• Title/Summary/Keyword: Cochrane Risk of Bias

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Efficacy of Herbal Medicines for the Treatment of Psoriasis : Systematic Review and Meta-analysis (건선의 한약치료 효과에 대한 체계적 문헌 고찰과 메타 분석)

  • Ryu, Deok-Hyun;Ryu, Deok-Seon;Roh, Seok-Sun
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.30 no.3
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    • pp.1-19
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    • 2017
  • Objectives : This study aimed to validate the effect of herbal medicine intervention to relieve the symptoms of psoriasis using systematic review and meta-analysis and provide the newest reason of effectiveness of Korean medicine to psoriasis. Methods : Data were collected through electronic database including Pubmed, Cochrane CENTRAL, NDSL OASIS, Koreantk. Two experts assessed risk of bias of randomized controlled trials by Cochrane group's Risk of Bias tool after searching, reviewing and selecting papers. Data were analyzed using Review Manager(RevMan) 5.3 and Comprehensive Meta Analysis 2.0. Results : Total number of selected trials was 16 randomized controlled trials. This study evaluated the risk of bias and effectiveness of herbal medicine to psoriasis. There were high frequency uncertain in selection bias, performance bias and detection bias. In this meta-analysis, Korean medicine treatment was more effective than western medicine (ES:0.507, 95%CI:0.147-0.867) and placebo (ES:0.955, 95%CI:0.598-1.312). Conclusions : Herbal medicine intervention can be an effective for treatment in psoriasis. But enhancing levels of evidence, we must try to accumulate clinical researches of herbal medicine to psoriasis in Korea.

Efficacy of corticosteroids for postoperative endodontic pain: A systematic review and meta-analysis

  • Nath, Ranjivendra;Daneshmand, Ali;Sizemore, Dan;Guo, Jing;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.4
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    • pp.205-221
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    • 2018
  • This systematic review aimed to analyze the efficacy of corticosteroid premedication compared to placebo or no treatment to reduce postoperative pain in endodontic patients. Randomized controlled trials (RCTs) assessing corticosteroids via oral, intramuscular, subperiosteal, intraligamentary or intracanal route compared to passive or active placebo, or no treatment were included. Four databases were searched: PubMed, Web of Science, Cochrane Library and Embase up to 2/21/2018. Risk of bias was assessed with Cochrane Risk of bias tool. Fourteen RCTs with 1,462 generally healthy adults in need of endodontic treatment were included. 50% of the studies were at unclear risk and 50% at high risk of bias. Meta-analysis showed Visual Analog Scale (VAS) pain at 4-6 hours after Inferior Alveolar Nerve Block (IANB) was significantly lower by 21 points (0-100 scale) in the corticosteroid group compared to the control group (95% CI -35 to -7; P = 0.003), however this difference was not statistically significant after 24 hours (P = 0.116). The route of administration was oral and intraligament injection. Patients who received corticosteroids prior to IANB were 70.7% more likely to have none or mild pain 4-8 hours after treatment (P = 0.001) and 13.5% more likely 24 hours after IANB (P = 0.013) than patients in the control group. In conclusion, corticosteroid administration (oral or intraligamental) may clinically reduce the level of postoperative pain at 4-8 hours after IANB, however the quality of the evidence was low/moderate due to risk of bias and heterogeneity. Further studies are recommended.

Effectiveness of Non-Pharmacologic Interventions in Chemotherapy Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis (항암화학요법 관련 말초신경병증에 적용한 비약물적 중재의 효과: 체계적 문헌고찰 및 메타분석)

  • Oh, Pok-Ja;Kim, You Lim
    • Journal of Korean Academy of Nursing
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    • v.48 no.2
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    • pp.123-142
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    • 2018
  • Purpose: This study was conducted to evaluate the effectiveness of non-pharmacologic interventions in chemotherapy-induced peripheral neuropathy (CIPN). Methods: PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL, and several Korean databases (Until August 2017) were searched. The main search strategy combined terms for peripheral neuropathy and presence of neoplasms. The risk of bias was assessed using the Cochrane's Risk of Bias tool for randomized studies and the Risk of Bias Assessment tool for non-randomized studies. To estimate the effect size, a meta-analysis of the studies was performed using the Rev Man 5.3 program of the Cochrane Library random-effects models were used in the analyses. Results: Twenty-two studies with a total of 954 participants met the inclusion criteria. Of the 22 studies, 12 were used to estimate the effect size of the non-pharmacologic interventions. The non-pharmacologic interventions used in patients with CIPN were exercise, acupuncture, massage, and foot bath. The acupuncture significantly reduced CIPN symptoms and signs (d=-0.71) and CIPN pain (d=-0.73) (p<.001). Massage and foot bath were also effective in reducing CIPN symptoms (d=-0.68; 95% CI=-1.05, -0.30; p<.001; $I^2=19%$).Exercises were effective in improving muscle strength and endurance(d=-0.55) and quality of life (d=-2.96), but they were not significantly effective in improving CIPN. Conclusion: Although these results provide little evidence of the effectiveness of acupuncture, massage, and foot bath in the treatment of CIPN, they suggest that these interventions can reduce CIPN symptoms in patients with cancer. However, the findings of this study should be interpreted with caution as there is a relative lack of data in this field, and additional well-designed studies are needed. PROSPERO registration: CRD42017076278.

A Systematic Review of Bee Venom Acupuncture for Ankle Sprain (족관절 염좌의 봉독 약침 치료에 대한 체계적 문헌 고찰)

  • Gu, Ji-Hyang;Li, Yu-Chen;Jo, Dong-Chan;Lee, Eun-Jung
    • Journal of Korean Medicine Rehabilitation
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    • v.28 no.3
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    • pp.55-66
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    • 2018
  • Objectives To evaluate the evidence supporting the effectiveness of bee venom acupuncture for ankle sprain. Methods We conducted search across 11 electronic databases (Pubmed, EMBASE, Cochrane CENTRAL [CENTRAL], KoreaMed, Kmbase, Koreanstudies Information Service System [KISS], National Digital Science Library [NDSL], Korea Institute of Science and Technology Information [KISTI], China National Knowledge Infrastructure [CNKI], Wanfang and Chinese Scientific Journals Database [VIP] database) to find clinical trials that used bee venom acupuncture as treatment for ankle sprain. The methodological quality of randomized controlled clinical trials (RCTs) were assessed using the Cochrane Risk of Bias (RoB) tool, while non-randomized controlled clinical trials (NRCTs) were assessed using the Cochrane Risk of Bias Assessment tool for Non-randomized Study (RoBANS) tool. Results Four RCTs and one nRCT met our inclusion criteria. Almost studies showed that bee venom acupuncture has positive effect on ankle sprain. 4 studies of same intervention and control included in the meta-analysis. When comparing bee venom acupuncture and acupuncture with acupuncture, the effect size of standardized mean difference (SMD) was -0.19 (95% confidence interval [CI]: -1.95~1.56, Z=0.55, p=0.83). And when comparing bee venom acupuncture with acupuncture, the effect size of SMD was -0.17 (95% CI: -0.65~0.31, Z=0.71, p=0.48). Conclusions Although our systematic review found encouraging but limited evidence of bee venom acupuncture for ankle sprain, most of the studies included in the analysis were evaluated as methodologically high risk of bias. From now on further well-designed RCTs should be encouraged.

Research Trends on the Acupotomy Treatment for Knee Osteoarthritis : A Systematic Review (무릎 골관절염의 도침 치료에 대한 연구 동향 : 체계적 문헌 고찰)

  • Hong, Su Min;Yoon, Kwang Sik
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.34 no.6
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    • pp.285-298
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    • 2020
  • This study aimed to review clinical studies about Acupotomy used for Knee Osteoarthritis. We searched the following 12 online databases (KISS, NDSL, RISS, OASIS, Earticle, Kmbase, MEDLINE/Pubmed, Cochrane library, Ebscohost, Ovid, CNKI, Wanfang), to find randomized controlled trials that used Acupotomy for knee osteoarthritis. The methodological quality of randomized controlled trials were assessed by using the Cochrane risk of bias tool and meta-analyses were performed. 16 randomized controlled trials were included. Total number of patients was 1169. The average duration of treatment was 3.14 weeks and most of the patients were treated once a week. The major treatment sites were ligaments, muscles, and tender nodules and the most used evaluation tool was the efficiency. We selected 4 studies and meta-analyzed them. All of the studies performed Acupotomy+sodium hyaluronate injection as a treatment group, and sodium hyaluronate injection as a control group. Meta-analysis showed positive results for Acupotomy+sodium hyaluronate injection in terms of efficiency rate compared to sodium hyaluronate injection. Also Meta-analysis showed positive results for Acupotomy+sodium hyaluronate injection in terms of WOMAC (pain, stiffness, function) compared to sodium hyaluronate injection. In this study, we reviewed studies about Acupotomy used for knee osteoarthritis. The studies showed that Acupotomy can significantly effective on knee osteoarthritis. But according to Cochrane Risk of Bias (RoB) evaluation method, most of the study's risk of bias was unclear. Threrefore, more high-quality studies will be needed.

The Assessment of Risk of Bias on Clinical Studies of Herbal Treatment for Acne (여드름의 한약 치료 임상연구에 대한 비뚤림 위험 평가)

  • Park, Hye-ryun;Roh, Seok-sun
    • Journal of Haehwa Medicine
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    • v.24 no.1
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    • pp.15-24
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    • 2015
  • Objectives : This study was carried out to assess the risk of bias of clinical trials on acne treatment with herbal medicine that have been published in Korea. Methods : 7 electronic databases in Korea were searched for clinical trials on acne treatment. Two independent reviewers selected clinical trials on herbal medicine treatment for acne. Selected studies are categorized according to DAMI(Study Design Algorithm for Medical literature of Intervention). RCTs are assessed according to Cochrane RoB(Risk of Bias), non-randomized studies(Before-after studies) are assessed according to RoBANS(Risk of Bias Assessment tool for Non-randomized Study). Results : After selection process, 25 articles are left. Among 25 articles, 3 RCTs and 4 before-after studies are finally included. In RCTs, the proportion of 'unclear' is high in criteria of 'random sequence generation', 'allocation concealment', and 'blinding'. In before-after studies, 'high' is high in criteria of 'blinding for outcome assessment' and 'incomplete outcome data'. Conclusions : Considering the above results of the assessment, it is necessary to conduct more well designed clinical trials on acne treatment with herbal medicine.

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Meta-analysis of Psychosocial Interventions to Reduce Pain in Patients with Cancer (심리사회적 중재가 암환자의 통증완화에 미친 효과: 메타분석)

  • Oh, Pok Ja;Han, Suk Jung
    • Journal of Korean Academy of Nursing
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    • v.43 no.5
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    • pp.658-668
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    • 2013
  • Purpose: The purpose of this study was to investigate the effects of psychosocial interventions on pain in cancer patients. Methods: Eight studies published between 1980 and 2012 in Korean and ten studies published between 2002 and 2012 in English met the inclusion criteria with a total of 1539 participants. Methodological quality assessed by Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. The data were analyzed by the RevMan 5.2 program of Cochrane library. Results: Overall, study quality was moderate to high. Effect sizes were heterogeneous and subgroup analysis was done. Cognitive behavioral therapy (CBT) were effective for pain (ES= -0.35; 95% CI= -0.56, -0.13). Pain education studies measured with NRS and VAS were effective for pain (ES= -0.77; 95% CI= -1.01, -0.52). Publication bias was not detected. Conclusion: This study support the use of psychosocial interventions administered to cancer patients for their pain management. However, more well-designed studies are needed.

A Systematic Review on Thread Embedding Therapy of Knee Osteoarthritis (퇴행성 슬관절염의 매선 치료에 대한 체계적 문헌 고찰)

  • Park, Jang Mi;Lee, Jae Sung;Lee, Eun Yong;Roh, Jeong Du;Jo, Na Young;Lee, Cham Kyul
    • Korean Journal of Acupuncture
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    • v.35 no.4
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    • pp.159-165
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    • 2018
  • Objectives : This study was performed to review the efficacy of national and international randomized controlled trials (RCTs) investigating evidence on thread embedding therapy for knee osteoarthritis. Methods : Online databases (PubMed, EMBASE, Cochrane, NDSL, OASIS, CNKI) were searched for studies where thread embedding therapy was performed for Knee Osteoarthritis from their inception to July 2018. Two researchers independently performed the search. Only RCTs were selected. Eligible studies were selected first by the abstract and the title and then included after full-texts were read. Risk of bias of the included studies were evaluated using the Cochrane risk of bias assessment tool. Data were narratively summarized. Results : There were 334 studies retrieved from the databases, resulting in analysis of 3 RCTs. There was an average of 1.5 treatment visits over a 7 day period and evaluation tool used was efficacy rate, with traditional acupuncture being the most common control used in the trials. Statistically significant improvement by thread embedding therapy was reported. None of the included RCTs reported on adverse reactions. The risk of bias of the included studies was generally unclear. Conclusion : The review suggests that thread embedding therapy can be effective in knee osteoarthritis. But there was a lack of detailed information about the treatment procedures, and the risk of bias was unclear. Therefore, there is insufficient evidence for thread embedding therapy for knee osteoarthritis.

No evidence on the effectiveness of oral splints for the management of temporomandibular joint dysfunction pain in both short and long-term follow-up systematic reviews and meta-analysis studies

  • Fouda, Atef Abdel Hameed
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.2
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    • pp.87-98
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    • 2020
  • The aim of this study was to determine the efficacy of oral splints in reducing the intensity of pain in patients with temporomandibular joint dysfunction in both short and long-term treatment durations. Electronic databases, Cochrane Library, MEDLINE via PubMed, Web of Science, Egyptian Knowledge Bank, and EMBASE were searched for randomized controlled trials comparing different types of splints to non-occluding splints, behavioral therapy, pharmacotherapy, counseling, and no treatment. The risk of bias was assessed by using Cochrane risk of bias recommendations. Fixed and random effects were used to summarize the outcomes. The effect estimates were expressed as standardized mean differences (SMD) or risk ratios with a 95% confidence interval (CI). Subgroup analyses were carried out according to the treatment duration. Twenty-two studies met the inclusion criteria. A meta-analysis of short-term studies up to three months revealed no significant difference between the study groups. However, long-term studies exhibited a significant difference in pain reduction in favor of the control group. Total analysis revealed that the control group resulted in significant pain reduction (SMD 0.14, 95% CI 0.05-0.23, P=0.002, I2=0%). Oral splints are not effective in reducing pain intensity or improving function in patients with temporomandibular joint dysfunction.

Fascia Chuna Therapy for Piriformis Syndrome: A Review of Clinical Study (이상근증후군의 근막 추나 요법에 대한 문헌 고찰 연구 보고)

  • Park, In-hwa
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.16 no.2
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    • pp.39-45
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    • 2021
  • Objectives The purpose of this study was to assess the effect of fascia chuna therapy in the treatment of piriformis syndrome. Methods A literature search was conducted using 8 databases to identify all randomized controlled clinical trials (RCTs) that investigated fascia chuna therapy as a treatment for piriformis syndrome. The selected studies are analyzed the risk of bias through Cochrane risk of bias tool. Results Among 37 articles that were searched, 3 RCTs met our inclusion criteria and were included in this analysis. These studies demonstrated positive results of Fascia Chuna Therapy with respect to the reduction of pain scale and functional scale compared with other treatment methods. Conclusions Based on results, fascia chuna therapy could be effective in piriformis syndrome. However there are limitations that the number of selected studies was small and risk of bias was unclear. More well-designed RCTs are required to provide clearer evidence.