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 [
