• Title/Summary/Keyword: Cochrane Risk of Bias

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A Systematic Review on the Clinical Efficacy of Digital Therapeutics for Sleep Disorders: Subgroup Analysis by Control Groups (수면 장애가 있는 환자에게 적용한 디지털 치료기기의 임상적 유효성에 대한 체계적 문헌고찰: 대조군분류에 따른 하위 분석)

  • Hyosun Jeon;Eunjee Kang;Soojung Yoo
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.4
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    • pp.221-241
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    • 2023
  • Background: The purpose of this systematic review was to investigate the effects of digital therapeutics for insomnia on sleep disorders and mental health improvement compared to the control group. Methods: Following the guidelines on systematic review(PRISMA, NECA), a literature search was conducted through PubMed, Cochrane Library, EMBASE, RISS, KISS, and KoreaMed using keywords. The Cochrane Risk of Bias Tool and Review Manager version 5.3 were used for risk of bias and effect size assessment. Results: Thirty eight RCT met criteria for inclusion. When compared against three control conditions, the digital therapeutics for insomnia was an effective intervention for improvement sleep disorders and mental health in comparison to waiting list and Patient-directed care with some intervention by medical staff. However, digital therapeutics for insomnia were no more effective than face-to-face CBT-I control group. Conclusion: The efficacy of digital therapeutics for insomnia was evaluated differently depending on the control group. Therefore, in phase 3 clinical trials for efficacy evaluation, it is necessary to review whether the control group has been properly established.

The Assessment of Risk of Bias on Randomised Controlled Trials of Oriental Medicine in Korea (한의학 관련 무작위배정비교임상연구의 비뚤림 위험 평가)

  • Lee, Yoon-Jae;Jang, Bo-Hyoung;Go, Ho-Yeon;Hyun, Min-Kyung;Park, Sun-Young;Lee, Chang-Hoon;Kim, Jin-Sung;Cho, Ki-Ho
    • The Journal of Korean Obstetrics and Gynecology
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    • v.24 no.4
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    • pp.105-113
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    • 2011
  • Objectives: To examine the current status of clinical research in oriental medicine, and to assess 'risk of bias'(ROB) of randomized clinical trials(RCTs) in oriental medicine in Korea. Methods: Special committee for EBM, KOMS(Korean Oriental Medicine Society) reviewed 17 journals related to oriental medicine in Korea (from the first issue to May 2010), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 2, 2010), and PubMed (1966 to May 2010). Then we selected eligible RCTs in terms of oriental medicine, and assessed 'risk of bias'. Results: We reviewed 12,653 articles from the 17 journals, and 41 articles from CENTRAL and PubMed. After non-clinical articles were excluded, 1,004 articles were left. Among them, the number of eligible studies in terms of oriental medicine was 306. In these eligible studies, 130 were RCTs. Of RCTs, 69 were on acupuncture, 25 on herbal medicine. The proportion of 'unclear' is high in the criteria of 'Allocation concealment', 'Blinding of participants and personnel', 'Blinding of outcome assessment' and 'Other bias'. On the other hand, 'low' has high in the criteria of 'Incomplete outcome data' and 'Selective reporting'. Conclusions: Risk of bias on oriental medicine is unclear in terms of 'allocation concealment' and 'blinding'. For high-quality research in oriental medicine, further research should be needed on randomization and blinding in the RCTs.

Review of the Latest Oriental and Traditional Clinical Articles and Protocol about Male Sexual Dysfunction (남성 성기능장애 관련 한의학 및 전통의학 임상 연구 동향 분석과 프로토콜 분석)

  • Park, Dong-Su;Park, Sun Young;Shin, Seon Mi
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.5
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    • pp.530-539
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    • 2013
  • This study reviews the latest articles about oriental and traditional medicine treatment of male sexual dysfunction. We searched the article from 2000 to 2012 using 5 data bases. There were no restrictions on the type of publication, but articles not available in full text were excluded. The methological quality of RCT study was assessed according to Jadad scores and Cochrane's assessment of risk of bias. 18 articles were included in this study. 5 articles published in Korea, the rest were foreign articles. 9 articles were randomized controlled trial(RCT), Case-control studies were 3, case reports were 3, One group pre-post test were 3. In RCT studies, Jadad scores were generally low, and risk of selection bias and performance bias were generally high, risk of detection bias was unclear. Oriental and traditional medicine treatment is as effective as western medicine treatment for male sexual dysfunction, more rigorous oriental medicine treatment studies should be warranted.

Low Social Support and Risk for Depression in People With Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis

  • Azmiardi, Akhmad;Murti, Bhisma;Febrinasari, Ratih Puspita;Tamtomo, Didik Gunawan
    • Journal of Preventive Medicine and Public Health
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    • v.55 no.1
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    • pp.37-48
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    • 2022
  • Objectives: Depression is a frequent complication of type 2 diabetes mellitus. This study aimed to investigate the relationship between low social support and risk for depression in people with type 2 diabetes through a meta-analysis. Methods: PubMed, ProQuest, SpringerLink, ScienceDirect, Scopus, the Cochrane Library, Embase, and Google Scholar were searched for English-language articles published up to 2021. Pooled adjusted odds ratios (aORs) were calculated using a random-effect model with 95% confidence intervals (CIs). Heterogeneity was evaluated by using the Cochrane Q test and I2 statistics. The risk of publication bias was estimated using a funnel plot, the Egger test, and the Begg test. The Joanna Briggs Institute Critical Appraisal Tools were used to assess the quality of evidence and the risk of bias. Results: Eleven studies were included in this meta-analysis, containing a total of 3151 people with type 2 diabetes mellitus. The pooled analysis showed that people with type 2 diabetes mellitus who had low social support had twice as high a risk of depression as those with high social support (aOR, 2.02; 95% CI, 1.51 to 2.70; p<0.001). A random-effect model was used because the heterogeneity was high (I2 = 87%). Conclusions: Low social support was found to increase the risk of depression among people with type 2 diabetes mellitus. Further investigation into factors that may moderate this relationship is required.

The Effectiveness of Moxibustion Treatment for Primary Dysmenorrhea: A Systematic Review and Meta-Analysis (원발성 월경곤란증의 뜸 치료에 대한 체계적 문헌고찰 및 메타분석)

  • Lee, Hye-In;Baek, Seon-Eun;Lee, Ho-Jung;Park, Kyoung-Sun;Lee, Jin-Moo;Yoo, Jeong-Eun
    • The Journal of Korean Obstetrics and Gynecology
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    • v.30 no.2
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    • pp.107-119
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    • 2017
  • Objectives: The purpose of this study is to investigate the effectiveness of moxibustion for primary dysmenorrhea (PD). Methods: We searched 10 electronic databases (CNKI, WANFANG, VIP, AMED, CiNii, Embase, PubMed, Cochrane, OASIS, Korea Traditional Knowledge Portal) to identify eligible studies published before November 2016. We included randomized controlled clinical trials (RCTs) using moxibustion for primary dysmenorrhea. The methodological quality of each RCT was assessed by the Cochrane risk of bias tool. Results: Ten RCT studies were eligible in our review. The overall risk of bias was evaluated as unclear. The meta-analysis of 4 trials indicated that favorable results for the use of moxibustion. Conclusions: This systematic review and meta-analysis of clinical trials suggests that moxibustion can achieve good efficacy for PD patients. However, because of studies included analysis was biased due to unclear risk of bias and unreliable study design, future high-quality RCT studies are needed to determine the association moxibustion with PD.

Acupuncture Treatment for Rotator Cuff Disorder: A Systematic Review (회전근개 질환에 대한 침술 치료의 효과: 체계적 문헌 고찰)

  • Choi, Hyun-Min;Han, Soo-Yeon;Hwang, Doo-Ree;Kang, Jun-Hyuk
    • Journal of Korean Medicine Rehabilitation
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    • v.28 no.4
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    • pp.11-20
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    • 2018
  • Objectives To systematically explore the effects of acupuncture treatment for rotator cuff disorders and review the clinical trials. Methods We searched 9 electronic databases (PubMed, Cochrane central, Embase, China National Knowledge Infrastructure [CNKI], Korea Institute of Science and Technology Information [KISTI], National Digital Science Library [NDSL], Korean studies Information Service System [KISS], Research Information Sharing Service [RISS], Oriental Medicine Advanced Searching Integrated System [OASIS]) to find randomized controlled trials that used acupunture treatment for rotator cuff disorders. We assessed the designs of the randomized controlled trials and the method of acupuncture treatment according to the Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA). The methodological quality of randomized controlled trials were assessed using the Cochrane Risk of Bias (RoB) tool. Results Total 5 trials were reviewed. 4 out of 5 randomized clinical trials reported meaningful effects of acupuncture treatments compared to control group. However risk of bias seemed high. Conclusions Although the results suggest that acupuncture treatment has favorable effects for rotator cuff disorders, most of the studies included methodologically high risk of bias. Thus, well designed randomized clinical trials which evaluate the effects of acupuncture treatment for rotator cuff disorders should be encouraged.

Systematic Review and Meta-analysis on Acupotomy for Piriformis Muscle Syndrome (이상근증후군의 도침치료에 대한 체계적 문헌고찰 및 메타 분석)

  • Park, Song-Mi;Jung, Sue-un;Park, Jung-Hyeon;Do, Hyun-jeong;Cho, Sung-Woo
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.2
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    • pp.25-40
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    • 2021
  • Objectives This study was conducted to analyze the effect of using acupotomy for piriformis muscle syndrome. Methods The databases used for the search were PubMed, Embase, Cochrane library, China National Knowledge Infrastructure (CNKI), Koreanstudies Information Service System (KISS), Research Information Sharing Service (RISS), Oriental Medicine Advanced Searching Integrated System (OASIS), KMbase, and National Digital Science Library (NDSL). The literature was searched using a total of 9 domestic and foreign databases. randomized controlled trial using only acupotomy as an intervention was selected. The selected studies are analyzed the risk of bias through Cochrane risk of bias, and meta-analysis was performed using Revman. Results As a result of meta-analysis of 11 selected studies, acupotomy was more effective than nerve block and acupuncture. In terms of visual analog scale and immediate analgesic effect, acupotomy did not have statistically significant results compared to other treatment methods. meta-analysis of electro-acupuncture and acupotomy showed no significant results. Conclusions When acupotomy is applied as a treatment for piriformis muscle syndrome, it is more effective than nerve block and acupuncture. but most of the studies have been judged as 'unclear' in the risk of bias assessment. Due to characteristics of treatment group and control group's intervention, It is judged that the blinding of the participant was not properly implemented. Therefore, it is considered that high-quality studies are necessary to supplement the problems in the future.

Effects of Virtual Reality Program on Recovery of Functional in individuals Stroke: A Systematic Review and Meta Analysis (뇌졸중 환자 대상의 가상현실 운동프로그램이 기능회복에 미치는 효과: 체계적 문헌고찰 및 메타분석)

  • Park, Seo-A;Kim, Hye-Young
    • Journal of Digital Convergence
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    • v.17 no.5
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    • pp.235-247
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    • 2019
  • This study was carried out to evaluate the efficacy of Virtual Reality(VR) program on recovery of functional in Stroke through systematic literature review and meta-analysis. The following databases were used to search the literature: RISS, KISS, KMbase. Keywords included 'stroke', 'CVA' 'virtual reality', 'rehabilitation', 'virtual reality program' and the evaluated articles were published from 2009 to November 2018. The statistical was used R program, the effect size of upper limb, balance and ADL were calculated by random-effects model. As a result, 9 RCT studies were meta-analyzed and were evaluated for the risk of bias by the RoB of Cochrane Collaboration; the overall risk of bias was low. The effect sizes of VR program was balance(g=.77), ADL(g=.80) as indicated by a "large effect size". Therefore, VR program is large effective in reducing balance and ADL in strokes. It is necessary to develop and apply a virtual reality-based program using more efficient program development.

Herbal Medicine for Liver Cancer: A Protocol for Systematic Review and Meta-Analysis (간암에 대한 한약치료: 체계적 문헌고찰 및 메타분석의 프로토콜)

  • Kwon, Seungwon;Song, Ga Yeon;Yang, Seung-Bo
    • The Journal of Internal Korean Medicine
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    • v.43 no.4
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    • pp.559-566
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    • 2022
  • Introduction: The aim of this systematic review is to provide evidence confirming the efficacy and safety of herbal medicines used in the treatment of liver cancer. Methods: The review will include randomized clinical trials that compared herbal medicines used as treatments for liver cancer with other therapies, such as placebos and Western medicine. Only randomized controlled trials will be included in this review, and all types of herbal medicine will be evaluated. Eleven electronic databases will be searched from the inception date: the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, AMED, CINAHL, one Chinese database (CNKI), and five Korean databases (OASIS, DBpia, RISS, KISS, and NDSL). The selection of studies, data extraction, and management will be performed independently by four researchers. Methodological quality, including the risk of bias, will be assessed using the Cochrane risk-of-bias assessment tool. Results: The review of current evidence for the effectiveness of herbal medicine for liver cancer will be summarized and quantitatively analyzed. Conclusions: Our systematic review will provide evidence of the efficacy of herbal medicines as treatments for liver cancer. This evidence will provide useful information for practitioners and patients in the fields of oncology and complementary medicine.

Chuna Manual Therapy for Neck Pain : A Systematic Review and Meta-analysis (경항통에 대한 추나요법의 효과: 체계적 문헌고찰과 메타분석)

  • Lee, Ki-Beom;Ha, In-Hyuk;Kim, Ho-Sun;Bae, Young-Hyun;Kim, No-Hyeon;Suh, Chang-Yong;Yang, Kyu-Jin;Jung, You-Hwa;So, Min-Ji;Lee, Yoon-Jae
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.11 no.2
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    • pp.11-21
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    • 2016
  • Objectives : To determine the effectiveness of Chuna manual therapy for neck pain Methods : We searched 7 electronic databases(OASIS, NDSL, Ovid-MEDLINE, Ovid-EMBASE, Cochrane library, AMED, CNKI) to find all Randomized controlled trials that used Chuna manual therapy as a treatment for neck pain. The methodological quality of each RCT was assessed by the Cochrane risk of bias tool. Results : 7 RCTs met our inclusion criteria. The meta-analysis of 7 studies showed favorable results for the use of Chuna manual therapy. High risk of bias were observed for performance bias and detection bias. Conclusions : Our systematic review found favorable results using Chuna manual therapy for neck pain. But there are several limitations in our study due to lack of well-designed RCT. To obtain stronger evidence, further clinical trials would be needed.

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