• Title/Summary/Keyword: Risk of bias

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자궁경부 상피내종양의 환상투열요법 후 한약치료의 효과 : 체계적 문헌고찰 및 메타분석 (Herbal Medicine for Cervical Intraepithelial Neoplasia After Loop Electrosurgical Excision Procedure: A Systematic Review and Meta-Analysis)

  • 이수정;지해리;이혜정;황덕상;이창훈;장준복;이진무
    • 대한한방부인과학회지
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    • 제33권2호
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    • pp.44-62
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    • 2020
  • Objectives: The purpose of this study is to evaluate the effectiveness of herbal medicine for recovery and treatment of cervical intraepithelial neoplasia (CIN) after loop electrosurgical excision procedure (LEEP). Methods: We searched two english, one chinese and four korean database up to November 4, 2019. Randomised controlled trials (RCTs) were eligible. Primary outcome included Human papilloma virus (HPV) clearance rate and the effective ratio of treatment. And vaginal bleeding time and volume, improvement of symptoms, and recovery of wound were regarded as secondary outcomes. The risk of bias was assessed by two independent authors using the Cochrane risk of bias tool. Results: Of 47 screened, 10 RCTs were included. Number of participants per study ranged from 58 to 360. The studies which used HPV clearance rate as primary outcome were considered as low risk of bias. Most of the studies had considerable heterogeneity in terms of type of intervention, comparison and time-points for outcome measurement. Compared to LEEP alone, herbal vaginal suppository combined group showed favorable results for HPV clearance in patients (5 studies, n=627, 95% CI 1.26 to 1.55, I2=75%). And compared to LEEP alone, herbal external application also showed favorable results for HPV clearance in patients (2 studies, n=252, 95% CI 1.19 to 1.61, I2=86%). Three studies reported mild and temporary adverse events, and no serious adverse events were reported. Conclusions: The studies showed that herbal medicine can significantly effective on recovery of CIN after LEEP. However, included studies suffered from incomplete reporting, high or unclear risk of bias and substantial heterogeneity between studies. In the Future, further high-quality RCTs are needed to prove effectiveness of herbal medicine for CIN after LEEP and reduce the risk of bias.

흉요추 압박 골절의 한의학적 치료에 대한 국내 임상 근거 : 체계적 문헌 고찰 (Korean Medicine for Thoracolumbar Compression Fracture in Korean Literature : a Systematic Review)

  • 배지민;김대훈;김재규;이병렬;양기영;김건형
    • Journal of Acupuncture Research
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    • 제32권4호
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    • pp.147-156
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    • 2015
  • Objectives : This study aims to evaluate the effectiveness and safety of Korean medicine for a thoracolumbar compression fracture. Methods : We searched six Korean databases (DBPIA, Korean Studies Information Service System, Oriental Medicine Advanced Searching Integrated System, National Digital Science Library, Research Information Sharing Service, KoreaMed) (up to June 2015) and the Journal of Korean Acupuncture and Moxibustion Society. Unpublished studies were also searched. Clinical research, other than case reports involving less than 10 patients, were eligible. The effectiveness and safety of Korean Medicine was analyzed. The 'Risk of Bias' was assessed using the 'Risk of Bias' assessment tool for non-randomized studies as well as the Cochrane Collaboration's 'Risk of Bias' tool. Results : We found 12 before-after studies (374 patients). There was no randomized trial. All studies combined at least three different types of Korean medicine treatments. The period of treatment varied between less a week and 154 days. All the included studies reported improvements in pain, functional disability related to lower back pain, global assessment, and benefits in the compression ratio of a fractured vertebrae and skin temperature measured by digital infrared thermal imaging in comparison with the baseline. However, all studies had a high risk of bias and three studies reported mild adverse events. Conclusions : There is no randomized trial for the role of Korean medicine for patients with a thoracolumbar compression fracture. The effectiveness and safety of Korean medicine for this population remains unclear. Findings in this review are seriously biased due to observational design and a high risk of bias included in the studies. Future high-quality randomized trials are warranted.

경옥고의 임상 효능 : 체계적 고찰 (Clinical Effect of Gyeongok-go: A Systematic Review of Randomized Controlled Trials)

  • 강희경;한창우
    • 대한한방내과학회지
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    • 제43권3호
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    • pp.423-435
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    • 2022
  • Purpose: The purpose of this study was to confirm the clinical efficacy of Gyeongok-go. Methods: Public/Publisher MEDLINE (PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), Excerpta Medica dataBASE (EMBASE), Research Information Sharing Service (RISS), ScienceON, Korean Traditional Knowledge Portal (KTKP), and China National Knowledge Infrastructure (CNKI) were searched for randomized controlled clinical trials administering Gyeongok-go as an intervention, published from inception to December 31, 2021. The risk-of-bias of the included trials was assessed with the Cochrane risk-of-bias tool for randomized trials version 2. From the experimental and control groups of the selected trials, the mean value (or rate) of each outcome was extracted and statistically compared. Results: Statistically significant mean differences were in VO2max (MD 6.82), post-exercise heart rate (MD -8.76 at 5 min, -11.58 at 30 min, -14.6 at 60 min), senescence scale (MD -6.52), Th1 cells and Th2 cells in pulmonary tuberculosis (MD 2.79 and -1.64), yin-deficient and qi-deficient score (MD -9.64 and -9.76), and phlegm-dampness score (MD 5.56). Overall risk-of-bias was 20% low risk, 80% some concerns, and 0% high risk. There were no reports of adverse events. Conclusions: Gyeongok-go is likely to have the effect of improving cardiorespiratory endurance, increasing fatigue recovery ability, reducing senescence, and enhancing immune function in tuberculosis patients. Also, it is more suitable for those who are yin-deficient or qi-deficient, and those with phlegm-dampness probably need caution.

심장판막 치환술 후 한의학적 치료에 대한 체계적 문헌고찰 및 메타분석 (East Asian Traditional Medicine Treatment for Patients after Heart Valve Replacements: A Systematic Review with Meta-Analysis)

  • 안무혁;김지호;신봉진;권정남
    • 대한한방내과학회지
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    • 제43권4호
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    • pp.720-737
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    • 2022
  • Objectives: To compare the effectiveness and safety of East Asian traditional medicine treatments (EATMT) versus conventional management in patients following heart valve replacement surgery. Methods: We searched several databases, including the Korean Studies Information Service System, PubMed, China National Knowledge Infrastructure, and Citation Information by NII. The search range included randomized controlled trials from each first issue until June 27, 2021. Two review authors independently extracted the data. We assessed the risk of systematic errors by evaluating risk domains using the "Risk of bias" tool. Results: We included 5 trials in the review. In the EATMT, the investigators reported significant improvements in reshaping of the heart structure: left ventricular end diastolic diameter (MD -4.43, 95% CI -6.06 to -2.79; 130 participants; 2 studies; high evidence). Comparisons with usual care revealed a significant decrease in gastrointestinal complications rate (OR 0.30, 95% CI 0.20 to 0.47; 503 participants; 2 studies; high evidence). We assessed 4 studies as having a low risk of bias and 1 study as having a high risk of bias. Conclusion: This systematic review suggests that East Asian traditional medicine interventions may be effective in preventing and alleviating complications, but we found evidence of important trade-offs between known benefits and known adverse effects in cardiac dysfunction and inflammation following heart valve replacement. Consequently, additional high-quality studies should be conducted.

소지역의 실업률에 대한 상대위험도의 추정에 관한 비교연구 (A comparison study on the estimation of the relative risk for the unemployed rate in small area)

  • 박종태
    • Journal of the Korean Data and Information Science Society
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    • 제20권2호
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    • pp.349-356
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    • 2009
  • 국내의 행정구역상 시군구 등과 같은 소지역에 있어서 실업률에 대한 남녀별 공통 상대위험도를 추정하는데, 추정방법으로 단순한 합동추정, 울프 방법에 기초한 가중추정과 잭나이프 추정들을 고려하고 이 추정 방법들의 효율성을 편의와 평균제곱오차의 개념을 통해서 비교하고자 한다. 이를 위해 2002년 12월 경기지역의 경제활동인구조사 자료를 이용하여 이 지역 내의 24개 시군단위 소지역들의 남녀별 실업률에 대한 상대위험도의 편의 및 평균제곱오차가 본 연구에서 제시된 추정절차에 의해 추정된다. 또한, 이들 추정치들의 안정성과 신뢰성은 상대편의와 상대오차제곱근을 통하여 비교된다. 추정결과 잭나이프 추정이 다른 두 추정들에 비해 매우 효율적임을 보였다.

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위험인식의 낙관적 편향 실험을 통한 스미싱 보안인식 개선 (Improving Security Awareness about Smishing through Experiment on the Optimistic Bias on Risk Perception)

  • 강지원;이애리;김범수
    • 정보보호학회논문지
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    • 제26권2호
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    • pp.475-487
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    • 2016
  • 최근 스마트폰 해킹과 관련한 다양한 종류의 위험들이 등장하고 있다. 이중 스미싱은 그 범죄 수법이 교묘해지고 피해 사례가 증가하고 있어 효과적인 예방 및 대응방안이 요구되고 있다. 특히 스미싱 위험에 대한 기술적 접근 외에 스마트폰 이용자의 보안인식 개선 및 교육의 필요성이 강조되고 있다. 본 연구는 스미싱 위험인식 제고를 위한 효과적인 홍보 메시지 및 뉴스 제공 방안에 대해 고찰하고자 한다. 이를 위해 본 연구에서는 스미싱에 대한 뉴스 프레임과 주제 유형, 그리고 관여도에 따라 스미싱 위험에 대한 낙관적 편향(자신보다는 타인에게 위험 발생 가능성이 높다고 생각하는 경향) 정도가 어떻게 달라지는지 실험을 통해 실증적으로 분석하도록 한다. 본 연구를 통해 스미싱 위험인식에 영향을 미치는 요인을 파악하고 어떠한 방식이 개인의 보안 인식 개선에 효과적인지 검증함으로써 스마트 기기 관련 정보보호 인식 제고를 위한 사용자 교육 및 홍보 방안에 대한 시사점을 제공하고자 한다.

Effect of endodontic sealer on postoperative pain: a network meta-analysis

  • Cynthia Maria Chaves Monteiro;Ana Cristina Rodrigues Martins;Alessandra Reis;Juliana Larocca de Geus
    • Restorative Dentistry and Endodontics
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    • 제48권1호
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    • pp.5.1-5.22
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    • 2023
  • This systematic review and network meta-analysis aimed to answer the following focused research question: "Does the type of endodontic sealer affect the postoperative pain in patients who received endodontic treatment?" Different databases and grey literature were surveyed. Only one randomized controlled trial were included. The risk of bias in the studies was evaluated by using the Cochrane Collaboration's tool. A random-effects meta-analysis was conducted to compare the risk and intensity of postoperative pain. The quality of the body of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Out of 11,601 studies, 15 remained for qualitative analyses and 12 for meta-analysis. Seven studies were classified at high risk of bias, and 8 studies raised some concerns. No significant differences between the endodontic materials were observed in the direct comparisons, both in risk and in intensity of postoperative pain (pairwise comparisons with 2 studies: I2 = 0%; p > 0.05 and 8 studies: I2 = 23%; p > 0.05, respectively). The certainty of the evidence was graded as low or moderate. There was no difference in the risk and intensity of postoperative pain after filling with different endodontic sealers. Further systematic reviews should be conducted.

비만에 대한 편견, 낙인, 차별 및 이에 대한 개선 방안 (Understanding and Exploring Weight-Based Bias, Stigma, and Discrimination)

  • 이가영
    • 비만대사연구학술지
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    • 제2권1호
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    • pp.1-5
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    • 2023
  • The importance of weight discrimination for people with obesity has been highlighted by research which has found that more than 40% of those living with obesity have experienced weight discrimination. Evidence suggests that weight bias among obese individuals puts their health at risk more than health issues caused by obesity itself. Although bias, stigma, and discrimination towards individuals living with obesity are factors that make it difficult for them to lose weight, weight bias and stigma among healthcare professionals are common, causing individuals living with obesity to avoid treatment and potentially exacerbating obesity-related health issues. The concept that one's own efforts matter contributes to stigma, discrimination, and bias. This issue will be more frequent among primary care providers treating individuals living with obesity; thus, it is important to acknowledge the issues of bias, stigma, and discrimination towards individuals living with obesity and to seek out solutions. In this review, I will discuss the concept of weight bias, stigma, and discrimination, the problems they cause, and seek solutions to weight prejudice, stigma, and discrimination.

The prevalence of apical periodontitis in patients prior to hematopoietic cell transplantation: a systematic review

  • Letícia Taina de Oliveira Lemes;Carolina Horn Troian-Michel;Theodoro Weissheimer;Marcus Vinicius Reis So
    • Restorative Dentistry and Endodontics
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    • 제49권2호
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    • pp.22.1-22.12
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    • 2024
  • Objectives: This systematic review addressed the question: "What is the prevalence of apical periodontitis in patients prior to hematopoietic cell transplantation?" Materials and Methods: A systematic search was conducted in MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Grey Literature Report. Eligibility criteria were based on the condition, content, and population strategy: the condition was the radiographic prevalence of apical periodontitis, the content comprised patients scheduled for hematopoietic stem cell transplantation, and the population consisted of adult and pediatric patients. The revised Risk of Bias in Nonrandomized Studies of Exposure tool was used to assess the quality of studies. The Grading Recommendations Assessments, Development, and Evaluation (GRADE) tool was used to assess the quality of evidence. Results: Eight studies were included in this review. The average number of patients with apical periodontitis was 15.65% (range, 2.1%-43.34%). One study was classified as having a very high risk of bias, 1 with a high risk of bias, and 6 with some concern for bias. GRADE analysis showed a very low certainty of evidence. Significant limitations concerning the absence of control over confounding variables were identified. Conclusions: With the caveat of the very low quality of evidence in the studies reviewed, there was a low to moderate prevalence of apical periodontitis in patients prior to undergoing hematopoietic cell transplantation.

좌골신경통에 적용한 추나 치료에 대한 체계적 문헌 고찰 및 메타 분석 (Systematic Review and Meta-analysis of Chuna Therapy for Sciatica)

  • 홍수민;오승준;이은정
    • 동의생리병리학회지
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    • 제34권6호
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    • pp.299-308
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    • 2020
  • This study aimed to evaluate the effects of Chuna therapy for Sciatica. We searched the following 16 online databases without a language restriction (Pubmed, Cochrane, Embase, CINAHL, Ovid, Kmbase, RISS, NDSL, OASIS, KISS, KNAL, KTKP, DBpia, CNKI, Wangfang, J-stage) to find randomized controlled clinical trials that used Chuna therapy for Sciatica. The methodological quality of randomized controlled clinical trials (RCTs) were assessed using the Cochrane risk of bias tool and meta-analysis were performed. Among 496 articles that were searched, 15 RCTs were finally selected for systematic review. 14 studies showed that Chuna therapy has positive effect on sciatica. Two studies noted that there were side effects, and the difference between the intervention group and the control group was statistically insignificant. One study noted no side effects and the rest of the study, there was no mention of side effects. Meta-analysis showed positive results for Chuna single therapy in terms of efficiency rate compared to painkiller, herb medicine excepting acupuncture. When comparing Chuna therapy plus acupuncture and acupuncture, Chuna therapy plus acupuncture had a more positive result than acupuncture in terms of efficiency rate. Cochrane Risk of Bias (RoB)evaluation method, most of the studies's selection, performance, detection and reporting bias were unclear. The studies showed that Chuna therapy can significantly effective on sciatica. However, most of the studies's Risk of Bias included in the analysis were not low enough. In the future, to prove the level of evidence of Chuna therapy, more high-quality studies will be needed.