• Title/Summary/Keyword: RevMan

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Effectiveness of Non-Pharmacologic Interventions in Chemotherapy Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis (항암화학요법 관련 말초신경병증에 적용한 비약물적 중재의 효과: 체계적 문헌고찰 및 메타분석)

  • Oh, Pok-Ja;Kim, You Lim
    • Journal of Korean Academy of Nursing
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    • v.48 no.2
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    • pp.123-142
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    • 2018
  • Purpose: This study was conducted to evaluate the effectiveness of non-pharmacologic interventions in chemotherapy-induced peripheral neuropathy (CIPN). Methods: PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL, and several Korean databases (Until August 2017) were searched. The main search strategy combined terms for peripheral neuropathy and presence of neoplasms. The risk of bias was assessed using the Cochrane's Risk of Bias tool for randomized studies and the Risk of Bias Assessment tool for non-randomized studies. To estimate the effect size, a meta-analysis of the studies was performed using the Rev Man 5.3 program of the Cochrane Library random-effects models were used in the analyses. Results: Twenty-two studies with a total of 954 participants met the inclusion criteria. Of the 22 studies, 12 were used to estimate the effect size of the non-pharmacologic interventions. The non-pharmacologic interventions used in patients with CIPN were exercise, acupuncture, massage, and foot bath. The acupuncture significantly reduced CIPN symptoms and signs (d=-0.71) and CIPN pain (d=-0.73) (p<.001). Massage and foot bath were also effective in reducing CIPN symptoms (d=-0.68; 95% CI=-1.05, -0.30; p<.001; $I^2=19%$).Exercises were effective in improving muscle strength and endurance(d=-0.55) and quality of life (d=-2.96), but they were not significantly effective in improving CIPN. Conclusion: Although these results provide little evidence of the effectiveness of acupuncture, massage, and foot bath in the treatment of CIPN, they suggest that these interventions can reduce CIPN symptoms in patients with cancer. However, the findings of this study should be interpreted with caution as there is a relative lack of data in this field, and additional well-designed studies are needed. PROSPERO registration: CRD42017076278.

The Effectiveness of Non-pharmacological Interventions on Anxiety in Children Undergoing Surgery: A Systematic Review and Meta-analysis (수술 환아의 불안에 적용한 비약물적 중재의 효과: 체계적 문헌고찰 및 메타분석)

  • Kim, Hyeon-Young;Shin, Sun Hwa
    • Journal of East-West Nursing Research
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    • v.27 no.1
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    • pp.1-13
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    • 2021
  • Purpose: The purpose of this study was to examine the effectiveness of non-pharmacological interventions for reducing perioperative anxiety in children undergoing surgery. Methods: A systematic review of randomized controlled trials (RCTs) with the primary outcome of children's perioperative anxiety was conducted. The literature search was performed using various databases, including Cochrane Library, CINAHL, EMBASE, PubMed, and Korean electronic databases with confined to RCTs between 2000 and 2020. A total of sixteen studies were suitable the inclusion criteria and were systematically reviewed. The bias risk of randomized studies was evaluated using Cochrane's risk of bias tool. For the meta-analysis, RevMan 5.4 was used to analyze effect sizes of interventional factors. Results: Finally, twelve RCTs studies were used for meta-analysis. The non-pharmacological interventions implemented to reduce perioperative anxiety in children were therapeutic play, clown therapy and information provision. First, therapeutic play had a significant effect on reducing preoperative anxiety, with an effect size of -1.46 (95% CI=-1.78~-1.14). Second, clown therapy had a significant effect on reducing preoperative anxiety, with an effect size of -0.97 (95% CI=-1.45~-0.49). Finally, the provision of information had a significant effect on reducing preoperative anxiety, with an effect size of -0.75 (95% CI=-0.99~-0.51). Conclusion: This meta-analysis suggests that non-pharmaceutical interventions provide effective methods of reducing perioperative anxiety in children. Therefore, the findings verify evidence that various non-pharmacological interventions are effective means for reducing children's preoperative anxiety.

Systematic Review on the Efficacy and Safety of Erenumab for the Prevention of Migraine (편두통 예방을 위한 erenumab의 유효성 및 안전성에 관한 체계적 고찰)

  • Son, Pyoungwoo;Chae, Hyunwoo;Ji, Eunhee;Yoo, Bong Kyu
    • Korean Journal of Clinical Pharmacy
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    • v.29 no.2
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    • pp.71-78
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    • 2019
  • Objective: This study aimed to provide efficacy and safety information on the use of erenumab for prevention of episodic and chronic migraines. Methods: The keywords "Erenumab and migraine" were used to search the PubMed database to then compile efficacy and safety data for erenumab. Data from relevant Phase 2 and Phase 3 clinical trials were analyzed, using RevMan for statistical analysis. Results: Three clinical trials (one Phase 2 and two Phase 3 studies) were retrieved. All three trials used the same primary endpoint (change from baseline in monthly migraine days (CBMD)) to evaluate efficacy and safety of erenumab use for prevention of episodic and chronic migraines. Subcutaneous doses of erenumab (70 or 140 mg) were administered monthly in each trial, for 3 months (Studies 2, and 3) or 6 months (Study 1). The mean differences in CBMD in the 70 mg and 140 mg erenumab arms were -1.36 and -1.98, respectively, compared to that in the placebo arm. Some adverse events, such as nasopharyngitis and upper respiratory tract infection, were reported, but no differences in safety between erenumab and placebo were found to be significant. Conclusions: Erenumab showed superior efficacy in prevention of migraines compared to placebo. However, additional information regarding the long-term safety of erenumab should be collected. Therefore, post-marketing surveillance for adverse events is needed.

A Systematic Review and Meta-Analysis of Randomized Controlled Trials on Chuna Manual Therapy for Cervicogenic Headache

  • Lee, Dong-Wha;Kim, Ju-Young;Hong, Min-Ho;Koo, Byung-Soo;Kim, Geun-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.30 no.2
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    • pp.89-105
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    • 2019
  • Objectives: We conducted this study to evaluate the efficacy of Chuna Manual Therapy (CMT) for treatment of cervicogenic headache (CeH) through systematic review and Meta-analysis of randomized controlled trials (RCTs) as a preceding research to further research the effective of Chuna Manual Therapy for patients who suffered from CeH. Methods: We conducted a systematic review and meta-analysis by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched the studies from MEDLINE, Elsevier-EMBASE, The Cochrane Library, CAJD, KISS, KMBase, Korean Traditional Knowledge Portal, NDSL, and OASIS. The studies selected only in randomized controlled trials. We selected the chosen studies by the selection and the exclusion criteria, and evaluated the quality of the selected studies using the Jadad score and the Cochran ROB tool. We used the Visual Analogue Scale score (VAS) and Clinical total Effective Rate (CER) for the results and analyzed the results of the included studies using RevMan 5.3 software provided by the Cochran library. Results: We included 20 RCTs, including 1,673 subjects, in the systematic review and meta-analysis. After the intervention, the CMT group showed better results than the pharmacotherapy group, the physiotherapy group, and the combined treatment group. The CMT group showed a good effect on the CER and the VAS but showed a significant heterogeneity compared to the pharmacotherapy group. Conclusions: The CMT as monotherapy might have benefits on Cervicogenic Headache patient. Further well-designed studies need to be conducted.

Effect of Autogenic Training for Stress Response: A Systematic Review and Meta-Analysis (아우토겐 트레이닝이 스트레스반응에 미치는 효과: 체계적 문헌고찰 및 메타분석)

  • Seo, Eunju;Kim, Soukyoung
    • Journal of Korean Academy of Nursing
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    • v.49 no.4
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    • pp.361-374
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    • 2019
  • Purpose: This study was conducted to evaluate the effectiveness of autogenic training on stress responses through a systematic review and meta-analysis. Methods: A systematic search was conducted using eight core electronic databases (Embase, CENTRAL, Medline, CINAHL, PsycInfo, DBpia, KISS, and RISS). To estimate the effect size, a meta-analysis of the studies was performed using RevMan 5.3.5 program. Results: A total 21 studies out of 950 studies were included in the review, and 11 were included for meta-analysis. These studies showed that autogenic training decreased anxiety and depression, and increased the high frequency of heart rate variability. Calculations to understand the effect of autogenic training on anxiety, through a meta-analysis, observed a reduction effect of anxiety score by 1.37 points (n=85, SMD=-1.37: 95% CI -2.07 to -0.67), in the studies on short-term intervention targeting healthy adults. On the other hand, similar calculations to understand the effect of autogenic training on depression observed, a reduction effect on the depression score by 0.29 point (n=327, SMD=-0.29: 95% CI -0.50 to -0.07), in the studies on long term intervention targeting the patient group. Conclusion: Autogenic training is effective for adults' stress management, and nurses will be able to effectively perform autogenic training programs for workers' stress relief at the workplace.

The Effect of Bojungikgi-tang on Stress Urinary Incontinence: A Systematic Review and Meta-Analysis (복압성 요실금에 대한 보중익기탕의 효과 : 체계적 문헌고찰과 메타분석)

  • Nam, Hyun-seo;Baek, Tae-hyun
    • The Journal of Internal Korean Medicine
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    • v.42 no.3
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    • pp.293-307
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    • 2021
  • Objectives: This study investigates the effects and safety of Bojungikgi-tang for stress urinary incontinence by systemic review and meta-analysis of randomized controlled trials (RCTs). Methods: RCTs were selected from articles published until December 2019 in seven domestic and foreign databases. The quality of the literature was evaluated using Cochrane's risk of bias (RoB) tool, and RevMan 5.3 was used to synthesize the results. Results: A total of 694 patients with stress urinary incontinence participated in eight RCTs. Meta-analysis showed that the total effective rate of treatment that combines pelvic floor muscle training (PFMT) and Bojungikgi-tang was significantly higher than that of PFMT alone. The volume of urine leakage per hour after the combined treatment was significantly lower than that of PFMT alone. The International Consultation on Insurance Questionnaire-Short Form (ICIQ-SF) scores from combining PFMT and Bojungikgi-tang were significantly lower than those for PFMT alone. Conclusion: This study suggests that Western medical treatment combined with Bojungikgi-tang for urinary incontinence from stress might be more effective in improving symptoms than conventional Western medical treatment alone. However, the number of studies included in the meta-analysis was insufficient, and the quality of the selected literature was generally low. Therefore, high-quality clinical studies on herbal medicine treatment for urinary incontinence would be required in the future.

A Systematic Review and Meta-analysis of Acupotomy for Scoliosis

  • Park, Jung Hyeon;Kim, Gyu Hui;Kim, Tae Kyung;Lee, Eun Ju;Yoon, Hyun Min;Seo, Jong Cheol;Song, Choon Ho;Cho, Sung Woo;Kim, Cheol Hong
    • Journal of Acupuncture Research
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    • v.38 no.4
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    • pp.265-275
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    • 2021
  • This review investigated the effectiveness and safety of acupotomy treatment for scoliosis. There were 7 online databases used in the search from inception to March 17, 2021, for randomized controlled trials of the use of acupotomy in patients with scoliosis. The Cochrane risk-of-bias tool was used to assess the methodological quality of the studies included (n = 12). A quantitative synthesis of the randomized controlled trials was performed using RevMan Version 5.3. The effect sizes of studies were presented as mean differences for continuous outcomes and risk ratios for dichotomous outcomes, with a 95% confidence interval. As part of combined therapy, acupotomy was reported to significantly improve Cobb's angle compared with other treatments. Likewise, the Visual Analog Scale score, the Oswestry Disability Index score, and pulmonary function were also reported to be improved following acupotomy combination therapy. Although 5 studies mentioned the criteria for reporting adverse events, only 1 study reported adverse events. In conclusion, acupotomy may be an effective treatment for scoliosis. However, the small number, and heterogeneity of the included studies, as well as the poor methodological quality, indicate that higher-quality studies should be conducted to verify the effectiveness and safety of acupotomy treatment for scoliosis.

Banhabaeckchulchunma-tang for Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-analysis (양성 발작성 자세변환성 현훈에 대한 반하백출천마탕(半夏白朮天麻湯)의 효과: 체계적 문헌고찰과 메타분석)

  • Kim, Geun-Lip;Hong, Chul-Hee;Lee, Kyou-Young
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.34 no.4
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    • pp.71-89
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    • 2021
  • Objectives : The purpose of this study is to evaluate the effect of Banhabaeckchulchunm a-tang(BBCT) for Benign Paroxysmal Positional Vertigo(BPPV) Methods : We searched randomized controlled trials(RCTs) which assess the effect of BB CT for BPPV through 8 electronic databases from their inception to July 2021. RevMan 5.4 was used to evaluate the risk of bias. Results : 12 RCTs with 901 subjects were included. The BBCT treatment group had significantly higher total effetive rate(TER) than the western medicine treatment group(P=0.0001), and the Dizziness Handicap Inventory(DHI) score(P=0.003), traditional chinese medicine syndrome(TCM syn.) score(P<0.00001), and Visual analog scale(VAS)(P=0.0006) were significantly lower than the western medicine treatment group. The combined treatment of BBCT and canalith repositioning procedure(CRP) group had significantly higher TER than only CRP treatment group(P=0.02), and there was no significant difference in DHI score(P=0.12). TG(P=0.006) and TC(P=0.04) were significantly lower, and ApoA1 was significantly higher(P=0.0001). There was no significant difference in LDL(P=0.24). Conclusions : These results demonstrate that BBCT could be effective for BPPV especially after CRP. However, because of limits of included studies such as high heterogeneity between the literatures, unclear risk of bias, insufficient reports of adverse events(AEs), a well-designed RCTs with a low risk of bias in more diverse countries are needed in the future.

Clinical Effects of Zinc Supplementation in Patients Hospitalized with COVID-19: A Systematic Review and Meta-analysis (코로나바이러스감염증-19로 입원한 환자들에 대한 아연의 임상적 효과: 체계적 문헌고찰 및 메타분석)

  • Park, Hye Won;Lee, So Yeon;An, Sook Hee
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.2
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    • pp.136-144
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    • 2021
  • Background: Zinc is known for modulating antiviral and antibacterial immunity and regulating inflammatory response. This study aimed to examine the effect of zinc supplementation on clinical outcomes of hospitalized COVID-19 patients through systematic literature review and meta-analysis. Methods: PubMed/Medline, Embase, and Cochrane library databases were searched for studies comparing zinc supplement group versus control group for clinical outcomes of COVID-19 up to November 3, 2020. The search results were updated on February 9, 2021. The meta-analysis was performed by RevMan 5.4 software. Results: Total 4 studies were included in this systematic review. The zinc administered group had a significantly lower mortality rate compared with the control group (odds ratio [OR] 0.63, 95% confidence interval [95% CI] 0.53-0.75, p<0.001), with significantly higher discharge rate (OR 1.32, 95% Cl 1.15-1.52, p<0.001). However, there were no significant differences in the intensive care unit admission rate (OR 1.07, 95% Cl 0.26-4.48, p=0.92), mechanical ventilation rate (OR 0.80, 95% Cl 0.45-1.41, p=0.44), and length of hospital stay (mean difference 0.75, 95% Cl -0.64 to 2.13, p=0.29) between the two groups. Conclusion: The meta-analysis of zinc administration showed positive clinical effects on the discharge rate and mortality of COVID-19 hospitalized patients. However, large-scale randomized controlled trial should be conducted for zinc to be considered as one of the adjuvant treatments.

Electromechanically assisted walking in patients with cerebral palsy: A meta-analysis

  • Kim, Kwonhoi;Lee, Sukmin
    • Physical Therapy Rehabilitation Science
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    • v.10 no.1
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    • pp.22-31
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    • 2021
  • Objective: This review aims to analyze the effects of electromechanically assisted walking in patients with cerebral palsy(CP). Design: A systematic review and meta-analysis. Methods: We reviewed systematically using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist guidelines. The inclusion criteria for this study were all CP patients. The intervention was electromechanically assisted walking. The outcome measures included gait parameters, function, spasticity. Studies excluded from this review were excluded from the review if they were non-English languages and if the study was not published as a full report, and if they were not randomized controlled trials (RCTs) designs. The RevMan 5.4 program was used to evaluate and explain the results. The risk of bias was evaluated independently by two reviewers. The quantitative meta-analysis, including mean differences (MD) and associated standard deviations (SD) from baseline and follow-up assessments, were recorded. Results: A total of 634 articles were searched. Two hundred eighty-nine duplicate articles were excluded, and 345 of 634 originals were left for selection. Of these 74 papers, 44 were out of topic, and 19 reported no mean or standard deviation values. And one was a non-experimental study. Finally, ten studies were included. All 10 RCTs of electromechanically assisted walking were analyzed. The meta-analysis showed a significant improvement in gait cycle (95% CI (confidence intervals), 0.09 to 0.19, I2=0%), Gross Motor Function Measure (GMFM) D (95% CI, 3.27 to 13.17, I2=0%) and GMFM E (95% CI, 0.22 to 6.41, I2=0%). Conclusions: Electromechanically assisted training helps in walking in patients with CP.