• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.12
• /
• pp.4787-4793
• /
• 2014

Background: Many cancer patients experience poor pain control due to various factors, including misconceptions regarding the use of opioid analgesics. For management of cancer pain, interventions involving education of both patients and physicians have been attempted. Objectives: This review aimed to assess the current evidence of the benefits of education for the management of cancer pain. Methods: We searched the Medline, EMBASE, Cochrane library, and major Korean databases to identify relevant studies. We included most study designs, but excluded case series. The primary outcomes were pain intensity and quality of life (QoL). Two reviewers assessed the risk of bias using the Cochrane's tool for RCT and Risk of Bias Assessment tool for Non-randomized Studies (RoBANS) for non-randomized studies, independently. Results: After extensive searches, 3,324 publications were screened, and 32 studies were selected. The education interventions used in the included studies included a wide variety of education methods, but the most common method was a booklet produced for patients. Regardless of the education method used, the results of the meta-analysis were as follows. The SMDs of the most severe, average, and current pain in the RCTs were significant. The SMD of worst, average, and current pain were -0.34 (-0.55, -0.13), -0.40 (-0.64, -0.15), and -0.79 (-1.35, -0.23). In the non-randomized studies, the effects on average pain were significant, but those on worst and current pain were not. Conclusions: Education intervention reduced the pain of cancer patients. Therefore, patient education could be considered to be an effective method of cancer pain management. However, our data should be interpreted with caution, and studies using standardized protocols are needed to confirm these observations.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.22 no.5
• /
• pp.171-179
• /
• 2021

This study was a meta-analysis of previous studies that subjected stroke patients to the whole-body vibration exercise, in an attempt to evaluate the effectiveness of such exercise in improving their balance and walking ability. The electronic databases used for literature search were the National Assembly Library, Korean Educational Academic Information (RISS), Korean Academic Information (KISS), and Nuri Media (DBPIA). We also investigated a prior study of the whole-body vibration exercise applied to stroke patients from January 2010 to August 2020. In assessing the quality of the study, the RCT (randomized controls trials) study used the risk of bias 2 (RoB2) tool developed by the Cochrane group. Meta-analysis was performed using R software for statistical computing version 4.0.3. The results of the study confirmed that the overall effect size was 0.40, and the whole-body vibration exercise used had a moderate effect on the balance and gait of stroke patients, the effect size of balance was 0.44, and the effect size of gait was 0.36, showing a positive effect. These results indicated that the whole-body vibration exercise is an effective intervention for stroke patients, and further research is needed.

• The Journal of Churna Manual Medicine for Spine and Nerves
• /
• v.15 no.1
• /
• pp.75-87
• /
• 2020

Objectives : This study aimed to evaluate the effectiveness of manual therapy for wrist pain. Methods : We searched electronic databases (PubMed, Embase, Cochrane, CAJ, KISS, RISS, NDSL, OASIS, and KMBASE) for randomized controlled trials for manual therapy as a treatment for wrist pain. Results : A total of 9 randomized controlled trials were selected and meta-analysis was conducted on 6 studies. Three studies with different design of the intervention/control group were excluded from the meta-analysis. A high risk of bias was observed for both performance bias and detection bias. Conclusions : Our systematic review verified the clinical effect of manual therapy on wrist pain. Based on the results of this study, it is expected that clinical studies on wrist diseases and high-level follow-up studies will be conducted.

• Journal of Ginseng Research
• /
• v.40 no.3
• /
• pp.269-277
• /
• 2016

Background: The findings of currently available studies are not consistent with regard to the association between the risk of cancer and ginseng consumption. Therefore, we aimed to evaluate this association by conducting a meta-analysis of different studies. Methods: To systematically evaluate the effect of ginseng consumption on cancer incidence, six databases were searched, including PubMed, Ovid Technologies, Embase, The Cochrane Library, China National Knowledge Infrastructure, and Chinese VIP Information, from 1990 to 2014. Statistical analyses based on the protocol employed for a systematic review were conducted to calculate the summary relative risks (RRs) and 95% confidence intervals (CIs). Results: We identified nine studies, including five cohort studies, three case-control studies, and one randomized controlled trial, evaluating the association between ginseng consumption and cancer risk; these studies involved 7,436 cases and 334,544 participants. The data from the meta-analysis indicated a significant 16% lower risk of developing cancer in patients who consumed ginseng (RR = 0.84, 95% CI = 0.76-0.92), with evidence of heterogeneity (p = 0.0007, $I^2$ = 70%). Stratified analyses suggested that the significant heterogeneity may result from the incidence data for gastric cancer that were included in this study. Publication bias also showed the same result as the stratified analyses. In addition, subgroup analyses for four specific types of cancer (colorectal cancer, lung cancer, gastric cancer, and liver cancer) were also performed. The summary RRs for ginseng intake versus no ginseng consumption were 0.77 for lung cancer, 0.83 for gastric cancer, 0.81 for liver cancer, and 0.77 for colorectal cancer. Conclusion: The findings of this meta-analysis indicated that ginseng consumption is associated with a significantly decreased risk of cancer and that the effect is not organ specific.

• Journal of Korean Academy of Nursing
• /
• v.47 no.2
• /
• pp.143-163
• /
• 2017

Purpose: This study was a systematic review and meta-analysis designed to investigate effects of psychoeducational intervention for cancer survivors. Methods: Ten databases were searched. Two reviewers independently performed the selection of the studies, data extraction and assessment. The risk of bias was assessed using Cochrane Collaboration's tool. To estimate the effect size, meta-analysis of the studies was performed using Comprehensive Meta-Analysis and RevMan programs. Results: Of 18,781 publications identified, 35 met inclusion criteria, and 25 studies were used to estimate effect size of psychoeducational intervention. Effect sizes (standardized mean difference [SMD]) were heterogeneous and random effects models were used in the analyses. Psychoeducational intervention was effective for quality of life (n=2,410, ES=0.23; 95% CI: 0.09~0.37), coping and self-efficacy (n=179, ES=0.68; 95% CI: 0.26~1.11), anxiety (n=1,786, ES=-0.26; 95% CI: -0.37~-0.15), depression (n=1,910, ES=-0.28; 95% CI: -0.37~-0.18), and psychological distress (n=2,242, ES=-0.31; 95% CI: -0.46~-0.17). Subgroup analysis showed that counseling was the most effective intervention for quality of life, and behavioral therapy was an effective intervention for all positive and negative outcomes. Publication bias was not detected except for psychological distress. Conclusion: Psychoeducational intervention appears to be effective in improving quality of life and coping and self-efficacy, and it is effective in reducing psychological symptoms in cancer survivors. Behavioral therapy, especially, is commonly effective in improving psychosocial outcomes. However, low-quality evidence, variability in the designs of existing studies, and publication bias suggest that additional high-quality trials should be conducted in the future.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.9
• /
• pp.4627-4630
• /
• 2012

Purpose: Methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms have been reported to be associated with pancreatic cancer, but the published studies have yielded inconsistent results. This study assessed the relationship between MTHFR gene polymorphisms and the risk for pancreatic cancer using a meta-analysis approach. Methods:A search of Google scholar, PubMed, Cochrane Library and CNKI databases before April 2012 was performed, and then associations of the MTHFR polymorphisms with pancreatic cancer risk were summarized. The association was assessed by odds ratios (ORs) with 95% confidence intervals (CIs). Publication bias was also calculated. Results: Four relative studies on MTHFR gene polymorphisms (C667T and A1298C) were included in this meta-analysis. Overall, C667T (TT vs. CC:OR=1.61,95%CI=0.78-3.34; TT vs. CT: OR=1.41,95%CI=0.88-2.25; Dominant model:OR=0.68,95%CI=0.40-1.17; Recessive model: OR=0.82,95%CI=0.52-1.30) and A1298C (CC vs. AA:OR=1.01,95%CI=0.47-2.17; CC vs. AC: OR=0.99,95%CI=0.46-2.14; Dominant model:OR=1.01, 95%CI=0.47-2.20; Recessive model: OR=1.01,95%CI=0.80-1.26) did not increase pancreatic cancer risk. Conclusions: This meta-analysis indicated that MTHFR polymorphisms (C667T and A1298C) are not associated with pancreatic cancer risk.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.3
• /
• pp.1313-1320
• /
• 2014

Introduction: Although most prostate cancers initially respond to castration with luteinizing hormonereleasing analogues or bilateral orchiectomy, progression eventually occurs. Based on the exciting results of several randomized controlled trials (RCTs), it seems that patients with metastatic castration-resistant prostate cancer (mCRPC) might benefit more from treatment withabiraterone. Therefore we conducted a systematic review to evaluate the efficacy and toxicity of abiraterone in the treatment of mCRPC. Methods: Literature was searched from Embase, PubMed, Web of Science, and Cochrane Library up to July, 2013. Quality of the study was evaluated according to the Cochrane's risk of bias of randomized controlled trial (RCT) tool, then the Grading of Recommendations Assessment, Development and Evaluation (GRADE) System was used to rate the level of evidence. Stata 12.0 was used for statistical analysis. Summary data from RCTs comparing abiraterone plus prednisone versus placebo plus prednisone for mCRPC were meta-analyzed. Pooled hazard ratios (HRs) for overall survival (OS), radiographic progression-free survival (RPFS) and time to PSA progression (TTPP); Pooled risk ratios (RR) for PSA response rate, objective response rate and adverse event were calculated. Results: Ten trials were included in the systematic review; Data of 2,283 patients (1,343 abiraterone; 940 placebo) from two phase 3 trials: COU-AA-301 and COU-AA-302 were meta-analyzed. Compared with placebo, abiraterone significantly prolonged OS (HR, 0.74; 95% confidence interval [CI], 0.66 to 0.84), RPFS (HR, 0.59; 95% CI, 0.48 to 0.74) and time to PSA progression (HR, 0.55; 95% CI, 0.43 to 0.70); it also significantly increased PSA response rate (RR, 3.63; 95% CI, 1.72 to 7.65) and objective response rate (RR, 3.05; 95% CI, 1.51 to 6.15). This meta-analysis suggested that the adverse events caused by abiraterone are acceptable and can be controlled. Conclutios: Abiraterone significantly prolonged OS, RPFS and time to progression patients with mCRPC, regardless of prior chemotherapy or whether chemotherapy-na$\ddot{i}$ve, and no unexpected toxicity was evident. Abiraterone can serve as a new standard therapy for mCRPC.

• The Journal of Internal Korean Medicine
• /
• v.44 no.3
• /
• pp.485-505
• /
• 2023

Objective: The purpose of this study is to assess the effectiveness and safety of using Taeksa-tang for dyslipidemia through a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: The search was conducted using keywords such as "dyslipidemia", "hyperlipidemia", "taeksa tang", "zexie tang", and "takusha to" in 12 databases (Pubmed, Cochrane, Embase, ScienceDirect, CNKI, Wanfang, CiNii, RISS, KISS, ScienceON, OASIS, and DBpia) on April 13, 2023. There were no limits on the publication period and language. Cochrane's risk of bias (RoB) was used to evaluate the quality of the studies. A meta-analysis was conducted according to the outcome measurements such as total effective rate (TER), total cholesterol (TC), triglyceride (TG), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), and adverse effects, using the Review Manager web. Results: A total of 9 RCTs were selected. In evaluating the RoB, 2 studies mentioning the random sequence generation, 1 study conducting double blindness, and 8 studies without missing values were evaluated as low risk, while 1 study without mentioning the random sequence generation was evaluated as high risk. All other parts were evaluated as unclear risk. The treatment group (Taeksa-tang or Taeksa-tang-gagam) showed more statistically significant effects compared to the control group (Western medicine or Chinese patent medicine) in TER (RR : 1.24, 95% CI 1.15 to 1.34, P<0.00001), TC (MD : -1.12, 95% CI -1.68 to -0.56, P<0.0001), TG (MD : -1.08, 95% CI -1.65 to -0.51, P=0.0002), HDL-C (MD : 0.63, 95% CI 0.34 to 0.93, P<0.0001), LDL-C (MD : -0.81, 95% CI -1.10 to -0.53, P<0.00001). In addition, the treatment group showed lower adverse effects compared to the control group (RR : 0.30, 95% CI 0.12 to 0.74, P=0.008). Conclusion: This study suggests that Taeksa-tang is effective and safe to use for treating dyslipidemia. However, due to the low quality of the included studies, more clinical studies need to be conducted in the future to increase the possibility of clinical use.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.35 no.4
• /
• pp.139-162
• /
• 2022

Objectives : The review was conducted to validate the effectiveness of herbal medicines on acne. Methods : Randomized controlled trials(RCTs) reporting the effects of herbal medicine treatment on acne were searched through seven electronic databases from the time of application of the material to October 2021. Cochrane Collaboration's Risk of Bias was used to assess the risk of bias. Analysis was performed using Review Manager 5.4 and R 4.1.0 Meta, Metafor program. Results : 34 RCTs was selected and meta-analysis was performed with 30 studies. The inflammatory lesion count of the herbal medicine(MD=0.29, 95% CI:-0.59-0.01, p<0.01, I²=80%) and the non inflammatory lesion count of herbal medicine(MD=-0.30, 95% CI:-0.70-0.10, p<0.01, I²=78%) were seen. The score of IGA(RR=1.43, 95% CI:0.90-2.27, p<0.91, I²=0%), VISIA(MD=0.36, 95% CI:0.21-0.51, p=0.07, I²=40%), effective rate(RR=1.23, 95% CI:1.05-1.44, p<0.01, I²=98%), DLQI(MD : 0.59, 95% CI:0.14-1.04, p=0.07, I²=63%) and recurrence rate(RR=0.36, 95% CI:0.23-0.58, p=0.73, I²=0%) were seen. The effective rate of herbal medicine were statistically higher that of the control group(WM)(RR=1.19, 95% CI:1.04-1.37, p<0.01, I²=97%). As a result of dividing the treatment groups into OHM, EHM, and OEHM, the EHM group(RR=1.17, 95% CI:0.79-1.72, p<0.01, I²=99%) showed the most statistically significant effect. The overall risk of bias of the included studies was some concerns. No serious adverse effects were observed. Conclusions : This review found the effectiveness of herbal medicine for acne.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.35 no.3
• /
• pp.48-65
• /
• 2022

Objectives : This study was conducted to find out the effectiveness and safety of herbal medicine eye drops on conjunctivitis. Methods : We searched randomized controlled trials on conjunctivitis through 10 DBs from the start to April 27, 2022. Study collection and data extraction, and evaluation of risk of bias were conducted by two independent researchers. The evaluation of the risk of bias in included RCTs was carried out by using Cochrane risk-of-bias tool. And the data synthesis was conducted by using Review Manager(RevMan, ver.5.4). Results : Total of 106 studies are researched and 7 studies of them are finally included. 1. The herbal medicine eye drops are more effective on than the western medicine eye drops, but the heterogeneity was very high. So we conducted sensitivity analysis and compared to the herbal medicine eye drops and the western medicine eye drops, the total effective rate was higher in the herbal medicine eye drops and the heterogeneity was somewhat reduced. 2. In the subgroup analysis, Fufang Xiongdan eye drops and Houttuynia cordata Thunb eye drops are more effective than the western medicine. It may represent substantial heterogeneity. 3. In the subgroup analysis, the herbal medicine eye drops are more effective than antibiotic and antiviral eye drops on acute bacterial conjunctivitis, but showed high heterogeneity. On the other hand, the herbal medicine eye drops are more effective than antibiotic and antiviral eyed drops on acute viral conjuctivitis and showed low heterogeneity. 4. In the subgroup analysis, we compared the effectiveness of herbal and western medicine eye drops according to total effectiveness rate evaluation methods. When comparing the studies calculating the total effective rate by the sum of 'Cured', 'Significantly Impaired', and 'Improved', the effective rate of the herbal medicine eye drops was higher than that of the western medicine eye drops, and the heterogeneity was very low. 5. In most studies, side effects of herbal medicine eye drops were absent or mild. Conclusions : This study shows that herbal medicine eye drops may be more effective than western medicine eye drops and have safety. But further researches are needed to resolve the heterogeneity of this study.