• Title/Summary/Keyword: RevMan

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Comparison of Concurrent Chemoradiotherapy Followed by Adjuvant Chemotherapy Versus Concurrent Chemoradiotherapy Alone in Locoregionally Advanced Nasopharyngeal Carcinoma: a Meta-analysis of 793 Patients from 5 Randomized Controlled Trials

  • Liang, Zhong-Guo;Zhu, Xiao-Dong;Zhou, Zhi-Rui;Qu, Song;Du, You-Qin;Jiang, Yan-Ming
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5747-5752
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    • 2012
  • Purpose: The main objective of the present study was to evaluate the efficacy and toxicity of concurrent chemoradiotherapy followed by adjuvant chemotherapy compared with concurrent chemoradiotherapy alone in the treatment of locoregionally advanced nasopharyngeal carcinoma. Methods: The search strategy included Pubmed, Embase, the Cochrane Library, China National Knowledge Internet Web, Chinese Biomedical Database and Wanfang Database. We also searched reference lists of articles and the volumes of abstracts of scientific meetings. Randomized controlled trials (RCTs) that compared concurrent chemoradiotherapy followed by adjuvant chemotherapy with concurrent chemoradiotherapy alone in locoregionally advanced nasopharyngeal carcinoma were included. Meta-analysis was performed with RevMan 5.1.0. The Grading of Recommendations Assessment, Development, and Evaluation system (GRADE) was used to rate the level of evidence. Results: Five studies were included. Risk ratios of 1.02 (95%CI 0.89-1.15), 0.93 (95%CI 0.72-1.21), 1.07 (95%CI 0.87-1.32), 0.95 (95%CI 0.80-1.13) were observed for 3 years overall survival, 5 years failure-free survival, 5 years locoregional failure-free survival and 5 years distant metastasis failure-free survival. There were no treatment-related deaths in both groups of five studies. Hematologic and gastrointestinal toxicity were the most significant for patients during adjuvant chemotherapy. The level of evidence was low. Conclusion: Compared with concurrent chemoradiotherapy alone, concurrent chemotherapy followed by adjuvant chemotherapy did not improve prognosis. More toxicity was found during adjuvant chemotherapy.

Could Clinical Pathways Improve the Quality of Care in Patients with Gastrointestinal Cancer? A Meta-analysis

  • Song, Xu-Ping;Tian, Jin-Hui;Cui, Qi;Zhang, Ting-Ting;Yang, Ke-Hu;Ding, Guo-Wu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8361-8366
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    • 2014
  • This meta-analysis was performed to assess the implementation effects of clinical pathways in patients with gastrointestinal cancer. A comprehensive search was conducted in the Cochrane Library, PubMed, EMBASE, Web of Science and Chinese Biomedical Literature Database (from inception to May 2014). Selection of studies, assessing risk of bias and extracting data were performed by two reviewers independently. Outcomes were analyzed by fixed-effects and random-effects model meta-analysis and reported as mean difference (MD), standardized mean difference (SMD) and odds ratio (OR) with 95% confidence intervals (CI). The Jadad methodological approach was used to assess the quality of included studies and the meta-analysis was conducted with RevMan 5.1 software. Nine citations (eight trials) involving 642 patients were included. The aggregate results showed that a shorter average length of stay [MD = -4.0; 95% CI (-5.1, -2.8); P < 0.00001] was observed with the clinical pathways as compared with the usual care. A reduction in inpatient expenditure [SMD = -1.5; 95% CI (-2.3, -0.7); P = 0.0001] was also associated with clinical pathways, along with higher patient satisfaction [OR = 4.9; 95% CI (2.2, 10.6); P < 0.0001]. Clinical pathways could improve the quality of care in patients with gastrointestinal cancer, as evidenced by a significant reduction in average length of stay, a decrease in inpatient expenditure and an improvement in patient satisfaction. Therefore, indicators and mechanisms within clinical pathways should be a focus in the future.

Cyclooxygenase-2 Promoter 765C Increase of Digestive Tract Cancer Risk in the Chinese Population: a Meta-analysis

  • Xu, Yan-Song;Zhao, Bo;Long, Chen-Yan;Li, Hui;Lu, Xing;Liu, Gang;Tang, Xiao-Zhun;Tang, Wei-Zhong
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.11
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    • pp.4563-4566
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    • 2014
  • Background: To evaluate relationship between the cyclooxygenase-2 promoter 765G/C polymorphism and digestive cancer risk in China. Materials and Methods: A literature search through February 2014 was performed using PubMed, Chinese Biomedical Literature Database (CBM) and China National Knowledge Infrastructure (CNKI) databases, and a meta-analysis was performed with RevMan 5.2 software for odds ratios and 95%CIs. Results: In total, 9 articles with 3,263 cases and 4,858 controls were included in this meta-analysis. The pooled OR (95%CIs) in the co-dominant model (GC vs GG) was 1.56 [1.19, 2.06], and in the dominant model ((CC+GC) vs GG), the pooled OR was 1.59 [1.21, 2.09] in overall cancers. In the subgroup analysis, stratified by cancer type, significant associations were found that the-765C allele had increased pancreatic cancer and gastric risk. No significant liver cancer and colorectal cancer risk of COX-2 -765G/C polymorphism was found. Conclusions: These findings suggest that COX-2-765*C is related to cancer susceptibility and may increase gastric and pancreatic cancer risk.

Effects of First Assisted Reproductive Technologies on Anxiety and Depression among Infertile Women: A Systematic Review and Meta-Analysis (1차 체외수정시술이 난임여성의 불안과 우울에 미치는 효과: 체계적 문헌고찰과 메타분석)

  • Ha, Ju-Young;Ban, Seon-Hwa;Lee, Hae-Jung;Lee, Misoon
    • Journal of Korean Academy of Nursing
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    • v.50 no.3
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    • pp.369-384
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    • 2020
  • Purpose: The purpose of this study was to analyze anxiety and depression among infertile women at different time points during the first In Vitro Fertilization (IVF) or Intracytoplasmic Sperm Injection (ICSI) treatment through a systematic review and meta-analysis. Methods: Seven out of 3,011 studies were included for meta-analysis. To estimate the effect size, a meta-analysis of the studies was performed using the RevMan 5.3 program. We compared the measurement outcomes at three time points: before the start of treatment (T0), cancellation of treatment after pregnancy detection (T2), one to six months after treatment (T3). The effect size used was the standardized mean difference (SMD). Results: In comparing the different time points of the pregnant women from their cycle, significantly lower levels of depression were found at T2 than at T0. In non-pregnant women, anxiety at T2 and depression at T2 and T3 were significantly higher than those at T0. At T2 and T3, the non-pregnant women reported higher levels of anxiety and depression compared with the pregnant women. Conclusion: Anxiety and depression in infertile women undergoing the first IVF or ICSI are associated with the time points and pregnancy status after treatment. These findings suggest that attention should be paid to helping infertile women prepare for and cope with treatment and treatment failure.

Effects of Aromatherapy on Menopausal Symptoms, Perceived Stress and Depression in Middle-aged Women: A Systematic Review (아로마테라피가 중년여성의 갱년기 증상, 스트레스 및 우울에 미치는 효과: 체계적 문헌고찰)

  • Kim, Shinmi;Song, Ji-Ah;Kim, Mi-Eun;Hur, Myung-Haeng
    • Journal of Korean Academy of Nursing
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    • v.46 no.5
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    • pp.619-629
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    • 2016
  • Purpose: This study was a systematic review to evaluate the effects of aromatherapy on menopausal symptoms, perceived stress and depression in middle aged-women. Methods: Eight databases were searched from their inception September 8, 2015. Two reviewers independently performed the selection of the studies, data abstraction and validations. The risk of bias was assessed using Cochrane criteria. For analysis of the data, a meta-analysis of the studies was performed. Results: From the electronic databases, 73 articles were selected, and 19 removed due to duplication. After two reviewers read the abstracts of 54 studies, 34 studies were selected. Complete papers for 34 s were read and, 12 studies which met selection criteria were reviewed and the effects of aromatherapy on menopausal symptoms, stress and depression analyzed using meta-analysis with RevMan. In the 2 studies which included Randomized Controlled Trials testing of aromatherapy on menopausal symptoms and comparison of control and placebo groups were done. Aromatherapy massage was favorably effective in reducing the menopausal symptoms compared to the control group (n=118, MD=-6.33; 95% CI -11.51 to -1.15), and compared to the placebo group (n=117, MD=-4.14; 95% CI -7.63 to -0.64). Also aromatherapy was effective in reducing stress (n=72, SMD=-0.64; 95% CI -1.12 to -0.17) and depression (n=158, MD=-5.63; 95% CI -10.04 to -1.22). Conclusion: There is limited evidence suggesting that aromatherapy for middle-aged women may be effective in controlling menopausal symptoms, perceived stress and depression.

Effects of Psychoeducational Intervention for Cancer Survivors: A Systematic Review and Meta-Analysis (암생존자를 위한 심리교육중재의 효과에 대한 체계적 고찰 및 메타분석)

  • Park, Jin-Hee;Bae, Sun Hyoung
    • Journal of Korean Academy of Nursing
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    • v.47 no.2
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    • pp.143-163
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    • 2017
  • Purpose: This study was a systematic review and meta-analysis designed to investigate effects of psychoeducational intervention for cancer survivors. Methods: Ten databases were searched. Two reviewers independently performed the selection of the studies, data extraction and assessment. The risk of bias was assessed using Cochrane Collaboration's tool. To estimate the effect size, meta-analysis of the studies was performed using Comprehensive Meta-Analysis and RevMan programs. Results: Of 18,781 publications identified, 35 met inclusion criteria, and 25 studies were used to estimate effect size of psychoeducational intervention. Effect sizes (standardized mean difference [SMD]) were heterogeneous and random effects models were used in the analyses. Psychoeducational intervention was effective for quality of life (n=2,410, ES=0.23; 95% CI: 0.09~0.37), coping and self-efficacy (n=179, ES=0.68; 95% CI: 0.26~1.11), anxiety (n=1,786, ES=-0.26; 95% CI: -0.37~-0.15), depression (n=1,910, ES=-0.28; 95% CI: -0.37~-0.18), and psychological distress (n=2,242, ES=-0.31; 95% CI: -0.46~-0.17). Subgroup analysis showed that counseling was the most effective intervention for quality of life, and behavioral therapy was an effective intervention for all positive and negative outcomes. Publication bias was not detected except for psychological distress. Conclusion: Psychoeducational intervention appears to be effective in improving quality of life and coping and self-efficacy, and it is effective in reducing psychological symptoms in cancer survivors. Behavioral therapy, especially, is commonly effective in improving psychosocial outcomes. However, low-quality evidence, variability in the designs of existing studies, and publication bias suggest that additional high-quality trials should be conducted in the future.

Meta-Analysis on the Effect of Therapeutic Horseback Riding on Children with Developmental Disabilities and Neural Patients

  • Noh, Hyunju;Kim, Jiyoung;Park, Jiwon
    • The Journal of Korean Physical Therapy
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    • v.32 no.5
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    • pp.312-318
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    • 2020
  • Purpose: This study aimed to investigate the evidence that therapeutic horseback riding can improve balance, muscle, ADL, equivalenc, GMFM, gait, emotion with developmental disabilities and neural patients. Methods: To conduct meta-analysis, the search focused on studies that employed therapeutic horseback riding for developmental disabilities and neural patients for which eight databases (KIS, RISS, DBpia, National Assembly Library, Pubmed, Embase, Google scholar and Cochrane Library) were used to extract literature published from 2002 to September 2019. The data were analyzed the RevMan 3.5.3 program. Results: As a result of meta-analysis, therapeutic horseback riding total effect size is 0.552 for children with developmental disabilities and neural patients. And effect size result of according to assessment type variable first, balance effect size is 0.594. Second, muscle activities effect size is 0.425. Third, ADL effect size is 0.430. Fourth, equivalance effect size is 0.640. Fifth, GMFM effect size is 0.482. Sixth, gait effect size is 0.400 and seventh emotion effect size is 0.876. Conclusion: These findings is horseback riding is effective The effect size by outcome was observed to be the effective for children with developmental disabilities and neural patients. and also the horseback riding provided the positive effects of balance, muscle activities, ADL, equivalance, GMFM, gait, emotion for children with developmental disabilities and neural patients. It is hoped that this study will contribute to the development of effective treatments for children with developmental disabilities and neural patients therapeutic horseback riding and the development of study.

Laparoscopic Versus Open Surgery for Rectal Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials

  • Zhang, Feng-Wa;Zhou, Zhao-Yu;Wang, Hai-Lin;Zhang, Jv-Xia;Di, Bao-Shan;Huang, Wen-Hui;Yang, Ke-Hu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9985-9996
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    • 2014
  • Background and Aim: Laparoscopic and open rectum surgery for rectal cancer remains controversial. This systematic review compared the short-term and long-term efficiency and complications associated with laparoscopic and open resection for rectal cancer. Materials and Methods: We searched PubMed, Embase, Cochrane Library, ISI Web of Knowledge and the China Biology Medicine Database to identify potential randomized controlled trials from their inception to March 31, 2014 without language restriction. Additional articles were identified from searching bibliographies of retrieved articles. Two reviewers independently assessed the full-text articles according to the pre-specified inclusion and exclusion criteria as well as the methodological quality of included trials. The meta-analysis was performed using RevMan 5.2. Results: A total of 16 randomized controlled trials involving 3,045 participants (laparoscopic group, 1,804 cases; open group, 1,241 cases) were reviewed. Laparoscopic surgery was associated with significantly lower intraoperative blood loss, earlier return of bowel movement and reduced length of hospital stay as compared to open surgery, although with increased operative time. It also showed an obvious advantage for minimizing late complications of adhesion-related bowel obstruction. Importantly, there were no significant differences in other postoperative complications, oncological clearance, 3-year and 5-year or 10 year recurrence and survival rates between two procedures. Conclusions: On the basis of this meta-analysis we conclude that laparoscopic surgery has advantages of earlier postoperative recovery, less blood loss and lower rates of adhesion-related bowel obstruction. In addition, oncological outcome is comparable after laparoscopic and open resection for rectal cancer.

A meta-analysis of intervention studies on the effects of self-management in knee osteoarthritis (무릎 골관절염 대상자에게 적용한 자가관리 중재의 효과 메타분석)

  • Kim, Young-Il;Park, Jeong Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.3
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    • pp.1946-1956
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    • 2015
  • The purpose of the this study was to provide objective evidence through a systematic review and meta-analysis regarding the effects of self-management in knee osteoarthritis. Articles published between 1999 and 2013 from periodicals indexed Ovid Medline, CINAHL, PubMed, RISS, KISS and other databases were selected, using the following key words: Osteoarthriti* OR OA, self-(management OR care OR help). A selection of 11 studies(7 randomized controlled trials and 4 quasi-experimental interventions that were used were exercise, education, massage and self-help group. As a result of mera-analysis, self-management significantly effected pain, physical function, activities of daily living, and self-efficacy. In particular, self-management showed great effect on ADL, and moderate effect on pain and physical function. Based upon these result, it is necessary to develop a standardized self-management program for knee osteoarthritis patients.

The Effectiveness of Acupuncture Treatment for Patients with Alzheimer's Disease: A Meta-Analysis of Randomized Controlled Trials

  • Shin, Jin Hyeon;Shin, Hye Jeong;Kim, Eui Byeol;An, Yun Young;Yook, Tae Han;Choi, Yoo Min;Song, Beom Yong;Kim, Jong Uk
    • Journal of Acupuncture Research
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    • v.37 no.4
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    • pp.209-223
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    • 2020
  • The purpose of this study was to evaluate the effectiveness of acupuncture treatment for the symptoms of Alzheimer's disease (AD). There were 11 databases searched for randomized controlled trials using acupuncture treatment for AD. The risk-of-bias assessment tool of the Cochrane Library was used to evaluate the quality of each study. Using the Review Manager (RevMan), a meta-analysis was performed using risk ratio, mean difference, 95% confidence interval, and random effect model. There were 32 studies selected, all of which were conducted in China. There were 16 studies where acupuncture was used as the intervention, and 23 studies used Donepezil as the control group. Acupoint GV20 was most frequently selected during the treatment. The Mini Mental State Examination (MMSE) was the most frequently used outcome variable. A period of 12 weeks was the most common treatment duration. As a result of meta-analysis (n = 25), acupuncture improved the MMSE and activities of daily living scores. Electroacupuncture improved the Alzheimer Disease Assessment Scale-Cognitive Subscale, and scalp acupuncture improved the MMSE score for AD. Acupuncture alleviates the symptoms of AD. However, further research is necessary to provide a better level of evidence.