• 제목/요약/키워드: Randomized controlled trials

검색결과 1,167건 처리시간 0.029초

Can platelet-rich plasma injections provide better pain relief and functional outcomes in persons with common shoulder diseases: a meta-analysis of randomized controlled trials

  • Barman, Apurba;Mishra, Archana;Maiti, Rituparna;Sahoo, Jagannatha;Thakur, Kaustav Basu;Sasidharan, Sreeja Kamala
    • Clinics in Shoulder and Elbow
    • /
    • 제25권1호
    • /
    • pp.73-89
    • /
    • 2022
  • Background: To evaluate the efficacy of autologous platelet-rich plasma (PRP) injections in the treatment of common shoulder diseases. Methods: The PubMed, Medline, and Central databases and trial registries were searched from their inception to October 2020 for randomized controlled trials of autologous PRP injections for shoulder diseases versus placebo or any control intervention. Preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed in the selection, analysis, and reporting of findings. The primary outcome was pain intensity (visual analog scale), and secondary outcomes were changes in function and quality of life (QoL). Results: A total of 17 randomized controlled trials of PRP versus control were analyzed. From 8-12 weeks to ≥1 year, PRP injections were associated with better pain relief and functional outcomes than control interventions. PRP injections were also associated with greater QoL, with an effect size of 2.61 (95% confidence interval, 2.01-14.17) at medium-term follow-up. Compared with placebo and corticosteroid injections, PRP injections provided better pain relief and functional improvement. In subgroup analyses, trials in which PRP was prepared by the double centrifugation technique, the platelet concentration in the PRP was enriched ≥5 times, leucocyte-rich PRP was used, or an activating agent was used before application reported the most effective pain relief at 6-7 months. Conclusions: PRP injections could provide better pain relief and functional outcomes than other treatments for persons presenting with common shoulder diseases. PRP injections have a greater capacity to improve shoulder-related QoL than other interventions.

근골격계 질환의 두침치료에 대한 체계적 문헌 고찰과 질 평가: 무작위 배정 대조 임상연구를 중심으로 (A Systematic Review and Quality Assessment of Scalp Acupuncture for Musculoskeletal Diseases: Focused on Randomized Controlled Trials)

  • 공도훈;신병철
    • 한방재활의학과학회지
    • /
    • 제33권4호
    • /
    • pp.61-78
    • /
    • 2023
  • Objectives This systematic review aimed to analyze the effectiveness, safety and the reporting quality of scalp acupuncture (SA) treatment for musculoskeletal disease (MSD). Methods Eleven databases were systematically searched up to July 12th 2023. Randomized controlled trials (RCTs) of SA treatment for MSD were selected manually by the inclusion criteria. The risk of bias of RCTs was assessed using the Cochrane's Risk of Bias (RoB) 1.0 and the reporting quality of studies was evaluated using Consolidated Standards of Reporting Trials (CONSORT) 2010 statement and Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) 2010 checklist. Results Ten clinical studies were met the inclusion criteria. Most of studies reported SA treatment significantly alleviated pain and functional disability of MSD patients and no serious adverse effects were reported. In RoB assessment, blinding of participants and personnel was found to have the highest RoB and allocation concealment was found to have the most unclear RoB. In CONSORT 2010 statement evaluation, all studies reported 15.3 items (41.4%) on average. In STRICTA 2010 checklist evaluation, all studies reported 11.2 items (65.9%) on average. Conclusions The systematic review found that SA treatment may alleviate pain and functional disability of MSD patients and have little severe adverse effect. The reporting quality of included studies was mainly low, therefore, further studies with strict adherence to the CONSORT and STRICTA checklist should be encouraged.

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
    • /
    • 제13권1호
    • /
    • 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.

지압이 항암요법환자의 오심과 구토에 미치는 효과 관련 연구 분석 (The Meta-Analysis of the Effect of Acupressure for Nausea and Vomiting in Cancer Patients Receiving Chemotherapy)

  • 장순양;박정숙
    • 종양간호연구
    • /
    • 제11권2호
    • /
    • pp.116-126
    • /
    • 2011
  • Purpose: This study was to analyze the characteristics and effect size of intervention studies that used acupressure for the control of chemotherapy-induced nausea and vomiting (CINV). Methods: Nine electronic databases including Korea Education Research and Information, the National Assembly Library, KISS, Korea Med, NDSL, PubMed, EBSCO, Cochrane library, and OVID (to December, 2009) were searched. Thirteen studies of randomized controlled trials (RCTs) or controlled clinical trials (CCTs) were selected. Data were analyzed by SPSS/WIN 18.0. Results: Overall effect size of acupressure was moderate (0.684). Nausea had a moderate effect size (0.770) and nausea and vomiting had a high effect size (0.899). Acupressure using sticker needles had a high effect size (1.368) among finger acupressure, si-acupuncture, and wrist band treatment. Conclusion: This study suggests that acupressure using sticker needles on the spots of nei-guan, chok-samni and hap-kok can reduce the levels of nausea and vomiting in cancer patients receiving chemotherapy. For improving the reliability of the meta-analysis results, further randomized controlled trials with better study methodology are needed.

뇌성마비(Cerebral palsy) 소아의 재활치료와 재활과 침치료의 병행치료를 비교한 체계적 문헌 고찰 (The Effect of Acupuncture combined with Conventional Rehabilitation Treatment for Cerebral palsy: A Systematic review of Randomized Controlled Trials(RCTs))

  • 장석주;성은학;김장현;민상연
    • 대한한방소아과학회지
    • /
    • 제34권3호
    • /
    • pp.81-96
    • /
    • 2020
  • Objectives This study aims to evaluate the effect of acupuncture combined with rehabilitation treatment for cerebral palsy in children. Methods 7 electro-database (PubMed, CENTRAL, CNKI, DBpia, KISS, OASIS, KJTK) were searched for using the keywords "cerebral palsy AND acupuncture" which study is designed in randomized controlled trials (RCTs). Results 10 out of 303 studies were included in analysis after screened. Acupuncture combined with rehabilitation treatment had a significant effect on motor function. Only 1 study reported minor adverse effects. Conclusions All of the studies have shown acupuncture combined with conventional rehabilitation treatment was effective in cerebral palsy. Additional well-designed studies are needed to justify the effectiveness of acupuncture in cerebral palsy.

성인 흡연자의 금연 프로그램 효과: 무작위대조군 실험연구의 체계적 문헌고찰 (The Effectiveness of Smoking Cessation Program in Adults: Systematic Review of Randomized Controlled Trials)

  • 박성희;황정해;최윤경;강창범
    • 보건교육건강증진학회지
    • /
    • 제29권3호
    • /
    • pp.1-14
    • /
    • 2012
  • Objectives: The purpose of this study was to determine if smoking cessation programs (SCPs) are effective for adults through a systematic review of the results of such programs in large randomized controlled trials (RCTs). Methods: The PICO (Patient, Intervention, Comparator, Outcome) strategy was established, 1,160 literature from domestic and foreign electronic databases was reviewed, and 22 references were selected based on the inclusion and exclusion criteria. The quality of each reference was evaluated using the Scottish Intercollegiate Guidelines Network tool, and meta-analysis was carried out. Results: The SCPs were significantly effective for adult smokers. Smoking cessation counseling, education, and smoking cessation medications such as nicotine patch were more effective than the other interventions. However, the results showed short-term effects (within six months), and differences were observed among the SCPs. For the outcome measures for SCPs, the abstinence rate of seven days was mainly used, but differences were identified between the CO level and the cotinine-verified abstinence rate of smoking cessation. Conclusions: For a smoking cessation program for adult smokers, the strength of the evidence of the program's effectiveness in RCTs that provide the identified intervention strategies should be considered.

무작위 배정 비교 임상 시험을 통한 국내의 약침 연구에 대한 체계적 고찰 (Randomized Clinical Controlled Trials with Herbal Acupuncture (Pharmacopuncture) in Korea - A Systematic Review)

  • 박봉기;조정효;손창규
    • 대한한의학회지
    • /
    • 제30권5호
    • /
    • pp.115-126
    • /
    • 2009
  • Objective: By assessing the quality of methodology and synthesis of results of RCTs (Randomized Controlled Clinical Trials) with herbal acupuncture (pharmacopuncture), we hope to help with administrating herbal acupuncture therapy in clinic and conducting RCT with herbal acupuncture. Methods: Reports of RCT conducted in Korea published in medical journals until February 2009 were collected. We surveyed elementary information of RCTs, evaluated randomization, double-blinding, allocation concealment and put together the results of RCTs by seven clinical topics. Results: 38 RCTs with herbal acupuncture were selected, then adequate methods for randomization and allocation concealment were found in 39% and 5% of studies. Complete double-blinding and a clear accounting of all participants were conducted in 42% and 50% of reports. The synthesis of RCTs revealed that herbal acupuncture was useful and effective on degenerative gonarthritis, omarthralgia on cerebrovascular accident, acute ankle sprain, back sprain, neck sprain, headache, rheumatoid arthritis and tennis elbow, generally. Conclusions: Although further improvement in quality of methodology of RCTs with herbal acupuncture is required, clinical usefulness of herbal acupuncture was shown especially on disorders of musculoskeletal system via RCTs.

  • PDF

Meta-analysis of the Efficacy of Sorafenib for Hepatocellular Carcinoma

  • Wang, Zhao;Wu, Xiao-Ling;Zeng, Wei-Zheng;Xu, Gui-Sen;Xu, Hui;Weng, Min;Hou, Juan-Ni;Jiang, Ming-De
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제14권2호
    • /
    • pp.691-694
    • /
    • 2013
  • Purpose: By carrying out a meta-analysis of randomized controlled trials that compared sorafenib or combined chemotherapy with placebo or combined chemotherapy, the effectiveness of sorafenib in hepatocellular carcinoma was evaluated in the present study, which also provided clinical practice guidelines of evidence-based-medicine. Methods: We reviewed PubMed citations concerning sorafenib treating hepatocellular carcinoma in randomized controlled trials from Jan 2000 to July 2012. All the literature was extracted by Cochrane systematic reviews and underwent meta-analysis with RewMan 5.0 software. Results: Finally, four papers documenting randomized controlled studies were included. Compared with controls, sorafenib was shown to significantly increase overall survival (OS), time to progression (TTP), and disease control rates (DCR), but not the time to symptom progression (TTSP) in hepatocellular carcinoma patients. The incidence of grade-III/IV adverse reactions, including hand-foot-skin reactions, diarrhea, hypertension and skin rash or desquamation, in sorafenib treatment group was higher than that in controls. However, there was no significant difference in the incidence of hypodynamia between the two groups. Conclusions: Sorafenib exerts significant curative effects in hepatocellular carcinoma.

CNKI로 검색한 소아 수두의 한약 내복 치료에 대한 임상연구 동향 - 2000년대 이후 RCT 연구를 중심으로- (Review of Clinical Studies of Oral Herbal Medicine Treatment for Pediatric Chickenpox using CNKI Database - Focused on Chinese Randomized Controlled Trials after 2000s -)

  • 최정윤;김장현;민상연
    • 대한한방소아과학회지
    • /
    • 제34권3호
    • /
    • pp.18-36
    • /
    • 2020
  • Objectives The purpose of this study is to analyze Chinese randomized controlled trials (RCTs), and to evaluate the effectiveness and safety of the oral herbal medicine treatment for pediatric chickenpox. Methods We searched RCTs after 2000s from the China National Knowledge Infrastructure (CNKI). Afterwards, the year of publication, demographic information, duration of chickenpox, intervention, treatment duration, outcome measure, results and adverse events were investigated and analyzed for this study. Results 21 RCTs out of 219 studies were collected and analyzed. Although each composition of the herbal medicine was different, they have common ingredients such as 清熱解毒, 散結消腫, 疏散風熱, 涼血解毒, 解表散風 in order to make efficacy of 清熱解毒, 散結消腫, 疏散風熱, 涼血解毒, 解表散風. The oral herbal medicine showed better efficacy and safety to improve clinical symptoms such as total efficacy, cure rate, antipyretic time, antipruritic time, scab time, anti-rash time, hospitalization period and herpes recovery time compared to the western medicine treatment. Conclusions These results show that the oral herbal medicine treatment on chickenpox in children may be more effective in reducing of clinical symptoms compared to the western medicine treatment.

Systematic Review of Fire Needling or Warm Needling Treatment for Ankle Sprain

  • Ko, Hong Je;Yoo, Jae Hee;Kim, Min Wook;Shin, Jeong Cheol
    • Journal of Acupuncture Research
    • /
    • 제37권1호
    • /
    • pp.19-27
    • /
    • 2020
  • The effectiveness of fire needling or warm needling treatment in clinical studies for the treatment of ankle sprains was reviewed using 4 international (PubMed, Cochrane library, EMBASE, CNKI) and 5 Korean databases (NDSL, RISS, KISS, OASIS, KTKP). Randomized controlled trials, that performed fire needling or warm needling treatment for ankle sprains until October, 2018 were retrieved (n = 8). All studies were performed in China, and 7 out of 8 studies were published within the last 5 years. There were 4 studies that used fire needling treatment, 3 studies used warm needling treatment, and 1 study used fire and warm needling treatment. The ashi-points and gallbladder meridian were the most frequently selected acupoint and meridian each. All intervention groups in the 8 studies showed statistically significant beneficial effects compared with control groups. The results of this study could provide preliminary data as the basis for well-designed randomized controlled trials on fire needling or warm needling treatment for ankle sprains.