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Quality of evidence supporting the role of acupuncture for breast cancer-related lymphoedema: an overview of systematic reviews and meta-analyses

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Abstract

Background

Breast cancer-related lymphedema (BCRL) may benefit from acupuncture as a therapeutic. However, the findings of systematic reviews (SRs) and meta-analyses (MAs) are inconsistent and their quality needs to be evaluated critically. We aimed to provide an overview of the methodological quality, risk of bias, quality of reporting, and quality of evidence for SRs/MAs of acupuncture for BCRL.

Methods

Publications were retrieved from four Chinese databases and four English databases. The methodological quality, risk of bias, reporting quality, and evidence quality of the included SRs/MAs were assessed by two independent researchers using the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2), Risk of Bias in Systematic Reviews (ROBIS), Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and Grading of Recommendations, Assessment, Development and Evaluation (GRADE), respectively.

Results

There were a total of 8 SRs/MAs included. By AMSTAR-2, all SRs/MAs were graded as having low or very low methodological quality. By ROBIS, all SRs/MAs in phase 1, domain 1, and domain 4 of phase 2 were at low risk, while in domain 2 were at high risk. By PRISMA, reporting weaknesses in protocol and registration, as well as search method, were identified. By GRADE, the level of evidence quality was “low” to “very low”, and the most commonly downgraded factor was the risk of bias.

Conclusions

Acupuncture may be beneficial in improving BCRL. However, due to the identified limitations and conflicting findings, further more prescriptive and rigorous SRs/MAs are required to give strong evidence for final judgments.

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Availability of data and materials

Supplementary materials: Supplementary file 1: the detailed search strategy for PubMed; Supplementary file 2: information on the items for AMSTAR-2; Supplementary file 3: information on the items for PRISMA. All analyses were based on previously published studies; thus, no other data are required.

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Funding

This work was funded by the Key Research and Development and Promotion Projects of Henan Province (Scientific and Technological Breakthroughs) (232102311195).

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Authors and Affiliations

  1. Henan University of Chinese Medicine, Zhengzhou, China

    Lei Wang, Xueyuan Du & Mingchao Yao

  2. The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China

    Peng Hu

  3. The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China

    Yaling Zhang

  4. The Quzhou Affiliated Hospital of Wenzhou Medical University (Quzhou People’s Hospital), Quzhou, China

    Xiaoling Che

Authors
  1. Lei Wang
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  2. Xueyuan Du
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  3. Peng Hu
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  4. Yaling Zhang
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  5. Mingchao Yao
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  6. Xiaoling Che
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Contributions

Conceptualization: LW, XD; methodology: PH, YZ; supervision: MY, XC; writing—original draft: LW; writing—review and editing: XC.

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Correspondence to Xiaoling Che.

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Wang, L., Du, X., Hu, P. et al. Quality of evidence supporting the role of acupuncture for breast cancer-related lymphoedema: an overview of systematic reviews and meta-analyses. J Cancer Res Clin Oncol 149, 16669–16678 (2023). https://doi.org/10.1007/s00432-023-05419-1

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