The Effect of Patient Characteristics on Acupuncture Treatment Outcomes: An Individual Patient Data Meta-Analysis of 20,827 Chronic Pain Patients in Randomized Controlled Trials.
The Effect of Patient Characteristics on Acupuncture Treatment Outcomes: An Individual Patient Data Meta-Analysis of 20,827 Chronic Pain Patients in Randomized Controlled Trials.
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患者特征对针灸治疗结果的影响：随机对照试验中 20,827 名慢性疼痛患者的个体患者数据荟萃分析。
DOI：
10.1097/ajp.0000000000000691
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
AcupunctureTrialists’Collaboration
中科院分区：
文献类型：
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作者：
Witt,ClaudiaM;Vertosick,EmilyA;Foster,NadineE;Lewith,George;Linde,Klaus;MacPherson,Hugh;Sherman,KarenJ;Vickers,AndrewJ;AcupunctureTrialists’Collaboration
目的：最佳选择慢性疼痛患者进行不同的治疗，因为确定可能调节治疗效果的患者特征是有意义的。我们的目的是使用大数据集评估可能的调节因素对针灸治疗效果的影响。方法：我们使用针灸治疗慢性头痛和偏头痛、骨关节炎以及背部、颈部和肩部疼痛的高质量随机试验的个体患者数据荟萃分析的数据。使用荟萃分析试验级和患者级回归分析，我们探讨了 5 项记录的患者特征（患者基线年龄、性别、疼痛持续时间、基线疼痛严重程度和基线心理困扰）对针灸效果的影响。 结果：共有 39 项试验符合纳入标准：25 项使用假针灸对照（n = 7097），25 项使用非针灸对照 （n = 16,041）。在分析的 5 名患者特征中，仅发现基线疼痛严重程度可能会调节针灸的治疗效果，与假手术对照或非针灸对照相比，基线时疼痛更严重的患者从针灸中获益更多。基线心理困扰显示出较小的治疗调节作用，并且性别结果不一致。没有强有力的证据表明年龄或疼痛持续时间影响对针灸的反应。讨论：
Objectives:To optimally select chronic pain patients for different treatments, as it is of interest to identify patient characteristics that might moderate treatment effect. Our aim was to evaluate the impact of possible moderators on the effect of acupuncture treatment using a large data set.Methods:We used data from an individual patient data meta-analysis of high-quality randomized trials of acupuncture for chronic headache and migraine, osteoarthritis, and back, neck, and shoulder pain. Using meta-analytic trial-level and patient-level regression analyses, we explored the impact of 5 documented patient characteristics (patients’ age at baseline, sex, pain duration, baseline pain severity and baseline psychological distress) on the effect of acupuncture.Results:A total of 39 trials met the inclusion criteria: 25 use sham-acupuncture controls (n= 7097) and 25 non-acupuncture controls (n= 16,041). Of the 5 patient characteristics analyzed, only baseline pain severity was found to potentially moderate the treatment effect of acupuncture, with patients reporting more severe pain at baseline experiencing more benefit from acupuncture compared to either sham-control or non-acupuncture control. Baseline psychological distress showed small treatment moderating effects, and results for sex were inconsistent. There was no strong evidence that age or duration of pain influenced the response to acupuncture.Discussion: