• 제목/요약/키워드: Risk of bias

검색결과 818건 처리시간 0.027초

비알콜성 지방간 환자에 대한 베르베린 투여 치료의 임상적 효능 연구: 체계적 문헌 고찰과 메타분석 (Clinical Efficacy of Coptidis Rhizoma for Non-Alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis)

  • 박송원;김민지;임성우
    • 한방비만학회지
    • /
    • 제22권2호
    • /
    • pp.158-166
    • /
    • 2022
  • Objectives: The purpose of this meta-analysis was to evaluate the effects of berberine on non-alcoholic fatty liver disease (NAFLD) through a systematic review and meta-analysis. Methods: We searched seven electronic databases for studies through October 2022. All randomized controlled trials (RTCs) of berberine were included. Data extraction and risk of bias assessments were performed by two independent reviewers. The RevMan 5.4.1 program was used for meta-analysis. Results: A total of 279 relevant studies were identified, and 6 eligible RCTs were included to study the efficacy berberine on NAFLD. The six selected trials are studies on the effect between berberine and conventional treatment combined treatment versus conventional treatment. Liver function tests, blood lipid levels, and blood glucose levels were assessed. Combination treatment with berberine, ursodeoxycholate acid, metformin, and monascus purpureus showed statistically significant improvements in liver function levels, blood lipid levels, and blood glucose levels compared to conventional treatment alone. However, there was no significant efficacy of berberine combination dietary, exercise than control group on NAFLD. The meta-analysis results of examining 4 RCTs comparing the therapeutic efficacy of berberine showed statistically significant improvement in the liver function test, blood lipids levels, blood glucose levels. Conclusions: This study suggests that berberine has positive efficacy on blood lipids, blood glucose liver function, fatty liver condition of NAFLD. However, the level of evidence is low because of small effect size,so further investigation is needed.

월경전증후군에 대한 침 치료의 효과 : 체계적 문헌고찰과 메타분석 (Acupuncture for Premenstrual Syndrome: A Systematic Review and Meta-analysis)

  • 김안나;김영은;이은희;손미주
    • 대한한방부인과학회지
    • /
    • 제36권3호
    • /
    • pp.154-172
    • /
    • 2023
  • Objectives: This study aimed to assess the clinical evidence supporting the use of acupuncture (AC) for premenstrual syndrome (PMS). Methods: We searched randomized controlled trials (RCTs) that used AC for PMS in 9 databases (PubMed, EMBASE, Cochrane Library, CINAHL, CNKI, CiNii, SCIENCE ON, KoreaMed, OASIS) from their inception to July 2022. Results: We identified 1,168 studies, of which 15 RCTs met the inclusion criteria. The risk of bias in the included studies was relatively unclear or high. Meta-analysis of 3 RCTs showed that the AC group had a significantly higher effective rate than the Medroxyprogesterone group (RR 1.48, 95% CI (1.23, 1.78), p<0.0001). Meta-analysis of 2 RCTs showed that there was no statistically significant difference between the AC group and the Sham AC group in the effective rate (RR 4.72, 95% CI (0.88, 25.36), p=0.07). In a review of individual studies, the AC group was more effective than the control group in terms of the effective rate, symptom scale, quality of life, adverse events, and recurrence rate. Conclusions: The AC group was more effective than general treatments groups such as sham AC, western medicine, and dietary supplements, and there were no serious adverse events. However, the evidence on the effectiveness and safety of acupuncture for PMS was inconclusive due to the small number of included studies and low quality. Therefore, systematic reviews based on more rigorously designed randomized clinical trials are needed in the future to properly evaluate the effect of AC on PMS.

치료적 운동을 포함한 도인운동의 어깨 통증에 대한 적용 가능성 탐색: 체계적 문헌고찰 및 메타 분석 (Applicability of Daoyin Exercise with Therapeutic Exercise for Shoulder Pain: A Systematic Review and Meta-analysis)

  • 박현선;박상현;이지호;박서현;금동호
    • 한방재활의학과학회지
    • /
    • 제33권4호
    • /
    • pp.79-93
    • /
    • 2023
  • Objectives The purpose of this study is to investigate therapeutic exercise and to provide the evidence of daoyin exercise for shoulder pain. Methods Electronic databases including PubMed, EMBASE, China National Knowledge Infrastructure, Science ON, Oriental Medicine Advanced Searching Integrated System were searched up to October 2022. We selected randomized controlled trials. The quality of studies was assessed by Cochrane risk of bias tool. Meta-analysis were perfomed by Review Manager software. Results Eighteen randomized controlled trials were collected in accordance with the selection and exclusion criteria. Among the 18 trials, 7 trials used strengthening exercise, 4 trials used stablilization exercise, 5 trials used both types of intervention, and 2 trials used daoyin exercise. The study characteristics, results and method of intervention were analyzed. Meta-analysis showed that therapeutic exercise appeared to more effective than no treatment group for shoulder pain (standardized mean difference=-1.18, 95% confidence interval=-1.44 to 0.91, Z=8.82, p<0.00001; chi2=2.71, p=0.61; I2=0%). Conclusions All of 18 selected studies reported the effectiveness of therapeutic exercise for shoulder pain. Combining strengthening and stablilization exercise is considered the most efficient way for shoulder pain. Based on this study, well-designed studies should be performed to be evidence of the use of daoyin exercise for shoulder pain.

Predictive modeling algorithms for liver metastasis in colorectal cancer: A systematic review of the current literature

  • Isaac Seow-En;Ye Xin Koh;Yun Zhao;Boon Hwee Ang;Ivan En-Howe Tan;Aik Yong Chok;Emile John Kwong Wei Tan;Marianne Kit Har Au
    • 한국간담췌외과학회지
    • /
    • 제28권1호
    • /
    • pp.14-24
    • /
    • 2024
  • This study aims to assess the quality and performance of predictive models for colorectal cancer liver metastasis (CRCLM). A systematic review was performed to identify relevant studies from various databases. Studies that described or validated predictive models for CRCLM were included. The methodological quality of the predictive models was assessed. Model performance was evaluated by the reported area under the receiver operating characteristic curve (AUC). Of the 117 articles screened, seven studies comprising 14 predictive models were included. The distribution of included predictive models was as follows: radiomics (n = 3), logistic regression (n = 3), Cox regression (n = 2), nomogram (n = 3), support vector machine (SVM, n = 2), random forest (n = 2), and convolutional neural network (CNN, n = 2). Age, sex, carcinoembryonic antigen, and tumor staging (T and N stage) were the most frequently used clinicopathological predictors for CRCLM. The mean AUCs ranged from 0.697 to 0.870, with 86% of the models demonstrating clear discriminative ability (AUC > 0.70). A hybrid approach combining clinical and radiomic features with SVM provided the best performance, achieving an AUC of 0.870. The overall risk of bias was identified as high in 71% of the included studies. This review highlights the potential of predictive modeling to accurately predict the occurrence of CRCLM. Integrating clinicopathological and radiomic features with machine learning algorithms demonstrates superior predictive capabilities.

간호사 주도의 중재가 신장이식 수혜자의 삶의 질, 약물 순응도, 불안 및 우울에 미치는 효과: 체계적 문헌고찰 및 메타분석 (The effectiveness of nurse-led interventions on quality of life, medication adherence, anxiety, and depression in kidney transplant recipients: A systematic review and meta-analysis)

  • 박승연;곽이화
    • 한국간호교육학회지
    • /
    • 제30권3호
    • /
    • pp.263-279
    • /
    • 2024
  • Purpose: This study was conducted to evaluate the effects of nurse-led interventions on quality of life, medication adherence, anxiety, and depression in kidney transplant recipients. Methods: A systematic literature review was conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Two researchers independently selected the final literature, and the quality assessment was performed using Cochrane's Risk of Bias tool. Additionally, a meta-analysis was conducted using the statistical software RevMan 5.4 to estimate effect sizes. Results: Among the reviewed 2,264 papers, 8 final papers, including 6 from the literature search and 2 from manual searches, were included in the analysis. The total number of participants included in the analysis was 477. Nurse-led interventions were found to be effective in improving quality of life (d=1.05) and reducing anxiety (d=-0.98) and depression (d=-1.25). Due to the heterogeneity of the measurement tools, the effect size for medication adherence could not be calculated. Despite this, nurse-led interventions were shown to improve medication adherence. In the cases of anxiety and depression, longer intervention periods showed a more significant reduction trend. Conclusion: The results of this study suggest that nurse-led interventions positively impact quality of life, medication adherence, anxiety, and depression in kidney transplant recipients. Therefore, it is important to recognize the crucial role of nurses and explore ways to provide continuous nursing interventions for kidney transplant recipients.

아로마테라피가 중년여성의 갱년기 증상, 스트레스 및 우울에 미치는 효과: 체계적 문헌고찰 (Effects of Aromatherapy on Menopausal Symptoms, Perceived Stress and Depression in Middle-aged Women: A Systematic Review)

  • 김신미;송지아;김미은;허명행
    • 대한간호학회지
    • /
    • 제46권5호
    • /
    • pp.619-629
    • /
    • 2016
  • Purpose: This study was a systematic review to evaluate the effects of aromatherapy on menopausal symptoms, perceived stress and depression in middle aged-women. Methods: Eight databases were searched from their inception September 8, 2015. Two reviewers independently performed the selection of the studies, data abstraction and validations. The risk of bias was assessed using Cochrane criteria. For analysis of the data, a meta-analysis of the studies was performed. Results: From the electronic databases, 73 articles were selected, and 19 removed due to duplication. After two reviewers read the abstracts of 54 studies, 34 studies were selected. Complete papers for 34 s were read and, 12 studies which met selection criteria were reviewed and the effects of aromatherapy on menopausal symptoms, stress and depression analyzed using meta-analysis with RevMan. In the 2 studies which included Randomized Controlled Trials testing of aromatherapy on menopausal symptoms and comparison of control and placebo groups were done. Aromatherapy massage was favorably effective in reducing the menopausal symptoms compared to the control group (n=118, MD=-6.33; 95% CI -11.51 to -1.15), and compared to the placebo group (n=117, MD=-4.14; 95% CI -7.63 to -0.64). Also aromatherapy was effective in reducing stress (n=72, SMD=-0.64; 95% CI -1.12 to -0.17) and depression (n=158, MD=-5.63; 95% CI -10.04 to -1.22). Conclusion: There is limited evidence suggesting that aromatherapy for middle-aged women may be effective in controlling menopausal symptoms, perceived stress and depression.

레이노병의 침치료에 대한 연구동향 (A Review of Acupuncture for the Treatment of Raynaud's Disease)

  • 전상우;김호;정민정;장인수
    • 대한한방내과학회지
    • /
    • 제38권4호
    • /
    • pp.433-442
    • /
    • 2017
  • Objectives: The purpose of this study was to assess the effectiveness of acupuncture for the treatment of Raynaud's disease. Methods: This review was conducted using nine electronic databases (CINAHL, CiNii, CNKI, EMBASE, J-STAGE, NDSL, OASIS, PubMed, and WANFANG) and the keywords "Raynaud's disease", "Raynaud disease", "acupuncture", and "needling". Only randomized controlled trials (RCTs) using acupuncture for Raynaud's disease were included, and the methodological quality of the trials was assessed using the Cochrane risk-of-bias tool. Results: After screening, six RCTs were selected among 67, and the total effective rate and peripheral blood flow were used as evaluation methods. In five studies, the total effective rate was significantly higher in the intervention group than in the control group. In three studies, peripheral blood flow was higher in the intervention group than in the control group, with two studies being statistically significant and the remaining study not being statistically significant. Conclusions: Acupuncture could be a suitable treatment without adverse effects for Raynaud's disease because it improves peripheral blood flow. However, further studies, including randomized, placebo-controlled, double-blind methods, and clear evaluation criteria are needed.

수술 후 폐 합병증 예방을 위한 심호흡 운동의 효과에 대한 체계적 고찰 (Effectiveness of Deep Breathing Exercise for Postoperative Pulmonary Complications Prevention: A Systematic Review)

  • 이월숙;양유리;오의금
    • 기본간호학회지
    • /
    • 제21권4호
    • /
    • pp.423-432
    • /
    • 2014
  • Purpose: This study was done to evaluate effectiveness of deep breathing exercise as a postoperative intervention to prevent pulmonary complications. Methods: A search of databases from 1990 to 2012 was done including MEDLINE, EMBASE, CINAHL, Cochrane Library and eight Korean databases. Ten studies met eligibility criteria. Researchers trained in systematic review, independently assessed the methodological quality of selected studies using the Cochrane's risk of bias tool. Data were analyzed using RevMan 5.2 program. Results: Among ten RCTs in four studies, deep breathing exercise was compared with an instrument using interventions such as incentive spirometry, in the other four studies deep breathing exercise was compared with non-intervention, and in last two studies bundles of interventions including coughing and early ambulation were assessed. A significant difference was found between deep breathing exercise group and non-intervention group. The odds ratio (OR) of occurrence of pulmonary complications for deep breathing exercise versus non-intervention was 0.30. However, there was no significant difference between deep breathing exercise group and incentive spirometry group (OR=1.22). Conclusion: Deep breathing exercise is vital to improving cost-effectiveness and efficiency of patient care in preventing postoperative pulmonary complications. For evidence-based nursing, standardized guidelines for deep breathing in postoperative care should be further studied.

Lack of Association of the MDR1 C3435T Polymorphism with Susceptibility to Gastric Cancer and Peptic Ulcer: a Systemic Review and Meta-analysis

  • Wu, Dan-Dan;Zhang, Ji-Xiang;Li, Jiao;Dong, Wei-Guo
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제15권7호
    • /
    • pp.3021-3027
    • /
    • 2014
  • Background: The multidrug resistance 1 gene (MDR1) C3435T polymorphism has been demonstrated to influence the P-glycoprotein (P-gp) activity level which is related to inflammation and carcinogenesis. This meta-analysis was performed to estimate the association between the MDR1 C3435T polymorphism and the risk of gastric cancer (GC) and peptic ulcer (PU). Materials and Methods: A literature search was conducted with PubMed, Embase and the Cochrane library up to November 2013. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of association. Data were analyzed using Review Manager (Version 5.2), and Stata package (version 12.0) for estimation of publication bias. Results: Six case-control studies were included, of which five were for GC and two for PU. Overall, no evidence was found for any association between the MDR1 C3435T polymorphism and the susceptibility to GC and PU. In the stratified analysis by H. pylori infection status, stage and histology classification of GC, and PU type, there was still no significant association between them. Conclusions: This meta-analysis suggested that the MDR1 C3435T polymorphism is not associated with susceptibility to GC and PU. Large and well-designed studies are warranted to validate our findings.

A Meta-Analysis of Treatment Effects on Viral Pneumonia Using TCM Injections Specified in the Clinical Guideline for COVID-19 in China

  • Chun, Hea Sun;Choi, Su Hyeon;Song, Ho Sueb
    • 대한약침학회지
    • /
    • 제24권3호
    • /
    • pp.107-121
    • /
    • 2021
  • Objectives: The purpose of this study is to analyze the efficacy of traditional Chinese medicine (TCM) injections specified in the clinical guideline for COVID-19 by conducting a meta-analysis of viral pneumonia data. Methods: TCM injections data on viral pneumonia were collected until July 31, 2021. CNKI, PubMed, EMBASE, and the Cochrane electronic database were used to collect the clinical data. "COVID-19," "Viral pneumonia," "Tanreqing," "Xiyanping," "Reduning," "Xingnaojing," "Xuebijing," "Shenmai," "Shengmai," and "Shenfu" were used as keywords. All data collected were mainly about TCM injections and viral pneumonia. Furthermore, studies that included results such as the total effective rate, cough disappearance time, antipyretic time, lung rhomboid disappearance time, and adverse drug reaction were collected for the meta-analysis to identify the efficacy of TCM injections. However, data unrelated to TCM injections specified in the clinical guidelines for COVID-19 or viral pneumonia were excluded. The quality of included RCTs was assessed by the Cochrane Risk of Bias Tool, and Review Manager 5.3 software was used to conduct the meta-analysis. Results: A total of 18 studies with 1540 patients were included in this study. The results of the meta-analysis showed that the total effective rate OR = 4.61 (95% CI 2.92, 7.25, p = 1.00/ I2 = 0%); the cough disappearance time: SMD -1.23 (-1.37, -1.09, p < 0.00001/ I2 = 94%); the antipyretic time: SMD -1.26 (-1.40, -1.11, p < 0.00001/ I2=94%); lung rhomboid disappearance time: SMD -1.17 (-1.33, -1.02, p < 0.00001/ I2 = 89%); and adverse drug reaction was OR 0.36 (95% CI 0.20, 0.64, p = 0.21/ I2 = 30%). From the results, the treatment group (TCM injection) showed better efficacy than the control group (Western medication). Conclusion: Xiyanping, Reduning, and Tanreqing injections may yield benefits as COVID-19 treatments. However, clinical trials on TCM injections for the treatment of COVID-19 are still lacking. More high-quality clinical trials are still required.