• 제목/요약/키워드: Cochrane Risk of Bias

검색결과 408건 처리시간 0.027초

A Meta-Analysis of Treatment Effects on Viral Pneumonia Using TCM Injections Specified in the Clinical Guideline for COVID-19 in China

  • Chun, Hea Sun;Choi, Su Hyeon;Song, Ho Sueb
    • 대한약침학회지
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    • 제24권3호
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    • pp.107-121
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    • 2021
  • Objectives: The purpose of this study is to analyze the efficacy of traditional Chinese medicine (TCM) injections specified in the clinical guideline for COVID-19 by conducting a meta-analysis of viral pneumonia data. Methods: TCM injections data on viral pneumonia were collected until July 31, 2021. CNKI, PubMed, EMBASE, and the Cochrane electronic database were used to collect the clinical data. "COVID-19," "Viral pneumonia," "Tanreqing," "Xiyanping," "Reduning," "Xingnaojing," "Xuebijing," "Shenmai," "Shengmai," and "Shenfu" were used as keywords. All data collected were mainly about TCM injections and viral pneumonia. Furthermore, studies that included results such as the total effective rate, cough disappearance time, antipyretic time, lung rhomboid disappearance time, and adverse drug reaction were collected for the meta-analysis to identify the efficacy of TCM injections. However, data unrelated to TCM injections specified in the clinical guidelines for COVID-19 or viral pneumonia were excluded. The quality of included RCTs was assessed by the Cochrane Risk of Bias Tool, and Review Manager 5.3 software was used to conduct the meta-analysis. Results: A total of 18 studies with 1540 patients were included in this study. The results of the meta-analysis showed that the total effective rate OR = 4.61 (95% CI 2.92, 7.25, p = 1.00/ I2 = 0%); the cough disappearance time: SMD -1.23 (-1.37, -1.09, p < 0.00001/ I2 = 94%); the antipyretic time: SMD -1.26 (-1.40, -1.11, p < 0.00001/ I2=94%); lung rhomboid disappearance time: SMD -1.17 (-1.33, -1.02, p < 0.00001/ I2 = 89%); and adverse drug reaction was OR 0.36 (95% CI 0.20, 0.64, p = 0.21/ I2 = 30%). From the results, the treatment group (TCM injection) showed better efficacy than the control group (Western medication). Conclusion: Xiyanping, Reduning, and Tanreqing injections may yield benefits as COVID-19 treatments. However, clinical trials on TCM injections for the treatment of COVID-19 are still lacking. More high-quality clinical trials are still required.

퇴행성 슬관절염의 화침 치료에 대한 체계적 문헌 고찰 및 메타분석: 최근 5년간의 호침 치료 비교 연구를 중심으로 (A Systematic Review and Meta-Analysis of Fire Needling Treatment for Knee Osteoarthritis: Focused on Comparative Studies with Manual Acupuncture Treatment during Recent Five Years)

  • 고홍제;유재희;신정철
    • Korean Journal of Acupuncture
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    • 제36권2호
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    • pp.104-114
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    • 2019
  • Objectives : The purpose of this study is to review the effectiveness of fire needling treatment for knee osteoarthritis in comparison with manual acupuncture treatment. Methods : Through four foreign online databases (PubMed, Cochrane library, EMBASE, and CNKI) and five domestic online databases (NDSL, RISS, KISS, OASIS, and KTKP), we searched for clinical studies that performed fire needling treatment for knee osteoarthritis until May 10, 2019. Only randomized controlled trials were selected and we assessed the risk of bias according to the Cochrane RoB criteria. This review examined the selected studies into first author, publication year, sample size, outcome measurements, results, acupoints, treatment time & period and so on. Results : A total of 7 RCTs were selected in this review and all were conducted in China. Treatment period of more than 4 weeks and treatment visits of 10 to 20 times were the most common. EX-LE4 and ST35 (=EX-LE5) acupoints were most frequently selected in treatment. Among the evaluation indexes, a total efficacy rate was used the most. Most of fire needling groups showed more significant results compared with the manual acupuncture groups statistically. Conclusions : All studies showed that fire needling treatments for knee osteoarthritis were more effective than manual acupuncture treatments statistically. Therefore, the results of this study could be utilized as a preliminary data for another clinical research on fire needling treatment for knee osteoarthritis. However, further well-designed randomized controlled trials will be needed to develop sufficient evidence about the effectiveness and safety of fire needling treatment for knee osteoarthritis in the future.

자하거 약침의 신경정신과 임상 응용에 관한 체계적 문헌 고찰 (A Systematic Review of Placenta Pharmacopuncture for Neuropsychiatric Diseases in Practice)

  • 신혜규;이재혁;강형원
    • 동의신경정신과학회지
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    • 제33권2호
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    • pp.157-180
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    • 2022
  • Objectives: To perform a systematic review of placenta pharmacopuncture for treating neuropsychiatric diseases, focusing on its efficacy and the safety so that evidence on its clinical use could be obtained, thus contributing to further studies. Methods: Through Korean, English, and Chinese databases (OASIS, Korean TK, KISS, RISS, ScienceON, Pubmed, Cochrane, EMBASE, CINAHL, AMED, CNKI, and Wanfang), combinations of keywords (placenta, pharmacopuncture, etc.) were used to select clinical studies published until January 2021 about placenta pharmacopuncture for neuropsychiatric diseases. Interventions included combined treatments. Study design included cases studies, series, and clinical trials. Cohort studies, literature reviews, in vitro and animal experiments were excluded. The primary outcomes involved measurements of symptoms, Visual Analogue Scale, or questionnaires. Data extracted from databases were imported to Endnote X7 to remove duplicates. The quality of the literature was assessed based on CAse REports Guidelines and Cochrane's Risk of Bias (ROB). Results: Twenty-one studies were selected, including ten case reports, three case series, two one-armed clinical trials, one non-randomized clinical trial, and five randomized clinical trials. There were six studies on sleep disorders, five studies on stroke sequela, two on mood disorders, two on enuresis, two on Guillain-Barré syndrome, two on multiple sclerosis, one on neurocognitive disorder, and one on vertigo. The most frequent combined treatment was acupuncture in both the experimental group (n=10) and the control group (n=3). Acupoints were ST36, SP6, BL23, CV4, GB20, GV20, N-HN54, and so on. All studies reported improvement of symptoms. The quality of case studies was relatively high. Assessment of ROBs resulted in low risks. Conclusions: Placenta pharmacopuncture is effective for neuropsychiatric diseases such as sleep disorders, mood disorders, enuresis, and neurocognitive disorders. Regarding insomnia, several studies have reported significant improvements with placenta pharmacopuncture. There was no adverse event associated with placenta pharmacopuncture.

요추 척추관 협착증에 대한 전침 치료의 효과: 체계적 문헌고찰 및 메타분석 (Electroacupuncture for Lumbar Spinal Stenosis: A Systematic Review and Meta-Analysis)

  • 나복연;손우석;김영준;우창훈
    • 한방재활의학과학회지
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    • 제33권3호
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    • pp.67-78
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    • 2023
  • Objectives To evaluate the evidence supporting the efficacy and safety of electroacupuncture for lumbar spinal stenosis. Methods We searched eight electronic databases (PubMed, EMBASE, Cochrane Library, Chinese Academic Journals, Research Information Sharing Service, ScienceOn, KMBASE, DBpia) and related two journals up to March 2023. We included randomized controlled trials of testing electroacupuncture for lumbar spinal stenosis patients. The methodological quality of relevant randomized controlled trials assessed by the Cochrane risk of bias tool. Results Among 90 articles that were searched, seven randomized controlled trials involving 474 participants were finally selected in this systematic review. Electroacupuncture was more effective on lumbar spinal stenosis compared with other treatments including analgesics, acupuncture, bed rest and exercise therapy, but showed ambiguous effect compared with physical therapy. Most of the side effects and adverse reactions were reported as minor and temporary. Conclusions Electroacupuncture for lumbar spinal stenosis was more effective than analgesics, acupuncture, bed rest and exercise therapy. In terms of safety, it was limited because there are many papers that do not mention side effects and adverse reactions related to electroacupuncture. Additional studies are needed to determine the effect of electroacupuncture on lumbar spinal stenosis.

턱관절장애에 대한 수기요법의 체계적 문헌 고찰과 메타분석 (A Systematic Review and Meta-analysis of Manual Therapy for Temporomandibular Disorder)

  • 김홍국;유덕우;정성목;김성진;백승원;이창희;윤진영
    • 척추신경추나의학회지
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    • 제12권1호
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    • pp.13-27
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    • 2017
  • Objectives: To evaluate and summarize the efficacy and safety of manual therapy in temporomandibular disorder(TMD). Methods: Ten databases (Pubmed, Cochrane, EMBASE, AMED, CINAHL, CNKI, and four Korean databases) were searched up to March 2017. Pain and range of motion(ROM) of temporomandibular joint were used as the primary outcome measure, and effective rates, dysfunction scale and adverse events were used as secondary outcome measures. The Cochrane risk of bias tool was used to evaluate the methodological quality. Results: 10 randomized controlled trials(RCTs) involving 603 participants were included. There were no significant differences between the two groups in comparison with placebo manual therapy group. In comparison with Wait-list and conventional treatment groups, manual therapy significantly alleviated pain and ROM. Five RCTs(50.0%) reported adverse events and there were no adverse cases by manual therapy. Conclusions: We found evidence that manual therapy may alleviate symptoms of patients with TMD. A positive effect was observed in comparison with conventional treatment and Wait-list, but no conclusion for the comparisons with placebo manual therapy. There is no evidence of worsening symptoms or causing adverse events.

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혈부축어탕의 본태성 고혈압에 대한 치료 효과 관한 메타 분석 및 체계적 고찰 (Xuefuzhuyu Decoction for Essential Hypertension: Meta-Analysis and Systemic Review)

  • 한인식;장인수;선승호
    • 대한한방내과학회지
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    • 제39권6호
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    • pp.1150-1167
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    • 2018
  • Objective: The purpose of this study was to investigate the effect reducing blood pressure (BP) using Xuefuzhuyu Decoction (XFZYD) in adults with essential hypertension (EH). Method: Search engine, such as PubMed, EMBASE, Cochrane library, Web of Science, J-STAGE, CiNii, CNKI, OASIS, NDSL, KISS, RISS, and DBpia, were used. The search period was from the beginning of the search engine to June 30, 2018 and there were no limits regarding languages. The selection and extraction of literatures were performed independently by two authors. Meta-analysis was done on the total effective rate (TER), Systolic BP (SBP) and Diastolic BP (DBP). Cochrane's risk of bias (ROB) was used as the methodological quality assessment scale. Results: Twenty studies were finally selected. We observed that a combination treatment using XFZYD and an antihypertensive drug (AHD) was 5.1 times more effective in lowering BP than using AHD alone on TER. The mean differences in SBP and DBP were -10.65 mmHg (95% Confidential Interval (CI) -13.55 mmHg, -7.74 mmHg, P<0.00001), -5.92 mmHg (95% CI -7.14, -4.38, P<0.00001), respectively. Conclusion: A combination treatment using XFZYD and AHD may be more effective in reducing BP than using AHD alone. Because of the poor methodological quality of the studies conducted thus far, high-quality clinical trials will be required in the future.

Effectiveness of worksite-based dietary interventions on employees' obesity: a systematic review and meta-analysis

  • Park, Seong-Hi;Kim, So-Young
    • Nutrition Research and Practice
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    • 제13권5호
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    • pp.399-409
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    • 2019
  • BACKGROUND/OBJECTIVES: This study was designed to provide scientific evidence on the effectiveness of worksite-based dietary intervention to reduce obesity among overweight/obese employees. MATERIALS/METHODS: Electronic search was performed using Ovid Medline, Embase, Cochrane Library, and CINAHL databases. The keywords used were "obesity," "nutrition therapy," and "worksite." The internal validity of the randomized controlled trials (RCTs) was assessed using the Cochrane's Risk of Bias. Meta-analysis of selected studies was performed using Review Manager 5.3. RESULTS: A total of seven RCTs with 2,854 participants were identified. The effectiveness of dietary interventions was analyzed in terms of changes in weight, body mass index (BMI), total cholesterol, and blood pressure. The results showed that weight decreased with weighted mean difference (WMD) of -4.37 (95% confidence interval (CI): -6.54 to -2.20), but the effectiveness was statistically significant only in short-term programs < 6 months (P = 0.001). BMI also decreased with WMD of -1.26 (95% CI: -1.98 to -0.55), but the effectiveness was statistically significant only in short-term programs < 6 months (P = 0.001). Total cholesterol decreased with WMD of -5.57 (95% CI: -9.07 to -2.07) mg/dL, demonstrating significant effectiveness (P = 0.002). Both systolic (WMD: -4.90 mmHg) and diastolic (WMD: -2.88 mmHg) blood pressure decreased, demonstrating effectiveness, but with no statistical significance. CONCLUSIONS: The worksite-based dietary interventions for overweight/obese employees showed modest short-term effects. These interventions can be considered successful because weight loss was below approximately 5-10 kg of the initial body weight, which is the threshold for the management of obesity recommended by the Scottish Intercollegiate Guideline Network (SIGN).

파킨슨병에 동반된 수면장애의 한약 치료에 대한 임상 연구 동향 : 무작위 대조연구를 중심으로 (Efficacy of Herbal Medicine on Sleep Disorders in Parkinson's Disease: A Review of Randomized Controlled Trials)

  • 강지현;백경민
    • 대한한방내과학회지
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    • 제44권4호
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    • pp.603-620
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    • 2023
  • Objectives: This study reviewed randomized controlled trials (RCTs) investigating the efficacy of herbal medicine on sleep disorders associated with Parkinson's disease and suggests a better research process. Methods: We searched for RCTs for herbal medicine treatments for sleep disorders related to Parkinson's disease on July 31, 2023 using eight databases (PubMed, Embase, the Cochrane library, China National Knowledge Infrastructure [CNKI], the Research Information Service System [RISS], Science ON, the Oriental Medicine Advanced Searching Integrated System [OASIS], and the Korea Citation Index [KCI]). Cochrane's risk of bias tool was used to assess the quality of the RCTs. Results: A total of 16 RCTs met all the inclusion criteria, and in most reports, the treatment group showed a significant improvement in sleep disorders compared to the control group. Total effective rate (TER), Pittsburgh Sleep Quality Index (PSQI), Unified Parkinson's Disease Rating Scale (UPDRS), TCM Symptom Score (TSS), Parkinson's Disease Sleep Scale (PDSS), etc., were used as evaluation indicators. Conclusion: Herbal medicine is a potential treatment for sleep disorders associated with Parkinson's disease. However, the selected RCTs were of poor quality, and it is necessary to perform more systematic studies.

국내 중환자실 섬망 예방 중재에 관한 체계적 고찰 및 메타분석 (A Systematic Review and Meta-analysis on the Effect of Delirium Prevention Intervention in Korean Intensive Care Units)

  • 강지연;최민정
    • 중환자간호학회지
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    • 제14권3호
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    • pp.141-156
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    • 2021
  • Purpose : This study aimed to systematically review the preventive interventions for delirium in Korean intensive care unit (ICU) patients and evaluate their efficacy. Methods : For this systematic review and meta-analysis, we searched the literature and selected studies from data sources that included the RISS, KISS, National Central Library, National Assembly Library, DBpia, Science on, MEDLINE, and Cochrane Library. We used Cochrane's revised tool for risk of bias in randomized trials and non-randomized studies of intervention tools to assess the quality of the selected studies. The effect size of the intervention was calculated as odds ratio (OR) and standardized mean difference (SMD). Results : Preventive interventions reported in 23 studies with a total of 4,799 ICU patients were effective in reducing the occurrence of delirium (OR=0.64, 95% CI : 0.49~0.91, p=.011), but not the duration (SMD=-0.22, 95% CI : -0.51~0.08, p=.148). As a result of a subgroup analysis, non-pharmacological interventions were effective in reducing the occurrence of delirium (OR=0.66, 95% CI : 0.47~0.94, p=.020), while pharmacological interventions had no effect (OR=0.68, 95% CI : 0.33~1.40, p=.295). Among the non-pharmacological interventions, multi-component intervention had the largest effect size (OR=0.38, 95% CI : 0.26~0.55, p<.001). Conclusion : Non-pharmacological interventions were effective in reducing the occurrence of delirium. We recommend the development and application of multi-component interventions to prevent delirium in the Korean ICU patients.

기침에 대한 반하사심탕의 효과 : 체계적인 문헌고찰과 메타분석 (The Effect of Banhasasim-tang in Cough: A Systematic Review and Meta-analysis)

  • 한승희;선승호
    • 대한한방내과학회지
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    • 제42권3호
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    • pp.385-402
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    • 2021
  • Objective: This study confirms the safety and efficacy of Banhasasim-tang (BST) against cough through systematic review and meta-analysis. Methods: PubMed, Cochrane, ScienceDirect, Wiley online library, OASIS, KISS, NDSL, RISS, Science and Technology Society Village, DBpia, CNKI, J-STAGE, and CiNii were used as search engines. The search period was from the start of search engine support to June 30. 2020. And search language was not limited. Cochrane's risk of bias (RoB) tool was used to evaluate the quality of the studies. A meta-analysis of the total effective rate (TER), cough symptom score, and spirometry results was performed using the Review Manager program. Results: 6 studies were finally selected. The group using BST showed significant symptom relief, as the odds ratio (OR) value of TER was 5.56 times higher (95% CI: 3.50, 8.82, P<0.0001) compared to the control groups. The reported adverse effects did not occur in the intervention group. In addition, the cough symptom score and spirometry results showed that BST was more effective than Western medicine alone. Conclusion: BST can be expected to relieve cough, and it can be applied to chronic cough that is not treated with existing treatments. However, due to the low quality of the selected articles, additional high-quality RCTs will be required in the future.