• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.30 no.3
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• pp.166-181
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• 2017

Objectives : The study was done to verify the relation between early-onset androgenetic alopecia(AGA) and metabolic syndrome(MetS). Methods : Data were collected through electronic database including KoreaMed, National Assembly Library, KMBASE, NDSL, KCI, KERIS, Google Scholar, Pubmed, Cochrane CENTRAL and EBSCO MEDLINE. A total of 13 case-control studies related to the MetS of early-onset alopecia patients were used for the systematic review and meta-analysis. Risk of bias of included studies were assessed by RoBANS tool. RevMan5.3, CMA3 were used for the meta-analysis. Results : In 13 evaluated articles, most frequent bias was the participant selection bias that was found in 10 articles. Significant association between early-onset AGA and MetS was found in 10(76.9%) out of 13 articles in the systematic review. In meta-analysis, early-onset male AGA was associated with increased risk of metabolic syndrome(OR: 3.73, 95% CI:2.49 -5.61). Conclusions : AGA, particularly early -onset male AGA, is significantly associated with MetS. Therefore all patients with early onset male AGA should be suggested to take preventive treatment to reduce the risk of MetS and various problems associated with it.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.9
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• pp.407-421
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• 2016

This paper reports a meta-analysis of sixteen studies that evaluated the efficacy of cognitive behavioral therapy (CBT) for persistent primary insomnia. PubMed, Cochrane Library, EMBASE, CINAHL and several Korean databases were searched between January 2015 and June 2015. The main search strategy involved the terms that indicate CBT-I (Cognitive Behavioral Therapy-Insomnia) and presence of insomnia. Methodological quality was assessed using Cochrane's Risk of Bias. Data were analyzed by the RevMan 5.3 program of Cochrane Library. Sixteen clinical trials met the inclusion criteria, resulting in a total of 1503 participants. Stimulus control, sleep restriction, sleep hygiene education, and cognitive restructuring were the main treatment components. CBT-I was conducted for a mean of 5.4 weeks, 5.5 sessions, and an average of 90 minutes per session. The effects of CBT-i on total sleep time (d=-0.31), sleep onset latency (d=-0.29), awakening time after sleep onset (d=-0.55), sleep efficiency (d=-0.70), insomnia severity (d=-0.77) and sleep belief (d=-0.64) were significant. Overall, we found a range from small to moderate effect size. CBT-I also was effective for anxiety (d=-0.30) and depression (d=-0.35). The findings demonstrate that CBT-I interventions will lead to the improvement of both sleep quality and quantity in patients with insomnia.

• Journal of Acupuncture Research
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• v.35 no.2
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• pp.61-68
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• 2018

Background: This study was performed to review the efficacy of national and international randomized controlled trials (RCT) investigating Chuna manipulative treatment for ankle sprains. Methods: Online databases (PubMed, Cochrane, EMBASE, CNKI, NDSL, OASIS), were searched for studies where Chuna treatment was performed for ankle sprains up to October 12th, 2017. Only RCT were selected that fulfilled the inclusion/exclusion criteria. Data were analyzed using the Cochrane risk of bias tool. Results: There were 676 studies retrieved from the databases, resulting in analysis of 24 RCT. There was an average of 7 treatment visits over a 7 day period and the most frequent evaluation tool used was efficacy rate, with drug therapy being the most common control used in the trials. In 15 RCT, several Chuna methods were used in combination, amongst which, the osteopathic technique was most common. Statistically significant improvement in evaluation indices was reported in 19 RCT, and in 3 RCT, statistically significant improvement was reported, but not for all indices. In the remaining 2 RCT, there were no significant differences in any of the evaluation indices. No adverse reactions were reported in any of the RCT, although it was unknown whether all the trial protocols indicated that adverse reactions should be monitored, and for this reason, the risk of bias was unclear. Conclusion: The review of 24 studies suggest that Chuna manipulative treatment for ankle sprains was effective in most cases, although, potential bias in these studies was difficult to evaluate.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.27 no.4
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• pp.1-15
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• 2014

Objective : This study was carried out to analyze the quality and quantity of Clinical Trials that have been published in the journal of korean medical ophthalmology, otolaryngology, dermatology(JKOOD). Methods : We analyzed 25 clinical trials that published in JKOOD from 1988 to 2014. We excluded case reports, protocol and retrospective studies and classified searched papers into three categories; Randomized Clinical Trials(RCT), Non Randomized Clinical Trials(NRCT), Before After Study(BAS) by using study Design Algorithm for Medical literature of Intervention(DMAI). All articles were analyzed according to diagnosis, statistics program and intervention period. The bias of RCTs were evaluated by Cochrane Risk of Bias(RoB). Result : 1. The number of searched journals is 25 papers; 13 RCT, 2 NRCT, 10 BAS 2. Distribution of clinical trial; 'Atopic dermatitis' ranked the highest(44%) in disease, 'External application' raked the highest(71%) in treatment method. 3. 'allocation sequence' and 'prevention of allocated intervent to patients and therapists' are graded 'Low' but 'incomplete outcome date' and 'selective outcome' are graded 'Uncertain'. Conclusions : It is necessary to study more RCT. It will be helpful to study systematic reviews and meta analysis in JKOOD.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.16 no.1
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• pp.35-42
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• 2021

Objectives The objective of this study was to evaluate the effect of chuna manual therapy for rhinitis. Methods We performed a literature search using ten electronic databases (PubMed, Embase, Cochrane Library, Chinese Academic Journals(CAJ), Research Information Sharing Service(RISS), Dbpia, National Digital Science Library(NDSL), Koreanstudies Information Service System(KISS), Korean Medical database(KMbase), and Oriental Medicine Advanced Searching Integrated System(OASIS)) and two academic journals up to the end of April 2021. We included randomized controlled trials (RCTs) which appraised the effect of chuna manual therapy (CMT) in the treatment of rhinitis. The risk of bias was evaluated from the Cochrane Risk of Bias tool. Results 4 appropriate RCTs were included and analyzed. The efficacy rate of the CMT group was statistically higher compared to the control group treated with medicine[RR 1.14 (95%CI 1.06 1.22), P<0.01]. Conclusions Based on results, CMT could be effective in rhinitis. However, evidence were limited due to small number of studies, lack of well-designed RCT and regional bias. Further well-designed research should be required to obtain stronger evidence.

• Restorative Dentistry and Endodontics
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• v.48 no.1
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• pp.5.1-5.22
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• 2023

This systematic review and network meta-analysis aimed to answer the following focused research question: "Does the type of endodontic sealer affect the postoperative pain in patients who received endodontic treatment?" Different databases and grey literature were surveyed. Only one randomized controlled trial were included. The risk of bias in the studies was evaluated by using the Cochrane Collaboration's tool. A random-effects meta-analysis was conducted to compare the risk and intensity of postoperative pain. The quality of the body of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Out of 11,601 studies, 15 remained for qualitative analyses and 12 for meta-analysis. Seven studies were classified at high risk of bias, and 8 studies raised some concerns. No significant differences between the endodontic materials were observed in the direct comparisons, both in risk and in intensity of postoperative pain (pairwise comparisons with 2 studies: I² = 0%; p > 0.05 and 8 studies: I² = 23%; p > 0.05, respectively). The certainty of the evidence was graded as low or moderate. There was no difference in the risk and intensity of postoperative pain after filling with different endodontic sealers. Further systematic reviews should be conducted.

• The Journal of Korean Medicine
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• v.41 no.1
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• pp.93-106
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• 2020

Objectives: The aim of this review is to ascertain whether Bojungikgi-tang and its modifications is more effective than non-specific management in chronic fatigue syndrome (CFS). Methods: We collected clinical trials to investigate the effects of Bojungikgi-tang and non-specific management on general symptoms, fatigue, and sleep quality in CFS patients. The databases used for data retrieval were Pubmed, Central Cochrane, CNKI, VIP, CiNii, OASIS, RISS, and Koreamed. We performed selection/exclusion process from the found records according to prespecified criteria, and assessed the final included trials according to the Cochrane risk of bias tool. The included studies were classified on the basis of interventions in experimental group. Results: Seven randomized controlled trials (476 participants) were eligible and their results were synthesized in the meta-analysis. The synthesis showed a substantial effect of Bojungikgi-tang (relative risk 0.20 [95% CI 0.13 to 0.31], Z=7.44, P<0.00001; I²=0%) and combination of Bojungikgi-tang and Sosiho-tang (relative risk 0.15 [95% CI 0.08 to 0.28], Z=5.85, P<0.00001; I²=0%) compared with non-specific management on improvement of general symptoms. However, we could not find sufficient clinical research records to determine their effects of improvement on fatigue and sleep quality. Conclusions: Bojungikgi-tang and its modifications are more effective than non-specific management for improvement of general symptoms in CFS post-treatment.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5755-5762
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• 2015

Background: Short-course preoperative radiation (SCRT) with delayed surgery was found to increase pathologic complete response (pCR) rates in several trials. However, there was no clear answer on whether SCRT or long-course chemo-radiotherapy (LCRT) is more effective. Therefore we conducted this meta-analysis to evaluate the safety and efficacy of SCRT versus LCRT, both with delayed surgery, for treatment of rectal cancer. Materials and Methods: The literature was searched from PubMed, EMBASE, Web of Science, Cochrane Library and clinicaltrials.gov up to November, 2014. Quality of the randomized controlled trials (RCTs) was evaluated according to the Cochrane's risk of bias tool of RCT. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to rate the level of evidence. Review Manager 5.3 was employed for statistical analysis. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated. Results: Three RCTs, with a total of 357 rectal cancer patients, were included in this systematic review. Metaanalysis results demonstrated there were no significantly differences in sphincter preservation rate, local recurrence rate, grade 3~4 acute toxicity, R0 resection rate and downstaging rate. Compared with SCRT, LCRT was associated with significant increase in the pCR rate [RR=0.49, 95%CI (0.31, 0.78), P=0.003]. Conclusions: In terms of sphincter preservation rate, local recurrence rate, grade 3~4 acute toxicity, R0 resection rate and downstaging rate, SCRT with delayed surgery is as effective as LCRT with delayed surgery for management of rectal cancer. LCRT significantly increased pCR rate compared with SCRT. Due to risk of bias and imprecision, further multi-center large sample RCTs were needed to confirm this conclusion.

• Asian Oncology Nursing
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• v.12 no.4
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• pp.257-266
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• 2012

Purpose: The purpose of this study was to evaluate the effectiveness of patient education interventions on distress, self-care knowledge and self-care behavior in cancer patients. Methods: A total of 1,102 studies were retrieved from 6 electronic databases in Korea. From these studies, 18 studies met the inclusion criteria with a total of 850 participants. Two authors independently assessed the methodological quality by Cochrane's Risk of Bias and Methodological Items for Non Randomized Studies. The data were analyzed by the RevMan 5.1 program of Cochrane library. Results: Overall effect size of education interventions on anxiety was -2.12 (95% CI:-3.90, -0.34) (p<.001). The effects on self-care knowledge and self care behavior were -1.08 (95% CI:-1.73, -0.43) (p=.001), and -1.41 (95% CI:-2.13, -0.68) (p<.001), respectively. Publication bias was detected as evaluated by funnel plot, but the fail-safe number was moderate. Conclusion: This study suggests that patient education interventions can relieve anxiety and self-care. Further randomized controlled trials studies are needed to evaluate the effects of patient education intervention on depression.

• Pediatric Infection and Vaccine
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• v.23 no.2
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• pp.109-116
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• 2016

Purpose: Recent observational studies have found that vitamin D deficiency is associated with respiratory tract infections. However, randomized controlled trials (RCTs) regarding the efficacy of vitamin D in childhood respiratory tract infection (RTI) have yield inconsistent results. We performed a systematic review and meta-analysis to evaluate the association between vitamin D supplementation and the risk of RTI. Methods: A comprehensive search was conducted using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trial. Randomized controlled trials of vitamin D supplementation for prevention of RTI in children were included for the analysis. Cochrane Collaboration's tool for assessing the risk of bias was used to assess the quality of the studies. Pooled risk ratios with 95% confidence intervals (CIs) were meta-analyzed using Review Manager 5.3. Results: A total of seven RCTs were included in the meta-analysis. According to a random-effects model, the risk ratio for vitamin D supplementation was 0.82 (95% CI: 0.69-0.98) and $I^2=62%$ for heterogeneity. On subgroup analysis, heterogeneity decreased in the subgroup with follow-up less than 1 year, participants ${\geq}5years$ of age, patients subgroup, and subgroup with dosing daily. Funnel plot showed that there might be publication bias in the field. Conclusions: The present meta-analysis supports a beneficial effect of vitamin D supplementation for the prevention of RTI in children. However, the result should be interpreted with caution due to limitations including a small number of available RCTs, heterogeneity among the studies, and potential publication bias.