The efficacy of acupuncture for attention deficit hyperactivity disorder (ADHD): An overview of systematic reviews and meta-analyses
Zhang L, Huang C, Chen X, Du S, Yang J, Hu B · Complementary Therapies in Medicine · 2023 September
DOI 10.1016/j.ctim.2023.102968
Objective
To investigate and assess the efficacy of acupuncture for attention deficit hyperactivity disorder (ADHD) based on existing systematic reviews (SRs) and meta-analyses (MAs), with a focus on evaluating the quality of these articles using the AMSTAR-2 tool and the GRADE system.
Conclusions
The quality assessment revealed that three articles were rated as having 'Low' quality, two were rated as 'Critically Low,' and the GRADE system indicated 'moderate,' 'low,' and 'very low' quality for different outcomes. It remains debatable whether acupuncture is efficacious in improving the Conners’ Index of Hyperactivity (CIH) score and the response rate. Large-sample and high-quality randomized controlled trials are needed to draw reliable conclusions, given the heterogeneity of clinical trials and the poor quality of existing evidence.
Critical Appraisal
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Insights
Acupuncture's effectiveness in treating attention deficit hyperactivity disorder remains inconclusive due to the low quality of existing systematic reviews and meta-analyses.
A comprehensive search of the literature up until September 2021 was carried out across seven electronic databases to gather systematic reviews and meta-analyses about the use of acupuncture for treating attention deficit hyperactivity disorder. The quality of these articles was subsequently assessed using the AMSTAR-2 tool, while the GRADE system was used to evaluate the quality of the presented evidence.
A total of five systematic reviews and meta-analyses were incorporated in this study. The AMSTAR-2 tool outlined that three articles were of 'low' quality and two were of 'critically low' quality. The GRADE system was applied to ten different outcomes across the included meta-analyses. It found four outcomes to be of 'moderate' quality, four more to be of 'low' quality, and the final two outcomes were considered 'very low' quality. The majority of downgrading factors in the gathered reviews came from the risk of bias and inconsistency. Therefore, the efficacy of acupuncture in improving the various related scores and response rate remains questionable.
