Moxibustion for treating knee osteoarthritis: A protocol for systematic review and meta analysis

BACKGROUND: Knee osteoarthritis (KOA) is a significant health issue because it causes pain and functional limitation. Many studies have reported that moxibustion, a treatment in traditional Chinese medicine, is effective in treating KOA. The aim of this overview is to synthesize and assess the reliability of evidence generated from these systematic reviews of the effectiveness of moxibusition for KOA. METHODS: This is a protocol for a systematic overview of reviews. We will search 7 databases: PubMed, Embase, Cochrane Library, Chinese Biomedical Literatures Database, China National Knowledge Infrastructure, WangFang Database, Chinese Scientific Journal Database from their inception to April 2020. We will consider systematic reviews and meta-analysis of randomized controlled trials evaluating the effectiveness of moxibustion for KOA. Independent reviewers will sift, perform data extraction in duplicate, and assess the quality of the reviews using the Change MeaSurement Tool to Assess Systematic Reviews-2 to Assessment of Multiple Systematic Reviews-2 and the Preferred Reporting Item for Systematic Review and Meta-Analysis statement. The outcomes of interest include: quality of life, knee function, and pain relief outcomes prioritized in the individual reviews. The evidence will be synthesized where appropriate by patient subgroups, intervention type, context, and outcome. Revman 5.3 software will be used to conduct meta-analysis and calculate the risk ratio for dichotomous data. Weighted mean difference or standard mean difference will be calculated for continuous data. The quality of evidence was assessed according to Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) considering the methodological quality of the randomized controlled trials and meta-analysis. RESULTS: The results of this study will be published in a peer-reviewed journal. CONCLUSIONS: We expect to compile evidence from multiple systematic reviews of symptomatic improvement in patients with KOA in an accessible and useful document. TRIAL REGISTRATION NUMBER: CRD42019141029 in PROSPERO 2019.