• 제목/요약/키워드: Cochrane Risk of Bias

검색결과 408건 처리시간 0.021초

조발성 탈모증과 대사증후군과의 관계: 체계적 문헌고찰 및 메타분석 (The Relationship between Early-onset Androgenetic Alopecia and Metabolic Syndrome: Systematic Review and Meta-Analysis)

  • 장진영;윤영준
    • 한방안이비인후피부과학회지
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    • 제30권3호
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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.

만성 일차성 불면증 환자에게 적용한 인지행동중재의 효과: 메타분석 (Cognitive Behavioral Therapy for Primary Insomnia: A Meta-analysis)

  • 김지현;오복자
    • 한국산학기술학회논문지
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    • 제17권9호
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    • pp.407-421
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    • 2016
  • 본 연구는 만성 일차성 불면증 환자에게 적용한 인지행동중재의 효과를 평가하는 16개의 논문을 메타분석한 것이다. PubMed, Cochrane Library, EMBASE, CINAHL와 여러 개의 국내 데이타 베이스를 통해 2015년 1월부터 2015년 6월까지 자료검색이 이루어졌다. 주요 검색전략은 인지행동중재와 불면증을 병합하여 이루어졌다. 논문의 방법론적 질 평가는 코크란의 RoB(The Cochrane's Risk of Bias)를 사용하였다. 자료는 Cochrane Library의 RevMan 5.3 프로그램으로 분석하였다. 최종 16편의 논문, 1503명의 대상자가 선정기준에 부합되었다. 자극조절요법, 수면제한법, 수면위생교육과 인지적 재구성이 인지행동중재의 주요 치료적 구성요소였다. 인지행동 중재의 적용 주수는 평균 5.4주, 적용횟수 평균 5.5회, 1회 평균 중재시간 90분으로 조사되었다. 인지행동중재의 효과는 총 수면시간(d=-0.31), 수면 잠복기(d=-0.29), 입면 후 각성시간(d=-0.55), 수면효율성(d=-0.70), 불면증 심각성(d=-0.77)과 수면에 대한 신념 및 태도(d=-0.64)에 유의하였다. 전반적으로 작은 효과크기에서 중간 정도의 효과크기를 나타냈다. 인지행동중재는 불안(d=-0.30)과 우울(d=-0.35)에도 효과적이었다. 이러한 결과는 인지행동중재가 불면증이 있는 환자들의 수면의 질과 수면시간을 증진시키는 것으로 나타났다.

Systematic Review of Chuna Manipulative Treatment for Ankle Sprain

  • Kwak, Min Kyung;Kim, Min Wook;Jeong, Sang Jun;Kim, Shin Ae;Jeong, Mi Young;Kim, Jae Hong
    • Journal of Acupuncture Research
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    • 제35권2호
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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.

한방안이비인후피부과학회지에 게재된 임상실험연구에 대한 고찰 (The Review of Clinical Studies Published in The Journal of Korean Medical Ophthalmology & Otolaryngology & Dermatology)

  • 김철윤;서형식;김남권;이동진;권강
    • 한방안이비인후피부과학회지
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    • 제27권4호
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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.

비염에 대한 추나요법의 효과: 체계적 문헌 고찰과 메타분석 (Chuna Manual Therapy for Rhinitis: Systematic Review and Meta Analysis)

  • 조주찬;박인화;허인
    • 척추신경추나의학회지
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    • 제16권1호
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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.

Effect of endodontic sealer on postoperative pain: a network meta-analysis

  • Cynthia Maria Chaves Monteiro;Ana Cristina Rodrigues Martins;Alessandra Reis;Juliana Larocca de Geus
    • Restorative Dentistry and Endodontics
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    • 제48권1호
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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.

만성피로증후군에 대한 보중익기탕과 그 변방의 효과 : 체계적인 문헌고찰 (The Effectiveness of Bojungikgi-tang and its modifications on Chronic Fatigue Syndrome: A Systematic Review And Meta-analysis)

  • 남동현
    • 대한한의학회지
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    • 제41권1호
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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.

Short-course Versus Long-course Preoperative Radiotherapy plus Delayed Surgery in the Treatment of Rectal Cancer: a Meta-analysis

  • Liu, Shi-Xin;Zhou, Zhi-Rui;Chen, Ling-Xiao;Yang, Yong-Jing;Hu, Zhi-De;Zhang, Tian-Song
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권14호
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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.

암환자교육이 암환자의 심리적 디스트레스와 자가간호지식 및 자가간호행위에 미치는 효과: 메타분석 (The Effect of Patient Education Interventions on Distress, Self-Care Knowledge and Self-Care Behavior of Oncology Patients: A Meta-Analysis)

  • 오복자;최형지
    • 종양간호연구
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    • 제12권4호
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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.

비타민 D와 소아 호흡기 감염의 위험성: 무작위 대조 연구에 대한 체계적 문헌고찰 및 메타분석 (Vitamin D and Risk of Respiratory Tract Infections in Children: A Systematic Review and Meta-analysis of Randomized Controlled Trials)

  • 안종균;이도경;김경효
    • Pediatric Infection and Vaccine
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    • 제23권2호
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    • pp.109-116
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    • 2016
  • 목적: 최근 관찰연구들에서 낮은 혈중 25(OH)D 농도가 호흡기 감염과 관련이 있다는 결과들이 보고되고 있다. 하지만, 소아의 무작위 대조 연구에서 비타민 D의 투여가 호흡기 감염을 예방하는 효과에 대해서는 아직 논란의 여지가 있다. 이번 연구는 비타민 D 보충 요법이 호흡기 감염 예방에 미치는 영향을 체계적 문헌고찰과 메타분석을 통하여 알아보고자 한다. 방법: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trial을 이용하여 소아의 호흡기 감염 예방을 위해 비타민 D 보충을 실험한 무작위 대조 연구들이 분석 대상에 포함되었다. 문헌의 비뚤림 위험도를 평가하기 위해 코크란 연합의 질 평가 방법(Cochrane Collaboration's tool for assessing the risk of bias)을 사용하였다. 연구별로 상대위험도와 95% 신뢰구간을 추출한 후, Review Manager 5.3을 이용하여 메타분석을 시행하였다. 결과: 총 7편의 무작위 대조 연구들이 메타분석 대상에 포함되었다. 임의효과모형을 사용하여 산출된 전체 비타민 D 보충군에서 상대적 위험도는 0.82 (95% CI: 0.69-0.98)이었고, 이질성에 대한 $I^2=62%$ 이었다. 연구 간의 이질성 원인을 파악하기 위해 시행한 하위 집단 분석에서 추적 관찰 기간이 1년 미만인 경우, 대상군의 나이가 5세 이상인 경우, 대상군이 환자인 경우, 비타민 D 투여 요법이 매일 요법인 경우 이질성이 감소하였다. 깔때기 그림에서 출판 비뚤림의 가능성을 시사하는 비대칭 소견을 보였다. 결론: 메타분석 결과는 소아에서 비타민 D 보충요법이 호흡기 감염을 예방하는 데 효과가 있을 수 있음을 보여준다. 하지만, 이번 연구에서는 분석대상에 포함된 연구들이 적고, 연구들 간에 이질성이 존재하며, 출판 비뚤림이 존재할 가능성이 있어 결과를 주의해서 해석할 필요가 있다.