Conceptualization: Ying Wang.

Data curation: Qi Lu, Jiabao Sun.

Formal analysis: Haoze Guo.

Funding acquisition: Bailin Song.

Investigation: Xiaomin Li, Hongyi Guan.

Methodology: Ying Wang, Qi Lu.

Supervision: Bailin Song.

Validation: Yu Gao.

Writing – original draft: Ying Wang.

Writing – review & editing: Ying Wang,

Bailin Song.

Abbreviations:
KOA = knee osteoarthritisRCTs =
randomized clinical trails
The datasets generated during and/or
analyzed during the current study are
publicly available.
This research was supported by the
National Key Research and
Development Program
(2019YFC1709900).

The authors have no conflicts of

interest to disclose.

This systematic review will evaluate the

efficacy and safety of acupuncture
combined with traditional Chinese
medicine in the treatment of knee
osteoarthritis. Ethical approval was not
required for the systematic review
because all the data included had been
published.
Registration number:
CRD42022366874

How to cite this article: Wang Y, Lu Q,

Guo H, Sun J, Li X, Guan H, Gao Y, Song
B. Acupuncture combined with
traditional Chinese medicine for knee
osteoarthritis: A protocol for
systematic review and meta-analysis.
Medicine 2022;101:50(e31820).

Go to:
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2.6. Assessment of heterogeneity
I2 will be used for assessing statistical
heterogeneity. It is acknowledged that
I2 < 25% indicates negligible
heterogeneity, 25% < I2 < 50%
indicates mild heterogeneity, 50% < I2
< 75% moderate heterogeneity, and I2
≥ 75% high heterogeneity.

2.7. Assessment of publication bias

Over 10 studies included,[14] we will
take advantage of funnel plot to assess
the reporting bias. Symmetrical funnel
indicates no 3 publishing bias, but if the
funnel is not symmetrical, which
indicates publishing bias exists. P value
will be utilized, while less than 10
studies included.

2.8. Data synthesis.

Quantitative analysis will be
implemented using RevMan version 5.4
with 95% confidence intervals. The
average change for each major and
minor result will be combined. In
addition, if the data is not suitable for
quantitative analysis, qualitative
description will be used.
2.9. Subgroup analysis
If possible, subgroups will be analyzed
according to different acupuncture
manipulation.

2.10. Sensitivity analysis

Robustness of the results will be
assessed by sensitivity analysis
performance which will focus on the
processing method of missing data.

2.11. Grading the quality of evidence

Grading of Recommendations
Assessment, Development, and
Evaluation Reliability Study (GRADE)
will be implemented to assess the
quality of evidence. Based on the risk
of bias, inconsistency, imprecision,
indirection, and publication bias,
GRADE grades evidence quality into 4
levels: high, medium, low, and very
low.