• 제목/요약/키워드: Randomized controlled trials

검색결과 1,181건 처리시간 0.031초

A Systematic Review of Risk Factors for Brain Metastases and Value of Prophylactic Cranial Irradiation in Non-Small Cell Lung Cancer

  • Sun, Dian-Shui;Hu, Li-Kuan;Cai, Ying;Li, Xiao-Mei;Ye, Lan;Hou, Hua-Ying;Wang, Cui-Hong;Jiang, Yu-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권3호
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    • pp.1233-1239
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    • 2014
  • Background: The incidence of brain metastases (BM) varies in patients with non-small cell lung cancer (NSCLC), calls into question the value of prophylactic cranial irradiation (PCI). It is possible that clinicopathologic characteristics are associated with the development of BM, but these have yet to be identified in detail. Thus, we conducted the present meta-analysis on risk factors for BM and the value of PCI in patients with NSCLC. Methods: Eligible data were extracted and the risk factors for BM and the value of PCI in patients with NSCLC were analyzed by calculating the pooled odds ratio (OR). Heterogeneity was detected using Q and I-squared statistics, and publication bias was tested by funnel plots and Egger's test. Results: Six randomized controlled trials with a focus on the value of PCI and 13 eligible studies with a focus on risk factors for BM were included. PCI significantly reduced the incidence of BM in patients with NSCLC (p=0.000, pooled OR=0.34, 95% confidence interval = 0.37-0.59). Compared with non-squamous cell carcinoma, squamous cell carcinoma was associated with a low incidence of BM in patients with NSCLC (p=0.000, pooled OR=0.47, 95% confidence interval =0.34-0.65). The funnel plot and Egger's test suggested that there was no publication bias in the current meta-analysis. Conclusions: This meta-analysis provides statistical evidence that compared with non-squamous cell carcinoma, squamous cell carcinoma can be used as a predictor for BM in patients with NSCLC, and PCI might reduce the incidence of BM in patients with NSCLC, but does not provide a survival benefit.

Systematic Review of Hominis Placenta Pharmacopuncture in English and Korean Literature

  • Ryoo, Dek-Woo;Kim, Hong-Guk;Kim, Sung-Jin;Baek, Seung-Won;Jeong, Seong-Mok;Yoon, Jin-Young;Lee, Chang-Hee;Goo, Bon-Hyuk;Kim, Min-Jeong;Park, Yeon-Cheol;Baek, Yong-Hyeon;Nam, Sang-Soo;Seo, Byung-Kwan
    • Journal of Acupuncture Research
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    • 제34권4호
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    • pp.153-158
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    • 2017
  • Background: Hominis placenta (HP) is used in Korean medicine to tonify qi and blood, and enrich yin and tonify yang. HP has been reported to have therapeutic effects. Methods: A survey of international and Korean electronic databases was conducted using the search terms "hominis placenta pharmacopuncture" and "hominis placenta extract". The search was limited to material published up to May 31, 2017. Results: A total of 83 studies were included in this systematic review: 50 were clinical studies, 25 were basic studies, and 8 were other types of study. Among clinical studies, the most frequently treated disease groups were musculoskeletal diseases and nervous system diseases. In vitro studies were conducted mainly on anti-inflammatory, analgesic, and anti-cell necrosis models. Most of the in vivo studies were performed in rheumatoid arthritis or diabetic complications models. Conclusion: HP pharmacopuncture has effects in the treatment of various diseases. Further large-scale randomized controlled trials are needed to improve the level of evidence for HP pharmacopuncture. It would be helpful if future in vitro and in vivo studies could identify the mechanism of action of HP pharmacopuncture.

뇌성마비 아동의 감각통합 중재 연구에 대한 체계적 고찰과 메타분석 (A Systematic Review and Meta-analysis of Sensory Integration Intervention Studies in Children with Cerebral Palsy)

  • 김은주;최유임
    • 디지털융복합연구
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    • 제11권4호
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    • pp.383-389
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    • 2013
  • 이 연구는 뇌성마비아동을 대상으로 감각통합중재를 실시한 연구에 대한 체계적 고찰과 메타분석을 통해 근거기반실제를 위한 자료를 제시하는 것이었다. 이를 위해 분석대상 논문을 선정한 후 집단실험설계 연구에 대해서는 메타분석을 통해 효과크기를 알아보았다. 분석대상 연구는 총 24편으로, 사례연구 7편, 단일대상연구 3편, 집단실험설계 연구 14편(무작위 임상실험설계 5편, 두 집단 비무작위연구 3편, 단일집단 비무작위연구 6편). 메타분석을 통해 실험연구의 전체 효과를 알아본 결과 0.272의 중간크기로 나타났다. 종속변수는 소근육 운동발달이, 출판여부는 출판된 논문이, 연구 설계는 두 집단 비무작위연구에서 효과크기가 가장 크게 나타났다. 또한 유아가 아동보다, 감각통합중재 프로그램은 기간이 8주, 횟수는 주5회, 시간은 90분에서 효과크기가 가장 크게 나타났다. 뇌성마비아동을 대상으로 한 감각통합중재는 중간 정도의 효과가 있는 것으로 나타났으나, 감각통합의 효과를 알아보기 위해서는 연구물의 축적이 좀 더 이루어져야 할 것으로 생각된다.

국내 뇌성마비 아동의 자세조절 향상을 위한 운동 중재 효과: 체계적 고찰 (Effects of Exercise Interventions on Postural Control for Children With Cerebral Palsy in Korea: A Systematic Review)

  • 박영주;홍은경
    • 대한감각통합치료학회지
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    • 제14권2호
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    • pp.46-57
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    • 2016
  • 목적 : 뇌성마비 아동의 자세조절을 향상시키기 위해 국내에서 사용되는 운동 중재의 방법과 효과를 알아보기 위해 체계적 고찰을 사용하여 근거를 제시하고자 하였다. 연구방법 : 누리미디어(DBpia), 학술연구정보서비스(RISS) 그리고 한국학술정보(KISS)의 데이터베이스를 사용하여 2006년 10월 이후로 게재된 국내학회지를 검색하였다. '뇌성마비', '자세조절', '균형'를 키워드로 검색하여 총 18개의 연구가 연구대상으로 선정되었다. 각 연구는 근거의 질적 수준과 방법론적 질적 수준으로 분석하였고 그 결과는 대상자, 중재, 대조군, 결과에 따라 Patient, Intervention, Comparison, Outcome(PICO)로 분석하였다. 결과 : 본 연구의 분석에 사용된 연구의 근거수준은 수준 I이 8개, 수준 III이 5개, 수준 IV가 2개, 수준 V가 3개이었고, 방법론적 질적 수준은 '우수'의 연구가 가장 많았다. 대상자는 경직형 양하지 마비, 실험설계는 무작위 대조군 실험 연구가 가장 많았다. 분석결과 국내에서 사용되는 자세조절 운동 중재는 뇌성마비 아동의 운동능력과 균형능력 향상에 긍정적인 영향을 보였다. 결론 : 국내에서 사용되는 운동 중재는 뇌성마비 아동의 자세조절 능력을 향상시켰다. 앞으로 뇌성마비 아동의 유형별 자세조절 향상을 위한 연구가 이루어져야 할 것이다.

EBM 구축을 위한 쌍화탕의 실험 연구 문헌 분석 (Analysis of Studies on Ssanghwa-tang for Establishment of Evidence Based Medicine)

  • 이준경;이남헌;하혜경;이호영;서창섭;정다영;이진아;신현규
    • 한국한의학연구원논문집
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    • 제14권3호
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    • pp.41-47
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    • 2008
  • Objective : The purpose of this report was to provide the information about activity and safety of Ssanghwa-tang by analyzing domestic papers and theses about Ssanghwa-tang. Methods : Domestic papers and theses related to Ssanghwa-tang were reviewed and analyzed. These papers were then classified by year, experimental method, and activity subject. Results : The following result s were obtained in this study. 1. The study of Ssanghwa-tang started from 1981 and continued steadily 1990s and it was decreased 2000s. 2. The paper of Ssanghwatang was entire domestic paper, 20 volumes. 3. In classified by experimental method and animal of Ssanghwa-tang paper, more than a half study used rat in vivo experiment. Furthermore clinical experiments were performed about anti-fatigue effect of Ssanghwa-tang and Ssanghwatang was proved a safety herbal medicine in acute toxicity experiment. 4. Decursin, glycyrrhizin, paeoniflorin were determined in Ssanghwa-tang by using HPLC analysis. 5. As these studies were classified by subject, papers related to anti-fatigue effect were most abundant by 7 papers. Besides there were several papers related to liver funtion, anti-inflammatory, alleviation, smooth muscle relaxation effect and so on. 6. According to experimental data, it is supported that Ssanghwa-tang was safety herbal medicine and it has a several activity about anti-fatigue, anti-inflammatory, alleviation, smooth muscle relaxation. Conclusion : Many study of basic science experiments and clinical experiments were performed and reported on Ssanghwa-tang in domestic journal. Ssanghwa-tang is being used in various ways associating with anti-fatigue, anti-inflammatory, alleviation and smooth muscle relaxation. furthermore Ssanghwatang was proved a safety herbal medicine in acute toxicity experiment. However, studies on randomized controlled trials of Ssanghwatang need to be completed at the clinical level.

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비만아동을 위한 정서적 자기조절 프로그램의 개발 및 효과: 혼합방법론의 적용 (An Emotional Self-Regulation Program for Obese Children: Pilot Study Using Mixed Methods)

  • 김희순;마유미;박지영;김승현
    • Child Health Nursing Research
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    • 제19권3호
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    • pp.187-197
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    • 2013
  • 목적 비만아동을 위한 이론기반의 정서적 자기조절 프로그램을 개발하고 운영하여 프로그램의 효과를 확인하고자 함. 방법 본 연구는 혼합방법 중 실험연구를 위한 끼워넣기 모형을 활용함. 즉 비동등성 대조군 전후 설계를 이용하여 본 프로그램이 비만아동의 우울, 식습관, 체질량지수에 미치는 효과를 평가하고 추가적으로 질적 자료를 통해 프로그램의 효과에 대한 이해를 돕고자 함. 결과 본 연구결과 정서적 자기조절 프로그램은 비만아동의 우울에 긍정적인 효과를 보였으며, 대상자는 '자신감 고취', '충동 조절', '또래와의 친밀감', '행복감', '체중감소를 위한 노력 및 경험' 등을 표현함. 결론 본 연구결과 정서적 자기조절 능력의 강화는 비만관리에 있어 효과적인 전략임을 확인하였으며 추후 대상자와 지역을 확대한 반복연구와 무작위 대조군 실험연구를 제언하는 바임. 본 연구는 프로그램의 효과에 대한 보다 풍부한 이해를 위해 혼합방법을 적용하고 프로그램의 개발 운영 평가에 있어 실무와의 연계성을 강조하였다는 점에서 의의를 가짐.

수술후 급성 동통에 대한 Tramadol/Acetaminophen과 Codeine/Acetaminophen/Ibuprofen의 효과 발현시점과 진통효과의 비교 (COMPARISON OF TRAMADOL/ACETAMINOPHEN AND CODEINE/ACETAMINOPHEN/IBUPROFEN IN ONSET OF ANALGESIA AND ANALGESIC EFFICACY FOR POSTOPERATIVE ACUTE PAIN)

  • 정영수;김동기;김문기;김형준;차인호;한무영;이의웅
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권2호
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    • pp.143-149
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    • 2004
  • Background: Some clinical trials have reported that a new analgesic combination of tramadol and acetaminophen provides good efficacy in various pain models. For the more clinical uses of this agent, comparisons about the onset of analgesia and analgesic efficacy in the acute state of pain with the other drugs known as strong analgesics were needed. Purpose: The goal of this study was to compare the times to onset of analgesia and the other analgesic efficacy of 75 mg tramadol/650 mg acetaminophen and 20 mg codeine/500 mg acetaminophen/400 mg ibuprofen in the treatment of acute pain after oral surgery. Patients and Methods: Using a randomized, single-dose, parallel-group, single-center, and active-controlled test design, this clinical study compared the times to onset of analgesia using a two-stopwatch technique and the other analgesic efficacy of the single-dose tramadol/acetaminophen and codeine/acetaminophen/ibuprofen. These were assessed in 128 healthy subjects with pain from oral surgical procedures involving extraction of one or more impacted third molars requiring bone removal. From the time of pain development, the times to onset of perceptible and meaningful pain relief, pain intensity, pain relief, an overall assessment, and adverse events of the study medications were recorded for 6 hours. Results: The demographic distribution and baseline pain data in the two groups were statistically similar. The median times to onset of perceptible pain relief were 21.0 and 24.4 minutes in the tramadol/acetaminophen and codeine/acetaminophen/ibuprofen groups respectively and those to onset of meaningful pain relief were 56.4 and 57.3 minutes, which were statistically similar. The other efficacy variables such as mean total pain relief (TOTPAR) and the sum of pain intensity differences (SPID) were also similar in the early period after pain development and drug dosing. The safety of tramadol/acetaminophen was well tolerated and very comparable to that of codeine/acetaminophen/ibuprofen. Conclusions: In this acute dental pain model, the onset of analgesia and analgesic efficacy of tramadol/acetaminophen was comparable to that of codeine/acetaminophen/ibuprofen. These results showed that tramadol/acetaminophen was recommendable for fast and effective treatment in the management of postoperative acute pain.

고충실도 시뮬레이션 기반 교육이 간호학생의 임상수행능력과 간호수행 자신감에 미치는 효과: 체계적 문헌 고찰 (The Effects of High Fidelity Simulation-Based Education on Clinical Competence and Confidence in Nursing Students: A Systematic Review)

  • 이정미;소향숙;김윤경;김정이;안민정
    • 한국콘텐츠학회논문지
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    • 제14권10호
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    • pp.850-861
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    • 2014
  • 본 연구는 국내 고충실도 시뮬레이터를 이용한 시뮬레이션 기반 교육 관련 선행연구들을 체계적으로 고찰하여 간호학생의 임상수행능력과 간호수행 자신감에 대한 효과를 분석하고, 이를 이용해 근거중심의 가이드라인 제공 및 향후 연구방향을 제시하고자 시도되었다. 데이터베이스인 한국교육학술정보원(RISS), 한국학술정보(KISS)와 Google Scholar에서 2005년부터 2014년까지의 문헌을 대상으로 키워드 '간호와 시뮬레이션' 또는 '간호와 시뮬레이터'로 검색하였다. 총 183편의 연구 중 16편의 논문이 최종 선정되었고, Quality Assessment Tool for Quantitative Studies를 이용해 문헌의 질을 확인하였다. 연구결과, 시뮬레이션 기반 교육은 간호학생의 임상수행능력과 자신감 증진에 긍정적인 효과가 있었고, 간호학생들의 직접 간호수행이 힘든 중환자와 분만간호 분야에서 임상실습 교육의 효과적인 교수-학습전략이 될 수 있음을 확인하였다. 시뮬레이션 기반 교육의 효과를 극대화하기 위해 교육자와 시설 등의 적절한 지원이 필요하다. 향후 결과의 일반화를 높이기 위해 충분한 표본수를 고려한 무작위대조연구, 교육효과 평가를 위한 표준화된 도구 개발 및 시뮬레이션이후 제공되는 디브리핑의 효과를 분석하는 연구를 고려해 볼 것을 제언한다.

조현병 환자에서 장기지속형 항정신병 주사제 팔리페리돈 팔미테이트의 효능과 안전 : 24주 개방형 연구 (Safety and Effectiveness of Long Acting Injectable Antipsychotic Paliperidone Palmitate Treatment in Schizophrenics : A 24-Week Open-Label Study)

  • 강현구;함웅;손인기;백인호
    • 생물정신의학
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    • 제20권3호
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    • pp.111-117
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    • 2013
  • Objectives We investigated the effectiveness and safety when treated in schizophrenics with paliperidone palmitate, a long acting injectable antipsychotic. Methods This was a 24-week open-label study, performed at one center in Korea. The eligible patients with schizophrenia diagnosed by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria were enrolled. Patients received long-acting paliperidone palmitate injection (234 mg, baseline; 156 mg, week 1 ; then once 4 weeks flexible dosing). Effectiveness assessments were measured by the Positive and Negative Syndrome Scale (PANSS), The Clinical Global Impression Severity Scale (CGI-S), The Personal and Social Performance (PSP) at baseline, week 1, every 4 weeks untill 24 weeks or endpoint. Safety assessments were measured by The Extrapyramidal Symptom Rating Scale (ESRS), body weight (BW) and incidence of adverse events. Oral antipsychotics were stopped or tapered off within next 14 days. Results Of 20 patients recruited, 9 patients (45%) completed the study. Paliperidone palmitate produced a significant improvement in PANSS total score from baseline to endpoint. The response rate was 75% [mean change (${\pm}SD$) $-25.9{\pm}14.4$, all p < 0.001]. The CGI-S and PSP total scores significantly improved during 24 weeks (All p < 0.001). Eighty percent of patients reported adverse events and most common adverse events (${\geq}10%$) in paliperidone palmitate were anticholinergic adverse event, extrapyramidal symptoms, weight gain, akathisia, insomnia, headache, agitation, anxiety and GI trouble. ESRS score is not statistically significant, but tends to get better at the end of the study when compared to baseline. Conclusions Our study results demonstrated maintained effectiveness and safety of paliperidone palmitate treatment in schizophrenics. And provides both clinicians and patients with a new choice of treatment that can improve the outcome of long term therapy. Their potential effectiveness and safety should be better addressed by future randomized-controlled trials.

수족냉증의 임상연구에 관한 문헌적 고찰 - 국내에 출판된 논문을 중심으로 - (Literature Review on clinical studies for cold hypersensitivity of hands and feet -Focusing on journals published in Korea)

  • 이해솔;한인식;선승호;김근엽;고호연;김태훈;이진무;장준복;송윤경;고성규;최유경;정종진;고유미;정금란;전찬용
    • 대한예방한의학회지
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    • 제21권1호
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    • pp.83-93
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    • 2017
  • Objectives : This study's aim is to investigate clinical studies of cold hypersensitivity of hands and feet (CHHF) published in Korea and to explore the direct of future research. Methods : We searched clinical studies of CHHF using the database, such as DBpia(http://www.dbpia.co.kr/), NDSL(www.ndsl.kr), OASIS(http://oasis.kiom.re.kr), and RISS(www.riss.kr). The search words were 'cold hypersensitivity(冷症)' and 'syncope(厥證)'. Inclusion criteria were randomized controlled trials (RCTs), non RCTs, Before and after clinical study (B&A) about CHHF. Selection journals and data extraction were conducted by HS Lee and SH Sun independently. Results : Total twenty-one articles were selected finally. RCTs, non-RCTs, and B&A were 3, 12, and 6, respectively. The topics for CHHF were classified into three categories: effect of treatment (n=2) characteristics (n=11), and diagnosis (n=8). Conclusions : This results showed that RCT about CHHF and treatment effect of cold hypersensitivity of hands and feet were small in number. Further systemic and larger studies about CHHF will be needed.