• Title/Summary/Keyword: Systematic risk

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Antimicrobial efficacy of QMix on Enterococcus faecalis infected root canals: a systematic review of in vitro studies

  • Lim, Benjamin Syek Hur;Parolia, Abhishek;Chia, Margaret Soo Yee;Jayaraman, Jayakumar;Nagendrababu, Venkateshbabu
    • Restorative Dentistry and Endodontics
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    • v.45 no.2
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    • pp.23.1-23.12
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    • 2020
  • Objectives: This study aimed to summarize the outcome of in vitro studies comparing the antibacterial effectiveness of QMix with other irrigants against Enterococcus faecalis. Materials and Methods: The research question was developed by using population, intervention, comparison, outcome, and study design framework. The literature search was performed using 3 electronic databases: PubMed, Scopus, and EBSCOhost until October 2019. The additional hand search was performed from the reference list of the eligible studies. The risk of bias of the studies was independently appraised using the revised Cochrane Risk of Bias tool (RoB 2.0). Results: Fourteen studies were included in this systematic review. The overall risk of bias for the selected studies was moderate. QMix was found to have a higher antimicrobial activity compared to 2% sodium hypochlorite (NaOCl), 17% ethylenediaminetetraacetic acid (EDTA), 2% chlorhexidine (CHX), mixture of tetracycline isonomer, an acid and a detergent (MTAD), 0.2% Cetrimide, SilverSol/H2O2, HYBENX, and grape seed extract (GSE). QMix had higher antibacterial efficacy compared to NaOCl, only when used for a longer time (10 minutes) and with higher volume (above 3 mL). Conclusions: QMix has higher antibacterial activity than 17% EDTA, 2% CHX, MTAD, 0.2% Cetrimide, SilverSol/H2O2, HYBENX, GSE and NaOCl with lower concentration. To improve the effectiveness, QMix is to use for a longer time and at a higher volume.

Chuna Manual Therapy For Simple Obesity: A Systematic Review and Meta-analysis (단순성 비만에 대한 추나요법의 효과: 체계적 문헌고찰과 메타분석)

  • Lee, Yun-Jin;Lee, Eun-Byeol;Kim, Hyeon-Ji;An, Hee-Duk;Yang, Doo-Hwa
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.16 no.1
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    • pp.43-52
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    • 2021
  • Objectives The purpose of this study was to investigate the effectiveness of Chuna manual therapy (CMT) in the treatment of simple obesity. Methods We used seven databases to perform a literature search using the keywords "Chuna OR Tuina" AND "Obesity." We selected randomized clinical trials in which Chuna was used as the main method for treating simple obesity. The risk of bias was assessed by three independent researchers using the Cochrane risk of bias. Results A total of 14 RCTs were selected and analyzed. The results of the meta-analysis showed a significantly higher efficacy rate in the patient group treated with CMT as the main treatment than that in the control group. Conclusions The results of this systematic review suggest that CMT is effective in the treatment of simple obesity. However, given the limitations such as the small number of studies and the high risk of bias in the studies, additional research is needed to lend further support to this claim.

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

  • Hong, Su Min;Oh, Seung Joon;Lee, Eun Jung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.34 no.6
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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.

Effectiveness of Exercise after Lung Cancer Surgery: A Systematic Review in PubMed Database (폐암 수술 후 운동의 효과: PubMed 내 연구에 대한 체계적 문헌고찰)

  • Jerng, Ui Min
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.1
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    • pp.149-163
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    • 2021
  • Objectives This study is to review the effectiveness of exercise after lung cancer surgery. Methods Relevant randomized controlled trials (RCTs) were searched in PubMed database. The systematic review was conducted through flow diagram. The risk of biases were assessed through the Cochrane guideline. Characteristics and outcomes were extracted from each study. Meta-analyses of forced expiratory volume in one second (FEV1), 6-minute walk test (6MWT), quality of life (QoL), pulmonary complications were conducted. Results 14 RCTs were selected. In meta-analysis, exercise improved FEV1 (mean difference [MD] 0.14; 95% confidence interval [CI] 0.04 to 0.25; p=0.009; I2=55%) and mean change of FEV1 (MD 0.11; 95% CI 0.02 to 0.20; p=0.02; I2=0%). Exercise increased the distance of 6MWT, but there was considerable heterogeneity (MD 45; 95% CI 21.16 to 68.83; p=0.0002, I2=89%). There was no differences in QoL scores by 2 questionnaires (European Organisation for Research and Treatment of Cancer quality of life questionnaire, short form-36). Exercise reduced the duration of hospital stay (MD -3.32; 95% CI -5.27 to -1.36; I2=0%; 2 studies) but not duration of chest tube intubation (MD -1.37; 95% CI -2.81 to 0.06; I2=0%) and incidence of pulmonary complications (pooled risk ratio 0.54; 95% CI 0.23 to 1.30; I2=0%). Conclusions Exercise might reduce the duration of hospital stay after lung surgery. There was not enough evidence to prove improvement of lung function, aerobic capacity, muscle strength, QoL, and decline of pulmonary complications. Low-quality risk of bias, different units or estimation of outcome, different exercise type and duration, heterogeneity among studies make the evidence of effectiveness weak. Future researches are required to redeem these defects.

The Effectiveness of Moxibustion Treatment in Infertility with IVF-ET: A Systematic Review and Meta-Analysis (보조생식술을 시행한 난임환자에서의 뜸 치료에 대한 체계적 문헌고찰 및 메타분석)

  • Lee, Ho-Sung;Park, Yong-Duk;Lee, Hye-Jung;Hwang, Deok-Sang;Jang, Jun-Bock;Lee, Chang-Hoon;Lee, Jin-Moo;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.35 no.2
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    • pp.28-41
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    • 2022
  • Objectives: The purpose of this study is to investigate the effectiveness of moxibustion in infertility with In Vitro Fertilization and Embryo Transfer (IVF-ET). Methods: We searched 8 databases (Embase, PubMed, CiNii, CNKI, OASIS, ScienceOn, KMBASE, KISS)to identify eligible studies published before 2021 Oct. We included randomized controlled clinical trials (RCTs) using moxibustion in infertility with IVF-ET. The methodological quality of each RCT was assessed by the Cochrane risk of bias tool. Results: Two RCT studies were eligible in our review. The overall risk of bias was evaluated as unclear. The meta-analysis of 2 trials indicated that favorable results for the use of moxibustion with IVF-ET. Conclusions: This systematic review and meta-analysis of clinical trials suggests that moxibustion with IVF-ET can effect on Infertility patients. However, because of studies included analysis was biased due to unclear risk of bias and unreliable study design, future RCT studies and additional Meta-Analysis are needed to judge the supplementary treatment role of moxibustion in infertility with IVF-ET.

The Effect of Task-Oriented Treadmill Training on Gait Function in Patients with Stroke: A Systematic Review and Meta-Analysis (과제 지향적 트레드밀 훈련이 뇌졸중 환자의 보행 능력에 미치는 영향: 체계적 고찰 및 메타분석)

  • Yong-Gu Han;Myoung-Kwon Kim
    • Journal of the Korean Society of Physical Medicine
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    • v.19 no.1
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    • pp.131-142
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    • 2024
  • PURPOSE: This study was a systematic review and meta-analysis of the literature comparing the differences between task-oriented treadmill training and general treadmill training for stroke patients. METHODS: Literature published in the Cumulated Index to Nursing and Allied Health Literature (CINAHL), Embase, Physiotherapy Evidence Database (PEDro), and PubMed was reviewed. A total of 1,163 studies were initially retrieved, of which eight articles were included in the final review. A quality assessment of the included studies was conducted using the Risk of Bias (RoB) 2.0 tool, and Duval and Tweedie's trim and fill method was used to evaluate publication bias. Data analysis was performed using R studio 4.2.1. RESULTS: According to the quality assessment using RoB 2.0, three articles were evaluated as low risk, two as of some concern, and three as high risk. The overall effect size of task-oriented tradmill training was .35. Regarding gait function, the values were .76, .25, and .40, respectively, for gait endurance, gait speed, and gait pattern. According to Duval and Tweedie's trim and fill method, no publication bias was observed. CONCLUSION: Study findings indicate that task-oriented treadmill training is the most effective intervention for improving gait endurance in patients with stroke. Therefore, applying this intervention to patients with stroke in the community is recommended.

Electroacupuncture for Rotator Cuff Disorder: A Systematic Review and Meta-Analysis (회전근개 질환의 전침 치료에 대한 체계적 문헌고찰 및 메타분석)

  • Bok-Yeon Na;Sang-Hoon Lee;Chang-Hoon Woo;Young-Jun Kim
    • Journal of Korean Medicine Rehabilitation
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    • v.34 no.3
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    • pp.27-41
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    • 2024
  • Objectives This study aims to evaluate the efficacy and safety of electroacupuncture for rotator cuff disorder. Methods We searched nine online databases (PubMed, Embase, Cochrane Library, Chinese Academic Journals, Korean studies Information Service System, Rsearch Information Sharing Service, ScienceON, KMbase, Oriental Medicine Advanced Searching Integrated System) and two related journals up to April 2024 to identify randomized controlled trials that applied electroacupuncture to rotator cuff disorder. Selected studies were analyzed for risk of bias using the Cochrane risk of bias tool, and a meta-analysis was performed with RevMan version 5.4.1. Results Out of 175 studies, eleven randomized controlled trials were selected for final analysis. Most studies showed that electroacupuncture had effect on rotator cuff disorder. In the meta-analysis, electroacupuncture combined with rehabilitation treatment was significantly more effective than rehabilitation treatment alone in improving visual analog scale (p<0.00001). Almost studies did not report any side effects or adverse reactions to electroacupuncture treatment. Conclusions This systematic review suggests that electroacupuncture is an effective treatment for pain management in rotator cuff disorder. However, the lack of adverse effect reporting and a high risk of bias indicate the need for high-quality randomized controlled trials from various countries.

The effects of remdesivir on mortality and the requirement for mechanical ventilation in patients with COVID-19: a systematic review stratified by disease severity

  • Seungeun Ryoo;Miyoung Choi;Su-Yeon Yu;Young Kyung Yoon;Kyungmin Huh;Eun-Jeong Joo
    • The Korean journal of internal medicine
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    • v.39 no.1
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    • pp.160-171
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    • 2024
  • Background/Aims: The effectiveness of remdesivir treatment in reducing mortality and the requirement for mechanical ventilation (MV) remains uncertain, as randomized controlled trials (RCTs) have produced conflicting results. Methods: We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and other data resources to find RCTs published prior to April 10, 2023. The selection of studies, assessment of risk of bias, and meta-analysis were conducted according to PRISMA guidelines. The primary outcomes were all-cause mortality and the need to initiate MV. Results: A total of 5,068 articles were screened, from eight RCTs comprising 11,945 patients. The meta-analysis found that, compared to standard care or placebo, remdesivir treatment provided no significant all-cause mortality benefit (pooled risk ratio [RR], 0.93; 95% confidence interval [CI], 0.85-1.02; 8 studies; high certainty evidence), while subgroup analyses revealed a trend towards reduced mortality among patients requiring oxygen but not MV (pooled RR, 0.88; 95% CI, 0.77-1.00; 6 studies; I2 = 4%). The need to initiate MV (pooled RR, 0.74; 95% CI, 0.59-0.94; 7 studies; moderate certainty evidence) in remdesivir-treated patients was also reduced compared to controls. Remdesivir significantly increased clinical improvement and discharge and significantly reduced serious adverse events. Conclusions: In this systematic review and meta-analysis of RCTs, it was found that remdesivir treatment did not show a substantial decrease in the risk of mortality. However, it was linked to a reduction in the necessity for additional ventilator support, suggesting remdesivir could be beneficial for COVID-19 patients, particularly those who are not on MV.

Effects of Non-Pharmacological Interventions on Major Adverse Cardiac Events in Patients Underwent Percutaneous Coronary Intervention: Systematic Review and Meta-Analysis (경피적 관상동맥 중재술을 시행한 대상자에게 적용한 비약물적 중재가 주요 심혈관 사건에 미치는 효과: 체계적 문헌고찰과 메타분석)

  • Jo, Sojeong;Lee, Haejung;Park, Gaeun
    • Journal of Korean Academy of Nursing
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    • v.54 no.3
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    • pp.311-328
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    • 2024
  • Purpose: In this study a systematic review and meta-analysis investigated the impact of non-pharmacological interventions on major adverse cardiac events (MACE) in patients with coronary artery disease who underwent percutaneous coronary intervention (PCI). Methods: A literature search was performed using PubMed, Cochrane Library, EMBASE, and Cumulative Index to Nursing & Allied Health Literature databases up to November 2023. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Effect sizes and 95% confidence intervals were calculated using R software (version 4.3.2). Results: Eighteen randomized studies, involving 2,898 participants, were included. Of these, 16 studies with 2,697 participants provided quantitative data. Non-pharmacological interventions (education, exercise, and comprehensive) significantly reduced the risk of angina, heart failure, myocardial infarction, restenosis, cardiovascular-related readmission, and cardiovascular-related death. The subgroup meta-analysis showed that combined interventions were effective in reducing the occurrence of myocardial infarction (MI), and individual and group-based interventions had significant effects on reducing the occurrence of MACE. In interventions lasting seven months or longer, occurrence of decreased by 0.16 times, and mortality related to cardiovascular disease decreased by 0.44 times, showing that interventions lasting seven months or more were more effective in reducing MI and cardiovascular disease-related mortality. Conclusion: Further investigations are required to assess the cost-effectiveness of these interventions in patients undergoing PCI and validate their short- and long-term effects. This systematic review underscores the potential of non-pharmacological interventions in decreasing the incidence of MACE and highlights the importance of continued research in this area (PROSPERO registration number: CRD42023462690).

Study of Explanatory Power of Deterministic Risk Assessment's Probability through Uncertainty Intervals in Probabilistic Risk Assessment (고장률의 불확실구간을 고려한 빈도구간과 결정론적 빈도의 설명력 연구)

  • Man Hyeong Han;Young Woo Chon;Yong Woo Hwang
    • Journal of the Korean Society of Safety
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    • v.39 no.3
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    • pp.75-83
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    • 2024
  • Accurately assessing and managing risks in any endeavor is crucial. Risk assessment in engineering translates the abstract concept of risk into actionable strategies for systematic risk management. However, risk validation is met with significant skepticism, particularly concerning the uncertainty of probability. This study aims to address the aforementioned uncertainty in a multitude of ways. Firstly, instead of relying on deterministic probability, it acknowledges uncertainty and presents a probabilistic interval. Secondly, considering the uncertainty interval highlighted in OREDA, it delineates the bounds of the probabilistic interval. Lastly, it investigates how much explanatory power deterministic probability has within the defined probabilistic interval. By utilizing fault tree analysis (FTA) and integrating confidence intervals, a probabilistic risk assessment was conducted to scrutinize the explanatory power of deterministic probability. In this context, explanatory power signifies the proportion of probability within the probabilistic risk assessment interval that lies below the deterministic probability. Research results reveal that at a 90% confidence interval, the explanatory power of deterministic probability decreases to 73%. Additionally, it was confirmed that explanatory power reached 100% only with a probability application 36.9 times higher.