• 제목/요약/키워드: Risk of bias

검색결과 788건 처리시간 0.036초

The effects of health care programs for gestational diabetes mellitus in South Korea: a systematic review

  • Park, Seo Jin;Lee, Jina
    • 여성건강간호학회지
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    • 제26권4호
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    • pp.274-284
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    • 2020
  • Purpose: The purpose of this study was to investigate the effects and characteristics of health care programs for pregnant women with gestational diabetes mellitus (GDM) in Korea. Methods: This study was conducted according to the Cochrane Collaboration's systematic literature review handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline. We searched eight international and domestic electronic databases for relevant studies. Two reviewers independently selected the studies and extracted data. For each study, information on the research method, participants, characteristics of the program, and results were extracted using a previously established coding table. The National Evidence-based Healthcare Collaborating Agency's risk of bias assessment tool for non-randomized studies was used to assess the risk of bias of the included articles. A qualitative review of the selected studies was performed because the interventions differed considerably and the measured outcomes varied. Results: Out of 128 initially identified papers, seven were included in the final analysis. The risk of bias was evaluated as generally low. Health care programs for pregnant women with GDM showed positive effects on blood glucose control. Anxiety and depression were reduced, and self-management and self-care behavior, self-efficacy, and maternal identity improved. Conclusion: Our study provides clinical evidence for the effectiveness of health care programs for pregnant women with GDM, and its results can be used to support the development of health care programs for GDM. More well-designed research is needed on GDM, especially studies that deal with emotional stress and apply a family-oriented approach.

학생들의 정신건강을 위한 감정자유기법(EFT): 체계적 문헌고찰 (Emotional Freedom Techniques (EFT) for Students' Mental Health: A Systematic Review)

  • 이승환;정보은;채한;임정화
    • 동의신경정신과학회지
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    • 제28권3호
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    • pp.165-182
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    • 2017
  • Objectives: The purpose of this systematic review was to understand clinical usefulness of Emotional Freedom Techniques (EFT) on students' mental health. Methods: Ten databases were included to extract clinical studies on effects of EFT intervention with students. Characteristics of selected studies were described, and biases were assessed with Risk of Bias (RoB) or Risk of Bias Assessment for Non-Randomized Studies (RoBANS). Results: A total of 14 clinical trials were extracted for analysis. There were 8 randomized-controlled trials (RCTs), 2 non-randomized-controlled trials (nRCTs), and 4 before-after studies. EFT have significant clinical usefulness in public speaking anxiety, test anxiety, stress, depression, learning related emotions, adolescent anxiety, and eating issues. The risk of selection bias in most studies was high or uncertain. Conclusions: EFT is an effective clinical technique for managing students' mental health issues. However, the included studies have been conducted with relatively poor quality and small sample size. Clinical trials with high quality study design and well-designed EFT education programs are needed to generalize clinical usefulness.

후관절 증후군의 침 치료에 대한 문헌 연구 보고 (Acupuncture for Facet Joint Syndrome: A Review of Clinical Study)

  • 구지향
    • 한방재활의학과학회지
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    • 제33권1호
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    • pp.13-29
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    • 2023
  • Objectives To evaluate the evidence supporting the effectiveness of acupuncture for facet joint syndrome. Methods We conducted search across 9 electronic databases (PubMed, EMBASE, Cochrane CENTRAL (CENTRAL), KoreaMed, Kmbase, Koreanstudies Information Service System (KISS), ScienceOn, China National Knowledge Infrastructure (CNKI), and Wanfang) to find clinical trials that used acupuncture as treatment for facet joint syndrome. 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 Nine RCTs and one nRCT met our inclusion criteria. Fire needle was more effective than medial branch block in terms of visual analogue scale (VAS) after 1 month (p=0.02). Also, Fire needle was more effective than Ibuprofen in terms of VAS and oswestry disability index (ODI) (p<0.05). However, in the rest of the study results, the intervention group did not show a statistically significant difference than the control group. Conclusions Although our review found encouraging but limited evidence of acupuncture for facet joint syndrome, 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.

국내 말초성 안면마비의 침 임상시험에 대한 체계적 고찰 (Acupuncture Trials for Peripheral Facial Palsy in Republic of Korea: A Systematic Review)

  • 이참결
    • Journal of Acupuncture Research
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    • 제30권3호
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    • pp.51-59
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    • 2013
  • Objectives : This study was designed to evaluate clinical evidence of acupuncture treatment for peripheral facial palsy in South Korea. Methods : All process was independently proceeded by two investigators. Literature search was performed in 9 databases from their inception to February 2013. Searched reports was twice excluded for title, abstract and body. And then, data extract and analysis was done before assessing risk of bias by Cochrane Handbook. Results : 10 randomized controlled trials(RCT) were finally included. 4 RCT handled postauricular pain with facial palsy. All articles at least used in combination with two treatments. Interventions like pharmacopuncture, electroacupuncture, scalp acupuncture etcetera were conducted as treatment to evaluate efficacy, and some study reported advantageous effects of treatment group compared to baseline or control group. Adverse events didn't referd to in any studies. In assessing risk of bias, indefinite and uncertain information made all included trials to have a high risk of bias. Conclusions : Because of methodological deficit, there is no sufficient evidence to allow any conclusion about the efficacy of acupuncture for peripheral facial palsy. Therefore, well designed trials with high quality is needed from now on.

인터넷전문은행 수용 의도와 저항에 관한 연구: 소비자, 혁신, 환경 특성을 중심으로 (Consumers' acceptance and resistance to virtual bank: views of non-users)

  • 김효정;이승신
    • Human Ecology Research
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    • 제57권2호
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    • pp.171-183
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    • 2019
  • Convergence between technology and financial services is ubiquitous and widespread. Virtual banks represent an important aspect of financial markets that can generate value added for consumers and enhance the quality of financial services. This study explores the effect of innovation characteristics (relative advantage, compatibility, and perceived risk), consumer characteristics (status quo bias), and social mechanisms (network externality: complementarity, numbers of peers) on consumers' adoption intention and resistance to virtual banks. This study adopted an innovation resistance model with two dependent variables: adoption intention and resistance to virtual banks. An online self-administered survey was conducted and 532 or non-users of virtual banks aged 20 to 69 years old were analyzed. Frequency analysis, descriptive analysis, and hierarchical multiple regression indicated that status quo bias, relative advantage, perceived risk, complementarity, and number of peers insignificantly influence the adoption intention regarding virtual banks. Furthermore, status quo bias, relative advantage, perceived risk, and number of peers insignificantly influence the resistance to virtual banks. Female respondents have a lower adoption intention and higher resistance to virtual banks than male respondents. The findings suggest that the innovation resistance model can be useful in understanding consumers'adoption and resistance behavior as well as reveal that innovation characteristics, consumer characteristics, and social mechanism are important antecedent variables of the innovation adoption decision.

조발성 탈모증과 대사증후군과의 관계: 체계적 문헌고찰 및 메타분석 (The Relationship between Early-onset Androgenetic Alopecia and Metabolic Syndrome: Systematic Review and Meta-Analysis)

  • 장진영;윤영준
    • 한방안이비인후피부과학회지
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    • 제30권3호
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    • pp.166-181
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    • 2017
  • Objectives : The study was done to verify the relation between early-onset androgenetic alopecia(AGA) and metabolic syndrome(MetS). Methods : Data were collected through electronic database including KoreaMed, National Assembly Library, KMBASE, NDSL, KCI, KERIS, Google Scholar, Pubmed, Cochrane CENTRAL and EBSCO MEDLINE. A total of 13 case-control studies related to the MetS of early-onset alopecia patients were used for the systematic review and meta-analysis. Risk of bias of included studies were assessed by RoBANS tool. RevMan5.3, CMA3 were used for the meta-analysis. Results : In 13 evaluated articles, most frequent bias was the participant selection bias that was found in 10 articles. Significant association between early-onset AGA and MetS was found in 10(76.9%) out of 13 articles in the systematic review. In meta-analysis, early-onset male AGA was associated with increased risk of metabolic syndrome(OR: 3.73, 95% CI:2.49 -5.61). Conclusions : AGA, particularly early -onset male AGA, is significantly associated with MetS. Therefore all patients with early onset male AGA should be suggested to take preventive treatment to reduce the risk of MetS and various problems associated with it.

Meta-analysis of GSTM1 and GSTT1 Polymorphisms and Risk of Nasopharyngeal Cancer

  • Murthy, Archana Krishna;Kumar, Vinod;Suresh, K.P.
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권3호
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    • pp.1697-1701
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    • 2013
  • Background: Studies of associations between genetic polymorphism of glutathione S-transferase M1 (GSTM1) and glutathione S-transferase T1 (GSTT1) with risk of nasopharyngeal cancer (NPC) have generated conflicting results. Thus, a meta-analysis was performed to clarify the effects of GSTM1 and GSTT1 polymorphisms on the risk of developing NPC. Materials and Methods: A literature search in two electronic databases namely PubMed and EMBASE up to December 2012 was conducted and eligible papers were finally selected based on the inclusion and exclusion criteria. The pooled odds ratio (OR) and presence of heterogeneity and publication bias in those studies were evaluated. Results: A total of 9 studies concerning nasopharyngeal cancer were evaluated. Analyses of all relevant studies showed increased NPC risk to be significantly associated with the null genotypes of GSTMI (OR=1.43, 95%CI 1.24-1.66) and GSTT1 (OR=1.28, 95%CI=1.09-1.51). In addition, evidence of publication bias was detected among the studies on GSTM1 polymorphism. Conclusions: This meta-analysis demonstrated the GSTM1 and GSTT1 null genotypes are associated with an increased risk of NPC.

Recreational Physical Activity and Risk of Ovarian Cancer: a Meta-analysis

  • Zhou, Li-Min
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권13호
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    • pp.5161-5166
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    • 2014
  • Our aim was to access the association between recreational physical activity (RPA) and risk of ovarian cancer (OC). The studies were retrieved from the PubMed and Embase databases up to February 20th, 2014. Risk ratios (OR) and 95% confidence intervals (CI) were used to estimate effect sizes. Random-effects or fixed-effects models were used to pool the data. The trim and fill method was applied for sensitivity analysis. Begg's rank correlation test and Egger's regression asymmetry test were employed to assess the publication bias. A total of 6 studies (435398 participants including 2983 OC patients) were included in this meta-analysis. The overall estimate indicated that there was weakly inverse association between RPA and OC risk (RR=0.90, 95%CI: 0.72-1.12, p=0.335). Meanwhile, for prospective cohort studies, a result consistent with the overall estimate was obtained (RR=1.12, 95% CI: 0.88-1.42, p=0.356). However, for case control studies, the pooled estimate of RR was 0.76 (95%CI: 0.64-0.90, p=0.002), indicating a clear significant association between RPA and OC risk. In addition, the sensitivity analysis indicated a significant link between RPA and risk of OC after removing Lahmann's study (RR=0.80, 95% CI: 0.68-0.93, p=0.004). No significant publication bias was found (Begg's test: p=1.00; Egger's test: p=0.817). In conclusion, our meta-analysis indicated a weakly inverse relationship between RPA and the occurrence of OC.

A review of analysis methods for secondary outcomes in case-control studies

  • Schifano, Elizabeth D.
    • Communications for Statistical Applications and Methods
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    • 제26권2호
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    • pp.103-129
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    • 2019
  • The main goal of a case-control study is to learn the association between various risk factors and a primary outcome (e.g., disease status). Particularly recently, it is also quite common to perform secondary analyses of the case-control data in order to understand certain associations between the risk factors of the primary outcome. It has been repeatedly documented with case-control data, association studies of the risk factors that ignore the case-control sampling scheme can produce highly biased estimates of the population effects. In this article, we review the issues of the naive secondary analyses that do not account for the biased sampling scheme, and also the various methods that have been proposed to account for the case-control ascertainment. We additionally compare the results of many of the discussed methods in an example examining the association of a particular genetic variant with smoking behavior, where the data were obtained from a lung cancer case-control study.

화병의 한의학적 치료에 대한 연구동향 (Current Trends in Intervention Studies of Hwabyung in Korean Medicine)

  • 서효원;최은지;김상호;김동희;김락형;김종우;이재혁;임재환;최우진;정선용
    • 동의신경정신과학회지
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    • 제27권4호
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    • pp.261-274
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    • 2016
  • Objectives: To determine the general characteristics of clinical studies about Hwabyung and assess their limitations and alternatives. Methods: Clinical studies that examined the effects of traditional Korean medicine intervention on Hwabyung were included in this study. A systematic search of English, Chinese, Japanese, and Korean databases was performed. The characteristics of included articles were described and those articles were assessed by Risk of Bias (RoB) tool or Risk of Bias for Nonrandomized Studies (RoBANS) tool. Results: Sixteen articles were selected from 1,826 articles. Most clinical studies about Hwabyung were published in Korea. The number of conducted trials was insufficient. The prevailing study design was randomized controlled trial. Traditional Korean medicine intervention used in the trials were acupuncture, herbal medicine, counselling, meditation, emotional freedom technique (EFT), music therapy, art therapy, and multi intervention program. Herbal medicine study used placebo as control while non-pharmacological intervention study mostly used no treatment as control. Most of the trials were supported by the government. Therefore, financial conflict of interest might not exist for results. We judged that some studies had a high risk of bias. In general, most of the studies with a high risk of bias were non-pharmacological intervention studies, and the risk of bias was mainly due to lack of blinding. Conclusions: More clinical studies of Hwabyung are needed. There are some issues about a suitable comparison and effective blinding strategy for non-pharmacological study. Improving methodological quality is required.