• Title/Summary/Keyword: Meta-Evaluation

Search Result 365, Processing Time 0.023 seconds

Abiraterone for Treatment of Metastatic Castration-resistant Prostate Cancer: a Systematic Review and Meta-analysis

  • Zhou, Zhi-Rui;Liu, Shi-Xin;Zhang, Tian-Song;Xia, Jun;Li, Bo
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.15 no.3
    • /
    • pp.1313-1320
    • /
    • 2014
  • Introduction: Although most prostate cancers initially respond to castration with luteinizing hormonereleasing analogues or bilateral orchiectomy, progression eventually occurs. Based on the exciting results of several randomized controlled trials (RCTs), it seems that patients with metastatic castration-resistant prostate cancer (mCRPC) might benefit more from treatment withabiraterone. Therefore we conducted a systematic review to evaluate the efficacy and toxicity of abiraterone in the treatment of mCRPC. Methods: Literature was searched from Embase, PubMed, Web of Science, and Cochrane Library up to July, 2013. Quality of the study was evaluated according to the Cochrane's risk of bias of randomized controlled trial (RCT) tool, then the Grading of Recommendations Assessment, Development and Evaluation (GRADE) System was used to rate the level of evidence. Stata 12.0 was used for statistical analysis. Summary data from RCTs comparing abiraterone plus prednisone versus placebo plus prednisone for mCRPC were meta-analyzed. Pooled hazard ratios (HRs) for overall survival (OS), radiographic progression-free survival (RPFS) and time to PSA progression (TTPP); Pooled risk ratios (RR) for PSA response rate, objective response rate and adverse event were calculated. Results: Ten trials were included in the systematic review; Data of 2,283 patients (1,343 abiraterone; 940 placebo) from two phase 3 trials: COU-AA-301 and COU-AA-302 were meta-analyzed. Compared with placebo, abiraterone significantly prolonged OS (HR, 0.74; 95% confidence interval [CI], 0.66 to 0.84), RPFS (HR, 0.59; 95% CI, 0.48 to 0.74) and time to PSA progression (HR, 0.55; 95% CI, 0.43 to 0.70); it also significantly increased PSA response rate (RR, 3.63; 95% CI, 1.72 to 7.65) and objective response rate (RR, 3.05; 95% CI, 1.51 to 6.15). This meta-analysis suggested that the adverse events caused by abiraterone are acceptable and can be controlled. Conclutios: Abiraterone significantly prolonged OS, RPFS and time to progression patients with mCRPC, regardless of prior chemotherapy or whether chemotherapy-na$\ddot{i}$ve, and no unexpected toxicity was evident. Abiraterone can serve as a new standard therapy for mCRPC.

A Systematic Review and Meta-Analysis of Herbal Medicine for Frozen Shoulder (동결견의 한약 치료에 대한 체계적 문헌고찰 및 메타분석)

  • Oh, Tae-Young;Kim, Yeon-Hee;Oh, Eun-Mi;Hong, Su-Min;Ha, Hyun-Ju;Lee, Eun-Jung;Oh, Min-Seok
    • Journal of Korean Medicine Rehabilitation
    • /
    • v.29 no.3
    • /
    • pp.15-33
    • /
    • 2019
  • Objectives The objective of this study is to provide the evidence of the effectivness of herbal medicine for frozen shoulder. Methods 2 Korean medical on-line databases (Oriental Medicine Advanced Searching Integrated System, Korean Traditional Knowledge), and 3 foreign databases (Pubmed, Cochrane library, China National Knowledge Infrastructure) were searched to find articles concerning herbal medicine for frozen shoulder. We selected randomized controlled trials (RCTs). Several repeated articles and those not relevant to the topic were excluded, as well as review articles and commentaries. The methodological quality of RCTs were evaluated using the Cochrane risk of bias tool and meta-analyes were perfomed. Results Total 474 studies were founded and 22 RCTs were selected for systematic review. Efficiency rate was used as the primary evaluation method. Almost studies reported that herbal medicine has significant effect on pain reduction, increasing shoulder function on frozen shoulder. 3 studies comparing herbal medicine and chuna with chuna and 3 studies comparing herbal medicine with ibuprofen were included in the meta-analysis. At herbal medicine and chuna with chuna meta-analysis, it showed positive results of herbal medicine for efficiency rate (risk ratio: 1.18, 95% confidence interval: 1.09-1.27, p<0.0001). At herbal medicine with ibuprofen medta-analysis, it showed positive results of herbal medicine for efficiency rate (risk ratio: 1.15, 95% confidence interval: 1.05-1.27, p=0.003). Conclusions The studies showed that herbal medicine can significantly effective on frozen shoulder. However, the risk of bias in RCTs were evaluated as uncertain. In the future, further well-designed RCTs are needed to prove the effectiveness of herbal medicine for frozen shoulder and reduce the risk of bias.

Value in math learning according to socio-cultural background and meta-affect of secondary school students (중등학생들의 사회문화적 배경과 메타정의에 따른 수학 학습에서의 가치 인식)

  • Kim, Sun Hee
    • The Mathematical Education
    • /
    • v.62 no.3
    • /
    • pp.327-340
    • /
    • 2023
  • The value that students consider important in math learning may vary depending on the student's socio-cultural background and personal experience. Although socio-cultural backgrounds are very diverse, I considered overseas vs domestic Koreans, and secondary school levels as variables in terms of students' educational experiences. Overseas students had a lower perception of the value in mathematics than domestic students, especially about understanding mathematics knowledge and the value of the latest teaching and learning methods. Middle school students perceived the value of mathematics as an activity higher than that of high school students, and high school students perceived student agency as a higher value than middle school students. In addition, I considered meta-affect as one of the individual students' experiences, finally meta-affect was a variable that could explain value perception in math learning, and in particular, affective awareness of achievement, affective evaluation of value, and affective using were significant. From the results, I suggested that research on ways to improve the value and the meta-affect in math learning, test to measure the value of students in math learning, the expansion of research subjects to investigate the value in math learning, and a teacher who teaches overseas Koreans are needed.

Effectiveness of Two-dose Varicella Vaccination: Bayesian Network Meta-analysis

  • Kwan Hong;Young June Choe;Young Hwa Lee;Yoonsun Yoon;Yun-Kyung Kim
    • Pediatric Infection and Vaccine
    • /
    • v.31 no.1
    • /
    • pp.55-63
    • /
    • 2024
  • Purpose: A 2-dose varicella vaccination strategy has been introduced in many countries worldwide, aiming to increase vaccine effectiveness (VE) against varicella infection. In this network meta-analysis, we aimed to provide a comprehensive evaluation and an overall estimated effect of varicella vaccination strategies, via a Bayesian model. Methods: For each eligible study, we collected trial characteristics, such as: 1-dose vs. 2-dose, demographic characteristics, and outcomes of interest. For studies involving different doses, we aggregated the data for the same number of doses delivered into one arm. The preventive effect of 1-dose vs. 2-dose of varicella vaccine were evaluated in terms of the odds ratio (OR) and corresponding equal-tailed 95% confidence interval (95% CI). Results: A total of 903 studies were retrieved during our literature search, and 25 interventional or observational studies were selected for the Bayesian network meta-analysis. A total of 49,265 observed individuals were included in this network meta-analysis. Compared to the 0-dose control group, the OR of all varicella infections were 0.087 (95% CI, 0.046-0.164) and 0.310 (95% CI, 0.198-0.484) for 2-doses and one-dose, respectively, which corresponded to VE of 69.0% (95% CI, 51.6-81.2) and VE of 91.3% (95% CI, 83.6-95.4) for 1- and 2-doses, respectively. Conclusions: A 2-dose vaccine strategy was able to significantly reduce varicella burden. The effectiveness of 2-dose vaccination on reducing the risk of infection was demonstrated by sound statistical evidence, which highlights the public health need for a 2-dose vaccine recommendation.

A Systematic Review and Meta-Analysis of the Effects of Action Learning-Based Education Program on Nursing Students (간호대학생의 액션러닝 기반 교육프로그램 효과에 대한 체계적 문헌고찰 및 메타분석)

  • Mi-Hyeon Park;Yong-Joo Cho
    • Journal of Practical Engineering Education
    • /
    • v.16 no.4
    • /
    • pp.587-598
    • /
    • 2024
  • This study aimed to evaluate the effectiveness of an action learning-based educational program for domestic nursing students. A systematic review and meta-analysis were conducted following PRISMA guidelines. Limited to the period from January 2013 to December 2023, a search conducted across the electronic databases DBpia, RISS, KCI, KISS, and SCIENCE ON identified a total of 779 documents. From these, 13 documents that met the established selection criteria were ultimately included. Thirteen documents meeting the selection criteria were identified, and quality evaluation was independently performed by two researchers using ROBINS-I. The effect size of the action learning-based education program was analyzed using the 'Meta package' in the R program. The effect size for problem-solving was ESr=.68 (95% CI=.30 to 1.06). For communication skills, the effect size was ESr=.39 (95% CI=-.08 to .85), and for critical thinking, the effect size was ESr=.26 (95% CI=.02 to .50). Action learning-based educational programs have been shown to be an effective method for enhancing problem-solving skills and critical thinking among nursing students. Therefore, there is a need for the active implementation of action learning techniques to further develop nursing students' clinical practice capabilities within nursing education.

LI-RADS Treatment Response versus Modified RECIST for Diagnosing Viable Hepatocellular Carcinoma after Locoregional Therapy: A Systematic Review and Meta-Analysis of Comparative Studies (국소 치료 후 잔존 간세포암의 진단을 위한 LI-RADS 치료 반응 알고리즘과 Modified RECIST 기준 간 비교: 비교 연구를 대상으로 한 체계적 문헌고찰과 메타분석)

  • Dong Hwan Kim;Bohyun Kim;Joon-Il Choi;Soon Nam Oh;Sung Eun Rha
    • Journal of the Korean Society of Radiology
    • /
    • v.83 no.2
    • /
    • pp.331-343
    • /
    • 2022
  • Purpose To systematically compare the performance of liver imaging reporting and data system treatment response (LR-TR) with the modified Response Evaluation Criteria in Solid Tumors (mRECIST) for diagnosing viable hepatocellular carcinoma (HCC) treated with locoregional therapy (LRT). Materials and Methods Original studies of intra-individual comparisons between the diagnostic performance of LR-TR and mRECIST using dynamic contrast-enhanced CT or MRI were searched in MEDLINE and EMBASE, up to August 25, 2021. The reference standard for tumor viability was surgical pathology. The meta-analytic pooled sensitivity and specificity of the viable category using each criterion were calculated using a bivariate random-effects model and compared using bivariate meta-regression. Results For five eligible studies (430 patients with 631 treated observations), the pooled per-lesion sensitivities and specificities were 58% (95% confidence interval [CI], 45%-70%) and 93% (95% CI, 88%-96%) for the LR-TR viable category and 56% (95% CI, 42%-69%) and 86% (95% CI, 72%-94%) for the mRECIST viable category, respectively. The LR-TR viable category provided significantly higher pooled specificity (p < 0.01) than the mRECIST but comparable pooled sensitivity (p = 0.53). Conclusion The LR-TR algorithm demonstrated better specificity than mRECIST, without a significant difference in sensitivity for the diagnosis of pathologically viable HCC after LRT.

A Systematic Review and Meta-Analysis of Moxibustion Treatment for Knee Osteoarthritis

  • Park, Jang Mi;Lee, Cham Kyul;Kim, Kyung Ho;Kim, Eun Jung;Jung, Chan Yung;Seo, Byung-Kwan;Goo, Bon Hyuk;Baek, Yong Hyeon;Lee, Eun Yong
    • Journal of Acupuncture Research
    • /
    • v.37 no.3
    • /
    • pp.137-150
    • /
    • 2020
  • The purpose of this study was to evaluate the evidence supporting the effectiveness of moxibustion treatment for osteoarthritis. There were 9 databases used to retrieve randomized controlled trials (RCTs) that used moxibustion as treatment for osteoarthritis. The quality of methodology for the RCTs was assessed using the Cochrane Risk of Bias tool [Review Manager (RevMan) Version 5.3 Windows, The Nordic Cochrane Centre, Copenhagen, Denmark]. The inclusion criteria for this review was met by 27 RCTs. All studies were conducted in China. A 4-week moxibustion treatment period was the most common. EX-LE4 and SP10 and GB34 acupoints were most frequently selected in the treatment of osteoarthritis. The most commonly used evaluation index was the visual analog scale (VAS). All studies, including a meta-analysis showed that moxibustion treatments were statistically significantly effective at treating knee osteoarthritis. However, well-designed randomized RCTs without a high risk of bias should be designed in the future.

Neoadjuvant Chemotherapy for Resectable Esophageal Carcinoma: A Meta-analysis of Randomized Clinical Trials

  • Xu, Xiao-Hua;Peng, Xue-Hong;Yu, Ping;Xu, Xiao-Yuan;Cai, Er-Hui;Guo, Pi;Li, Ke
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.13 no.1
    • /
    • pp.103-110
    • /
    • 2012
  • Neoadjuvant chemotherapy for resectable esophageal carcinoma has been a focus of study, but no agreement has been reached on clinical randomized controlled trials and relevant systematic evaluation. The purpose of this study was to perform a meta-analysis on published randomized controlled trials (RCTs) that compared neoadjuvant chemotherapy and surgery with surgery alone for resectable esophageal carcinoma. Medline and manual searches was conducted in PubMed, ASCO (American Society of Clinical Oncology) meeting summary, Embase, the Cochrane Library (up to October 2010), Chinese Biomedical Literature Database, China National Knowledge Infrastructure, VIP Database, Wanfang Database. The selection contents were to identify all published and unpublished RCTs that compared neoadjuvant chemotherapy and surgery with surgery alone for resectable esophageal carcinoma. Sixteen RCTs which included 2,594 patients were selected. The risk ratio (RR) (95% confidence interval [CI]; P value), expressed as neoadjuvant chemotherapy and surgery versus surgery alone (treatment versus control), was 1.02 (0.95, 1.10; P=0.54) for 1-year survival, 1.29 (1.13, 1.47; P=0.0001) for 3-year survival, 1.31 (1.13, 1.51; P=0.0003) for 5-year survival, 1.00 (0.95, 1.04; P= 0.85) for rate of resection and 0.89 (0.64, 1.23; P=0.48) for operative mortality. The results showed that neoadjuvant chemotherapy for resectable esophageal carcinoma can raise the overall survival rate of patients with esophageal carcinoma, but it does not affect treatment-related mortality.

Experimental Investigation of Macroscopic Analysis of Traffic Safety Using Meta Analysis Focused on Busan Metropolitan City (메타분석을 이용한 교통안전성의 거시적 분석에 대한 실험적 고찰 : 부산광역시를 중심으로)

  • Park, Jongseo;Oh, Yun Pyo;Kim, Hoe Kyoung;Ahn, Woosung
    • KSCE Journal of Civil and Environmental Engineering Research
    • /
    • v.35 no.6
    • /
    • pp.1339-1345
    • /
    • 2015
  • Korean government annually estimates and reports the traffic safety index to evaluate the traffic safety of 228 Gu Gun. However, since the traffic safety index is derived from the spatially macroscopic perspective based on collected relative data, there are a couple of problems such as inability to investigate the individual traffic accidents on the spot, insecurity of accuracy and reliability of traffic safety index estimation method, and absence of establishing temporal relationship of traffic accidents. Thus, this study investigated temporal traffic safety in macroscopic manner for Gu Gun in Busan depending on the installation of the traffic safety facility (i.e., urban median), employing meta analysis. As a result, all Gu Gun in Busan except Saha, Buk, Dong, and Busanjin experienced more traffic accidents after installing the urban median, indicating that there are more rooms for improvement of macroscopic traffic safety evaluation.

Interventions for anesthetic success in symptomatic irreversible pulpitis: A network meta-analysis of randomized controlled trials

  • Sivaramakrishnan, Gowri;Alsobaiei, Muneera;Sridharan, Kannan
    • Journal of Dental Anesthesia and Pain Medicine
    • /
    • v.19 no.6
    • /
    • pp.323-341
    • /
    • 2019
  • Background: Local anesthetics alone or in combination with adjuncts, such as oral medications, have routinely been used for pain control during endodontic treatment. The best clinical choice amongst the vast numbers of agents and techniques available for pain control for irreversible pulpitis is unclear. This network meta-analysis combined the available evidence on agents and techniques for pulpal anesthesia in the maxilla and mandible, in order to identify the best amongst these approaches statistically, as a basis for future clinical trials. Methods: Randomized trials in MEDLINE, DARE, and COCHRANE databases were screened based on inclusion criteria and data were extracted. Heterogeneity was assessed and odds ratios were used to estimate effects. Inconsistencies between direct and indirect pooled estimates were evaluated by H-statistics. The Grading of Recommendation, Assessment, Development, and Evaluation working group approach was used to assess evidence quality. Results: Sixty-two studies (nine studies in the maxilla and 53 studies in the mandible) were included in the meta-analysis. Increased mandibular pulpal anesthesia success was observed on premedication with aceclofenac + paracetamol or supplemental 4% articaine buccal infiltration or ibuprofen+paracetamol premedication, all the above mentioned with 2% lignocaine inferior alveolar nerve block (IANB). No significant difference was noted for any of the agents investigated in terms of the success rate of maxillary pulpal anesthesia. Conclusion: Direct and indirect comparisons indicated that some combinations of IANB with premedication and/or supplemental infiltration had a greater chance of producing successful mandibular pulpal anesthesia. No ideal technique for maxillary anesthesia emerged. Randomized clinical trials with increased sample size may be needed to provide more conclusive data. Our findings suggest that further high-quality studies are required in order to provide definitive direction to clinicians regarding the best agents and techniques to use for mandibular and maxillary anesthesia for irreversible pulpitis.