• 제목/요약/키워드: Cochrane Risk of Bias

검색결과 408건 처리시간 0.027초

Low-Level Laser Therapy including Laser Acupuncture for Non-Specific Chronic Low Back Pain : Protocol for a Systematic Review

  • Yeum, Hyewon;Nam, Dongwoo
    • Journal of Acupuncture Research
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    • 제36권4호
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    • pp.251-255
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    • 2019
  • Background: Low-level laser therapy (LLLT) including laser acupuncture (LA) has been widely used to treat chronic low back pain (CLBP), but there is no critically appraised evidence of the potential benefits. The purpose of this protocol for a systematic review was to enable the evaluation of the effectiveness of LLLT including LA for non-specific CLBP to identify the potential benefits. Methods: The electronic databases MEDLINE (PubMed), Embase (Ovid), the Cochrane Central Register of Controlled Trials (CENTRAL), Korean medical databases (KoreaMed, KMBASE, KISS, NDSL, KISTI, OASIS), the Chinese database (CNKI), and Japanese databases (CiNII, J-STAGE) are recommended. Results: Randomized controlled trials in LLLT including LA should be included in the searches. All data synthesis and subgroup analyses should be conducted using a Review Manager software. The Cochrane risk of bias tool can be used to evaluate methodological quality of the studies. A risk ratio or mean difference with a 95% confidence interval will show the effects of LLLT including LA. Conclusion: The primary outcome would be pain intensity and functional status/disability due to low back pain. The secondary outcome would be a global measurement of recovery or improvement, quality of life and adverse event.

여성 난임 환자에게 적용되는 온라인 기반 중재의 특성 및 효과 분석: 체계적 문헌고찰 (Characteristics and Effectiveness of Online-based Intervention for Infertile Women: A Systematic Review)

  • 김찬희;이선희
    • 근관절건강학회지
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    • 제25권3호
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    • pp.205-217
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    • 2018
  • Purpose: The purpose of this review was to analyze the characteristics and effectiveness of online-based intervention for infertile women. Methods: We established the PICO (Participant-Intervention-Comparison-Outcome) strategy and conducted a systematic review of 7 literatures retrieved from 3 electronic databases of Ovid-Medline, Ovid-Embase, and the Cochrane Library. Two investigators independently extracted the data and assessed the quality of included studies using Cochrane risk of bias. Results: The pregnancy outcome showed that higher total risk scores (TRS) about lifestyle behavior was significantly associated with lower chance of pregnancy (aHR 0.79, 95% CI 0.72~0.85). Stress was significantly decreased in experimental groups receiving online-based interventions (p<.05). Depression score was significantly lower in groups receiving additional interventions besides on-line interventions than those who used online-based intervention only. The other outcomes, including anxiety, self-efficacy, helpfulness of intervention, perceived social support, and knowledge scores were not significantly different within and between groups in overall. Characteristics of the interventions were heterogeneous. Conclusion: There is evidence that online-based intervention in infertile women enhances the pregnancy and reduces stress levels.

The prevalence of apical periodontitis in patients prior to hematopoietic cell transplantation: a systematic review

  • Letícia Taina de Oliveira Lemes;Carolina Horn Troian-Michel;Theodoro Weissheimer;Marcus Vinicius Reis So
    • Restorative Dentistry and Endodontics
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    • 제49권2호
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    • pp.22.1-22.12
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    • 2024
  • Objectives: This systematic review addressed the question: "What is the prevalence of apical periodontitis in patients prior to hematopoietic cell transplantation?" Materials and Methods: A systematic search was conducted in MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Grey Literature Report. Eligibility criteria were based on the condition, content, and population strategy: the condition was the radiographic prevalence of apical periodontitis, the content comprised patients scheduled for hematopoietic stem cell transplantation, and the population consisted of adult and pediatric patients. The revised Risk of Bias in Nonrandomized Studies of Exposure tool was used to assess the quality of studies. The Grading Recommendations Assessments, Development, and Evaluation (GRADE) tool was used to assess the quality of evidence. Results: Eight studies were included in this review. The average number of patients with apical periodontitis was 15.65% (range, 2.1%-43.34%). One study was classified as having a very high risk of bias, 1 with a high risk of bias, and 6 with some concern for bias. GRADE analysis showed a very low certainty of evidence. Significant limitations concerning the absence of control over confounding variables were identified. Conclusions: With the caveat of the very low quality of evidence in the studies reviewed, there was a low to moderate prevalence of apical periodontitis in patients prior to undergoing hematopoietic cell transplantation.

뇌졸중 후 우울증 : 한방 치료에 대한 국내외 최신 문헌 고찰 (Poststroke Depression : A Review of the Latest Oriental Medicine Articles)

  • 이제원;이보매나;장우석;황하연;백경민
    • 대한한방내과학회지
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    • 제33권4호
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    • pp.448-464
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    • 2012
  • Objectives : This study reviews the latest articles in Korea and other countries that studied oriental medicine treatment on poststroke depression. Methods : Korean articles were retrieved from the 9 major Korean web article search engines. Foreign articles were retrieved from PubMed. Article published date was from 2000 up to September 2012. There were no restrictions on the types of publication, but articles not available in full text were excluded. The methodological quality was assessed according to Cochrane's assessment of risk of bias and Newcastle-Ottawa quality assessment scale. Results : Twenty-two articles were included in this study. Eleven articles were published in Korea, the rest were published in China. Nine articles were randomized controlled trials (RCT), one article was a non-randomized study (NRS), four articles were case reports, three articles were cross-sectional studies, two articles were comparative studies. In RCT articles, risk of selection bias and performance bias were generally high, risk of detection bias was unclear. The NRS article took four stars in Newcastle-Ottawa quality assessment. Comparison Hamilton rating scale for depression score between oriental medicine treated group and western medicine treated group revealed that there was no remarkable difference in mean score changes after treatment on PSD. Conclusions : The results of this study suggest that oriental medicine treatment is as effective as western medicine treatment for PSD. In the future, more rigorous oriental medicine treatment studies should be conducted.

소아 야제에 대한 추나요법 효과; 체계적 문헌고찰 (Chuna Manual Therapy for Nocturnal Crying; A Systematic Review)

  • 황만석;신병철;허광호;허인;김병준;김기봉;천진홍;박재홍;황의형
    • 한방재활의학과학회지
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    • 제25권3호
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    • pp.51-57
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    • 2015
  • Objectives To evaluate the evidence supporting the effectiveness of Chuna manual therapy for nocturnal crying. Methods We conducted search across the 3 electronic databases (Pubmed, CAJ and Oasis) to find all of randomized controlled clinical trials(RCTs) that used Chuna manual therapy as a treatment for nocturnal crying. The methodological quality of each RCTs was assessed using the Cochrane Risk of Bias tool and nRCTs was assessed using the Cochrane Risk of Bias Assessment tool for Non-randomized Study tool. Results Two RCTs and three nRCTs met our inclusion criteria. The meta-analysis showed positive results for the use of Chuna manual therapy in terms of the efficacy rate when compared to medication treatments alone. Positive results were also obtained, in terms of the efficacy rate, when comparing Chuna manual therapy combined with acupoint application therapy to Chuna manual therapy alone, but was not statistically significant. Conclusions Our systematic review found encouraging but limited evidence of Chuna manual therapy for nocturnal crying. We recommend clinical trials which compare the effectiveness of Chuna manual therapy with usual care to obtain stronger evidence without the demerits of trial design.

Efficacy of topical interventions for temporomandibular disorders compared to placebo or control therapy: a systematic review with meta-analysis

  • Mena, Mariam;Dalbah, Lana;Levi, Lauren;Padilla, Mariela;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제20권6호
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    • pp.337-356
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    • 2020
  • This systematic review focused on the efficacy of topical products in reducing temporomandibular joint disorder (TMD)-associated pain, in comparison to placebo or control interventions. The EMBASE, Web of Science, Cochrane Library, and MEDLINE via PubMed databases were searched for randomized controlled trials (RCTs) using topical interventions in adults diagnosed with TMD. The pain intensity was the primary outcome, and other clinical findings were the secondary outcomes. The risk of bias was evaluated according to the Cochrane's handbook. The search up to February 7, 2020 identified a total of 496 unduplicated references. Nine RCTs with 355 adult patients diagnosed with TMD were included. The meta-analysis did not show a significant reduction in baseline pain intensity in the nonsteroidal anti-inflammatory drug (NSAIDs) group, when compared to the placebo group (P = 0.288). One study demonstrated a statistically significant pain score decrease for Theraflex-TMJ compared to placebo after 10 d of treatment (P = 0.003) and follow-up, 5 d after the last application (P = 0.027). Ping On reduced pain at 4 weeks of application (P < 0.001) but not after 7 d of application (P = 0.136). In one study, cannabidiol (CBD) significantly improved the pain intensity compared to placebo (P < 0.001). However, no differences were found with capsaicin in the two studies (P = 0.465). Evidence was of low quality because the studies were considered as having an unclear or a high risk of bias and a small number of studies were analyzed. The evidence is not sufficient to support the use of topical NSAIDs and capsaicin, and limited evidence was found for Threraflex-TMJ, bee venom, Ping On, and CBD, with only one study reporting for each. Additional studies are recommended to validate these results.

Disinfectant effectiveness of chlorhexidine gel compared to sodium hypochlorite: a systematic review with meta-analysis

  • Theodoro Weissheimer;Karem Paula Pinto;Emmanuel Joao Nogueira Leal da Silva;Lina Naomi Hashizume;Ricardo Abreu da Rosa;Marcus Vinicius Reis So
    • Restorative Dentistry and Endodontics
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    • 제48권4호
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    • pp.37.1-37.17
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    • 2023
  • This study aimed to compare the disinfectant ability of chlorhexidine (CHX) gel and sodium hypochlorite (NaOCl). Systematic searches were conducted from inception until December 8th, 2022 (MEDLINE/PubMed, Cochrane Library, Web of Science, Scopus, Embase, and Grey Literature databases). Only randomized clinical trials were included. The revised Cochrane risk of bias tools for randomized trials were used to assess the quality of studies. Meta-analyses were performed. The overall quality of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation tool. Six studies were included. Five had a low risk of bias and 1 had some concerns. Three studies assessed bacterial reduction. Two were included in the meta-analysis for bacterial reduction (mean difference, 75.03 [confidence interval, CI, -271.15, 421.22], p = 0.67; I2 = 74%); and 3 in the meta-analysis for cultivable bacteria after chemomechanical preparation (odds ratio, 1.03 [CI, 0.20, 5.31], P = 0.98; I2 = 49%). Five studies assessed endotoxin reduction. Three were included in a meta-analysis (mean difference, 20.59 [CI, -36.41, 77.59], p = 0.48; I2 = 74%). There seems to be no difference in the disinfectant ability of CHX gel and NaOCl, but further research is necessary.

A Systematic Review and Meta-Analysis of Moxibustion Treatment for Knee Osteoarthritis

  • Park, Jang Mi;Lee, Cham Kyul;Kim, Kyung Ho;Kim, Eun Jung;Jung, Chan Yung;Seo, Byung-Kwan;Goo, Bon Hyuk;Baek, Yong Hyeon;Lee, Eun Yong
    • Journal of Acupuncture Research
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    • 제37권3호
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    • pp.137-150
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    • 2020
  • The purpose of this study was to evaluate the evidence supporting the effectiveness of moxibustion treatment for osteoarthritis. There were 9 databases used to retrieve randomized controlled trials (RCTs) that used moxibustion as treatment for osteoarthritis. The quality of methodology for the RCTs was assessed using the Cochrane Risk of Bias tool [Review Manager (RevMan) Version 5.3 Windows, The Nordic Cochrane Centre, Copenhagen, Denmark]. The inclusion criteria for this review was met by 27 RCTs. All studies were conducted in China. A 4-week moxibustion treatment period was the most common. EX-LE4 and SP10 and GB34 acupoints were most frequently selected in the treatment of osteoarthritis. The most commonly used evaluation index was the visual analog scale (VAS). All studies, including a meta-analysis showed that moxibustion treatments were statistically significantly effective at treating knee osteoarthritis. However, well-designed randomized RCTs without a high risk of bias should be designed in the future.

견관절 통증에 대한 팔단금 운동의 효과: 체계적 문헌 고찰 (Baduanjin Exercise for Shoulder Pain: A Systematic Review)

  • 김현태;이상현;박선영;허인;황만석;신병철;황의형
    • 척추신경추나의학회지
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    • 제15권1호
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    • pp.89-100
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    • 2020
  • Objectives : This study aimed to verify the clinical effectiveness of Baduanjin for shoulder pain. Methods : We searched 10 electronic databases (PubMed, EMBASE, Cochrane Library, CAJ, KISS, KISTI, KMBASE, RISS, NDSL, and OASIS) up to May 2020. We included randomized controlled trials (RCTs) using Baduanjin for shoulder pain. The methodological quality of each RCT was assessed using the Cochrane risk of bias tool. Results : As a result of the search, a total of 6 RCTs were eligible for analysis. Of these 6 studies, one applied Baduanjin alone and 5 cases used Baduanjin in combination with other treatments, such as acupuncture or electroacupuncture. Except for 2 studies, descriptive analysis was performed without meta-analysis due to the high level of heterogeneity between studies. A high risk of bias was observed in all studies. Conclusions : When considering the results of the included papers, there was limited information derived on the therapeutic effect of using Baduanjin as a single intervention, but the results showed significant effectiveness when Baduanjin was combined with other oriental interventions, such as acupuncture and electroacupuncture, in the clinical field. Although all RCTs included in the analysis were biased to CAJ and the number was limited, this study was conducted in accordance with the methodological process of systematic literature reviews and revealed the clinical effects of Baduanjin on shoulder pain.

임상에서 흔히 접하는 외상성 손상에 대한 봉독약침요법의 체계적 문헌고찰 (Systematic Review of Bee Venom Therapy for Traumatic Injury)

  • 이재은;이치호;이은정;이정민;오민석
    • 한방재활의학과학회지
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    • 제26권3호
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    • pp.67-77
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    • 2016
  • Objectives To evaluate the evidence supporting the effectiveness of Bee Venom therapy for traumatic injury. Methods We conducted search across 3 electronic databases (Pubmed, CAJ and Oasis) to find clinical trials that used Bee Venom therapy as treatment for traumatic injury. The methodological quality of RCTs (Randomized controlled clinical trials) were assessed using the Cochrane Risk of Bias (RoB) tool, while NRCTs (Non-Randomized controlled clinical trials) were assessed using the Cochrane Risk of Bias Assessment tool for Non-randomized Study (RoBANS) tool. Results Among 87 articles that were searched, 10 RCTs and 19 NRCTs were finally selected. Among 19 selected studies, all studies showed that Bee Venom therapy has significant effect on traumatic injury. Conclusions Our systematic review found encouraging but limited evidence of Bee Venom therapy for traumatic injury. We recommend clinical trials which compare the effectiveness of Bee Venom therapy with other pharmacopuncture therapies to clarify the effectiveness of Bee Venom therapy from other pharmacopuncture therapies.