• 제목/요약/키워드: Cochrane Risk of Bias

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Efficacy of intralipid administration to improve in vitro fertilization outcomes: A systematic review and meta-analysis

  • Han, E Jung;Lee, Hye Nam;Kim, Min Kyoung;Lyu, Sang Woo;Lee, Woo Sik
    • Clinical and Experimental Reproductive Medicine
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    • 제48권3호
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    • pp.203-210
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    • 2021
  • We performed a systematic review and meta-analysis to evaluate whether intralipid administration improved the outcomes of in vitro fertilization. Online databases (PubMed, Cochrane Library, Medline, and Embase) were searched until March 2020. Only randomized controlled trials (RCTs) that assessed the role of intralipid administration during in vitro fertilization were considered. We analyzed the rates of clinical pregnancy and live birth as primary outcomes. Secondary outcomes included the rates of chemical pregnancy, ongoing pregnancy, and missed abortion. We reviewed and assessed the eligibility of 180 studies. Five RCTs including 840 patients (3 RCTs: women with repeated implantation failure, 1 RCT: women with recurrent spontaneous abortion, 1 RCT: women who had experienced implantation failure more than once) met the selection criteria. When compared with the control group, intralipid administration significantly improved the clinical pregnancy rate (risk ratio [RR], 1.48; 95% confidence interval [CI], 1.23-1.79), ongoing pregnancy rate (RR, 1.82; 95% CI, 1.31-2.53), and live birth rate (RR, 1.85; 95% CI, 1.44-2.38). However, intralipid administration had no beneficial effect on the miscarriage rate (RR, 0.75; 95% CI, 0.48-1.17). A funnel plot analysis revealed no publication bias. Our findings suggest that intralipid administration may benefit women undergoing in vitro fertilization, especially those who have experienced repeated implantation failure or recurrent spontaneous abortion. However, larger, well-designed studies are needed to confirm these findings.

불면 장애에 대한 족욕 치료법의 체계적 문헌고찰과 메타분석 연구 (A Systematic Review and Meta-Analysis of Foot Bath Therapy for Insomnia Disorder)

  • 김동현;조준희;임정화;김보경
    • 동의신경정신과학회지
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    • 제34권3호
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    • pp.163-179
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    • 2023
  • Objectives: The purpose of this study was to provide evidence for the clinical effects of foot bath therapy for insomnia disorder through a systematic review and meta-analysis. Methods: Studies were selected from seven domestic and international literature databases. Data on diagnostic tools, pattern identification, sample size, intervention methods, outcome measurements, results, and adverse events were extracted. The quality of the selected literature was assessed using Cochrane's risk of bias (RoB) assessment tool. Results: A total of 11 studies were included in this study. The primary diagnostic tool for insomnia dis- order was the criteria for the diagnosis and therapeutic effect of diseases and syndromes in traditional Chinese medicine (CDTDSTCM), along with the Chinese classification of mental disorders-3 (CCMD-3). Treatment effects were mainly evaluated by the effective rate and the Pittsburgh Sleep Quality Index (PSQI). The meta-analysis results showed statistically higher effectiveness rates for treating insomnia disorder in the experimental groups receiving herbal medicine foot bath therapy with sleeping or herbal medication compared to the control group. The PSQI was lower in the treatment group receiving herbal medicine foot bath therapy with sleeping medication. The herbal materials used in herbal medicine foot bath therapy mainly included Radix Angelicae Sinensis, Polygonum Multiflorum, Ziziphi Spinosae Semen, Rhizoma Coptidis, Radix Salviae Miltiorrhizae, and Cortex Albizziae. The quality of the included studies was generally poor. Conclusions: This study found that foot bath therapy had clinical efficacy for treating insomnia disorder. The research findings could provide foundational evidence for establishing the clinical basis of foot bath therapy in the treatment of insomnia.

근치적 전립선적출술 후 요실금에 대한 케겔운동의 효과: 무작위 대조군 실험연구의 체계적 문헌고찰 (Effect of Kegel Exercise on Urinary Incontinence after Radical Prostatectomy: Systematic Review of Randomized Controlled Trials)

  • 박성희;조윤수;곽미정;이희선;강창범
    • 성인간호학회지
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    • 제25권2호
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    • pp.219-230
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    • 2013
  • Purpose: This study is reviewed of the available literature to identify the evidence of the value of Kegel exercise programs as an intervention to decrease urinary incontinence and the improvement of the quality of life following a radical prostatectomy in localized prostate cancer. Methods: We searched studies of randomized controlled trials that utilized the Kegel exercise programs with patient with a radical prostatectomy. The review was conducted electronic bibliographic database of Ovid-Medline, Embase, Scopus, KoreaMed and NDSL, etc. Of 630 publications identified, seven studies that met the inclusion criteria, and all studies analyzed by meta-analysis. To ensure the quality of the studies, we used Cochrane's Risk of Bias. Results: Kegel exercise helped patient to achieve continence more quickly (after 1, 3, 6, 12 months) than men not using Kegel exercises. Especially, Kegel exercise significantly reduced the development of urinary incontinence at one month after prostatectomy. The effectiveness of Kegel exercise after prostatectomy was found to improve the quality of life at a significant level. Conclusion: Based on available evidence, Kegel exercise that nurses can teach improved the return to continence more than usual care in men with prostatectomy urinary incontinence.

뇌졸중의 추나요법에 대한 체계적 문헌 고찰 (Chuna Manual Therapy for Stroke: A Systematic Review and Meta-analysis)

  • 김미경;한창호
    • 척추신경추나의학회지
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    • 제14권2호
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    • pp.15-28
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    • 2019
  • Objectives : This study aimed to systematically and comprehensively review controlled clinical trials on the effectiveness and safety of Chuna Manual Therapy for stroke. Methods : By October 7, 2019, three core databases and three domestic databases were searched. Seven major academic journals on the related field were also hand-searched. Methodological quality of the included studies was evaluated using the Cochrane risk of bias tool. Meta-analysis was conducted and the quality of its evidence was assessed using the GRADE methodology. Results : Five articles met the eligibility criteria. The results of most of included studies were in favor of Chuna Manual Therapy. No study described any adverse events during or after the clinical trials. Meta-analysis of three eligible studies showed that the pre- and post-treatment scores on the Modified Barthel Index (mean difference 8.00, 95% confidence interval 0.26 to 15.74) and Berg Balance Scale (mean difference 3.57, 95% confidence interval 0.64 to 6.51) of the Chuna-treated group were significantly different, but only marginally higher than those of the non-treatment group. Thus, the level of evidence gathered from these studies was assessed to be low. Conclusions : Based on current available evidence, any confirmative conclusions cannot be made on the effectiveness and safety of Chuna Manual Therapy for stroke because of the small sample size, low methodological quality, presence of statistical heterogeneity, and missing safety information. More rigorously designed large-scale multi-center studies are needed to establish more specific and credible evidence to support or oppose the use of Chuna Manual Therapy for stroke.

무릎 골관절염 환자에게 적용된 운동 프로그램이 통증 및 삶의 질에 미치는 영향: 체계적 문헌고찰과 메타분석 (The Effect of Exercise Program on Pain and Quality of Life for Patients with Knee Osteoarthritis: A Systematic Review and Meta-Analysis)

  • 윤청구;안창식
    • 근관절건강학회지
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    • 제21권3호
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    • pp.173-183
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    • 2014
  • Purpose: This study examined the effects of exercise programs on the pain and quality of life in patients with knee osteoarthritis. Methods: Electronic bibliographic databases of KiSTi, KoreaMed, KISS and KERIS were searched to identify studies of randomized controlled trials and non-randomized controlled trials. As a result, 1213 publications identified and 16 studies met inclusion and exclusion criteria. All studies examined for quality assessment of studies using Cochrane's risk of bias. Results: The 16 studies were eligible for inclusion criteria, then the meta-analysis was conducted to examine effectiveness of exercise programs on pain and quality of life in patients with knee osteoarthritis. The meta- analysis based on the random effect model showed that the exercise program was beneficial in decreasing pain (effect size .69; 95% confidence interval 0.45~0.91). Also, the exercise programs have been shown to be effective in significantly improving the quality of life. However, it was not statistically significant due to severe deviations of studies (effect size 1.06; 95% confidence interval -0.34~2.46). Conclusion: Exercise programs had positive effects on pain relief and improvement of the quality of life in patients with knee osteoarthritis, although the quality of life was not statistically significant due to severe deviations of studies.

중국 및 한국 Database에서의 위식도 역류질환에 대한 반하사심탕의 효과에 대한 최근 10년간의 연구경향 (A Study Trend for the Effects of Banxia-xiexin-tang Decoction (Banhasasim-tang) on Gastroesophageal Reflux Disease (GERD) in Chinese and Korean Databases over the Last Ten Years)

  • 정유진;김윤정;홍상훈
    • 대한한방내과학회지
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    • 제41권3호
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    • pp.362-413
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    • 2020
  • Objectives: The purpose of this research is to examine the recent clinical research trends on the efficiency of traditional herb medicine (THM) on gastroesophageal reflux disease (GERD), and to provide clinical evidence of herbal medicine, Banhasasin-tang or Banxiexin decoction by using a systemic review and meta-analysis of randomized trials (RCTs). Methods: In this study, randomized controlled trials (RCTs) were included that verified effects of traditional herbal medicine (THM), including a Banxia-xiexin-tang decoction, as a treatment for GERD. A study of the literature in Chinese and Korean databases was performed for papers published from January 1, 2010, to January 1, 2020. The selected literature was assessed by Cochrane's risk of bias (RoB). Results: A total of 90 RCTs met the inclusion criteria. Except for four RCT studies, all studies identified the effect of a Banxia-xiexin-tang decoction in the treatment of GERD. The effectiveness of treatment was significantly higher in the intervention group than in the control group, as shown through various evaluation indicators, including the reflux disease diagnostic questionnaire (RDQ). Adverse effects were reported in 22 articles (24.44%). Conclusions: Treatment with Banhasasin-tang, or a Banxia-xiexin-tang decoction, was found to be effective in treating GERD. However, due to the low quality of available studies, the significance of this conclusion is somewhat limited. This study could serve as a foundation for further clinical studies on the development of diagnosis and treatment methods for GERD based on Korean medicine.

복압성 요실금에 대한 보중익기탕의 효과 : 체계적 문헌고찰과 메타분석 (The Effect of Bojungikgi-tang on Stress Urinary Incontinence: A Systematic Review and Meta-Analysis)

  • 남현서;백태현
    • 대한한방내과학회지
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    • 제42권3호
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    • pp.293-307
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    • 2021
  • Objectives: This study investigates the effects and safety of Bojungikgi-tang for stress urinary incontinence by systemic review and meta-analysis of randomized controlled trials (RCTs). Methods: RCTs were selected from articles published until December 2019 in seven domestic and foreign databases. The quality of the literature was evaluated using Cochrane's risk of bias (RoB) tool, and RevMan 5.3 was used to synthesize the results. Results: A total of 694 patients with stress urinary incontinence participated in eight RCTs. Meta-analysis showed that the total effective rate of treatment that combines pelvic floor muscle training (PFMT) and Bojungikgi-tang was significantly higher than that of PFMT alone. The volume of urine leakage per hour after the combined treatment was significantly lower than that of PFMT alone. The International Consultation on Insurance Questionnaire-Short Form (ICIQ-SF) scores from combining PFMT and Bojungikgi-tang were significantly lower than those for PFMT alone. Conclusion: This study suggests that Western medical treatment combined with Bojungikgi-tang for urinary incontinence from stress might be more effective in improving symptoms than conventional Western medical treatment alone. However, the number of studies included in the meta-analysis was insufficient, and the quality of the selected literature was generally low. Therefore, high-quality clinical studies on herbal medicine treatment for urinary incontinence would be required in the future.

전립선비대증에 대한 추나요법의 효과: 체계적 문헌 고찰 (Chuna Manual Therapy for Benign Prostatic Hyperplasia: A Systematic Review)

  • 전천후;박나리;이예지;조충식
    • 척추신경추나의학회지
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    • 제15권1호
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    • pp.65-74
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    • 2020
  • Objectives : This study aimed to evaluate the randomized controlled clinical trials (RCTs) analyzing the effectiveness of Chuna manual therapy (CMT) for benign prostatic hyperplasia (BPH). Methods : Among the literature published until May 2020, a literature search was carried out using 10 electronic databases using related keywords to identify all RCTs that applied CMT for the treatment of BPH. The Cochrane risk of bias tool was used to assess the methodological quality of each RCT. Results : Five RCTs met our inclusion criteria and were included in the analysis. These studies showed that CMT had no positive results compared to herbal medication. However, positive results were shown in terms of an increased efficacy rate, reduced international prostate symptom scores, and increased maximum flow rate when CMT was combined with acupuncture or herbal medication. Conclusions : Based on the analysis, this review has limited evidence of CMT being beneficial in the treatment of BPH. Therefore, further investigation is required using well-designed RCTs to support the effectiveness of CMT and to obtain higher evidence.

불면증에 대한 시호소간산 치료의 임상연구 동향 (A Review on Clinical Research Trend in Treatment of Chai-Hu-Shu-Gan-San (Sihosogan-San) for Insomnia)

  • 이재은;김상호;김보경;임정화
    • 동의신경정신과학회지
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    • 제31권1호
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    • pp.25-38
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    • 2020
  • Objectives: This review aimed to investigate the effectiveness of Chai-Hu-Shu-Gan-San (CHSGS) for treatment of insomnia. Methods: 9 databases were comprehensively searched from their inception dates until Jan 2020 using keywords like Insomnia, Chai-Hu-Shu-Gan-San and Sihosogan-san. We included randomized controlled trials (RCTs) using CHSGS as the main intervention for insomnia patients. We assessed the quality of RCTs using the Cochrane risk of bias tool and Jadad scale. Results: 5 RCTs were included. The Chinese classification of mental disorders -3 (CCMD-3) was the most frequently used diagnostic criteria. The effective rate was the most frequently used as outcome. All the 5 RCTs that reported CHSGS and CHSGS adjunctive therapy on insomnia were more effective compared to western medication. Only one study reported adverse effects. The methodological quality of the included RCTs were generally poor. Conclusions: This review found that CHSGS may be effective to treating insomnia. However, because of the small number, heterogeneity and very low methodological quality of included studies, we could not draw any definitive conclusions. Therefore, more rigorous randomized control studies are warranted.

Surgical management of male genital lymphedema: A systematic review

  • Aulia, Indri;Yessica, Eva Chintia
    • Archives of Plastic Surgery
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    • 제47권1호
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    • pp.3-8
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    • 2020
  • Genital lymphedema (GL) is an uncommon and disabling disease that manifests as enlargement of the genital region resulting from the disturbance of lymphatic drainage. Although conservative treatment such as decompression is typically the first-line approach, surgical intervention has been shown to be effective in certain cases. This study aimed to systematically review studies evaluating available surgical alternatives for the treatment of male GL. A systematic search strategy using keyword and subject headings was applied to PubMed, Scopus, EMBASE, and Cochrane Library in May 2019. Studies investigating various surgical techniques to treat penile and scrotal lymphedema were included. The potential risk of bias of included trials was evaluated using the methodological index for non-randomized studies (MINORS). In total, 13 studies met the inclusion criteria, nine of which were determined to be high-quality. The average MINORS score was 12.45 for studies involving excision and 14 for studies involving lymphovenous anastomosis (LVA). The most common reason for a low score was a failure to describe the inclusion criteria. Recurrence of lymphedema during follow-up was reported in four studies involving excision and in no studies involving LVA. In general, the quality of the included literature was considered to be fair. Although surgical intervention might not always prevent the recurrence of lymphedema, all of the studies reported improved quality of life after the procedure. This study could be used as the basis for evidence-based guidelines to be applied in clinical practice for managing male GL.