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Thread embedding acupuncture for musculoskeletal pain: a systematic review and meta-analysis protocol
  1. Yeeun Cho1,2,
  2. Seunghoon Lee1,
  3. Jihye Kim1,
  4. Jung Won Kang3,
  5. Jae-Dong Lee3
  1. 1 Department of Acupuncture and Moxibustion, Kyung Hee University Korean Medical Hospital, Seoul, South Korea
  2. 2 Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
  3. 3 Department of Acupuncture and Moxibustion, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
  1. Correspondence to Professor Jae-Dong Lee; ljdacu{at}


Introduction Thread embedding acupuncture (TEA) is a special type of acupuncture that inserts certain medical threads (eg, catgut or polydioxanone) into subcutaneous tissue or muscles at specific points. Although TEA has been widely used for the treatment of musculoskeletal pain in Korea, China and Taiwan, evidence regarding its efficacy is lacking. The aim of this protocol is to evaluate the effectiveness and safety of TEA in the treatment of musculoskeletal pain, by conducting a systematic review and meta-analysis.

Methods and analysis The following 16 databases will be searched from their inception to 14 May 2017: MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, the Cumulative Index to Nursing and Allied Health Literature, the Allied and Complementary Medicine Database, three Chinese database (China National Knowledge Infrastructure, the Chongqing VIP Chinese Science and Technology Periodical Database and the Wanfang database) and eight Korean databases (Korean Medical Database, Korean Association of Medical Journal Editors, Korean Studies Information Service System, Korean National Assembly Digital Library, National Digital Science Library, Oriental Medicine Advanced Searching Integrated System, ’Database Periodical Information Academic and Korean Traditional Knowledge Portal'). The WHO International Clinical Trials Registry Platform will also be searched to retrieve the recently completed studies.

All randomised controlled studies in which TEA was used on specific points for the treatment of musculoskeletal pain will be included and no restrictions on language will be applied. The risk of bias of each study will be evaluated by the Cochrane risk of bias tool.

Mean difference or standardised mean difference for continuous data and risk ratio for dichotomous data will be calculated with 95% CIs using a random effects model or a fixed effects model. Additional subgroup and sensitivity analyses will be conducted according to a predefined protocol.

Ethics and dissemination No ethical issues are predicted. The systematic review will be published in a peer-reviewed journal or conference presentation. These findings will summarise the current evidence of TEA for the treatment of musculoskeletal pain and may provide guidance for clinicians and patients to select TEA for musculoskeletal pain.

PROSPERO registration number CRD42015019046.

  • thread embedding acupuncture
  • randomised controlled trial
  • musculoskeletal pain
  • systematic review
  • meta-analysis

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  • YC and SL contributed equally.

  • Contributors YC and SL contributed to the development of the search strategy, searched and selected the studies, also read the full texts of studies, extracted data, assessed the risk of bias and reported quality of evidences and contributed to the initial drafting. JDL will act as an arbiter in the selection stage. JK and JWK made revisions. All authors have read and approved the final manuscript for publication.

  • Funding This study was supported by the Traditional Korean Medicine R&D program funded by the Ministryof Health & Welfare through the Korea Health Industry Development Institute (KHIDI) (HI15C0070).

  • Competing interests None declared.

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All exracted data will be available on request to the extent that it is not reported in the systematic review article.