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：检索4个国际电子数据库（Cochrane数据库、PubMed、Embase、Web of Science）及4个中文电子数据库：中国知网（China National Knowledge Infrastructure）、万方数据库（Wanfang database）、中国生物医学文献数据库（SinoMed database）与维普数据库（VIP database），检索时限均为各库建库至2023年2月4日。检索词包含“针刺”（Acupuncture）、“呃逆”（Hiccup）、“脑卒中”（Stroke）及“Meta分析”（Meta analysis）。 数据提取与分析：采用系统评价偏倚风险评估工具（risk of bias in systematic reviews, ROBIS）、《系统评价与Meta分析优先报告条目2020版》（preferred reporting items for systematic reviews and meta-analyses, PRISMA 2020）分别评价系统评价（systematic reviews, SRs）的偏倚风险、报告质量，并采用推荐分级、评估、制定与评价系统（grading, assessment, development and Evaluation, GRADE）对结局指标的证据质量进行评价。由2名评价员独立开展数据提取与分析工作，采用κ指数评价两名评价员的一致性程度。 研究结果：共7篇系统评价符合纳入标准。在PRISMA 2020报告质量评价中，结构化摘要、研究方案与注册、检索策略、偏倚风险、数据提取、分析模板与代码及利益冲突等模块均存在关键报告条目缺失、其余条目报告不完整的问题。基于ROBIS工具评估，所有纳入的系统评价均被评定为高偏倚风险。根据GRADE系统，所有研究结果均被评为低质量证据。原始研究局限性与发表偏倚是最主要的降级因素，其次为结果不一致性与精确性不足。