• 제목/요약/키워드: Cochrane Risk of Bias

검색결과 408건 처리시간 0.023초

상기도 감염 환자의 amoxicillin 대비 한약의 효과에 대한 체계적 문헌고찰 : PubMED를 중심으로 (Systematic Review on the Effects of Herbal Medicine Compared to Amoxicillin in Patients with Upper Respiratory Tract Infection : Focusing on PubMED)

  • 곽승연;정설;조은지;정의민
    • 대한본초학회지
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    • 제36권5호
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    • pp.37-46
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    • 2021
  • Objective : This study aims to examine the effectiveness and safety of herbal medicines in upper respiratory tract infection by conducting systematic review against amoxicillin. Methods : Relevant randomized controlled trials (RCTs) published by December 2020 were searched in PubMED database. Study selection was conducted according to the PRISMA guideline. The Risk of Bias of the RCTs were evaluated based on the Cochrane criteria. Study selection and bias assessment were conducted independently by two researchers, and the third party was involved if there is a disagreement. Results : Three RCTs were included. Meta-analysis was not performed due to different specific disease and outcome measurements among the included studies. Herbal medicine showed statistically significant improvement in symptoms and endoscopic findings compared to amoxicillin in acute rhinosinusitis. In addition, herbal medicine showed statistically significant improvement in symptoms and a smaller dose of additional antibiotics in acute tonsillitis. However, herbal medicine showed no significant effects compared to amoxicillin in chronic sinusitis patients after functional endoscopic sinus surgery. In terms of adverse events, no significant difference was observed between the herbal medicine group and the amoxicillin group in all studies. Conclusion : Herbal medicine might be more effective than amoxicillin in the treatment of upper respiratory tract infection. Nevertheless, it is hard to clear that conclusion due to the fact that the collected studies were conducted on different specific diseases and herbal medicine, and that the included studies had flaws in the research methodology.

뇌졸중 환자의 지역사회이동을 위한 작업치료 중재: 체계적 고찰 (Occupational Therapy for Community Mobility in Stroke Patients : Systematic review)

  • 조은주;감경윤;장문영
    • 대한지역사회작업치료학회지
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    • 제8권3호
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    • pp.77-89
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    • 2018
  • 목적 : 본 연구는 뇌졸중 환자에게 적용한 지역사회이동을 위한 작업치료적 중재를 분석한 논문으로, 임상에서 지역사회이동에 대한 중재를 사용하는데 있어 근거를 제시하고자 한다. 연구방법 : PRISMA checklist와 diagram을 통해 체계적 고찰을 시행하였고, 데이터베이스는 PubMed, EMBASE, Cochrane library (CENTRAL), ProQuest Dissertations & thesis (PQDT), 한국교육학술정보원(RISS)과 코리아메드(KoreaMed)를 이용하였다. 검색기간은 2005년부터 2018년 9월까지로 하였다. 연구에 선택된 문헌의 질 평가는 RoBANS (Riks of Bias Assessment tool for Non-randomized Study)를 사용하였다. 연구에 포함된 문헌은 총 8개이었다. 문헌에서 사용된 중재들은 종류에 따라 분류하였다. 결과 : 문헌의 연구디자인은 무작위배정 실험연구, 유사실험연구, 전후비교연구, 환자-대조군연구, 횡단적 연구로 다양하게 나타났다. 포함된 문헌의 질적수준은 level I이 1편(12.5%), level II가 6편(75%), level III가 1편(12.5%)으로 나타났다. 문헌의 '편향 위험 낮음' 비율은 62.5%~87.5%로 각 문헌마다 다르게 나타났다. 문헌에 사용된 중재는 가상 현실 및 가상환경을 기반으로 한 중재가 4편(50%)으로 가장 많았고, 프로토콜을 이용한 중재가 3편(37.5%), 휠체어 사용훈련이 1편(12.5%)으로 나타났다. 각 중재의 효과는 전반적으로 유의미하게 나타났다. 결론 : 본 연구는 지역사회이동에 대한 작업치료의 중재효과를 체계적으로 보고하여 임상적 적용근거를 제공하였다. 추후 지역사회이동성에 대해 다양한 형태로 중재를 적용한 연구가 이루어져야 할 것이다.

비만치료에 있어서 환자특성에 따른 인지행동요법과 행동수정요법의 효과 비교: 체계적 문헌고찰 및 메타분석 (Comparison of the Effects of Cognitive Behavioral Therapy and Behavioral Treatment on Obesity Treatment by Patient Subtypes: A Systematic Review and Meta-analysis)

  • 차진영;김서영;신인수;박영배;임영우
    • 한방비만학회지
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    • 제20권2호
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    • pp.178-192
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    • 2020
  • Objectives: The present study aimed to compare the impacts of cognitive behavioral therapy (CBT) and behavioral treatment (BT) on weight loss and psychological outcomes among patients with three different subtypes of obesity: simple obesity, obesity with binge eating disorder, and obesity with depression. Methods: Embase, PubMed, the Cochrane Central Register of Controlled Trials, Research Information Sharing Service, and Korean Studies Information Service System were systematically searched for randomized controlled trials conducted on or before May 2020, that used CBT to treat obesity. Methodological quality was assessed using Cochrane's risk of bias tool 2 and publication bias was evaluated through the funnel plot using the trim and fill method, Egger's test, and Begg and Mazumdar rank correlation test. A meta-analysis was conducted using a random-effects model and the standardized mean difference with 95% confidence interval (CI) was used to determine effect size. Results: Twenty-one randomized controlled trials with a total of 22 intervention arms and 2,590 patients were included. Our study results revealed that the effects of CBT, compared with BT, on weight loss distinctly differed across all patient subgroups. In the simple obesity group, CBT was more effective than BT (Hedges' g=0.138, CI=0.012~0.264); however, in the obesity with binge eating disorder group, BT was more effective than CBT (Hedges' g=-0.228, CI=-0.418~-0.038); in the obesity with depression group, the effect of CBT was not statistically different from that of BT (Hedges' g=0.276, CI=-0.307~0.859). Further studies with larger sample sizes are required to confirm the outcomes observed in this study. Conclusions: Our results indicated that the effects of CBT on obesity treatment vary based on patient subtype. Therefore, our findings suggest that CBT or BT should be selectively recommended as a treatment strategy for different obesity subtypes.

재난 후 근골격계 통증에 침치료의 유효성: 체계적 문헌고찰 (Effectiveness of Acupuncture in the Treatment of Post-Disaster Musculoskeletal Pain: A Systematic Review)

  • 김가현;최성원;홍혜원;윤주영;김용준;김정현
    • 한방재활의학과학회지
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    • 제33권3호
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    • pp.135-148
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    • 2023
  • Objectives To investigate the effectiveness of acupuncture in the treatment of post-disaster musculoskeletal pain by reviewing relevant clinical studies. Methods A systematic search was conducted across 10 electronic databases to identify relevant clinical studies on acupuncture treatment for post-disaster musculoskeletal pain until May 2023. The methodological quality was evaluated using the Cochrane Risk of Bias 2 and Risk of Bias Assessment tool for non-randomized studies tools. Results Six articles were analyzed, including two randomized controlled trials (RCTs), two before-after studies, one qualitative research, and one case series. Overall, acupuncture therapy showed some improvement in pain scale among musculoskeletal pain survivors. However, no significant improvement was observed in the Short-Form McGill Pain Questionnaire (SF-MPQ-2). Subgroup analysis of participants who completed at least four acupuncture sessions revealed a significant effect on the SFMPQ-2. Additionally, a significant improvement in 36-Item Short Form Survey (SF36P) was observed after 6 months of treatment, but the 2-month treatment period did not show statistically significant effects on SF-36P improvement. The evaluation of the methodological quality of the RCTs identified some concerns of bias. Conclusions The results suggest that acupuncture is effective in alleviating post-disaster musculoskeletal pain. However, considering the limited number of selected studies and the inclusion of subjective evaluation measures, caution should be exercised in interpreting the results. Further large-scale follow-up studies are needed to determine the optimal frequency and duration of acupuncture treatment. Well-designed controlled trials should be conducted to provide more robust evidence regarding the effectiveness of acupuncture for post-disaster musculoskeletal pain.

산림치유 활동이 노인에게 미치는 효과에 대한 체계적 문헌고찰 (Systematic Review on the Effect of Forest Healing Activities on the Elderly)

  • 이미진;최정기;김소연
    • 한국산림과학회지
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    • 제112권1호
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    • pp.93-104
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    • 2023
  • 고령화로 인해 기대수명이 높아지고 있으며, 다양한 노인성 질병 등의 문제가 증가하고 있다. 본 연구의 목적은 산림치유 활동이 노인에게 어떠한 영향을 미치는지 체계적으로 문헌을 분석하여 노인 대상 산림치유 활동 확대를 위한 기초자료를 제공하는 것이다. 문헌 수집을 위해 국내는 RISS, KISS, Korea Med, Science On, 국외는 PubMed, Cochrane central, MDPI, Google Scholar를 이용하였다. 수집된 문헌의 방법론적인 질적 평가를 위해 코크란 그룹의 RoB2와 RoBANS를 이용하여 비뚤림 평가를 진행하였다. 2000년부터 2022년 1월 사이에 게재된 노인 대상 산림치유 활동의 연구 논문으로 한정하여 총 1,856편에서 최종 21편의 문헌을 선정하였다. 대상자는 60세 이상이며, 선정된 문헌의 참가자는 최소 7명에서 최대88명으로 총 750명이 참가하였다. 분석결과, 각 지표에서 가장 많이 수행된 검사는 심리지표에서 우울 7편, 인지지표에서 MMSE(Mini Mental State Examination) 2편, 생리지표에서 혈압 4편, 생화학지표에서 멜라토닌 2편, 신체지표에서 체지방과 근력 3편으로 나타났다. 총21편의 연구 중 19편의 연구가 2가지 이상의 검사항목을 사용하였으며, 심리적 지표를 가장 많이 측정하였다. 향후 노인대상 산림치유 활동의 적용을 위해서는 인지기능 예방의 산림치유 프로그램이 다양하게 개발 및 보급되어야 하며, 산림치유 활동에 대한 근거를 제공하기 위해 후속연구는 지속적으로 제시되어야 한다.

음악요법이 치매노인의 인지기능, 초조행동, 불안 및 우울에 미치는 효과: 체계적 고찰 및 메타분석 (Effects of Music Therapy on Cognitive function and Agitation, Anxiety and Depression in Dementia Elderly: a Systematic Review and Meta-analysis of Randomized Controlled Trials)

  • 채공주;이미경;남은숙;이호연
    • 한국산학기술학회논문지
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    • 제22권1호
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    • pp.520-530
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    • 2021
  • 목표: 본 연구는 음악요법이 치매 노인의 인지기능, 초조행동, 불안, 우울에 미치는 영향을 규명하는 것을 목적으로 한다. 방법: 2010년부터 2019년까지 PubMed, EMBASE, Cochrane Library, CINAHL, Web of Science, Google scholar, PsycINFO에서 종합적인 문헌검색을 하였고 메타분석에서는 RevMan 5.4 프로그램을 사용하여 표준화된 평균 차이(Hedge's g)와 95% 신뢰 구간은 요약 측정으로 산출하고 랜덤 효과 모델과 역분산 방법을 적용하였다. 총 13개의 연구가 포함되었으며, 모두 오류 위험 평가를 위한 코크란 평가도구를 근거로 질 평가를 하였다. 결과: 효과 크기(Hedge's g)는 1차 결과 변수인 인지기능 0.31[95% CI:-0.02, 0.65], 초조행동 -0.03[95% CI: -0.17, 0.11], 2차 결과 변수인 불안 -0.61[95% CI: -1.17, -0.05], 우울 -0.44[95% CI: -0.88, 0.00]이었다. 음악중재 유형별 하위그룹 분석 결과 복합음악요법이 치매 환자의 인지기능(g=0.45[95% CI: 0.03, 0.87])에 유의한 증가 효과가 있는 것으로 나타났다. 결론: 음악요법은 불안과 우울을 감소시키는 데 유의한 효과를 보였으며, 복합음악치료는 치매 환자의 인지기능 개선 효과를 보였다.

고혈압에 대한 천마구등음의 효과 : 체계적 문헌고찰과 메타분석 (The Effect of Cheonmagudeung-eum for Hypertension: A Systematic Review and Meta-analysis)

  • 강기완;강자연;정민정;김홍준;선승호;장인수
    • 대한한방내과학회지
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    • 제39권1호
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    • pp.22-43
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    • 2018
  • Objective: The purpose of this study is to investigate the effect of Cheonmagudeung-eum (CGE) for essential hypertension by systematic review and meta-analysis. Methods: The period of literature search was until October 30, 2016, and 14 electronic databases were utilized as search engines. The evaluation for the risk of bias (RoB) was conducted by using the Cochrane Risk of Bias Tool. The meta-analysis was performed by synthesizing outcome data, including total effective rate (TER), systolic blood pressure (SBP), diastolic blood pressure (DBP), and the incidence of adverse events. Result: There were a total of 64 RCTs using CGE on adult essential hypertension. In the RoB evaluation, most of the items were unclear, and the qualities of studies were rated low. The concurrent treatment of CGE and antihypertensive drug (AHD) showed a significant hypotensive effect since the risk ratio (RR) of TER was 1.17 times (95% CI 1.14, 1.20, p<0.01) higher than that of AHD alone. In addition, the mean difference (MD) appeared low as 8.73 mm/Hg in SBP (95% CI -11.36, -6.09, p<0.01) and 5.81 mm/Hg in DBP (95% CI -7.50, -4.12, p<0.01). Conclusion: Through this study, it was identified that the combined treatment of CGE and AHD on hypertension would be more effective than that of AHD treatment alone. However, due to the low quality of the selected original articles, the significance of this conclusion is somewhat limited, and we hope that this would be complemented through more rigorous RCTs in the future.

소아 식욕부진에 대한 이공산(異功散) 치료의 효과 : 체계적 문헌고찰 및 메타분석 (Effects of Yigong-san for the Treatment of Anorexia in Children: A Systematic Review and Meta-Analysis)

  • 이보람;하다정;허태영;박상은;이선행;장규태
    • 대한한방내과학회지
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    • 제43권4호
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    • pp.542-558
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    • 2022
  • Objectives: The purpose of this study was to assess the effect of Yigong-san on anorexia in children by conducting a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: Eleven electronic databases were searched on May 30, 2022 to collect relevant studies. All studies published up to the search date were considered. RCTs reporting the effect of Yigong-san on the treatment of anorexia in children were included. The primary outcome was an improvement in clinical anorexia symptoms after treatment. In this meta-analysis, continuous and binary outcomes were assessed, and the data were presented as the mean difference and risk ratio with their 95% confidence intervals. The risk of bias was assessed using the Cochrane Collaboration's risk of bias tool. Results: A total of nine studies were included in this systematic review. The treatment group (Yigong-san only or Yigong-san plus conventional treatment) showed a statistically significant effect compared to the control group (conventional treatment only) in total effective rate (Yigong-san only: RR 1.26, 95% CI 1.17, 1.36, I2=0%; Yigong-san plus conventional treatment: RR 1.32, 95% CI 1.18, 1.47, I2=0%), clinical symptoms, some of the anthropometric outcomes, and biological markers related to appetite and growth in children with anorexia. No serious adverse events related to Yigong-san were reported. Conclusions: Yigong-san showed statistically significant effects as a treatment for anorexia in children. However, the number of studies included in the meta-analysis was insufficient, and the herbs contained in the Yigong-san used in the included studies were not standardized. Future research should focus on the implementation of methodologically robust clinical research.

금연에 대한 침술 병용 치료의 효과 및 안전성 : 체계적 검토를 위한 프로토콜 (The effectiveness and safety of acupuncture combination treatment on smoking cessation: A protocol for systematic review)

  • 최인서;성원석;조민기;김정현;박연철;김은정;백용현;김근우;서병관
    • 대한융합한의학회지
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    • 제3권1호
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    • pp.5-13
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    • 2022
  • Objectives: Smoking had a long negative impact on public health. The ingredients of a cigarette are major risk factors for several diseases. Owing to the problems about economic and quality of life, we need to ensure smoking cessation (SC). There are several approaches for SC including pharmacological therapy, nicotine replacement therapy, education, and behavioral intervention. However, due to some limitations, other alternative approaches are gaining popularity. Acupuncture has been reported to have few side effects and be more effective than some conventional treatments in several articles. However, there are no systematic reviews on the comparison of acupuncture combination treatment with other conventional monotherapies. Methods: Randomized controlled trials that used acupuncture as an adjunct treatment for SC will be searched and data will be summarized according to the predefined criteria. The primary outcome will be the abstinence rate, and secondary outcomes will be adverse events and biochemical indicators. We will use Review Manager to perform a meta-analysis, Cochrane Collaboration Risk of Bias tool for the risk of bias assessment, and the Grades of Recommendation, Assessment, Development and Evaluation approach to determine the quality of evidence. We will investigate the efficacy and safety of acupuncture combination treatment for SC with this study. Ethics and dissemination: This study will provide reliable clinical evidence on additional effect of acupuncture on smoking cessation. We will publish our results in a peer-review journal.