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Use of statistical methods among acupuncture randomized controlled trials was far from satisfactory
Jiali Liu1, Xiaochao Luo1, Minghong Yao1
1Chinese Evidence-based Medicine Center and Cochrane China Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China; NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu 610041, Sichuan, China; Sichuan Center of Technology Innovation for Real World Data, Chengdu 610041, Sichuan, China.
Statistical methods in acupuncture randomized controlled trials (RCTs) are inadequate. This review highlights the need for improved statistical practices in acupuncture research to ensure reliable results.
Area of Science:
- Medical Statistics
- Clinical Trials
- Acupuncture Research
Background:
- Statistical methodology is crucial for the validity of randomized controlled trials (RCTs).
- The application of appropriate statistical methods in acupuncture RCTs requires examination.
Purpose of the Study:
- To assess the utilization of suitable statistical methods in acupuncture RCTs.
- To compare statistical practices between trials published in core clinical journals and complementary and alternative medicine (CAM) journals.
Main Methods:
- A systematic search of PubMed was conducted for acupuncture RCTs with continuous primary outcomes published between 2010 and 2019.
- Included trials were analyzed for predefined primary outcomes, intention-to-treat analysis, handling of missing participant data, repeated measures analysis, and adjustment for multiple acupuncturists.
Main Results:
- Out of 262 included RCTs, only 50.4% clearly predefined the primary outcome, and 27.5% used intention-to-treat analysis.
- Suboptimal methods for handling missing participant data were used in 70.7% of relevant trials, and only 13.0% employed advanced statistical models for repeated measures.
- Trials in core clinical journals demonstrated superior statistical reporting compared to those in CAM journals, particularly in outcome definition and handling of missing data.
Conclusions:
- The current application of statistical methods in acupuncture RCTs is unsatisfactory.
- There is a critical need for researchers to adopt optimal statistical methodologies.
- Journal editors should enforce stricter standards for statistical reporting in acupuncture research.
