• Title/Summary/Keyword: Cochrane Risk of Bias

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The Effectiveness and Safety of Dokwhalkisaeng-tang Combined with the Medication on Rheumatoid Arthritis: A Study Protocol for Systematic Review and Meta-analysis (류마티스 관절염 치료제와 병용한 독활기생탕의 효과 및 안전성: 체계적 문헌고찰 및 메타분석 프로토콜)

  • Chae, Soo-Yeon;Jung, Chan-Yung;Kim, Joo-Hee;Kim, Eun-Jung;Seo, Byung-Kwan;Hwang, Min-Seop;Park, Seong-Sik;Kim, Kyung-Ho;Yoon, Jong-hwa;Sung, Won-Suk
    • Herbal Formula Science
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    • v.30 no.2
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    • pp.95-100
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    • 2022
  • Objectives : Recent studies reported that Dokwhalkisaeng-tang (DHJST) could relieve the clinical rheumatoid arthritis (RA) symptoms and the level of RA-related blood test. However, evidence-based review on effectiveness and safety of DHJST with medication on RA was not yet provided. Methods : Searching randomized controlled trials on the use of DHJST for RA will be performed using multiple electronic databases, manual search, and contact to author. Studies will be selected according to the pre-defined criteria and collected data on study participants, interventions, control groups, outcome measurements, the results, adverse events, and risk of bias will be summarized. Primary outcome will be the disease activity score (including effective rate, swollen joint count, tender joint count, and morning stiffness), and the secondary outcomes will be RA-related blood test and adverse events. We will use Review Manager software to perform a meta-analysis, Cochrane Collaboration "risk of bias" tool for assessing the risk of bias, and Grades of Recommendation, Assessment, Development and Evaluation for the determination of quality of evidence. Results : We are going to investigate the effectiveness and safety of DHJST with medication for RA. Conclusion : This study will provide reliable evidence on whether DHJST combined with medicine is more effective on RA than medicine monotherapy.

Acupuncture for glaucoma: A systematic review and meta-analysis of randomized controlled trials (녹내장의 침치료 효과에 대한 체계적 문헌고찰 및 메타분석)

  • Yi, Gil-Hee;Jung, Chan-Yung;Chang, Seok-Joo;Hong, Seung-Ug
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.33 no.3
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    • pp.45-68
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    • 2020
  • Objectives : This study aims to evaluate the effectiveness and safety of manual and electroacupuncture on glaucoma. Method : We searched 11 electronic databases using index words to identify randomized clinical trials. Meta-analysis of weighted mean difference (WMD) or standardized mean difference (SMD) were used to evaluate the outcomes. Cochrane bias risk assessment tool was used to assess the risk of bias in each clinical study. The collected data was analyzed using RevMan software (ver. 5.3). Results : At the initial stage of data retrieval, 549 papers were searched. After reviewing 37 full texts, a total of 10 RCT studies (426patients, 715 eyes) were selected and 8 RCT studies (357 people, 617 eyes) were involved in meta-analysis. Meta-analysis of 8 RCTs showed that acupuncture alone was more effective in reducing intraocular pressure(IOP) than conventional treatment (WMD = -5.73, 95% CI: [-12.30, 0.83], P = 0.09, I2 = 97%) The combination of acupuncture or electroacupuncture with conventional treatment was also effective in lowering IOP (WMD = -1.84, 95% CI: [-2.31, -1.37], P <0.00001, I2 = 45%). It was estimated that the combination of acupuncture with conventional treatment was also effective for improving visual field (VF) (WMD = -2.17, 95% CI: [-4.32, -0.02], P = 0.05, I2 = 89%) but improvement in visual acuity (VA) was not significant (MD = 0.06, 95% CI: [-0.03, 0.15], P = 0.23, I2 = 0%). Subgroup analyzes were performed only for the studies that used open glaucoma as the study's disease and combination of acupuncture or electroacupuncture with conventional therapy would have an effect on lowering intraocular pressure (WMD = -1.68)., 95% CI: [-2.46, -0.90], P <0.0001, I2 = 29%). Conclusion : This study suggests that acupuncture treatment for glaucoma may be effective in reducing intraocular pressure and helpful in improving visual field defects. However, due to the small sample size, high risk of bias and high heterogeneity in the methodology, it is expected that further studies will be needed to verify the results. Further studies in large-scale samples based on a minimized biased methodology would be necessary.

Systematic Review on Presbycusis Treated by Herbal Medicine Focusing on Kidney Deficiency (노인성 난청의 한약 치료에 대한 체계적 문헌고찰: 신허(腎虛)을 중점으로)

  • Lim, Hui-yeong;Jin, Han-Sol;Ko, Woo-Shin;Yoon, Hwa-Jung
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.34 no.4
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    • pp.49-70
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    • 2021
  • Objectives : This study was conducted to approve the effectiveness and safety of herbal medicine on presbycusis with kidney deficiency. Methods : We searched randomized controlled trials(RCTs) on presbycusis patients diagnosed with kidney deficiency through 10 electronic databases from the start to Sep 7, 2021. Study collection and data extraction, and evaluation of risk of bias were conducted by two independent collaborator. 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 : 1. The treatment group which used herbal medicine(HM) alone was more effective than the control group which used only western medicine(WM) on effective rate of hearing loss. 2. In 3 studies comparing the HM-WM combination treatment group with the control groups using the same WM treatment, the effective rate was statistically significantly higher in the HM-WM combination treatment group. 3. Of the 5 studies that reported adverse reactions, one study reported mild nausea and dizziness, but the difference between the HM treatment group and the WM control group was not statistically significant, and no side effects occurred in other 3 studies. 4. In studies comparing HM and WM, the HM treatment group improved hearing loss, whole blood viscosity, serum TNF-𝛼, IL-1𝛽, IL-6, and oxidative stress indicators better than the WM control group, and there was no significant difference. 5. In studies comparing the HM-WM treatment group with the WM control group, the severity of tinnitus, quality of life, and feelings of anxiety and depression were better in the treatment group than the control group. Conclusions : This study shows that the herbal medicine can improve symptoms of presbycusis with kidney deficiency.

The Effects of Nursing Educations on Anxiety, Uncertainty, Pain for Patients with Benign Tumor of Uterine: A Systematic Review and Meta-Analysis (자궁양성종양 환자의 수술 사전 교육이 불안, 불확실성, 통증에 미치는 효과: 체계적 문헌고찰 및 메타분석)

  • Park, Seo-A;Kim, Gaeun;Kim, Hye-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.5
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    • pp.207-220
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    • 2021
  • This study aimed to evaluate the impact of education and counselling by nurses on anxiety, uncertainty, and pain in patients with benign uterine tumors. Electronic databases, including PubMed, OVID, CINAHL, Google Scholar, and Korean databases and were searched during January 2020. A total of 401 studies were identified of which 13 were suitable for meta-analysis. Cochrane's risk of bias tool and the R version 3.5.2 (Meta-analysis with R) program were used for analysis. The authors performed a meta-analysis of the 13 trials that met eligibility criteria. The findings in this study indicate that the effect size of nursing education for anxiety was Hedges' g=-0.89 (95% CI:-1.39 to -0.47), as indicated by a "large effect size" and the effect size of pain was Hedges' g=-0.49 (95% CI:-0.95 to -0.02) as indicated by a "moderate effect size". The effect size of uncertainty was Hedges' g=-1.38 (95% CI:-3.98 to 1.23), and it was not statistically significant. In the meta-subgroup analyses by approach intervention type, cognitive-behavioral programs, demonstration intervention, and relaxation therapy had a significant effect. The risk of publication bias was low. It may therefore be concluded that pre-operative education by nurses for patients with benign uterine tumors would affect their levels of anxiety, uncertainty, and pain.

Effects of Transcranial Direct Current Stimulation on Lower Extremity Function of Stroke Patients : A meta-analysis of domastic research (뇌졸중 환자의 다리 기능에 대한 경두개직류자극의 효과: 국내 연구의 메타분석)

  • Lee, Jeong-Woo;Lim, Ji-Sun
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.3
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    • pp.87-97
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    • 2021
  • Purpose : The purpose of this meta-analysis was to evaluate the effects of transcranial direct current stimulation on the lower extremity function of stroke patients. Methods : Domestic data were gathered from studies that conducted clinical trials associated with transcranial direct current stimulation and its impact on lower extremity function of stroke patients. A total of 592 studies published between 2012 and 2020 were identified, with 7 studies satisfying the inclusion data. The studies consisted of patient, intervention, comparison, and outcome (PICO) data. The search outcomes were items associated with muscle activity, balance, muscle strength and walking ability. Cochrane risk of bias (ROB) was used to evaluate the quality of 3 randomized control trials. The quality of 4 non-randomized control trials was evaluated using risk of bias assessment tool for non-randomized studies (RoBANS). Effect sizes in this study 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 and 'trim-and-fill' tests were carried out to analyze the publishing bias. Results : The following factors had a large total effect size (Hedges's g=2.10, 95 %CI=1.54~2.66) involving transcranial direct current stimulation on stroke patients: muscle activity (Hedges's g=2.38, 95 %CI=1.08~3.68), balance (Hedges's g4=2.41, 95 %CI=1.33~3.60), walking ability (Hedges's g=1.54, 95 %CI=0.49~2.59), and muscle strength (Hedges's g=2.45, 95 % CI: 0.85~4.05). Egger's regression test showed that the publishing bias had statistically significant differences but 'trim-and-fill' test showed that there was still statistical difference. Conclusion : This study provides evidence for the effectiveness of transcranial direct current stimulation on the lower extremity in terms of muscle activity, balance, walking ability, and muscle strength in stroke patients. However, due to the low quality of studies and high heterogeneity factors, the results of our study should be interpreted cautiously.

Common Variants in the PALB2 Gene Confer Susceptibility to Breast Cancer: a Meta-analysis

  • Zhang, Yi-Xia;Wang, Xue-Mei;Kang, Shu;Li, Xiang;Geng, Jing
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7149-7154
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    • 2013
  • Objective: Increasing scientific evidence suggests that common variants in the PALB2 gene may confer susceptibility to breast cancer, but many studies have yielded inconclusive results. This meta-analysis aimed to derive a more precise estimation of the relationship between PALB2 genetic variants and breast cancer risk. Methods: An extensive literary search for relevant studies was conducted in PubMed, Embase, Web of Science, Cochrane Library, CISCOM, CINAHL, Google Scholar, CNKI and CBM databases from their inception through September 1st, 2013. A meta-analysis was performed using the STATA 12.0 software and crude odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Results: Six case-control studies were included with a total of 4,499 breast cancer cases and 6,369 healthy controls. Our meta-analysis reveals that PALB2 genetic variants may increase the risk of breast cancer (allele model: OR>1.36, 95%CI: 1.20~1.52, P < 0.001; dominant model: OR>1.64, 95%CI: 1.42~1.91, P < 0.001; respectively). Subgroup analyses by ethnicity indicated PALB2 genetic variants were associated with an increased risk of breast cancer among both Caucasian and Asian populations (all P < 0.05). No publication bias was detected in this meta-analysis (all P > 0.05). Conclusion: The current meta-analysis indicates that PALB2 genetic variants may increase the risk of breast cancer. Thus, detection of PALB2 genetic variants may be a promising biomarker approach.

Association between the TP53BP1 rs2602141 A/C Polymorphism and Cancer Risk: A Systematic Review and Meta-Analysis

  • Liu, Lei;Zhang, Dong;Jiao, Jing-Hua;Wang, Yu;Wu, Jing-Yang;Huang, De-Sheng
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2917-2922
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    • 2014
  • Background: The p53-binding protein 1 (TP53BP1) gene may be involved in the development of cancer through disrupting DNA repair. However, investigation of associations between TP53BP1 rs2602141 A/C polymorphism and cancer have yielded contradictory and inconclusive outcomes. We therefore performed a meta-analysis to evaluate the association between the TP53BP1 rs2602141 A/C polymorphism and cancer susceptibility. Materials and Methods: Published literature from PubMed, Medline, the Cochrane Library, EMbase, Web of Science, Google (scholar), CBMDisc, Chongqing VIP database, and CNKI database were retrieved. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using fixed or random-effects models. Publication bias was estimated using funnel plots, Begg's and Egger's test. Results: A total of seven studies (3,018 cases and 5,548 controls) were included in the meta-analysis. Our results showed that the genotype distribution of TP53BP1 rs2602141 A/C was not associated with cancer risk overall. However, on subgroup analysis, we found that TP53BP1 rs2602141 A/C was associated with cancer risk within an allele model (A vs C, OR=1.14, 95%CI: 1.01-1.29) and a codominant model (AA vs CC, OR=1.36, 95%CI: 1.06-1.74) in Asians rather than in Caucasians. Subgroup analysis by cancer type, genotype, and with or without adjustment for controls showed no significant association. Conclusions: The findings suggested an association between rs2602141 A/C polymorphism in TP53BP1 gene and increased risk of cancer in Asians.

MTHFR Polymorphisms and Pancreatic Cancer Risk:Lack of Evidence from a Meta-analysis

  • Li, Lei;Wu, Sheng-Di;Wang, Ji-Yao;Shen, Xi-Zhong;Jiang, Wei
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.2249-2252
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    • 2012
  • Objective: Methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms have been reported to be associated with pancreatic cancer, but the published studies had yielded inconsistent results.We therefore performed the present meta-analysis. Methods: A search of Google scholar, PubMed, Cochrane Library and CNKI databases before April 2012 was conducted to summarize associations of MTHFR polymorphisms with pancreatic cancer risk. Assessment was with odds ratios (ORs) and 95% confidence intervals (CIs). Publication bias were also calculated. Results: Four relative studies on MTHFR gene polymorphisms (C667T and A1298C) were involved 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. Conclusion: This meta-analysis indicated that MTHFR polymorphisms (C667T and A1298C) were not associated with pancreatic cancer risk.

The Effect of Laser Therapy for Diabetic Ulcer : Systematic Review (당뇨병성 궤양의 레이저치료에 대한 효과 : 체계적 문헌고찰)

  • Kang, Ki-Wan;Kang, Ja-Yeon;Jeong, Min-Jeong;Kim, Hong-Jun;Seo, Hyung-Sik;Jang, In-Soo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.30 no.4
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    • pp.62-74
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    • 2017
  • Objectives : The purpose of this study is to investigate the effect of laser therapy for diabetic ulcer by using methods of systematic review. Methods : In this review, PubMed, Cochrane library, Web of Science, CNKI, CiNii, J-STAGE, NDSL and OASIS were used as the search engines. The search period is from the start date of the search engine to October 3, 2016. Randomized controlled trials(RCTs) using laser therapy for diabetic ulcer were searched and extracted by two independent researchers. Risk of bias(RoB) of Cochrane was used to assess methodological quality of studies. Results : Finally, five RCTs were selected. The follow-up period ranged from 15 days to 20 weeks. InGaAlP laser, GaAlAs laser and light emitting diode(LED) were used to treat diabetic ulcer. The clinical trials used sham laser irradiation or standard treatment as control in comparison to laser therapy. The endpoints included ulcer size, rate of healing and time to healing with follow-up period. The RCTs demonstrated therapeutic outcomes with no adverse effect. Most items of RoB were unclear and methodological quality was low. Conclusions : Our analysis suggests that laser therapy has therapeutic effects for diabetic ulcer. However, more systematic and stringent clinical trials will be required.

Head and neck radiotherapy-induced changes in dentomaxillofacial structures detected on panoramic radiographs: A systematic review

  • Munhoz, Luciana;Nishimura, Danielle Ayumi;Iida, Christyan Hiroshi;Watanabe, Plauto Christopher Aranha;Arita, Emiko Saito
    • Imaging Science in Dentistry
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    • v.51 no.3
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    • pp.223-235
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    • 2021
  • Purpose: This study aimed to summarize the impact of neck and head radiation treatment on maxillofacial structures detected on panoramic radiographs. Materials and Methods: In this systematic review, the authors searched PubMed Central, Embase, Scopus, Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar for original research studies up to February 2020 that included the following Medical Subject Headings keywords: words related to "radiotherapy" and synonyms combined with keywords related to "panoramic radiography" and "oral diagnosis" and synonyms. Only original studies in English that investigated the maxillofacial effects of radiotherapy via panoramic radiographs were included. The quality of the selected manuscripts was evaluated by assessing the risk of bias using Cochrane's ROBINS-I tool for non-randomized studies. Results: Thirty-three studies were eligible and included in this review. The main objectives pertained to the assessment of the effects of radiation on maxillofacial structures, including bone architecture alterations, periodontal space widening, teeth development abnormalities, osteoradionecrosis, and implant bone loss. The number of participants evaluated ranged from 8 to 176. Conclusion: The interaction between ionizing radiation and maxillofacial structures results in hazard to the tissues involved, particularly the bone tissue, periosteum, connective tissue of the mucosa, and endothelium. Hard tissue changes due to radiation therapy can be detected on panoramic radiographs.