• Title/Summary/Keyword: Meta analysis

검색결과 2,677건 처리시간 0.032초

군 간부와 지역주민 간 군 가족복지 지원 인식의 상호지향성 (Mutually Perceive between Military Executive Members and Local Residents on the Military Family Welfare Support)

  • 정미경
    • 한국콘텐츠학회논문지
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    • 제16권2호
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    • pp.25-44
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    • 2016
  • 본 연구는 군 가족복지 지원인식에 대한 군 간부와 지역주민 간 상호지향성을 알아보기 위해 군 간부 217명, 지역주민 191명을 대상으로 설문조사를 실시하였다. 연구결과, 첫째, 두 집단 간 인식의 객관적 일치도에서, 군 간부들은 지역사회의 지원 필요성을 보다 높게 인식하고 있으며, 두 집단 간 인식은 불일치하였다. 둘째, 두 집단 간 인식의 주관적 일치도(1)에서, 군 간부의 실제 지원인식 정도와 군 간부 추정 지역주민의 지원인식 간에는 상호 불일치하였다. 주관적 일치도(2)에서, 지역주민의 실제 지원인식과 지역주민 추정 군 간부의 요구 간에는 상호 불일치하였다. 셋째, 두 집단 간 인식의 정확도(1)에서, 군 간부는 지역사회에 보다 더 높은 지원을 요구하는 반면, 지역주민이 추정하기에 군 간부들은 지역사회 지원 요구가 그다지 높지 않을 것이라고 인식하고 있는 것으로 나타났다. 정확도(2)에서, 지역주민의 실제 지원인식과 군이 추정한 지역주민의 지원인식 간에는 일치하지 않았다. 넷째, 두 집단 간 인식의 메타동의에서, 군 가족복지 지원에 대하여 군 간부가 추정하고 있는 지역주민 인식과 지역주민이 추정하고 있는 군 간부의 인식은 낮은 수준에서 일치한 것으로 나타났다.

A Systematic Review of MRI, Scintigraphy, FDG-PET and PET/CT for Diagnosis of Multiple Myeloma Related Bone Disease - Which is Best?

  • Weng, Wan-Wen;Dong, Meng-Jie;Zhang, Jun;Yang, Jun;Xu, Qin;Zhu, Yang-Jun;Liu, Ning-Hu
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권22호
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    • pp.9879-9884
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    • 2014
  • Aim: The purpose of the current study was to conduct a systematic review of the published literature to evaluate the diagnostic accuracy of FDG-PET, PTE/CT, MRI and scintigraphy for multiple myeloma related bone disease. Methods: Through a search of PubMed, EMBASE, and the Cochrane Library, two reviewers independently assessed the methodological quality of each study. We estimated pooled sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR), and two sample Z-tests were conducted to evaluate for differences in sensitivity, specificity, area under the curve (AUC), and the $Q^*$ index between any two diagnostic modalities. Results: A total of 17 studies were reviewed. The MRI had a pooled sensitivity of 0.88, specificity of 0.68, AUC of 0.897, and $Q^*$ index of 0.828, whereas for MIBI, the corresponding values were 0.98, 0.90, 0.991, and 0.962, respectively, and for bone scan, they were 066, 0.83, 0.805, and 0.740, respectively. The corresponding values of MIBI were 0.98, 0.90, 0.991, and 0.962, respectively. For PET and PET/CT, the values were 0.91, 0.69, 0.927 and 0.861, respectively. Statistically significant differences were not found in the sensitivity, specificity, AUC, and $Q^*$ index between MRI, scintigraphy, FDG-PET and PET/CT. Conclusions: On the condition that X ray is taken as a reference in our study, we suggested that FDG-PET, PTE/CT, MRI and scintigraphy are all associated with high detection rate of bone disease in patients with MM. Thus, in clinical practice, it is recommended that we could choose these tests according to the condition of the patient.

Effectiveness of Education Interventions for the Management of Cancer Pain: A Systematic Review

  • Lee, Yoon Jae;Hyun, Min Kyung;Jung, Yea Ji;Kang, Min Joo;Keam, Bhumsuk;Go, Su Jin
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권12호
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    • pp.4787-4793
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    • 2014
  • Background: Many cancer patients experience poor pain control due to various factors, including misconceptions regarding the use of opioid analgesics. For management of cancer pain, interventions involving education of both patients and physicians have been attempted. Objectives: This review aimed to assess the current evidence of the benefits of education for the management of cancer pain. Methods: We searched the Medline, EMBASE, Cochrane library, and major Korean databases to identify relevant studies. We included most study designs, but excluded case series. The primary outcomes were pain intensity and quality of life (QoL). Two reviewers assessed the risk of bias using the Cochrane's tool for RCT and Risk of Bias Assessment tool for Non-randomized Studies (RoBANS) for non-randomized studies, independently. Results: After extensive searches, 3,324 publications were screened, and 32 studies were selected. The education interventions used in the included studies included a wide variety of education methods, but the most common method was a booklet produced for patients. Regardless of the education method used, the results of the meta-analysis were as follows. The SMDs of the most severe, average, and current pain in the RCTs were significant. The SMD of worst, average, and current pain were -0.34 (-0.55, -0.13), -0.40 (-0.64, -0.15), and -0.79 (-1.35, -0.23). In the non-randomized studies, the effects on average pain were significant, but those on worst and current pain were not. Conclusions: Education intervention reduced the pain of cancer patients. Therefore, patient education could be considered to be an effective method of cancer pain management. However, our data should be interpreted with caution, and studies using standardized protocols are needed to confirm these observations.

건축을 활용한 초등학교 수학 중심의 융합교육 수업자료 개발 (The Development of STEAM Education Material Focused on Elementary Mathematics Using Architectures)

  • 이종학;윤마병
    • 한국콘텐츠학회논문지
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    • 제14권6호
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    • pp.499-512
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    • 2014
  • 건축은 기술과 예술의 결합체이면서 다양하고 수준 높은 수학 과학적 원리들을 담고 있다. 석굴암과 불국사 대웅전, 부석사 무량수전, 파르테논 신전 등과 같은 국내외의 뛰어난 건축물들에 내재된 흥미로운 수학적 사실들과 원리들을 학습소재로 하여 탐구하는 기회를 학생들에게 제공할 수 있다. 건축물들에 내재된 수학적 사실들을 직접 찾아보고 그 원리들을 탐구해 보는 활동은 학생들에게 수학의 실용성을 인식하고, 왜 공부해야 하는지에 대한 당위성을 부여하면서 학습에 대한 흥미와 관심을 제공할 수 있다. 본 연구는 수학적 원리를 담고 있는 역사적인 건축물들에 대해서 알아보고, 이를 기반으로 건축을 활용한 초등학교 수학 중심의 융합교육(STEAM)자료를 개발 했다. 본 연구의 결과는 다음과 같다. 첫째, 2009개정교육 과정을 바탕으로 초등학교 수학 교과의 '비례', '대칭', '도형의 이동', '쌓기나무', '삼각형' 단원의 목표 및 학습 내용을 분석하여 주제를 선정하고, 적절한 역사적 건축물을 학습소재로 선정하였다. 둘째, 수학적 내용을 담고 있는 역사적 건축물들에 대해서 메타분석을 하였다. 셋째, 교실 수업에서 실제적으로 활용이 가능하도록 건축을 활용한 수학 중심의 25차시 융합교육 자료를 개발하고, 개발한 융합교육 자료에 대한 전문가 집단의 타당도 검사에서 수업 자료로서 적절하다는 평가를 받았다.

The Efficacy of P2Y12 Reactive Unit to Predict the Periprocedural Thromboembolic and Hemorrhagic Complications According to Clopidogrel Responsiveness and Safety of Modification of Dual Antiplatelet Therapy : A Meta-Analysis

  • Kim, Hyun Jung;Oh, Jae Sang;Park, Sukh Que;Yoon, Seok Mann;Ahn, Hyeong Sik;Kim, Bum Tae
    • Journal of Korean Neurosurgical Society
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    • 제63권5호
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    • pp.539-549
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    • 2020
  • The efficacy of P2Y12 reaction unit (PRU) of VerifyNow still remains as a controversial issue in neurointervention. So we investigated the usefulness of PRU of VerifyNow to predict the peri-procedural thromboembolic events (TE) and hemorrhagic events (HE). And we evaluated the safety of modified dual antiplatelet therapy (DAPT) or triple antiplatelet therapy (TAPT) for clopidogrel hyporesponders. We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science and Scopus on August 19 2018. Data was collected the 1) incidence of TE between clopidogrel responder and clopidogrel hypo-responder, 2) incidence of HE between clopidogrel hyper-responder and clopidogrel responder and hypo-responder, and 3) incidence of TE and HE between modified DAPT or TAPT and standard DAPT in clopidogrel hypo-responder. High cut-off value of PRU was defined as PRU >40% or <220. Fifteen studies were enrolled. Clopidogrel responder showed lower incidence of TE than hypo-responder (risk ratio [RR], 0.32; 95% confidence interval [CI], 0.17-0.61; p<0.001). With the high cut-off value of PRU, clopidogrel responder showed more lower incidence of TE than hypo-responder (RR, 0.11; 95% CI, 0.02-0.45; p=0.002). The incidence of periprocedural HE have higher on clopidogrel hyper-responder than clopidogrel responder and hypo-responder (RR, 4.26; 95% CI, 1.10-16.44; p=0.04; I2=66%). The incidence of periprocedural TE after changing regimen of DAPT for clopidogrel hypo-responder have a tendency to reduce, but there was no significant difference between modified DAPT or TAPT group and standard DAPT group (p>0.05). The incidence of periprocedural HE after changing regimen of DAPT for clopidogrel hypo-responder was no significant difference between modified DAPT or TAPT group and standard DAPT group (p>0.05). PRU is a useful tool as a predictor of peri-procedural TE or HE on neurointervention. PRU has a threshold effect of cut-off value to predict the peri-procedural TE. Modified DAPT or TAPT to prevent TE in clopidogrel hypo-responders could not reduce the incidence of TE. We should investigate the further research about modification of regiment on neurointervention.

아동복지기관이 제공하는 서비스품질에 대한 서비스제공자와 이용자간의 상호지향성 (Coorientation between Service Provider and Users about Providing Service Quality by the Child Welfare Agency)

  • 엄경호;박영규
    • 산경연구논집
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    • 제10권5호
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    • pp.67-76
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    • 2019
  • Purpose - The Korean child welfare services may have different feelings between providers and users. Few studies on the child welfare service quality have been conducted and research on the coorientation model of child welfare services are nonexistent. We compared the perceptions of Korean child welfare service providers and users in this study. It will have many applications in the service quality fields by applying a coorientation model. Research design, data, and methodology - In order to enhance user satisfaction with child welfare services, around 200 samples were carried out both in Busan and Kyungsangnamdo randomly. Seven point Likert scale was used in the questionnaire. Two measurements were made to evaluate the different positions on the part of child welfare service providers and users to assess their mutual orientation. Paired t-test verification was conducted for congruency analysis, and the verification of agreement and accuracy was analyzed by independent t-tests. Results - We empirically examined the differences between the providers and the users stance. The results are as follows. We have verified the statistical significance of the difference in perception between providers and users. We also confirmed a degree of agreement, a degree of congruency, a degree of accuracy and a degree of meta agreement in the study. In the Korean child welfare service quality, the coorientation model of process quality appeared in the form of semi-dissensus, the coorientation model of results quality were shown in the form of ignorances and the coorientation model of physical environment quality were investigated in the form of semi-dissensus. Conclusion - The study concluded that users need to understand more about the providers in order to enhance the coorientation model in process quality and physical environmental quality, and the providers need to persuade the users clearly about the positive factors. To enhance the coorientation model of the result quality, it can be misunderstood by guessing that the other party will positively evaluate it. Therefore, users believe that they need to talk more clearly to the provider about the results of the korean child welfare service quality to reduce misunderstandings and to understand each other about the resulting quality.

미국작업치료학회지(AJOT)에 나타난 직업재활에 관한 연구동향 (Research Trends in Vocational Rehabilitation: Through Analysis of Studies in American Journal of Occupational Therapy)

  • 노동희;조은주;감경윤
    • 한국산학기술학회논문지
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    • 제18권5호
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    • pp.436-444
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    • 2017
  • 본 연구는 미국작업치료학회지(AJOT)에 게재된 연구를 바탕으로 작업치료 영역에서 직업재활과 관련된 연구동향을 살펴보고자 실시하였다. 2000년 1월부터 2016년 6월까지 미국작업치료학회지에 게재된 직업재활과 관련 있는 35편의 논문을 대상으로 연구형태, 연구의 질적 수준, 연구대상자, 연구주제 등을 분류하여 기술적 통계를 실시하였다. 연구 분석 결과 연구형태에서는 종설과 메타분석이 8편(22.9%), 질적 및 자연주의적 연구가 7편(20%), 집단비교 및 상관관계연구, 실험 및 결과연구는 각 4편(11.4%), 사례 연구 및 단일대상연구, 설문조사는 각 3편(8.6%)순으로 나타났으며, 질적 수준은 level V 14편(40.0%), 연구 대상자의 진단명은 정신과 환자를 대상으로 한 연구가 7편(33.3%)으로 가장 많았다. 연구주제별 분류 및 결과에서는 직업재활 과정과 관련된 연구 25편(71.4%), 일의 의미 및 가치에 관련된 연구 10편(28.6%)으로 나타났다. 본 연구를 통해 미국의 작업치료 분야에서 직업재활과 관련된 주요 연구동향과 대상자, 연구형태, 질적 수준을 알 수 있었고 추후 국내에서도 직업재활과 관련하여 질적으로도 높고, 다양한 질환을 대상으로 하는 연구가 필요하며 아울러 직업재활의 과정과 일의 의미 및 가치에 대한 연구도 수행되어야 함을 알 수 있었다.

비만과 대사증후군에 관한 임상시험의 최근 경향 (Recent Topics of Clinical Trials in Obesity and Metabolic Study)

  • 이주아;공경환;고호연;배광호;박선영;박경무;송윤경;박정현;김호준;박선주;박정수;고성규
    • 한방비만학회지
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    • 제9권1호
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    • pp.15-22
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    • 2009
  • Objectives The aim of this study is to review and analyze the status on the recent clinical trials of 'obesity' and 'metabolic syndrome'. Methods We search 'www.clinicaltrail.gov' for research trend of Obesity and metabolic syndrome. Search terms used were 'obesity' and 'metabolic syndrome'. In order to see detail review, searching was performed from 01, 01, 2007 to 05, 31, 2009 with intervention, phase III or phase IV, And we classified all the searched studies into design, intervention, purpose, end point, diseases and condition Results We could search total 232 trials. Of them, we found 32 trials with intervention, phase III or phase IV from 01, 01, 2007 to 05, 31, 2009 Also we could see various design of clinical trials. Conclusion To improve obesity and metabolic study in Traditional Korean Medicine, it is need to activate clinical trial, meta analysis, develope of clinical practice guidelines, co-works with conventional medicine and etc.

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자궁경부 상피내종양의 환상투열요법 후 한약치료의 효과 : 체계적 문헌고찰 및 메타분석 (Herbal Medicine for Cervical Intraepithelial Neoplasia After Loop Electrosurgical Excision Procedure: A Systematic Review and Meta-Analysis)

  • 이수정;지해리;이혜정;황덕상;이창훈;장준복;이진무
    • 대한한방부인과학회지
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    • 제33권2호
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    • pp.44-62
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    • 2020
  • Objectives: The purpose of this study is to evaluate the effectiveness of herbal medicine for recovery and treatment of cervical intraepithelial neoplasia (CIN) after loop electrosurgical excision procedure (LEEP). Methods: We searched two english, one chinese and four korean database up to November 4, 2019. Randomised controlled trials (RCTs) were eligible. Primary outcome included Human papilloma virus (HPV) clearance rate and the effective ratio of treatment. And vaginal bleeding time and volume, improvement of symptoms, and recovery of wound were regarded as secondary outcomes. The risk of bias was assessed by two independent authors using the Cochrane risk of bias tool. Results: Of 47 screened, 10 RCTs were included. Number of participants per study ranged from 58 to 360. The studies which used HPV clearance rate as primary outcome were considered as low risk of bias. Most of the studies had considerable heterogeneity in terms of type of intervention, comparison and time-points for outcome measurement. Compared to LEEP alone, herbal vaginal suppository combined group showed favorable results for HPV clearance in patients (5 studies, n=627, 95% CI 1.26 to 1.55, I2=75%). And compared to LEEP alone, herbal external application also showed favorable results for HPV clearance in patients (2 studies, n=252, 95% CI 1.19 to 1.61, I2=86%). Three studies reported mild and temporary adverse events, and no serious adverse events were reported. Conclusions: The studies showed that herbal medicine can significantly effective on recovery of CIN after LEEP. However, included studies suffered from incomplete reporting, high or unclear risk of bias and substantial heterogeneity between studies. In the Future, further high-quality RCTs are needed to prove effectiveness of herbal medicine for CIN after LEEP and reduce the risk of bias.

Association Between Gestational Diabetes Mellitus and Subsequent Risk of Cancer: a Systematic Review of Epidemiological Studies

  • Tong, Gui-Xian;Cheng, Jing;Chai, Jing;Geng, Qing-Qing;Chen, Peng-Lai;Shen, Xin-Rong;Liang, Han;Wang, De-Bin
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권10호
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    • pp.4265-4269
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    • 2014
  • Purpose: This study aimed at summarizing epidemiological evidence of the association between gestational diabetes mellitus (GDM) and subsequent risk of cancer. Materials and Methods: We searched Medline, Embase, Cancer Lit and CINAHL for epidemiological studies published by February 1, 2014 examining the risk of cancer in patients with history of GDM using highly inclusive algorithms. Information about first author, year of publication, country of study, study design, cancer sites, sample sizes, attained age of subjects and methods used for determining GDM status were extracted by two researchers and Stata version 11.0 was used to perform the meta-analysis and estimate the pooled effects. Results: A total of 9 articles documented 5 cohort and 4 case-control studies containing 10,630 cancer cases and 14,608 women with a history of GDM were included in this review. Taken together, the pooled odds ratio (OR) between GDM and breast cancer risk was 1.01 (0.87-1.17); yet the same pooled ORs of case-control and cohort studies were 0.87 (0.71-1.06) and 1.25 (1.00-1.56) respectively. There are indications that GDM is strongly associated with higher risk of pancreatic cancer (HR=8.68) and hematologic malignancies (HR=4.53), but no relationships were detected between GDM and other types of cancer. Conclusions: Although GDM increases the risk of certain types of cancer, these results should be interpreted with caution becuase of some methodological flaws. The issue merits added investigation and coordinated efforts between researchers, antenatal clinics and cancer treatment and registration agencies to help attain better understanding.