• 제목/요약/키워드: risk and meta-analysis

검색결과 895건 처리시간 0.027초

캥거루 케어가 미숙아와 어머니에게 미치는 효과 : 체계적 문헌고찰 및 메타분석 (Effects for kangaroo care: systematic review & meta analysis)

  • 임정희;김가은;신영희
    • 한국산학기술학회논문지
    • /
    • 제17권3호
    • /
    • pp.599-610
    • /
    • 2016
  • 본 연구는 미숙아와 어머니를 대상으로 캥거루 케어 효과를 비교하기 위해 수행된 체계적 문헌고찰 및 메타분석 연구이다. 2015년 2월까지 출간된 무작위 임상실험연구를 검토하였으며, 국내문헌은 연구설계수준에 따른 제한 없이 비무작위 임상실험연구를 포함하였다. 문헌은 Ovid-Medline, CINAHL, PubMed와 국내 DB인 KoreaMed, 국립중앙도서관, 국회도서관, 국가과학기술전자도서관, KISS, RISS, 한국의학논문을 통해 ((kangaroo OR KC OR skin-to-skin) AND (care OR contact)) AND (infant OR preterm OR Low Birth Weight OR LBW), ((캥거루 OR 캉가루 OR 캉가루식) AND (케어 OR 간호 OR 관리 OR 돌보기 OR 피부접촉)) 등을 주요어로 조합하여 검색하였으며, 선택배제과정을 거쳐 최종 25편(n=3051)의 문헌이 분석에 포함되었다. 문헌에 대한 질평가는 SIGN에서 제시한 평가도구를 사용하였으며, 질평가 결과는 16편에서 ++, 9편에서 +로 평가되어 전반적으로 비뚤림 위험은 없는 것으로 판단하였다. 미숙아를 대상으로 한 캥거루 케어의 효과에 대한 메타분석 결과, 미숙아 사망률, 중증 감염/패혈증 발생률, 저체온 발생률, 병원입원기간, 모유수유율, 수면상태, 어머니의 불안, 어머니 역할수행 자신감, 어머니 역할수행 만족도에서 통계적으로 유의한 효과가 있었으며, 고체온 발생률, 미숙아의 성장발달(신장, 체중), 모아애착, 우울, 스트레스는 유의미한 차이가 없었다. 국내에서 캥거루 케어에 대한 무작위 임상실험연구 수가 적어 효과크기에 대한 확증적 결과를 얻는 데에는 다소 제한이 있었으므로 향후 이와 관련된 무작위 임상실험연구의 효과검증에 대한 노력이 지속적으로 이루어져야 할 것으로 사료된다.

Effect of Genetic Predisposition on Blood Lipid Traits Using Cumulative Risk Assessment in the Korean Population

  • Go, Min-Jin;Hwang, Joo-Yeon;Kim, Dong-Joon;Lee, Hye-Ja;Jang, Han-Byul;Park, Kyung-Hee;Song, Ji-Hyun;Lee, Jong-Young
    • Genomics & Informatics
    • /
    • 제10권2호
    • /
    • pp.99-105
    • /
    • 2012
  • Dyslipidemia, mainly characterized by high triglyceride (TG) and low high-density lipoprotein cholesterol (HDL-C) levels, is an important etiological factor in the development of cardiovascular disease (CVD). Considering the relationship between childhood obesity and CVD risk, it would be worthwhile to evaluate whether previously identified lipid-related variants in adult subjects are associated with lipid variations in a childhood obesity study (n = 482). In an association analysis for 16 genome-wide association study (GWAS)-based candidate loci, we confirmed significant associations of a genetic predisposition to lipoprotein concentrations in a childhood obesity study. Having two loci (rs10503669 at LPL and rs16940212 at LIPC) that showed the strongest association with blood levels of TG and HDL-C, we calculated a genetic risk score (GRS), representing the sum of the risk alleles. It has been observed that increasing GRS is significantly associated with decreased HDL-C (effect size, $-1.13{\pm}0.07$) compared to single nucleotide polymorphism combinations without two risk variants. In addition, a positive correlation was observed between allelic dosage score and risk allele (rs10503669 at LPL) on high TG levels (effect size, $10.89{\pm}0.84$). These two loci yielded consistent associations in our previous meta-analysis. Taken together, our findings demonstrate that the genetic architecture of circulating lipid levels (TG and HDL-C) overlap to a large extent in childhood as well as in adulthood. Post-GWAS functional characterization of these variants is further required to elucidate their pathophysiological roles and biological mechanisms.

치주질환과 만성신장질환의 연관성: 코호트 연구에 대한 체계적 고찰 (Relationship between Periodontal Disease and Chronic Kidney Disease: A Systematic Review of Cohort Studies)

  • 이은선;도경이
    • 치위생과학회지
    • /
    • 제17권2호
    • /
    • pp.160-167
    • /
    • 2017
  • 본 연구는 치주질환과 신장질환의 연관성을 알아보기 위한 체계적 고찰이다. Embase, PubMed, The Cochrane Library 데이터베이스에서 2016년 4월 17일 검색을 완료하였다. 문헌의 선택은 코호트 연구 설계를 기준으로 하였으며, 환자군은 치주질환 또는 중증의 치주질환이 있는 대상자로 하였다. 최종 결과는 만성신장질환의 발생이나 신장기능의 저하로 eGFR을 제시한 연구로 하였다. 최종 선정된 문헌의 양적합성을 위하여 Review Manager (RevMan) 통계 분석 소프트웨어를 이용하였다. 고정효과모형 멘텔-헨젤 방법(M-H)을 이용하여 메타분석을 시행하여 치주질환과 만성신장질환의 연관성을 추정하였다. 검색 전략을 이용하여 총 3,018개의 문헌이 검색되었고, 그 중 4개의 문헌이 최종 분석에 포함되어 메타 분석한 결과 치주질환이 만성신장질환 발생위험과 유의한 연관성이 있음이 나타났다(OR, 1.65; 95% CI, 1.44~1.90; p<0.001). 만성신장질환 발생 및 신장기능저하를 예방하기 위해서는 개인의 삶의 질 저하와 의료비용부담을 줄이기 위해 기존에 알려진 전통적 위험인자 외에 만성신장질환에 영향을 미치는 치주질환의 예방 및 관리의 필요성이 크다.

견관절 통증에 대한 팔단금 운동의 효과: 체계적 문헌 고찰 (Baduanjin Exercise for Shoulder Pain: A Systematic Review)

  • 김현태;이상현;박선영;허인;황만석;신병철;황의형
    • 척추신경추나의학회지
    • /
    • 제15권1호
    • /
    • pp.89-100
    • /
    • 2020
  • Objectives : This study aimed to verify the clinical effectiveness of Baduanjin for shoulder pain. Methods : We searched 10 electronic databases (PubMed, EMBASE, Cochrane Library, CAJ, KISS, KISTI, KMBASE, RISS, NDSL, and OASIS) up to May 2020. We included randomized controlled trials (RCTs) using Baduanjin for shoulder pain. The methodological quality of each RCT was assessed using the Cochrane risk of bias tool. Results : As a result of the search, a total of 6 RCTs were eligible for analysis. Of these 6 studies, one applied Baduanjin alone and 5 cases used Baduanjin in combination with other treatments, such as acupuncture or electroacupuncture. Except for 2 studies, descriptive analysis was performed without meta-analysis due to the high level of heterogeneity between studies. A high risk of bias was observed in all studies. Conclusions : When considering the results of the included papers, there was limited information derived on the therapeutic effect of using Baduanjin as a single intervention, but the results showed significant effectiveness when Baduanjin was combined with other oriental interventions, such as acupuncture and electroacupuncture, in the clinical field. Although all RCTs included in the analysis were biased to CAJ and the number was limited, this study was conducted in accordance with the methodological process of systematic literature reviews and revealed the clinical effects of Baduanjin on shoulder pain.

허파암 수술 전과 후에 적용한 운동의 효과: PubMed 내 연구에 대한 체계적 문헌고찰 (Effects of Exercise-Based Intervention Before and After Lung Cancer Surgery: A systematic review in pubmed database)

  • 오보람;김희수;박수경
    • 대한통합의학회지
    • /
    • 제11권2호
    • /
    • pp.23-35
    • /
    • 2023
  • Purpose : Lung cancer induces a decrease in physical activity and a deterioration of respiratory ability. Exercise is an effective treatment to reduce side effects of anti-cancer treatments, also influence the survival and successful rehabilitation in lung cancer patients. However, there is insufficient evidence to show which period is the most effective to apply exercise for lung cancer patients. Therefore, this study was conducted to evaluate the efficacy of exercise-based interventions before and after surgery. Methods : Clinical trials (CTs) and randomized controlled trials (RCTs) reported in PubMed database were investigated. The trials investigated in this study were published for 10 years before August 20, 2022. The risk of bias was judged according to the Cochrane guideline. The materials included in this meta-analysis were 6-minute walk test (6MWT), pulmonary function, and quality of life (QOL). Results : 1 CT and 9 RCTs were selected in current study. In the meta-analysis, exercise increased 6MWT in preoperation (mean difference [MD] 29.49; 95 % confidence interval [CI] .99 to 57.99; p=.04; I2=0 %), 3 months postoperation (MD 54.97; 95 % CI 31.85 to 78.09; p<.001; I2=45 %) and 6 months postoperation (MD 85.59; 95 % CI 45.06 to 126.12; p<.001; I2=47 %). Exercise, also enhanced the lung function such as FEV1/FVC (%) in postoperation (MD 7.64; 95 % CI 6.26 to 9.02; p<.001; I2=19 %). Additionally, exercise improved QOL, such as preoperative EORTC-QLQ-C30-LC13 in mental function (MD 3.21; 95 % CI .64 to 5.79; p=.01; I2=0 %) and postoperative SF-36 in mental component summary (MD 9.24; 95 % CI 4.94 to 13.54; p<.001; I2=0%). Conclusion : These results indicate that exercise-based intervention can elevate the ability to exercise and the mental componentof QOL within 3 months.

경피적 관상동맥중재술 후 재협착 예방에 대한 한약의 효과 : 무작위배정 대조군 임상연구에 대한 체계적 문헌고찰 및 메타분석 (Effect of Herbal Medicines on Preventing Restenosis After Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis of Randomized Controlled Trials)

  • 허나연;안수빈;김홍준;장인수
    • 대한한방내과학회지
    • /
    • 제44권3호
    • /
    • pp.387-401
    • /
    • 2023
  • Objective: This study was conducted to investigate the preventive effect of herbal medicines on restenosis after percutaneous coronary intervention (PCI) by reviewing randomized controlled trials (RCTs). Methods: RCTs were searched for herbal medicine treatment after PCI using eight online databases (PubMed, CNKI, Wanfang, J-STAGE, OASIS, ScienceON, KTKP, and KISS). Studies that confirmed restenosis through coronary angiography at follow-up were selected according to the inclusion and exclusion criteria. The primary outcome was the restenosis rate, and the secondary outcome was the angina recurrence rate. Data were extracted from the final selected studies according to the research methodology and then analyzed with Review Manager 5.4.1. Study quality was assessed using Cochrane's risk-of-bias (RoB) tool. Results: Of the 252 papers obtained through the primary search, nine studies that met the selection criteria were finally selected. In these nine studies, herbal medicine combined with western medicine was used for the experimental group, and western medicine treatment was used alone for the control group. The meta-analysis result revealed that the restenosis rate and angina recurrence rate were significantly lower in the experimental group than in the control group (RR=0.34, 95% CI: 0.22-0.53, p<0.00001, I2=0% and RR=0.47, 95% CI: 0.29-0.78, p=0.004, I2=0%, respectively). Furthermore, the quality of studies assessed by Cochrane's RoB was low. Conclusions: This study showed that the combined treatment of herbal medicine and western medicine was effective in preventing restenosis and angina after PCI. As the number of papers included in this study was small, a large number of high-quality clinical studies should be considered in the future.

프라바스타틴에서 $SLCO1B1^*15$의 약동학적 영향: 체계적 고찰 및 메타분석 (Effect of $SLCO1B1^*15$ on Pravastatin Pharmacokinetics: A Systematic Review and Meta-analysis)

  • 김종윤;나오토 나카가와;윤현옥;천부순;유기연
    • 한국임상약학회지
    • /
    • 제24권4호
    • /
    • pp.231-239
    • /
    • 2014
  • Background and objective: Pravastatin has been shown to have favorable risk-benefit profile when it is administered to hypercholesterolemic subjects to prevent cardiovascular events. However, subjects with impaired OATP1B1 activity may be more susceptible to pravastatin-induced muscle toxicity than subjects with normal OATP1B1 activity. A systematic review was conducted to evaluate the effect of SLCO1B1 genetic polymorphism on pharmacokinetics of pravastatin. Method: Medline$^{(R)}$ and Embase$^{(R)}$ were searched for relevant studies until July 2013. The search terms used were pravastatin AND (SLCO1B1 OR OATP1B1 OR LST1 OR SLC21A6) AND (gene OR $genetic^*$ OR $genomic^*$ OR $pharmacogenet^*$ OR $pharmacogenom^*$ OR $polymorph^*$). Results: A meta-analysis of the area under the concentration-time curve (AUC) of pravastatin in $SLCO1B1^*15$ and $SLCO1B1^*1a/^*1a$ was conducted. Five studies met all the inclusion criteria and methodological requirements. There was no statistically significant difference in the AUC value between $SLCO1B1^*15$ and $SLCO1B1^*1a/^*1a$ (p=0.728). However, $SLCO1B1^*15$ participants exhibited significantly higher AUC values than $SLCO1B1^*1b/^*1b$ carriers (p<0.001). In case of $SLCO1B1^*15^*15$ carriers, they had significantly higher AUC value than $SLCO1B1^*1a/^*1a$ subjects (p=0.002). Lastly, compared with to the subjects of $SLCO1B1^*1a/^*1a$, the carriers of heterozygous $SLCO1B1^*15$ increased the AUC value of pravastatin statistically significantly in Asian population (p=0.014). Conclusion: The present meta-analysis suggests that subjects with $SLCO1B1^*15$ are associated with increased AUC of pravastatin.

Diet and Cancer Risk in the Korean Population: A Meta-analysis

  • Woo, Hae Dong;Park, Sohee;Oh, Kyungwon;Kim, Hyun Ja;Shin, Hae Rim;Moon, Hyun Kyung;Kim, Jeongseon
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제15권19호
    • /
    • pp.8509-8519
    • /
    • 2014
  • Many studies have found links between diet and cancer. The summary estimates of the association between dietary factors and cancer risk were investigated using previously reported studies of the Korean population. Gastric cancer risk was inversely associated with the high intake of soy foods [OR (95% CI): 0.32 (0.25-0.40) for soybean, 0.56 (0.45-0.71) for soybean curd, and 0.67 (0.46-0.98) for soymilk], allium vegetables [OR (95% CI): 0.37 (0.26-0.53) for green onion, 0.54 (0.40-0.73) for garlic, and 0.54 (0.35-0.85) for onion], fruits [OR (95% CI): 0.61 (0.42-0.88)], and mushrooms [OR (95% CI): 0.43 (0.21-0.88)]. Salt and Kimchi were associated with an increased gastric cancer risk [OR (95% CI): 1.92 (1.52-2.43) and 2.21 (1.29-3.77), respectively]. Colorectal cancer risk was positively associated with meat intake [OR (95% CI): 1.25 (1.15-1.36)]. Total soy products, soybean curd, and soymilk showed an inverse association with breast cancer risk [OR (95% CI): 0.61 (0.38-0.99), 0.47 (0.34-0.66), and 0.75 (0.57-0.98), respectively]. Green/yellow and light colored vegetables were associated with a reduced risk of breast cancer [OR (95% CI): 0.34 (0.23-0.49) and 0.44 (0.21-0.90), respectively]. Mushroom intake was inversely associated in pre-menopausal women only [OR (95% CI): 0.47 (0.26-0.86)]. In conclusion, soy foods, fruits and vegetables might reduce cancer risk in the Korean population. High salt food might be risk factor for gastric cancer, and intake of high amount of meat might cause colorectal cancer.

이압요법이 노인의 수면 장애 개선에 미치는 효과에 대한 체계적 문헌고찰 및 메타분석 (The Effects of Auricular Acupressure on Sleep Disorder in The Elderly: A Systematic Review and Meta-analysis)

  • 장민진;박효정
    • 한국산학기술학회논문지
    • /
    • 제21권6호
    • /
    • pp.116-126
    • /
    • 2020
  • 본 연구의 목적은 이압요법이 60세 이상 노인의 수면장애 개선에 미치는 효과를 분석하기 위함이다. 자료수집은 국내외 컴퓨터 데이터베이스를 기반으로 하였다. 검색어는 'auricular', 'sleep', 'insomnia' 등을 조합하였다. 선정한 문헌의 비뚤림 위험평가는 RoB와 RoBANS도구를 사용하였고, 메타분석은 Cochrane Library의 RevMan 5.3 Program을 이용하였다. 총 386개의 문헌 중 7개 문헌이 선정되었다. 이압요법 중재 평균 횟수는 4.1회, 총 적용 기간은 평균 2.8주, 이압요법 1회 적용 시 유지 기간은 평균 4일이었다. 수면 장애 개선을 위해 자주 사용한 부위는 신문, 뒷머리, 심장으로 4편의 문헌에서 모두 사용되었다. 수면 정도는 총 중재 기간이 4주 미만인 문헌에서 WMD 25.66 (95% CI 20.18 to 31.14)로 대조군보다 유의하게 높았으며, 4주 이상인 문헌에서는 WMD 8.59 (95% CI 6.26 to 10.92)로 대조군보다 유의하게 높았다. 수면 만족도는 이압요법 1회 적용 시, 유지 기간이 3일 이하인 문헌에서 SMD 13.37 (95% CI 5.29 to 21.45)로 대조군보다 유의하게 높았으며, 4일 이상인 문헌에서 SMD 2.27 (95% CI 1.82 to 2.72) 대조군보다 유의하게 높았다. 이압요법은 수면 정도와 수면 만족도에 효과가 있어 노인의 수면 장애 개선에 효과가 있었다. 그럼에도 불구하고, 본 연구의 메타분석에 이용된 문헌은 모두 비 무작위 대조군 연구이며, 대조군에 아무런 조치도 취하지 않았으며, 주관적 도구만 사용하였다. 또한, 총 중재 기간, 1회 적용 시, 유지 기간에 따라 효과 크기가 다른 것으로 나타났으나, 문헌의 수가 적어 해석에 제한점이 있다.

보육교사의 회복탄력성 관련 요인에 대한 메타분석 (A Meta-analysis of The Factors Related to Resilience of Childcare Teachers)

  • 문동규
    • 한국산학기술학회논문지
    • /
    • 제21권10호
    • /
    • pp.222-230
    • /
    • 2020
  • 본 연구는 보육교사의 회복탄력성과 관련하여 지난 10여년 간 국내에서 연구된 석·박사 학위논문과 학술지 논문을 중심으로 관련요인들의 효과크기를 메타분석을 통해 검증하였다. 검증결과는 다음과 같다. 첫째, 보호요인의 전체효과크기는 큰효과크기를 보였고, 보호요인군 별 효과크기는 모두 큰 효과크기로 개인특성요인군이 가장 큰 것으로 나타났고 그다음 직무특성요인군, 조직특성요인군 순이었다. 둘째, 보호요인군 중 개인특성요인군의 하부요인의 효과크기는 모두 큰효과크기를 보였고, 조직특성요인군과 직무특성요인군은 중간효과크기를 보인 원장리더십과 정서노동을 제외한 모든 하부요인이 큰효과크기를 보였다. 셋째, 위험요인 전체효과크기는 큰효과크기를 보였고, 직무특성 위험요인군인 소진은 큰효과크기, 직무특성 위험요인군인 직무스트레스는 중간효과 크기로 소진이 상대적으로 직무스트레스보다 더 큰 효과크기를 보였다. 결론적으로 본 연구는 지난 20년간의 보육교사의 회복탄력성과 관련하여 선행된 연구들을 통합적으로 정리하여 객관적 결과를 살피기 위한 수량적 통합을 시도했다는데 의의가 있으며, 보육교사의 회복탄력성 증진을 위한 프로그램 개발과 정책수립에 기초적 자료를 제공하였다는데 의의가 있다.