STRICTA 권장안에 기초한 침 연구방법론의 적절성 평가 - 새로운 평가지수를 이용한 5편 Systematic Review와 그 대상인 58편 무작위대조시험의 고찰 - = The Assessment of Appropriateness of Acupuncture Methodology Based on STRICTA Recommendations -The Discussion of 5 Systematic Reviews and Their Objects 58 Randomized Controlled Trials Using the New Tool -

다국어 초록 (Multilingual Abstract)

Backgraounds : Recent studies provide the evidences that the efficacy of acupuncture may be no better than placebo or inconclusive. These results are very different from those of the actual clinical situations in many acupuncture medical institutions.
Objectives : The present study was designed to evaluate the influencing factors which affect the efficacy of acupuncture scale(FEAS) as the methodological assessment tool of acupuncture for examining acupuncture interventions and to demonstrate the importance of it in randomized controlled trials of acupuncture.
Data sources : Electronic data were retrieved from NDSL, Pubmed, sciencedirect, LWW, OVID, Black- Well Synergy, Wiley Interscience, EBSCO HOST, springer, PML, and Kluwer. No electronic data were collected from MEDLIS and MEDLAS.
Study selection : The inclusion criteria were five systematic reviews included in Alberta study and all randomized controlled trials obtained from their references.
Study analysis : The acupuncture rationale, methods of stimulation, treatment regimen, and the prac- titioner’s background were rated by FEAS, and the scores were compared with those by other methodo- logical assessment tools.
Results : The number of positive conclusions of high-rank RCTs by FEAS was the same as or higher than that of high-rank RCTs by other methodological assessment tools.
Conclusions : We have analysed 5 systematic reviews and their objectives 58 RCTs using FEAS. Prac- titioner’s background has been described slightly in some reviews and studies. It may directly influence the effectiveness of acupuncture negatively in the systematic reviews.

다국어 초록 (Multilingual Abstract)

Backgraounds : Recent studies provide the evidences that the efficacy of acupuncture may be no better than placebo or inconclusive. These results are very different from those of the actual clinical situations in many acupuncture medical institutions.
Objectives : The present study was designed to evaluate the influencing factors which affect the efficacy of acupuncture scale(FEAS) as the methodological assessment tool of acupuncture for examining acupuncture interventions and to demonstrate the importance of it in randomized controlled trials of acupuncture.
Data sources : Electronic data were retrieved from NDSL, Pubmed, sciencedirect, LWW, OVID, Black- Well Synergy, Wiley Interscience, EBSCO HOST, springer, PML, and Kluwer. No electronic data were collected from MEDLIS and MEDLAS.
Study selection : The inclusion criteria were five systematic reviews included in Alberta study and all randomized controlled trials obtained from their references.
Study analysis : The acupuncture rationale, methods of stimulation, treatment regimen, and the prac- titioner’s background were rated by FEAS, and the scores were compared with those by other methodo- logical assessment tools.
Results : The number of positive conclusions of high-rank RCTs by FEAS was the same as or higher than that of high-rank RCTs by other methodological assessment tools.
Conclusions : We have analysed 5 systematic reviews and their objectives 58 RCTs using FEAS. Prac- titioner’s background has been described slightly in some reviews and studies. It may directly influence the effectiveness of acupuncture negatively in the systematic reviews.

참고문헌 (Reference)

1 "placebo in the common migraine" 7 499-6 500, 1987

2 "double blind evalua- tion of trigger point injection therapy for low back pain" 962-4, 1989

3 "a review of con- trolled trials" 799-802, 1991

4 "Zur neuroregulativen Wirkung der Akupunktur bei Kopfschmerz- patienten" Weinchrtz T 106-17, 1994

5 "Zum Stellenwert der Akupunktur in der Migranetherapie" 14 : 295-301, 1995

6 "User’s guide to the orthopaedic literature How to use a systematic literature review" 1672-1679, 2002

7 "Treatment of obesity by acupuncture Ame- rican Journal of Clinical Nutrology" 832-5, 1976

8 "Treatment of low back pain with acupuncture" 303-6, 1976

9 "Treating chronic headache by means of acupuncture, A clinical trial" 15 : 14-25, 2000

10 "Traditional Chinese acupuncture in tension type headache" t : 325-9, 1992

11 "The potential and limitations of meta-analysis" 89-92, 1991

12 "The national oriental medical school" The acupuncture text book 1391-, 1999

13 "The effects of acupuncture versus placebo in the treatment of headache" 35-42, 1985

14 "The effectiveness of acupuncture in the management of acute and chronic low back pain" A systematic review within the framework of the Cochrane Collaboration Back Review Group 24 (24): 1113-1123, 1999

15 "The effectiveness of acu- puncture in the management of acute and chronic low back pain" 24 (24): 1113-1123, 1999

16 "The clinical evaluation of traditional East Asian systems of medicine" 3 : 16-19, 2002

17 "The acupuncture treat- ment of low back pain American Journal of Chinese Me- dicine" 1980181-9

18 "The acupunc- ture treatment of neck pain American Journal of Chi- nese Medicine" 326-32, 1981

19 "The CONSORT statement: revised recommandations for improving the quality of reports of parallel- group randomized trials" 357 : 1191-1194, 2001

20 "Testing traditionally based systems of acupuncture" 4 : 84-87, 2003

21 "Teasing apart quality and validity in systemic reviews an example from acupuncture trials in chronic neck and back pain" 86 : 119-132, 2000

22 "Systematic review: method- ology for clinical acupuncture studies" Seoul National Univ 2005

23 "Systematic review of randomised clinical trials of complementary/alternative therapies in the treatment of tension type and cervicogenic headache" 7 : 142-155, 1999

24 "Systematic review of acupuncture-are there problems with these" 2 : 17-22, 2000

25 "Superficial acuuncture in the re- lief of chronic low back pain Annals of the Royal College of Surgeons of England" 44-6, 1983

26 "Standards for reporting interventions in controlled trials of acupuncture, The STRICTA recommendations, STandards for Reporting Interventions in Controlled Trails of Acupuncture" 20 (20): 22-25, 2002

27 "Single-point transcutaneous electric nerve stimulation in a simple place- bo comparison in migraine Zeitschrift fur artzliche Fort- bildung und Qualitatassicherung" 881-3, 1989

28 "Richardson WS, Evidence Based Medicine, what it is and what it isn't" 312 : 71-72, 1996

29 "Problems with systemic reviews of acupuncture What should we do about these" 5 : 105-108, 2004

30 "Problems with systemic reviews of acupuncture What should we do about these" 4 : 105-108, 2004

31 "Management of migraine using acupuncture in a double-blind study Health status in patients with tension headache treated with acupuncture or physiotherapy" 669 131-73 41, 19781990

32 "Ling Shu or The Spiritual Pivot translated by Wu Jing-Nuan" The Taoist Center 1993

33 "Laseracupuncture in migraine therapy-methodological considerations and results of a randomized controlled clinical and electrophysical study" 27 : 159-170, 1999

34 "Laser acupuncture in migraine therapy and its effects on humoral parameters" 28 : 32-43, 2000

35 "Laser acupuncture for migraine and muscle tension headache : a double-blind controlled trial" 16 : 73-76, 1998

36 "Issues to consider in determining and adequate treatment in a clinical trial of acupuncture" 5 : 8-12, 1997

37 "Interventions for preventing obesity in children(Cochrane Review)" UK :The Cochrane Library 2005.2

38 "Imprtance of modes of acupunca Anaesthesiologica Scandinavica" 63-9, 1994

39 "Guidelines for clinical research on acupuncture" 14 : 1995

40 "Foundation for Acupuncture Resaerch, Acupuncture and Electroacupuncture" Evidence Based Treatment Guidelines 2004

41 "Explanation of Columns in Natural Standard Evidence"

42 "Evidence from Sys- tematic Reviews and Meta-analyses HTA 27 Series A Health Technology Assessment March 2002 Alberta Heritage Foundation for Medical Research"

43 "Evaluation of the re- sults of treatment of low backache by acu- puncture or suggestin" 405-9, 1979

44 "Electroacupuncture and exercise in body weight reduction and their application in rehabilitating patients with knee os- teoarthritis" 13 : 15-25, 1995

45 "Effectiveness of acupuncture and physiotherapy on myogenic headache" 141-50, 1984

46 "Effect of acupuncture in ten- sion headache" 140-8, 1992

47 "Effect of acupuncture and nal- oxone in patients with osteoarthritis pain" Pain Clin 155-61, 1991

48 "Ef- ficacy of electroacupuncture and TENS in the rehabilitation of chronic low back pain pa- tients" 277-90, 1986

49 "Dry needling of muscle motor points for chronic low-back pain a randomized cli- nical trial with long-term follow-up" 279-91, 1980

50 "Does quality of reports of randomized trials affect estimates of intervention efficacy reported in meta-analyses" 352 : 609-613, 1998

51 "Does pyschological testing help to predict the res ponse to acupuncture or massage/relaxation therapy in patients presenting to a general neurology clinic with headache" 17 : 130-139, 1997

52 "Comparison of the effectiveness of drug therapy invasive and non-invasive acupuncture in migraine Zeits- chrift fur artzliche Fortbildung und Qualita- tassicherung" 877-9, 1989

53 "Clinical trials of acupuncture: consensus recommendations for optimal treatment, sham controls and blinding" 9 : 237-245, 2001

54 "Clinical research on acupuncture, Part 2, Controlled clinical trials, an overview of their methods" 10 (10): 481-48, 2004

55 "Clinical research on acupuncture, Part 1, What have reviews of the efficacy and safety of acupuncture told us so far?" 10 (10): 468-480, 2004

56 "Auricular acupuncture therapy" Daesung Pulisher 175-179, 1999

57 "Aupuncture/acupressure for weight reduction?" Wien Klin Wochenschr 109 (109): 60-62, 1997

58 "American Jour- nal of Acupuncture" 151-3, 1975

59 "Acupuncture versus medical treatment for migraine and muscle tension headaches Jour- nal of neurology" 333-7, 1984

60 "Acupuncture treat- ment of chronic tension headache-a control- led cross-over trial" 137-42, 1985

61 "Acupuncture in chron- ic cervical pain British Journal of Rheuma- toloty" 1986

62 "Acupuncture for the relief of cancer ralated pain a systematic review" 9 : 437-444, 2005

63 "Acupuncture for recurrent headaches, a systematic review of randomized controlled trials" 19 (19): 779-786, 1999

64 "Acupuncture for migraine and headache in primary care: a protocol for a pragmatic" 7 (7): 13-18, 1999

65 "Acupuncture for labor pain management, A systematic review" 191 : 1573-1579, 2004

66 "Acupuncture for idiopathic headache" 1 (1): 2001

67 "Acupuncture for back pain a meta analysis of randomized controlled trials" 158 : 2235-2241, 1998

68 "Acupuncture for Osteoarthritis of Knee: a systematic review" 44 (44): 819-825, 2001

69 "Acupuncture and the treatment of chronic low-back pain, a review of the literature" 29 : 112-118, 1999

70 "Acupuncture and the opioid system : implications in management of migraine" 17 : 129-133, 1997

71 "Acupuncture and sciatica in the acute phase Double blind study of 30cases" 3109-14, 1983

72 "Acupuncture and laser treat- ment in cervical and lumbar syndrome" sch (sch): 1360-6, 1981

73 "Acupuncture analgesia during surgery, a systematic review" 114 : 511-517, 2005

74 "Acu- puncture versus metoprolol in migraine pro- phylaxis a randomized trial of trigger point inactivation Journal of Internal Medicin" 451-6, e1994

75 "AAOS clinical guideline on osteoarthritis of the knee phase Ⅱ support document Available from www"

76 "A trial method for as- sessing the adequacy of acupuncture treatments" 4 : 66-71, 1998

77 "A systematic review of randomized controlled trials of acupuncture for neck pain" 38 : 143-147, 1999

78 "A randomized placebo-controlled clinical trial of an acupressure device for weight loss" 19 : 653-658, 1995

79 "A muscle and vascular-oriented relaxation program for the treatment of chronic migraine patients Zeitschrift fur psychosomatische Medizin und Psycho- analyse" 247-66, 1985

80 "A controlled trial of the treat- ment of migraine by acupuncture Clinical Journal of Pain" Vincent CA 305-12, 1989

81 "A controlled trial of arthroscopic surgery for osteoarthritis of the knee" 247 (247): 81-88, 2002

82 "A comparison of laser acupuncture versus placebo in radicular and pseudoradicular pain syndromes as recorded by subjective responses of patients" 207-16, 1986

83 "A comparative study on the treatment of migraine headache with combined distant and local acupuncture points versus conventional drug therapy" 27 : 27-30, 1999