• Title/Summary/Keyword: Controlled Clinical Trials as Topic

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Literature Review of Randomized Clinical Trials Regarding Insomina (불면증 무작위배정 임상시험에 대한 문헌 고찰)

  • Park, Hye Joo;Yoo, Jong Hyang;Kwon, Ji Hye;Lee, Si Woo
    • Journal of Oriental Neuropsychiatry
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    • v.24 no.3
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    • pp.201-210
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    • 2013
  • Objectives : To review the recent trend of randomized controlled clinical trials on insomnia and to provide information for future clinical trials. Methods : A total of 667 pieces of literature were searched using the key words 'insomnia' and 'randomized controlled trial' and using the title 'insomnia' with the topic 'trial or trials', published from 2008 to 2012 through Web of Science. Studies including randomized controlled clinical trials were sorted from the search result and finally 104 pieces of the literature were selected and examined. Results : Besides 104 clinical trials, 14 trials related to CAM (Complementary and Alternative Medicine) were also reviewed. On average, 20 trials were annually conducted and they showed a growing trend. Participants were between 31 and 90 (34.6%), and were observed for less than 30 days (28.8%) in most trials. As intervention methods for clinical trials, non-pharmaceutical methods were used in 59 studies (56.7%), pharmaceutical drug in 43 studies (41.3%) and combinations in 2 studies (1.9%). In 60 studies, only insomnia without any underlying diseases was examined and other 44 studies involved other diseases. As diagnosis assessment tools, Sleep diary and Polysomnography were used. Conclusions : Randomized controlled trials relevant to insomnia were on the increase, but only a small number of clinical trials on Oriental Medicine have been performed. Larger scientific and well-founded randomized controlled trials are required for developing Oriental Medicine and establishing high-quality guideline going forward.

Quantity and Quality Assessment of Randomized Controlled Trials in the Atopic Dermatitis (아토피 피부염 무작위배정 임상연구 논문 질 평가)

  • Park, Hye-Joo;Kwon, Ji-Hye;Yoo, Jong-Hyang
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.27 no.4
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    • pp.45-57
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    • 2014
  • Objective : This study aims to provide fundamental data for new directions(the improvement directions) from searching research papers of randomized controlled trials among thesis of Atopic Dermatitis related to oriental medicine in Korea from 2004 to 2014 and identifying the problem and level of a clinical study through an assessment of the quality, CONSORT statement. Methods : Data was collected through the Koreanstudies Information Service System(KISS). Two experts in Oriental Medicine reviewed the title and abstract in thesis, the results of searching the title, "Atopic dermatitis" and topic, "oriental medicine" at KISS, and then they handsearched Randomized Controlled Trials related to oriental medicine in Korea. According to guidelines defined by CONSORT statement, they assessed whether 37 items were followed by guidelines at yes or no answers in order to evaluate the quality as well. They assessed the definition of each item independently. After comparing, they made a decision on the item of different outcomes through an agreement with a third party. Results : Total number of randomized controlled trials in Atopic Dermatitis related to oriental medicine is eleven. A randomized controlled trial was first published in 2007. One or two papers associated it were released every year except 2013. 9 papers of them were approved by Institutional Review Board and were received written consent. The study included between 20 to 40 subjects for 2-arm parallel study design. The effect of treatment was observed for 4 to 8 weeks. On average, the number followed guidelines was 18.64 among those of 37 CONSORT statement and 50.38% of them was followed overall. Conclusion : As an interest about randomized controlled trials was increased, it was needed to care the standard providing information of CONSORT statement on randomized controlled trials related to oriental medicine in Korea. It is suggested to provide more clear information about it, so that it can be a motive for improving quality of the journal in oriental medicine.

Efficacy and Safety of Gabapentin in the Treatment of Chronic Cough: A Systematic Review

  • Shi, Guanglin;Shen, Qin;Zhang, Caixin;Ma, Jun;Mohammed, Anaz;Zhao, Huan
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.3
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    • pp.167-174
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    • 2018
  • Despite recent clinical guidelines, the optimal therapeutic strategy for the management of refractory chronic cough is still a challenge. The present systematic review was designed to assess the evidence for efficacy and safety of gabapentin in the treatment of chronic cough. A systematic search of PubMed, Embase, Cochrane Library databases, and publications cited in bibliographies was performed. Articles were searched by two reviewers with a priori criteria for study selection. Seven relevant articles were identified, including two randomized controlled trials, one prospective case-series designed with consecutive patients, one retrospective case series of consecutive patients, one retrospective case series with unknown consecutive status, and two case reports comprising six and two patients, respectively. Improvements were detected in cough-specific quality of life (Leicester Cough Questionnaire score) and cough severity (visual analogue scale score) following gabapentin treatment in randomized controlled trials. The results of prospective case-series showed that the rate of overall improvement of cough and sensory neuropathy with gabapentin was 68%. Gabapentin treatment of patients with chronic cough showed superior efficacy and a good safety record compared with placebo or standard medications. Additional randomized and controlled trials are needed.

Regulatory innovation for expansion of indications and pediatric drug development

  • Park, Min Soo
    • Translational and Clinical Pharmacology
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    • v.26 no.4
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    • pp.155-159
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    • 2018
  • For regulatory approval of a new drug, the most preferred and reliable source of evidence would be randomized controlled trials (RCT). However, a great number of drugs, being developed as well as already marketed and being used, usually lack proper indications for children. It is imperative to develop properly evaluated drugs for children. And expanding the use of already approved drugs for other indications will benefit patients and the society. Nevertheless, to get an approval for expansion of indications, most often with off-label experiences, for drugs that have been approved or for the development of pediatric indications, either during or after completing the main drug development, conducting RCTs may not be the only, if not right, way to take. Extrapolation strategies and modelling & simulation for pediatric drug development are paving the road to the better approval scheme. Making the use of data sources other than RCT such as EHR and claims data in ways that improve the efficiency and validity of the results (e.g., randomized pragmatic trial and randomized registry trial) has been the topic of great interest all around the world. Regulatory authorities should adopt new methodologies for regulatory approval processes to adapt to the changes brought by increasing availability of big and real world data utilizing new tools of technological advancement.

Therapeutic alternatives in painful diabetic neuropathy: a meta-analysis of randomized controlled trials

  • Vilar, Samuel;Castillo, Jose Manuel;Martinez, Pedro V. Munuera;Reina, Maria;Pabon, Manuel
    • The Korean Journal of Pain
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    • v.31 no.4
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    • pp.253-260
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    • 2018
  • Background: One of the most frequent problems caused by diabetes is the so called painful diabetic neuropathy. This condition can be treated through numerous types of therapy. The purpose of this study was to analyze, as a meta-analysis, different treatments used to alleviate painful diabetic neuropathy, with the aim of generating results that help making decisions when applying such treatments to tackle this pathology. Methods: A search was conducted in the main databases for Health Sciences, such as PUBMED, Web of Science (WOS), and IME biomedicina (Spanish Medical Reports in Biomedicine), to gather randomized controlled trials about treatments used for painful diabetic neuropathy. The analyzed studies were required to meet the inclusion criteria selected, especially those results related to pain intensity. Results: Nine randomized controlled trials were chosen. The meta-analysis shows significant positive effects for those treatments based on tapentadol [g: -1.333, 95% CI (-1.594; -1.072), P < 0.05], duloxetine [g: -1.622, 95 % CI (-1.650; -1.594), P < 0.05], pregabalin [g: -0.607, 95% CI (-0.980; -0.325), P < 0.05], and clonidine [g: -0.242, 95 % CI (-0.543; -0.058), P < 0.05]. Conclusions: This meta-analysis indicates the effectiveness of the treatments based on duloxetine, gabapentin and pregabalin, as well as other drugs, such as tapentadol and topic clonidine, whose use is better prescribed in more specific situations. The results provided can help increase the knowledge about the treatment of painful diabetic neuropathy and also in the making of clinical practice guidelines for healthcare professionals.

A Review of Research on Acupuncture and Moxibustion Treatment for De Quervain's Stenosing Tenosynovitis

  • Kong, Hae Jin;Kang, Jae Hui;Yun, Gee Won;Oh, Seo Young;Lee, Hyun
    • Journal of Acupuncture Research
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    • v.34 no.3
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    • pp.71-90
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    • 2017
  • Objectives : This study was performed to review articles concerning acupuncture and moxibustion treatment for De Quervain's Stenosing Tenosynovitis. Methods : On-line databases including Cochrane Library, Pubmed, CNKI, NDSL and OASIS were searched to identify articles concerning acupuncture and moxibustion treatment for De Quervain's Stenosing Tenosynovitis (DQST). Several duplicated articles and those not relevant to this topic were excluded, as were review articles and commentaries. Results : Fifty-one studies were identified, which included 28 clinical case studies with 1,227 patients and 23 randomized controlled trials with 2,040 patients. In these studies, acupuncture, acupotomy, moxibustion, pharmacopuncture, and laser acupuncture were used as DQST interventions. Although DQST is a common disease seen in clinical practice, only four of the 51 studies we identified in our search were published in Korean academic journals, all of which used pharmacopuncture. Conclusion : Although the results of the studies to date provide evidence that acupuncture and moxibustion are effective treatments for De Quervain's Stenosing Tenosynovitis, the absence of a standard, objective evaluation tool, and a lack of reporting on the negative side-effects associated with treatment remain important factors that should be addressed in future studies.

Effect of Vitamin D on Muscular Strength in Postmenopausal Women: A Meta-Analysis (비타민D 보충 요법이 폐경 후 여성 근력에 미치는 효과: 메타분석)

  • Kang, Purum;Kim, Jeehyoung;Kim, Myung Jin
    • Journal of Korean Biological Nursing Science
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    • v.21 no.4
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    • pp.239-248
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    • 2019
  • Purpose: Postmenopausal women are a unique population with high risk for the degeneration of muscle. The aim of the present meta-analysis was to accurately evaluate the effects of vitamin D on muscular strength in postmenopausal women. Methods: A review was conducted using electronic databases, including PubMed, EMBASE, Ovid Medline, CINAHL complete, and the Cochrane Library from inception through 19 March 2019. Included studies were selected by two independent reviewers. The meta-analysis were performed using Review Manager 5.3 software. Results: A total of nine randomized controlled clinical trials were included in this review. Vitamin D interventions led to no changes in the upper limb muscle strength (mean difference -0.16, 95% CI: -1.09 to 0.77), lower body muscle strength (standard mean difference 0.08, 95% CI: -0.11 to 0.26), and back/hip muscle strength (standard mean difference 0.06, 95% CI: -0.05 to 0.17). Conclusion: Pooled results from eight studies indicated that supplementation of vitamin D did not increase muscle strength in postmenopausal women. Apparently, the present review suggests that supplementation of vitamin D alone had no didn't show any beneficial effects on muscle strength in postmenopausal women.

The Research Trends on the Acupuncture Treatment of Lumbar Herniated Intervertebral Disc Using PubMed Database (PubMed 검색을 통한 요추 추간판 탈출증의 침치료 연구 동향)

  • Shin, Woo-Suk;Park, Won-Hyung;Cha, Yun-Yeop
    • Journal of Korean Medicine Rehabilitation
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    • v.24 no.4
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    • pp.49-60
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    • 2014
  • Objectives The purpose of this study is to research current trends of acupuncture treatment of lumbar herniated intervertebral disc using the PubMed database. Methods We set up the search strategy and investigated clinical trials on acupuncture treatment of lumbar herniated intervertebral disc through PubMed search. This study analyzed previous researched papers published from January 1st, 2000 to April 30th, 2014, and classified them by publication year, journal names, types of literature, treatment methods and evaluation scales. To assess the quality of the reviewed literature, randomized controlled trial (RCT) studies were assessed by Cochrane's risk of bias (ROB) tool and non-RCT studies were assessed by risk of bias for non-randomized studies (RoBANS). Results We found 35 studies on the acupuncture treatment of lumbar herniated intervertebral disc. Papers on this topic have been published, on average, three to four times annually in 9 journals since the mid-2000's. The journal with the largest number of publications was Chinese Acupuncture & Moxibustion, and most of articles were classified as RCT. Acupuncture treatment was performed individually or together with other treatments. The most frequently used pain evaluation index was visual analogue scale (VAS). The index of effective rate was used frequently but there was a lack of objectivity. In regards to the quality of the studies, outcome assessment in RCT showed that random sequence generation, allocation concealment, and the blinding of participants and personnel increase potential of risk of bias. For non-RCT assessment, outcome showed that confounding variable, measurement of intervention were at high risk of bias. Conclusions In order to obtain objective clinical evidence of acupuncture treatment of lumbar herniated intervertebral disc, further clinical studies should be designed to minimize the risk of bias, using STRICTA with larger sample sizes.

A Systematic Review of Non-pharmacological Intervention for Depression in Korean Middle-aged Women (한국 중년여성의 비약물적 우울중재연구: 체계적 문헌고찰)

  • Chae, Myung-Ock;Jeon, Hae Ok;Kim, Ahrin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.3
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    • pp.638-651
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    • 2016
  • The purpose of this study was to review the literature and examine the effects on non-pharmacological depression intervention for middle-aged women in Korea. This systematic review analyzed the literature from 2006 to September, 2015. The existing literature was searched in the electronic databases in RISS, KISS and DBPia using the following key words: middle-aged women and depression, menopause and depression, climacterium and depression. Two hundred eighty studies were found through the database. According to PICOTS-SD, twelve studies were included for analysis. Among the twelve studies, four studies were conducted in the nursing field. Six studies were randomized controlled trials. Aerobic exercise, laughter therapy, meditation, aroma massage, counseling and art therapy were performed as non-pharmacological interventions for depression in Korean middle-aged women. The length of each session ranged from 20 to 120 minutes. The intervention period varied from 2 to 24 weeks, and the total number of the interventions ranged from 8 to 72 times. They influenced not only depression, but also physical aspects that are associated with obesity and psychosocial variables, such as anxiety, quality of life, life satisfaction, etc.

Current situation of Translational research on Acupuncture, Moxibustion and Pharmacopuncture (침구와 약침에 대한 중개연구 현황)

  • Sin, Dae Chul;Song, Ho Sueb
    • Journal of Acupuncture Research
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    • v.33 no.2
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    • pp.109-116
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    • 2016
  • Objectives : Our primary objective lies in understanding the current landscape of translational research on acupuncture, moxibustion and pharmacopuncture. Methods : We searched our own selection of keywords of acupuncture, moxibustion and pharmacopuncture and translational research from three overseas databases (Pubmed, Scopus, Medicine) and four domestic databases (DBpia, KISS, Riss4u, Korea Med). Results : We have chosen 41 articles in total-40 articles on acupunture, 6 article on moxibustion(5 articles were duplicated in use in each category). Origin-wise, 48.8 %/24.8 %/17.0 % of our articles pool came from USA/China/Korea, respectively. UK, Austria, Thailand and Italy contributed the rest of our article pool. For those articles written in USA and China, review articles were the most common type. For the US articles, all 10 review articles were non-systematic reviews, while, for China's contribution, one out of 4 review articles were systematic review. Type-wise, our research pool's breakdown is as follows ; 17 review articles, 11 experimental research, 2 randomized controlled trials(RCT), 1 clinical trial, 4 conference reports, 1 letter, 1 study protocol and 4 uncategorized. Topic-wise, brain-neurology was most frequently referred with 8 articles, followed by parkinson's disease (3 articles) and epilepsy (2 articles). Conclusion : 1. In terms of research submission articles, Korea appears to be lacking translational research on acupuncture, moxibustion and pharmacopuncture, compared to USA and China, in our view. 2. Unlike the cases of USA and China, most of Korean translational research is limited to doing a T1 level of translational research. In order to bring bench-to-bedside to light. we believe, there should be more studies, and thereby a certain level of activation, to the T2 level of translational research in Korea. 3. Further, in our view there should be more efforts to improve article quality at the T1 level of translational research, which eventually becomes the fundamentals of the next level of research (i.e. T2 research), as well as to increase the number of research submissions, going forward.