assessment could take only very limited information into account. OTHER RESULTS Results from comparative effectiveness reviews (ie, reviews comparing acupuncture to other active treatments) were summarized in a narrative synthesis for each of the domains. Adverse events of acupuncture interventions were summarized in a narrative synthesis. For this broad overview we only included reviews addressing adverse events in the title or the abstract of the publication and thereby indicating that adverse events were one of the main research questions addressed by the review. FUTURE RESEARCH We identified evidence gaps by documenting clinical indications for which there is conflicting evidence across identified reviews or where reviews concluded that the existing evidence base is insufficient to come to firm conclusions. In addition, we documented those topic areas for which systematic reviews exist, but for which the reviews did not identify relevant RCTs. For the nonpriority areas we highlighted where research on acupuncture was available but there were only Evidence Map of Acupuncture Evidence-based Synthesis Program 7 one or 2 systematic reviews published since 2005 to provide a current estimate of the evidence. Finally, we checked the literature for ongoing systematic reviews that may become available to summarize a topic area in the near future. TECHNICAL EXPERT PANEL The technical expert panel (TEP] for the project included Dr. Stephen Ezeji-Okoye, VHA CO Field Advisory Committee on Complementary and Alternative Medicine; Laura Krejci, Associate Director Office of Patient Centered Care and Cultural Transformation; Dr. Edward Seunghoon Lee; Dr. Marc Goldstein; Dr. An-Fu Hsiao; and Dr. Walter Fricke. PEER REVIEW A draft version of the deliverables was reviewed by technical experts, as well as clinical leadership. Reviewer comments were addressed in the final product and are documented in the appendix. Evidence Map of Acupuncture Evidence-based Synthesis Program 8 RESULTS The electronic literature search identified 1,223 citations. Of these, 183 citations were classified as unique systematic review citations meeting the inclusion criteria.24-205 The number of systematic review publications by year is shown in Figure 1 below. Figure 1: Systematic reviews on acupuncture published January 2005 to March 2013 The number of published reviews is increasing, between 9 and 35 reviews were published each year with a peak at 2012. The 2013 column only shows systematic reviews published between January and March 2013. For the evidence map, the results of the existing systematic reviews are presented in the priority areas: Pain, Wellness, and Mental Health. The distribution of topics is shown in Figure 2 below. Figure 2: Research volume by priority topic areas Of the identified priority areas, the most systematic reviews were published relevant to the indication Pain (N=65). In total, 44 reviews were classified as relevant to Wellness. For the indication Mental Health, the fewest systematic reviews were identified (N=20). A large number of systematic review did not appear to be relevant to any of the priority areas (Other Indication N=48). Six systematic reviews focused on Adverse Events, not the clinical effectiveness of acupuncture. The specific clinical topics targeted in the existing systematic reviews included pain, headache, migraine, fibromyalgia, myofascial trigger point pain, burning mouth syndrome, ankle sprain, neck disorder, dysmenorrhea, trigeminal neuralgia, analgesia during surgery, anxiety, schizophrenia, depression, posttraumatic stress disorder, dementia, Alzheimer’s Disease, chronic Evidence Map of Acupuncture Evidence-based Synthesis Program 9 fatigue syndrome, addiction in general, cocaine addiction, alcohol addiction, opiate addiction, smoking, opioid withdrawal symptoms, quality of life, exercise performance, hiccups, hot flushes, cancer, menopause-related effects, insomnia, cancer-related fatigue, nausea, cancer treatment-related adverse events, uremic pruritus, vasomotor menopausal symptoms, dry eye, dry mouth, premenstrual syndrome, erectile dysfunction, obesity, irritable bowel syndrome, constipation, Ménière’s disease, allergic rhinitis, tinnitus, restless legs, temporomandibular disorders, stroke, Bell’s palsy, fertility treatment, arthritis, Parkinson, uterine fibroids, pressure ulcer, traumatic brain injury, spinal cord injury, fetal breech presentation, labor induction, aphasia, blood pressure, glaucoma, epilepsy, respiratory disease, asthma, facial spasm, cervical spondylotic radiculopathy, polycystic ovarian syndrome, and angina pectoris symptoms. Evidence Map of Acupuncture Evidence-based Synthesis Program 10 EVIDENCE MAP OF ACUPUNCTURE FOR PAIN The results for the clinical indication Pain are presented in the bubble plot and a text summary below. The bubble plot summarizes the results of 59 systematic reviews for 21 distinct indications relevant to the outcome pain [search date: March 2013]. Legend: The bubble plot shows an estimate of the evidence base for pain-related indications judging from systematic reviews and recent large RCTs. The plot depicts the estimated size of the literature (y-axis, number of RCTs included in largest review), the estimated effect (x-axis), and the confidence in the estimate (bubble size). Evidence Map