• Title/Summary/Keyword: Evidence Combination

Search Result 370, Processing Time 0.026 seconds

Qualitative Assessment and Development of Level of Evidence and Strength of Recommendation Models in the Field of Physical Therapy in Korea (국내 물리치료분야에 대한 질적 평가와 근거 수준 및 권고 등급 모형 개발 방안)

  • Sung-Hyoun Cho;Jeong-Woo Lee
    • Journal of The Korean Society of Integrative Medicine
    • /
    • v.11 no.2
    • /
    • pp.231-242
    • /
    • 2023
  • Purpose : This study aimed to identify ways to improve the quality of physical therapy research and ultimately review the current situation to improve evidence-based decision-making in physical therapy. Methods : For better evidence-based decision-making in physical therapy, researchers should review the quality assessment of articles in more detail and report their findings for valid and appropriate level of evidence and strength of recommendations. The level of evidence affects how well the findings are derived from well-designed literature. The evaluation of the evidence focuses primarily on the study design and the degree of bias that may compromise the validity of the findings. The final recommendation is based on a combination of the study design and literature quality. To uncover gems of information in each paper, a risk of bias assessment should be performed after the literature has been initially selected. Results : Researchers should consider the complexity of the intervention, appropriate grouping, and calculation of effect sizes for the intervention. Researchers conducting systematic reviews should provide a detailed description of the quality assessment performed and present a detailed analysis of their interpretation of the results. The results of systematic reviews and meta-analyses should be interpreted with caution and include a risk of bias assessment. Guidelines for the level of evidence and strength of recommendations should be developed and utilized more broadly to improve reporting practices in physical therapy. Conclusion : Researchers should be knowledgeable about the strengths and limitations of each study design and methodology. In the future, researchers will also need to improve their ability to critically evaluate their findings, given the potential for their results to influence clinical practice.

Metformin Synergistically Potentiates the Antitumor Effects of Imatinib in Colorectal Cancer Cells

  • Lee, Jaeryun;Park, Deokbae;Lee, Youngki
    • Development and Reproduction
    • /
    • v.21 no.2
    • /
    • pp.139-150
    • /
    • 2017
  • Metformin is the most commonly prescribed anti-diabetic drug with relatively minor side effect. Substantial evidence has suggested that metformin is associated with decreased cancer risk and anticancer activity against diverse cancer cells. The tyrosine kinase inhibitor imatinib has shown powerful activity for treatment of chronic myeloid leukemia and also induces growth arrest and apoptosis in colorectal cancer cells. In this study, we tested the combination of imatinib and metformin against HCT15 colorectal cancer cells for effects on cell viability, cell cycle and autophagy. Our data show that metformin synergistically enhances the imatinib cytotoxicity in HCT15 cells as indicated by combination and drug reduction indices. We also demonstrate that the combination causes synergistic down-regulation of pERK, cell cycle arrest in S and $G_2/M$ phases via reduction of cyclin B1 level. Moreover, the combination resulted in autophagy induction as revealed by increased acidic vesicular organelles and cleaved form of LC3-II. Inhibition of autophagic process by chloroquine led to decreased cell viability, suggesting that induction of autophagy seems to play a cell protective role that may act against anticancer effects. In conclusion, our present data suggest that metformin in combination with imatinib might be a promising therapeutic option in colorectal cancer.

Transcriptome analysis of iBET-151, a BET inhibitor alone and in combination with paclitaxel in gastric cancer cells

  • Kang, Sun Kyoung;Bae, Hyun Joo;Kwon, Woo Sun;Che, Jingmin;Kim, Tae Soo;Chung, Hyun Cheol;Rha, Sun Young
    • Genomics & Informatics
    • /
    • v.18 no.4
    • /
    • pp.37.1-37.11
    • /
    • 2020
  • BET inhibitor, as an epigenetic regulator inhibitor, reduces the expression of oncogenes such as Myc and Bcl-2, which affects cancer growth and development. However, it has modest activity because of the narrow therapeutic index. Therefore, combination therapy is necessary to increase the anti-tumor effect. Paclitaxel, an anti-mitotic inhibitor, is used as second-line therapy for gastric cancer (GC) as a monotherapy or combination. In this study, we performed RNA sequencing of GC cells treated with iBET-151 and/or paclitaxel to identify the differentially expressed genes associated with possible mechanisms of synergistic effect. We also performed Gene Ontology enrichment and Kyoto Encyclopedia of Genes and Genomes pathway analyses to determine the most enriched terms and pathways of upregulated and downregulated genes. We found 460 genes in which iBET-151 and paclitaxel combination treatment changed more than single-treatment or no-treatment. Thus, additional functional studies are needed, but our results provide the first evidence of the synergistic effect between iBET-151 and paclitaxel in regulating the transcriptome of GC cells.

The Need for Evidence-Based Treatment and Standardization in Korean Medicine - Focusing on Consumer Opinions from the Ministry of Health and Welfare's Survey on Usage of Korean Medicine (2008, 2011, and 2014) - (한의학에서 근거중심진료와 표준화의 필요성 - 2008, 2011, 2014년 한방의료이용실태조사(보건복지부)중 소비자의견을 중심으로 -)

  • Sung, Angela Dong Min;Heo, Seung;Oh, Hyun Ho;Lee, Jung Jun;Park, Sung Joon;Lee, Sundong
    • Journal of Society of Preventive Korean Medicine
    • /
    • v.20 no.3
    • /
    • pp.31-43
    • /
    • 2016
  • Objectives : It focuses on what the consumers expected Korean medicine to improve on, and analyzes patients' impressions. Methods : This research is based on the Ministry of Health and Welfare's Survey on Usage of Korean Medicine (2008, 2011, and 2014) and was new analysis for our research objective. Results : The general consensus among the consumers was uncertainty of effectiveness, expensive costs, side effects, need for expertise, lack of scientific evidence, expansion of diseases treated, and improvement of equipment. Consumers distrusted Korean medicine due to its uncertainty of its effectiveness, expensive costs, side effects, and lack of scientific evidence for its effectiveness, and avoided using Korean medicine. Conclusions : These results seem to be a combination of the Korean medicinal doctors treating patients not based on evidence but on their individual experiences, lack of health insurance for Korean medicine resulting in expensive costs, lack of research on toxicity and safety of Korean medicine, and lack of scientific and clinical studies for evidence-based research. To solve these problems, the Korean medicine community needs to standardize treatments based on evidence, and look to Chinese medicine for possible solutions.

Feature Extraction and Fusion for land-Cover Discrimination with Multi-Temporal SAR Data (다중 시기 SAR 자료를 이용한 토지 피복 구분을 위한 특징 추출과 융합)

  • Park No-Wook;Lee Hoonyol;Chi Kwang-Hoon
    • Korean Journal of Remote Sensing
    • /
    • v.21 no.2
    • /
    • pp.145-162
    • /
    • 2005
  • To improve the accuracy of land-cover discrimination in SAB data classification, this paper presents a methodology that includes feature extraction and fusion steps with multi-temporal SAR data. Three features including average backscattering coefficient, temporal variability and coherence are extracted from multi-temporal SAR data by considering the temporal behaviors of backscattering characteristics of SAR sensors. Dempster-Shafer theory of evidence(D-S theory) and fuzzy logic are applied to effectively integrate those features. Especially, a feature-driven heuristic approach to mass function assignment in D-S theory is applied and various fuzzy combination operators are tested in fuzzy logic fusion. As experimental results on a multi-temporal Radarsat-1 data set, the features considered in this paper could provide complementary information and thus effectively discriminated water, paddy and urban areas. However, it was difficult to discriminate forest and dry fields. From an information fusion methodological point of view, the D-S theory and fuzzy combination operators except the fuzzy Max and Algebraic Sum operators showed similar land-cover accuracy statistics.

Effectiveness of Acupuncture for Scoliosis: A Systematic Review

  • Choi, Seong-Kyeong;Jo, Hyo-Rim;Moon, Jeong-Hyun;Jang, Jung-Eun;Park, Seo-Hyun;Sung, Won-Suk;Geum, Dong-Ho;Kim, Eun-Jung
    • Journal of Acupuncture Research
    • /
    • v.39 no.1
    • /
    • pp.17-28
    • /
    • 2022
  • Scoliosis is a 3-dimensional change of the spine, presenting 10° above Cobb angle. Various acupuncture methods are being increasingly performed to correct scoliosis. However, no systematic review has been published. Therefore, we report on the effectiveness of acupuncture on mild scoliosis in this systematic review. We searched various databases for acupuncture treatment for scoliosis published before June 2021. The primary outcome was Cobb angle, and the secondary outcomes were patient-centered scores. Six studies were identified. RCTs that compared combination therapy with acupuncture, and other treatment methods and showed significant improvement in the Cobb angle, and effective rate, but, with low quality evidence. Acupuncture monotherapy resulted in significant improvement in the Cobb angle and had high heterogeneity compared with other treatment methods, but no significant improvement in the effective rate was observed, and the quality of evidence was low. Regardless of the type of scoliosis, acupuncture monotherapy or combination therapy with acupuncture showed significant improvement in the Cobb angle, and the quality of evidence was moderate. No serious adverse events were observed in the 6 studies reviewed. Acupuncture is considered safe, and it is more effective when performed with other conventional treatments.

Korean Medicine for Women Infertility (여성 난임과 한의학 (다낭성난소증후군으로 인한 난임의 한양방 치료))

  • Hwang, Deok-sang
    • Journal of East-West Nursing Research
    • /
    • v.28 no.2
    • /
    • pp.100-108
    • /
    • 2022
  • Korean medicine has traditionally provided a lot of medical care for the treatment of infertility. The combination treatment of Korean medicine and Western medicine can be effective for infertility to improve the problems caused by the extremely low fertility rate and the aging of pregnant women. In relation to female infertility, we reviewed the evidence for Korean medicine treatment for polycystic ovary syndrome, which has recently been increasing interest in female infertility, and the evidence for the collaboration between Korean and Western medicine in the treatment of polycystic ovary syndrome and infertility. Because polycystic ovary syndrome is closely related to metabolic diseases related to endocrine abnormalities, hormone treatment alone has limited therapeutic effects and has side effects. In domestic and international research, herbal medicine and acupuncture in the treatment of infertility have shown good clinical effects based on the hypothesis of various mechanisms of effect, and many cases of successful pregnancy have been reported. Although continuous research through large-scale randomized clinical studies is needed to prove efficacy, the importance of combined treatment of Korean medicine and Western medicine in infertility treatment is increasing in order to solve the extremely low fertility rate. Combining artificial insemination or in vitro fertilization with Korean medicine treatment is highly likely to be effective in increasing pregnancy success and fertility rates. In women with polycystic ovary syndrome, which is recognized as a metabolic disease due to endocrine abnormalities among the causes of female infertility, Korean medicine treatment can increase the pregnancy rate with herbal medicines and acupuncture, etc. Although well-designed large-scale clinical studies are currently lacking and meta-analysis has not provided sufficient evidence, the combination treatment of Korean medicine and Western medicine is more active to increase the pregnancy rate for solving the problem of low fertility.

Forecasting Exchange Rates: An Empirical Application to Pakistani Rupee

  • ASADULLAH, Muhammad;BASHIR, Adnan;ALEEMI, Abdur Rahman
    • The Journal of Asian Finance, Economics and Business
    • /
    • v.8 no.4
    • /
    • pp.339-347
    • /
    • 2021
  • This study aims to forecast the exchange rate by a combination of different models as proposed by Poon and Granger (2003). For this purpose, we include three univariate time series models, i.e., ARIMA, Naïve, Exponential smoothing, and one multivariate model, i.e., NARDL. This is the first of its kind endeavor to combine univariate models along with NARDL to the best of our knowledge. Utilizing monthly data from January 2011 to December 2020, we predict the Pakistani Rupee against the US dollar by a combination of different forecasting techniques. The observations from M1 2020 to M12 2020 are held back for in-sample forecasting. The models are then assessed through equal weightage and var-cor methods. Our results suggest that NARDL outperforms all individual time series models in terms of forecasting the exchange rate. Similarly, the combination of NARDL and Naïve model again outperformed all of the individual as well as combined models with the lowest MAPE value of 0.612 suggesting that the Pakistani Rupee exchange rate against the US Dollar is dependent upon the macro-economic fundamentals and recent observations of the time series. Further evidence shows that the combination of models plays a vital role in forecasting, as stated by Poon and Granger (2003).

Systematic review of the effect of coenzyme Q10 on antioxidant capacity while focused on evaluation of claims for health functional food (건강기능식품의 기능성을 중심으로 한 코엔자임Q10의 항산화 기능성에 대한 체계적 고찰)

  • Kim, Ji Yeon;Jeong, Sewon;Paek, Ju Eun;Kim, Joohee;Kwak, Jin Sook;Lee, Yoon Jung;Kang, Tae Seok;Kwon, Oran
    • Journal of Nutrition and Health
    • /
    • v.46 no.3
    • /
    • pp.218-225
    • /
    • 2013
  • Although the functional ingredient has been evaluated by the Korea Food and Drug Administration (KFDA) based on scientific evidence, the levels of scientific evidence and consistency of the results might vary according to emerging data. Therefore, periodic re-evaluation may be needed for some functional ingredients. In this study, we re-evaluated scientific evidence for the antioxidant activity of coenzyme Q10 as a functional ingredient in health functional food. Literature searches were conducted using the Medline and Cochrane, KISS, and IBIDS databases for the years 1955-2010 with the search term of coenzyme Q10 in combination with antioxidant. The search was limited to human studies published in Korean, English, and Japanese. Using the KFDA's evidence based evaluation system for scientific evaluation of health claims, 33 human studies were identified and reviewed in order to evaluate the strength of the evidence supporting a relation between coenzyme Q10 and antioxidant activity. Among 33 studies, significant effects for antioxidant activities were reported in 22 studies and their daily intake amount was 60 to 300 mg. Based on this systematic review, we concluded that there was possible evidence to support a relation between coenzyme Q10 intake and antioxidant activities. However, because inconsistent results have recently been reported, future studies should be monitored.

Systematic Review and Meta-Analysis of Efficacy and Safety of Fire Needling and Warm Needling on Acute Gout

  • Ji Hye Hwang;Aejin Song;Ho-Sueb Song
    • Journal of Pharmacopuncture
    • /
    • v.25 no.4
    • /
    • pp.301-316
    • /
    • 2022
  • Objectives: This study aimed to evaluate the efficacy and safety of heat stimuli (e.g., fire needling, warm needling) in acupuncture for acute gout. Methods: Four international online databases (PubMed, Cochrane, Embase, and Chinese National Knowledge Infrastructure) were searched to identify randomized, controlled trials (RCTs) that used fire needling and warm needling for acute gout. The methodological quality of the RCTs was evaluated using the Cochrane risk-of-bias (RoB) tool. Thirteen RCTs (840 patients) were included and analyzed. Three evaluation tools (total effective rate, uric acid level, and pain score) were mainly used. Comparisons were made between Western medicine (WM) and i) fire needling or warm needling treatment alone, ii) fire needling and bloodletting combination treatment, iii) combination of fire needling, bloodletting, and herbal medicine, iv) warm needling (concurrently). Heat stimuli in acupuncture alone or in combination treatment were more effective in terms of the total efficacy rates, uric acid levels, and pain scores than WM alone. Results: In all the evaluation tools, the treatment effects in the fire needling alone or warm needling alone treatment group and the fire needling and bloodletting combination intervention group were significantly better than those in the WM control group. The warm needling and WM combination intervention groups also experienced significantly better treatment effects in terms of total efficacy rates and uric acid levels. Only the pain scores in the fire needling, bloodletting, and herbal medicine combination groups demonstrated significant improvement. Only four studies mentioned adverse reactions: one reported loss of appetite; three studies reported none. According to the Cochrane RoB tool, most studies showed either high or uncertain RoB. Conclusion: Heat stimuli during acupuncture could be effective for acute gout. However, as the included studies were regionally biased, more high-quality studies are needed to confirm the level of evidence.