Introduction
“Systematic Review: Acupuncture vs. Standard Pharmacological Therapy for Migraine Prevention” is a study conducted by Zhang et al. (2019). The research reviews used at least seven articles for screening and concluding. The results showed that acupuncture is more effective than standard pharmacological treatment in migraine prevention. I chose this article because it is not perfect hence has the chance for hosting critiques. Zhang et al. (2019) show that although the study attained the results, they are not conclusive.
CASP Checklist Appraisal Tool Application
Are the Results of the Study Valid?
The study review addressed a focused question of the research. The inquiry sought to determine which treatment methods between acupuncture and standard pharmacological methods were more suitable for preventing migraines. One thousand four hundred thirty participants were included in the review without limitation of years of study. It is not possible to specify the population because the screening involved randomized trials in data collection. However, the chosen articles were closely related to the research question and had related outcomes.
The authors of the review study did not look for the correct type of papers. The reviewers might have narrowed down from 706 to 7 search results but still not the relevant articles. The studies did not use a standard methodology because while some used acupuncture sham, and others used active comparator, thus making it impossible to fetch similar results. The study designs employed by the seven studies were not matching hence corrupting the study design of the review. According to Zhang et al. (2019), the methodological heterogeneity prevented the reviewers from aggregating data. Although the study design uses Randomized Control Trial, its basis of choosing review sources is not perfect.
The study did not include all the relevant sources for review. First, the study used only two custom-designed search strategies whereby in Pubmed, MEDLINE was used, while in Scopus, only EMBASE was applied. The authors could search for articles in several other databases but did not (Craig et al., 2021). The reviewed studies had recorded follow-ups, but the reviewers did not follow up with the selected studies. There was also direct contact with the studies experts as required by the clinical trials. The study only used published articles and materials while leaving out the unpublished ones. Furthermore, only the English written studies were selected for the review. In other words, the study was strict on what to consider indicating that the authors were not open-minded.
As individual studies, the sources used had rigor or were careful and thorough in research. According to Maher et al. (2018), a rigorous analysis is the one that measures what was intended and shows a true reflection of participants’ social reality. All the seven studies selected had outcomes of the intended theory. Most studies used different methods and had varied results hence indicating originality and persuasion of the research purpose. For example, the survey by Diener et al.used three modes to cover the same research topic, obtaining precise results.
Considering that the review results were not precise, combining the study’s outcomes were not reasonable. Different studies applied varied methodologies and found conclusive but different effects. While some studies were specific about their outcomes concerning the research topic, some were not precise. For example, Streng et al. study mention that acupuncture might be an effective and safe treatment method. The findings show doubts thus do not qualify as accurate to be included in combined outcomes. Instead of giving different results based on various studies products, the authors gave combined results and had a problem in data aggregation.
What are the Results?
The results are that studies have proved acupuncture as an effective treatment method compared to standard pharmacological treatment methods in preventing migraines. The results are not clearly expressed after summarizing the trials data. However, in the provision of combined effects, the authors include that since the studies used different methodologies, data aggregation was not possible. The primary outcomes of various examinations were significantly different based on participants’ factors such as disability, percentage of responders, and headaches. Considering the mentioned differences in the studies, the systematic review by the authors lacked the meta-analysis needed (Munn et al., 2018). Thus, it is accurate to say that the results of the study were not conclusive.
The results of the review based on the seven selected studies are not precise. Indeed, the study lacks the accuracy and the confidence in what was finally obtained. The lack of confidence is shown in both some of the studies used and the review. In the list of limitations of the study, the authors included the lack of data analysis across the trials. The studies made data analysis impossible because most of them were aligned to the needed methodology.
Will the results help locally?
It is not clear whether the results could be applied to the local population. Little to no information is given about the people covered in the studies under review. Zhang et al. (2019) state that adult patients diagnosed with episodic or chronic migraines with or without aura was included in the analyses. There are no other factors to determine what made the participants suitable for the study. Furthermore, unless factors like age, gender, and other environmental conditions are included, it is not possible to tell whether it can be applied locally or not. My local settings might be different from those of the participants; hence there is uncertainty. The demography of the participants is another aspect to consider when determining the application of the study.
All the study outcomes were considered when concluding. The outcomes of the various studies were different based on what they were measuring. The summary of the trials indicates the causes of varied results. Although the reviewers might have combined the final results, they accounted for all the different outcomes. The authors took into account that analysis of studies data was not possible following other methods applied. However, more analyzed outcomes of the studies were provided systematically at the studies’ findings in the review analysis.
The benefits of the review are not worth the cost and harm of the study. Despite taking time to search and select relevant studies, the review did not end up with conclusive results. The cost and liability of the evaluation would have been worthwhile should the authors have chosen the suitable sources, made specific data aggregation, and found precise outcomes. The available result is staggering between perfection and inaccuracy without forgetting the limitations.
Evidence-Based Practice
The evidence-based practice integrates problem-solving methods used in clinical practice by incorporating patient preferences and values, expertise in making the best patient care decisions, and evidence from well-researched studies (Lehane et al., 2019). The three significant factors that compose the practice are equally important. EBP is substantial because it aims at providing the best care there is and whose effectiveness has been proven. The evidence from the review is that acupuncture is more effective than standard pharmacological treatment in the prevention of migraines.
In application to EBP, evidence from the review would be used to recommend alternative treatment for migraines. In treating chronic and, episodic migraines clinicians should suggest acupuncture to their patients as a more effective method of treatment to prevent migraines. The primary reason acupuncture is preferred is that the approach has no chemical damage to the body, and prolonged use would not have side effects, as opposed to pharmacological treatment (Ramos‐Morcillo et al., 2021). Continuous use of pain killers for migraines could lead to worse side effects, including failure to respond to the treatment.
Conclusion
The review of the seven studies shows that acupuncture is more effective than pharmacological treatment in the prevention of migraines. The results are, however, not precise due to a lack of enough data analysis. The studies, when considered separately, have robust study designs compared to the review design. The overall quality of the review is low, and the evidence may not be so much reliable.
References
Craig, S. L., McInroy, L. B., Goulden, A., & Eaton, A. D. (2021). Engaging the senses in qualitative research via multimodal coding: Triangulating transcript, audio, and video data in a study with sexual and gender minority youth. International Journal of Qualitative Methods, 20, 1-16.
Lehane, E., Leahy-Warren, P., O’Riordan, C., Savage, E., Drennan, J., O’Tuathaigh, C., & Hegarty, J. (2019). Evidence-based practice education for healthcare professions: An expert view. BMJ Evidence-Based Medicine, 24(3), 103-108.
Maher, C., Hadfield, M., Hutchings, M., & de Eyto, A. (2018). Ensuring rigor in qualitative data analysis: A design research approach to coding combining NVivo with traditional material methods. International Journal of Qualitative Methods, 17(1), 1-6.
Munn, Z., Peters, M. D., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Medical Research Methodology, 18(1), 1-7.
Ramos‐Morcillo, A. J., Fernández‐Salazar, S., Leal‐Costa, C., & Ruzafa‐Martinez, M. (2021). Evidence‐based practice nurses’ competency: Spanish national survey and establishment of a scale of the EBP‐COQ‐Prof©. Journal of Nursing Management, 29(4), 794-804.
Zhang, N., Houle, T., Hindiyeh, N., & Aurora, S. K. (2020). Systematic review: Acupuncture vs. standard pharmacological therapy for migraine prevention. Headache: The Journal of Head and Face Pain, 60(2), 309-317.