• Title/Summary/Keyword: Review bias

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Poststroke Depression : A Review of the Latest Oriental Medicine Articles (뇌졸중 후 우울증 : 한방 치료에 대한 국내외 최신 문헌 고찰)

  • Lee, Je-Won;Lee, Bo-Mae-Na;Jang, Woo-Seok;Hwang, Ha-Yeon;Baek, Kyung-Min
    • The Journal of Internal Korean Medicine
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    • v.33 no.4
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    • pp.448-464
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    • 2012
  • Objectives : This study reviews the latest articles in Korea and other countries that studied oriental medicine treatment on poststroke depression. Methods : Korean articles were retrieved from the 9 major Korean web article search engines. Foreign articles were retrieved from PubMed. Article published date was from 2000 up to September 2012. There were no restrictions on the types of publication, but articles not available in full text were excluded. The methodological quality was assessed according to Cochrane's assessment of risk of bias and Newcastle-Ottawa quality assessment scale. Results : Twenty-two articles were included in this study. Eleven articles were published in Korea, the rest were published in China. Nine articles were randomized controlled trials (RCT), one article was a non-randomized study (NRS), four articles were case reports, three articles were cross-sectional studies, two articles were comparative studies. In RCT articles, risk of selection bias and performance bias were generally high, risk of detection bias was unclear. The NRS article took four stars in Newcastle-Ottawa quality assessment. Comparison Hamilton rating scale for depression score between oriental medicine treated group and western medicine treated group revealed that there was no remarkable difference in mean score changes after treatment on PSD. Conclusions : The results of this study suggest that oriental medicine treatment is as effective as western medicine treatment for PSD. In the future, more rigorous oriental medicine treatment studies should be conducted.

Efficacy of corticosteroids for postoperative endodontic pain: A systematic review and meta-analysis

  • Nath, Ranjivendra;Daneshmand, Ali;Sizemore, Dan;Guo, Jing;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.4
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    • pp.205-221
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    • 2018
  • This systematic review aimed to analyze the efficacy of corticosteroid premedication compared to placebo or no treatment to reduce postoperative pain in endodontic patients. Randomized controlled trials (RCTs) assessing corticosteroids via oral, intramuscular, subperiosteal, intraligamentary or intracanal route compared to passive or active placebo, or no treatment were included. Four databases were searched: PubMed, Web of Science, Cochrane Library and Embase up to 2/21/2018. Risk of bias was assessed with Cochrane Risk of bias tool. Fourteen RCTs with 1,462 generally healthy adults in need of endodontic treatment were included. 50% of the studies were at unclear risk and 50% at high risk of bias. Meta-analysis showed Visual Analog Scale (VAS) pain at 4-6 hours after Inferior Alveolar Nerve Block (IANB) was significantly lower by 21 points (0-100 scale) in the corticosteroid group compared to the control group (95% CI -35 to -7; P = 0.003), however this difference was not statistically significant after 24 hours (P = 0.116). The route of administration was oral and intraligament injection. Patients who received corticosteroids prior to IANB were 70.7% more likely to have none or mild pain 4-8 hours after treatment (P = 0.001) and 13.5% more likely 24 hours after IANB (P = 0.013) than patients in the control group. In conclusion, corticosteroid administration (oral or intraligamental) may clinically reduce the level of postoperative pain at 4-8 hours after IANB, however the quality of the evidence was low/moderate due to risk of bias and heterogeneity. Further studies are recommended.

Moxibustion Treatment for Knee Pain: A Systematic Review (슬통의 뜸치료에 대한 체계적 고찰)

  • Kim, Seok Hee;Lee, Kyung Jin;Choi, Yoo Min;Kim, Ju Yong;Yook, Tae Han;Lee, Sang Lyoung;Kim, Jong Uk
    • Journal of Acupuncture Research
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    • v.32 no.3
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    • pp.135-146
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    • 2015
  • Objectives : This study was designed to evaluate clinical evidence of moxibustion treatment for knee pain. Methods : All processes were independently carried out by three investigators. A literature search was performed in 3 databases from their inception to May 2015. Ten reports were found based on their title, abstract and text. Following this, data extraction and analysis were done using a risk of bias(ROB) and through an assessment of multiple systematic reviews(AMSTAR). Results : 10 studies(6RCT, 2SR, 2CR) were included. Generally, indirect moxibustion was used for knee pain, but only one study indicated the use of direct moxibustion. Moxibustion was shown to be effective in treating knee pain, and the number of required treatments was fourteen on average. In assessing risk of bias, indefinite and uncertain information made all included trials subject to a high risk of bias. On the other hand, SR showed all evaluation items in the assessment of multiple systematic reviews, with the exception of an included or excluded studies list. Conclusions : Because of deficient study design or limited research planning, there is not sufficient evidence to allow for any conclusion about the efficacy of moxibustion for knee pain. Therefore, well-designed high quality trials are needed from now on.

Effectiveness of hyaluronic acid in the management of oral lichen planus: a systematic review and meta-analysis

  • Manjushri, Waingade;Raghavendra S, Medikeri;Shamali, Gaikwad
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.6
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    • pp.405-417
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    • 2022
  • Oral lichen planus (OLP) is a chronic inflammatory immune-mediated condition that has been identified as a potentially malignant oral disorder. Various therapies have been proposed for its management as alternative to corticosteroids. However, no definitive treatment has been identified that can result in complete remission or minimal recurrence. Hyaluronic acid has recently been used as an alternative therapy for the management of OLP. This study aimed to systematically review the effectiveness of Hyaluronic acid in the management of symptomatic OLP. Online electronic databases and manual searches were performed for randomized controlled trials (RCTs) published in English between January 2010 and April 2022. RCTs were identified that compared the efficacy of hyaluronic acid and other interventional therapies at baseline and during follow-up. The Cochrane Risk of Bias tool was used to assess the quality of the included studies. Visual analog scale (VAS) scores, Thongprasom sign scores, lesion size, degree of erythema, clinical severity, and disease severity were assessed both quantitatively and qualitatively. Seven studies were analyzed. Five studies reported a high risk of bias while the remaining two studies reported an unclear risk of bias. The overall quantitative assessment of size, symptoms, degree of erythema, and sign score in OLP lesions treated with HA was not statistically significant compared to that in the control group (P > 0.05). In addition, subgroup analysis comparing HA with placebo or corticosteroids did not yield statistically significant (P > 0.05) results. Qualitatively, both HA and tacrolimus resulted in an effective reduction in signs and symptoms. Clinical/disease severity index/scores were inconsistent. A high degree of heterogeneity was observed among the included studies. None of the included studies reported the side effects of HA. These findings suggest that corticosteroids, tacrolimus, placebo, and HA could be equally effective in OLP management. The clinical/disease severity index or score reduction cannot be determined with certainty. Thus, OLP can be treated with HA as an alternative therapy. Owing to limited clinical trials on HA, high heterogeneity, and high risk of bias in the included studies, definitive conclusions cannot be derived.

A Systematic Review of Bee Venom Acupuncture for Ankle Sprain (족관절 염좌의 봉독 약침 치료에 대한 체계적 문헌 고찰)

  • Gu, Ji-Hyang;Li, Yu-Chen;Jo, Dong-Chan;Lee, Eun-Jung
    • Journal of Korean Medicine Rehabilitation
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    • v.28 no.3
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    • pp.55-66
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    • 2018
  • Objectives To evaluate the evidence supporting the effectiveness of bee venom acupuncture for ankle sprain. Methods We conducted search across 11 electronic databases (Pubmed, EMBASE, Cochrane CENTRAL [CENTRAL], KoreaMed, Kmbase, Koreanstudies Information Service System [KISS], National Digital Science Library [NDSL], Korea Institute of Science and Technology Information [KISTI], China National Knowledge Infrastructure [CNKI], Wanfang and Chinese Scientific Journals Database [VIP] database) to find clinical trials that used bee venom acupuncture as treatment for ankle sprain. The methodological quality of randomized controlled clinical trials (RCTs) were assessed using the Cochrane Risk of Bias (RoB) tool, while non-randomized controlled clinical trials (NRCTs) were assessed using the Cochrane Risk of Bias Assessment tool for Non-randomized Study (RoBANS) tool. Results Four RCTs and one nRCT met our inclusion criteria. Almost studies showed that bee venom acupuncture has positive effect on ankle sprain. 4 studies of same intervention and control included in the meta-analysis. When comparing bee venom acupuncture and acupuncture with acupuncture, the effect size of standardized mean difference (SMD) was -0.19 (95% confidence interval [CI]: -1.95~1.56, Z=0.55, p=0.83). And when comparing bee venom acupuncture with acupuncture, the effect size of SMD was -0.17 (95% CI: -0.65~0.31, Z=0.71, p=0.48). Conclusions Although our systematic review found encouraging but limited evidence of bee venom acupuncture for ankle sprain, most of the studies included in the analysis were evaluated as methodologically high risk of bias. From now on further well-designed RCTs should be encouraged.

Systematic Review of Chuna Manipulative Treatment for Ankle Sprain

  • Kwak, Min Kyung;Kim, Min Wook;Jeong, Sang Jun;Kim, Shin Ae;Jeong, Mi Young;Kim, Jae Hong
    • Journal of Acupuncture Research
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    • v.35 no.2
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    • pp.61-68
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    • 2018
  • Background: This study was performed to review the efficacy of national and international randomized controlled trials (RCT) investigating Chuna manipulative treatment for ankle sprains. Methods: Online databases (PubMed, Cochrane, EMBASE, CNKI, NDSL, OASIS), were searched for studies where Chuna treatment was performed for ankle sprains up to October 12th, 2017. Only RCT were selected that fulfilled the inclusion/exclusion criteria. Data were analyzed using the Cochrane risk of bias tool. Results: There were 676 studies retrieved from the databases, resulting in analysis of 24 RCT. There was an average of 7 treatment visits over a 7 day period and the most frequent evaluation tool used was efficacy rate, with drug therapy being the most common control used in the trials. In 15 RCT, several Chuna methods were used in combination, amongst which, the osteopathic technique was most common. Statistically significant improvement in evaluation indices was reported in 19 RCT, and in 3 RCT, statistically significant improvement was reported, but not for all indices. In the remaining 2 RCT, there were no significant differences in any of the evaluation indices. No adverse reactions were reported in any of the RCT, although it was unknown whether all the trial protocols indicated that adverse reactions should be monitored, and for this reason, the risk of bias was unclear. Conclusion: The review of 24 studies suggest that Chuna manipulative treatment for ankle sprains was effective in most cases, although, potential bias in these studies was difficult to evaluate.

Manual Therapy for Wrist Pain: A Systematic Review and Meta-analysis (손목 통증의 수기 치료에 대한 체계적 문헌 고찰과 메타분석)

  • Lee, Ye-Ji;Jeon, Cheon-Hoo;Kim, Hyo-Bin;Jeon, Ju-Hyun;Kim, Eun-Seok;Kim, Jin-Youp;Choi, Kang-Min;Kim, Young-Il
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.15 no.1
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    • pp.75-87
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    • 2020
  • Objectives : This study aimed to evaluate the effectiveness of manual therapy for wrist pain. Methods : We searched electronic databases (PubMed, Embase, Cochrane, CAJ, KISS, RISS, NDSL, OASIS, and KMBASE) for randomized controlled trials for manual therapy as a treatment for wrist pain. Results : A total of 9 randomized controlled trials were selected and meta-analysis was conducted on 6 studies. Three studies with different design of the intervention/control group were excluded from the meta-analysis. A high risk of bias was observed for both performance bias and detection bias. Conclusions : Our systematic review verified the clinical effect of manual therapy on wrist pain. Based on the results of this study, it is expected that clinical studies on wrist diseases and high-level follow-up studies will be conducted.

Systematic Review of Chuna Manual Therapy for Cervicogenic Headache (경추성 두통에 대한 추나 요법의 체계적 문헌고찰)

  • Shin, Seon-Ho;Han, Kuk-In;Jeon, Yong-Tae;Ko, Youn-Seok;Lee, Jung-Han
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.12 no.1
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    • pp.1-12
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    • 2017
  • Objective : The purpose of this study is to review the randomized clinical trials of Chuna manual therapy for cervicogenic headache and provide a evidence for the efficacy of Chuna manual therapy. Methods : We searched randomized clinical trials that performed Chuna manual therapy for cervical headache up to Feb. 2017 in 6 databases. Randomized clinical trials were selected according to the inclusion criteria and the data were extracted and analyzed. The risk of bias was assessed using the Cochrane Risk of Bias Criteria. Results : 16 RCTs met the inclusion criteria. The meta-analysis of 13 RCTs showed favorable results for the use of chuna manual therapy compared to drug, physical treatment. Conclusions : In 16 RCTs, we found that Chuna manual therapy was effective in cervicogenic headache. However, all RCTs are exposed to a number of bias risks. Therefore, well designed clinical trial would be needed to raise the evidence level of Chuna manual therapy.

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Literature Review of Catgut-embedding Therapy for Lumbar Disk Herniation (요추 추간판 탈출증의 매선치료에 대한 문헌적 고찰)

  • Park, Sang-Hun;Jeon, Yong-Tae;Han, Kuk-In;Kim, Min-Ji;Lee, Ha-Il;Lee, Jung-Han;Ko, Youn-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.25 no.4
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    • pp.29-40
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    • 2015
  • Objectives We have attempted to provide the basis of treatment effects by considering foreign & domestic randomized controlled trials (RCTs), being implemented with catgut-embedding therapy for lumbar disc herniation. Methods We found the literatures prepared in Korean, English, and Chinese by December 2014 in electronic databases (Pubmed, Science Direct, Proquest, OASIS, KMbase, NDSL, RISS, National Assembly Library). We choosed RCTs by selection criteria through abstracts & articles, extracted and analyzed data. Cochrane's Risk of Bias Tool was used & implemented for the risk of bias. Results The total of 17 studies were included in the review. 88.2% of studies were accomplished within the last decade. The experimental group has shown more significant effects in 70.6% of studies, and the long-term & partial significant results were obtained in 29.4% of studies. Affected lumbar area and pelvic limb area with radiating pain were mostly selected for acupoint. Conclusions Overall and partial significant results were obtained from 17 foreign & domestic comparative RCTs which substantiates the treatment effects of catgut-embedding therapy for lumbar disc herniation. Since all studies, however, were exposed to the risk of bias, so future research of higher quality shall be necessary.

Acupuncture Treatment for Rotator Cuff Disorder: A Systematic Review (회전근개 질환에 대한 침술 치료의 효과: 체계적 문헌 고찰)

  • Choi, Hyun-Min;Han, Soo-Yeon;Hwang, Doo-Ree;Kang, Jun-Hyuk
    • Journal of Korean Medicine Rehabilitation
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    • v.28 no.4
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    • pp.11-20
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    • 2018
  • Objectives To systematically explore the effects of acupuncture treatment for rotator cuff disorders and review the clinical trials. Methods We searched 9 electronic databases (PubMed, Cochrane central, Embase, China National Knowledge Infrastructure [CNKI], Korea Institute of Science and Technology Information [KISTI], National Digital Science Library [NDSL], Korean studies Information Service System [KISS], Research Information Sharing Service [RISS], Oriental Medicine Advanced Searching Integrated System [OASIS]) to find randomized controlled trials that used acupunture treatment for rotator cuff disorders. We assessed the designs of the randomized controlled trials and the method of acupuncture treatment according to the Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA). The methodological quality of randomized controlled trials were assessed using the Cochrane Risk of Bias (RoB) tool. Results Total 5 trials were reviewed. 4 out of 5 randomized clinical trials reported meaningful effects of acupuncture treatments compared to control group. However risk of bias seemed high. Conclusions Although the results suggest that acupuncture treatment has favorable effects for rotator cuff disorders, most of the studies included methodologically high risk of bias. Thus, well designed randomized clinical trials which evaluate the effects of acupuncture treatment for rotator cuff disorders should be encouraged.