# Bee Venom Acupuncture in Traditional Korean Medicine: A Review of Clinical Practice Guidelines
## 5 Grade of Recommendation for BVA Therapy in TKM-CPGs  
Table 4 summarizes the grade of recommendation for BVA therapy across the included TKM-CPGs. The grades generally reflect the strength of the recommendation, ranging from Grade A (strongly endorsed) to Grade D (not recommended) [17; 22; 23]. \begin{table}
\begin{tabular}{c c c c c c} \hline \hline
**CPG for** & **Grade** & **Harm** & **Availability** & **Medical Cost** &
\begin{tabular}{c} **Patients’** \\ **Preference** \\ \end{tabular} \\ \hline \multirow{4}{*}{Ankle sprain [29]} & (Acute) & Assessed with preceding safety & Assessed with professionals’ & NA & NA \\  & C & reports & consensus & & \\ \cline{2-6}  & (Chronic) & Assessed with professionals’ & NA & NA & NA \\  & C & consensus & & & \\ \hline \multirow{2}{*}{Cancer-accompanying symptoms [39]} & \multirow{2}{*}{C} & Assessed with preceding safety & Assessed with official literature and use statistics & Assessed with inconsistent data & Assessed with professionals’ \\ \cline{2-6}  & & & Assessed but & Assessed with professionals’ & Assessed but inconclusive due to inconsistent data & NA \\ \hline \multirow{2}{*}{Carpal tunnel syndrome [30]} & \multirow{2}{*}{C *} & Assessed with inconsistent data & Assessed with professionals’ & Assessed but inconclusive due to inconsistent data & NA \\ \cline{2-6}  & & & & \\ \hline \multirow{2}{*}{Cervical pain [25]} & \multirow{2}{*}{B} & Assessed with preceding safety & NA & NA & NA \\  & & reports & & & \\ \hline \multirow{2}{*}{Chronic low back pain *[24]} & \multirow{2}{*}{B} & Assessed with preceding safety & Assessed with professionals’ & Assessed but inconclusive due to insufficient data & NA \\  & & reports & & & \\ \hline \multirow{4}{*}{Degenerative arthritis [32]} & (Hip joint) & Assessed with professionals’ & Assessed with use statistics & NA & NA \\  & GPP & consensus & & & \\ \cline{2-6}  & (Phalangal joint) & Assessed with professionals’ & Assessed with use statistics & NA & NA \\  & GPP & consensus & & & \\ \hline \multirow{4}{*}{Facial nerve palsy [37]} & (Facial palsy with delayed treatment) & Assessed with professionals’ & Assessed with professionals’ & NA & NA \\  & C & consensus & & & \\ \cline{2-6}  & (Idiopathic facial & Assessed with professionals’ & NA & NA & NA \\  & C & consensus & & & \\ \cline{2-6}  & (Idiopathic facial & Assessed but inconclusive due to inconsistent data & Assessed with professionals’ & NA & NA \\  & B * & insufficient data & consensus & & \\ \hline \multirow{2}{*}{Gout [41]} & \multirow{2}{*}{GPP *} & \multirow{2}{*}{NA} & Assessed with use statistics & NA & NA \\  & & & & & \\ \hline \multirow{2}{*}{Knee osteoarthritis [27]} & \multirow{2}{*}{B} & Assessed with exceeding safety & Assessed with use statistics & NA & NA \\  & & reports & & & \\ \hline \multirow{2}{*}{Lumbar herinated intervertebral disk [28]} & \multirow{2}{*}{B *} & Assessed with preceding safety & Assessed with use statistics & NA & NA \\  & & reports & & & \\ \hline \multirow{2}{*}{Postoperative syndrome [34]} & \multirow{2}{*}{C *} & Assessed with preceding safety & Assessed with professionals’ & Assessed but inconclusive due to insufficient data & NA \\  & & reports & & consensus & \\ \hline \multirow{2}{*}{Prostatic hypertrophy [40]} & \multirow{2}{*}{GPP *} & Assessed, but no specific reasons & Assessed with use statistics & Assessed, but no specific reasons & Assessed, but no specific reasons \\ \hline \multirow{2}{*}{Rheumatoid arthritis [31]} & \multirow{2}{*}{C} & Assessed with preceding safety & Assessed with use statistics & Assessed, but no specific reasons & NA \\  & & reports & & & \\ \hline \hline \end{tabular}
\end{table} 
Table 4: Recommendations for bee venom acupuncture therapy in clinical practice guidelines of traditional Korean medicine. Overall, the grades of recommendation for BVA varied across conditions. A significant proportion of the recommendations were graded as B or C, indicating that BVA is generally considered advisable or potentially beneficial in specific clinical conditions.