• Title/Summary/Keyword: Cochrane Risk of Bias

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Recent Research Trends of Acupuncture for Wrinkle Treatment (주름 개선을 위한 침 연구의 현황분석)

  • Jung, Hyeon-Suk;Kim, Tae-Jun;Park, Ji-Yeun
    • Korean Journal of Acupuncture
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    • v.38 no.2
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    • pp.62-74
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    • 2021
  • Objectives : The aim of this study is to analyze the effect of acupuncture and the details of acupuncture treatment methods on skin wrinkles. Methods : Search was conducted in Pubmed, KISS, and NDSL databases for acupuncture studies on skin wrinkles. The detailed therapeutic techniques of acupuncture used for skin wrinkles and the effect of acupuncture on skin wrinkle improvement were analyzed. Then, the study results using the same indicator were compared through meta-analysis in order to compare the effects of acupuncture with the control group. The quality of randomized controlled trials (RCTs) was assessed using the risk of bias (ROB) assessment tool (Ver. 1.0, Cochrane Collaboration). Results : A total of 10 RCTs and 19 case series were included in this study. The most frequently used therapeutic technique for skin wrinkle improvement was Microneedle therapy system (MTS, n=19), and they were mostly used with aesthetic solutions (13 out of 19 studies). Skin wrinkle related indexes were most commonly used to evaluate skin wrinkle improvement (n=14). Panax Ginseng pharmacopuncture showed the most remarkable effect in improving the range of skin wrinkles and the depth of skin wrinkles. MTS+epidermal growth factor improved the levels of skin hydration, skin elasticity, and variation of skin pigment the most. MTS+Endothelial precursor cell improved the number of skin melanin the most. Three RCTs included in the meta-analysis showed moderate ROB on average. Conclusions : Acupuncture treatment was effective in improving skin wrinkles. However, a precise study design using unified indicators and appropriate controls needs to be performed in further studies in order to establish more convincing evidence of the effectiveness of acupuncture for improving skin wrinkles.

Review on the Objective Effect and Mechanism Studies of Herbal Medicine, Acupuncture and Moxibustion Treatment for Irritable Bowel Syndrome Patients (과민성 대장증후군 환자를 대상으로 수행된 한약 및 침구치료의 객관적 효과와 기전 연구에 대한 문헌고찰)

  • Noh, Hyun Deok;Kim, Min Jeong;Cho, Im Hak;Kim, So Yeon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.35 no.5
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    • pp.199-209
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    • 2021
  • The purpose of this study was to explore objective indicators(outcomes) which are used to evaluate clinical efficacy and figure out the mechanisms of herbal medicine, acupuncture and moxibustion treatment for Irritable bowel syndrome(IBS). We searched randomized controlled trials(RCTs) that mediated with herbal medicine, acupuncture and moxibustion treatment for IBS and used objective indicators for outcome from November 1, 2020 to December 31, 2020. The RCTs that were published in Korean, English and Chinese were included in this study. The selected literatures were analyzed about methods of result measurement and assessed by Cochrane's risk of bias(RoB). Total 18 RCTs were included in this study. There were lots of objective indicators for result measurement; the concentration of hormones in blood and neurotransmitters, the sensitivity of rectum, the functional assessment of central nerve and autonomic nerve system, the change of intestinal flora, the concentration of serum cytokines. Various objective indicators can be used to evaluate the clinical efficacy of with herbal medicine, acupuncture and moxibustion treatment for IBS, but due to the limitations of the quality of the included studies, systematic review and meta-analysis will be needed.

Outcomes of comprehensive fixed appliance orthodontic treatment: A systematic review with meta-analysis and methodological overview

  • Papageorgiou, Spyridon N.;Hochli, Damian;Eliades, Theodore
    • The korean journal of orthodontics
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    • v.47 no.6
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    • pp.401-413
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    • 2017
  • Objective: The aim of this systematic review was to assess the occlusal outcome and duration of fixed orthodontic therapy from clinical trials in humans with the Objective Grading System (OGS) proposed by the American Board of Orthodontics. Methods: Nine databases were searched up to October 2016 for prospective/retrospective clinical trials assessing the outcomes of orthodontic therapy with fixed appliances. After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of the mean OGS score and treatment duration were performed and 95% confidence intervals (CIs) were calculated. Results: A total of 34 relevant clinical trials including 6,207 patients (40% male, 60% female; average age, 18.4 years) were identified. The average OGS score after treatment was 27.9 points (95% CI, 25.3-30.6 points), while the average treatment duration was 24.9 months (95% CI, 24.6-25.1 months). There was no significant association between occlusal outcome and treatment duration, while considerable heterogeneity was identified. In addition, orthodontic treatment involving extraction of four premolars appeared to have an important effect on both outcomes and duration of treatment. Finally, only 10 (39%) of the identified studies matched compared groups by initial malocclusion severity, although meta-epidemiological evidence suggested that matching may have significantly influenced their results. Conclusions: The findings from this systematic review suggest that the occlusal outcomes of fixed appliance treatment vary considerably, with no significant association between treatment outcomes and duration. Prospective matched clinical studies that use the OGS tool are needed to compare the effectiveness of orthodontic appliances.

Clinical Effect of Acupuncture Combined with Herbal Medicine in Treatment of PSD: A Systematic Review and Meta-Analysis (뇌졸중 후 우울증에 대한 침과 한약의 결합 치료 효과: 체계적 문헌 고찰 및 메타분석 연구)

  • Sakong, Jong-Won;Lim, Su-Yeon;Kim, Sang-Ho;Chung, Dae-kyoo
    • Journal of Oriental Neuropsychiatry
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    • v.31 no.3
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    • pp.169-186
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    • 2020
  • Objectives: The purpose of this study was to provide clinical evidence to support the use of acupuncture combined herbal medicine for post-stroke depression. Methods: Studies were identified by searching Pubmed, EMBASE, Cochrane Library, NDSL, RISS, KMbase, KISS, and CNKI. Randomized controlled trials that verified effects of the acupuncture combined with the herbal medicine for PSD were included in this study. Literature searches of English, Chinese, and Korean databases were performed. Two authors independently extracted the data and assembled the study quality. Results: Of 698 RCTs screened, 17 RCTs were selected. Most of the studies had unclear risk of bias. Among the 17 RCTs, 10 were meta-analyzed. As for the outcome measurement, the effective rate and the HAMD were most commonly used. The meta-analysis of the studies revealed that the PSD cure effective rate in the acupuncture combined with herbal medicine group was higher than that in the Western medicine group (RR: 1.23, 95% CI: 1.14 to 1.33, p<0.00001, I2=0%). Also, the HAMD in the acupuncture combined with herbal medicine group was significantly different compared to the Western medicine group (MD -5.54, 95% CI -9.80 to -1.29, p=0.01, I2=99%). The quality of the selected RCTs was low. Conclusions: Acupuncture combined with herbal medicine is effective for treating post-stroke depression. However, It is worth noting that the included studies were of relatively poor quality. The sample sizes were also small. Based on the findings of this study, further investigations into the diagnosis and treatment of PSD are warranted.

A Study on the Combination Effect of Herbal Medicine and Western Medicine on BPSD in Patients with Alzheimer's Disease: A Systematic Review (알츠하이머병 환자의 이상행동심리증상(BPSD)에 대한 한약과 양약의 병용 효과에 대한 연구: 체계적 문헌 고찰)

  • Kim, Man-Gi;Chang, Seok-Joo;Hong, Min-Ho;Kim, Geun-Woo;Koo, Byung-Soo
    • Journal of Oriental Neuropsychiatry
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    • v.31 no.4
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    • pp.301-314
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    • 2020
  • Objectives: The purpose of this study was to provide clinical evidence to support the use of herbal medicine combined with western medicine for BPSD. Methods: Studies were identified by searching CNKI, Pubmed, EMBASE, Cochrane Library, SCIENCEON, RISS, KMbase, KISS, OASIS. Literature searches of Chinese, English, and Korean databases were performed. Two authors independently extracted the data and evaluated the quality of each study. Results: The literature search identified 203 articles. Of these, 7 were selected for the analysis. The risk of bias in most studies was unclear. The most frequently used diagnostic tools were the NINCDS-ADRDA and DSM-IV. The most commonly used results indicator was NPI. In 6 of the 7 papers, combination treatment (herbal & Western medicine) was statistically significantly more effective than single treatment (Western medicine alone) for BPSD. No significant adverse events were reported. Conclusions: Herbal medicine in combination with Western medicine is more effective for treating BPSD than Western medicine alone. However, the quality of the studies used in this study was uncertain and the sample size was too small. Based on the findings of this study, more high-quality clinical trials are needed to confirm the efficacy of combination treatment.

Acupuncture for the Treatment of Burns: A Systematic Review of Randomized Controlled Trials and Case Controlled Trials (화상의 침 치료에 대한 체계적 문헌고찰)

  • Lee, Jieun;Jeong, Seoyoon;Choi, Yoomin;Jeong, Minjeong
    • The Journal of Pediatrics of Korean Medicine
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    • v.31 no.4
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    • pp.19-30
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    • 2017
  • Objectives The study was conducted to evaluate the acupuncture treatment for burns by reviewing international randomized controlled studies and case controlled studies. Methods In the review, ten academic literature archives; NDSL, OASIS, PubMed, Cochrane library, CNKI, WANFANG, CINAHL, J-STAGE, CiNii, and EMBASE were used as the main databases to search for the randomized controlled trials or the case controlled trials about acupuncture treatment of burns using the keywords "burns AND acupuncture", "burn AND acupuncture", and "scald AND acupuncture". Results Initially, a total of 852 studies were founded except duplicate studies. 801 studies were excluded after screening of title and abstract. After reviewing 51 papers, a total of four randomized controlled trials and two case controlled trials were selected. These studies were analyzed by year, subjects, treatment intervention, evaluation criteria, treatment effect, adverse events, and 'Risk of Bias' assessment for randomized studies and non-randomized studies. From the six papers out of 51 papers those were reviewed, patients with burns were divided into two groups. The experimental group received acupuncture treatment, while the control group did not. The results of the completed studies have shown that the experimental group receiving acupuncture treatment demonstrated significant improvement compared to the control group, and there was no serious adverse events. Conclusions According to some of the studies, acupuncture in burn treatment is worth to try. However, additional well-designed randomized controlled studies will be required to justify the effectiveness of acupuncture treatment of burns.

Effects of Acupuncture after Rotator Cuff Surgery: A Systematic Review (회전근개 수술 후 침 치료의 효과: 체계적 문헌고찰)

  • Lee, Sang-Jin;Ko, You-Me;Park, Jung-Sik;Park, Tae-Yong;Lee, Jung-Han;Cho, Jae-Heung;Hwang, Eui-Hyoung;Kim, Kyoung-Ja;Choi, Mi-Young;Song, Yun-Kyung
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.4
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    • pp.25-34
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    • 2021
  • Objectives This study was conducted to evaluate the therapeutic effect of acupuncture after rotator cuff surgery. Methods Key words such as rotator cuff surgery and acupuncture were searched in 10 databases (Ovid-Medline, Ovid-EMBASE, Ovid-AMED, Cochrane Library, China National Knowledge Infrastructure [CNKI], National Digital Science Library [NDSL], Koreanstudies Information Service System [KISS], Oriental medicine Advanced Searching Integrated System [OASIS], KoreaMed, KMBASE), and only suitable randomized controlled trials (RCTs) were selected. Results 6 RCTs were finally selected, and acupuncture showed positive results for pain relief and functional recovery after rotator cuff surgery. However, the analyzed 6 RCTs showed a high overall risk of bias. Conclusions In the future, RCTs with a higher level of evidence on the effect of acupuncture after rotator cuff surgery need to be continuously conducted.

Effects of Herbal Medicine after Total Knee Arthroplasty: A Systematic Review and Meta-Analysis (슬관절 전치환술 후 한약 치료의 효과: 체계적 문헌고찰과 메타분석)

  • Lee, Sang-Jin;Ko, You-Me;Park, Jung-Sik;Park, Tae-Yong;Lee, Jung-Han;Cho, Jae-Heung;Hwang, Eui-Hyoung;Kim, Kyoung-Ja;Choi, Mi-Young;Song, Yun-Kyung
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.4
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    • pp.35-47
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    • 2021
  • Objectives This study was conducted to evaluate the therapeutic effect of herbal medicine after total knee arthroplasty. Methods Key words such as total knee arthroplasty and herbal medicine were searched in 10 databases (Ovid-Medline, Ovid-EMBASE, Ovid-AMED, Cochrane Library, China National Knowledge Infrastructure [CNKI], National Digital Science Library [NDSL], Koreanstudies Information Service System [KISS], Oriental medicine Advanced Searching Integrated System [OASIS], KoreaMed, KMBASE), and only suitable randomized controlled trials (RCTs) were selected. Results 8 RCTs were finally selected, and herbal medicine showed positive results for pain relief and functional recovery after total knee arthroplasty. However, the analyzed 8 RCTs showed a high overall risk of bias. Conclusions In the future, RCTs with a higher level of evidence on the effect of herbal medicine after total knee arthroplasty need to be continuously conducted.

Chuna Manual Therapy for Patients after Total Knee Arthroplasty: A Systematic Review and Meta-Analysis (슬관절 전치환술 환자에 적용한 추나치료: 체계적 문헌고찰 및 메타분석)

  • Lee, Eun-Byeol;Lee, Yun-Jin;Kim, Hyeon-Ji;Ahn, Hee-Duk;Yang, Doo-Hwa
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.16 no.1
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    • pp.13-23
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    • 2021
  • Objectives To assess the effectiveness of chuna manual therapy for patients with total knee arthroplasty. Methods We searched 9 electronic databases(KISS, NDSL, RISS, OASIS, KMBASE, Cochrane Library, PubMed, CNKI, Wangfang data) using the keywords 'total knee arthroplasty OR total knee replacement' and 'tuina OR chuna' to identify RCTs that investigated the effectiveness of Chuna manual therapy after total knee arthroplasty. Results 23 RCTs were selected based on inclusion criteria. The systematic review showed positive effect of using chuna manual therapy after total knee arthroplasty. Conclusions 23 studies reported that chuna manual therapy had significant effects on total knee arthroplasty. However, many studies were exposed to probable high risk of bias. Also, all of the studies were published in one overseas country. Therefore, further research is required using well-designed RCTs to support the effectiveness of chuna manual therapy.

Success rate of nitrous oxide-oxygen procedural sedation in dental patients: systematic review and meta-analysis

  • Rossit, Marco;Gil-Manich, Victor;Ribera-Uribe, Jose Manuel
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.6
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    • pp.527-545
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    • 2021
  • The aim of this systematic review was to determine the success rate of nitrous oxide-oxygen procedural sedation (NOIS) in dentistry. A systematic digital search was conducted for publications or reports of randomized controlled trials evaluating the clinical performance of NOIS. Abstracts of research papers were screened for suitability, and full-text articles were obtained for those who met the inclusion and exclusion criteria accordingly. The quality of the studies was assessed using the revised Cochrane risk-of-bias tool (RoB 2). A total of 19 articles (eight randomized clinical trials with parallel intervention groups and 11 crossover trials), published between May 1988 and August 2019, were finally selected for this review. The studies followed 1293 patients reporting NOIS success rates, with a cumulative mean value of 94.9% (95% CI: 88.8-98.9%). Thirteen trials were conducted on pediatric populations (1098 patients), and the remaining six were conducted on adults (195 patients), with cumulative efficacy rates of 91.9% (95% CI: 82.5-98.1%) and 99.9% (95% CI: 97.7-100.0%), respectively. The difference was statistically significant (P = 0.002). Completion of treatment and Section IV of the Houpt scale were the most used efficacy criteria. Within the limitations of this systematic review, the present study provides important information on the efficacy rate of NOIS. However, further well-designed and well-documented clinical trials are required and there is a need to develop guidelines for standardization of criteria and definition of success in procedural sedation. Currently, completion of treatment is the most used parameter in clinical practice, though many others also do exist at the same time. To maximize NOIS efficacy, clinicians should strictly consider appropriate indications for the procedure.