Acupuncture; cannot recommend

There were five high- and five moderate- strength studies that compared acupuncture to comparison groups receiving non-intervention sham, usual care, or education. The five moderate-strength studies were included because they reported outcomes that were different than the high-strength evidence. High-strength studies included: Berman et al, ⁶¹ Suarez-Almazor et al.,⁶² Weiner et al.,⁶³ Williamson et al.⁶⁴ and Taechaarpornkul et al.⁶⁵ Moderate-strength studies included: Sandgee et al.,⁶⁶ Vas et al.,⁶⁷ Witt et al.⁶⁸ and Berman et al.⁶⁹ The majority of studies were not statistically significant and an even larger proportion of the evidence was not clinically significant. Some outcomes were associated with clinical- but not statistical- significance. The strength of this recommendation was based on lack of efficacy, not on potential harm.