• Journal of Preventive Medicine and Public Health
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• v.49 no.2
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• pp.97-107
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• 2016

Objectives: Research on how the risk of gastric cancer increases with Epstein-Barr virus (EBV) infection is lacking. In a systematic review that investigated studies published until September 2014, the authors did not calculate the summary odds ratio (SOR) due to heterogeneity across studies. Therefore, we include here additional studies published until October 2015 and conduct a meta-analysis with meta-regression that controls for the heterogeneity among studies. Methods: Using the studies selected in the previously published systematic review, we formulated lists of references, cited articles, and related articles provided by PubMed. From the lists, only case-control studies that detected EBV in tissue samples were selected. In order to control for the heterogeneity among studies, subgroup analysis and meta-regression were performed. Results: In the 33 case-control results with adjacent non-cancer tissue, the total number of test samples in the case and control groups was 5280 and 4962, respectively. In the 14 case-control results with normal tissue, the total number of test samples in case and control groups was 1393 and 945, respectively. Upon meta-regression, the type of control tissue was found to be a statistically significant variable with regard to heterogeneity. When the control tissue was normal tissue of healthy individuals, the SOR was 3.41 (95% CI, 1.78 to 6.51; I-squared, 65.5%). Conclusions: The results of the present study support the argument that EBV infection increases the risk of gastric cancer. In the future, age-matched and sex-matched case-control studies should be conducted.

• Quality Improvement in Health Care
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• v.22 no.2
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• pp.27-40
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• 2016

Purpose: Globally, falls are a major public health problem. The study aimed to evaluate the predictive validity of the Timed Up and Go test (TUGT) as a screening tool for fall risk. Methods: An electronic search was performed Medline, EMBASE, CINAHL, Cochran Library, KoreaMed and the National Digital Science Library and other databases, using the following keywords: 'fall', 'fall risk assessment', 'fall screening', 'mobility scale', and 'risk assessment tool'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Thirteen studies were analyzed using meta-analysis with MetaDisc 1.4. Results: The selected 13 studies reporting predictive validity of TUGT of fall risks were meta-analyzed with a sample size of 1004 with high methodological quality. Overall predictive validity of TGUT was as follows. The pooled sensitivity 0.72 (95% confidence interval [CI]: 0.67-0.77), pooled specificity 0.58 (95% CI: 0.54-0.63) and sROC AUC was 0.75 respectively. Heterogeneity among studies was a moderate level in sensitivity. Conclusion: The TGUT's predictive validity for fall risk is at a moderate level. Although there is a limit to interpret the results for heterogeneity between the literature, TGUT is an appropriate tool to apply to all patients at a potential risk of accidental fall in a hospital or long-term care facility.

• Journal of Korean Academy of Nursing
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• v.44 no.6
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• pp.595-607
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• 2014

Purpose: The Braden Scale is one of the most intensively studied risk assessment scales used in identifying the risk of developing pressure sore. However, not all studies show that the predictive validity of this scale is sufficient. The purpose of this study was to evaluate the Braden Scale for predicting pressure ulcer development. Methods: Articles published 1946 and 2013 from periodicals indexed in Ovid Medline, Embase, CINAHL, KoreaMed, NDSL and other databases were selected, using the following keywords: 'pressure ulcer'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Selected studies were analyzed using meta-analysis with MetaDisc 1.4. Results: Thirty-eight diagnostic studies with high methodological quality, involving 17,934 patients, were included. Results of the meta-analysis showed that the pooled sensitivity and specificity of the Braden Scale were 0.74 (95% CI: 0.72-0.76), 0.75 (95% CI: 0.74-0.76) respectively. However the predictive validity of the Braden Scale has limitation because there was high heterogeneity between studies. Conclusion: The Braden Scale's predictive validity of risk for pressure ulcer is interpreted as at a moderate level. However there is a limitation to the interpretation of the results, because of high heterogeneity among the studies.

• Journal of Preventive Medicine and Public Health
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• v.57 no.1
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• pp.8-17
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• 2024

Objectives: The effectiveness and efficiency of pre-exposure prophylaxis (PrEP) in reducing the transmission of human immunodeficiency virus (HIV) among men who have sex with men (MSM) relies on how widely it is adopted and adhered to, particularly among high-risk groups of MSM. The meta-analysis aimed to collect and analyze existing evidence on various factors related to PrEP adherence in MSM, including demographic characteristics, sexual behaviors, substance use, and psychosocial factors. Methods: The meta-analysis followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search included articles published between January 2018 and December 2022, obtained from the PubMed, ScienceDirect, and Scopus databases. The studies that were included in the analysis reported the proportion of MSM who demonstrated adherence to PrEP and underwent quality appraisal using the Newcastle-Ottawa Scale. Results: Of the 268 studies initially identified, only 12 met the inclusion criteria and were included in the final meta-analysis. The findings indicated that education (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.12 to 2.40), number of sexual partners (OR, 1.16; 95% CI, 1.02 to 1.31), engaging in sexual activities with an human immunodeficiency virus-positive partner (OR, 1.59; 95% CI, 1.16 to 2.26), substance use (OR, 0.83; 95% CI, 0.70 to 0.99), and lower levels of depression (OR, 0.55; 95% CI, 0.37 to 0.82) were associated with higher rates of PrEP adherence among MSM. Conclusions: Despite these findings, further research is necessary to investigate PrEP adherence more comprehensively. The findings of this meta-analysis can be utilized to inform interventions aimed at improving PrEP adherence among MSM and provide directions for future research in this area.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.21
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• pp.9085-9091
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• 2014

Background: Epidemiology studies have shown an inconclusive relationship between phytoestrogen intake and ovarian cancer risk and there have been no relevant meta-analyses directly regarding this topic. The purpose of the present meta-analysis was therefore to investigate any association between phytoestrogen intake and ovarian cancer in detail. Materials and Methods: We conducted a search of PubMed, EMBASE, EBSCO, the Cochrane Library, CNKI and Chinese Biomedical Database (up to April 2014) using common keywords for studies that focused on phytoestrogen and ovarian cancer risk. Study-specific risk estimates (RRs) were pooled using fixed effect or random-effect models. Results: Ten epidemiologic studies were finally included in the meta-analysis. The total results indicated higher phytoestrogen intake was associated with a reduced ovarian cancer risk (RR, 0.70; 95%CI: 0.56-0.87). The association was similar in sensitivity analysis. Meta regression analysis demonstrated sources and possibly types and regions as heterogeneous factors. Subgroup analysis of types, sources and regions showed that isoflavones (RR: 0.63; 95%CI: 0.46, 0.86), soy foods (RR: 0.51; 95%CI: 0.39, 0.68) and an Asian diet (RR: 0.48; 95%CI: 0.37, 0.63) intake could reduce the incidence of ovarian cancer. Conclusions: Our findings show possible protection by phytoestrogens against ovarian cancer. We emphasize specific phytoestrogens from soy foods, but not all could reduce the risk. The habit of plentiful phytoestrogen intake by Asians is worthy to recommendation. However, we still need additional larger well designed observational studies to fully characterize underlying associations.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.6127-6130
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• 2013

This study aimed to investigate the association between p53 Arg72Pro polymorphism and the risk of human papillomavirus (HPV)-related head and neck squamous cell carcinoma (HNSCC) by conducting meta-analysis. The PubMed database was searched for relevant studies until May 30, 2013. Relevant studies were selected and data were extracted by two independent authors. Overall, subgroup, and sensitivity analyses were then conducted using the Comprehensive Meta-Analysis v2.2 software. Wild-genotype ArgArg was considered as reference [odds ratio (OR) = 1.00]. Nine studies involving 1071 HNSCC cases were obtained. Meta-analysis results indicated no association between p53 Arg72Pro polymorphism and the risk of HPV-related HNSCC: for Pro/Pro vs. Arg/Arg, OR = 1.17, 95% confidence interval (CI) = 0.70-1.98; for Arg/Pro vs. Arg/Arg, OR = 1.25, 95% CI = 0.97-1.72; and for (Pro/Pro + Arg/Pro) vs. Arg/Arg, OR = 1.28, 95% CI = 0.95-1.70. These meta-analysis results were supported by subgroup and sensitivity analysis results. In conclusions, p53 Arg72Pro polymorphism is a potential marker of HP infection-related HNSCC rather than a susceptibility gene polymorphism.

• Korean Journal of Radiology
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• v.23 no.3
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• pp.355-369
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• 2022

Objective: To evaluate the completeness of the reporting of systematic reviews and meta-analyses published in a general radiology journal using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Materials and Methods: Twenty-four articles (systematic review and meta-analysis, n = 18; systematic review only, n = 6) published between August 2009 and September 2021 in the Korean Journal of Radiology were analyzed. Completeness of the reporting of main texts and abstracts were evaluated using the PRISMA 2020 statement. For each item in the statement, the proportion of studies that met the guidelines' recommendation was calculated and items that were satisfied by fewer than 80% of the studies were identified. The review process was conducted by two independent reviewers. Results: Of the 42 items (including sub-items) in the PRISMA 2020 statement for main text, 24 were satisfied by fewer than 80% of the included articles. The 24 items were grouped into eight domains: 1) assessment of the eligibility of potential articles, 2) assessment of the risk of bias, 3) synthesis of results, 4) additional analysis of study heterogeneity, 5) assessment of non-reporting bias, 6) assessment of the certainty of evidence, 7) provision of limitations of the study, and 8) additional information, such as protocol registration. Of the 12 items in the abstract checklists, eight were incorporated in fewer than 80% of the included publications. Conclusion: Several items included in the PRISMA 2020 checklist were overlooked in systematic review and meta-analysis articles published in the Korean Journal of Radiology. Based on these results, we suggest a double-check list for improving the quality of systematic reviews and meta-analyses. Authors and reviewers should familiarize themselves with the PRISMA 2020 statement and check whether the recommended items are fully satisfied prior to publication.

• The Mathematical Education
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• v.58 no.4
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• pp.519-530
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• 2019

According to previous studies, meta-affect based on the interaction between cognitive and affective elements in mathematics learning activities maintains a close mechanical relationship with the learner's mathematical ability in a similar way to meta-cognition. In this study, in order to grasp these characteristics phenomenologically, small group problem-solving cases of 5th grade elementary mathematically gifted children were analyzed from a meta-affective perspective. As a result, the two types of problem-solving cases of mathematically gifted children were relatively frequent in the types of meta-affect in which cognitive element related to the cognitive characteristics of mathematically gifted children appeared first. Meta-affects were actively acted as the meta-function of evaluation and attitude types. In the case of successful problem-solving, it was largely biased by the meta-function of evaluation type. In the case of unsuccessful problem-solving, it was largely biased by the meta-function of the monitoring type. It could be seen that the cognitive and affective characteristics of mathematically gifted children appear in problem solving activities through meta-affective activities. In particular, it was found that the affective competence of the problem solver acted on problem-solving activities by meta-affect in the form of emotion or attitude. The meta-affecive characteristics of mathematically gifted children and their working principles will provide implications in terms of emotions and attitudes related to mathematics learning.

• Journal of Korean Academy of Nursing
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• v.50 no.3
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• pp.385-400
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• 2020

Purpose: Previous randomized controlled trials (RCT) found that mind-body therapy can improve the health outcomes of patients with irritable bowel syndrome (IBS). The purpose of this meta-analysis was to identify the combined effects of mind-body therapy on patients' IBS symptoms, quality of life, anxiety, and depression. Methods: A systematic literature search was conducted using various databases such as PubMed, EMBASE, CINAHL CENTRAL, DBpia, RISS, and KISS. The primary outcome variables were IBS symptoms and quality of life; the secondary outcome variables were anxiety and depression. Comprehensive Meta-Analysis version 3.0 was used to analyze the extracted data. The effect size was calculated using standardized mean difference (SMD) and 95% confidence interval (CI). Results: Eleven final RCTs were used for this meta-analysis. Mind-body therapy was found to have a significant effect on the IBS patients' symptoms (SMD, -0.63; 95% CI, -0.77 to -0.48), quality of life (SMD, 1.03; 95% CI, 0.40 to 1.66), anxiety (SMD, -0.28; 95% CI, -0.47 to -0.09), and depression (SMD, -0.31; 95% CI, -0.06 to -0.12). Conclusion: This meta-analysis reveals that mind-body therapy significantly improves IBS patients' symptoms, quality of life, anxiety, and depression. The results suggest that, in the future, appropriate mind-body therapy should be applied to Koreans suffering from IBS. Moreover, the therapy's long-term effects should be assessed.

• Journal of Korean Academy of Nursing
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• v.47 no.6
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• pp.713-730
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• 2017

Purpose: This study was a systematic review and meta-analysis designed to evaluate the effects of breastfeeding intervention on breastfeeding rates. Methods: Based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), a systematic search was conducted using eight core electronic databases and other sources including gray literature from January 9 to 19, 2017. Two reviewers independently select the studies and assessed methodological risk of bias of studies using the Cochrane criteria. The topics of breastfeeding interventions were analyzed using descriptive analysis and the effects of intervention were meta-analyzed using the Review Manager 5.2 software. Results: A total of 16 studies were included in the review and 15 were included for meta-analysis. The most frequently used intervention topics were the importance of good latch-on and frequency of feeding and determining adequate intake followed. The pooled total effect of breastfeeding intervention was 1.08 (95% CI 1.03~1.13). In the subgroup analysis, neither pre-nor post-childbirth intervention was effective on the breastfeeding rates at 1, 3, and 6 months, and neither group nor individual interventions had an effect. Only the 1 month breastfeeding rate was found to be affected by the individual intervention with the persistent strategies 1.21 (95% CI 1.04~1.40). Conclusion: Effective breastfeeding interventions are needed to help the mother to start breastfeeding after childbirth and continue for at least six months. It should be programmed such that individuals can acquire information and specific breastfeeding skills. After returning home, there should be continuous support strategies for breastfeeding as well as managing various difficulties related to childcare.