Does brain entrainment using binaural auditory beats affect pain perception in acute and chronic pain?: a systematic review

Table 2 GRADE evidence profile for binaural beats effects in acute and chronic pain

Outcomes		Quality assessments					Number of participants		Overall Quality of Evidence
Outcomes	Number of studies	Risk of bias	Inconsistency	Indirectness	Imprecision	Publication bias	Binaural beats	Control
Chronic pain perception	2 RCTs Gkolias,2020 Thanyawinichkul,2022	Serious^a	Not serious^b	Not serious^c	Very serious^d	Undetected^e	20 10	20 12	⊕⊕⊖⊖ Low^f
Acute pain perception	8 RCTs Dabu-Bondoc,2010 Kurdi,2018 Roshani,2019 Olcucu,2021 Tani,2021 Tani,2022 Loong,2022 Nelson,2023	Very serious^g	Very serious^h	Not serious^c	Very serious^d	Undetected^e	20 59 30 102 20 42 31 20	20 62 30 127 20 48 30 20	⊕⊖⊖⊖ Very lowⁱ
Perioperative analgesic consumption	5 RCTs Kliempt,1999 Lewis,2004 Dabu-Bondoc,2010 Tani,2021 Bae,2023	Serious^a	Serious^j	Serious^k	Very serious^d	Undetected^e	25 30 20 20 63	26 30 20 20 60	⊖⊖⊖⊖ Very lowⁱ

^a Two of the five risk of bias domains were judged as unclear or high in most studies
^b I-squared statistic (I²) < 50.0%
^c Population, interventions, and outcome measures were representative of our inclusion criteria
^d Wide confidence interval (CI) around the estimate of the effect (estimated by forest plots)
^e Based on Begg’s and Egger’s tests (P > 0.05)
^f The confidence in the effect estimate is limited (The true effect may be substantially different from the estimate of the effect)
^g More than two of the five risk of bias domains were judged as unclear or high in most studies
^h I-squared statistic (I²) > 75.0%
ⁱ There is very little confidence in the effect estimate (The true effect is likely to be substantially different from the estimate of effect)
^j I-squared statistic 50.0%< (I²) < 75.0%
^k outcome measure was not representative of our inclusion criteria

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