¹ The IBS Severity Scoring System (IBS‐SSS) possesses responsiveness, face and construct validity (Francis 1997), and is one of the most widely used IBS symptom severity outcome measures. Better values are indicated by lower scores.
² This outcome is for the short‐term follow‐up time point, defined as the time point closest to 8 weeks and less than or equal to 3 months after randomization. Outcomes were measured at the end of the treatment period in all studies, and because in all studies the end of treatment time point coincided with the time point closest to 8 weeks and less than or equal to 3 months, our short term outcome time points were the end of treatment for all trials.
³ We used the Lembo 2009 trial as the representative trial for the final value scores of symptom severity and quality of life in the control group because this trial was sufficiently large; the patient characteristics and the baseline means and SDs of symptom severity and quality of life in the control group of this trial were similar to and representative of the other trials; and this trial used the familiar IBS‐SSS scale for symptom severity and the well‐validated IBS‐QoL for quality of life.
⁴ The standardized mean difference (SMD) was re‐expressed into a mean difference by applying the calculated SMD back into the Lembo 2009 study and depicted on the IBS‐SSS scale used in that study. This calculation was made by multiplying the post‐treatment standard deviation of the IBS‐SSS score of the sham group in the Lembo trial by the pooled SMD.
⁵ Imprecision due to sparse data (less than 400 events ) and confidence intervals include possibility of benefit.
⁶ The IBS Quality of Life measure (IBS‐QoL) (Patrick 1998) is an extensively validated IBS quality of life scale (Bijkerk 2003; Irvine 2006). Better values are indicated by higher scores.
⁷ The standardized mean difference (SMD) was re‐expressed into a mean difference by applying the calculated SMD back into the Lembo 2009 study and depicted on the IBS‐QoL scale used in that study. This calculation was made by multiplying the post‐treatment standard deviation of the IBS‐QoL score of the sham group in the Lembo trial by the pooled SMD.

¹ In cases where dichotomous outcomes such as improvement in IBS symptoms were presented in the form of multiple strata, such that we had the option of choosing cutpoints for the dichotomous outcome, we created a dichotomous measure in which all positive outcomes were combined into a single positive category (i.e., improvement) and the remaining strata constituted the negative category (i.e., no improvement). When investigators selected a cutpoint on a continuous scale to dichotomize between improvement and no improvement, we used the same cutpoint to define the dichotomous outcome.
² This outcome is for the short‐term follow‐up time point, defined as the time point closest to 8 weeks and less than or equal to 3 months after randomization.
³ The assumed risk in the control group is based on the percentage of all participants in the control group who experienced improvement in symptom severity. There were a total of 229 control group participants, and 145 of these participants experienced improvement in symptom severity.
⁴ The primary limitation is that treatment in these studies was unblinded, and it is unclear whether or not the greater benefits of acupuncture reported by patients in these unblinded trials are due entirely to patients' greater expectations of improvement from acupuncture than drugs. Additionally, one study author (Xue Y 2009) explained that allocation to treatment was by means of a random number table and did not give further details.

⁵ Imprecision due to sparse data (less than 400 events).