• 제목/요약/키워드: Cochrane Risk of Bias

검색결과 408건 처리시간 0.025초

Sodium Picosulphate with Magnesium Citrate versus Polyethylene Glycol for Bowel Preparation in Children: A Systematic Review

  • Dziechciarz, Piotr;Ruszczynski, Marek;Horvath, Andrea
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제25권3호
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    • pp.228-239
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    • 2022
  • Purpose: To compare the effectiveness, tolerability, acceptability, and safety of sodium picosulphate with magnesium citrate (PS/Mg) and polyethylene glycol (PEG) in children (≤18 years) preparing for colonoscopy. Methods: Three electronic databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials) were searched till July 2020. Only randomized controlled trials (RCTs) were included. At least two authors independently selected studies and performed risk of bias assessment and data extraction. Results: Four RCTs (n=390), with overall good quality were included. A meta-analysis of two trials (n=224) found no statistically significant difference between the groups with respect to the proportion of patients who had excellent and good scores (≥6 points) according to the Boston Bowel Preparation Scale (relative risk: 0.99; 95% confidence interval [CI]: 0.90 to 1.08). Excellent and good scores were observed in both groups in approximately 90% of children. A meta-analysis of two other trials (n=150) showed no significant difference between the groups with respect to the mean total score for the Ottawa Bowel Preparation Scale (mean difference: 0.20; 95% CI: -0.74 to 1.14). Both regimens provided a comparable safety profile; however, PS/Mg was significantly superior to high volume PEG in terms of tolerability (abdominal pain, nausea, vomiting, bloating/flatulence/fullness) and acceptability (ease of formulation consumption, taste acceptance, need for nasogastric tube, compliance with full dose). Conclusion: PS/Mg provides a quality and safety profile similar to PEG for bowel cleansing; however, it has better acceptance and tolerance in children preparing for colonoscopy.

혈액투석과 근감소증의 연관성에 관한 문헌고찰 (Association of Hemodialysis and Sarcopenia : A systematic review)

  • 최경욱;이화경;김수아;오윤재
    • 대한통합의학회지
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    • 제11권3호
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    • pp.185-194
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    • 2023
  • Purpose : This study aimed to investigate the relationship between the characteristics of hemodialysis patients and the occurrence of sarcopenia through a comprehensive literature review. Methods : A systematic literature search was conducted to identify eligible studies in the Cochrane library, PubMed and Embase. In this review, we included all papers published since the initiative's inception and summarized results as of december 2022. Studies that investigated association between sarcopenia diagnosis and hemodialysis patients (aged≥18 years) were included. Ultimately, 16 studies met our selection criteria. The risk of bias was assessed using the Newcastle-Ottawa scale. Results : Fourteen of the sixteen studies (88 %) reported that significant association between sarcopenia diagnosis and hemodialysis patients. However, two studies reported no association between sarcopenia diagnosis and hemodialysis patients. As a factor statistically related to sarcopenia in hemodialysis patients, Mortality (6 studies, 38 %), age (5 studies, 31 %), body composition (4 studies, 25 %), physical activity (2 studies, 13 %), diabetes (2 studies, 13 %), cardiovascular abnormalities (1 studies, 6 %), nutritional status (3 studies, 19 %), and gender (3 studies, 19 %). Conclusion : Our findings highlight the necessity of developing a physical therapy program that accurately reflects the health status of hemodialysis patients. To further investigate the association between the diagnosis of sarcopenia and hemodialysis patients, it is recommended to conduct large-scale longitudinal studies using standardized diagnostic criteria and evaluation methods, as well as analyze potential risk factors. Consequently, this study emphasizes the importance and potential of developing physical therapy programs that effectively address the health consequences associated with hemodialysis. The significance of this research lies in its ability to provide valuable insights and lay the foundation for future studies focused on developing preventive and therapeutic interventions targeting muscle wasting syndrome resulting from hemodialysis.

임신 및 출산 여성의 요실금 및 대변실금 예방을 위한 케겔운동의 효과: 체계적 문헌 고찰 (Effect of Kegel Exercise to Prevent Urinary and Fecal Incontinence in Antenatal and Postnatal Women: Systematic Review)

  • 박성희;강창범;장선영;김보연
    • 대한간호학회지
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    • 제43권3호
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    • pp.420-430
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    • 2013
  • Purpose: The aim of this study was to review the literature to determine whether intensive pelvic floor muscle training during pregnancy and after delivery could prevent urinary and fecal incontinence. Methods: Randomized controlled trials (RCT) of low-risk obstetric populations who had done Kegel exercise during pregnancy and after delivery met the inclusion criteria. Articles published between 1966 and 2012 from periodicals indexed in Ovid Medline, Embase, Scopus, KoreaMed, NDSL and other databases were selected, using the following keywords: 'Kegel, pelvic floor exercise'. The Cochrane's Risk of Bias was applied to assess the internal validity of the RCT. Fourteen selected studies were analyzed by meta-analysis using RevMan 5.1. Results: Fourteen RCTs with high methodological quality, involving 6,454 women were included. They indicated that Kegel exercise significantly reduced the development of urinary and fecal incontinence from pregnancy to postpartum. Also, there was low clinical heterogeneity. Conclusion: There is some evidence that for antenatal and postnatal women, Kegel exercise can prevent urinary and fecal incontinence. Therefore, a priority task is to develop standardized Kegel exercise programs for Korean pregnant and postpartum women and make efficient use of these programs.

불면증에 대한 한방 족욕요법의 무작위 대조군 임상연구 현황 : CNKI를 중심으로 (Randomized Controlled Clinical Trials of Warm Herbal Foot Bath Therapy for Insomnia: A Literature Review Based on the CNKI)

  • 권찬영;이보람;이경은
    • 대한한방내과학회지
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    • 제44권4호
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    • pp.726-740
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    • 2023
  • 목적: 이 연구의 목적은 불면증에 대한 한방 족욕요법의 연구 동향을 검토하는 것이다. 방법: 관련 연구의 수집을 위해 CNKI에서 검색을 수행하여, 2023년 8월 29일까지 발표된 연구를 검토하였다. 불면증 환자를 대상으로 한방 족욕요법과 수면제를 비교한 무작위 대조군 임상시험 만을 분석에 포함하였다. 포함된 연구들의 방법론적 질은 Cochrane risk-of-bias assessment tool을 사용하여 평가하였다. 메타분석의 결과는 위험비(risk ratios, RRs)와 평균차(mean differences, MDs) 및 그 95% 신뢰구간(confidence intervals, CIs)으로 제시되었다. 결과: 총 11편의 무작위 대조군 임상시험이 포함되었다. 분석 결과, 한방 족욕요법은 벤조디아제핀계 약물과 비교하여 유의하게 더 높은 총유효율(RR, 1.25; 95% CI, 1.15 to 1.36; I2=25%)과 개선된 피츠버그 수면의 질 지수(Pittsburgh Sleep Quality Index, PSQI) 총 점수(MD, -3.10; 95% CI, -4.24 to -1.95; I2=73%)를 보였다. 또한, 벤조디아제핀계 약물에 한방 족욕요법을 병용한 경우, 벤조디아제핀계 약물을 단독으로 사용한 것과 비교하여 유의하게 더 높은 총유효율(RR, 1.15; 95% CI, 1.04 to 1.27; I2=0%)과 개선된 PSQI 총 점수(MD, -2.23; 95% CI, -4.09 to -0.38; I2=80%)을 보였다. 네트워크 분석을 통해 한방 족욕요법에 포함된 약재를 분석하고 시각화한 결과, 4개의 클러스터가 발견되었으며, 핵심 약재는 야교등과 산조인이었다. 포함된 연구들의 방법론적 질은 전반적으로 낮았다. 결론: 이 연구는 불면증 개선에 있어서 단독요법 또는 병행치료로서의 한방 족욕요법이 효과적이라는 제한된 수준의 근거를 보여준다. 이 연구의 발견은 향후 한국에서 시행할 한방 족욕요법 연구의 기초자료로 활용될 수 있을 것이다.

극상근 건병증의 한의학적 치료에 대한 연구 동향: 체계적 문헌 고찰과 메타 분석 (The Effect of Oriental Medicine Treatments for Supraspinatus Tendinopathy: Systematic Review and Meta-Analysis)

  • 강동협;이도훈;유상준;양석규;손자연;정설;김혜주;권민진;권오빈;장선우;조현우
    • 한방재활의학과학회지
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    • 제33권4호
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    • pp.45-59
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    • 2023
  • Objectives The aim of this study was to analyze the trends of researches on oriental medicine treatments for supraspinatus tendinopathy. Methods We used five databases for searching researches; Korean studies Information Service System, Oriental Medicine Advanced Searching Integrated System, Research Information Sharing Service, PubMed, and China National Knowledge Infrastructure. Only randomized controlled trials suitable for the subject were selected. The methodological quality of included randomized controlled trials (RCTs) was assessed by the Cochrane risk of bias tool. Results Twenty randomized controlled trials were analyzed. There were 9 types of treatment interventions; acupuncture, acupotomy, pharmacopuncture, electroacupuncture, fire needling, warming needle, catgut-embedding therapy, herbal medicine, cupping. The most frequently used treatment intervention was acupuncture and acupotomy. There were 9 outcome measurements including visual analog scale (VAS), Constant-Murley Score (CMS), and range of motion. The most used measurement was VAS. As a result of meta-analysis, acupuncture was more effective than control group in VAS. Additionally, acupotomy was clinically significant compared to control groups in VAS and CMS. Conclusions In this review, we analyzed researches on effectiveness of oriental medicine for supraspinatus tendinopathy. A provisional conclusion can be produced that acupuncture and acupotomy showed beneficial effect to supraspinatus tendinopathy. Although there were some RCT studies, many of them had a high risk of bias, so it is hard to conclude that our study can include overall clinical status. Further well-designed trials are needed.

골다공증 유발 동물모델에서 녹용 추출물의 경구 투여 효과: 체계적 문헌고찰 및 메타분석 (The Effects of Oral Administration of Deer Antler Extracts on an Osteoporosis-induced Animal Model: A Systematic Review and Meta-analysis)

  • 이정민;김남훈;이은정
    • 한방재활의학과학회지
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    • 제32권2호
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    • pp.65-81
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    • 2022
  • Objectives This study aimed to assess the effects of oral administration of deer antler extracts on an osteoporosis-induced animal model. We analyzed the results of using deer antler single extracts on animal models with osteoporosis through a systematic review and meta-analysis. Methods We included osteoporosis studies in animal experiments that administrated deer antler extracts orally. We searched the following 13 databases without a language restriction: PubMed, EMBASE, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), China National Knowledge Infrastructure (CNKI), Wanfang, Korean Medical Database (KMbase), National Digital Science Library (NDSL), Korean Traditional Knowledge (Koreantk), Oriental Medicine Advanced Searching Integrated System (OASIS), Research Information Sharing Service (RISS), Korea Institute of Science and Technology Information (KISTI), and Koreanstudies Information Service System (KISS). We used Systematic Review Centre for Laboratory Animal Experimentation's risk of bias tool for assessing the methodological quality of the included studies. Results A total of 299 potentially relevant studies were searched and 11 were included for a systematic review. Nine studies used a single deer antler extract. A study compared the effects of single extracts of deer antler and antler glue, while another study compared the effects of three single extracts of deer antler, old antler, and antler glue. For evaluating the intervention effect, bone mineral density (BMD) was measured as the primary outcome, while the histomorphometric indicators of the bone and serum alkaline phosphatase and osteocalcin levels were used as the secondary outcome variables. On conducting a meta-analysis of studies on single deer antler extract, BMD was observed to be significantly increased compared to that in control group (standardized mean difference [SMD]=2.11; 95% confidence interval [CI]=1.58~2.65; Z=7.75; p<0.00001; I2=56%). As a result of meta-analysis, according to the concentration of deer antler, the group with high concentration showed statistically significantly higher BMD than the group with low concentration (SMD=1.28; 95% CI=0.74~1.82; Z=4.63; p<0.00001; I2=9%). Conclusions The research shows that the deer antler extracts have significant anti-osteoporotic effects on the osteoporosis-induced animal model. However the studies included in this research had a high methodological risk of bias. This indicates the requirement of considerable attention in the interpretation of the study results.

산조인탕치료가 여성갱년기 수면장애에 미치는 효과 : 체계적 문헌고찰 및 메타분석 (Sanjoin-tang (Suanzaoren decoction) for Insomnia in Menopausal Syndromes: A Systematic Review and Meta-analysis)

  • 전지희;최태영;이명수;송은혜;;박선주
    • 대한예방한의학회지
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    • 제24권1호
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    • pp.1-14
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    • 2020
  • Objectives : The purpose of this systematic review was to investigate the efficacy and safety of Sanjoin-tang (Suanzaoren decoction, SZRD) for insomnia in menopausal syndromes. Method : We searched the following databases: PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Chinese Science and Technique Journals Database (VIP), Wanfang, Research Information Service System (RISS), OASIS, Korean studies Information Service System (KISS), and National Digital Science Library (NDSL) databases. Randomized controlled trials (RCTs) or quasi-RCTs that used SZRD for women in menopause were included. The methodological quality of each RCT was assessed using the risk of bias tool. Results : In total, nine RCTs were finally included. The included RCTs had a high risk of bias across their domains. Three RCTs examined the effects of SZRD compared with western medicine (WM) in insomnia. Three RCTs showed favorable effects of SZRD with insomnia. Infrastructure also showed that SZRD resulted in better clinical WM (RR 1.19, 95% CI 1.07 to 1.32, P=0.001, I2=0%). Four RCTs showed favorable effects of Modified SZRD with insomnia. Infrastructure also showed that Modified SZRD resulted in better clinical WM (RR 1.13, 95% CI 1.04 to 1.23, P=0.004, I2=0%). Among the 4 RCTs, three RCTs showed an equivalent effect on the total Pittsburh Sleep Quality Index (PSQI). The meta-analysis also showed that Modified SZRD had a superior effect on the total of PSQI (total of PSQI : MD -2.55, 95% CI -3.72 to -1.37, P<0.0001, I2=85%). Only 2 trials reported adverse events and none reported severe adverse events. Conclusion : SZRD appears to be safe, but there is insufficient evidence to make a definitive conclusion because only a few studies reported adverse events. Due to the poor methodological quality of the included studies and the small number of trials included, the evidence cannot be reproduced and assessed. Well-designed RCTs with a larger sample size are needed in the future.

PLCE1 rs2274223 Polymorphism and Susceptibility to Esophageal Cancer: a Meta-analysis

  • Guo, Li-Yan;Yang, Ning;Hu, Die;Zhao, Xia;Feng, Bing;Zhang, Yan;Zhai, Min
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권21호
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    • pp.9107-9112
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    • 2014
  • Purpose: To investigate and study the relationship between the PLCE1 rs2274223 gene polymorphism and susceptibility to esophageal cancer by meta-analysis. Materials and Methods: The literature was searched in Wanfang, CNKI, PubMed, CBM, Web of Science, MEDLINE, EMBASE, Springer, Elsevier and Cochrane databases from the date of January $1^{st}$ 2004 to April $1^{st}$ 2014 to collect case-control studies on the PLCE1 polymorphism and susceptibility to esophageal cancer. For the population genotype distributions of both esophagus cancer and control groups, their odds ratios (ORs) and 95% confidence intervals (CIs) were taken as effect indexes. Disqualified studies were excluded. Odds ratios of PLCE1 rs2274223 genotype distributions in the group of patients with esophageal cancer and the group of healthy control were calculated. The metaanalysis software, RevMan5.0, was applied for heterogeneity test, pooled OR and 95% confidence intervals. Sensitivity analysis and publication bias were also explored. Results: A total of twelve case-control studies were included, covering a total of 9, 912 esophageal cancer cases and 13, 023 controls were included. The pooled odds ratio of PLCE1 rs2274223 genotype GA vs AA was 1.29 (95%CI=1.17~1.43), p<0.01, GG vs AA was 1.65 (95%CI=1.32~2.05), p<0.01, GG/GA vs AA was 1.30 (95%CI=1.16~1.46), p<0.01 and GG vs GA/AA was 1.48 (95%CI=1.22~1.80), p<0.01. The PLCE1 rs2274223 polymorphism was thus associated with risk of esophageal cancer in all genetic models. In the stratified analysis by ethnicity, and source of controls, no significantly increased risk was observed for white persons. There was no obvious publication bias detected. Conclusions: This meta-analysis showed there was a significantly association between PLCE1 rs2274223 polymorphism and esophageal cancer in yellow race populations. Due to some minor limitations, our findings should be confirmed in further studies.

주사(Rosacea)의 한약 치료에 대한 체계적 문헌고찰 및 메타분석 (Herbal Medicine for the Treatment of Rosacea: A Systematic Review and Meta-analysis of Randomized Controlled Trials)

  • 강은정;감은영;김서희;윤석영;전석희;최정화;김종한;박수연;정민영
    • 한방안이비인후피부과학회지
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    • 제34권3호
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    • pp.27-54
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    • 2021
  • Objectives : This review was conducted to validate the effectiveness and safety of herbal medicine combined with conventional therapy for rosacea. Methods : Randomized controlled trials(RCTs) reporting the effects of herbal medicine treatment on rosacea were searched through eight electronic databases from 2016 to March 17, 2020. This study collection and data extraction were performed by two independent reviews. The Cochrane risk-of-bias tool was used for the evaluation of the risk of bias in all included RCTs. Mean differences(MD) and Risk ratio(RR) of 95% Confidence intervals(Cls) were calculated and data synthesis was conducted using Review Manager(RevMan, ver.5.4) Results : Eighteen RCTs were included and all trials compared the combined therapy of herbal medicine with conventional western therapy to conventional therapy alone. The effective rate of the combination of herbal medicine with western medicine(RR 1.20, 95% CI : 1.13-1.28, p<0.00001, I2=0%), the effective rate of the combination of herbal medicine with laser-based therapy(RR 1.12, 95% CI : 1.04-1.21, p=0.004, I2=18%) and the effective rate of the combination treatment group using herbal medicine, western medicine and external drugs were all statistically higher that of the control group(RR 1.19, 95% CI : 1.11-1.28, p<0.00001, I2=0%). The score of non transient erythema(MD -0.36, 95% CI : -1.01 0.29, p=0.27, I2=93%), flushing(MD -0.69, 95% CI : -0.97, 0.41, p<0.00001, I2=32%), papules or pustules(MD 0.10, 95% CI : -0.15, 0.35 p=0.44, I2=0%) were also seen in the herbal medicine and western medicine combination group. The overall risk of bias of the included studies was some concerns. No serious adverse effects were observed. Conclusions : This review found the safety and effectiveness of the combined therapy of herbal medicine with conventional western therapy for rosacea.

본태성 고혈압에 대한 기국지황환(杞菊地黄丸)의 효과에 관한 체계적 고찰 및 메타 분석 (Qu-Ji-Du-Huang-Wan for Essential Hypertension : Systemic Review and Meta-analysis)

  • 한인식;신지혜;조윤영;박해모;양창섭;정민정;장인수;선승호
    • 동의생리병리학회지
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    • 제31권2호
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    • pp.118-125
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    • 2017
  • The purpose of this study is to investigate the blood pressure reducing effect of Qi-Ju-Di-Huang-Wan (QJDHW) in adults with essential hypertension by using methods of systemic review and meta-analysis. Major search engines, such as PubMed, EMBASE, Cochrane library, Web of Science, CNKI, CiNii, J-STAGE, KISS, NDSL, RISS, OASIS, DBpia and so on, were used. The search period we used is from the start date of the search engine to October 30, 2016 and no language limits were placed. Randomized controlled trials using QJDHW in adults with essential hypertension were searched and extracted by two independent researchers. Meta-analysis was performed on outcome variables of the total effective rate (TER), systolic blood pressure (SBP) and diastolic blood pressure (DBP). Risk of bias (RoB) of Cochrane was used to assess methodological quality. Thirteen studies were finally selected. We observed that the combined treatment of QJDHW and antihypertensive drug had 3.6 times the odds ratio of TER for blood pressure lowering than a single use of an antihypertensive drug. Additionally, mean differences of SBP and DBP were -8.88 mmHg (95% Confidential Interval (CI) -12.77 mmHg, -5.00 mmHg, P<0.00001), -7.09 mmHg (95% CI -9.93, -4.25, P <0.00001), respectively. Single use of QJDHW did not reduce blood pressure more than an antihypertensive drug. All items of RoB were unclear and the methodological quality was low. Our analysis suggests that the combination of QJDHW and antihypertensive drugs may be more effective in reducing blood pressure than a single antihypertensive drug. But due to low methodological quality, careful interpretation will be needed and systematic long-term clinical trials will be required.