/153 (2.6%)	30/143 (21%)	RR 0.16 (0.07, 0.39)	⨁◯◯◯VERY LOW
Acupuncture/EA + conventional treatment compared to conventional treatment
HAM-D₁₇
3	[26, 28, 37]	serious ^a	not serious	not serious	serious ^c	none	126	126	MD −5.08 (−6.4, − 3.67)	⨁⨁◯◯LOW
HAM-D₂₄
2	[16, 35]	serious ^a	serious ^g	not serious	very serious ^c	none	63	60	MD −9.72 (−14.54, − 4.91)	⨁◯◯◯VERY LOW
HAM-D
2	[17, 24]	serious ^a	not serious	not serious	very serious ^c	none	79	78	MD −2.72 (−3.61, − 1.82)	⨁◯◯◯VERY LOW
Adverse events
2	[17, 37]	serious ^a	not serious	serious ^f	very serious ^c	none	5/79 (6.3%)	8/79 (10.1%)	RR 0.66 (0.15,2.89)	⨁◯◯◯VERY LOW

CI confidence interval, MD mean difference, RR relative risk, HAM-D Hamilton Depression Scale, HAM-D₁₇ HAM-D scale-17 items, HAM-D₂₄ HAM-D scale-24 items
^aThis trial had a large bias in randomization, allocation concealment, blinding, or selective reporting; ^bI² = 51%; ^cSmall sample size; ^dI² = 90%; ^eI² = 95%; ^fThis is a secondary outcome; ^gI² = 65%

ISSN: 2662-7671