• Title/Summary/Keyword: risk and meta-analysis

Search Result 921, Processing Time 0.025 seconds

The effects of diagnostic hysteroscopy on the reproductive outcomes of infertile women without intrauterine pathologies: a systematic review and meta-analysis

  • Yang, Soo Yeon;Chon, Seung-Joo;Lee, Seon Heui
    • Women's Health Nursing
    • /
    • v.26 no.4
    • /
    • pp.300-317
    • /
    • 2020
  • Purpose: Hysteroscopy can be used both to diagnose and to treat intrauterine pathologies. It is well known that hysteroscopy helps to improve reproductive outcomes by treating intrauterine pathologies. However, it is uncertain whether hysteroscopy is helpful in the absence of intrauterine pathologies. This study aimed to confirm whether hysteroscopy improves the reproductive outcomes of infertile women without intrauterine pathologies. Methods: We conducted a systematic review of 11 studies retrieved from Ovid-MEDLINE, Ovid-Embase, and the Cochrane Library. Two independent investigators extracted the data and used risk-of-bias tools (RoB 2.0 and ROBINS-I) to assess their quality. Results: Diagnostic hysteroscopy prior to in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) was associated with a higher clinical pregnancy rate (CPR) and live birth rate (LBR) than non-hysteroscopy in patients with recurrent implantation failure (RIF) (odds ratio, 1.79 and 1.46; 95% confidence interval, 1.40-2.30 and 1.08-1.97 for CPR and LBR, respectively) while hysteroscopy prior to first IVF was ineffective. The overall meta-analysis of LBR showed statistically significant findings for RIF, but a subgroup analysis showed effects only in prospective cohorts (odds ratio, 1.40 and 1.47; 95% confidence interval, 0.62-3.16 and 1.04-2.07 for randomized controlled trials and prospective cohorts, respectively). Therefore, the LBR should be interpreted carefully and further research is needed. Conclusion: Although further research is warranted, hysteroscopy may be considered as a diagnostic and treatment option for infertile women who have experienced RIF regardless of intrauterine pathologies. This finding enables nurses to educate and support infertile women with RIF prior to IVF/ICSI.

The Effectiveness of Acupuncture and Moxibustion Treatment for Mastitis: A Systematic Review (유방염의 침구 치료에 대한 체계적 문헌고찰)

  • Jeong, Seo-Yoon;Sohn, Yu-Jin;Jeong, Min-Jeong;Lee, Eun-Hee;Jang, In-Soo
    • The Journal of Korean Obstetrics and Gynecology
    • /
    • v.30 no.3
    • /
    • pp.29-39
    • /
    • 2017
  • Objectives: The purpose of this study is to investigate the effectiveness of acupuncture and moxibustion for mastitis. Methods: We used ten databases including Embase, PubMed, and CNKI to investigate the literatures of mastitis using the keywords "mastitis" and "acupuncture", "breast inflammation" and "acupuncture", "mastitis" and "needle", "breast inflammation" and "needle", "mastitis" and "moxibustion". We excluded studies which included treatments that could affect the judgement of the effectiveness of acupuncture treatment, and the control group was limited to antibiotics. The quality of the paper was evaluated by Risk of Bias. A meta-analysis was performed using a "Review manager" to see the effectiveness of acupuncture and moxibustion compared to antibiotics. Results: Only six RCT were finally selected. Five studies use the total effective rate as a evaluating index, and it was significantly higher than that of the control group in two studies. In other three studies, acupuncture showed similar effectiveness to antibiotics. Meta-analysis was performed through three studies, there was no statistically significant difference in total effective rate between acupuncture and antibiotic treatment. Conclusions: Analysis of six RCT showed that acupuncture and moxibustion seem to have many possibilities as one of the treatments for mastitis. However the number of documents is not sufficient, more research should be done to obtain reliable information.

The effectiveness and safety of acupuncture combination treatment on smoking cessation: A protocol for systematic review (금연에 대한 침술 병용 치료의 효과 및 안전성 : 체계적 검토를 위한 프로토콜)

  • In Suh Choi;Won-Suk Sung;Min-gi Jo;Jung-Hyun Kim;Yeon-Cheol Park;Eun-Jung Kim;Yong-Hyeon Baek;Geun-Woo Kim;Byung-Kwan Seo
    • Journal of Convergence Korean Medicine
    • /
    • v.3 no.1
    • /
    • pp.5-13
    • /
    • 2022
  • Objectives: Smoking had a long negative impact on public health. The ingredients of a cigarette are major risk factors for several diseases. Owing to the problems about economic and quality of life, we need to ensure smoking cessation (SC). There are several approaches for SC including pharmacological therapy, nicotine replacement therapy, education, and behavioral intervention. However, due to some limitations, other alternative approaches are gaining popularity. Acupuncture has been reported to have few side effects and be more effective than some conventional treatments in several articles. However, there are no systematic reviews on the comparison of acupuncture combination treatment with other conventional monotherapies. Methods: Randomized controlled trials that used acupuncture as an adjunct treatment for SC will be searched and data will be summarized according to the predefined criteria. The primary outcome will be the abstinence rate, and secondary outcomes will be adverse events and biochemical indicators. We will use Review Manager to perform a meta-analysis, Cochrane Collaboration Risk of Bias tool for the risk of bias assessment, and the Grades of Recommendation, Assessment, Development and Evaluation approach to determine the quality of evidence. We will investigate the efficacy and safety of acupuncture combination treatment for SC with this study. Ethics and dissemination: This study will provide reliable clinical evidence on additional effect of acupuncture on smoking cessation. We will publish our results in a peer-review journal.

A Systematic Review and Meta-Analysis on the Effect of Herbal Medicine for Endometrial Hyperplasia - Focusing on Chinese Randomised Controlled Trials (자궁내막증식증에서 한약 치료의 효과에 대한 체계적 문헌 고찰 및 메타분석 - 중국 임상 연구를 중심으로)

  • Yu, Jin-Sil;Park, Kyoung-Sun;Ahn, Young-Tae;Cho, Yu-Jin;Kang, Eun-Sol;Jung, Sung-Yub;Lee, Yoon-Jae
    • The Journal of Korean Obstetrics and Gynecology
    • /
    • v.34 no.3
    • /
    • pp.96-113
    • /
    • 2021
  • Objectives: The purpose of this study is to analyze the effectiveness of herbal medicine that are used for endometrial hyperplasia. Methods: We searched on three databases [PubMed, China national knowledge infrastructure (CNKI), and Oriental medicine advanced searching integrated system (OASIS)] with keywords for Endometrial hyperplasia(English, Korean, and Chinese) and evaluated the risk of bias. Meta-analysis was performed on the selected studies. Results: 15 RCTs were finally selected. According to the analysis, Most of the participants were endometrial hyperplasia without atypia. And the combined therapeutic effects of hormonal medicine and herbal medicine were statistically significant (RR 1.21 [95% CI 1.15, 1.28], P<0.00001), The endometrial thickness tended to be thinner when treated combined therapy. And they also showed improvement on levels of pictorial blood assessment chart (PBAC) and hemoglobin. Also, the therapeutic effects of herbal medicine can be identified as similar to Western medicine, and no superior effects have been confirmed (RR 1.05 [95% CI 0.87, 1.28], P=0.60). Conclusion: The combination Western and herbal medicine was more effective than Western medicine alone treated for endometrial hyperplasia without atypia. Moreover there were also significant improvements in endometrial thickness, PBAC and hemoglobin levels.

Efficacy of intralipid administration to improve in vitro fertilization outcomes: A systematic review and meta-analysis

  • Han, E Jung;Lee, Hye Nam;Kim, Min Kyoung;Lyu, Sang Woo;Lee, Woo Sik
    • Clinical and Experimental Reproductive Medicine
    • /
    • v.48 no.3
    • /
    • pp.203-210
    • /
    • 2021
  • We performed a systematic review and meta-analysis to evaluate whether intralipid administration improved the outcomes of in vitro fertilization. Online databases (PubMed, Cochrane Library, Medline, and Embase) were searched until March 2020. Only randomized controlled trials (RCTs) that assessed the role of intralipid administration during in vitro fertilization were considered. We analyzed the rates of clinical pregnancy and live birth as primary outcomes. Secondary outcomes included the rates of chemical pregnancy, ongoing pregnancy, and missed abortion. We reviewed and assessed the eligibility of 180 studies. Five RCTs including 840 patients (3 RCTs: women with repeated implantation failure, 1 RCT: women with recurrent spontaneous abortion, 1 RCT: women who had experienced implantation failure more than once) met the selection criteria. When compared with the control group, intralipid administration significantly improved the clinical pregnancy rate (risk ratio [RR], 1.48; 95% confidence interval [CI], 1.23-1.79), ongoing pregnancy rate (RR, 1.82; 95% CI, 1.31-2.53), and live birth rate (RR, 1.85; 95% CI, 1.44-2.38). However, intralipid administration had no beneficial effect on the miscarriage rate (RR, 0.75; 95% CI, 0.48-1.17). A funnel plot analysis revealed no publication bias. Our findings suggest that intralipid administration may benefit women undergoing in vitro fertilization, especially those who have experienced repeated implantation failure or recurrent spontaneous abortion. However, larger, well-designed studies are needed to confirm these findings.

Effectiveness of miniscrew assisted rapid palatal expansion using cone beam computed tomography: A systematic review and meta-analysis

  • Siddhisaributr, Patchaya;Khlongwanitchakul, Kornkanok;Anuwongnukroh, Niwat;Manopatanakul, Somchai;Viwattanatipa, Nita
    • The korean journal of orthodontics
    • /
    • v.52 no.3
    • /
    • pp.182-200
    • /
    • 2022
  • Objective: This study aims to examine the effectiveness of miniscrew assisted rapid palatal expansion (MARPE) treatment in late adolescents and adult patients using cone-beam computed tomography (CBCT). Methods: Literature search was conducted in five electronic databases (PubMed, Embase, Scopus, Web of Science, and Cochrane Library) based on the PICOS keyword design focusing on MARPE. Out of the 18 CBCT screened outcomes, only nine parameters were sufficient for the quantitative meta-analysis. The parameters were classified into three main groups: 1) skeletal changes, 2) alveolar change, and 3) dental changes. Heterogeneity test, estimation of pooled means, publication bias, sensitivity analysis and risk of bias assessment were also performed. Results: Upon database searching, only 14 full-text articles were qualified from the 364 obtained results. Heterogeneity test indicated the use of the random-effects model. The pooled mean estimate were as follows: 1) Skeletal expansion: zygomatic width, 2.39 mm; nasal width, 2.68 mm; jugular width, 3.12 mm; and midpalatal suture at the posterior nasal spine and anterior nasal spine, 3.34 mm and 4.56 mm, respectively; 2) Alveolar molar width expansion, 4.80 mm; and 3) Dental expansion: inter-canine width, 3.96 mm; inter-premolar width, 4.99 mm and inter-molar width, 5.99 mm. The percentage of expansion demonstrated a skeletal expansion (PNS) of 55.76%, alveolar molar width expansion of 24.37% and dental expansion of 19.87%. Conclusions: In the coronal view, the skeletal and dental expansion created by MARPE was of the pyramidal pattern. MARPE could successfully expand the constricted maxilla in late adolescents and adult patients.

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

  • Kim, Shinmi;Song, Ji-Ah;Kim, Mi-Eun;Hur, Myung-Haeng
    • Journal of Korean Academy of Nursing
    • /
    • v.46 no.5
    • /
    • 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.

Contamination Rates in Duodenoscopes Reprocessed Using Enhanced Surveillance and Reprocessing Techniques: A Systematic Review and Meta-Analysis

  • Shivanand Bomman;Munish Ashat;Navroop Nagra;Mahendran Jayaraj;Shruti Chandra;Richard A Kozarek;Andrew Ross;Rajesh Krishnamoorthi
    • Clinical Endoscopy
    • /
    • v.55 no.1
    • /
    • pp.33-40
    • /
    • 2022
  • Background/Aims: Multiple outbreaks of multidrug-resistant organisms have been reported worldwide due to contaminated duodenoscopes. In 2015, the United States Food and Drug Administration recommended the following supplemental enhanced surveillance and reprocessing techniques (ESRT) to improve duodenoscope disinfection: (1) microbiological culture, (2) ethylene oxide sterilization, (3) liquid chemical sterilant processing system, and (4) double high-level disinfection. A systematic review and meta-analysis was performed to assess the impact of ESRT on the contamination rates. Methods: A thorough and systematic search was performed across several databases and conference proceedings from inception until January 2021, and all studies reporting the effectiveness of various ESRTs were identified. The pooled contamination rates of post-ESRT duodenoscopes were estimated using the random effects model. Results: A total of seven studies using various ESRTs were incorporated in the analysis, which included a total of 9,084 post-ESRT duodenoscope cultures. The pooled contamination rate of the post-ESRT duodenoscope was 5% (95% confidence interval [CI]: 2.3%-10.8%, inconsistency index [I2]=97.97%). Pooled contamination rates for high-risk organisms were 0.8% (95% CI: 0.2%-2.7%, I2=94.96). Conclusions: While ESRT may improve the disinfection process, a post-ESRT contamination rate of 5% is not negligible. Ongoing efforts to mitigate the rate of contamination by improving disinfection techniques and innovations in duodenoscope design to improve safety are warranted.

East Asian Traditional Medicine Treatment for Patients after Heart Valve Replacements: A Systematic Review with Meta-Analysis (심장판막 치환술 후 한의학적 치료에 대한 체계적 문헌고찰 및 메타분석)

  • Ahn, Mu-hyeok;Kim, Ji-ho;Shin, Bong-jin;Kwon, Jung-nam
    • The Journal of Internal Korean Medicine
    • /
    • v.43 no.4
    • /
    • pp.720-737
    • /
    • 2022
  • Objectives: To compare the effectiveness and safety of East Asian traditional medicine treatments (EATMT) versus conventional management in patients following heart valve replacement surgery. Methods: We searched several databases, including the Korean Studies Information Service System, PubMed, China National Knowledge Infrastructure, and Citation Information by NII. The search range included randomized controlled trials from each first issue until June 27, 2021. Two review authors independently extracted the data. We assessed the risk of systematic errors by evaluating risk domains using the "Risk of bias" tool. Results: We included 5 trials in the review. In the EATMT, the investigators reported significant improvements in reshaping of the heart structure: left ventricular end diastolic diameter (MD -4.43, 95% CI -6.06 to -2.79; 130 participants; 2 studies; high evidence). Comparisons with usual care revealed a significant decrease in gastrointestinal complications rate (OR 0.30, 95% CI 0.20 to 0.47; 503 participants; 2 studies; high evidence). We assessed 4 studies as having a low risk of bias and 1 study as having a high risk of bias. Conclusion: This systematic review suggests that East Asian traditional medicine interventions may be effective in preventing and alleviating complications, but we found evidence of important trade-offs between known benefits and known adverse effects in cardiac dysfunction and inflammation following heart valve replacement. Consequently, additional high-quality studies should be conducted.