• Title/Summary/Keyword: Randomized Clinical Trials

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Endovascular Treatment of Acute Ischemic Stroke (급성 허혈성 뇌졸중의 혈관 내 치료)

  • Jun Hwee Kim;Byung Moon Kim
    • Journal of the Korean Society of Radiology
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    • v.81 no.3
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    • pp.562-576
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    • 2020
  • Acute ischemic stroke is one of the leading causes of disability and death around the world, especially in developed countries. Since the introduction of the 2nd generation devices, endovascular treatment of acute ischemic stroke has rapidly developed and is now considered to be a standard treatment. Here, we summarize the results of recent randomized clinical trials that have compared endovascular thrombectomy with conventional treatment for acute stroke and review the indications, current devices, and endovascular thrombectomy methods used.

E-learning system to improve the endoscopic diagnosis of early gastric cancer

  • Kenshi Yao;Takashi Yao;Noriya Uedo;Hisashi Doyama;Hideki Ishikawa;Satoshi Nimura;Yuichi Takahashi
    • Clinical Endoscopy
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    • v.57 no.3
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    • pp.283-292
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    • 2024
  • We developed three e-learning systems for endoscopists to acquire the necessary skills to improve the diagnosis of early gastric cancer (EGC) and demonstrated their usefulness using randomized controlled trials. The subjects of the three e-learning systems were "detection", "characterization", and "preoperative assessment". The contents of each e-learning system included "technique", "knowledge", and "obtaining experience". All e-learning systems proved useful for endoscopists to learn how to diagnose EGC. Lecture videos describing "the technique" and "the knowledge" can be beneficial. In addition, repeating 100 self-study cases allows learners to gain "experience" and improve their diagnostic skills further. Web-based e-learning systems have more advantages than other teaching methods because the number of participants is unlimited. Histopathological diagnosis is the gold standard for the diagnosis of gastric cancer. Therefore, we developed a comprehensive diagnostic algorithm to standardize the histopathological diagnosis of gastric cancer. Once we have successfully shown that this algorithm is helpful for the accurate histopathological diagnosis of cancer, we will complete a series of e-learning systems designed to assess EGC accurately.

The Survey on the Standardization of Chuna Manual Technique for Operating RCT of Non-acute Low Back Pain (비급성 요통에 대한 무작위대조군 임상연구 수행을 위한 추나표준화 설문조사 보고)

  • Kim, Byung-Jun;Hwang, Eui-Hyoung;Heo, Kwang-Ho;Hwang, Man-Suk;Heo, In;Song, Yun-Kyung;Lee, Jung-Han;Ko, Youn-Seok;Park, Tae-Young;Cho, Jae-Heung;Lee, Eun-Jung;Mun, Su-Jeong;Ha, In-Hyuk;Lee, Min-Ho;Shin, Byung-Cheul
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.10 no.2
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    • pp.13-25
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    • 2015
  • Objectives : To find out the standardized chuna manual technique for non-acute low back pain. Methods : The survey questions were developed by the consensus from the professor who major in Rehabillitation Medicine of Korean Medicine(RMKM). August 15th to september 1st 2015, the questionnaire was given to 23 RMKM doctors by e-mail. 20(90.9%) the questionnaire were retrieved out. Standardized technique of chuna were selected through experts consesus based on questionaire results. Results : Two essential techniques and two selective techniques were selected as standardized Chuna manual technique for lumbar region. Six essential technique and one selective technique were selected as standardized Chuna manual technique for iliac region. Conclusions : This is the first consensus of experts opinion for Chuna manual technique for operating randomized controlled trials(RCT). These reports are helpful for Korean Medicine doctor who operate Chuna manual technique and expected to make clinical evidence of Chuna manual medicine

The Domestic Trends of Korean Medicine Treatments on Traffic Accident for Recent 5 Years (최근 5년간 교통사고 후유증의 한의학적 치료에 대한 국내 연구 동향)

  • Choi, Young-Il;Kim, Min-Yeong;Choi, Hee-Seung;Jeong, Yun-Gyu;Ro, Hae-Rin;Kim, Se-Jun;Shin, Dong-Jae
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.8 no.1
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    • pp.27-38
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    • 2013
  • Objectives : The purpose of this study is to investigate the latest trends of korean Medicine treatments on traffic accident for recent 5 years. Methods : We investigated the studies on korean Medicine treatments for traffic accident via searching 6 Korean web databases. As a result, 65 research papers were found to be analyzed according to their published year, the titles of journals, the types of study, the number of cases, the sites of injury, the types of treatments the instruments for assessment and ethics approvals. Results : 65 articles were published since 2008. The studies on korean Medicine treatments about traffic accident were mainly published in Journal of Oriental Rehabilitation Medicine. 10 case studies, 14 case series, 11 non randomized controlled trials, 21 randomized controlled trials and 9 systemic reviews had been under research. The most frequently occurred symptoms were neck pain and low back pain. In most studies, various korean Medicine treatments were used to treat the symptoms. Visual analogue scale(VAS) and neck disability index(NDI) were used as primary assessments. In most clinical studies, there were no mention about approval of institutional review board(IRB). Conclusion : In this study, we analyzed the trends of korean Medicine treatments on traffic accident from 2008 to 2012. Reviewing the domestic trends of studies on korean Medicine treatments for traffic accident and examining the strong and weak points of those treatments are essential for the future studies. It is needed to adopt the qualitative methods of evaluation in order to develop a level of evidence.

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Herbal Medicine for Liver Cancer: A Protocol for Systematic Review and Meta-Analysis (간암에 대한 한약치료: 체계적 문헌고찰 및 메타분석의 프로토콜)

  • Kwon, Seungwon;Song, Ga Yeon;Yang, Seung-Bo
    • The Journal of Internal Korean Medicine
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    • v.43 no.4
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    • pp.559-566
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    • 2022
  • Introduction: The aim of this systematic review is to provide evidence confirming the efficacy and safety of herbal medicines used in the treatment of liver cancer. Methods: The review will include randomized clinical trials that compared herbal medicines used as treatments for liver cancer with other therapies, such as placebos and Western medicine. Only randomized controlled trials will be included in this review, and all types of herbal medicine will be evaluated. Eleven electronic databases will be searched from the inception date: the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, AMED, CINAHL, one Chinese database (CNKI), and five Korean databases (OASIS, DBpia, RISS, KISS, and NDSL). The selection of studies, data extraction, and management will be performed independently by four researchers. Methodological quality, including the risk of bias, will be assessed using the Cochrane risk-of-bias assessment tool. Results: The review of current evidence for the effectiveness of herbal medicine for liver cancer will be summarized and quantitatively analyzed. Conclusions: Our systematic review will provide evidence of the efficacy of herbal medicines as treatments for liver cancer. This evidence will provide useful information for practitioners and patients in the fields of oncology and complementary medicine.

The Effectiveness and Safety of Dokwhalkisaeng-tang Combined with the Medication on Rheumatoid Arthritis: A Study Protocol for Systematic Review and Meta-analysis (류마티스 관절염 치료제와 병용한 독활기생탕의 효과 및 안전성: 체계적 문헌고찰 및 메타분석 프로토콜)

  • Chae, Soo-Yeon;Jung, Chan-Yung;Kim, Joo-Hee;Kim, Eun-Jung;Seo, Byung-Kwan;Hwang, Min-Seop;Park, Seong-Sik;Kim, Kyung-Ho;Yoon, Jong-hwa;Sung, Won-Suk
    • Herbal Formula Science
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    • v.30 no.2
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    • pp.95-100
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    • 2022
  • Objectives : Recent studies reported that Dokwhalkisaeng-tang (DHJST) could relieve the clinical rheumatoid arthritis (RA) symptoms and the level of RA-related blood test. However, evidence-based review on effectiveness and safety of DHJST with medication on RA was not yet provided. Methods : Searching randomized controlled trials on the use of DHJST for RA will be performed using multiple electronic databases, manual search, and contact to author. Studies will be selected according to the pre-defined criteria and collected data on study participants, interventions, control groups, outcome measurements, the results, adverse events, and risk of bias will be summarized. Primary outcome will be the disease activity score (including effective rate, swollen joint count, tender joint count, and morning stiffness), and the secondary outcomes will be RA-related blood test and adverse events. We will use Review Manager software to perform a meta-analysis, Cochrane Collaboration "risk of bias" tool for assessing the risk of bias, and Grades of Recommendation, Assessment, Development and Evaluation for the determination of quality of evidence. Results : We are going to investigate the effectiveness and safety of DHJST with medication for RA. Conclusion : This study will provide reliable evidence on whether DHJST combined with medicine is more effective on RA than medicine monotherapy.

Effect of Herbal Medicines on Preventing Restenosis After Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis of Randomized Controlled Trials (경피적 관상동맥중재술 후 재협착 예방에 대한 한약의 효과 : 무작위배정 대조군 임상연구에 대한 체계적 문헌고찰 및 메타분석)

  • Nayeon Hur;Subin Ahn;Hongjun Kim;Insoo Jang
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.387-401
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    • 2023
  • Objective: This study was conducted to investigate the preventive effect of herbal medicines on restenosis after percutaneous coronary intervention (PCI) by reviewing randomized controlled trials (RCTs). Methods: RCTs were searched for herbal medicine treatment after PCI using eight online databases (PubMed, CNKI, Wanfang, J-STAGE, OASIS, ScienceON, KTKP, and KISS). Studies that confirmed restenosis through coronary angiography at follow-up were selected according to the inclusion and exclusion criteria. The primary outcome was the restenosis rate, and the secondary outcome was the angina recurrence rate. Data were extracted from the final selected studies according to the research methodology and then analyzed with Review Manager 5.4.1. Study quality was assessed using Cochrane's risk-of-bias (RoB) tool. Results: Of the 252 papers obtained through the primary search, nine studies that met the selection criteria were finally selected. In these nine studies, herbal medicine combined with western medicine was used for the experimental group, and western medicine treatment was used alone for the control group. The meta-analysis result revealed that the restenosis rate and angina recurrence rate were significantly lower in the experimental group than in the control group (RR=0.34, 95% CI: 0.22-0.53, p<0.00001, I2=0% and RR=0.47, 95% CI: 0.29-0.78, p=0.004, I2=0%, respectively). Furthermore, the quality of studies assessed by Cochrane's RoB was low. Conclusions: This study showed that the combined treatment of herbal medicine and western medicine was effective in preventing restenosis and angina after PCI. As the number of papers included in this study was small, a large number of high-quality clinical studies should be considered in the future.

A Systematic Review of the Korean Medicine Treatments for Torticollis (Focused on Research from 2018 to 2023) (사경증의 한방 치료에 대한 체계적 문헌고찰 (2018년부터 2023년 연구를 중심으로))

  • Kyung Jun Ser;Jong Chan Choi;Min Jun Ji;Do Young Kwon;Jae Eun Yang;Ji Hyang Gu;Eun Jung Lee;Min Seok Oh
    • Journal of Korean Medicine Rehabilitation
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    • v.34 no.2
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    • pp.29-49
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    • 2024
  • Objectives The purpose of this study is to systemically review the recent studies in the Korean medicine treatments for torticollis. Methods We search the clinical studies from January 1, 2018 to December 31, 2023. The studies were searched through 10 databases (Oriental Medicine Advanced Searching Integrated System, Korean studies Information Service System, Research Information Sharing Service, Korean Medical Database, ScienceON, PubMed, Cochrane Library, Embase, Wanfang Data, China National Knowledge Infrastructure). Results A total of 19 studies were included in the study. 12 studies were case report studies, 5 studies were randomized controlled trials, 2 studies were non-randomized controlled trials. Of the 19 interventions, Chuna was the most used in this study and of the 28 evaluation tools, Sternocleidomastoid thickness was the most used in this study except efficiency rate. All 19 studies had improvements after treatment, and 8 studies had statistically significant improvements. As a result of the study, we found that Chuna, GB, GB20, BL10, Glycyrrhiza uralensis were commonly used Korean medicine treatments for torticollis. Conclusions We analyzed the Korean medicine treatments for torticollis. Through this study, we found that the Korean medicine was effective for torticollis. However, more research is needed to confirm the more detailed effect.

Study on the Current Situation and Issues for Clinical Research in Korean Medicine worldwide - Future Clinical Research Strategy I - (한의 임상 연구에 대한 국내외 현황 및 논쟁에 관한 고찰 - 미래 임상 연구 전략 I -)

  • Jung, Ki Yong;Go, Ho Yeon;Sun, Seung Ho;Jeong, Jong Jin;Park, Jeong Su;Song, Yun Kyung;Kim, Tae Hoon;Hong, Sung In;Choi, You Kyung;Go, Seong Gyu;Lim, Eun Mee;Lee, Choong Yeol;Park, Jong Hyeong;Jeon, Chan Yong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.28 no.2
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    • pp.137-145
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    • 2014
  • The purpose of this paper is to explore the strategy of future Korean medicine(KM) clinical research through the study on the current situation and issues for KM clinical research worldwide. In this study, the papers published in English through Pubmed were investigated mainly. And we analyzed the methodological issues from the clinical research reports in the KM fields. As a result of examining the current situation of the RCTs(Randomized Controlled Trials) studies in KM, the sample size for most studies was small and the overall methodological quality appeared to be low. And there was a discussion about whether or not to apply RCTs method to the KM clinical research. The majority of studies have argued the use of RCTs method for KM clinical research. In addition, we could find some problems through the analysis of KM clinical studies. First, the majority of RCTs in KM were of low quality. Second, RCTs method was applied to the KM clinical studies according to the Western medicine methods only. Third, the actual KM diagnosis was not used in the KM studies and inadequate outcomes measurement methods were utilized without considering the characteristics of KM practice. The methodological issues in the KM clinical research were caused by the conflict between the characteristics of KM practice and clinical research method based on the western medicine.

Moxibustion for Benign Prostatic Hyperplasia: A Systematic Review and Meta-analysis (전립선 비대증에 대한 뜸치료의 효과 : 체계적 문헌고찰과 메타분석)

  • Bae, Go-eun;Lee, Seung-hwan;Hong, Jin-woo;Lee, In;Kim, So-yeon;Choi, Jun-young;Han, Chang-woo;Yun, Young-ju;Park, Seong-ha;Kwon, Jung-nam
    • The Journal of Internal Korean Medicine
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    • v.39 no.3
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    • pp.372-388
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    • 2018
  • Objective: This study evaluates the effectiveness and safety of moxibustion for benign prostatic hyperplasia (BPH). Methods: Using the keywords "benign prostatic hyperplasia", "benign prostatic hypertrophy", "benign prostatic enlargement", "prostatic hyperplasia", and "moxibustion", we searched papers in numerous databases, including National Discovery for Science Leaders (NDSL), Korean Traditional Knowledge Portal (KTKP), Oriental Medicine Advanced Searching Integrated System (OASIS), Research Information Sharing Service (RISS), PubMed, Embase, and CENTRAL. The search range included randomized controlled trials (RCTs). Papers not matched with inclusion criteria were excluded. The methodological quality of each RCT was assessed using the Cochrane risk-of-bias tool. Where appropriate, meta-analyses were performed. Results: Initially, 77 studies were found. Of these, 11 duplicate studies were removed and 27 were excluded following title and abstract screening. After the remaining 39 papers were scanned, 13 RCTs were selected and analyzed. Among these 13 RCTs, five compared moxibustion therapy and oral medication, seven compared moxibustion plus acupuncture therapy and oral medication, and one compared moxibustion plus acupuncture therapy and sham-moxibustion. The meta-analysis showed positive results for the use of moxibustion therapy in terms of International Prostate Symptom Score (IPSS), Quality Of Life (QOL), Maximum Flow Rate (Qmax), Prostate Volume (PV), and the efficacy rate. The meta-analysis showed positive results for the use of moxibustion plus acupuncture therapy in terms of IPSS, QOL, and the efficacy rate. Conclusions: This meta-analysis of clinical trials suggests that moxibustion is effective intreating BPH patients. The results of this study could be applied to clinical treatment of BPH. However, additional large-scale clinical researches should be conducted.