Reliability of Results from Randomized Studies and Systematic Reviews in Acupuncture: A Methodological Review for...

Acupuncture is a method of traditional Chinese medicine that has been adapted in the Western world. However, the exact mechanism behind the effect of acupuncture is still unclear. The objective of this study was to critically assess the evidence presented in randomized controlled trials (RCTs) and systematic reviews (SRs) about the effectiveness of acupuncture on menopausal symptoms in breast cancer patients.

A systematic search was conducted in February 2025 using five databases [Medline (Ovid), CINAHL (EBSCO), EMBASE (Ovid), Cochrane CENTRAL and PsycINFO (EBSCO)]. All RCTs were evaluated with the RoB 2 tool, and all SRs were evaluated with the AMSTAR-2 instrument.

Fifteen RCTs and 10 SRs on hot flashes were included. The methodological quality of the RCTs and SRs was rather poor. For musculoskeletal symptoms, 7 RCTs and 9 SRs were included, which were also of low methodological quality. Thus, no reliable effects of acupuncture on hot flashes and on musculoskeletal symptoms can be found.

The methodological quality of both RCTs and SRs is generally substandard. The validity of the SRs' findings is doubtful given the poor quality of the RCTs they are based on. Despite the apparent abundance of RCTs and SRs, there is no definitive evidence regarding the efficacy of acupuncture in alleviating menopausal symptoms.