A Critical Overview of Systematic Reviews and Meta-Analyses on Acupuncture for Poststroke Insomnia

Table 3

Certainty of evidence quality evaluation.

Studies	Interventions	Outcomes	Studies (participants)	Limitations	Inconsistency	Indirectness	Imprecision	Publication bias	Quality
Lee and Lim 2016 [13]	AT versus CM	PSQI score	6 (385)	−1^①	−1^②	0	0	0	Low
		TCM syndrome score	7 (497)	−1^①	−1^②	0	0	0	Low
	AT versus sham AT	ISI score	2 (82)	−1^①	0	0	−1^③	−1^④	Very low
		AIS score	2 (82)	−1^①	0	0	−1^③	−1^④	Very low
Nie et al. 2020 [14]	AT versus CM	Effective rate	12 (786)	−1^①	0	0	0	0	Moderate
	AT + other therapies versus CM	Effective rate	7 (749)	−1^①	0	0	0	0	Moderate
Zhang et al. 2019 [15]	AT versus CM	Effective rate	26 (1993)	−1^①	−1^②	0	0	0	Low
		Cure rate	32 (2330)	−1^①	0	0	0	0	Moderate
		PSQI score	27 (1764)	−1^①	−1^②	0	0	0	Low
		TCM syndrome score	2 (130)	−1^①	−1^②	0	−1^③	−1^④	Very low
		Scores for depression and anxiety	3 (190)	−1^①	−1^②	0	−1^③	−1^④	Very low
Wu 2019 [16]	AT versus CM	Effective rate	12 (803)	−1^①	0	0	0	0	Moderate
Fu et al. 2018 [17]	AT + AA versus CM	Effective rate	7 (436)	−1^①	0	0	0	0	Moderate
		Sleep onset latency	3 (180)	−1^①	0	0	−1^③	−1^④	Very low
		Sleep time	3 (180)	−1^①	0	0	−1^③	−1^④	Very low
		Daytime dysfunction	3 (180)	−1^①	0	0	−1^③	−1^④	Very low
Liang 2015 [18]	AT versus CM	Effective rate	12 (1015)	−1^①	0	0	0	0	Moderate
	AT + other therapies versus CM	Effective rate	5 (342)	−1^①	0	0	0	0	Moderate

AT: acupuncture therapy; CM: conventional medicine; AA: auricular acupressure; PSQI: Pittsburgh Sleep Quality Index; TCM: traditional Chinese medicine; AIS: Athens Insomnia Scale; ISI: Insomnia Severity Index. ^①The design of the experiment has a large bias in randomization, distributive concealment, or blinding; ^②the confidence interval overlaps less, the heterogeneity test is very small, and the I² is larger; ^③the confidence interval is not narrow enough; ^④funnel graph asymmetry; fewer studies are included and there may be a greater risk of publication bias.