Objective Given the international focus and rigorous literature searches employed in Cochrane systematic reviews, this study was undertaken to evaluate strategies employed in Cochrane reviews and protocols assessing acupuncture as a primary or secondary intervention. Methods The Cochrane Collaboration of systematic reviews was searched in February 2009 for all reviews and protocols including information on acupuncture. Information was abstracted from all retrieved articles on review status, type and number of English and Chinese language databases searched, participation of at least one Chinese speaking author and language restriction. Frequencies were calculated and bivariate analyses were performed stratifying on interventions of interest to assess differences in search strategy techniques, language restrictions and results. Results The search retrieved 68 titles, including 48 completed reviews, 17 protocols and three previously withdrawn titles. Acupuncture was the primary intervention of interest in 44/65 (67.7%) of the retrieved reviews and protocols. While all articles searched at least one English language database, only 26/65 (40.0%) articles searched Chinese language databases. Signifi cantly more articles where acupuncture was the primary intervention of interest searched Chinese language databases (53% vs 9%, p<0.01). Inconclusive fi ndings as to the effectiveness of acupuncture were found in 28/48 (58.3%) of all completed reviews; this type of fi nding was more common in reviews which did not search any Chinese language databases. Conclusions It is important for reviews assessing the effectiveness of acupuncture to search Chinese language databases. The Cochrane Collaboration should develop specifi c criteria for Chinese language search strategies to ensure the continued publication of high-quality reviews.
INTRODUCTIONAcupuncture consists of the application of needles (as well as pressure and heat) to certain points on the body. Although it has been part of traditional Chinese medicine for centuries, 1 it has only recently entered into practice in the West. English language clinical descriptions of acupuncture fi rst appeared in Medline in the 1950s. The fi rst randomised Heterogeneity in search strategies among Cochrane acupuncture reviews: is there room for improvement? trials on acupuncture were not published until the 1970s with the volume of scientifi c studies increasing since (fi gure 1).The Cochrane Collaboration is an international organisation whose primary aim is to assist healthcare providers, consumers, researchers and policy makers in navigating the often unmanageable amounts of healthcare information by synthesising the evidence within systematic review frameworks. At its core is the collection of Cochrane reviews, a database that contain high-quality, independent evidence to inform healthcare decisionmaking.2 Cochrane reviews are thought to represent the highest level of evidence on which to base clinical treatment decisions because they are 'doubly peer reviewed' and also be...