• Title/Summary/Keyword: Risk of Bias

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Abiraterone for Treatment of Metastatic Castration-resistant Prostate Cancer: a Systematic Review and Meta-analysis

  • Zhou, Zhi-Rui;Liu, Shi-Xin;Zhang, Tian-Song;Xia, Jun;Li, Bo
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.3
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    • pp.1313-1320
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    • 2014
  • Introduction: Although most prostate cancers initially respond to castration with luteinizing hormonereleasing analogues or bilateral orchiectomy, progression eventually occurs. Based on the exciting results of several randomized controlled trials (RCTs), it seems that patients with metastatic castration-resistant prostate cancer (mCRPC) might benefit more from treatment withabiraterone. Therefore we conducted a systematic review to evaluate the efficacy and toxicity of abiraterone in the treatment of mCRPC. Methods: Literature was searched from Embase, PubMed, Web of Science, and Cochrane Library up to July, 2013. Quality of the study was evaluated according to the Cochrane's risk of bias of randomized controlled trial (RCT) tool, then the Grading of Recommendations Assessment, Development and Evaluation (GRADE) System was used to rate the level of evidence. Stata 12.0 was used for statistical analysis. Summary data from RCTs comparing abiraterone plus prednisone versus placebo plus prednisone for mCRPC were meta-analyzed. Pooled hazard ratios (HRs) for overall survival (OS), radiographic progression-free survival (RPFS) and time to PSA progression (TTPP); Pooled risk ratios (RR) for PSA response rate, objective response rate and adverse event were calculated. Results: Ten trials were included in the systematic review; Data of 2,283 patients (1,343 abiraterone; 940 placebo) from two phase 3 trials: COU-AA-301 and COU-AA-302 were meta-analyzed. Compared with placebo, abiraterone significantly prolonged OS (HR, 0.74; 95% confidence interval [CI], 0.66 to 0.84), RPFS (HR, 0.59; 95% CI, 0.48 to 0.74) and time to PSA progression (HR, 0.55; 95% CI, 0.43 to 0.70); it also significantly increased PSA response rate (RR, 3.63; 95% CI, 1.72 to 7.65) and objective response rate (RR, 3.05; 95% CI, 1.51 to 6.15). This meta-analysis suggested that the adverse events caused by abiraterone are acceptable and can be controlled. Conclutios: Abiraterone significantly prolonged OS, RPFS and time to progression patients with mCRPC, regardless of prior chemotherapy or whether chemotherapy-na$\ddot{i}$ve, and no unexpected toxicity was evident. Abiraterone can serve as a new standard therapy for mCRPC.

Herbal Medicine for Tension-type Headache: Systematic Review and Meta Analysis of Randomized Controlled Trials (긴장성두통에 대한 한약치료: 체계적 문헌고찰 및 메타분석)

  • Choi, Eun-Ji;Kwon, Chan-Young;Han, Kyung-Hun;Kim, Jong-Woo;Chung, Sun-Young
    • Journal of Oriental Neuropsychiatry
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    • v.26 no.4
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    • pp.383-406
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    • 2015
  • Objectives: People with tension-type headache generally take pain relievers, but long term dependency causes problems as well as side effects. The present study aimed to provide clinical evidence of herbal medicine for tension-type headache by systematic review of randomized controlled trials on the effect of herbal medicine for tension-type headache. Methods: Randomized or quasi-randomized controlled trials that verified effects of herbal medicine intervention on patients with tension-type headache were included in the study. A literature search of English, Japanese, Chinese, Korean databases was performed. The selected literature were assessed by Jadad scale and Risk of Bias. Results: Herein, 40 reports were selected from a total of 157. Meta-analyses of 2 trials indicated that the effective rate was significantly higher in the herbal medicine treatment group, as compared to the placebo control (risk ratio: 1.49, 95% confidence interval (CI): 1.23 to 1.80, p<0.0001, I2=0%). Four trials that compared herbal medicine with routine care with routine care only group showed a significantly higher effective rate of benefits for herbal medicine with routine care, as compared to routine care only (RR: 1.57, 95% CI: 1.18 to 2.10, p=0.002, I2=0%). Conclusions: The effective rate was significantly higher than control and adverse events were less in the treatment group. Pattern analysis (辨證) indicated that the studies on wind-fire pattern (風火證) were highest. Yougeun-bang (柔筋方) in prescription and Paeoniae Radix Alba (白芍藥) in medicinal herbs were most used. This finding could be widely utilized in future clinical practice and form the basis for the development of clinical practice guidelines in advance.

The Role of Psychological Distance and Relative Optimism in Information Security Decision Making (정보보호 의사결정에서 정보보호 침해사고 발생가능성의 심리적 거리감과 상대적 낙관성의 역할)

  • Jongki Kim;Jiyun Kim
    • Information Systems Review
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    • v.20 no.3
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    • pp.51-71
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    • 2018
  • Many studies in the field of information security reveal the need to increase awareness. However, although awareness of information security has been raised to a considerable extent, actual security behavior has been shown to fall short of that. Therefore, we wanted to identify the role of psychological factors in making information security decisions by conducting a experimental study. The results show that there are differences in perception of information security risks according to the probabilistic distance and the degree of relative optimism due to social distance. In relation to their relative optimism and intention of information security, they reduced the level of perceived risk compared to those close to them and found that their influence varied according to their probabilistic distance. This study has made valuable attempt in terms of methodology and it is meaningful that the psychological factor is taken into consideration for the information protection behavior, so that the range of relative optimism that actually affects the perception of risk is narrowed. It is expected to contribute to the improvement of information security level of information technology users and protection of information assets by empirically identifying necessity of various approaches to decision making process for information security.

Effects of Biased Awareness of Security Policies on Security Compliance Behavior (보안정책에 대한 편향적 사고가 보안준수 행동에 미치는 영향)

  • Heo, Jun;Ahn, Seongjin
    • The Journal of Korean Association of Computer Education
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    • v.23 no.1
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    • pp.63-75
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    • 2020
  • From the perspective of compliance with security policies by members of the organization, which is a major cause of security incidents, this study presented biased thinking as factors that affect compliance with security policies and verified the following: First, the impact of biased thinking on security policies on compliance with security policies is verified. Second, the participation of management, perceived risk, education and punishment of management will verify the adjustment effect of increasing or decreasing biased thinking. Finally, we have verified that compliance attitudes have a significant impact on compliance behavior. To this end, 157 people were surveyed, statistical analysis of research models and structural equations, and conformity analysis were conducted. Studies have shown that biased thinking has a negative effect on the attitude of compliance with information security. In addition, it was analyzed that the attitude of compliance with information security policy increases policy compliance behavior. On the other hand, the higher the perceived risk of information security, the lower the bias was the adjustment effect, but management's participation, education and punishment were found to have no adjustment effect.

Effects for kangaroo care: systematic review & meta analysis (캥거루 케어가 미숙아와 어머니에게 미치는 효과 : 체계적 문헌고찰 및 메타분석)

  • Lim, Junghee;Kim, Gaeun;Shin, Yeonghee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.3
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    • pp.599-610
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    • 2016
  • This paper reports the results of a systematic review (SR) and meta-analysis research to compare the effect of Kangaroo care, targeting mothers and premature infants. A randomized clinical trial study was performed until February 2015. The domestic literature contained the non-randomized clinical trial research without restriction according to the level of the study design. A search of the Ovid-Medline, CINAHL, PubMed and KoreaMed, the National Library of KOREA, the National Assembly Library, NDSL, KISS and RISS. Through the KMbase we searched and combined the main term ((kangaroo OR KC OR skin-to-skin) AND (care OR contact)) AND (infant OR preterm OR Low Birth Weight OR LBW), ((kangaroo OR kangaroo OR kangaroo) AND (care OR nursing care OR management OR skin contact)) was made; these were all combined with a keywords search through the selection process. They were excluded in the final 25 studies (n=3051). A methodology checklist for randomized controlled trials (RCTs) designed by SIGN (Scottish Intercollegiate Guidelines Network) was utilized to assess the risk of bias. The overall risk of bias was regarded as low. In 16 studies that were evaluated as a grade of "++", 9 studies were evaluated as a grade of "+". As a result of meta-analysis, kangaroo care regarding the effects of premature mortality, severe infection/sepsis had an insignificant effect. Hyperthermia incidence, growth and development (height and weight), mother-infant attachment, hypothermia incidence, length of hospital days, breast feeding rate, sleeping, anxiety, confidence, and gratification of mothering role were considered significant. In satisfaction of the role performance, depression and stress presented contradictory research results for individual studies showing overall significant difference. This study has some limitations due to the few RCTs comparing kangaroo care in the country. Therefore, further RCTs comparing kangaroo care should be conducted.

Pain Reduction Effects of Lidocaine Gel for Urethral Catheterization : A Systematic Review and Meta-Analysis (요도 카테터 삽입술에서 리도카인 윤활제의 통증 감소 효과 : 체계적 문헌고찰과 메타분석)

  • Hong, Hyun-Jung;Kim, Ga-Eun;Lee, Ha-Nee;Lee, A-Reum
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.6
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    • pp.438-448
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    • 2017
  • This study was a systematic review and meta-analysis that evaluated the results of research on the pain reduction effects of lidocaine gel for urethral catheterization in adults. A literature search was conducted using seven electronic databases, gray literature and other resources based on the guidelines of Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA). A Risk of Bias (RoB) tool was applied to assess the quality of selected studies. Data were analyzed using the RevMan 5.3.-program. Sixteen randomized controlled trials involving 1904 adults were included. RoB was not observed in the funnel plot. Overall, lidocaine gel was effective for pain reduction during urethral catheterization (Standard Mean Difference[SMD] -0.96;95% CI: -1.43, -0.49). To explore the cause of heterogeneity (I2=95%, p<.001), subgroup analysis was conducted according to three catheter types (urinary catheter, flexible cystoscopy, and rigid cystoscopy) and the SMDs were -0.88 (95% CI:-1.51, -0.26), -0.31 (95% CI:-0.63, 0.01), and -1.93 (95% CI:-2.88, -0.97), respectively. A significant pain reduction effect was observed regardless of gender in urinary catheterization. However, in rigid cystoscopy, a significant pain reduction effect was observed only in male subjects. Pain reduction effects were observed when 10~11ml lidocaine gel was used during rigid cystoscopy and when lubrication was used during urinary catheterization, irrespective of application time. These findings suggest that lidocaine gel is a useful anesthetic lubricant for urinary catheterization and rigid cystoscopy in male adults.

Meditating effect of Planned Happenstance Skills between the Belief in Good luck and Entrepreneurial Opportunity (행운에 대한 신념과 창업 기회 역량과의 관계에서 우연기술의 매개효과에 관한 연구)

  • Hwangbo, Yun;Kim, YoungJun;Kim, Hong-Tae
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.14 no.5
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    • pp.79-92
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    • 2019
  • When asked about the success factors of successful entrepreneurs and celebrities, he says he was lucky. The remarkable fact is that the attitude about luck is different. However, despite the fact that the belief that we believe is lucky is actually a dominant concept, there has not been much scientific verification of luck. In this study, we saw good luck not being determined randomly by the external environment, but by being able to control luck through the internal attributes of individuals. This study is significant that we have empirically elucidated what kind of efforts have gained good luck, whereas previous research has largely ended in vague logic where luck ends up with an internal locus of control among internal entrepreneurial qualities and efforts can make a successful entrepreneur. We introduced the concept of good luck belief to avoid confirmation bias, which is, to interpret my experience in a direction that matches what I want to believe, and used a good luck belief questionnaire in previous studies and tried to verify that those who have a good belief can increase entrepreneurial opportunity capability through planned happenstance skills. The reason for choosing the entrepreneurial opportunity capacity as a dependent variable was based on the conventional research, that is, the process of recognizing and exploiting the entrepreneurial opportunity is an important part of the entrepreneurship research For empirical research, we conducted a questionnaire survey of a total of 332 people, and the results of the analysis turned out that the belief of good luck has all the positive impacts of planned happenstance skills' sub-factors: curiosity, patience, flexibility, optimism and risk tolerance. Second, we have shown that only the perseverance, optimism, and risk tolerance of planned happenstance skills' sub-factors have a positive impact on this opportunity capability. Thirdly, it was possible to judge that the sub-factors of planned happenstance skills, patience, optimism, and risk tolerance, had a meditating effect between belief in luck and entrepreneurial opportunity capability. This study is highly significant in logically elucidating that people in charge of business incubation and education can get the specific direction when planning a training program for successful entrepreneur to further enhance the entrepreneurial opportunity ability, which is an important ability for the entrepreneur's success.

Predictive Modeling of Bacillus cereus on Carrot Treated with Slightly Acidic Electrolyzed Water and Ultrasonication at Various Storage Temperatures (미산성 차아염소산수와 초음파를 처리한 당근에서 저장 중 Bacillus cereus 균의 생육 예측모델)

  • Kim, Seon-Young;Oh, Deog-Hwan
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.43 no.8
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    • pp.1296-1303
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    • 2014
  • This study was conducted to develop predictive models for the growth of Bacillus cereus on carrot treated with slightly acidic electrolyzed water (SAcEW) and ultrasonication (US) at different storage temperatures. In addition, the inactivation of B. cereus by US with SAcEW was investigated. US treatment with a frequency of 40 kHz and an acoustic energy density of 400 W/L at $40^{\circ}C$ for 3 min showed the maximum reduction of 2.87 log CFU/g B. cereus on carrot, while combined treatment of US (400 W/L, $40^{\circ}C$, 3 min) with SAcEW reached to 3.1 log CFU/g reduction. Growth data of B. cereus on carrot treated with SAcEW and US at different temperatures (4, 10, 15, 20, 25, 30, and $35^{\circ}C$) were collected and used to develop predictive models. The modified Gompertz model was found to be more suitable to describe the growth data. The specific growth rate (SGR) and lag time (LT) obtained from the modified Gompertz model were employed to establish the secondary models. The newly developed secondary models were validated using the root mean square error, bias factor, and accuracy factor. All results of these factors were in the acceptable range of values. After compared SGR and LT of B. cereus on carrot, the results showed that the growth of B. cereus on carrot treated with SAcEW and US was slower than that of single treatment. This result indicates that shelf life of carrot treated with SAcEW and US could be extended. The developed predictive models might also be used to assess the microbiological risk of B. cereus infection in carrot treated with SAcEW and US.

Efficacy of glycine powder air-polishing in supportive periodontal therapy: a systematic review and meta-analysis

  • Zhu, Mengyuan;Zhao, Meilin;Hu, Bo;Wang, Yunji;Li, Yao;Song, Jinlin
    • Journal of Periodontal and Implant Science
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    • v.51 no.3
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    • pp.147-162
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    • 2021
  • Purpose: This systematic review and meta-analysis was conducted to assess the effects of glycine powder air-polishing (GPAP) in patients during supportive periodontal therapy (SPT) compared to hand instrumentation and ultrasonic scaling. Methods: The authors searched for randomized clinical trials in 8 electronic databases for relevant studies through November 15, 2019. The eligibility criteria were as follows: population, patients with chronic periodontitis undergoing SPT; intervention and comparison, patients treated by GPAP with a standard/nozzle type jet or mechanical instrumentation; and outcomes, bleeding on probing (BOP), patient discomfort/pain (assessed by a visual analogue scale [VAS]), probing depth (PD), gingival recession (Rec), plaque index (PI), clinical attachment level (CAL), gingival epithelium score, and subgingival bacteria count. After extracting the data and assessing the risk of bias, the authors performed the meta-analysis. Results: In total, 17 studies were included in this study. The difference of means for BOP in patients who received GPAP was lower (difference of means: -8.02%; 95% confidence interval [CI], -12.10% to -3.95%; P<0.00001; I2=10%) than that in patients treated with hand instrumentation. The results of patient discomfort/pain measured by a VAS (difference of means: -1.48, 95% CI, -1.90 to -1.06; P<0.001; I2=83%) indicated that treatment with GPAP might be less painful than ultrasonic scaling. The results of PD, Rec, PI, and CAL showed that GPAP had no advantage over hand instrumentation or ultrasonic scaling. Conclusions: The findings of this study suggest that GPAP may alleviate gingival inflammation more effectively and be less painful than traditional methods, which makes it a promising alternative for dental clinical use. With regards to PD, Rec, PI, and CAL, there was insufficient evidence to support a difference among GPAP, hand instrumentation, and ultrasonic scaling. Higher-quality studies are still needed to assess the effects of GPAP.

Qu-Ji-Du-Huang-Wan for Essential Hypertension : Systemic Review and Meta-analysis (본태성 고혈압에 대한 기국지황환(杞菊地黄丸)의 효과에 관한 체계적 고찰 및 메타 분석)

  • Han, In Sik;Shin, Ji Hye;Cho, Yoon Young;Park, Hae Mo;Yang, Chang Sop;Jeong, Min Jeong;Jang, Insoo;Sun, Seung Ho
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.31 no.2
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    • pp.118-125
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    • 2017
  • The purpose of this study is to investigate the blood pressure reducing effect of Qi-Ju-Di-Huang-Wan (QJDHW) in adults with essential hypertension by using methods of systemic review and meta-analysis. Major search engines, such as PubMed, EMBASE, Cochrane library, Web of Science, CNKI, CiNii, J-STAGE, KISS, NDSL, RISS, OASIS, DBpia and so on, were used. The search period we used is from the start date of the search engine to October 30, 2016 and no language limits were placed. Randomized controlled trials using QJDHW in adults with essential hypertension were searched and extracted by two independent researchers. Meta-analysis was performed on outcome variables of the total effective rate (TER), systolic blood pressure (SBP) and diastolic blood pressure (DBP). Risk of bias (RoB) of Cochrane was used to assess methodological quality. Thirteen studies were finally selected. We observed that the combined treatment of QJDHW and antihypertensive drug had 3.6 times the odds ratio of TER for blood pressure lowering than a single use of an antihypertensive drug. Additionally, mean differences of SBP and DBP were -8.88 mmHg (95% Confidential Interval (CI) -12.77 mmHg, -5.00 mmHg, P<0.00001), -7.09 mmHg (95% CI -9.93, -4.25, P <0.00001), respectively. Single use of QJDHW did not reduce blood pressure more than an antihypertensive drug. All items of RoB were unclear and the methodological quality was low. Our analysis suggests that the combination of QJDHW and antihypertensive drugs may be more effective in reducing blood pressure than a single antihypertensive drug. But due to low methodological quality, careful interpretation will be needed and systematic long-term clinical trials will be required.