Time points of outcome are often neglected in acupuncture meta-analyses: a methodological survey

What is new? Key findings: Transparency in reporting outcome time points for acupuncture meta-analyses and appropriate methods to pool the effect size of multiple time points are lacking. What this adds to what is known Previous surveys often focused on the PICO framework but ignored the "T" component in acupuncture meta-analyses. Our survey specifically focused on this neglected element in acupuncture meta-analyses and identified several important methodological issues related to it. What is the implication, what should change now? About half of the published meta-analyses of acupuncture did not report outcome time points. Both the research protocol and the final report of a meta-analysis should explicitly specify the time points of outcomes. Caution is warranted when using inappropriate methods to synthesis effect sizes at multiple time points and more advanced meta-analysis methods is recommended. Objectives To systematically understand the transparency of outcome measurement time point reporting in meta-analyses of acupuncture. Study Design and Setting We searched for meta-analyses of acupuncture published between 2013–2022 in PubMed, Embase, and Cochrane Library. A team of method-trained investigators screened studies for eligibility and collected data using pilot-tested standardized questionnaires. We documented in detail the reporting of outcome measurement time points in acupuncture meta-analyses. Results A total of 224 acupuncture meta-analyses were included. Of these, 98 (43.8%) studies did not specify the time points of primary outcome. Among 126 (56.3%) meta-analyses which reported the time points of primary outcome, only 22 (17.5%) meta-analyses specified time points in corresponding protocol. Among 48 (38.1%) meta-analyses that estimated treatment effects of multiple time points, 11 (22.9%) meta-analyses used inappropriate meta-analysis method (subgroup analysis) to pool effect size, and none of the meta-analyses used advanced methods for pooling effect sizes at different time points. Conclusions Transparency in reporting outcome time points for acupuncture meta-analyses and appropriate methods to pool the effect size of multiple time points were lacking. For future systematic reviews, the transparency of outcome measurement time points should be emphasized in the protocols and final reports. Furthermore, advanced methods should be considered for pooling effect sizes at multiple time points. To systematically understand the transparency of outcome measurement time point reporting in meta-analyses of acupuncture. We searched for meta-analyses of acupuncture published between 2013–2022 in PubMed, Embase, and Cochrane Library. A team of method-trained investigators screened studies for eligibility and collected data using pilot-tested standardized questionnaires. We documented in detail the reporting of outcome measurement time points in acupuncture meta-analyses. A total of 224 acupuncture meta-analyses were included. Of these, 98 (43.8%) studies did not specify the time points of primary outcome. Among 126 (56.3%) meta-analyses which reported the time points of primary outcome, only 22 (17.5%) meta-analyses specified time points in corresponding protocol. Among 48 (38.1%) meta-analyses that estimated treatment effects of multiple time points, 11 (22.9%) meta-analyses used inappropriate meta-analysis method (subgroup analysis) to pool effect size, and none of the meta-analyses used advanced methods for pooling effect sizes at different time points. Transparency in reporting outcome time points for acupuncture meta-analyses and appropriate methods to pool the effect size of multiple time points were lacking. For future systematic reviews, the transparency of outcome measurement time points should be emphasized in the protocols and final reports. Furthermore, advanced methods should be considered for pooling effect sizes at multiple time points.