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| Health economic evaluation of acupuncture along meridians for treating migraine in China: results from a randomized controlled trial |
| Deng Z-Q, Zheng H, Zhao L, Zhou S-Y, Li Y, Liang F-R |
| BMC Complementary and Alternative Medicine 2012 Jun 14;12(75):Epub |
| clinical trial |
| 5/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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BACKGROUND: To evaluate different types of acupuncture treatment for migraine in China from the perspective of health economics, particularly the comparison between treatment of specific acupoints in Shaoyang meridians and penetrating sham acupoints treatment. METHODS: Data were obtained from a multicenter, randomized controlled trial of acupuncture treatment in patients with migraine. Four-hundred eighty migraineurs were randomly assigned to 3 arms of treatment with genuine acupoints and 1 arm of penetrating sham acupoints. The primary outcome measurement was the cost-effectiveness ratio (C/E), expressed as cost per 1 day reduction of headache days from baseline to week 16. Cost-comparison analyses, differences in the migraine-specific quality of life questionnaire (MSQ), and the incremental cost-effectiveness ratio were taken as secondary outcome measurements. In addition, a sensitivity analysis was conducted. RESULTS: The total cost per patient was Yen1,273.2 (95% CI 1,171.3 to 1,375.1) in the Shaoyang specific group, Yen1,427.7 (95% CI 1,311.8 to 1,543.6) in the Shaoyang non-specific group, Yen1,490.8 (95% CI 1,327.1 to 1,654.6) in the Yangming specific group, and Yen1,470.1 (95% CI 1,358.8 to 1,581.3) in the sham acupuncture group. The reduced days with migraine were 3.972 +/- 2.7, 3.555 +/- 2.8, 3.793 +/- 3.6, and 2.155 +/- 3.7 in these 4 groups (p < 0.05 for each genuine acupoints group versus the sham group), respectively, at week 16. The C/Es of the 4 groups were 320.5, 401.6, 393.1, and 682.2, respectively. Results of the sensitivity analysis were consistent with that of the cost-effectiveness analysis. The Shaoyang specific group significantly improved in all 3 MSQ domains compared with the sham acupuncture group. CONCLUSIONS: Treatment of specific acupoints in Shaoyang meridians is more cost-effective than that of non-acupoints, representing a dramatic improvement in the quality of life of people with migraine and a significant reduction in cost. Compared with the other 3 groups, Shaoyang-specific acupuncture is a relatively cost-effective treatment for migraine prophylaxis in China. TRIAL REGISTRATION: ClinicalTrials.gov NCT00599586.
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