Reporting quality assessment of acupuncture case reports of adverse events using the CARE Guideline

Objective

As a popular complementary therapy, the safety of acupuncture must be considered. Acupuncture case reports of adverse events (ACR-AEs) significantly contribute to the assessment of acupuncture safety. However, the reporting quality of ACR-AEs remains unclear. We aimed to promote the application of the CARE (case report) guidelines and improve the reporting quality of ACR-AEs.

Methods

We systematically searched for ACR-AE from six databases: Medline, Embase, Chinese Biomedical Literature Service System, China National Knowledge Infrastructure, Wanfang Data, and VIP, and collected published ACR-AEs from January 1, 2016, to December 31, 2020. We included only case reports of adverse events related to acupuncture therapy. The retrieved case reports were screened and filtered by two reviewers independently. Then, basic information extraction and CARE evaluation of the included ACR-AEs were performed.

Results

A total of 56 ACR-AE were included, 15 of which were from China. The top two major diseases were nervous system diseases (28.6%) and infections (21.4%). For all ACR-AEs, seven of 30 CARE subordinate items were reported in 30% or less, seven items were reported in 30–60%, and only five items got reporting proportion over 90%. In Chinese ACR-AE, only three items, “the main concerns and symptoms of the patient(5b)”, “types of intervention(9a)” and “adverse and unanticipated events (10d)” were sufficiently reported. In English ACR-AE, item “the main concerns and symptoms of the patient(5b)” and item “the primary takeaway lessons(11d)” were also generally reported.

Conclusion

Overall, the reporting quality of ACR-AE was unsatisfactory, and we believe that a special reporting guideline for clinical cases targeted at acupuncture should be extended in future studies.