Introduction
Methods
Data sources and searches
Study selection
Data extraction
Quality assessment
Data synthesis and analysis
Results
Selection of studies
Characteristics of included studies
Treatment | Placebo | |
---|---|---|
No. of participants | 4795 | 4804 |
Mean age (range), year | 48.8 (39.4–59.2) | 48.58 (35.3–58.7) |
Mean percentage of women (range), % | 91.7 (39.2–100) | 91.7 (61.8–100) |
Median years of symptom (range) | 7.8 (2.9–16.1) | 7.9 (3.3–14.4) |
Mean duration of treatment (weeks) | 12.2 | |
Jadad score, mean | 4.47 | |
Industry funding, n (%) | 26 (51.0) | |
Dropout rate, n (%) | 37 (72.5) | |
Random sequence, n (%) | 32 (62.7) | |
Allocation concealment, n (%) | 31 (61.0) | |
Blinding participants, n (%) | 47 (92.2) | |
Blinding care provider, n (%) | 34 (66.7) | |
Blinding assessors, n (%) | 38 (74.5) | |
Intention to treat analysis, n (%) | 26 (51.0) |
Proportion of contextual effect
Number of studies included | Number of participants | PCE | 95%CI |
I
2
, % |
P (Egger test) | |
---|---|---|---|---|---|---|
Pain | ||||||
Antidepressants | 19 | 6399 | 0.668 | 0.616 to 0.725 | 99.5 | |
CNS depressants | 2 | 743 | 0.527 | 0.427 to 0.650 | 99.0 | |
Anticonvulsants | 2 | 516 | 0.504 | 0.387 to 0.655 | 98.5 | |
Analgesics | 2 | 356 | 0.440 | 0.371 to 0.520 | 83.2 | |
Other medications | 5 | 319 | 0.782 | 0.326 to 1.880 | 97.0 | |
Electromagnetic therapy | 9 | 390 | 0.442 | 0.221 to 0.885 | 98.9 | |
Acupuncture | 4 | 196 | 0.577 | 0.379 to 0.879 | 86.0 | |
Others | 3 | 178 | 0.548 | 0.339 to 0.888 | 86.7 | |
Overall | 46 | 9097 | 0.599 | 0.557 to 0.643 | 99.4 |
0.014
|
FIQ total | ||||||
Antidepressants | 11 | 4993 | 0.623 | 0.565 to 0.686 | 99.5 | |
Anticonvulsants | 3 | 890 | 0.527 | 0.456 to 0.608 | 97.8 | |
CNS depressants | 2 | 743 | 0.577 | 0.395 to 0.843 | 99.8 | |
Analgesics | 1 | 313 | 0.555 | 0.533 to 0.578 | – | |
Other medications | 4 | 292 | 0.687 | 0.502 to 0.940 | 90.5 | |
Electromagnetic therapy | 7 | 265 | 0.379 | 0.239 to 0.599 | 94.7 | |
Acupuncture | 1 | 49 | 0.634 | 0.482 to 0.835 | – | |
Others | 1 | 35 | 0.537 | 0.384 to 0.749 | – | |
Overall | 30 | 7580 | 0.569 | 0.530 to 0.612 | 99.2 |
0.017
|
Fatigue | ||||||
Antidepressants | 12 | 4733 | 0.625 | 0.578 to 0.674 | 97.5 | |
Anticonvulsants | 1 | 374 | 0.702 | 0.675 to 0.730 | ||
CNS depressants | 2 | 743 | 0.547 | 0.473 to 0.633 | 98.3 | |
Analgesics | 1 | 313 | 0.808 | 0.773 to 0.845 | ||
Other medications | 2 | 135 | 1.272 | 0.449 to 3.601 | 59.7 | |
Electromagnetic therapy | 6 | 263 | 0.396 | 0.221 to 0.708 | 90.3 | |
Acupuncture | 2 | 105 | 1.075 | 0.230 to 5.028 | 97.4 | |
Others | 1 | 62 | 0.330 | 0.165 to 0.661 | ||
Overall | 27 | 6728 | 0.632 | 0.588 to 0.680 | 97.6 | 0.820 |
Subgroup and meta-regression analyses
Variable | Exp(β) | SE | 95% CI |
P value |
---|---|---|---|---|
Duration of treatment (≤ 4 weeks vs. > 4 weeks) | 1.47 | 0.40 | 0.84 to 2.56 | 0.168 |
Proportion of female participants (%) | 1.00 | 0.01 | 0.98 to 1.02 | 0.886 |
Number of participants (< 100 vs. ≥ 100) | 1.09 | 0.20 | 0.74 to 1.59 | 0.665 |
Allocation concealment (yes vs. no) | 0.94 | 0.20 | 0.62 to 1.43 | 0.767 |
Blinding (none vs. patient blinding vs. double blinding) | 1.04 | 0.15 | 0.78 to 1.41 | 0.773 |