• 제목/요약/키워드: Randomized Clinical Trials

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The Efficacy of Visual Activity Schedule Intervention in Reducing Problem Behaviors in Children With Attention-Deficit/Hyperactivity Disorder Between the Age of 5 and 12 Years: A Systematic Review

  • Thomas, Naveena;Karuppali, Sudhin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제33권1호
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    • pp.2-15
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    • 2022
  • Objectives: Children with attention-deficit/hyperactivity disorder (ADHD) tend to be noisy and violate rules with their disruptive behaviors, resulting in greater difficulties with off-task behaviors and being at risk for social refusal. The visual activity schedule (VAS) intervention program is a frequently used method to teach multiple skills involving on-task, use of schedules, transition behaviors, social initiation, independent play skills, classroom skills, and academic skills. The current systematic review aimed to examine the efficacy of using VAS intervention in reducing problem behaviors in children with ADHD between 5 and 12 years of age. Methods: Systematic searches were conducted using two electronic databases (PubMed and Scopus) to identify relevant studies published in English between 2010 and 2020. Four studies met the inclusion criteria: two studies examined the effect of schedule-based tasks and the use of an iPad on classroom skills, while the other two examined randomized clinical trials (RCTs) of psychosocial treatment for ADHD inattentive type and a cross-sectional study examined the impact of the group size on task behavior and work productivity in children with ADHD. Results: The findings indicate that the interventions used in all four studies could lead to increased satisfaction among participants and parents, as well as a reduction in problem behavior. In terms of the research indicators, the RCT had low quality, while the others were of high quality. Conclusion: A larger number of studies and the ADHD clinical population would help to increase the generalizability of future reviews of treatments in this context.

두드러기의 한약 치료에 대한 최근 국내외 임상 연구 동향 (Research Trend of Herbal Medicine Treatments for Urticaria)

  • 남혜진;박재은;김현진;안재영;신나영;전명규;이영진;채고은;고아라;조혜정;김현우
    • 한방안이비인후피부과학회지
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    • 제35권2호
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    • pp.49-60
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    • 2022
  • Objectives : The purpose of this review is to overview the research trend of herbal medicine for urticaria. Methods : We searched for studies of urticaria treated with herbal medicine published from 2010 until March 2022, through 5 web databases. After searching studies, we analyzed selected studies. Results : As a result, 7 studies have been found and analyzed. Three studies were randomized controlled trials, and four studies were before & after clinical research. All of research which selected have reported that herbal medicine treatment was effective for urticaria. Conclusion : According to the results, herbal medicine treatments can be effective treatment for urticaria. Further clinical studies are expected using evaluation methods to analyze the results and to establish high level of evidence.

비알코올 지방간질환에 대한 한의학 연구 동향 보고: 국내 논문을 중심으로 (A Review of Research Trends in Traditional Korean Medicine for Nonalcoholic Fatty Liver Disease)

  • 김나연;윤미정;최홍식;김승모;김상찬;김경순
    • 대한한방내과학회지
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    • 제43권4호
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    • pp.680-719
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    • 2022
  • Objectives: The aim of this study was to investigate the trends in research on non-alcoholic fatty liver disease (NAFLD) using Korean traditional medicine. Methods: This review included studies related to the treatment of NAFLD, irrespective of the year of publication. The search terms were "nonalcoholic fatty liver disease", "non-alcoholic fatty liver", "nonalcoholic hepatitis", "herb", "herbal medicine", "acupuncture", and "traditional medicine". The studies were analyzed according to the type of research. Results: After screening, 179 studies were selected from the 592 identified by the search. The types of studies were 151 in vivo or in vitro studies, 5 randomized controlled trials, 12 case reports, 2 unspecified clinical studies, 8 review articles, and 1 article that was difficult to classify. Conclusion: Analysis of the trends in Korean traditional medicine treatment by reviewing the studies on NAFLD revealed a focus on experimental studies rather than clinical studies. Therefore, multifaceted and well-designed studies are needed.

Resuscitation Fluids for Patients at High Risk of Multiple Organ Dysfunction Syndromes: A Systematic Review and Meta-analysis

  • Nam, Jae Hyun;Kwack, Hee Jin;Ha, Woo Seob;Chung, Jee-Eun
    • 한국임상약학회지
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    • 제32권3호
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    • pp.251-259
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    • 2022
  • Background: Intravenous fluid therapy is one of the most common interventions in critically ill patients. Normal saline is frequently used, but there have been some concerns about hyperchloremia. Due to closer to plasma composition, crystalloids have been used as alternatives to normal saline. However, the optimal choice of resuscitative fluids remains controversial. Methods: MEDLINE, EMBASE, and CENTRAL were comprehensively searched until July 2021 to compare balanced crystalloids with normal saline in critically ill patients with the risk factors for multiple organ dysfunction syndromes (MODS).The primary endpoint was composite mortality. Secondary outcomes were acute kidney injury (AKI)/acute renal failure (ARF), and new receipt of renal replacement therapy (RRT). Results: A total of 1,240 studies were searched, and finally, 8 randomized controlled trials and 5 cohort studies were included. In the meta-analysis of composite mortality of 30,710 patients, balanced crystalloids compared to normal saline were significantly associated with reduced mortality (OR 0.80, 95% CI 0.68-0.95). In AKI/ARF, balanced crystalloids had a lower risk than normal saline (OR 0.91, 95% CI 0.84-0.99). There was no difference between balanced crystalloids and normal saline in risk of new receipt of RRT (OR 0.91, 95% CI 0.80-1.04). Conclusion: In fluid resuscitation for patients at high risk of MODS, the use of balanced crystalloids showed a significantly lower incidence of mortality compared to normal saline.

소아 식욕부진에 대한 삼령백출산(蔘苓白朮散)의 효과: 체계적 문헌고찰 및 메타분석 (Effects of Samryungbaekchul-san on Childhood Anorexia: A Systematic Review and Meta-Analysis)

  • 이해솔;이선행;장규태;이보람
    • 대한한방소아과학회지
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    • 제37권1호
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    • pp.1-14
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    • 2023
  • Objectives This study aimed to evaluate the effect of Samryungbaekchul-san on childhood anorexia. Methods We searched 11 English, Korean, Chinese, and Japanese databases for studies published up to May 30, 2022. Randomized controlled trials (RCTs) assessing the effect of Samryungbaekchul-san on childhood anorexia were included. In the meta-analysis, relative risk (RR) and 95% confidence intervals (CI) were indicated as dichotomous variables, and mean difference (MD) or standardized mean difference (SMD) and 95% CIs were indicated as continuous variables. Results We included 12 RCTs with 1345 participants. The Samryungbaekchul-san treatment group had a significantly higher total effective rate (TER) than that of the western medicine control group (RR 1.42, 95% CI 1.23-1.64, I2 = 0%). The combined Samryungbaekchul-san and western medicine treatment group had significantly higher TER (RR 1.31, 95% CI 1.23 to 1.40, I2 = 0%) and levels of neuropeptide Y (SMD 0.93, 95% CI 0.47-1.39, I2 = 70%) and ghrelin (SMD 1.45, 95% CI 1.14-1.76, I2 = 0%) than those of the western medicine alone group. Additionally, leptin levels were significantly lower in the combined treatment group (SMD -1.19, 95% CI -1.88 to -0.51, I2 = 86%) compared with the western medicine alone group, although statistical heterogeneity was substantial. Conclusions Samryungbaekchul-san may be effective for childhood anorexia. However, owing to limitations such as high clinical heterogeneity between the studies, unclear risks of biases, and insufficient reports of adverse events and follow-ups, well-designed RCTs with a low risk of bias are needed in the future.

Research Trends of Pharmacopuncture: a bibliometric analysis using VOSviewer (2007-2023)

  • Chan-Young Kwon
    • 대한약침학회지
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    • 제26권3호
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    • pp.227-237
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    • 2023
  • Objectives: Pharmacopuncture is considered a unique new type of acupuncture in Korean medicine (KM). This study was performed to investigate the research trends regarding pharmacopuncture through a bibliometric analysis using VOSviewer. Methods: The Web of Science Core Collection was searched for this study. The search terms were pharmacopuncture and pharmaco-puncture. The search was conducted on May 23, 2023, and 185 studies retrieved up to this date were included. Software VOSviewer version 1.6.19 was used to perform the bibliometric analysis. After data clearing, keyword co-occurrence and cooperation pattern analyses were performed. Results: The number of studies on pharmacopuncture have gradually increased since the mid-2000s, with the most published in 2020 (46 studies). The quality of the studies has also steadily increased, and recently, several randomized controlled trials of pharmacopuncture have been conducted. Moreover, this treatment has been investigated in the context of KM clinical practice guideline development in Korea. The scope of pharmacopuncture studies to date seems to be limited to musculoskeletal pain and bee venom pharmacopuncture. The researchers from Jaseng Medical Foundation have been the core researchers in the field of pharmacopuncture in Korea. They collaborated with researchers from universities or government-funded research institutes. However, small-scale research teams from KM clinics and university researchers were also identified as independent clusters. Conclusion: Pharmacopuncture research has grown both quantitatively and qualitatively, but the scope needs to be further expanded. There is also a gap between the use of pharmacopuncture by KM doctors in clinical settings and pharmacopuncture research. Based on these findings, some suggestions for future studies in this field are discussed. Furthermore, these findings may be used as data to expand and globalize pharmacopuncture research in the future.

조현병 환자의 정서를 위한 프로그램의 효과: 무작위 대조군 실험연구의 체계적 고찰 (The Effect of Program on Emotion of Patients with Schizophrenia: A systematic review of randomized controlled trials)

  • 주은솔
    • 대한통합의학회지
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    • 제11권2호
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    • pp.77-86
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    • 2023
  • Purpose : This study systematically assessed 9 emotion-function programs for schizophrenic individuals that have been implemented over the past 10 years in Korea and abroad, with the objective of providing clinical grounds and data for further programs. Methods : This study identified 2,558 studies from among those registered in the RISS, KISS, EMbase, PubMed and Scopus databases from 2013 to September 2023, using 'schizophrenia' AND 'emotion' AND ('program' OR 'therapy') as keywords. Of the 2,558 studies retrieved from electronic databases, 602 duplicate papers were excluded. After this process, 1,915 papers that did not meet the study's inclusion and exclusion criteria were excluded based on their titles and abstracts. Following a review of the texts of the remaining 41 papers, nine papers were finally selected, excluding 32 papers according to the selection and exclusion criteria. Results : Programs for the emotional function of patients with schizophrenia have continued to be researched. The results of an evaluation on the quality of the selected literature confirmed that a majority of the reviewed items were "uncertain", confirming that there was a risk of bias. The interventions for emotions included art, cognitive-behavioral, and physical programs, of which art programs were frequently applied. Most of the interventions were implemented in hospitals. The dependent variables for evaluating emotions included emotional expression, depression, anxiety, and positive emotions, and among them, emotional expression was used most frequently. Accordingly, the Berkeley expressivity questionnaire was commonly used as an evaluation tool. Conclusion : This study is significant for intending to analyze domestic and overseas programs for the emotions of patients with schizophrenia, thereby proposing the direction for planning and applying interventions in clinical settings. In follow-up studies, it will be necessary to develop a protocol that confirms interventions according to the settings and patient characteristics of programs and expands the scope of literature reviews.

보조생식술에 있어서 침의 중재에 대한 임상연구 동향 - Pubmed를 중심으로 - (Investigation of Clinical Research of Acupuncture Intervention in Assisted Reproductive Technology in Pubmed)

  • 배경미;조혜숙;이승환;이인선
    • 대한한방부인과학회지
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    • 제22권4호
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    • pp.65-82
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    • 2009
  • Purpose: The purpose of this study is to examine acupuncture intervention suggested in the papers of assisted reproductive technology(ART, hereafter) in medicine journals and to establish the further direction. Methods: The papers published between 1996 and 2009 in Pubmed were reviewed. Results: 1. A variety of randomized controlled trials and case series were found in Pubmed concerning influence of acupuncture in ART. It was investigated into improvement of pregnancy rate, analgesic effect during oocyte retrieval, change of serum hormone, and reduction of anxiety. 2. It was on clinical pregnancy rate that main focus of the investigation was placed and the improvement of pregnancy rate differed from studies. 3. For the analgesic effect during oocyte retrieval, the electro acupuncture was mainly used and the studies reported the reduced pain rate, tiredness, and nausea. 4. Acupuncture was reported as significant in improving the state of anxiety during ART. Conclusion: It would be necessary to further study the period of acupuncture intervention, the selection of acupoint through well-designed study, and establish standard of evidence of them.

주요우울장애에 대한 한약 단독치료의 효과와 안전성: 체계적 문헌고찰 및 메타분석 (Effectiveness and Safety of Traditional East Asian Herbal Medicine as Monotherapy for Major Depressive Disorder: A Systematic Review and Meta-Analysis)

  • 승혜빈;권희주;김상호
    • 동의신경정신과학회지
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    • 제33권1호
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    • pp.79-111
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    • 2022
  • Major depressive disorder (MDD) causes a persistent feeling of sadness and loss of interest. It can lead to emotional and physical problems. Treatments such as antidepressant and cognitive behavioral therapy for MDD have many limitations. Traditional East Asian Herbal Medicine (TEAM) is a representative modality of Complementary and Integrative Medicine (CIM) which can be used for MDD. However, no study has systematically reviewed the efficacy or safety of TEAM for MDD so far. Therefore, we performed a systematic review and meta-analysis to evaluate effectiveness and safety of TEAM as a monotherapy for MDD. We only included TEAM that could be used in context of clinical setting in Korean Medicine. Outcomes were the Hamilton Depression Rating Scale (HAMD) and total effective rate (TER). After comprehensive electronic search of 11 databases, we included 28 randomized controlled trials (RCTs) that compared HM as monotherapy with antidepressant for MDD. Meta-analysis showed that TEAM had significant benefits in reducing HAMD (MD=-0.40, 95% CI: -0.67 to -0.13, p=0.003, I2=85%) and improving TER (RR=1.06, 95% CI: 1.02 to 1.10, p=0.003, I2=0%). It also appeared to be safer than antidepressant in terms of adverse effects. Methods used for RCTs were poor and the quality of evidence was graded 'low' or 'moderate'. These findings indicate that the use of HM as a monotherapy might have potential benefits in MDD treatment as an alternative to antidepressant. However, considering the methodological quality of included RCTs, the clinical evidence is uncertain. Further well-designed RCTs are required to confirm these findings.

Romosozumab의 효과 및 심혈관계 안전성: 체계적 문헌고찰 및 메타분석 (Efficacy and Cardiovascular Safety of Romosozumab: A Meta-analysis and Systematic Review)

  • 최서용;김정민;오상현;천승현;정지은
    • 한국임상약학회지
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    • 제33권2호
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    • pp.128-134
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    • 2023
  • Background: This systematic review and meta-analysis aimed to evaluate the efficacy and cardiovascular safety of romosozumab compared with placebo. Methods: Randomized controlled trials (RCTs) were searched from Medline, EMBASE, Cochrane Central, and Web of Science until July 2022. Primary outcomes included the change in bone mineral density (BMD) from baseline at month 6. The secondary outcomes were the change of bone turnover markers (N-terminal propeptide of type 1 procollagen (P1NP); C-terminal telopeptide of type 1 collagen (CTX)) from baseline at month 3, and the incidence of cardiovascular adverse events for the total follow-up period. Results: A total of 7 RCTs on 8,370patients were included. Romosozumab showed better effects in improving BMD in both lumbar spine and femoral neck at month 6 (standardized mean difference, SMD 2.20 [95% CI: 1.89-2.52], SMD 0.63 [95% CI: 0.41-0.86]). In contrast to placebo, romosozumab significantly increased PINP levels and reduced CTX levels at month 3 (SMD 0.93 [95% CI: 0.65-1.22], SMD -1.03 [95% CI: -1.23~ -0.82]. However, there was no significant difference in the composite incidence of cardiovascular adverse events and major adverse cardiovascular events (OR 1.16 [95% CI: 0.82-1.65], OR 1.08 [95% CI: 0.75-1.56]). Conclusion: This analysis showed that romosozumab significantly improved BMD compared to placebo and was beneficial for change in bone turnover markers. There is no significant difference in the incidence of cardiovascular adverse events compared to placebo.