{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T20:04:41Z","timestamp":1792872281161,"version":"4.5.0"},"reference-count":32,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"unspecified","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Experts Inheritance Studio Construction Project","award":["GZS2021027"],"award-info":[{"award-number":["GZS2021027"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,10,21]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Sudden sensorineural hearing loss (SSNHL) is an otologic emergency that can profoundly impact patients\u2019 auditory function and quality of life. While conventional treatments like corticosteroids offer moderate efficacy, a proportion of patients experience persistent deficits, highlighting the need for effective adjunctive therapies. Acupuncture has demonstrated therapeutic potential for SSNHL, but the relative efficacy of various acupuncture-related modalities remains unclear. This protocol outlines a systematic review (SR) and network meta-analysis (NMA) aimed at comprehensively evaluating the comparative efficacy of different acupuncture modalities in treating SSNHL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>An extensive literature search across nine databases and five clinical trial registries will be conducted to identify randomised controlled trials investigating acupuncture-related therapies for SSNHL. The primary outcome measure is the change in pure-tone audiometric thresholds. Secondary outcomes include the proportion of recovered patients, tinnitus severity, psychological symptoms and adverse events. Two independent reviewers will perform study selection, data extraction and methodological quality assessment using the Cochrane\u2019s risk of bias (V.2.0) tool. A Bayesian NMA will be employed to compare the relative efficacy among multiple acupuncture modalities. The overall quality of evidence will be evaluated using the Grading of Recommendations, Assessment, Development and Evaluation methodology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>As this study will use data from previously published studies, it does not require ethical approval. The findings of this SR and NMA will be disseminated through publication in a peer-reviewed academic journal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD42024525763.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-094239","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T04:45:10Z","timestamp":1761799510000},"page":"e094239","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Comparing the efficacy of various acupuncture-related therapies for sudden sensorineural hearing loss: a PRISMA-compliant protocol for systematic review and network meta-analysis"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8759-5083","authenticated-orcid":false,"given":"Hantong","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunhuo","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Nursing, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianqiang","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3273-6616","authenticated-orcid":false,"given":"Hong","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,10,29]]},"reference":[{"key":"2025120415094246000_15.10.e094239.1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819859885"},{"key":"2025120415094246000_15.10.e094239.2","unstructured":"Murphy-Lavoie HM , Mutluoglu M . Hyperbaric treatment of sensorineural hearing loss. In: StatPearls. StatPearls Publishing.2024."},{"key":"2025120415094246000_15.10.e094239.3","doi-asserted-by":"crossref","first-page":"108565","DOI":"10.1016\/j.heares.2022.108565","article-title":"Idiopathic sudden sensorineural hearing loss: a critique on corticosteroid therapy","volume":"422","author":"Murray","year":"2022","journal-title":"Hear Res"},{"key":"2025120415094246000_15.10.e094239.4","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1001\/jamaoto.2020.0047","article-title":"Intratympanic vs systemic corticosteroids in first-line treatment of idiopathic sudden sensorineural hearing loss: a systematic review and meta-analysis","volume":"146","author":"Mirian","year":"2020","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"key":"2025120415094246000_15.10.e094239.5","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1177\/09645284221076513","article-title":"Acupuncture as a salvage treatment for sudden sensorineural hearing loss","volume":"40","author":"Kim","year":"2022","journal-title":"Acupunct Med"},{"key":"2025120415094246000_15.10.e094239.6","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1089\/acm.2020.0330","article-title":"Combined acupuncture-hyperbaric oxygen-steroids therapy for idiopathic sudden sensorineural hearing loss: a retrospective observational study","volume":"27","author":"Lee","year":"2021","journal-title":"J Altern Complement Med"},{"key":"2025120415094246000_15.10.e094239.7","doi-asserted-by":"crossref","first-page":"11","DOI":"10.51507\/j.jams.2023.16.1.11","article-title":"Lipid profile response to acupuncture in obese patients with subjective tinnitus: a randomized controlled trial","volume":"16","author":"Ali Ismail","year":"2023","journal-title":"J Acupunct Meridian Stud"},{"key":"2025120415094246000_15.10.e094239.8","doi-asserted-by":"crossref","unstructured":"Zhang X , Xu X , Xu W , et al . Acupuncture therapy for sudden sensorineural hearing loss: a systematic review and meta-analysis of randomized controlled trials. PLoS One 2015;10. doi:10.1371\/journal.pone.0125240","DOI":"10.1371\/journal.pone.0131031"},{"key":"2025120415094246000_15.10.e094239.9","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.ctim.2018.12.009","article-title":"Acupuncture for the treatment of sudden sensorineural hearing loss: a systematic review and meta-analysis: Acupuncture for SSNHL","volume":"42","author":"Chen","year":"2019","journal-title":"Complement Ther Med"},{"key":"2025120415094246000_15.10.e094239.10","doi-asserted-by":"crossref","unstructured":"Shim S , Yoon B-H , Shin I-S , et al . Network meta-analysis: application and practice using Stata. Epidemiol Health 2017;39. doi:10.4178\/epih.e2017047","DOI":"10.4178\/epih.e2017047"},{"key":"2025120415094246000_15.10.e094239.11","doi-asserted-by":"publisher","DOI":"10.7326\/M14-2385"},{"key":"2025120415094246000_15.10.e094239.12","doi-asserted-by":"crossref","unstructured":"Moher D , Shamseer L , Clarke M , et al . Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 2015;4. doi:10.1186\/2046-4053-4-1","DOI":"10.1186\/2046-4053-4-1"},{"key":"2025120415094246000_15.10.e094239.13","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2020-209567"},{"key":"2025120415094246000_15.10.e094239.14","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000222"},{"key":"2025120415094246000_15.10.e094239.15","doi-asserted-by":"crossref","first-page":"1939","DOI":"10.2147\/JPR.S370476","article-title":"The efficacy and safety of acupuncture for depression-related insomnia: protocol for a systematic review and meta-analysis","volume":"Volume 15","author":"Hu","year":"2022","journal-title":"JPR"},{"key":"2025120415094246000_15.10.e094239.16","doi-asserted-by":"crossref","first-page":"2957","DOI":"10.2147\/JPR.S383968","article-title":"The efficacy and safety of acupuncture for tinnitus-associated insomnia: a protocol for a systematic review and meta-analysis","volume":"15","author":"Fan","year":"2022","journal-title":"J Pain Res"},{"key":"2025120415094246000_15.10.e094239.17","doi-asserted-by":"crossref","unstructured":"Ahmadzai N , Kilty S , Wolfe D , et al . A protocol for a network meta-analysis of interventions to treat patients with sudden sensorineural hearing loss. Syst Rev 2018. doi:10.1186\/s13643-018-0736-3","DOI":"10.1186\/s13643-018-0736-3"},{"key":"2025120415094246000_15.10.e094239.18","doi-asserted-by":"crossref","unstructured":"Liang J , Xie H , Chiang H-J , et al . Postauricular injection glucocorticoid in the treatment of sudden hearing loss: a protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020;99. doi:10.1097\/MD.0000000000023241","DOI":"10.1097\/MD.0000000000023241"},{"key":"2025120415094246000_15.10.e094239.19","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1001\/jamaoto.2021.2685","article-title":"Hyperbaric oxygen therapy for patients with sudden sensorineural hearing loss: a systematic review and meta-analysis","volume":"148","author":"Joshua","year":"2022","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"key":"2025120415094246000_15.10.e094239.20","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1007\/7854_2020_175","article-title":"Tinnitus questionnaires for research and clinical use","volume":"51","author":"Theodoroff","year":"2021","journal-title":"Curr Top Behav Neurosci"},{"key":"2025120415094246000_15.10.e094239.21","doi-asserted-by":"publisher","DOI":"10.1176\/appi.psy.12.6.371"},{"key":"2025120415094246000_15.10.e094239.22","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.23.1.56"},{"key":"2025120415094246000_15.10.e094239.23","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(89)90047-4"},{"key":"2025120415094246000_15.10.e094239.24","doi-asserted-by":"crossref","unstructured":"Flemyng E , Dwan K , Moore TH , et al . Risk of Bias 2 in Cochrane Reviews: a phased approach for the introduction of new methodology. Cochrane Database Syst Rev 2020;10. doi:10.1002\/14651858.ED000148","DOI":"10.1002\/14651858.ED000148"},{"key":"2025120415094246000_15.10.e094239.25","unstructured":"Akl EA , Altman DG , Aluko P , et al . Cochrane handbook for systematic reviews of interventions. In: Cochrane Handbook for Systematic Reviews of Interventions. 2019."},{"key":"2025120415094246000_15.10.e094239.26","doi-asserted-by":"crossref","unstructured":"Fu H-J , Zhou H , Tang Y , et al . Tai Chi and other mind-body interventions for cancer-related fatigue: an updated systematic review and network meta-analyses protocol. BMJ Open 2022;12. doi:10.1136\/bmjopen-2021-052137","DOI":"10.1136\/bmjopen-2021-052137"},{"key":"2025120415094246000_15.10.e094239.27","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39489.470347.AD"},{"key":"2025120415094246000_15.10.e094239.28","doi-asserted-by":"publisher","DOI":"10.1111\/biom.12817"},{"key":"2025120415094246000_15.10.e094239.29","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.jams.2019.05.002","article-title":"Thermal effects of acupuncture by the infrared thermography test in patients with tinnitus","volume":"12","author":"Cai","year":"2019","journal-title":"J Acupunct Meridian Stud"},{"key":"2025120415094246000_15.10.e094239.30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2022\/6106993","article-title":"Electroacupuncture promotes neuroplasticity of central auditory pathway: an auditory evoked potentials study","volume":"2022","author":"Chang","year":"2022","journal-title":"Evid Based Complement Alternat Med"},{"key":"2025120415094246000_15.10.e094239.31","doi-asserted-by":"crossref","unstructured":"Wei Y , Zhang W , Li Y , et al . Acupuncture treatment decreased temporal variability of dynamic functional connectivity in chronic tinnitus. Front Neurosci 2021;15. doi:10.3389\/fnins.2021.737993","DOI":"10.3389\/fnins.2021.737993"},{"key":"2025120415094246000_15.10.e094239.32","first-page":"3","article-title":"Acupuncture randomized controlled trials: comparing China-based vs. Western-based studies","volume":"42","author":"Gang","year":"2022","journal-title":"Zhongguo Zhen Jiu"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2024-094239","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T23:17:27Z","timestamp":1764890247000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2024-094239"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":32,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10,29]]},"published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1136\/bmjopen-2024-094239"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2024-094239","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]}}}