• 제목/요약/키워드: data heterogeneity

검색결과 606건 처리시간 0.031초

A Critical Systematic Review for Inhaled Corticosteroids on Lung Cancer Incidence: Not Yet Concluded Story

  • Suh-Young Lee;Soon Ho Yoon;Hyunsook Hong
    • Tuberculosis and Respiratory Diseases
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    • 제86권2호
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    • pp.120-132
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    • 2023
  • Background: To systematically review studies on inhaled corticosteroids (ICS) and lung cancer incidence in chronic airway disease patients. Methods: We conducted electronic bibliographic searches on OVID-MEDLINE, EMBASE, and the Cochrane Database before May 2020 to identify relevant studies. Detailed data on the study population, exposure, and outcome domains were reviewed. Results: Of 4,058 screened publications, 13 eligible studies in adults with chronic obstructive pulmonary disease (COPD) or asthma evaluated lung cancer incidence after ICS exposure. Pooled hazard ratio and odds ratio for developing lung cancer in ICS exposure were 0.81 (95% confidence interval, 0.64 to 1.02; I2=95.7%) from 10 studies and 1.02 (95% confidence interval 0.50 to 2.07; I2=94.7%) from three studies. Meta-regression failed to explain the substantial heterogeneity of pooled estimates. COPD and asthma were variously defined without spirometry in 11 studies. Regarding exposure assessment, three and 10 studies regarded ICS exposure as a time-dependent and fixed variable, respectively. Some studies assessed ICS use for the entire study period, whereas others assessed ICS use for 6 months to 2 years within or before study entry. Smoking was adjusted in four studies, and only four studies introduced 1 to 2 latency years in their main or subgroup analysis. Conclusion: Studies published to date on ICS and lung cancer incidence had heterogeneous study populations, exposures, and outcome assessments, limiting the generation of a pooled conclusion. The beneficial effect of ICS on lung cancer incidence has not yet been established, and understanding the heterogeneities will help future researchers to establish robust evidence on ICS and lung cancer incidence.

Movie Choice under Joint Decision: Reassessment of Online WOM Effect

  • Kim, Youngju;Kim, Jaehwan
    • Asia Marketing Journal
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    • 제15권1호
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    • pp.155-168
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    • 2013
  • This study describes consumers' movie choices in conjunction with other group members and attempts to reassess the effect of the online word of mouth (WOM) source in a joint decision context. The tendency of many people to go to movies in groups has been mentioned in previous literature but there is no modeling research that studies movie choice from the group decision perspective. We found that ignoring the group movie-going perspective can result in a misunderstanding, especially underestimation of genre preference and the impact of the WOM variables. Most of the studies to measure online WOM effects were done at the aggregate level, and the role of online WOM variables(volume vs valence) is mixed in the literature. We postulate that group-level analysis might offer insight to resolve these mixed understanding of WOM effects in the literature. We implemented the study via a random effect model with group-level heterogeneity. Romance, drama, and action were selected as genre variables; valence and volume were selected as online WOM variables. A choice-based conjoint survey was used for data collection and the models was estimated via Bayesian MCMC method. The empirical results show that (i) both genre and online WOM are important variables when consumers choose movies, especially as group, and (ii) the WOM valence effect are amplified more than the volume effect does as individuals are engaged in group decision. This research contributes to the literature in several ways. First, we investigate movie choice from a group movie-going perspective that is more realistic and consistent with the market behavior. Secondly, the study sheds new light on the WOM effect. At group-level, both valence and volume significantly affect movie choices, which adds to the understanding of the role of online WOM in consumers' movie choice.

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Reference values for pulp oxygen saturation as a diagnostic tool in endodontics: a systematic review and meta-analysis

  • Paula Lambert;Sergio Augusto Quevedo Miguens Jr;Caroline Solda;Juliana Tomaz Sganzerla;Leandro Azambuja Reichert;Carlos Estrela;Fernando Branco Barletta
    • Restorative Dentistry and Endodontics
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    • 제45권4호
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    • pp.48.1-48.11
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    • 2020
  • Objectives: This systematic review aimed to identify mean oxygen saturation values (SpO2) using pulse oximetry in permanent maxillary anterior teeth. Materials and Methods: The MEDLINE, Scientific Electronic Library Online, Cochrane Central Register of Controlled Trials, EMBASE, and Literatura Latino Americana em Ciências da Saúde electronic databases were searched. Combinations and variations of "oximetry" AND "dental pulp test" were used as search terms. Studies reporting means and standard deviations of SpO2 values were included. Two reviewers independently extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Heterogeneity was assessed using the I2 statistic, and all analyses were performed using R software. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and the Newcastle-Ottawa scale. Results: Of the 251 studies identified, 19 met the eligibility criteria and were included (total sample, 4,541 teeth). In the meta-analysis, the mean SpO2 values were 84.94% (95% confidence interval [CI], 84.85%-85.04%) for the central incisors, 89.29% (95% CI, 89.22%-89.35%) for the lateral incisors, and 89.20% (95% CI, 89.05%-89.34%) for the canines. The studies were predominantly low-quality due to the high risk of bias associated with the index test, unclear risk regarding patient selection, and concerns about outcome assessment. Conclusions: Although most studies were low-quality, the oxygen saturation levels in normal pulp could be established (minimum saturation, 77.52%). Despite the risk of bias of the included studies, the reference values reported herein are clinically relevant for assessments of changes in pulp status.

소아 일과성 고관절 활액막염에 대한 한약의 효과: 체계적 문헌 고찰 및 메타분석 (Effect of Herbal Medicine on Transient Synovitis of Hip in Children: A Systemic Review and Meta-analysis )

  • 홍예나;이영훈;유선애
    • 대한한방소아과학회지
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    • 제37권4호
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    • pp.34-52
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    • 2023
  • Objective This study aimed to evaluate the effect of herbal medicines on transient hip synovitis (TSH) in children. Methods We searched 10 Korean, English, Japanese, and Chinese databases for studies published up to September 19, 2023. Randomized controlled trials (RCTs) evaluating the effect of herbal medicines on TSH levels in children were included. The Cochrane risk of bias was used to evaluate the quality of the studies. A meta-analysis was conducted according to outcome measurements, such as total effective rate (TER), visual analog score (VAS), time to pain relief, and hip joint mobility disorder disappearance time, using the Review Manager website. Results Eleven RCTs were included in this study. TER in the treatment group was significantly higher than in the control group. The duration of pain relief was significantly shorter in the treatment group than in the control group. The VAS score of the treatment group was significantly lower than that of the control group, although the statistical heterogeneity was substantial. The hip joint mobility disorder disappeared in the treatment group treated with external therapy, which was significantly shorter than in the control group. Regarding safety, two of the 11 studies reported that there were no adverse events. Conclusions Herbal medicines are effective in the treatment of TSH in children. However, the safety of herbal medicines should be carefully considered due to the lack of data.

Comparison of Effectiveness of Manual Therapy for Infant Crying: systematic review and meta-analysis of randomized controlled trials

  • Ui Jin Park;Hye In Jeong;Kyeong Han Kim
    • 대한약침학회지
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    • 제26권4호
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    • pp.285-297
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    • 2023
  • Objectives: The aim of this systematic review and meta-analysis is to assess and compare the effectiveness of manual therapy in alleviating infant crying, a common symptom of nocturnal crying (NC) and infantile colic (IC). Methods: Total effective rate, crying time and adverse events were used as outcome indicators. To assess the quality, the risk of bias was determined for each study by two authors, using the Cochrane Collaboration's risk of bias tool. RevMan 5.0 was used for data analysis. A total of 98 articles were identified from 6 electronic databases. Results: Among them, twenty-seven studies which included 13 NC and 14 IC were included. Meta-analysis showed favorable effects tuina therapy on total effective rate (TER) of NC (RR: 1.20 [95% CI 1.05 to 1.37], p = 0.007), chiropractic therapy on crying time change of IC (SMD: -0.83 [95% CI -1.61 to -0.06], p = 0.04) and massage on total crying time of IC (SMD: -0.86 [95% CI -1.09 to -0.63], p < 0.00001). This systematic review compares different manual therapies for the treatment of NC and IC. While tuina, chiropractic, and massage show results in alleviating symptoms, the overall evidence remains limited due to the low quality and heterogeneity of the included studies. Conclusion: Therefore, further high-quality research with unified control groups is needed to establish manual therapy as a recommended treatment option for NC and IC. Protocol registration number is CRD42022348143 01/08/2022.

간호·간병통합서비스병동 간호사의 업무 적응 경험 (Experience of Adaptation to Work In Comprehensive Nursing Service Units of Nurses)

  • 박수현;원서현;김보선;양진향;허선혜
    • 문화기술의 융합
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    • 제10권3호
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    • pp.69-88
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    • 2024
  • 본 연구는 간호·간병통합서비스병동 간호사의 업무 적응 경험을 심층적으로 파악하기 위해 현상학적 방법으로 시행되었다. 본 연구의 자료수집 기간은 2023년 11월~2024년 1월까지였으며, 일반 병동과 간호·간병통합서비스병동에서 각각 6개월 이상의 업무 경험이 있는 간호사를 대상으로 심층 면담이 이루어졌다. 심층 면담 시 녹음한 파일은 모두 전사 후 Giorgi의 현상학적 방법으로 분석하였다. 분석결과, 5개의 구성요소와 14개의 하위 구성요소가 도출되었으며 구성요소는 '변화된 업무 환경을 마주침', '예상하지 못했던 업무의 이질감', '당면한 현실을 평가함', '전략을 찾아 균형을 도모함', '전문직 간호사로 성장함'으로 나타났다. 이러한 연구결과를 바탕으로 간호·간병통합서비스병동 간호사가 업무에 적응할 수 있는 시스템을 구축하고 역량 강화를 위한 프로그램을 지속적으로 개발할 필요가 있다.

Efficacy, immunogenicity, and safety of COVID-19 vaccines in individuals with liver cirrhosis: a rapid review and meta-analysis

  • Faranak Salajegheh;Mohammad Rezaei Zadeh Rukerd;Mohsen Nakhaie;Zohreh-Al-Sadat Ghoreshi;Javad Charostad;Nasir Arefinia
    • Clinical and Experimental Vaccine Research
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    • 제13권2호
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    • pp.83-90
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    • 2024
  • The emergence of coronavirus disease 2019 (COVID-19) vaccines has been a remarkable advancement. However, the efficacy, immunogenicity, and safety of these vaccines in individuals with liver cirrhosis require careful evaluation due to their compromised immune status and potential interactions with underlying liver disease. The present study aimed to evaluate the safety and efficacy of COVID-19 vaccines in liver cirrhosis patients. In the present study, we searched international databases, including Google Scholar, PubMed, Scopus, Embase, and Web of Science. The search strategy was carried out by using keywords and MeSH (Medical Subject Headings) terms. STATA ver. 15.0 (Stata Corp., USA) was used to analyze the data statistically. The analysis was performed using the randomeffects model. We also used the chi-square test and I2 index to calculate heterogeneity among studies. For evaluating publication bias, Begg's funnel plots and Egger's tests were used. A total of 4,831 liver cirrhosis patients with COVID-19 were examined from 11 studies. The rate of hospitalization in the patients with liver cirrhosis was 17.6% (95% confidence interval [CI], 9%-44%). The rate of fever in the patients with liver cirrhosis was 4.5% (95% CI, 0.9%-8.1%). The rate of positive neutralizing antibodies in the patients with liver cirrhosis was 82.5% (95% CI, 69.8%-95.1%). Also, the rates of seroconversion after the second vaccination in patients with liver cirrhosis and the control group were 96.6% (95% CI, 92.0%-99.0%), and 99.7% (95% CI, 99.0%-100.0%), respectively. COVID-19 vaccines have demonstrated promising efficacy, immunogenicity, and safety profiles in individuals with liver cirrhosis, providing crucial protection against COVID-19-related complications.

Is drug use associated with the presence of periodontitis and oral lesions? A meta-analysis

  • Michele Natara Portilio;Mayara Colpo Prado;Lilian Rigo
    • Journal of Periodontal and Implant Science
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    • 제54권4호
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    • pp.224-235
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    • 2024
  • Purpose: This systematic review investigated whether drug use is associated with the presence of oral lesions and periodontitis. Methods: A search was performed for studies that analyzed the presence of periodontitis and/or oral lesions in users of crack, cocaine, and/or marijuana in the PubMed, Scopus, and Web of Science databases. Observational studies in English, Spanish, or Portuguese, without limitation of year, age, and sex, were included. Studies that did not evaluate periodontitis and oral lesions according to the eligibility criteria were excluded. Two authors independently performed study selection and data extraction using a standardized form. The risk of bias of studies included in the meta-analysis was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. The meta-analysis included studies that investigated the association of drug use with the outcome. Results: The initial search resulted in 9,279 articles, from which 16 studies with 15,434 participants were included in the review and 8 studies were included in the meta-analysis. Most studies that evaluated periodontitis in drug users and non-users found a positive association in users. Most studies that analyzed oral lesions reported a higher prevalence, association, or risk of oral lesions in drug users than in non-users. A critical evaluation identified a need to improve the control and reporting of confounding factors in studies on this topic. An association was found between periodontitis and the use of crack, cocaine, and/or marijuana (odds ratio [OR], 1.84; 95% confidence interval [CI], 1.04-3.27; P=0.04) and between oral lesions and the use of these drugs (OR, 2.13; 95% CI, 1.58-2.86; P<0.001). Conclusions: Drug users are more likely to develop oral lesions and periodontitis than nonusers. However, the results should be interpreted with caution, considering the heterogeneity and quality of the studies included in the analysis.

Prognostic Role of Hypoxic Inducible Factor Expression in Non-small Cell Lung Cancer: A Meta-analysis

  • Li, Cong;Lu, Hua-Jun;Na, Fei-Fei;Deng, Lei;Xue, Jian-Xin;Wang, Jing-Wen;Wang, Yu-Qing;Li, Qiao-Ling;Lu, You
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권6호
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    • pp.3607-3612
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    • 2013
  • Introduction: Reported prognostic roles of hypoxic inducible factor (HIF) expression in non-small cell lung cancer (NSCLC) have varied. This meta-analysis aimed to examine the relationship between HIF expression and clinical outcome in NSCLC patients. Methods: PubMed were used to identify relevant literature with the last report up to December $20^{th}$, 2012. After careful review, survival data were collected from eligible studies. We completed the meta-analysis using Stata statistical software (Version 11) and combined hazard ratio (HR) for overall survival (OS). Subgroup specificity, heterogeneity and publication bias were also assessed. All of the results were verified by two persons to ensure accuracy. Results: Eight studies were finally stepped into this meta-analysis in which seven had available data for HIF-$1{\alpha}$ and three for HIF-$2{\alpha}$. Combined HRs suggested that higher expression of $HIF1{\alpha}$ had a negative impact on NSCLC patient survival (HR=1.50; 95%CI=1.07-2.10; p=0.019). The expression of HIF-$2{\alpha}$ was also relative to a poorer survival (HR=2.02; 95%CI=1.47-2.77; p=0.000). No bias existed in either of the two groups. Conclusion: This study suggests that elevations of HIF-$1{\alpha}$ and HIF-$2{\alpha}$ expression are both associated with poor outcome for patients with NSCLC. The data support further and high quality investigation of HIF expression for predicting poor outcome in patients with NSCLC.

한국간호사들이 경험한 미국병원에서의 언어장애 극복 과정 (Overcoming Langage Barrier by Korean Nurses in U.S. Hospital Settings)

  • 이명선
    • 대한간호학회지
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    • 제26권2호
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    • pp.483-496
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    • 1996
  • The purpose of this study was to describe how Korean nurses overcome the language barrier while working in the U.S. hospital settings. Twelve Korean nurses living in New York metropolitan area were asked open-ended, descriptive questions to collect the data. The interviews were done in Korean. All interviews were audiotaped under the permission of the participants and were transcribed verbatim. The data were analyzed using grounded theory analysis. The research process consisted of two phases. In the first phase 8 Korean nurses were interviewed and analyzed. In the second phase, further data were collected to verify categories and working hypotheses that were emerged from the first phase. The results of this study show that all Korean nurses experienced severe psychological stress such as confusion, anxiety, frustration, loss of self-confidence, embarrassment, guilt, depression, anger, and fear. Among the mode of communication such as listening, speaking, leading, and writing, they had the most difficulty in speaking. Speaking ability was especially important for them because of the emphasis of individualism and self-defense in the U.S. Among the verbal communication modes, non-face-to-face communications such as phone conversation and body language were the most difficu1t for them to overcome. It took at least 2 years for the participants to initially overcome the language barrier in U.S. hospitals. After 2-5 years they began to feel comfortable even in non-face-to-face communication. They could actively search for the better place to work after 5 years. They finally felt comfortable in English and in their job almost after 10 years. The factors that influenced the English improvement were ‘the years of clinical experience in Korea’, ‘the decade they came to the U.S.’ ‘coming to U.S. alone or with other Korean nurses’, ‘racial homogeneity or heterogeneity of the working unit’, and ‘the degree of social support’. The strategies Korean nurses used to overcome the language barrier included depending on the written communication, using ‘nunchi’, working and studying hard, and establishing good interpersonal relationships with co-workers. They also employed assertive behavior of the U.S., such as using more explicit verbal language and employing smiles and eye contact with others during the conversation. The results of the study may help Korean nurses and nursing students who try to work in U.S. hospital settings by understanding problems other Korean nurses faced, factors that influenced their English improvement, and strategies they used. They may also help U.S. nurses and administrators in developing and implementing efficient programs for newly employed Korean nurses by understanding major problems and feelings the Korean nurses experienced and strategies they used to overcome the language barriers.

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