Efficacy of Acupuncture in Subpopulations with Constipation: A protocol for a Systematic Review and Individual Patient data Meta-analysis

Abstract Background: Several systematic reviews have suggested that acupuncture is effective against constipation, but the factors predicting the effect of acupuncture in subpopulations with constipation are still unknown.Methods: We will search six major English and Chinese electronic databases and two clinical trial registries from inception for randomized controlled trials that evaluate acupuncture for constipation. Two authors will independently identify the relevant studies, extract the information from the papers, and assess the risk of bias using the Cochrane RoB 2 tool. We will contact the primary researchers of the eligible trials for individual patient data (IPD). IPD from four trials are available from the China Academy of Chinese Medical Sciences CliniRsearch Data Management System. The primary outcomes are the change in weekly complete spontaneous bowel movements. IPD from the researchers will be standardized and harmonized. A one-stage approach will be used to synthesize the IPD. Our primary analysis will examine the efficacy of acupuncture in subpopulations with constipation using a general linear mixed model.Discussion: This review will provide an IPD meta-analysis of acupuncture in constipation and demonstrate how the benefits of acupuncture may vary among subgroups of patients with constipation.Systematic review registration: International Prospective Register of Systematic Reviews (Number: CRD42020188366)