A comparison of the efficacy and safety of complementary and alternative therapies for the primary dysmenorrhea: A network meta-analysis protocol.

Background: There are a number of complementary and alternative therapies for the primary dysmenorrhea (PD) and their efficacy has been assessed by several systematic reviews. But only pair-wised drugs have been evaluated in the traditional meta-analyses and conflicting interpretation of results also existed among different studies. Here, a protocol for a network meta-analysis will be presented aimed to compare the efficacy and safety of different complementary and alternative therapies for PD. Methods: All randomized controlled trials of complementary and alternative therapies for the PD will be included. The primary outcomes of our interest are pain intensity and pain duration and the secondary outcomes are quality of life, clinical effective rate, and adverse events. We will search relevant database, the ongoing trial, previous relevant reviews and reference lists, and so on. The identification and selection of studies and data extraction will be conducted by two independent reviewers. We will perform a battery of pairwise meta-analyses and Bayesian network meta-analyses to assess the relative outcomes of different complementary and alternative therapies. We will use the surface under the cumulative ranking curve values and the mean ranks to get the treatment hierarchy, and then use the node-splitting method to evaluate consistency. The softwares WinBUGS 1.4.3 and STATA will be selected and the quality of the evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation instrument. Ethics and dissemination: This review does not require ethical approval. PROSPERO registration number: PROSPERO CRD42018107763.