• Title/Summary/Keyword: Cochrane Risk of Bias

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Clinical Effect of Gyeongok-go: A Systematic Review of Randomized Controlled Trials (경옥고의 임상 효능 : 체계적 고찰)

  • Kang, Heekyung;Han, Changwoo
    • The Journal of Internal Korean Medicine
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    • v.43 no.3
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    • pp.423-435
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    • 2022
  • Purpose: The purpose of this study was to confirm the clinical efficacy of Gyeongok-go. Methods: Public/Publisher MEDLINE (PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), Excerpta Medica dataBASE (EMBASE), Research Information Sharing Service (RISS), ScienceON, Korean Traditional Knowledge Portal (KTKP), and China National Knowledge Infrastructure (CNKI) were searched for randomized controlled clinical trials administering Gyeongok-go as an intervention, published from inception to December 31, 2021. The risk-of-bias of the included trials was assessed with the Cochrane risk-of-bias tool for randomized trials version 2. From the experimental and control groups of the selected trials, the mean value (or rate) of each outcome was extracted and statistically compared. Results: Statistically significant mean differences were in VO2max (MD 6.82), post-exercise heart rate (MD -8.76 at 5 min, -11.58 at 30 min, -14.6 at 60 min), senescence scale (MD -6.52), Th1 cells and Th2 cells in pulmonary tuberculosis (MD 2.79 and -1.64), yin-deficient and qi-deficient score (MD -9.64 and -9.76), and phlegm-dampness score (MD 5.56). Overall risk-of-bias was 20% low risk, 80% some concerns, and 0% high risk. There were no reports of adverse events. Conclusions: Gyeongok-go is likely to have the effect of improving cardiorespiratory endurance, increasing fatigue recovery ability, reducing senescence, and enhancing immune function in tuberculosis patients. Also, it is more suitable for those who are yin-deficient or qi-deficient, and those with phlegm-dampness probably need caution.

TheAssessment of risk of bias in randomized controlled trials published in the Korean Journal of Physical Therapy: A 2018~2022 review (한국 물리치료 학술지에 무작위대조연구의 비뚤림 위험 평가: 2018~2022년 검토)

  • Jae Hyun Lim;Chi Bok Park;Byeong Geun Kim
    • Journal of Korean Physical Therapy Science
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    • v.30 no.4
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    • pp.82-91
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    • 2023
  • Background: Randomized controlled trials (RCTs) provide evidence on the effectiveness and safety of interventions and inform systematic reviews and guideline preparation for clinical application. However, methodological flaws can occur in many RCTs, and Cochrane's risk of bias version 2 (RoB2) can be used to evaluate RCTs' risk of bias (RoB). However, physical therapy RCTs in Korea did not confirm RoB. Therefore, the purpose of this study was to evaluate RoB using RoB2 in RCTs published in the Korean Physical Therapy Journal. Design: Review. Methods: The RCTs subject to evaluation were RCTs published in 11 physical therapy journals in Korea from 2018 to 2022. RoB2 evaluated a total of five domains: bias arising from the randomization process, bias due to deviations from intended interventions, bias due to missing outcome data, bias in measurement of the outcome, and bias in selection of the reported result. Results: A total of 616 RCTs were evaluated. As for bias arising from the randomization process, high risk was the highest at 555 (90.1%), followed by low risk at 41 (6.7%) and some concerns at 20 (3.2%). For bias due to deviations from intended interventions, the proportion of some concerns was the highest at 390 (63.3%), followed by high risk at 218 (35.4%) and low risk at 8 (1.3%). As for the bias due to missing outcome data, the rate of low risk was the highest at 399 (64.8%), followed by high risk at 159 (25.8%) and some concerns at 58 (9.4%). As for bias in measurement of the outcome, high risk was the highest at 294 (47.7%), followed by low risk at 224 (36.4%) and some concerns at 98 (15.9%). In the bias due to missing outcome data, the ratio of high risk was the highest at 610 (99%), followed by low risk at 4 (0.7%) and some concerns at 2 (0.3%). Conclusion: Most of the RoB evaluation results of RCTs published in the Korean Physical Therapy Journal were rated as high risk. Methodological quality of RCTs needs to be improved.

Occupational Exposure to Knee Loading and the Risk of Osteoarthritis of the Knee: A Systematic Review and a Dose-Response Meta-Analysis

  • Verbeek, Jos;Mischke, Christina;Robinson, Rachel;Ijaz, Sharea;Kuijer, Paul;Kievit, Arthur;Ojajarvi, Anneli;Neuvonen, Kaisa
    • Safety and Health at Work
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    • v.8 no.2
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    • pp.130-142
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    • 2017
  • Background: Osteoarthritis of the knee is considered to be related to knee straining activities at work. The objective of this review is to assess the exposure dose-response relation between kneeling or squatting, lifting, and climbing stairs at work, and knee osteoarthritis. Methods: We included cohort and case-control studies. For each study that reported enough data, we calculated the odds ratio (OR) per 5,000 hours of cumulative kneeling and per 100,000 kg of cumulative lifting. We pooled these incremental ORs in a random effects meta-analysis. Results: We included 15 studies (2 cohort and 13 case-control studies) of which nine assessed risks in more than two exposure categories. We considered all but one study at high risk of bias. The incremental OR per 5,000 hours of kneeling was 1.26 (95% confidence interval 1.17-1.35, 5 studies, moderate quality evidence) for a log-linear exposure dose-response model. For lifting, there was no exposure dose-response per 100,000 kg of lifetime lifting (OR 1.00, 95% confidence interval 1.00-1.01). For climbing, an exposure dose-response could not be calculated. Conclusion: There is moderate quality evidence that longer cumulative exposure to kneeling or squatting at work leads to a higher risk of osteoarthritis of the knee. For other exposure, there was no exposure dose-response or there were insufficient data to establish this. More reliable exposure measurements would increase the quality of the evidence.

A Systematic Review on the Effects of Group Art Therapy on the Older with Dementia (집단미술치료가 치매 노인에게 미치는 영향에 대한 체계적 고찰)

  • Kim, Do-Yoen;Lee, Hye-Mi;Bae, Ji-Woo;Jung, Nam-Hae
    • Journal of The Korean Society of Integrative Medicine
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    • v.10 no.4
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    • pp.71-81
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    • 2022
  • Purpose : This study aimed to present evidence by analyzing the characteristics and effectiveness of group art therapy interventions through an examination of domestic studies on group art therapy for older people with dementia. Methods : The database used DBpia, Riss, and Google Scholar, and the research period was from 2016 to November 2021. For the selected studies, the level of evidence was analyzed, bias evaluation was performed, and patient, intervention, comparison, and outcome were analyzed. For the evaluation of bias, the risk of bias assessment tool for non-randomized study (RoBANS) and Cochrane's risk of bias (RoB) were used. Results : As for the level of evidence of the included studies, level I consisted of five studies, and levels II and III each had one article. As a result of the bias evaluation of five studies through RoB, a "low risk of bias" was found for incomplete result data, selective result reporting, and others, except for four unclear evaluation areas. The "low risk of bias" ratio was 0~25 % in the evaluation of bias in two studies through RoBANS. For the evaluation tool, cognitive evaluation tool was used the most while mini-mental state examination-Korea was used the most frequently. For the intervention method, the most frequently used was group art therapy that employed recall in three studies, while collage, Korean painting, use of paper media, and procedural memory were used in each of the other studies. Each intervention was found to be significantly effective overall. Conclusion : This study provided clinical evidence by systematically reporting research on group art therapy for older people with dementia. In the future, it is necessary to check the effect of group art therapy on various areas other than cognition for older people with dementia. Moreover, the study should be conducted with the risk of bias sufficiently taken into consideration.

Effect of Electroacupuncture on Impairment of Motor and Sensory Functions after Spinal Cord Injury: A Systematic Review and Meta-analysis (척수손상으로 인한 운동 및 감각 기능 손상에 대한 전침의 효과: 체계적 문헌 고찰 및 메타 분석)

  • Jung, Su-Eun;Kim, Gyu-Hui;Park, Jung-Hyeon;Lee, Young-Hun;Park, Sang-Eun;Cho, Sung-Woo
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.2
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    • pp.37-54
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    • 2022
  • Objectives This review investigates the effectiveness of electroacupuncture for impairment of motor and sensory functions after spinal cord injury. Methods The databases used for the search were PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), National Digital Science Library (NDSL), Koreanstudies Information Service System (KISS), Research Information Sharing Service (RISS), KMBASE, and Oriental Medicine Advanced Searching Integrated System (OASIS). The literature were searched using a total of 9 domestic and foreign databases. Randomized controlled trials (RCTs) using electroacupuncture as an intervention was selected. The selected studies are analyzed the risk of bias through Cochrane risk-of-bias tool, and meta-analysis was perfomed using RevMan version 5.3 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). Results A total of 14 RCT studies were selected through 9 domestic and foreign databases, and analyzed. As a result of meta-analysis, when electroacupuncture was performed together with rehabilitation treatment or western drug treatment, it was effective in the recovery of motor and sensory functions of spinal cord injury patients. Conclusions This review suggests that electroacupuncture can be applied as an effective treatment for the recovery of motor and sensory functions of spinal cord injuries. However, there are several limitations, including the small number and heterogeneity of the included studies, as well as their poor methodological quality. Therefore, further, higher-quality studies should be required.

Systematic Review of an Intervention Program for the Improved Reading Comprehension of Elementary School Students (초등학생의 읽기이해력 향상 중재프로그램에 대한 체계적 문헌고찰)

  • Joo, So-Hyun;Lee, Soo-Sang
    • Journal of Korean Library and Information Science Society
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    • v.52 no.3
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    • pp.197-215
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    • 2021
  • This study analyzed experimental studies of intervention programs provided to improve reading comprehension of elementary school students using a systematic review research method. Cochrane's handbook was applied, and key questions were formulated according to the PICOTS-SD. The inclusion and exclusion criteria were applied to 1,610 papers searched in KCI, and the final 18 cases were selected for analysis. The risk of bias was evaluated using the 'RevMan5' tool provided by Cochrane. As a result of the evaluation, the risk of bias was low in most areas. And for the qualitative analysis of these papers, a data summary table was prepared. As a result, the types of intervention programs were diverse, and in many cases, upper grade students were applied. The size of the experimental group ranged from 6 to 29, and there were more QED-based studies than RCT-based studies. The most mediation time was 40 minutes, and the number of mediation sessions was 8 to 24. And in all studies, the intervention programs were found to be effective in improving reading comprehension.

Influence of the root canal filling technique on the success rate of primary endodontic treatments: a systematic review

  • Daniel Feijolo Marconi ;Giovana Siocheta da Silva ;Theodoro Weissheimer;Isadora Ames Silva ;Gabriel Barcelos So;Leonardo Thomasi Jahnke ;Jovito Adiel Skupien ; Marcus Vinicius Reis So ; Ricardo Abreu da Rosa
    • Restorative Dentistry and Endodontics
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    • v.47 no.4
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    • pp.40.1-40.18
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    • 2022
  • Objectives: This study aimed to investigate the influence of different obturation techniques compared to cold lateral compaction on the success rate of primary non-surgical endodontic treatments. Materials and Methods: Systematic searches were performed for studies published up to May 17th, 2022 in MEDLINE/PubMed, Cochrane Library, Web of Science, Scopus, EMBASE, and Grey Literature Reports. Randomized clinical trials and nonrandomized (nonrandomized clinical trials, prospective or retrospective) studies that evaluated the success rate of primary non-surgical endodontic treatments obturated with the cold lateral compaction (control) and other obturation techniques were included. The revised Cochrane risk of bias tools for randomized trials (RoB 2) and nonrandomized studies of interventions (ROBINS-I) were used to evaluate the risk of bias. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool was used to evaluate the certainty of evidence. Results: Eleven studies (4 randomized clinical trials (RCTs), 4 prospective, and 3 retrospectives) were included. Two RCTs were classified as having some concerns risk of bias and 2 as a low risk of bias. Two nonrandomized studies were classified as having a critical risk of bias and 5 as having a moderate risk of bias. The GRADE analysis demonstrated a very low to moderate certainty of evidence. Conclusions: This systematic review generally evidenced no differences in the success rate of primary non-surgical endodontic treatments when the cold lateral compaction technique and other obturation techniques are performed. Further well-designed studies are still necessary.

Effects of hippotherapy on children with cerebral palsy: systematic review and meta-analysis

  • Kim, Kwon-Hoi;Lee, Suk-Min
    • Physical Therapy Rehabilitation Science
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    • v.9 no.1
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    • pp.55-65
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    • 2020
  • Objective: The most important goal of hippotherapy is to improve function, gait, and balance. The purpose of this study was to investigate the effects of hippotherapy on function, gait, and balance of children with cerebral palsy (CP). Design: A systematic review and meta-analysis. Methods: We've searched the PubMed, EMBASE, and Cochrane Library CENTRAL databases for English experimental studies published up until September 2018. To analyze the effects of hippotherapy on the function, gait, and balance of children with cerebral palsy, the systematic review and meta-analysis were performed on Patient/Participants/Population Problem, Intervention, Comparison, Outcome with Timing, Setting Study Design. Papers retrieved from the database were removed from the literature management database. Methodological quality evaluation was evaluated using Cochrane's risk of bias. Data was analyzed using the Revman 5.3 program of the Cochrane library. Results: In this study, we found that the effect size of hippotherapy, denoted as d, was -3.82, and that hippotherapy had the most effect on gait, but no statistical significant difference was observed. We also found no significant difference in function and balance after hippotherapy. It was found from the funnel plot that there was no publication bias as the plot was symmetrically distributed around the dotted line. Conclusions: There are many unclear studies and a lack of randomized controlled trials (RCTs) in this research area. More RCTs on the effects of hippotherapy on children with CP should be conducted in the future.

Intravaginal Administration of Oriental Medicine on Vaginal Atrophy in Menopause : A Systemic Review (폐경기 질 위축에 대한 한약제제 질 내 투여의 효과 : 체계적 문헌 고찰)

  • Lee, Soo-Hyung;Jung, Hyun-Tae;Kim, Song-Baek
    • The Journal of Korean Obstetrics and Gynecology
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    • v.34 no.2
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    • pp.62-81
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    • 2021
  • Objectives: The purpose of this study is to review clinical studies and evaluate effectiveness of intravaginal administration of oriental medicine on vaginal atrophy in menopausal women. Methods: 'postmenopause', 'menopause', 'vaginal atrophy', 'atrophic vaginitis', 'vaginal cream', 'vaginal gel', 'pessary', 'suppository' were searched on 3 online databases (Pubmed, Cochrane Library, OASIS). The risk of bias was assessed by using Cochrane risk of bias (RoB) 2.0 tool. Results: 9 randominized controlled trials (RCTs) were selected among 489 articles. The types of intervention were intravaginal administration of oriental medicine. 6 studies showed that treatment group was better than placebo control group or both treatment group and western medicine control group improved similarly. 2 studies were not significant effective in some results and 1 study was not statistically significant. Conclusions: Intravaginal administration of oriental medicine can be an effective option in treating menopausal women with vaginal atrophy. but considering the small number and low quality of studies, further well-designed studies are needed to confirm the effectiveness of this treatment.

A review of herbal medicines for chemotherapy induced peripheral neuropathy (한약을 이용한 chemotherapy-induced peripheral neuropathy (CIPN) 치료 관련 무작위 배정 임상 시험에 대한 고찰)

  • Park, Bongki
    • Journal of Korean Traditional Oncology
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    • v.21 no.2
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    • pp.51-61
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    • 2016
  • Background : Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect in cancer patients who were exposed to chemotherapy. CIPN impacts on the quality of life and could delay chemotherapy. The aim of this review was to assess the therapeutic effectiveness of herbal medicine in CIPN patients. Methods : Randomized controlled trials (RCTs) were included in this review. We searched MEDLINE, Cochrane database, EMBASE, CNKI, Wanfang and four Korean databases without restrictions on time or language. The risk of bias was assessed using the Cochrane risk of bias tool. Results : Eleven RCTs involving 706 patients met the inclusion criteria. Eleven different herbal medicines were examined in the included trials. Almost RCTs showed insufficiency in the reporting randomization method and allocation concealment. One trial used allocation concealment and a double-blinding method. Five studies reported that participants dropped out of RCTs and conducted an 'as-treated analysis'. One trials reported adverse effects of herbal medicine. In ten of the eleven trials, the use of herbal medicine had shown significant differences in clinical symptoms or nerve conduction velocity. Conclusions : The use of herbal medicines for CIPN showed significant improvements in the management of CIPN. However, conclusions cannot be drawn because of the generally low quality of methodology and low quantity of data for each single herbal medicine. Further rigorous trials are needed.