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

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The Review of Clinical Studies Published in The Journal of Korean Medical Ophthalmology & Otolaryngology & Dermatology (한방안이비인후피부과학회지에 게재된 임상실험연구에 대한 고찰)

  • Kim, Chul-Yun;Seo, Hyung-Sik;Kim, Nam-Kwen;Lee, Dong-Jin;Kwon, Kang
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.27 no.4
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    • pp.1-15
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    • 2014
  • Objective : This study was carried out to analyze the quality and quantity of Clinical Trials that have been published in the journal of korean medical ophthalmology, otolaryngology, dermatology(JKOOD). Methods : We analyzed 25 clinical trials that published in JKOOD from 1988 to 2014. We excluded case reports, protocol and retrospective studies and classified searched papers into three categories; Randomized Clinical Trials(RCT), Non Randomized Clinical Trials(NRCT), Before After Study(BAS) by using study Design Algorithm for Medical literature of Intervention(DMAI). All articles were analyzed according to diagnosis, statistics program and intervention period. The bias of RCTs were evaluated by Cochrane Risk of Bias(RoB). Result : 1. The number of searched journals is 25 papers; 13 RCT, 2 NRCT, 10 BAS 2. Distribution of clinical trial; 'Atopic dermatitis' ranked the highest(44%) in disease, 'External application' raked the highest(71%) in treatment method. 3. 'allocation sequence' and 'prevention of allocated intervent to patients and therapists' are graded 'Low' but 'incomplete outcome date' and 'selective outcome' are graded 'Uncertain'. Conclusions : It is necessary to study more RCT. It will be helpful to study systematic reviews and meta analysis in JKOOD.

A Systematic Review on the Treatment of Post-Stroke Patients Based on Sasang Constitutional Medicine (사상의학적 중풍 후유증 치료에 대한 체계적 문헌 고찰)

  • Oh, Hyunjoo;Lee, Jeongyun;Lee, Hyeri;Lee, Junhee
    • Journal of Sasang Constitutional Medicine
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    • v.34 no.2
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    • pp.48-64
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    • 2022
  • Objectives The purpose of this study was to review and evaluate the clinical evidence of the efficacy and safety of treatment based on Sasang constitutional medicine (SCM) for post-stroke patients by systematic review and meta-analysis. Methods Randomized controlled trials (RCTs), published in 10 electronic databases up to December 2020, were searched. For the included studies, Cochrane's risk of bias assessment was performed to analyze the methodological quality. The strength of evidence was evaluated using the grading of recommendations assessment, development, and evaluation system based on the results of analyses. All review processes were performed by two independent researchers. Results Five RCTs were finally included. All included RCTs were conducted for one month on post-stroke patients in 60-80s, four studies on Tae-Eum patients and one study on So-Yang patients. Four types of constitution-specific herbal medicine (Chungpyesagan-tang, Cheongsimsanyak-tang, Yeoldahanso-tang, and Yangkyuksanhwa-tang) and constitution-specific acupuncture therapy were identified as interventions. More than half of the included studies were evaluated as low quality due to the high-risk of bias in selection, performance, and detection. The combination of constitution-specific herbal medicine, acupuncture, and conventional treatment was more effective in improving the patients' motor impairment, dysphagia, aphasia, and depression than conventional treatment alone. No serious adverse events by SCM treatment were reported. Conclusions SCM treatment may improve the sequelae of post-stroke patients safely in combination with conventional treatment. Since the quality of clinical evidence included in this study was low, higher quality clinical evidence obtained in well-designed clinical studies will be needed.

Electroacupuncture for Women with Overactive Bladder: A Systematic Review and Meta-analysis of Randomized Controlled Trials (여성 과민성 방광 전침 치료의 무작위 대조군 연구에 관한 체계적 문헌 고찰)

  • Ha, Su-Jin;Hwang, Deok-Sang;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock
    • The Journal of Korean Obstetrics and Gynecology
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    • v.33 no.3
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    • pp.1-19
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    • 2020
  • Objectives: The purpose of this study is to assess the efficacy and safety of electroacupuncture for women with overactive bladder (OAB) comparing with sham- acupuncture, and electroacupuncture plus drugs. Methods: We searched 8 databases upto May 26, 2020. Randomised controlled trials (RCTs) were eligible. The risk of bias was assessed by two independent authors using the Cochrane risk of bias tool. Study outcomes were calculated by standardized mean differences (SMD) with 95% confidence intervals (Cls) and mean differences (MD) with 95% Cls. Results: Of 146 screened, 5 RCTs were included. Number of participants per study ranged from 5 to 57. The combined results showed that electroacupuncture (EA) may be more effective than sham acupuncture or enhance solifenacin succinates in improving Overactive Bladder Symptom Score (OABSS) and urination frequency of 24 h. However, more trials with high quality and larger sample sizes will be needed to provide sufficient evidence. Only 5 of 187 OAB patients from the included studies reported mild adverse reactions related to EA, therefore, electroacupuncture is safe for treating OAB. Conclusions: Electroacupuncture might have effect in decreasing urination frequency of 24 h and OABSS. However, the evidences ins in sufficient to show the effect using electroacupuncture alone or additional effect to drugs in treating OAB.

Aquatic exercise for the treatment of knee osteoarthritis: a systematic review & meta analysis (무릎 골관절염 환자를 대상으로 한 수중 운동과 지상운동 비교: 체계적 문헌고찰 및 메타분석)

  • Kim, Young-il;Choi, Hyo-Shin;Han, Jung-haw;Kim, Juyoung;Kim, Gaeun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.9
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    • pp.6099-6111
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    • 2015
  • This study was a systematic review and meta-analysis comparing the effects of aquatic exercise and land-based exercise in the treatment of knee osteoarthritis. 7 studies (n=449) met selection and exclusion criteria out of 287 potential studies obtained from the literature search via Ovid-Medline, Cochrane Library CENTRAL, CINAHL, RISS and KISS. The overall risk of bias of selected studies using SIGN (Scottish Intercollegiate Guidelines Network) checklist for randomized controlled trials (RCT) was regarded as low. As a result of meta analysis, Standardized Mean Difference (SMD) for pain was -0.26(95% CI -0.49, -0.03, p=0.03, $I^2=14%$), which implies that aquatic exercise groups had significant less pain than land-based exercise groups. On the other hand, there was no significant difference between aquatic exercise groups and land based exercise groups for flexion Range of Motion (ROM) (-0.12, 95% CI -0.51, 0.27, p=0.53, $I^2=0%$), extension ROM (-0.04, 95% CI -0.55, 0.48, p=0.89, $I^2=43%$), physical function (-0.12, 95% CI -0.44, 0.19, p=0.44, $I^2=0%$), Quality of Life (QOL) (-0.15, 95% CI -0.54, 0.24, p=0.46, $I^2=0%$). This study has some limitations due to few RCTs comparing aquatic exercise groups and land-based exercise groups in the treatment of knee osteoarthritis. Therefore, further RCTs should be conducted along with long-term outcomes.

Recent Trends in Clinical Research on Herbal Medicine Based on Pinellia Ternata for Treatment of Gastroesophageal Reflux Disease (위식도역류질환의 한약 치료에 대한 최신 임상 연구 동향 - 반하(半夏)를 중심으로 -)

  • Jang, Hye-yeon;Kim, Young-kwang;Jeong, Seo-yun;Kim, Do-hyeong;Kim, Kyeong-ok;Lee, Young-su
    • The Journal of Internal Korean Medicine
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    • v.41 no.6
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    • pp.1119-1140
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    • 2020
  • Objective: The purpose of this study was to review Chinese clinical studies of the treatment of gastroesophageal reflux disease (GERD) with herbal medicine including Pinellia ternata. Methods: We searched the China National Knowledge Infrastructure (CNKI) database for clinical studies on herbal treatments including Pinellia ternata for GERD, from January 1st, 2015 to September 30th, 2019. We evaluated the risk of bias using Cochrane's risk of bias to confirm the quality of the 37 selected documents. Results: The 37 papers included high-dose and middle-dose Pinellia ternata groups. The outcome measures included treatment effectiveness rate, symptom comparisons, and endoscopy effectiveness rates or scores. In both groups, most studies showed significant improvement in the treatment group compared with the control group. The meta-analysis revealed a higher treatment effectiveness rate and a lower recurrence rate in the treatment group than in the control group. Conclusions: Comparing the treatment effect between the two groups was difficult due to the low quality of most studies. However, the results suggest that herbal remedies including Pinellia ternata showed statistically significant improvement in GERD compared to control groups.

Herbal Medicine for the Treatment of Rosacea: A Systematic Review and Meta-analysis of Randomized Controlled Trials (주사(Rosacea)의 한약 치료에 대한 체계적 문헌고찰 및 메타분석)

  • Kang, Eun-Jeong;Kam, Eun-Young;Kim, Seo-Hee;Yoon, Seok-Yeong;Jeon, Seok-Hee;Choi, Jung-Wha;Kim, Jong-Han;Park, Soo-Yeon;Jung, Min-Yeong
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.34 no.3
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    • pp.27-54
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    • 2021
  • Objectives : This review was conducted to validate the effectiveness and safety of herbal medicine combined with conventional therapy for rosacea. Methods : Randomized controlled trials(RCTs) reporting the effects of herbal medicine treatment on rosacea were searched through eight electronic databases from 2016 to March 17, 2020. This study collection and data extraction were performed by two independent reviews. The Cochrane risk-of-bias tool was used for the evaluation of the risk of bias in all included RCTs. Mean differences(MD) and Risk ratio(RR) of 95% Confidence intervals(Cls) were calculated and data synthesis was conducted using Review Manager(RevMan, ver.5.4) Results : Eighteen RCTs were included and all trials compared the combined therapy of herbal medicine with conventional western therapy to conventional therapy alone. The effective rate of the combination of herbal medicine with western medicine(RR 1.20, 95% CI : 1.13-1.28, p<0.00001, I2=0%), the effective rate of the combination of herbal medicine with laser-based therapy(RR 1.12, 95% CI : 1.04-1.21, p=0.004, I2=18%) and the effective rate of the combination treatment group using herbal medicine, western medicine and external drugs were all statistically higher that of the control group(RR 1.19, 95% CI : 1.11-1.28, p<0.00001, I2=0%). The score of non transient erythema(MD -0.36, 95% CI : -1.01 0.29, p=0.27, I2=93%), flushing(MD -0.69, 95% CI : -0.97, 0.41, p<0.00001, I2=32%), papules or pustules(MD 0.10, 95% CI : -0.15, 0.35 p=0.44, I2=0%) were also seen in the herbal medicine and western medicine combination group. The overall risk of bias of the included studies was some concerns. No serious adverse effects were observed. Conclusions : This review found the safety and effectiveness of the combined therapy of herbal medicine with conventional western therapy for rosacea.

Meta-Analytic Approach to the Effects of Food Processing Treatment on Pesticide Residues in Agricultural Products (식품가공처리가 농산물 잔류농약에 미치는 영향에 대한 메타분석)

  • Kim, Nam Hoon;Park, Kyung Ai;Jung, So Young;Jo, Sung Ae;Kim, Yun Hee;Park, Hae Won;Lee, Jeong Mi;Lee, Sang Mi;Yu, In Sil;Jung, Kweon
    • The Korean Journal of Pesticide Science
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    • v.20 no.1
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    • pp.14-22
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    • 2016
  • A trial of combining and quantifying the effects of food processing on various pesticides was carried out using a meta-analysis. In this study, weighted mean response ratios and confidence intervals about the reduction of pesticide residue levels in fruits and vegetables treated with various food processing techniques were calculated using a statistical tool of meta-analysis. The weighted mean response ratios for tap water washing, peeling, blanching (boiling) and oven drying were 0.52, 0.14, 0.34 and 0.46, respectively. Among the food processing methods, peeling showed the greatest effect on the reduction of pesticide residues. Pearsons's correlation coefficient (r=0.624) between weighted mean response ratios and octanolwater partition coefficients ($logP_{ow}$) for twelve pesticides processed with tap water washing was confirmed as having a positive correlation in the range of significance level of 0.05 (p=0.03). This means that a pesticide having the higher value of $logP_{ow}$ was observed as showing a higher weighted mean response ratio. These results could be used effectively as a reference data for processing factor in risk assessment and as an information for consumers on how to reduce pesticide residues in agricultural products.

The Effectiveness and Safety of Acupuncture for Recovery of Patients with Vertebral Compression Fractures: A Systematic Review and Meta-analysis (척추 압박 골절 환자의 회복에 대한 침 치료의 유효성 및 안전성 평가: 체계적 문헌 고찰과 메타분석)

  • Bae, Ji min;Lee, Myeong su;Choi, Ji won;Yang, Gi young;Kim, Kun hyung
    • Korean Journal of Acupuncture
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    • v.36 no.1
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    • pp.1-18
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    • 2019
  • Objectives : The purpose of this study was to evaluate the effectiveness and safety of acupuncture treatment for recovery of patients with vertebral compression fracture(VCF). Methods : We searched ten English and Chinese and seven Korean database up to April 2018. Randomised controlled trials(RCTs), quasi-RCTs, non-radomised Controlled Trials(CCTs) were eligible. Quasi-RCTs and CCTs were assessed only for safety assessment. Pain and adverse events were primary outcome of this review. Quality of life, dysfunction, patient satisfaction, incidence of new vertebral compression fracture were regarded as secondary outcomes. The risk of bias was assessed by two independent authors using the Cochrane risk of bias tool. Level of evidence was tabulated using the GRADE methods. Results : Of 1656 screened, 15 RCTs, 1 quasi-RCT and 3 CCTs were included. Number of participants per study ranged from 45 to 135. Most of the studies had unclear or high risk of bias and considerable heterogeneity in terms of type of intervention, comparison and time-points for outcome measurement. Compared to usual care alone, acupuncture combined with usual care showed short-term favorable results for pain relief in patients with VCF(5 studies, n=252, MD -1.05 point on a 0 to 10 point scale, 95% CI -1.45 to -0.65, $I^2=74%$). Four studies reported mild and temporary adverse events, and no serious adverse events were reported. One study descriptively reported that acupuncture was effective for improving quality of life without providing numerical outcomes. There were no reports of patient satisfaction and incidence of new VCF. Conclusions : Level of evidence is very low for the effectiveness and safety of acupuncture for pain, harms and other clinical outcomes in patients with VCF. Included studies suffered from incomplete reporting, high or unclear risk of bias and substantial heterogeneity between studies. Future high-quality RCTs are needed to assess whether acupuncture is beneficial for recovery of patients with VCF.

Analysis on Construction Clients' Role for Safety and Health Management in Plan, Design, and Construction Stage (건설공사 발주자의 계획, 설계, 공사단계 안전보건관리 역할 분석)

  • Lim, Se Jong;Jeong, Seong-choon;Na, Ye Ji;Won, Jeong-Hun
    • Journal of the Korean Society of Safety
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    • v.35 no.3
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    • pp.24-31
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    • 2020
  • The duty of construction clients in WSH (Workplace Safety and Health) system was included in the amendment of Occupational Safety and Health Act (enforced on 16 January 2020), which was estimated the shift of paradigm in the prevention of construction accidents. The purpose of this paper is to introduce the analysis results of construction clients' role in the construction project, which were performed by authors over the recent years in order to impose the duty on construction clients, and to suggest their role according the plan, design, and construction stage. Utilizing the systematic literature review process based on Meta analysis, the related papers were selected. For the selected papers, related domestic and foreign regulations, and other prominent report, the construction clients' role was analyzed by reflecting the experts' advice. Results show that the construction clients should control the designer and contractor for implementing the WHS system during the whole process of the construction project. They should supply sufficient source and time to ensure the workers' safety. In the plan stage, the key role of construction clients is to identify intensively controlled hazard and risk reduction plan and to transfer the results. In the design stage, their key role is to select the designer with the capacity in WSH and to assist the designer for the safety design. The main key role of construction clients in the costruction stage is to select the contractor with specialty in WSH including a contract reflecting the WSH requirement and to check implementation of WSH plan, WSH cost, WSH education, and accident report. In addition, it is thought that the construction clients' participations in the site WSH activity and adjustment of safety and health problem among contractors can be effect in the prevention of construction accidents.

Work-Related Musculoskeletal Pain and Workload Evaluation of Physical Therapists: Focused on Neurological Injury Treatment of Adults (물리치료사의 작업관련 근골격계 통증과 부담작업 유해요인 평가: 성인 신경계 손상 치료를 중심으로)

  • Lee, Jung-Ho;Choi, Young-Chul;Kim, Jin-Sang
    • Physical Therapy Korea
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    • v.19 no.2
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    • pp.69-79
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    • 2012
  • Importance of the work-related musculoskeletal disorders (WMSDs) has been increasing in the hospital industry such as health care industry and financial industry. This study investigated in order to identify the factors like general, occupational and ergonomically characteristics of the subjects related to musculoskeletal disorders (MSDs) of physical therapists (PTs). Ergonomic tools of rapid upper limb assessment (RULA) were used for evaluation workload of the tasks. Prevalence of MSDs were 13 PTs (26.0%) for neck, 31 PTs (62.0%) for shoulder, 9 PTs (18.0%) for arm/elbow, 27 PTs (54.0%) for hand/wrist, 28 PTs (56.0%) for back, 14 PTs (28.0%) for leg/foot. The analysis of the rate of the pain intensity showed that 53.5% subjects experience moderate pain and 14.0% subjects experience severe pain. Factors which were general characteristics, for example, height, ergonomically characteristics such as 'Posture Score A' were related musculoskeletal subjective symptoms in logistic analysis (p<.05). Among physical therapists, action level of RULA were action level 2 (6.0%), action level 3 (52.0%), action level 4 (42.0%). Physical therapists were estimated one of the highest risk factor in this study. This study suggested that the need of preventive education and program for PTs (physical therapists). Comprehensive and systematic management plans should be established to include both ergonomic and sociopsychological aspects.