• Title/Summary/Keyword: Cochrane Risk of Bias

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Anesthetic efficacy in vital asymptomatic teeth using different local anesthetics: a systematic review with network meta-analysis

  • Amy Kia Cheen Liew;Yi-Chun Yeh ;Dalia Abdullah ;Yu-Kang Tu
    • Restorative Dentistry and Endodontics
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    • v.46 no.3
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    • pp.41.1-41.23
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    • 2021
  • Objectives: This study aimed to evaluate the efficacy of various local anesthesia (LA) in vital asymptomatic teeth. Materials and Methods: Randomized controlled trials comparing pulpal anesthesia of various LA on vital asymptomatic teeth were included in this review. Searches were conducted in the Cochrane CENTRAL, MEDLINE (via PubMed), EMBASE, ClinicalTrials.gov, Google Scholar and 3 field-specific journals from inception to May 3, 2019. Study selection, data extraction, and risk of bias assessment using Cochrane Risk of Bias Tool were done by 2 independent reviewers in duplicate. Network meta-analysis (NMA) was performed within the frequentist setting using STATA 15.0. The LA was ranked, and the surface under the cumulative ranking (SUCRA) line was plotted. The confidence of the NMA estimates was assessed using the CINeMA web application. Results: The literature search yielded 1,678 potentially eligible reports, but only 42 were included in this review. For maxillary buccal infiltration, articaine 4% with epinephrine 1:100,000 was more efficacious than lidocaine 2% with epinephrine 1:100,000 (odds ratio, 2.11; 95% confidence interval, 1.14-3.89). For mandibular buccal infiltration, articaine 4% with epinephrine 1:100,000 was more efficacious than various lidocaine solutions. The SUCRA ranking was highest for articaine 4% with epinephrine when used as maxillary and mandibular buccal infiltrations, and lidocaine 2% with epinephrine 1:80,000 when used as inferior alveolar nerve block. Inconsistency and imprecision were detected in some of the NMA estimates. Conclusions: Articaine 4% with epinephrine is superior when maxillary or mandibular infiltration is required in vital asymptomatic teeth.

Intranasal Phototherapy for Allergic Rhinitis : a systematic review (알레르기 비염의 비강 내 광 치료 : 체계적 문헌고찰)

  • Kang, Jeong-In;Min, Kyung-Jin;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.33 no.4
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    • pp.55-73
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    • 2020
  • Objectives : We investigated the effectiveness and safety of intranasal phototherapy for allergic rhinitis (AR). Methods : We searched 8 electronic databases (PubMed, Cochrane Library, CNKI, CiNii Articles, OASIS, NDSL, KISS, KMbase) to identify randomized controlled trials (RCTs) that reported the use of intranasal phototherapy for AR from their inception until May 30, 2020. Two investigators independently searched, collected, and screened the RCTs. We performed data extraction and evaluation for risk of bias using the Cochrane risk-of-bias tool. Results : This study included 12 RCTs; six studies compared intranasal and sham phototherapy, of which four studies reported a significant inter group difference and two studies reported a significant difference partially. No significant changes in symptoms were observed between the phototherapy and conventional therapy groups. The phototherapy and concurrent acupuncture treatment group showed a significantly higher effectiveness rate compared with the group that received only acupuncture. Both the phototherapy and laser acupuncture group showed significant improvement in the symptom severity scale scores. Six studies reported mild adverse effects, such as dryness and nasal pain in the intranasal phototherapy group; however, no severe adverse effects were reported. Conclusions : This study confirmed the safety and effectiveness of intranasal phototherapy for symptom relief and improved quality of life in patients with AR. However, further studies are needed on this topic in order to demonstrate it clearly.

A Systematic Review on Nurse-Led Transitional Care Programs for Discharged Patients from Hospital to Home (퇴원환자를 위한 간호사 주도 전환 프로그램의 내용과 효과에 관한 체계적 문헌고찰)

  • Lee, Hyun Joo;Kim, Yukyung;Oh, Eui Geum
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.3
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    • pp.376-387
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    • 2017
  • Purpose: This study was to systematically review the contents and effects of nurse-led transitional care programs for discharged patients from hospital to home. Methods: Randomized controlled trials published between 2005 and 2015 were searched in Pubmed, Embase, Cochrane(Central Register of Controlled Trials) and CINAHL. Data were analyzed using Cochrane Review Manager(Revman) software 5.3. Results: Nine studies were selected and analyzed. Patient assessment, education and discharge planning were included in pre-discharge phase. Referring, communication and care planning were performed by nurses in transition phase. Home and phone visits, monitoring and multidisciplinary advices were included in post-discharge phase. Various outcome measures such as hospital utilization(30 days readmission and emergency department visit), quality of life, and cost were used to identify effectiveness of nurse-led transitional care programs. 30 days readmission(OR=.73, 95% CI 0.54, 0.98; p=.03) and emergency department visit(OR=.67, 95% CI 0.50, 0.88; p=.005) were statistically significant in meta-analysis. However, participant blinding was not done in seven studies which put at the risk of performance bias. Conclusion: The results indicated that nurse-led transitional care program is effective in reducing unnecessary hospital utilization. Nevertheless, small sample size and risk at performance bias are the limitation of this study. Thus, we suggest that well-designed randomized controlled trials need to be conducted.

Trends of Research on the Effects of Psychosocial Intervention for Children with Epilepsy: Systematic Review (간질아동에게 제공된 심리사회적 중재의 효과에 대한 연구동향: Systematic Review)

  • Yoo, Hana;Yun, O Bok
    • The Journal of the Korea Contents Association
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    • v.14 no.6
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    • pp.219-228
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    • 2014
  • The purpose of this study was to determine the trends of research on the effects of psychosocial intervention related to children with epilepsy. 454 articles were retrieved from databases (Ovid-MEDLINE, EMBASE, PubMed, CINAHL, The Cochrane library, KMbase, and Koreamed), and 7 articles met our criterias. Interventions were classified into four categories: education; counseling; cognitive-behavioral therapy; and physical activity. The target outcomes of the interventions were quite diverse. Each intervention showed some benefits for epilepsy-related health outcomes, but each study had methodological weaknesses, including incomplete information, poorly defined or validated outcome measures, small sample sizes, and design limitations.

Effects of Microcurrent on Inflammatory Musculoskeletal Diseases: A Meta-Analysis (염증성 근육뼈대계 질환에 대한 미세전류의 효과: 메타분석)

  • Lee, Jeongwoo;Ko, Un;Doo, Yeongtaek
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.4
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    • pp.1-11
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    • 2020
  • Purpose : The purpose of this meta-analysis was to examine the effects of microcurrent on inflammatory musculoskeletal diseases. Methods : Domestic databases (RISS, NDSL, KISS, DBpia, and Kmbase) were searched for studies that conducted clinical trials associated with microcurrent and its impact on inflammatory musculoskeletal diseases. A total of 606 studies published between 2002 and 2019 were identified, with 8 studies satisfying the inclusion data. The studies were classified according to patient, intervention, comparison, and outcome (PICO). The search outcomes were items associated with blood component, pain, and function. The 8 studies that were included in the study were evaluated using R meta-analysis (version 4.0). The quality of 7 randomized control trials was evaluated using Cochrane risk of bias (ROB). The quality of 1 non-randomized control trial was evaluated using risk of bias assessment tool for non-randomized studies (RoBANS). Effect sizes were computed as the corrected standard mean difference (SMD). A random-effect model was used to analyze the effect size because of the high heterogeneity among the studies. Egger's regression test was carried out to analyze the publishing bias. Results : The following factors had a large effect size involving microcurrent on inflammatory musculoskeletal diseases: blood component (Hedges's g=-2.46, 95 % CI=-4.20~-0.73), pain (Hedges's g=3.51, 95 % CI=2.44~4.77), and function (Hedges's g=3.06, 95 % CI: 1.53~4.58). Except for function (t=1.572, p=.191), Egger's regression test showed that the publishing bias had statistically significant differences. Conclusion : This study provides evidence for the effectiveness of microcurrent on inflammatory musculoskeletal diseases in terms of blood component, pain, and function. However, due to the small sample sizes used in the included studies, the results of our study should be interpreted cautiously, especially considering the publishing bias.

Effects of Workplace Risk Assessment-based Ergonomic Intervention on Work-Related Muscular Skeletal Disorders: Systematic Literature Review and Meta-Analysis (작업장 유해요인조사에 기반한 인체공학적 중재가 작업 관련성 근골격계 질환의 증상에 미치는 효과: 체계적 문헌고찰 및 메타분석)

  • Cho, Jung Young;Kim, Gaeun
    • Korean Journal of Occupational Health Nursing
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    • v.29 no.4
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    • pp.342-353
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    • 2020
  • Purpose: This study aimed to systematically review literature and conduct a meta-analysis to comprehensively identify and evaluate the effects of workplace risk assessment-based ergonomic intervention on work-related muscular-skeletal disorders in workers. Methods: We searched the Ovid-Medline, EMBASE, and Cochrane library and up to 2018 using search terms such as muscular-skeletal, disorder, impairment, work-related muscular-skeletal disorders, ergonomic, intervention, management with no language limitations; screened reference lists; and contacted experts in the field. Results: We identified 545 references and included 13 randomized controlled tests (3,368 workers). We judged nine studies to have a low risk of bias, while the other four studies have a high risk of bias. Conclusion: Ergonomic intervention based on risk assessment in the workplace did not significantly differ in terms of the intensity of pain or duration of workers in the workplace, but low-quality evidence decreased the frequency of musculoskeletal disorder pain in three to six months moderate-quality evidence and in six to nine months low-quality evidence. Besides, low-quality evidence to reduce discomfort and moderate-quality evidence to improve worker posture. Therefore, ergonomic intervention based on the assessment of risk factors in the workplace should be applied to reduce pain frequency and discomfort and improve workers posture among musculoskeletal disorders.

Systematic Review of Herbal Medicine Fumigation Treatment for Mycotic Vaginitis (Candida Vaginitis) (진균성 질염의 한약 훈증 치료에 대한 체계적 문헌 고찰)

  • Park, Kyung-Dug;Bae, Ju-Eun;Yoon, Young-Jin
    • The Journal of Korean Obstetrics and Gynecology
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    • v.31 no.3
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    • pp.20-32
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    • 2018
  • Objectives: The purpose of this study is to identify the effectiveness of fumigation treatment, provide a clinical basis for fumigation therapy, and develop treatment protocols through consideration of treatment methods and herbal medicines. Methods: We searched for randomized controlled clinical trials using fumigation treatment on mycotic vaginitis in 8 electronic databases such as EMBASE, Pubmed, and CNKI. The results of the studies were analyzed and the risk of bias was assessed by using Cochrane risk of bias tool. A meta-analysis was performed to reveal the effectiveness of fumigation compared to control treatments. Results: We finally selected 5 studies among 54 articles according to inclusion criteria and exclusion criteria. In all selected studies, herbal fumigation was more effective than any control treatment and all the studies were statistically significant. Conclusions: The study provides a basis for applying fumigation treatment to patients with mycotic vaginitis and helps developing a treatment protocol of caring patients of mycotic vaginitis. But the limitation of this study is that the number of studies included is small and quantitative synthesis of all results has not been achieved.

A Systematic Review and Meta-Analysis of Manual Therapy for Neck Pain Caused by Traffic Accidents (교통사고로 인한 경항통에 적용한 수기요법의 효과: 체계적 고찰 및 메타분석)

  • Kang, Seok-Beom;Shon, Woo-Seok;Kim, Young-Jun;Woo, Chang-Hoon
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.16 no.2
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    • pp.21-28
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    • 2021
  • Objectives To investigate the effectiveness of manual therapy for neck pain caused by traffic accidents. Methods We searched six electronic databases (OASIS, KISS, RISS, NDSL, MEDLINE, and Cochrane Library) to gather randomized controlled trials using the keywords 'manual theray OR chuna OR tuina' and 'whiplash injury OR neck sprain'. Results Eight RCTs were selected based on the inclusion criteria. Four studies were meta-analyses. The systematic review found a positive effect of manual therapy for whiplash injury. All studies showed a high risk of performance bias. Conclusions The systematic review reported favorable results using manual therapy for neck pain caused by traffic accidents. However, this study has several limitations owing to the high risk of bias. Further clinical studies and the development of a study design are required for stronger evidence.

The Reliability of Balance, Gait, and Muscle Strength Test for the Elderly with Dementia: A Systematic Review

  • Lee, Han-Suk;Park, Sun-Wook
    • Journal of the Korean Society of Physical Medicine
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    • v.12 no.3
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    • pp.49-58
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    • 2017
  • PURPOSE: To summarize the evaluation tools of balance [Berg Balance Scale (BBS), timed up and Go (TUG), forward reaching test (FRT)], gait [6 m walking Test (6MWT)], and strength [Chair Stand Test (CST)] for patients with dementia. METHODS: The following databases were searched: Pub MED, Cochrane, Sciences Direct, and Web of Sciences. The inclusion criteria were as follows: 1) repeated measurement design, 2) subjects with dementia, 3) use of testing tools such as the BBS, TUG, FRT, 6MWT, and CST, 4) report the reliability. One reviewer performed the quality assessment of diagnostic accuracy study and two evaluators performed data extraction independently. RESULTS: Six articles and one letter were included. The interrater reliability of 6MWT, TUG, and CST, were acceptable (ICC>.90). However, FRT had unacceptable reliability. In test-retest reliability, only BBS has acceptable reliability (ICC>.90). Others had various reliabilities. The risk of interrater reliability bias was low in all studies. However, the risk of bias of intrarater reliability was low in five studies and moderate in two studies. CONCLUSION: The interrater reliability of the 6MWT, TUG, and CST were acceptable. However, in test-retest reliability, only BBS has acceptable reliability. Therefore, we suggest the use of BBS to test the balance of dementia patients. In addition, the study of tool reliability according to the subtype of dementia is needed in the future.

A Study on the Clinical Study of Herbal Medicine for Glucose-Lipid Metabolism Abnormalities in Polycystic Ovary Syndrome (다낭성 난소 증후군의 당-지질대사 이상에 대한 한약 임상 연구 고찰)

  • Park, Su-Yeon;Park, Kyung-Dug;Yoon, Young-Jin
    • The Journal of Korean Obstetrics and Gynecology
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    • v.32 no.4
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    • pp.67-86
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    • 2019
  • Objectives: The purpose of this study is to investigate the effect of herbal medicine treatment for glucose and lipid metabolic abnormalities caused by polycystic ovary syndrome (PCOS). Methods: We searched for randomized controlled clinical trials (RCTs) in 6 electronic databases and search key words were 'PCOS' and 'chinese medicine' or 'herbal medicine' and 'Metabolic syndrome' or 'glucose' or 'lipid'. The results of the studies were analyzed and the risk of bias was assessed by using Cochrane risk of bias (RoB) tool. Results: We finally selected 7 studies. In 3 of selected studies, herbal medicine was more effective than western medicine in all outcomes and in other 3 selected studies, herbal medicine was partially more effective than western medicine. Conclusions: The study provides a basis for applying herbal medicine treatment to patients with metabolic syndrome caused by PCOS and helps developing a treatment protocol of caring patients with PCOS. But the limitation of this study is that the number of studies included is small and lack of uniformity of outcome indicators made it difficult to observe overall interrelationship between indicators.