Acupuncture and safety for post-stroke hiccups: An overview of systematic reviews

Methods: Four international electronic databases (Cochrane database, PubMed, Embase, Web of Science) and four Chinese electronic databases (China National Knowledge Infrastructure, Wanfang database, SinoMed database and VIP database) were searched from their creation to February 4, 2023. Search terms such as “Acupuncture”, “Hiccup”, “Stroke” and “Meta analysis” were used.
Data extraction and analysis: The risk of bias, quality of reporting and evidence for SRs were assessed by the risk of bias in systematic reviews (ROBIS) tool, the preferred reporting items for systematic reviews and meta-analyses (PRISMA 2020), and the quality of evidence for outcome measures by recommending grading, assessment, development and Evaluation (GRADE) for assessment. Two reviewers independently performed data extraction and analysis, and the degree of agreement was scored using the κ index.
Results: Seven SRs met the inclusion criteria. In PRISMA 2020 reporting quality assessment, there were missing key reporting items and incomplete reporting of other items in the topics of structured abstracts, protocols and registrations, search strategies, risk of bias, data extraction, analysis templates and codes, and conflicts of interest. All SRs were rated as high risk of bias based on the ROBIS tool. According to the GRADE system, the results were all rated as low-quality evidence. Limitations of the original trial and publication bias topped the list of downgrading factors, followed by inconsistency and imprecision.

研究方法：自数据库创建以来至2023年2月4日，检索了四个国际电子数据库（Cochrane数据库、PubMed、Embase、Web of Science）以及四个中国电子数据库（中国知网、万方数据库、SinoMed数据库和VIP数据库）。检索词包括“针灸”、“打嗝”、“中风”和“荟萃分析”。
数据提取与分析：采用系统评价偏倚风险（ROBIS）工具、系统评价与荟萃分析推荐报告项目（PRISMA 2020）以及推荐分级、评估、发展和评价（GRADE）系统对系统评价的偏倚风险、报告质量以及结果测量的证据质量进行评估。两位评审员独立进行数据提取和分析，并使用κ指数评估其一致性。
结果：共有七个系统评价符合纳入标准。在PRISMA 2020报告质量评估中，结构化摘要、方案和注册、检索策略、偏倚风险、数据提取、分析模板和代码以及利益冲突等主题存在关键报告项目的缺失和其他项目的报告不完整。所有系统评价根据ROBIS工具评估均被评定为高偏倚风险。根据GRADE系统，所有结果均被评定为低质量证据。原始试验的局限性以及发表偏倚是降级因素中的首要因素，其后依次是不一致性和不精确性。