Criteria

NQ

Comments

Randomization properly done

Baseline comparability reported

Same data collection for all arms

Subjects blinded to treatment assignment

Care givers blinded to treatment assignment

Treatments clearly described

Co intervention monitored

Compliance monitored and equal in all groups

Side effects assessed

Outcomes defined, measurable and valid

Blind assessment of outcomes

Section I: Author's key results and conclusions

Including quantitative estimates, e.g. relative risk, reduction in risk, confidence intervals, and p values)

The average magnitude of BP declines achieved by participants was no greater than the magnitude of decrease observed in the placebo arms of 7 pharmaceutical trials analyzed by the Individual Data Analysis of Antihypertensive Intervention trials (INDANA) research committee. Results suggest that 6 weeks of twice-weekly sessions of fully individualized TCM acupuncture are unlikely to achieve clinically meaningful reductions in SBP or DBP for the average patient with mild-to-moderate hypertension relative to invasive sham acupuncture.

Section S: Conclusions and Assessment of the Article

Strengths of Paper

Treatment...

This gives the results validity. Thanks to the inclusion of STD and IND treatment groups, the differential benefit of the three acupuncture treatments could be effectively evaluated. Careful blood pressure monitoring throughout, clear eligibility criteria, and objective randomization all contribute to the effectiveness of the presentation and the validity of the results.
Weaknesses of Paper

The SHARP trial was not designed for the detection of small effects. For subjects with stage 2 hypertension, the use of acupuncture without the use of antihypertensives is not reflective of usual practice among acupuncturists. In general, further research is required in order to determine whether acupuncture enhances the management of hypertension when used in combination with antihypertensives.

Reviewer's conclusions (if different from author's)

Clinical Relevance

Highly relevant [

Relevant [x]

Questionable relevant [

Irrelevant [

Not qualified to evaluate [

Scientific Merit

Very good [x]

Good [

Scientifically admissible [

Scientifically inadmissible [