• 제목/요약/키워드: risk and meta-analysis

검색결과 921건 처리시간 0.024초

고형암 환자의 수술 후 통증에 대한 침 치료 효과 : 체계적 문헌고찰 및 메타분석 (The Efficacy of Acupuncture for Postoperative Pain in Patients with Solid Tumor : A Systematic Review and Meta Analysis)

  • 윤성수;류한성;오혜경;이지영;윤성우
    • 대한암한의학회지
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    • 제22권2호
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    • pp.1-11
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    • 2017
  • Objectives: Postoperative pain is one of postoperative complications in patients with solid tumor. This systematic review and meta-analysis were aimed to evaluate the efficacy of acupuncture for postoperative pain in solid tumor. Methods: We searched for randomized controlled trials (RCTs) using acupuncture for postoperative pain in adult patients with solid tumor up to September 2016. Acupuncture was defined as manual acupuncture, electroacupuncture and pharmacopuncture. The following databases were searched: PubMed, EMBASE, Cochrane Library, CNKI, CiNii, KoreaMed, Kmbase, KISS, NDSL, KISTI. The results of the studies were meta-analyzed and the risk of bias was assessed. Results: Five studies were included in this review. When acupuncture was compared with usual care, Prince-Henry pain scale score was significantly lower in acupuncture group (MD=-0.44, 95% CI: -0.62 to -0.26, P<0.001, $I^2=87%$) and 10 points pain score (including Numeric Rating Scale and Visual Analog Scale) was lower in acupuncture group but not significantly (MD=-1.00, 95% CI: -2.00 to -0.00, p=0.05). When acupuncture was compared with sham acupuncture, 10 points pain score was significantly lower in acupuncture group (MD=-0.39, 95% CI: -0.65 to -0.14, p=0.002, $I^2=0%$). Any serious adverse events were not reported. Conclusion: This review shows that acupuncture may be considered for postoperative pain in patients with solid tumor without serious adverse events. However, only a few studies were included in this study, further investigation is needed in this area.

해양의 부착 미세조류 분류군 현황 및 선체부착 연구의 중요성 (Status of Attachment Microalgae Taxa in the Korean Sea and Importance of their Research on Hull Ship Fouling)

  • 박재영;김태희;기장서
    • Ocean and Polar Research
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    • 제44권2호
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    • pp.161-177
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    • 2022
  • Microalgae can attach to the surface of ships and then spread to various areas by means of ship transport. The introduction of invasive species through ships is recognized as a marine problem worldwide. Identification of attached microalgae is necessary to investigate such movement between countries through ships. In the present study, through analytical methods we reviewed research data to identify the taxa of domestic attached microalgae and assess the ecological impacts of such microalgae. A total of 87 genera and 153 species (143 species of diatoms, 10 species of cyanobacteria, and 4 genera of dinoflagellates) were identified as native attached microalgae in Korea, and diatoms accounted for 93% of the total. Most of these attached microalgae were identified through research on natural substrates such as seaweeds and bedrock, and some were also identified through experiments using artificial adherent plates. To date, there is no information on microalgae attached to international ships and introduced into Korea. Molecular genetic analysis and systematic management through on-site sampling of international ships, microscopic analysis, and meta-barcoding are necessary to assess the inflow and spread path of hull-attached marine alien species and evaluate the risk they pose to the domestic ecosystem.

Diagnostic Accuracy of Lactate Dehydrogenase/Adenosine Deaminase Ratio in Differentiating Tuberculous and Parapneumonic Effusions: A Systematic Review

  • Larry Ellee Nyanti;Muhammad Aklil Abd Rahim;Nai-Chien Huan
    • Tuberculosis and Respiratory Diseases
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    • 제87권1호
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    • pp.91-99
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    • 2024
  • Background: Tuberculous pleural effusion (TPE) and parapneumonic effusion (PPE) are often difficult to differentiate owing to the overlapping clinical features. Observational studies demonstrate that the ratio of lactate dehydrogenase to adenosine deaminase (LDH/ADA) is lower in TPE compared to PPE, but integrated analysis is warranted. Methods: We conducted a systematic review to evaluate the diagnostic accuracy of the LDH/ADA ratio in differentiating TPE and PPE. We explored the PubMed and Scopus databases for studies evaluating the LDH/ADA ratio in differentiating TPE and PPE. Results: From a yield of 110 studies, five were included for systematic review. The cutoff value for the LDH/ADA ratio in TPE ranged from <14.2 to <25. The studies demonstrated high heterogeneity, precluding meta-analysis. Quality Assessment of Diagnostic Accuracy Studies Tool 2 assessment revealed a high risk of bias in terms of patient selection and index test. Conclusion: LDH/ADA ratio is a potentially useful parameter to differentiate between TPE and PPE. Based on the limited data, we recommend an LDH/ADA ratio cutoff value of <15 in differentiating TPE and PPE. However, more rigorous studies are needed to further validate this recommendation.

The Significant Roles of Corporate Counselors to Reduce Employee Stress for Enhancing their Performance

  • PARK, Joo-Young;KIM, Seong-Gon
    • 산경연구논집
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    • 제13권8호
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    • pp.1-7
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    • 2022
  • Purpose: The present study concentrates on the issues that affected the employees directly and acted as stress factors. These stress factors affect how the employees perform while undertaking their duties. Furthermore, this study evaluated how the involvement of the corporate counsel affected the company by enhancing the productivity of the employees. Research design, data and methodology: The research design of this research is a literature content analysis and method for data handling should be described, and the resultant combination of the studies should include the consistency measures for every meta-analysis. Specify any risk assessment of bias that may impact the cumulative evidence, such as the publication bias and the selective reporting within studies. Results: The finding shows that change in the location of employees' organizational restructuring and the introduction of new technologies also contributed to significant organizational stress factors. These results show a substantial correlation between the magnitude of the adjustments' effects on employees' performance. Conclusions: The current study strongly concludes that counselors, through their prowess, can analyze and evaluate the stress factors that are evident among the employees and in the organization. Some of these factors may be office layout, organizational codes of ethics, organization rules, and employees' personal challenges.

Comparison of healing assessments of periapical endodontic surgery using conventional radiography and cone-beam computed tomography: A systematic review

  • Sharma, Garima;Abraham, Dax;Gupta, Alpa;Aggarwal, Vivek;Mehta, Namrata;Jala, Sucheta;Chauhan, Parul;Singh, Arundeep
    • Imaging Science in Dentistry
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    • 제52권1호
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    • pp.1-9
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    • 2022
  • Purpose: This systematic review aimed to compare assessments of the healing of periapical endodontic surgery using conventional radiography and cone-beam computed tomography (CBCT). Materials and Methods: This review of clinical studies was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. All articles published from 1990 to March 2020 pertaining to clinical and radiographic healing assessments after endodontic surgery using conventional radiography and CBCT were included. The question was "healing assessment of endodontic surgery using cone-beam computed tomography." The review was conducted by manual searching, as well as undertaking a review of electronic literature databases, including PubMed and Scopus. The studies included compared radiographic and CBCT assessments of periapical healing after periapical endodontic surgery. Results: The initial search retrieved 372 articles. The titles and abstracts of these articles were read, leading to the selection of 73 articles for full-text analysis. After the eligibility criteria were applied, 11 articles were selected for data extraction and qualitative analysis. The majority of studies found that CBCT enabled better assessments of healing than conventional radiography, suggesting higher efficacy of CBCT for correct diagnosis and treatment planning. A risk of bias assessment was done for 10 studies, which fell into the low to moderate risk categories. Conclusion: Three-dimensional radiography provides an overall better assessment of healing, which is imperative for correct diagnosis and treatment planning.

Diffusion-Weighted Magnetic Resonance Imaging in the Diagnosis of Cerebral Venous Thrombosis : A Meta-Analysis

  • Lv, Bin;Jing, Feng;Tian, Cheng-lin;Liu, Jian-chao;Wang, Jun;Cao, Xiang-yu;Liu, Xin-feng;Yu, Sheng-yuan
    • Journal of Korean Neurosurgical Society
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    • 제64권3호
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    • pp.418-426
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    • 2021
  • Objective : A role of diffusion-weighted imaging (DWI) in the diagnosis of cerebral venous thrombosis (CVT) is not well-understood. This study evaluates the effectiveness of DWI in the diagnosis of CVT. Methods : Literature search was conducted in electronic databases for the identification of studies which reported the outcomes of patients subjected to DWI for CVT diagnosis. Random-effects meta-analyses were performed to achieve overall estimates of important diagnostic efficiency indices including hyperintense signal rate, the sensitivity and specificity of DWI in diagnosing CVT, and the apparent diffusion coefficient (ADC) of DWI signal areas and surrounding tissue. Results : Nineteen studies (443 patients with 856 CVTs; age 40 years [95% confidence interval (CI), 33 to 43]; 28% males [95% CI, 18 to 38]; symptom onset to DWI time 4.6 days [95% CI, 2.3 to 6.9]) were included. Hyperintense signals on DWI were detected in 40% (95% CI, 26 to 55) of the cases. The sensitivity of DWI for detecting CVT was 22% (95% CI, 11 to 34) but specificity was 98% (95% CI, 95 to 100). ADC values were quite heterogenous in DWI signal areas. However, generally the ADC values were lower in DWI signal areas than in surrounding normal areas (mean difference-0.33×10-3 ㎟/s [95% CI, -0.44 to -0.23]; p<0.00001). Conclusion : DWI has a low sensitivity in detecting CVT and thus has a high risk of missing many CVT cases. However, because of its high specificity, it may have supporting and exploratory roles in CVT diagnosis.

측두하악 장애 치료를 위한 수기치료에 대한 체계적 고찰의 프로토콜 (Manual Therapy in the Treatment of Temporomandibular Disorders: A Protocol for a Systematic Review)

  • 김형석;정재영;정석희
    • 한방재활의학과학회지
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    • 제25권4호
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    • pp.41-46
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    • 2015
  • Objectives This systematic review will analyse randomised controlled trials (RCTs) of manual therapy in patients with temporomandibular disorders (TMDs) to evaluate the efficacy of this approach. Methods RCTs will be identified in the following ten databases based on searches starting with their inception: MEDLINE, EMBASE, CENTRAL, four Korean databases as KoreaMed, DBPIA, NDSL, and RISS and three Chinese databases as CNKI, VIP and Wanfang. The quality of these studies will be analysed using the Cochrane risk of bias. A meta-analysis will be conducted, and subgroup analysis will be considered if comparatively large heterogeneity is detected. Conclusions We plan to publish this systematic review in a peer-reviewed journal. Findings from this review may contribute to the treatment process in clinical situations. Trial registration number: PROSPERO 2015: CRD42015024090

Association Between Gestational Diabetes Mellitus and Subsequent Risk of Cancer: a Systematic Review of Epidemiological Studies

  • Tong, Gui-Xian;Cheng, Jing;Chai, Jing;Geng, Qing-Qing;Chen, Peng-Lai;Shen, Xin-Rong;Liang, Han;Wang, De-Bin
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권10호
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    • pp.4265-4269
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    • 2014
  • Purpose: This study aimed at summarizing epidemiological evidence of the association between gestational diabetes mellitus (GDM) and subsequent risk of cancer. Materials and Methods: We searched Medline, Embase, Cancer Lit and CINAHL for epidemiological studies published by February 1, 2014 examining the risk of cancer in patients with history of GDM using highly inclusive algorithms. Information about first author, year of publication, country of study, study design, cancer sites, sample sizes, attained age of subjects and methods used for determining GDM status were extracted by two researchers and Stata version 11.0 was used to perform the meta-analysis and estimate the pooled effects. Results: A total of 9 articles documented 5 cohort and 4 case-control studies containing 10,630 cancer cases and 14,608 women with a history of GDM were included in this review. Taken together, the pooled odds ratio (OR) between GDM and breast cancer risk was 1.01 (0.87-1.17); yet the same pooled ORs of case-control and cohort studies were 0.87 (0.71-1.06) and 1.25 (1.00-1.56) respectively. There are indications that GDM is strongly associated with higher risk of pancreatic cancer (HR=8.68) and hematologic malignancies (HR=4.53), but no relationships were detected between GDM and other types of cancer. Conclusions: Although GDM increases the risk of certain types of cancer, these results should be interpreted with caution becuase of some methodological flaws. The issue merits added investigation and coordinated efforts between researchers, antenatal clinics and cancer treatment and registration agencies to help attain better understanding.

선택실험법을 활용한 통계적 생명가치의 추정 (A Choice Experiment Approach to the Value of a Statistical Life)

  • 전호철
    • 자원ㆍ환경경제연구
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    • 제29권2호
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    • pp.247-270
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    • 2020
  • 통계적 생명가치는 환경정책의 편익 산정에 있어 매우 중요한 역할을 한다. 예를 들어 대기오염물질의 감소에 따른 건강 편익의 최종적인 화폐가치화 단위로 활용되며 이는 비용편익 분석의 기초가 된다. 통계적 생명가치는 사망위험 감소를 위해 사회의 구성원이 지불하고자 하는 화폐적 가치로 정의될 수 있다 따라서 통계적 생명가치는 각 사회를 구성하고 있는 구성원의 특성에 따라 결정된다. 본 연구는 웹 설문조사를 통해 수집된 총 3,081명의 응답자를 질문의 형태에 따라 두 개의 표본으로 분리하여 선택실험법을 적용하였다. 추정결과 총 1,528명의 표본 집단의 자료를 통해 도출된 약 13억 원의 통계적 생명가치가 가장 적절한 것으로 나타났으며, 이는 국내 선행연구를 활용한 메타분석의 결과와 유사하다. 또한 응답자들은 사망위험을 감소시키기 위해 정부의 정책비용에 대한 지불보다는 개인 차원의 예방에 비용을 지불하는 것을 선호하는 것으로 나타났다.

Efficacy and Safety of COVID-19 Vaccines in Adolescents: Systematic Review of Randomized Controlled Studies and Observational Studies

  • Soo-Han Choi;Su-Yeon Yu;Jimin Kim;Miyoung Choi;Youn Young Choi;Jae Hong Choi;Ki Wook Yun;Young June Choe
    • Pediatric Infection and Vaccine
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    • 제31권1호
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    • pp.12-24
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    • 2024
  • 본세계적으로 소아 코로나바이러스 감염 2019 (COVID-19) 환자 수가 질병 초기와 비교하여 증가하고 있으며, 이는 고도로 전염성이 있는 중증 급성 호흡기 증후군 코로나바이러스 변이와 성인 COVID-19 백신 접종 증가와 관련이 있다. 본 연구는 청소년 대상 COVID-19 백신 접종의 무작위 임상시험 (randomized controlled trial, RCT) 후향적 관찰연구를 대상으로 신속 체계적 문헌고찰과 메타 분석을 수행했다. 체계적 문헌고찰 결과, 17개의 연구가 최종적으로 포함되었다. 메타 분석 결과, 청소년 대상 예방접종은 후향적 관찰 연구에서 COVID-19 감염을 예방하는 데 유의미하게 효과적이었으나 (risk ratio [RR], 0.29; 95% confidence interval [CI], 0.22-0.37; I2=100%), RCT보다 COVID-19 감염을 예방하는 효과가 낮았다 (RR, 0.05; 95% CI, 0.01-0.27). 5개의 후향적 관찰 연구에서, 국민 10만 명당 심근염 및/또는 심낭염 비율은 2.33명 (95% CI, 0.97-5.61 명)이었다. 성별 및 백신 접종 횟수에 따른 하위 그룹 분석 결과, 남성 (국민 10만 명당 5.35 명) 및 두 번째 접종 (국민 10만 명당 9.71명)은 여성 (국민 10만 명당 1.09명) 및 첫 번째 접종 (국민 10만 명당 1.61명)보다 심근염 및/또는 심낭염 발생률이 유의하게 높았다. 본 연구에서는 청소년을 대상으로 mRNA COVID-19 백신을 접종하는 것은 RCT 및 관찰연구 모두에서 COVID-19에 대해 효과적이었다. 또한 청소년 대상 BNT162b2 백신의 안전성 결과를 탐색하였으며, 성별 및 백신 접종 횟수에 따른 안전성의 차이를 확인했다. 향후 mRNA COVID-19 예방접종 후 부작용 발생은 계속 모니터링할 필요가 있다.