Supplementary Material for: Acupuncture as an adjunctive therapy for acute cerebral infarction: A modified Delphi consensus study

Background: Acupuncture is an effective adjunctive therapy for stroke and has been suggested for the treatment for acute cerebral infarction (ACI). However, there is a lack of high-quality data from randomized clinical trials. Thus, this study aims to reach a consensus to guide the clinical research and practice. Methods: The initial project list was based on a systematic review of research evidence and a clinical problem survey conducted by a multidisciplinary team. After discussion with experts and a two-round Delphi consensus survey, the final list was optimized. Then, Likert scale of 9 points was used to measure the degree of expert consensus (1 = strongly disagree, 9 = strongly agree) and 80% of scores between 7 and 9 were defined as "agreement". Results: A total of 30 professionals (response rate: 100%) confirmed their participation in the voting group. After two rounds of Delphi voting, a consensus was achieved including 34 items that can be broadly categorized into six aspects. According to expert consensus, acupuncture should be initiated within 6 hours and the main acupoints are Shuigou (GV26), Neiguan (PC6), Hegu (LI4), and Taichong (LR3), while the auxiliary acupoints include Quchi (LI11), Waiguan (SJ5), Huantiao (GB30), Weizhong (BL40), etc. Furthermore, the adverse events of acupuncture are generally considered to be few, only subcutaneous hematoma is commonly reported. Conclusion: This expert consensus provides recommendations for clinical research and practice in treating ACI with acupuncture. However, due to the limited clinical evidence, further exploration is needed through rigorous clinical trials.