• Title/Summary/Keyword: Cochrane Risk of Bias

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Electro-Acupuncture for Cervical Vertigo: A Systematic Review and Meta-analysis (경추성 현훈에 대한 전침 치료: 체계적 문헌고찰 및 메타분석)

  • Kim, Ye-eun;Chung, In-che;Cha, Yun-yeop;Han, In-sik;Park, In-hwa
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.1
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    • pp.109-118
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    • 2021
  • Objectives The objective of this study was to appraise the effect of electro-acupuncture (EA) for the treatment of cervical vertigo. Methods We performed a literature search using nine electronic databases up to the end of November 2020. We included randomized controlled trials (RCTs) which appraised the effect of EA in the treatment of cervical vertigo. The risk of bias was evaluated from the Cochrane risk of bias tool. Results Thirteen appropriate RCTs were included and analyzed. The efficacy rate of the EA group was statistically higher compared with the control group treated with western medicine (p<0.00001). EA treatment significantly improved efficacy rate when combined with western medicine than western medicine alone (p<0.0001). Also EA used with combined therapy (traction, traditional chinese medicine, injection) significantly improved efficacy rate compared with combined therapy alone (p=0.02). Meta-analysis of thirteen studies demonstrated positive results for using EA for the treatment of cervical vertigo. Conclusions Based on results, EA treatment could be effective in cervical vertigo. However, it should be noted that the studies included in this research are regionally biased and small in number. Further well-designed research should be required.

Diagnostic accuracy of clinical tests to rule out elbow fracture: a systematic review

  • Giorgio Breda;Gianluca De Marco;Pierfranco Cesaraccio;Paolo Pillastrini
    • Clinics in Shoulder and Elbow
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    • v.26 no.2
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    • pp.182-190
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    • 2023
  • Elbow traumas represent a relatively common condition in clinical practice. However, there is a lack of evidence regarding the most accurate tests for screening these potentially serious conditions and excluding elbow fractures. The purpose of this investigation was to analyze the literature concerning the diagnostic accuracy of clinical tests for the detection or exclusion of suspected elbow fractures. A systematic review was performed using the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) guidelines. Literature databases including PubMed, Cumulative Index to Nursing and Allied Health Literature, Diagnostic Test Accuracy, Cochrane Library, the Web of Science, and ScienceDirect were searched for diagnostic accuracy studies of subjects with suspected traumatic elbow fracture investigating clinical tests compared to imaging reference tests. The risk of bias in each study was assessed independently by two reviewers using the Quality Assessment of Diagnostic Accuracy Studies 2 checklist. Twelve studies (4,485 patients) were included. Three different types of index tests were extracted. In adults, these tests were very sensitive, with values up to 98.6% (95% confidence interval [CI], 95.0%-99.8%). The specificity was very variable, ranging from 24.0% (95% CI, 19.0%-30.0%) to 69.4% (95% CI, 57.3%-79.5%). The applicability of these tests was very high, while overall studies showed a medium risk of bias. Elbow full range of motion test, elbow extension test, and elbow extension and point tenderness test appear to be useful in the presence of a negative test to exclude fracture in a majority of cases. The specificity of all tests, however, does not allow us to draw useful conclusions because there was a great variability of results obtained.

Ginseng for Reducing the Blood Pressure in Patients with Hypertension: A Systematic Review and Meta-Analysis

  • Hur, Myung-Haeng;Lee, Myeong-Soo;Yang, Hye-Jeong;Kim, Chan;Bae, Ik-Lyul;Ernst, Edzard
    • Journal of Ginseng Research
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    • v.34 no.4
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    • pp.342-347
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    • 2010
  • Ginseng is one of the most-widely used herbal remedies. This systematic review evaluates the current evidence for its use in the reducing blood pressure (BP) in patients with hypertension. Systematic searches of 12 electronic databases were conducted without language restrictions. All randomized clinical trials (RCTs) of ginseng as a treatment for hypertension were candidates for inclusion. Methodological quality was assessed using the Cochrane risk of bias. Five RCTs met the inclusion criteria. The risk of bias was low in most of the trials. Four of the included RCTs compared the effectiveness of ginseng to placebo. The meta-analysis of these data failed to show a statistically significant acute effect on systolic BP (SBP) or diastolic BP (DBP). However, subgroup analyses showed beneficial effects of Korean red ginseng (KRG) on both SBP (n=54, mean difference [MD], -6.52; 95% confidence interval [CI], -9.99 to -3.04; p=0.0002) and DBP (n=54, MD, -5.21; 95% CI, -7.90 to -2.51; p=0.0001). Two RCTs tested the long-term effects of ginseng for BP for 24hours. One of these trials failed to show any benefits of KRG compared to no treatment, and the other failed to show superior effects of North American ginseng compared to placebo. Adverse events with ginseng were none in one trial or not assessed. Collectively, these RCTs provide limited evidence for the acute effectiveness of KRG in the treatment of high BP. The total number of RCTs included in the analysis and the total sample size were insufficient to draw definitive conclusions. More rigorous studies are warranted.

Red Meat Intake and Risk of Non-Hodgkin Lymphoma: A Meta-Analysis

  • Fallahzadeh, Hosein;Cheraghi, Maria;Amoori, Neda;Alaf, Mehrangiz
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10421-10425
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    • 2015
  • Background: While the incidence of non-Hodgkins lymphoma (NHL) has been rising worldwide, the reasons remain undefined. Recent research has focused on effect of red andf processed meat intake as a risk factor, but with inconclusive results. We therefore conducted a meta-analysis of data published to date, to ascertain the overall association between intake and NHL. Materials and Methods: A published literature search was performed through Pubmed, Cochrane Library, Medline, and Science Citation Index Expanded databases for articles published in English. Pooled odds ratios (ORs) and 95% confidence intervals (95%CIs) were calculated using random or fixed effects models. Heterogeneity was assessed using Chi-square and I2 statistics. Dissemination bias was evaluated by funnel plot analysis.We performed a formal meta-analysis using summary measures from these studies. Results: In total, 11 published studies were included in the final analysis. The combined analysis revealed that there was significant association between the red meat and NHL risk (OR=1.10, 95%CI: 1.02 to 1.19, p=0.01). Additionally, there was showed significance association between processed red meat and NHL risk (OR=1.17, 95%CI: 1.06 to 1.29, p=0.001). In subgroup analysis, a statistical significant association was noted between diffuse large B-cell lymphoma (DLBCL) (OR=1.20, 95%CI: 1.04 to 2.37, P=0.01) and red meat intake. Conclusions: In this meta-Analysis, there was evidence for association between consumption of red meat, or processed meat and risk of NHL, particularly with the DLBCL subtype in the red meat case.

Recent Trends in Clinical Research on Herbal Medicine Based on Pinellia Ternata for Treatment of Gastroesophageal Reflux Disease (위식도역류질환의 한약 치료에 대한 최신 임상 연구 동향 - 반하(半夏)를 중심으로 -)

  • Jang, Hye-yeon;Kim, Young-kwang;Jeong, Seo-yun;Kim, Do-hyeong;Kim, Kyeong-ok;Lee, Young-su
    • The Journal of Internal Korean Medicine
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    • v.41 no.6
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    • pp.1119-1140
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    • 2020
  • Objective: The purpose of this study was to review Chinese clinical studies of the treatment of gastroesophageal reflux disease (GERD) with herbal medicine including Pinellia ternata. Methods: We searched the China National Knowledge Infrastructure (CNKI) database for clinical studies on herbal treatments including Pinellia ternata for GERD, from January 1st, 2015 to September 30th, 2019. We evaluated the risk of bias using Cochrane's risk of bias to confirm the quality of the 37 selected documents. Results: The 37 papers included high-dose and middle-dose Pinellia ternata groups. The outcome measures included treatment effectiveness rate, symptom comparisons, and endoscopy effectiveness rates or scores. In both groups, most studies showed significant improvement in the treatment group compared with the control group. The meta-analysis revealed a higher treatment effectiveness rate and a lower recurrence rate in the treatment group than in the control group. Conclusions: Comparing the treatment effect between the two groups was difficult due to the low quality of most studies. However, the results suggest that herbal remedies including Pinellia ternata showed statistically significant improvement in GERD compared to control groups.

A Systematic Review on the Treatment of Post-Stroke Patients Based on Sasang Constitutional Medicine (사상의학적 중풍 후유증 치료에 대한 체계적 문헌 고찰)

  • Oh, Hyunjoo;Lee, Jeongyun;Lee, Hyeri;Lee, Junhee
    • Journal of Sasang Constitutional Medicine
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    • v.34 no.2
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    • pp.48-64
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    • 2022
  • Objectives The purpose of this study was to review and evaluate the clinical evidence of the efficacy and safety of treatment based on Sasang constitutional medicine (SCM) for post-stroke patients by systematic review and meta-analysis. Methods Randomized controlled trials (RCTs), published in 10 electronic databases up to December 2020, were searched. For the included studies, Cochrane's risk of bias assessment was performed to analyze the methodological quality. The strength of evidence was evaluated using the grading of recommendations assessment, development, and evaluation system based on the results of analyses. All review processes were performed by two independent researchers. Results Five RCTs were finally included. All included RCTs were conducted for one month on post-stroke patients in 60-80s, four studies on Tae-Eum patients and one study on So-Yang patients. Four types of constitution-specific herbal medicine (Chungpyesagan-tang, Cheongsimsanyak-tang, Yeoldahanso-tang, and Yangkyuksanhwa-tang) and constitution-specific acupuncture therapy were identified as interventions. More than half of the included studies were evaluated as low quality due to the high-risk of bias in selection, performance, and detection. The combination of constitution-specific herbal medicine, acupuncture, and conventional treatment was more effective in improving the patients' motor impairment, dysphagia, aphasia, and depression than conventional treatment alone. No serious adverse events by SCM treatment were reported. Conclusions SCM treatment may improve the sequelae of post-stroke patients safely in combination with conventional treatment. Since the quality of clinical evidence included in this study was low, higher quality clinical evidence obtained in well-designed clinical studies will be needed.

Acupuncture for Rehabilitation in Patients with Traffic Accident in South Korea: a Systematic Review (국내 교통사고 후유증의 침치료에 대한 체계적 문헌고찰)

  • Kim, Kun-Hyung;Nam, Dong-Woo;Kang, Jung-Won;Lee, Jae-Dong;Choi, Do-Young
    • Journal of Acupuncture Research
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    • v.27 no.1
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    • pp.21-29
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    • 2010
  • Objectives : This study aims to evaluate current clinical evidence of acupuncture treatment for rehabilitation in patients with traffic accident in South Korea. Methods : Seven Korean databases were searched for prospective clinical trials for acupuncture on rehabilitation in patients with traffic accident from their inception to June, 2009. Only studies conducted in Korean language were searched. Risk of bias in included randomized controlled trials were assessed by Cochrane Handbook procedure. Results : Fifteen clinical trials were included among 31 studies searched. Eight were observational studies, five were non-randomizedcontrolled trials, and two were randomized controlled trials. In all of included studies, acupuncture were conducted with other concomitant treatment. Included studies dealt with such conditions as neck pain, low back pain tinnitus after traffic accident, post-traumatic stress, oculomotor nerve palsy, diplopia and insomnia. All of included studies reported favorable effects of acupuncture group compared to baseline or control group. All of included studies lacked the occurrence of adverse events. High risk of bias were observed in two randomized controlled trials. Conclusions : There is no evidence that acupuncture is effective for rehabilitation of traffic accident. All of included studies lacked appropriate methodological qualities and internal validity. Future welldesigned clinical trials that evaluate the effects and safety of acupuncture treatment for rehabilitation in patients with traffic accident is needed.

A Systematic Review and Meta-Analysis on the Effect of Guibi-tang for Postpartum Depression (산후우울증에서 귀비탕(歸脾湯)의 임상효과에 대한 체계적 문헌 고찰 및 메타분석)

  • Eun-Sol Kang;Young-Tae Ahn;Hyo-Jeong Kim;Ji-Soo Hyun;Jin-Young Kang;Yoon-Jae Lee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.36 no.2
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    • pp.55-68
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    • 2023
  • Objectives: The purpose of this study is to analyze the effectiveness of Guibi-tang that are used for postpartum depression. Methods: We searched on five databases [Korean studies Information Service (KISS), Oriental medicine advanced searching integrated system (OASIS), The Cochrane Library, PubMed, and China national knowledge infrastructure (CNKI)] with keywords for Postpartum depression (English, Korean, and Chinese) and evaluated the risk of bias. Meta-analysis was performed on the selected studies. Results: 8 potentially relevant articles were retrieved for further evaluation. There was evidence that Guibi-tang compared with Western medicine was significantly higher rate in total effect rate (RR 1.20, 95% CI 1.04, 1.39, p=0.01). Also, the combined therapeutic effects of Guibi-tang and Psychological intervention compared with Psychological intervention were statistically significant in total effect rate (RR 1.14, 95% CI 1.05, 1.24, p=0.002). And they showed improvement on scores of HAMD (Hamilton depression scale, HAMD) and SF-36 (36-Item short form health survey, SF-36). Conclusion: Guibi-tang appears to be more effective compared to Western medicine in the treatment of postpartum depression. The combination Guibi-tang and Psychological intervention was more effective than psychological intervention alone treated for postpartum depression. However, since unclear risk of bias, the result of this study should be considered carefully. Further clinical trials should be carried out in order to academical clinical progress regarding treatment of Postpartum Depression.

Electroacupuncture for Women with Overactive Bladder: A Systematic Review and Meta-analysis of Randomized Controlled Trials (여성 과민성 방광 전침 치료의 무작위 대조군 연구에 관한 체계적 문헌 고찰)

  • Ha, Su-Jin;Hwang, Deok-Sang;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock
    • The Journal of Korean Obstetrics and Gynecology
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    • v.33 no.3
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    • pp.1-19
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    • 2020
  • Objectives: The purpose of this study is to assess the efficacy and safety of electroacupuncture for women with overactive bladder (OAB) comparing with sham- acupuncture, and electroacupuncture plus drugs. Methods: We searched 8 databases upto May 26, 2020. Randomised controlled trials (RCTs) were eligible. The risk of bias was assessed by two independent authors using the Cochrane risk of bias tool. Study outcomes were calculated by standardized mean differences (SMD) with 95% confidence intervals (Cls) and mean differences (MD) with 95% Cls. Results: Of 146 screened, 5 RCTs were included. Number of participants per study ranged from 5 to 57. The combined results showed that electroacupuncture (EA) may be more effective than sham acupuncture or enhance solifenacin succinates in improving Overactive Bladder Symptom Score (OABSS) and urination frequency of 24 h. However, more trials with high quality and larger sample sizes will be needed to provide sufficient evidence. Only 5 of 187 OAB patients from the included studies reported mild adverse reactions related to EA, therefore, electroacupuncture is safe for treating OAB. Conclusions: Electroacupuncture might have effect in decreasing urination frequency of 24 h and OABSS. However, the evidences ins in sufficient to show the effect using electroacupuncture alone or additional effect to drugs in treating OAB.

Systematic Review of External Qigong Therapy for Joint Pain (관절 통증에 대한 외기 방사 기공 요법의 체계적 문헌고찰)

  • Lee, Hyeon-Yeop;Hwang, Man-Suk;Heo, In;Shin, Byung-Cheul;Heo, Kwang-Ho;Hwang, Eui-Hyoung
    • Journal of Korean Medicine Rehabilitation
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    • v.24 no.4
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    • pp.187-193
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    • 2014
  • Objectives The aim of this study is to analyze the therapeutic effect of external Qigong therapy for treatment of other people's disease on joint pain. Methods We searched articles from Pubmed, Chinese Academic Journals (CAJ) and Oasis online databases. Searching keywords were 'external qigong', 'external qi gong', 'qi therapy', '外气', '关节' and '기공'. After searching the articles, we performed quality assessment using Cochrane risk of bias (RoB) tool and risk of bias assessment tool for non-randomized study (RoBANS). Results Among the 117 articles were searched, 2 randomized controlled clinical trials (RCTs) and 2 single-group before and after studies were finally selected. All of 4 studies showed that external Qigong therapy has significant effect on joint pain. Conclusions Although external Qigong therapy has therapeutic effect on joint pain, it is not common therapy yet. However, external Qigong therapy requires more interests and studies in the future, because it is faithful therapy for Korean medicine theory.