• Title/Summary/Keyword: Risk of bias

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Review of Acupuncture Treatment for Hypertension in Clinical Trials (임상연구의 고혈압 침치료법에 대한 고찰)

  • Jung, So-Young;Park, Ji-Eun;Kim, Jung-Eun;Kim, Ae-Ran;Choi, Sun-Mi
    • The Journal of Korean Medicine
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    • v.33 no.1
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    • pp.12-23
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    • 2012
  • Objectives: This study evaluated clinical trials of acupuncture treatment for hypertension and to assess their methodology and results. Methods: Eight Korean databases and four international databases were searched for clinical trials of acupuncture treatment for hypertension up to June 2011. Study quality was assessed using the risk of bias (ROB) tool. Results: Twenty-four trials of acupuncture for hypertension were included. There were 14 randomized and 1 non-randomized controlled trials and 9 before-after studies. The most frequently used acupuncture points were zsnli (ST36), qch (LI11), fngch (GB20), snynjio (SP06), snjin (LI03) and hgu (LI04). In more than half of the studies, needle retention time was 20~30 minutes. Compared to baseline, change of blood pressure after treatment was significant in all studies. However, the results of effect on blood pressure between acupuncture and control were not consistent. Conclusions: There is insufficient evidence to suggest that acupuncture is an effective treatment for hypertension. Further well-designed clinical trials will be required to evaluate the effects and safety of acupuncture treatment for hypertension.

Misclassification Adjustment of Family History of Breast Cancer in a Case-Control Study: a Bayesian Approach

  • Moradzadeh, Rahmatollah;Mansournia, Mohammad Ali;Baghfalaki, Taban;Ghiasvand, Reza;Noori-Daloii, Mohammad Reza;Holakouie-Naieni, Kourosh
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8221-8226
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    • 2016
  • Background: Misreporting self-reported family history may lead to biased estimations. We used Bayesian methods to adjust for exposure misclassification. Materials and Methods: A hospital-based case-control study was used to identify breast cancer risk factors among Iranian women. Three models were jointly considered; an outcome, an exposure and a measurement model. All models were fitted using Bayesian methods, run to achieve convergence. Results: Bayesian analysis in the model without misclassification showed that the odds ratios for the relationship between breast cancer and a family history in different prior distributions were 2.98 (95% CRI: 2.41, 3.71), 2.57 (95% CRI: 1.95, 3.41) and 2.53 (95% CRI: 1.93, 3.31). In the misclassified model, adjusted odds ratios for misclassification in the different situations were 2.64 (95% CRI: 2.02, 3.47), 2.64 (95% CRI: 2.02, 3.46), 1.60 (95% CRI: 1.07, 2.38), 1.61 (95% CRI: 1.07, 2.40), 1.57 (95% CRI: 1.05, 2.35), 1.58 (95% CRI: 1.06, 2.34) and 1.57 (95% CRI: 1.06, 2.33). Conclusions: It was concluded that self-reported family history may be misclassified in different scenarios. Due to the lack of validation studies in Iran, more attention to this matter in future research is suggested, especially while obtaining results in accordance with sensitivity and specificity values.

Lack of Association between Using Aspirin and Development of Non-Hodgkins Lymphoma: A Meta-analysis

  • Cheraghi, Maria;Amoori, Neda;Fallahzadeh, Hosein;Rahmani, Hossein
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.787-792
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    • 2015
  • Background: Non-Hodgkins lymphoma (NHL) is a heterogeneous group of malignancies, originating in the lymphatic organs, whose incidence is increasing in developed as well as developing countries. Epidemiological evidence suggests that aspirin may reduce the incidence and mortality of several cancers. The main objective of this study was to evaluate the potential relationship between using aspirin and development of NHL with a meta-analysis. Materials and Methods: A total of 7 studies were included. Outcome was calculated and reported as odds ratios (ORs). Heterogeneity was assessed with Cochrane Q and $I^2$ statistics. Dissemination bias was evaluated by funnel plot visualization and trim-and-fill analysis. Results: Our analysis showed OR of developing NHL overall of 1(95% CI: 0.87-1.16, p=0.9), and in females this was 0.81 (95%CI: 0.72-.92, p=0.001) and in males 1.01 (95%CI: 0.82-1.26, p=0.86). The odds ratio (OR) of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) was 0.85 (95%CI: 0.75-0.97, p=0.02), The ORs of follicular lymphoma (FL) and large B-cell lymphoma (DLBCL) in individuals exposed to aspirin were 1.12 (95%CI: 0.86-1.45, p=0.37) and 1.03 (95%CI: 0.9-1.19, p=0.6) respectively. Conclusions: In conclusion, individuals taking aspirin do not demonstrate any change in risk of Non-Hodgkins lymphoma.

Wuqinxi Daoin exercise for osteoporosis: A Systematic Review (오금희 도인 운동이 골다공증에 미치는 영향 : 체계적 문헌 고찰)

  • Park, In-Hwa;Kim, Byung-Jun;Lim, Kyeong-Tae;Shin, Byung-Cheul;Hwang, Man-suk;Hwang, Eui-Hyoung
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.12 no.2
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    • pp.31-42
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    • 2017
  • Objectives : This review aims to assess the effect of Wuqinxi exercise for osteoporosis. Methods : We searched 9 electronic databases(Pubmed, EMBASE, Cochrane Library, CAJ, Oasis, KISS, NDSL, KMBASE, KISTI) and related 2 journals until November 2017. We included randomized controlled trials(RCTs) of testing Wuqinxi exercise for osteoporosis. The methodological quality of RCTs related assessed by the Cochrane risk of bias tool. Results : 12 RCTs were eligible in our inclusion criteria. No statistical differences were found between the Wuqinxi versus no intervention, Wuqinxi plus antiosteoporosis medications versus antiosteo-porosis medications on lumbar spine, femora bone mineral density (BMD). However, Wuqinxi significantly improved lumbar spine BMD compared with antiosteoporosis medications (P < 0.00001). Additionally, the results showed a remarkable effect in improving pain score(VAS) when Wuqinxi or Wuqinxi plus antiosteoporosis medications (P < 0.0005) was used. Conclusions : There is evidence of Wuqinxi exercise for osteoporosis with meta-analysis. However, our systematic review has limited evidence to support Wuqinxi exercise for osteoporosis. because of low quality of original articles and further well-designed RCTs should be encouraged.

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Estimation of Water Storage in Small Agricultural Reservoir Using Sentinel-2 Satellite Imagery (Sentinel-2 위성영상을 활용한 농업용 저수지 가용수량 추정)

  • Lee, Hee-Jin;Nam, Won-Ho;Yoon, Dong-Hyun;Jang, Min-Won;Hong, Eun-Mi;Kim, Taegon;Kim, Dae-Eui
    • Journal of The Korean Society of Agricultural Engineers
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    • v.62 no.6
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    • pp.1-9
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    • 2020
  • Reservoir storage and water level information is essential for accurate drought monitoring and prediction. In particular, the agricultural drought has increased the risk of agricultural water shortages due to regional bias in reservoirs and water supply facilities, which are major water supply facilities for agricultural water. Therefore, it is important to evaluate the available water capacity of the reservoir, and it is necessary to determine the water surface area and water capacity. Remote sensing provides images of temporal water storage and level variations, and a combination of both measurement techniques can indicate a change in water volume. In areas of ungauged water volume, satellite remote sensing image acts as a powerful tool to measure changes in surface water level. The purpose of this study is to estimate of reservoir storage and level variations using satellite remote sensing image combined with hydrological statistical data and the Normalized Difference Water Index (NDWI). Water surface areas were estimated using the Sentinel-2 satellite images in Seosan, Chungcheongnam-do from 2016 to 2018. The remote sensing-based reservoir storage estimation algorithm from this study is general and transferable to applications for lakes and reservoirs. The data set can be used for improving the representation of water resources management for incorporating lakes into weather forecasting models and climate models, and hydrologic processes.

Research Trends of Traditional Chinese Medicine on Combined Treatment of Acupuncture and Relaxation Therapy (침과 이완요법 병행치료에 대한 중의학 연구동향)

  • Lee, Seung-Hwan;Bae, Yeong-Long;Shin, A-Ri;Kim, Sang-Ho;Lim, Jung-Hwa
    • Journal of Oriental Neuropsychiatry
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    • v.28 no.2
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    • pp.109-121
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    • 2017
  • Objectives: The purpose of this study was to investigate clinical trends of Traditional Chinese Medicine (TCM) on combined treatment of acupuncture and relaxation therapy. Methods: Clinical trials based on acupuncture and relaxation therapy searched and were selected from China National Knowledge Infrastructure (CNKI). In this study we selected clinical research articles using acupuncture and relaxation therapy as intervention. Studies were assessed by Risk of Bias (RoB) tool, and Jadad scale. Results: Eleven randomized controlled trials on combined treatment of acupuncture and relaxation therapy were selected, and these studies were published in China. Most studies have targeted psychiatric disorders such as insomnia and anxiety. Manual Acupuncture (MA) was the most used acupuncture treatment, and in five studies two or more relaxation therapies were used in parallel. Although the treatment result using acupuncture and relaxation therapy was superior, heterogeneity of the control group was high and it was difficult to estimate additional effects of relaxation therapy. Conclusions: Qualitative analysis revealed that the combination of acupuncture and relaxation was more effective than control in most studies. However, quality of most studies was low. Therefore, higher quality clinical research on combined treatment of acupuncture and relaxation therapy is required.

Efficacy of intralipid administration to improve in vitro fertilization outcomes: A systematic review and meta-analysis

  • Han, E Jung;Lee, Hye Nam;Kim, Min Kyoung;Lyu, Sang Woo;Lee, Woo Sik
    • Clinical and Experimental Reproductive Medicine
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    • v.48 no.3
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    • pp.203-210
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    • 2021
  • We performed a systematic review and meta-analysis to evaluate whether intralipid administration improved the outcomes of in vitro fertilization. Online databases (PubMed, Cochrane Library, Medline, and Embase) were searched until March 2020. Only randomized controlled trials (RCTs) that assessed the role of intralipid administration during in vitro fertilization were considered. We analyzed the rates of clinical pregnancy and live birth as primary outcomes. Secondary outcomes included the rates of chemical pregnancy, ongoing pregnancy, and missed abortion. We reviewed and assessed the eligibility of 180 studies. Five RCTs including 840 patients (3 RCTs: women with repeated implantation failure, 1 RCT: women with recurrent spontaneous abortion, 1 RCT: women who had experienced implantation failure more than once) met the selection criteria. When compared with the control group, intralipid administration significantly improved the clinical pregnancy rate (risk ratio [RR], 1.48; 95% confidence interval [CI], 1.23-1.79), ongoing pregnancy rate (RR, 1.82; 95% CI, 1.31-2.53), and live birth rate (RR, 1.85; 95% CI, 1.44-2.38). However, intralipid administration had no beneficial effect on the miscarriage rate (RR, 0.75; 95% CI, 0.48-1.17). A funnel plot analysis revealed no publication bias. Our findings suggest that intralipid administration may benefit women undergoing in vitro fertilization, especially those who have experienced repeated implantation failure or recurrent spontaneous abortion. However, larger, well-designed studies are needed to confirm these findings.

Extracorporeal Shock Wave Therapy with Meridian and Acupoint Theory for Knee Osteoarthritis: Systematic Review (경혈경락이론에 근거한 체외충격파 치료가 무릎 관절염에 미치는 영향: 체계적 문헌 고찰)

  • Kim, Byung-Jun;Lee, Sang-Hyun;Kim, Hyun-Tae;Park, Hye-Jin;Park, Sun-Young;Heo, In;Hwang, Man-Suk;Shin, Byung-Cheul;Hwang, Eui-Hyoung
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.2
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    • pp.41-48
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    • 2021
  • Objectives To determine the evidence of effectiveness and safety of extracorporeal shock wave therapy (ESWT) with meridian and acupoint theory for knee osteoarthritis. Methods By March 3, 2021, five foreign electronic databases and six Korean medical electronic databases were reviewed with the key words 'extracorporeal shock wave' and '(acupoint OR acupuncture point)'. This key words was set up to increase the sensitivity of the search. After the search, knee osteoarthritis study was selected based on the title and abstract and then included after full-texts were read. Results Five randomized controlled trials were eligible in our inclusion criteria. The meta-analysis of three studies showed positive results for the using ESWT with meridian and acupoint theory for knee osteoarthritis compared with the control group on efficancy rate, visual analog scale and lysholm knee score. but there remains a conundrum regarding the safety of ESWT in the treatment of knee osteoarthritis. Conclusions Most of studies showed ESWT with meridian and acupoint theory were statistically effective to knee osteoarthritis. However there are limitations that the number of selected studies was small, risk of bias was unclear. So use of ESWT with meridian and acupoint theory for knee arthritis has limited evidence compared to usual care.

A Systematic Review and Meta-Analysis of Foot Bath Therapy for Insomnia Disorder (불면 장애에 대한 족욕 치료법의 체계적 문헌고찰과 메타분석 연구)

  • Dong-Hyun Kim;Jun-Hee Cho;Jung-Hwa Lim;Bo-Kyung Kim
    • Journal of Oriental Neuropsychiatry
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    • v.34 no.3
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    • pp.163-179
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    • 2023
  • Objectives: The purpose of this study was to provide evidence for the clinical effects of foot bath therapy for insomnia disorder through a systematic review and meta-analysis. Methods: Studies were selected from seven domestic and international literature databases. Data on diagnostic tools, pattern identification, sample size, intervention methods, outcome measurements, results, and adverse events were extracted. The quality of the selected literature was assessed using Cochrane's risk of bias (RoB) assessment tool. Results: A total of 11 studies were included in this study. The primary diagnostic tool for insomnia dis- order was the criteria for the diagnosis and therapeutic effect of diseases and syndromes in traditional Chinese medicine (CDTDSTCM), along with the Chinese classification of mental disorders-3 (CCMD-3). Treatment effects were mainly evaluated by the effective rate and the Pittsburgh Sleep Quality Index (PSQI). The meta-analysis results showed statistically higher effectiveness rates for treating insomnia disorder in the experimental groups receiving herbal medicine foot bath therapy with sleeping or herbal medication compared to the control group. The PSQI was lower in the treatment group receiving herbal medicine foot bath therapy with sleeping medication. The herbal materials used in herbal medicine foot bath therapy mainly included Radix Angelicae Sinensis, Polygonum Multiflorum, Ziziphi Spinosae Semen, Rhizoma Coptidis, Radix Salviae Miltiorrhizae, and Cortex Albizziae. The quality of the included studies was generally poor. Conclusions: This study found that foot bath therapy had clinical efficacy for treating insomnia disorder. The research findings could provide foundational evidence for establishing the clinical basis of foot bath therapy in the treatment of insomnia.

Systematic Review and Meta-Analysis on Herbal Medicine for Generalized Anxiety Disorder: Focusing on Clinical Studies over the Past 5 Years (범불안장애의 한약 치료에 관한 체계적 문헌고찰 및 메타분석: 최근 5년 임상연구를 중심으로)

  • Min-Jae Kim;Hyun-Seob Park;Chan-Young Kwon
    • Journal of Oriental Neuropsychiatry
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    • v.34 no.4
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    • pp.403-420
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    • 2023
  • Objectives: This study investigated the effectiveness of herbal medicine for generalized anxiety disorder (GAD) based on recent clinical studies. Methods: Studies were searched through four databases. Clinical research studies on herbal medicine treatment for GAD patients were included. The studies were analyzed according to study design, diagnostic criteria, population, and intervention. A risk of bias assessment was performed to assess the quality of the included randomized controlled trials (RCT). If the intervention applied to the treatment and control groups was the same and two or more studies were reporting the same items as outcome indicators, a meta-analysis was performed. Results: A total of 19 studies, including 12 RCTs were selected. The most common pattern identification was 'Phlegm fire disturbing upward' (痰熱上擾), and the most used herb for therapeutic purposes was 'Rhizome of Poria cocos' (茯苓). Meta-analysis results of three studies showed that there were no significant differences in effectiveness between the herbal medicine intervention and the Western medicine intervention. Meta-analysis results of five studies showed that the Hamilton Anxiety Rating Scale was significantly reduced in the case of herbal medicine intervention compared to Western medicine intervention. Conclusions: The results of our study demonstrated that herbal medicine treatment for GAD is effective in alleviating anxiety symptoms and chief symptoms of GAD. However, this study has several limitations; there was a lack of placebo-controlled RCT and an absence of objective diagnostic criteria in case reports. Therefore, further well-designed clinical studies, conducted based on the results of this study, are recommended.