• Title/Summary/Keyword: Cochrane Risk of Bias

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Vegetable Oil Intake and Breast Cancer Risk: a Meta-analysis

  • Xin, Yue;Li, Xiao-Yu;Sun, Shi-Ran;Wang, Li-Xia;Huang, Tao
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.12
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    • pp.5125-5135
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    • 2015
  • Background: Total fat intake may be associated with increased risk of breast cancer, and fish oil has been suggested as a protection factor to breast cancer. But the effect of vegetable oils is inconclusive. We aimed to investigate the association with high vegetable oils consumption and breast cancer risk, and evaluated their dose-response relationship. Design: We systematically searched the MEDLINE, EMBASE, Cochrane databases, and CNKI updated to December 2014, and identified all observational studies providing quantitative estimates between breast cancer risk and different vegetable oils consumption. Fixed or random effect models were used to estimate summary odds ratios for the highest vs. lowest intake, and dose-response relationship was assessed by restricted cubic spline model and generalized least-squares trend (GLST) model. Results: Five prospective cohort studies and 11 retrospective case-control studies, involving 11,161 breast cancer events from more than 150,000 females, met the inclusion criteria. Compared with the lowest vegetable oils consumption, higher intake didn't increased the risk of breast cancer with pooled OR of 0.88 (95% CIs:0.77-1.01), and the result from dose-response analyses didn't show a significant positive or negative trend on the breast cancer risk for each 10g vegetable oil/day increment (OR=0.98, 95% CIs: 0.95-1.01). In the subgroup analyses, the oils might impact on females with different strata of BMI. Higher olive oil intake showed a protective effect against breast cancer with OR of 0.74 (95% CIs: 0.60-0.92), which was not significant among the three cohort studies. Conclusions: This meta-analyses suggested that higher intake of vegetable oils is not associated with the higher risk of breast cancer. Olive oil might be a protective factor for the cancer occurrence among case-control studies and from the whole. Recall bias and imbalance in study location and vegetable oils subtypes shouldn't be ignored. More prospective cohort studies are required to confirm the interaction of the impact of vegetable oils on different population and various cancer characteristic, and further investigate the relationship between different subtype oils and breast cancer.

The Effectiveness of Acupuncture Treatment for Patients with Alzheimer's Disease: A Meta-Analysis of Randomized Controlled Trials

  • Shin, Jin Hyeon;Shin, Hye Jeong;Kim, Eui Byeol;An, Yun Young;Yook, Tae Han;Choi, Yoo Min;Song, Beom Yong;Kim, Jong Uk
    • Journal of Acupuncture Research
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    • v.37 no.4
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    • pp.209-223
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    • 2020
  • The purpose of this study was to evaluate the effectiveness of acupuncture treatment for the symptoms of Alzheimer's disease (AD). There were 11 databases searched for randomized controlled trials using acupuncture treatment for AD. The risk-of-bias assessment tool of the Cochrane Library was used to evaluate the quality of each study. Using the Review Manager (RevMan), a meta-analysis was performed using risk ratio, mean difference, 95% confidence interval, and random effect model. There were 32 studies selected, all of which were conducted in China. There were 16 studies where acupuncture was used as the intervention, and 23 studies used Donepezil as the control group. Acupoint GV20 was most frequently selected during the treatment. The Mini Mental State Examination (MMSE) was the most frequently used outcome variable. A period of 12 weeks was the most common treatment duration. As a result of meta-analysis (n = 25), acupuncture improved the MMSE and activities of daily living scores. Electroacupuncture improved the Alzheimer Disease Assessment Scale-Cognitive Subscale, and scalp acupuncture improved the MMSE score for AD. Acupuncture alleviates the symptoms of AD. However, further research is necessary to provide a better level of evidence.

A Systematic Review and Meta-analysis of Acupotomy for Scoliosis

  • Park, Jung Hyeon;Kim, Gyu Hui;Kim, Tae Kyung;Lee, Eun Ju;Yoon, Hyun Min;Seo, Jong Cheol;Song, Choon Ho;Cho, Sung Woo;Kim, Cheol Hong
    • Journal of Acupuncture Research
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    • v.38 no.4
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    • pp.265-275
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    • 2021
  • This review investigated the effectiveness and safety of acupotomy treatment for scoliosis. There were 7 online databases used in the search from inception to March 17, 2021, for randomized controlled trials of the use of acupotomy in patients with scoliosis. The Cochrane risk-of-bias tool was used to assess the methodological quality of the studies included (n = 12). A quantitative synthesis of the randomized controlled trials was performed using RevMan Version 5.3. The effect sizes of studies were presented as mean differences for continuous outcomes and risk ratios for dichotomous outcomes, with a 95% confidence interval. As part of combined therapy, acupotomy was reported to significantly improve Cobb's angle compared with other treatments. Likewise, the Visual Analog Scale score, the Oswestry Disability Index score, and pulmonary function were also reported to be improved following acupotomy combination therapy. Although 5 studies mentioned the criteria for reporting adverse events, only 1 study reported adverse events. In conclusion, acupotomy may be an effective treatment for scoliosis. However, the small number, and heterogeneity of the included studies, as well as the poor methodological quality, indicate that higher-quality studies should be conducted to verify the effectiveness and safety of acupotomy treatment for scoliosis.

The Effect of Korean Herbal Medicine that Function by Inducing Diuresis for Hypertension: Systematic Review and Meta-Analysis of Randomized Controlled Trials (고혈압에 대한 한약 이수 처방 효과에 대한 체계적 문헌 고찰 및 메타분석)

  • Kang, Ja-yeon;Kang, Ki-wan;Jeong, Min-jeong;Kim, Hong-jun;Jan, In-soo
    • The Journal of Internal Korean Medicine
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    • v.38 no.6
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    • pp.902-916
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    • 2017
  • Objectives: The aim of this study was to review the clinical research on antihypertensive effects of Korean herbal medicines that function by inducing diuresis. Methods: Literature searches were performed using PubMed, Cochrane, CNKI, Wanfang, Cinii, Oasis, KISS, NDSL, RISS, DBPia, with the keywords "利水", "利尿", "高血壓", "hypertension", and "lishui." The search range included only randomized controlled trials that verified the effects of Korean herbal medicine interventions on hypertension. The selected studies were assessed by risk of bias (RoB). Results: 26 reports were selected from a total of 532 identified. For these reports, meta-analysis was performed using Revman 5.3. From this analysis, it was observed that the combined treatment of Korean medicine and antihypertensive drugs had a significantly higher total effective rate (TER) and improvement in systolic blood pressure (SBP) and diastolic blood pressure (DBP) than did the use of a single antihypertensive drug. The risk ratio of TER for lowering blood pressure was 1.25. The mean differences of SBP, DBP were -19.63 mm Hg (95% confidential interval (CI), -22.45 mm Hg, -16.80 mm Hg, p<0.00001), and -5.39 mm Hg (95% CI, -7.36 mm Hg, -3.42 mm Hg, p<0.00001) respectively. The use of Korean medicine only did not improve blood pressure, as compared to the use of an antihypertensive drug. Most of items of RoB were unclear, and the methodological quality was low. Conclusions: The combination of antihypertensive drugs and Korean medical treatment can effectively improve SBP, DBP, and TER. This finding could be widely utilized in clinical practice in Korean medicine.

Meta-analysis and Systematic Review on the Effects of Herbal Medicine and Synthetic Drugs in Helicobacter pylori Infection: Focusing on PubMED (Helicobacter pylori infection에 대한 한약과 합성의약품 병용투여 효과에 대한 메타분석 및 체계적 문헌고찰 : PubMED를 중심으로)

  • Jeong, Seol;Gwak, Seung Yeon;Cho, Eun ji;Jerng, Ui Min
    • The Korea Journal of Herbology
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    • v.36 no.5
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    • pp.69-79
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    • 2021
  • Objectives : In clinical practice, there are many cases of co-administration of herbal medicine and synthetic drugs. This study tried to identify whether the combined administration of herbal medicine and synthetic drugs including amoxicillin increases Helcicobacter pylori eradication rate compared to the single administration of synthetic drugs or the combined administration of synthetic drugs and placebo herbal medicine through systematic review. Methods : Relevant randomized controlled trials were searched in PubMED database. The risk of biases was assessed through the Cochrane Risk of Bias criteria. Three reviewers were extracted the characteristics and outcomes of each study. Meta-analysis of eradication rate and adverse event was conducted. Results : Four RCTs were selected. In meta-analysis, the combination of herbal medicine and synthetic drugs showed eradication effect, but it was not statistically significant (Odds Ratio [OR] 0.46; 95% confidence interval [CI] 0.17 to 1.24; p=0.13; I2=56%) than administration of synthetic medicine alone. Combination of herbal medicine and synthetic medicine did not increased the incidence of adverse event(OR 1.07; 95% CI 0.72 to 1.59; p=0.68, I2=0%) compared to single administration of synthetic medicine. Conclusion : Although no significant difference was observed between the two groups in the eradication rate and the incidence rate of adverse events, it was difficult to draw a clear conclusion due to the heterogeneity between studies and the low quality of reporting. A number of studies that have overcome these limitations in the future will lead to definite conclusions.

Effect of Carrot Intake in the Prevention of Gastric Cancer: A Meta-Analysis

  • Fallahzadeh, Hossein;Jalali, Ali;Momayyezi, Mahdieh;Bazm, Soheila
    • Journal of Gastric Cancer
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    • v.15 no.4
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    • pp.256-261
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    • 2015
  • Purpose: Gastric cancer is the third leading cause of cancer-related mortality, with the incidence and mortality being higher in men than in women. Various studies have shown that eating carrots may play a major role in the prevention of gastric cancer. We conducted a meta-analysis to determine the relationship between carrot consumption and gastric cancer. Materials and Methods: We searched multiple databases including PubMed, Cochrane Library, Scopus, ScienceDirect, and Persian databases like Scientific Information Database (SID) and IranMedx. The following search terms were used: stomach or gastric, neoplasm or cancer, carcinoma or tumor, and carrot. Statistical analyses were performed using Comprehensive Meta Analysis/2.0 software. Results: We retrieved 81 articles by searching the databases. After considering the inclusion and exclusion criteria, 5 articles were included in this study. The odds ratio (OR) obtained by fixed effects model showed that a 26% reduction in the risk of gastric cancer has been associated with the consumption of carrots) OR=0.74; 95% confidence interval=0.68~0.81; P<0.0001). According to funnel graph, the results showed that the possibility of a publication bias does not exist in this study. Conclusions: The findings of this study showed an inverse relationship between the consumption of carrots and the risk of gastric cancer.

A Meta-analysis of the Effectiveness of Acupuncture for the Treatment of Essential Tremors (본태성 떨림의 침치료 효과에 대한 메타분석)

  • Sohn, Yu-jin;Jung, Seo-yoon;Kang, Ki-wan;Jeong, Min-jeong;Jang, In-soo
    • The Journal of Internal Korean Medicine
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    • v.38 no.4
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    • pp.419-432
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    • 2017
  • Objectives: This study provides an evaluation of the effectiveness of acupuncture for the treatment of essential tremors (ETs) using randomized controlled trials (RCTs). Methods: Nine databases (PubMed, CINAHL, EMBASE, OASIS, NDSL, CNKI, Wanfang, J-STAGE, and CiNii) and the keywords "Essential tremor", "Benign tremor", "Familial tremor", and "Acupuncture" were used to compile RCTs that used acupuncture to treat ETs. Studies that were not RCTs, such as case studies, reviews, and essays, were excluded. The methodological quality of each RCT was assessed using the Cochrane risk-of-bias tool, and where appropriate, meta-analyses were performed. Results: Initially, 819 studies were found, but 773 were excluded after title and abstract screening. After further screening of the resulting 46 papers, eight RCTs were selected that had been published between 2003 and 2016, and the total effective rate (TER) was used as the primary evaluation method for all eight studies. It was found that the TER was significantly higher in treatment groups (83.33-96.7%) than in control groups (56.5-80.0%), and seven studies included in the meta-analysis showed positive results for acupuncture for ETs (Risk Ratio: 1.43, 95% Confidence Interval: 1.21-1.69, P<0.0001) Confidence Interval. Conclusions: This meta-analysis of clinical trials suggests that acupuncture is effective for treating ET patients; however, further studies are needed or larger populations to prove its effectiveness.

Effectiveness of the Shugan Jieyu Capsule against Psychiatric Symptoms in Epilepsy: a protocol for systematic review and meta-analysis

  • Sejin Kim;Yunna Kim;Seung-Hun Cho
    • Journal of Pharmacopuncture
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    • v.26 no.1
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    • pp.38-43
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    • 2023
  • Objectives: Psychiatric symptoms in epilepsy are very common, and the most common symptoms are depression, insomnia, and anxiety. These symptoms not only lower the quality of life of epilepsy patients, but also elevate the risk of epileptic seizures. There are no specific criteria for the available antiepileptic drugs to ameliorate these symptoms in patients with epilepsy, and there is a lack of evidence to support the efficacy and safety of existing drugs. The Shugan Jieyu capsule (SJC) is a traditional herbal medicine composed of Acanthopanax senticosus and Hypericum perforatum and is reported to be effective in relieving psychiatric symptoms. The purpose of this study was to assess the efficacy of SJC as a treatment for psychiatric symptoms in epilepsy patients. Methods: Electronic databases will be investigated for publications in English, Korean, Japanese, and Chinese. The participants of the study are epilepsy patients with psychiatric symptoms diagnosed using any validated criteria. All types of controls will be compared-placebo, conventional treatments, and no treatment-to groups treated with SJC or modified SJC. We will measure the degree of improvement in psychiatric symptoms and check epileptic symptoms, such as the frequency of seizures. The study selection and data extraction will be performed by two independent reviewers, who will also assess methodological quality using the risk-of-bias tool by Cochrane. We will use Review Manager software (RevMan) to carry out all statistical analyses. Results: This systematic review and meta-analysis will be performed in accordance with the PRISMA-P statement. Conclusion: This systematic review is the first study to assess the efficacy and safety of SJC for the treatment of psychiatric symptoms in epilepsy. We expect that this study will provide clinically applicable evidence for patients with epilepsy when selecting drug treatments.

Effects of Manual Therapy on Musculoskeletal Diseases : A Meta-Analysis (근육뼈대계 질환에 대한 도수치료의 효과: 메타분석)

  • Lee, Jeong-Woo;Gong, Gwang-Sik;Kim, Dong-Yeon;Koh, Un
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.1
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    • pp.203-217
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    • 2021
  • Purpose: The purpose of this meta-analysis was to examine the high-level evidence of the effects of manual therapy on musculoskeletal diseases. Methods: Domestic databases were searched for studies that conducted clinical trials associated with manual therapy on chronic musculoskeletal diseases. A total of 591 studies published between 2005 and 2018 were identified, with 18 studies satisfying the inclusion data. The studies were classified according to patient, intervention, comparison, and outcome (PICO). The search outcomes were items associated with pain and physical function. The 18 studies included in the study were evaluated by using the R meta-analysis (version 4.0). The quality of 18 randomized control trials was evaluated by using the Cochrane risk of bias (ROB). The effect sizes were computed as the corrected standardized mean difference (SMD). Subgroup and meta-regression analyses were also used. Egger's regression test was carried out in order to analyze the publication bias. Cumulative meta-analysis and sensitivity analysis were also conducted in order to analyze the data error. Results: The following factors showed the large effect size of manual therapy on chronic musculoskeletal diseases: pain (Hedges's g = 2.66; 95% CI = 1.47 ~ 3.85), and physical function (Hedges's g = 2.15; 95% CI: 1.22 ~ 3.08). The subgroup analysis only showed a statistical difference in the type of manual therapy (pain) and outcome (physical function). No statistically significant difference was found in the meta-regression analysis. Publication bias was found in the data, but the results of the trim-and-fill method showed that such bias did not largely affect the obtained data. Furthermore, there were no data errors in the cumulative meta-analysis and sensitivity analysis. Conclusion: This study provides evidence for the effectiveness of manual therapy on chronic musculoskeletal diseases in pain and physical function. Subgroup analysis suggests that only the type of manual therapy for pain and the type of outcome for physical function differed in effect size.

Metformin Association with Lower Prostate Cancer Recurrence in Type 2 Diabetes: a Systematic Review and Meta-analysis

  • Hwang, In Cheol;Park, Sang Min;Shin, Doosup;Ahn, Hong Yup;Rieken, Malte;Shariat, Shahrokh F.
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.595-600
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    • 2015
  • Background: Accumulating evidence suggests that metformin possesses anticarcinogenic properties, and its use is associated with favorable outcomes in several cancers. However, it remains unclear whether metformin influences prognosis in prostate cancer (PCa) with concurrent type 2 diabetes (T2D). Materials and Methods: We searched PubMed, EMBASE, and the Cochrane Library from database inception to April 16, 2014 without language restrictions to identify studies investigating the effect of metformin treatment on outcomes of PCa with concurrent T2D. We conducted a meta-analysis to quantify the risk of recurrence, progression, cancer-specific mortality, and all-cause mortality. Summary relative risks (RRs) with corresponding 95% confidence intervals (CIs) were calculated. Publication bias was assessed by Begg's rank correlation test. Results: A total of eight studies fulfilled the eligibility criteria. We found that diabetic PCa patients who did not use metformin were at increased risk of cancer recurrence (RR, 1.20; 95%CI, 1.00-1.44), compared with those who used metformin. A similar trend was observed for other outcomes, but their relationships did not reach statistical significance. Funnel plot asymmetry was not observed among studies reporting recurrence (p=0.086). Conclusions: Our results suggest that metformin may improve outcomes in PCa patients with concurrent T2D. Well-designed large studies and collaborative basic research are warranted.