Clinical practice guidelines of Korean medicine on acupuncture and herbal medicine for atopic dermatitis: A GRADE approach

Lee, Ju Ah; Choi, Jiae; Choi, Tae‐Young; Jun, Ji Hee; Lee, Dong‐Hyo; Roh, Seok-Seon; Lee, Myeong Soo

doi:10.1016/j.eujim.2016.07.028

Cited by 10 publications

(10 citation statements)

References 13 publications

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“…28,29,32,34,35,41,42,[46][47][48][49][51][52][53][54][55]58,60,61 Dissemination was mostly done through medical journals (30) and 10 reports 12,[28][29][30][31]34,49,51,57,63,66 were only available on the website of either a medical society or a governmental agency. Full public access was available for 36 of them, while four 14,44,[46][47][48]60 needed a login (journal or website). Eight CPGs were in languages other than English: Danish (one), Dutch (one), Finnish (one), Spanish (three), Russian (one) and Ukrainian (one).…”

Section: Characteristics Of the Included Clinical Practice Guidelinesmentioning

confidence: 99%

Global Guidelines in Dermatology Mapping Project (GUIDEMAP), a systematic review of atopic dermatitis clinical practice guidelines: are they clear, unbiased, trustworthy and evidence based (CUTE)?*

Arents¹,

Zuuren

Vermeulen

et al. 2022

Br J Dermatol

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Background Clinical practice guidelines (CPGs) are essential in delivering optimum healthcare, such as for atopic dermatitis (AD), a highly prevalent skin disease. Although many CPGs are available for AD, their quality has not been critically appraised. Objectives To identify CPGs on AD worldwide and to assess with validated instruments whether those CPGs are clear, unbiased, trustworthy and evidence based (CUTE). Methods We searched MEDLINE, Embase, PubMed, Web of Science, Cochrane Library, Emcare, Epistemonikos, PsycINFO and Academic Search Premier for CPGs on AD published between 1 April 2016 and 1 April 2021. Additionally we hand searched prespecified guideline resources. Screening, data extraction and quality assessment of eligible guidelines were independently carried out by two authors. Instruments used for quality assessment were the AGREE II Reporting Checklist, the US Institute of Medicine (IOM) criteria of trustworthiness and Lenzer’s Red Flags. Results Forty CPGs were included, mostly from countries with a high sociodemographic index. The reporting quality varied enormously. Three CPGs scored ‘excellent’ on all AGREE II domains and three scored ‘poor’ on all domains. We found no association between AGREE II scores and a country’s gross domestic product. One CPG fully met all nine IOM criteria and two fully met eight. Three CPGs had no red flags. ‘Applicability’ and ‘rigour of development’ were the lowest scoring AGREE II domains; ‘external review’, ‘updating procedures’ and ‘rating strength of recommendations’ were the IOM criteria least met; and most red flags were for ‘limited or no involvement of methodological expertise’ and ‘no external review’. Management of conflicts of interest (COIs) appeared challenging. When constructs of the instruments overlapped, they showed high concordance, strengthening our conclusions. Conclusions Overall, many CPGs are not sufficiently clear, unbiased, trustworthy or evidence based (CUTE) and lack applicability. Therefore improvement is warranted, for which using the AGREE II instrument is recommended. Some improvements can be easily accomplished through robust reporting. Others, such as transparency, applicability, evidence foundation and managing COIs, might require more effort.

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Section: Characteristics Of the Included Clinical Practice Guidelinesmentioning

confidence: 99%

Global Guidelines in Dermatology Mapping Project (GUIDEMAP), a systematic review of atopic dermatitis clinical practice guidelines: are they clear, unbiased, trustworthy and evidence based (CUTE)?*

Arents¹,

Zuuren

Vermeulen

et al. 2022

Br J Dermatol

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“…The treatment acupoint for AD is the Quchi acupoint (LI11), which is the typical acupoint used in skin diseases [35, 36]. In addition, the Atopic Dermatitis Korean Medicine Clinical Practice Guideline recommends the Quchi acupoint (LI11) at the GPP level [37]. This study was performed to characterize the effects of needle-embedding therapy at the Quchi acupoint (LI11) on AD and to compare these effects with those of acupuncture therapy.…”

Section: Discussionmentioning

confidence: 99%

“…In Korea, patients with AD have frequently used Traditional Korean Medicine, such as acupuncture and herbal medicine, for symptom management [12]. Regarding the use of acupuncture for AD, studies of the effects of acupuncture treatments have been published overseas [13–17], as well as in Korea [18–21].…”

Section: Introductionmentioning

confidence: 99%

Preliminary Comparison of the Efficacy and Safety of Needle-Embedding Therapy with Acupuncture for Atopic Dermatitis Patients

Lee

Park

2019

Evidence-Based Complementary and Alternative Medicine

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Objectives. Among Traditional Korean Medicine approaches, needle-embedding therapy is used in various fields and consistently studied; however, there have been no clinical studies of the treatment of adult atopic dermatitis (AD) with needle-embedding therapy. Thus, there is a need to investigate the effects of needle-embedding therapy for treatment of AD. This study was performed to identify possible effects of needle-embedding therapy at Quchi acupoint (LI11) on AD and to compare these effects with those of acupuncture therapy. Methods. A total of 14 participants were enrolled in this study. Participants received acupuncture or needle-embedding treatments for 4 weeks and then were followed for an additional 2 weeks because of safety assessment. The participants were divided into 2 groups: the acupuncture group, receiving treatment at Quchi acupoint (LI11) 3 times per week, and the needle-embedding group, receiving treatment at Quchi acupoint (LI11) once per week. The groups were compared on the basis of the SCORing Atopic Dermatitis (SCORAD) index, Transepidermal Water Loss (TEWL), skin hydration, and Dermatology Life Quality Index (DLQI) at baseline and 1 week after treatment was completed (5th week). Results. The SCORAD index, TEWL, Skin hydration, and DLQI at 1 week after treatment were significantly improved in both groups (p<0.05). However, there were no significant differences between the acupuncture and needle-embedding groups in any of the main evaluation indices (p>0.05). The study participants received a total of 84 acupuncture treatments or 28 needle-embedding treatments. No adverse events occurred during the study period. Conclusions. Based on changes in the SCORAD index, TEWL, skin hydration, and DLQI value, we found that both needle-embedding and acupuncture treatments at the Quchi acupoint (LI11) were effective in decreasing the symptoms of AD and exhibited similar therapeutic effects, which suggests that needle-embedding treatment may be more clinically convenient than acupuncture, with longer effects and fewer treatments.

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“…Due to the limitations of conventional therapy, the use of complementary and alternative therapies, such as acupuncture, is increasing [ 6 , 7 ]. Functional magnetic resonance imaging studies have suggested that acupuncture alleviates allergen-induced itch in AD patients, which was not observed in the placebo or antihistamine group.…”

Section: Introductionmentioning

confidence: 99%

Effect of acupuncture treatment in patients with mild to moderate atopic dermatitis: a randomized, participant- and assessor-blind sham-controlled trial

Park

Lee

Yeom

et al. 2021

BMC Complement Med Ther

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Background Atopic dermatitis (AD) is a chronic recurrent inflammatory skin disease that affects 1–3% of adults worldwide. Currently, it is not possible to completely cure AD; therefore, alternative treatments need to be developed to meet the patients’ needs. Here, based on our previous pilot study, we conducted the first confirmatory randomized controlled trial to evaluate the effect of acupuncture in patients with mild to moderate AD. Methods A randomized, participant- and assessor-blinded, sham-controlled trial was designed with an intervention period twice-weekly for 4 weeks and a 4-week follow-up. We equally allocated 36 participants to the verum acupuncture (VA) and sham acupuncture (SA) groups. The main outcome measure was the change in SCORing Atopic Dermatitis index (SCORAD) score before and after treatment. Results A total of 36 participants, aged 19 to 38 years, were enrolled, and 35 were included in the intention-to-treat analyses. The mean change in total SCORAD score differed significantly among the two groups at 4 weeks after randomization (P < .0001): the mean difference was − 11.83 (7.05) in the VA group and 0.45 (7.77) in the SA group. The mean SCORAD score substantially decreased 2-weeks after starting the acupuncture treatment and continued to improve for at least 4 weeks after the end of the treatment in the VA group compared to the SA group (each P < .0001). No serious adverse events were observed. Conclusions Twice-weekly acupuncture treatment was effective in reducing AD symptoms in patients with mild to moderate AD without serious adverse events. Trial registration Clinical Research Information Service Identifier: KCT0002796.

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Clinical practice guidelines of Korean medicine on acupuncture and herbal medicine for atopic dermatitis: A GRADE approach

Cited by 10 publications

References 13 publications

Global Guidelines in Dermatology Mapping Project (GUIDEMAP), a systematic review of atopic dermatitis clinical practice guidelines: are they clear, unbiased, trustworthy and evidence based (CUTE)?*

Global Guidelines in Dermatology Mapping Project (GUIDEMAP), a systematic review of atopic dermatitis clinical practice guidelines: are they clear, unbiased, trustworthy and evidence based (CUTE)?*

Preliminary Comparison of the Efficacy and Safety of Needle-Embedding Therapy with Acupuncture for Atopic Dermatitis Patients

Effect of acupuncture treatment in patients with mild to moderate atopic dermatitis: a randomized, participant- and assessor-blind sham-controlled trial

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