• Title/Summary/Keyword: Risk of bias

검색결과 798건 처리시간 0.029초

전립선 비대증에 대한 뜸치료의 효과 : 체계적 문헌고찰과 메타분석 (Moxibustion for Benign Prostatic Hyperplasia: A Systematic Review and Meta-analysis)

  • 배고은;이승환;홍진우;이인;김소연;최준용;한창우;윤영주;박성하;권정남
    • 대한한방내과학회지
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    • 제39권3호
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    • pp.372-388
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    • 2018
  • Objective: This study evaluates the effectiveness and safety of moxibustion for benign prostatic hyperplasia (BPH). Methods: Using the keywords "benign prostatic hyperplasia", "benign prostatic hypertrophy", "benign prostatic enlargement", "prostatic hyperplasia", and "moxibustion", we searched papers in numerous databases, including National Discovery for Science Leaders (NDSL), Korean Traditional Knowledge Portal (KTKP), Oriental Medicine Advanced Searching Integrated System (OASIS), Research Information Sharing Service (RISS), PubMed, Embase, and CENTRAL. The search range included randomized controlled trials (RCTs). Papers not matched with inclusion criteria were excluded. The methodological quality of each RCT was assessed using the Cochrane risk-of-bias tool. Where appropriate, meta-analyses were performed. Results: Initially, 77 studies were found. Of these, 11 duplicate studies were removed and 27 were excluded following title and abstract screening. After the remaining 39 papers were scanned, 13 RCTs were selected and analyzed. Among these 13 RCTs, five compared moxibustion therapy and oral medication, seven compared moxibustion plus acupuncture therapy and oral medication, and one compared moxibustion plus acupuncture therapy and sham-moxibustion. The meta-analysis showed positive results for the use of moxibustion therapy in terms of International Prostate Symptom Score (IPSS), Quality Of Life (QOL), Maximum Flow Rate (Qmax), Prostate Volume (PV), and the efficacy rate. The meta-analysis showed positive results for the use of moxibustion plus acupuncture therapy in terms of IPSS, QOL, and the efficacy rate. Conclusions: This meta-analysis of clinical trials suggests that moxibustion is effective intreating BPH patients. The results of this study could be applied to clinical treatment of BPH. However, additional large-scale clinical researches should be conducted.

Improved Socio-Economic Status of a Community Population Following Schistosomiasis and Intestinal Worm Control Interventions on Kome Island, North-Western Tanzania

  • Mwanga, Joseph R.;Kaatano, Godfrey M.;Siza, Julius E.;Chang, Su Young;Ko, Yunsuk;Kullaya, Cyril M.;Nsabo, Jackson;Eom, Keeseon S.;Yong, Tai-Soon;Chai, Jong-Yil;Min, Duk-Young;Rim, Han-Jong;Changalucha, John M.
    • Parasites, Hosts and Diseases
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    • 제53권5호
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    • pp.553-559
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    • 2015
  • Research on micro-level assessment of the changes of socio-economic status following health interventions is very scarce. The use of household asset data to determine wealth indices is a common procedure for estimating socio-economic position in resource poor settings. In such settings information about income is usually lacking, and the collection of individual consumption or expenditure data would require in-depth interviews, posing a considerable risk of bias. In this study, we determined the socio-economic status of 213 households in a community population in an island in the north-western Tanzania before and 3 year after implementation of a participatory hygiene and sanitation transformation (PHAST) intervention to control schistosomiasis and intestinal worm infections. We constructed a household 'wealth index' based housing construction features (e.g., type of roof, walls, and floor) and durable assets ownership (e.g., bicycle, radio, etc.). We employed principal components analysis and classified households into wealth quintiles. The study revealed that asset variables with positive factor scores were associated with higher socio-economic status, whereas asset variables with negative factor scores were associated with lower socio-economic status. Overall, households which were rated as the poorest and very poor were on the decrease, whereas those rated as poor, less poor, and the least poor were on the increase after PHAST intervention. This decrease/increase was significant. The median shifted from -0.4376677 to 0.5001073, and the mean from -0.2605787 (SD; 2.005688) to 0.2605787 (SD; 1.831199). The difference in socio-economic status of the people between the 2 phases was highly statistically significant (P<0.001). We argue that finding of this study should be treated with caution as there were other interventions to control schistosomiasis and intestinal worm infections which were running concurrently on Kome Island apart from PHAST intervention.

B형 및 C형 간염에 대한 한약 치료의 효과 - 체계적 고찰 연구 (Herbal Medicine for the Treatment of Viral Hepatitis B and C: A Systematic Review of Randomized Controlled Trials)

  • 김승모;이유리;조나경;최홍식;김경순
    • 대한한방내과학회지
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    • 제42권4호
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    • pp.455-474
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    • 2021
  • 본 연구는 B형 및 C형 간염에 대한 한약 치료의 효과를 평가하기 위해 무작위 임상연구를 대상으로 체계적 문헌고찰 및 메타분석을 시행하였다. 검색엔진은 EMBASE, Pubmed, NDSL, KMBASE, KISS, KISTI, Koreamed, Koreantk, Oasis database를 이용하였으며 국내의 검색 엔진 키워드는 '간염' 또는 '바이러스성간염', '한약', '무작위 배정 임상시험'을, 국외 검색 엔진 키워드는 'hepatitis' or 'viral hepatitis' and 'herbal medicine' or 'traditional chinese medicine' and 'randomized controlled trial'을 이용하였다. 연구 결과 15개의 무작위배정 임상시험을 선택되었으며, 그 중 통계적으로 유의미한 결과를 나타낸 연구는 한약과 양약 복합치료군이 양약을 투여한 대조군에 비해 HBV DNA loss에서 높은 효과를 보였다. 한약과 양약 복합치료군이 양약을 투여한 대조군에 비해 HBeAg loss에서 통계적으로 유의한 효과를 보였으며, 한약과 양약 복합치료군이 양약을 투여한 대조군에 비해 ALT가 감소하였다. 본 연구는 B형 및 C형 간염환자를 대상으로 한약의 효과를 확인하기 위해 기존에 시행된 RCT 연구를 대상으로 체계적 문헌고찰을 시행하였으며, 한약과 양약의 복합치료가 양약 단독치료에 비해 치료효과가 더 높은 것으로 나타났다.

섬유근통의 통증 및 우울증상에 대한 침치료의 효과성: 체계적 문헌고찰 및 메타분석 (Effectiveness of Acupuncture for Pain and Depressive Symptoms in Fibromyalgia: Systematic Review and Meta-Analysis)

  • 이현우;박찬;방태훈;지형민;김종우;정선용
    • 동의신경정신과학회지
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    • 제34권2호
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    • pp.95-113
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    • 2023
  • Objectives: To review studies evaluating effects of acupuncture on pain and depressive symptoms in fibromyalgia. Methods: Quantitative evidences (RCTs) were systematically reviewed. Literature were searched for a combination of fibromyalgia and depression (The Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, medline (via PubMed), Kmbase, KISS, ScienceON, OASIS, CiNii, CNKI). Quantitative research findings were critically appraised by Cochrane risk of bias (RoB) tool and pooled. Meta-analysis was then conducted using Review Manager (RevMan) 5.4. Results: Eighteen studies were selected. American College of Rheumatology (ACR) classification criteria for Fibromyalgia Syndrome was most frequently used as diagnostic criteria for fibromyalgia. As for outcome measurement, Hamilton Rating Scale for Depression (HAMD), Visual Analog Scale (VAS), and Total Effective Rate (TER) were used most commonly. Meta-analysis of ten studies revealed that both Depression and VAS scores of the Acupuncture+Western Medicine group were significantly lower than those of Western Medicine group (Depression: SMD, -0.94, 95% CI, -1.17 to -0.70; VAS: MD, -1.51, 95% CI, -1.83 to -1.19). Also, TERs of both Acupuncture group and Acupuncture+Western Acupuncture+Western Medicine group were significantly higher than those of the Western Medicine group (OR: 2.38, 95% CI: 1.29 to 4.41; and OR: 7.40, 95% CI: 3.41 to 16.07). There was no significant difference in Depression or VAS score between the Acupuncture Group and the Western Medicine Group. Conclusions: Acupuncture might be an effective option for pain and depressive symptoms of fibromyalgia when it is combined with Western Medicine treatment. For more accurate results, more types of Korean medicine treatment should be conducted.

월경전증후군에 대한 한약 치료의 효과 : 체계적 문헌 고찰과 메타 분석 (Herbal Medicine for Premenstrual Syndrome: A Systematic Review and Meta-analysis)

  • 서지인;이윤재;고서림;김누리;김정훈;손미주;김영은;김안나;이은희
    • 대한한방부인과학회지
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    • 제36권4호
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    • pp.96-120
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    • 2023
  • Objectives: This study reports the findings that support the efficacy of herbal medicine (HM) for premenstrual syndrome (PMS). Methods: We conducted meta-analysis of findings from randomized controlled trials (RCTs) for PMS treated with HM. The articles were published before July 2022, located using 9 databases (Pubmed, EMBASE, Cochrane Library, CINAHL, CNKI, CiNii, SCIENCE ON, KoreaMed, OASIS). Results: We observed 2,034 studies, of which 23 RCTs met our inclusion criteria. The risk of bias in the included studies was relatively unclear or high. Meta-analysis of 3 RCTs showed that HM group had a significantly higher total effective rate than the western medicine group (RR 1.20 [95% CI 1.06, 1.36, p=0.004]). Meta-analysis of 1 RCT showed that HM group had a significantly lower symptom score (MD -3.04 [95% CI -5.36, -0.72, p=0.01]), while there was no significant difference in daily record of severity of problems scale (MD -20.52 [95% CI -49.33, 8.29, p=0.16]). Conclusions: HM significantly improved PMS symptoms than general treatment and no serious adverse events were reported. However, the evidence on the effectiveness and safety of HM for PMS was not enough to provide reliable results due to the small number and low quality of included studies. We believe that rigorous RCTs will lead to more reliable evidence of the intervention.

지역사회 노인을 대상으로 적용한 라이프스타일 중재의 형태와 효과에 관한 체계적 고찰 (Characteristics and Effects of Lifestyle Interventions for Community Dwelling Older Adults: A Systematic Review)

  • 원경아;신윤찬;박상미;한아름;박지혁
    • 재활치료과학
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    • 제8권2호
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    • pp.7-30
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    • 2019
  • 목적 : 본 연구는 지역사회 노인에게 적용한 라이프스타일 중재의 형태와 효과를 알아보고자 하며, PRISMA 가이드라인를 통해 체계적 고찰을 시행하였다. 연구방법 : 2008년 1월부터 2017년 12월까지 국 내외 학술지에 개제된 논문을 국가과학기술정보센터(National Digital Science Library), RISS, PubMed, CINAHL을 통하여 검색하였다. 선정기준에 따라 최종적으로 20편의 연구를 분석하였으며, PEDro scale(Physiotherapy Evidence Database scale)을 사용하여 문헌의 질 평가를 하였다. 문헌에서 사용된 중재는 참가자들의 질환적 특성에 따라 분류하였다. 결과 : 라이프스타일 중재의 주요 구성요소는 중등도 이상의 운동과 같은 신체활동 증진과 건강한 식습관 형성을 위한 교육 및 훈련으로 확인되었다. 최종 분석된 20편 중 17편의 연구에서는 운동프로그램과 교육 또는 식단관리와 운동과 같이 두 가지 이상의 구성요소를 갖는 형태로 중재가 적용되었다. 노인의 건강 및 삶의 질을 평가하기 위해 다면적인 평가가 이뤄졌으며 그 중 생화학적 요인(biochemical factor)과 건강 및 웰빙(Health and well-being)을 평가하는 도구가 가장 많았다. 연구 분석 결과 지역사회 노인을 대상으로 한 라이프스타일 중재의 효과는 연구별로 상이하게 나타났으나, 14편의 연구에서 중재 직후 실험군과 대조군 간에 건강 및 삶의 질의 유의한 차이가 나타났다. 결론 : 본 연구는 노인의 질환적 특성에 따른 라이프스타일 중재기법을 선택하는데 도움을 줄 수 있을 것으로 사료된다. 향후 국내 지역사회 상황에 부합되는 중재의 개발 및 효과에 관한 연구를 통해, 작업치료적 라이프스타일 중재의 실행가능성에 관한 연구들이 체계적으로 이루어져야 할 것이다.

화학공정산업에서 안전문화 이행과 영향 변수 (Safety Oimate Practice and its Affecting Variables in the Chemical Process Industry)

  • 백종배
    • 한국안전학회지
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    • 제21권4호
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    • pp.127-133
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    • 2006
  • 이 논문의 주요 목적은 안전 분위기를 확인하여 공장과 근로자의 안전문화 수준에 영향을 주는 변수들을 찾아내고 더 나아가 화학공장의 안전문화를 향상시킬 수 있는 영향요소를 찾는데 있다. 이 논문에 사용된 질문표는 영국의 HSE(Health and Safety Executive) 의 질문표를 근간으로 문헌 조사를 통하여 경영자와 근로자로 분류하여 개발하였다. 안전문화 수준을 확인하기 위해 빈도수 분석을 하였으며 공장규모, 사고 발생, 사고 및 상해 경험과 심각성, 그리고 고용기간 등과 같은 영향변수들은 ANOVA(Analysis of Variance) 분석을 적용하여 테스트하였다. 빈도수 분석의 결과 일반적으로 경영자와 근로자 모두가 안전문화의 수준이 높게 나타났으며 주된 문제점들로는 부적당한 안전 보건 절차와 규칙, 생산에 대한 압력, 그리고 규칙위반으로 나타났다. 또한 ANOVA 분석결과에 의하면, '고용기간'은 다른 안전 문화의 수준을 만드는 유일한 변수인 것으로 나타났다. 그리고 안전문화의 조사로부터 공장들의 안전 문화요소에 대한 주요 3가지 문제점과 안전문화수준을 발견하였으며 안전 이행 능력을 향상시킬 수 있는 2가지 영향요소를 제안하였다.

The XRCC1 Arg399Gln Genetic Polymorphism Contributes to Hepatocellular Carcinoma Susceptibility: An Updated Meta-analysis

  • Pan, Yan;Zhao, Lei;Chen, Xing-Miao;Gu, Yong;Shen, Jian-Gang;Liu, Lu-Ming
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권10호
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    • pp.5761-5767
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    • 2013
  • The potential correlation of X-ray repair cross-complementing group 1 (XRCC1) Arg399Gln polymorphism with hepatocellular carcinoma (HCC) susceptibility is ambiguous. Taking account of inconsistent results of previous meta-analyses and new emerging literatures, we conducted a meta-analysis covering 15 case-control datasets to evaluate the relationship. Relevant studies from Medline, Embase and CNKI were retrieved. A fixed-effect model or a random-effect model, depending on between-study heterogeneity, were applied to estimate the association between XRCC1 polymorphism Arg399Gln and HCC risk with the results presented as odds ratios (ORs) and 95% confidence intervals (95% CIs). In accordance with Hardy-Weinberg equilibrium, 15 studies with data for 6,556 individuals were enrolled in this systematic review. For overall HCC,thr XRCC1 polymorphism Arg399Gln was significantly associated with HCC susceptibility in a homozygote model as well as in a dominant model (G/G vs. A/A, OR=1.253, p=0.028; G/G+A/G vs. A/A, OR= 1.281, p=0.047, respectively), but not in a heterozygote model (A/G vs. A/A, OR=1.271, p=0.066) or a recessive model (G/G vs. A/G + A/A, OR= 1.049, p=0.542). Similar results were also observed on stratification analysis by ethnicity (A/G vs. A/A, OR=1.357, p=0.025; G/G vs. A/A, OR=1.310, p=0.011; G/G+A/G vs. A/A, OR= 1.371, p=0.013). However, no potential contribution of XRCC1 Arg399Gln polymorphism to HCC susceptibility in HBV/HCV subgroups was identified. No publication bias was found in this study. In conclusion, the XRCC1 Arg399Gln polymorphism contributes to HCC susceptibility. Due to the lack of studies in Western countries, further large-sample and rigorous studies are needed to validate the findings.

본태성 진전에 대한 중의학 연구동향 (A Review on Treatment of Essential Tremor in Traditional Chinese Medicine)

  • 신아리;배영롱;임재유;이승환;김상호;임정화
    • 동의신경정신과학회지
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    • 제28권2호
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    • pp.95-107
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    • 2017
  • Objectives: This study was performed to review studies on Essential Tremor (ET) in Traditional Chinese medicine (TCM). Methods: We reviewed papers in the China National Knowledge Infrastructure (CNKI) from 2007~2016. Search keywords were 原发性震颤, 特发性震颤, essential tremor and idiopathic tremor, and excluded non-clinical studies, non-related to ET or TCM studies, theses for degrees and non-Randomized Controlled Trial (RCT). The quality of the articles was assessed by Jadad scale and the Risk of Bias (RoB). Results: Thirteen studies were selected. 'Criteria for the diagnosis of ET' was most frequently used as diagnostic criteria. 'Tremor rating scale' was primarily used for outcome measurement. Meta-analysis of nine trials revealed the effective rate of acupuncture and Western medicine (WM+Acu) groups was significantly higher compared to the WM group (RR: 1.48, 95 percent CI: 1.20 to 1.82, p=0.0002, $I^2=0$ percent) and tremor rating scale was also significantly decreased in the treatment group (MD: -1.35, 95 percent CI: -2.17 to -0.54, p=0.001, $I^2=0$ percent). Also, effective rates of Electro-acupuncture (EA) and Chinese herbal medicine (CHM) groups were significantly higher than that of the WM group {(RR: 1.53, 95 percent CI: 1.22 to 1.92, p=0.0003, $I^2=0$ percent) in EA vs. WM and (RR: 1.35, 95 percent CI: 1.16 to 1.57, p<0.0001, $I^2=0$ percent) in CHM vs. WM}. However, the quality of selected clinical studies was poor. Conclusions: Treatment of ET in TCM may be more effective and safe than in Western medicine. Therefore, we hope this study will lead to further clinical research on treatment of ET in Korean medicine.

기능성소화불량 환자에서 나타나는 정신적 증상의 한약 치료 : 체계적 문헌고찰과 메타분석 (Herbal Medicine for Functional Dyspepsia with Psychological Symptoms: A Systematic Review and Meta-Analysis)

  • 조윤재;이하늘;정해인;이현진;금창열;한아람;하나연;김진성
    • 대한한방내과학회지
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    • 제42권4호
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    • pp.488-509
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    • 2021
  • Purpose: Functional dyspepsia (FD) is a chronic syndrome accompanied by repetitive digestive symptoms that appear in the upper gastrointestinal tract and are not caused by specific diseases. Psychological symptoms like anxiety, depression, insomnia, and somatization are frequently observed in FD. The purpose of this study was to review the effect of herbal medicine on the psychological symptoms that accompany FD. Methods: Database search (PubMed, EMBASE, KISS, Kmbase, KoreanMed, NDSL, OASIS, CNKI) was performed on February 24, 2021; a total of 1825 studies were searched. After the screening, 22 studies were included. Results: The studies were assessed by Cochrane RoB 2 and sorted into a table according to psychological symptoms. Meta-analysis was performed to estimate the effect of herbal medicine. Twenty of the twenty-two studies reported that herbal medicine was significantly more effective than the control group. Only three of the studies did not have a high risk of bias. Conclusion: Herbal medicine was significantly effective with or without Western medicine and had fewer adverse effects. Severe adverse effect was not reported. Psychological symptoms in FD affect onset and duration of FD, and some FD patients want to be treated for their anxiety before other symptoms. Reliable information about treatment for the psychological symptoms of FD is lacking. We reviewed the effect of herbal medicine treatment in this study, the results of which could be selected for primary or secondary treatment for FD.