• 제목/요약/키워드: Controlled clinical trials, randomized

검색결과 762건 처리시간 0.027초

소아 선천성 근성 사경의 추나 치료 효과에 대한 임상연구 고찰 - 중의학 무작위 대조군 임상연구를 중심으로 - (A Systematic Review of Clinical Studies of Tuina Treatment on Congenital Muscular Torticollis - Focused on Chinese Randomized Controlled Trials -)

  • 권효은;오수민;장수비;최일신;김기봉;천진홍
    • 대한한방소아과학회지
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    • 제37권2호
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    • pp.12-27
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    • 2023
  • Objective This study aimed to analyze the efficacy of the tuina treatment for congenital muscular torticollis based on randomized controlled clinical studies in China. Methods The China National Knowledge Infrastructure was the main source of data. Using the keywords "tuina", "chuna", "推拿", and "斜颈", 12 randomized controlled clinical studies were identified and analyzed. Results Compared with the control group, the tuina treatment group showed statistically significant changes with respect to the therapeutic effect. Conclusions This study suggests that tuina treatment is effective for congenital muscular torticollis patients and provides evidence for further studies on oriental medicine treatments, including tuina for congenital muscular torticollis.

Subcutaneous progesterone versus vaginal progesterone for luteal phase support in in vitro fertilization: A retrospective analysis from daily clinical practice

  • Schutt, Marcel;Nguyen, The Duy;Kalff-Suske, Martha;Wagner, Uwe;Macharey, Georg;Ziller, Volker
    • Clinical and Experimental Reproductive Medicine
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    • 제48권3호
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    • pp.262-267
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    • 2021
  • Objective: Progesterone application for luteal phase support is a well-established concept in in vitro fertilization (IVF) treatment. Water-soluble subcutaneous progesterone injections have shown pregnancy rates equivalent to those observed in patients receiving vaginal administration in randomized controlled trials. Our study aimed to investigate whether the results from those pivotal trials could be reproduced in daily clinical practice in an unselected patient population. Methods: In this retrospective cohort study in non-standardized daily clinical practice, we compared 273 IVF cycles from 195 women undergoing IVF at our center for luteal phase support with vaginal administration of 200 mg of micronized progesterone three times daily or subcutaneous injection of 25 mg of progesterone per day. Results: Various patient characteristics including age, weight, height, number of oocytes, and body mass index were similar between both groups. We observed no significant differences in the clinical pregnancy rate (CPR) per treatment cycle between the subcutaneous (39.9%) and vaginal group (36.5%) (p=0.630). Covariate analysis showed significant correlations of the number of transferred embryos and the total dosage of stimulation medication with the CPR. However, after adjustment of the CPR for these covariates using a regression model, no significant difference was observed between the two groups (odds ratio, 0.956; 95% confidence interval, 0.512-1.786; p=0.888). Conclusion: In agreement with randomized controlled trials in study populations with strict selection criteria, our study determined that subcutaneous progesterone was equally effective as vaginally applied progesterone in daily clinical practice in an unselected patient population.

침 임상연구에 사용된 거짓침의 분석 (Review and Analysis of Sham Acupuncture in Acupuncture Clinical Trials)

  • 장진영;김소정;김남식;남상수;김용석
    • Journal of Acupuncture Research
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    • 제28권5호
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    • pp.29-38
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    • 2011
  • Objectives : Recent well-designed randomized controlled trials(RCTs) and their meta-analysis have been published on the efficacy of acupuncture in different condition. In most of them, real acupuncture is compared with sham acupuncture including invasive and non-invasive sham methods. But it is not clear how active sham methods are. These results tend to lead the conclusion that acupuncture has no more effective than sham acupuncture. In order to investigate that sham acupuncture is appropriate as a control, we reviewed several acupuncture trials using different sham acupuncture as a control. Methods : We searched Cochrane researches of acupuncture, reviewed and analyzed 25 RCTs in 42 Cochrane reviews. And especially we compared the effect of acupuncture according to the type of sham acupuncture. Results : Invasive sham acupunctures are used in 12 RCTs and non-invasive types are used in the rest. The majority of studies(19 RCTs) fail to show effects beyond a sham acupuncture. Streitberger's sham needle is a validated sham acupuncture of non-invasive type that was used in 8 trials and also no significant group differences are shown except one trial. Conclusions : Acupuncture is a complex intervention. Clinical trials of acupuncture need to be reexamined and redesigned to remove several bias. Especially, sham acupuncture as a control might be investigated for physiological effects as well as validation test including patient-blinding and de qi sensation. Other research need to be investigated and developed for acupuncture trials.

임상연구의 고혈압 침치료법에 대한 고찰 (Review of Acupuncture Treatment for Hypertension in Clinical Trials)

  • 정소영;박지은;김정은;김애란;최선미
    • 대한한의학회지
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    • 제33권1호
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    • pp.12-23
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    • 2012
  • Objectives: This study evaluated clinical trials of acupuncture treatment for hypertension and to assess their methodology and results. Methods: Eight Korean databases and four international databases were searched for clinical trials of acupuncture treatment for hypertension up to June 2011. Study quality was assessed using the risk of bias (ROB) tool. Results: Twenty-four trials of acupuncture for hypertension were included. There were 14 randomized and 1 non-randomized controlled trials and 9 before-after studies. The most frequently used acupuncture points were zsnli (ST36), qch (LI11), fngch (GB20), snynjio (SP06), snjin (LI03) and hgu (LI04). In more than half of the studies, needle retention time was 20~30 minutes. Compared to baseline, change of blood pressure after treatment was significant in all studies. However, the results of effect on blood pressure between acupuncture and control were not consistent. Conclusions: There is insufficient evidence to suggest that acupuncture is an effective treatment for hypertension. Further well-designed clinical trials will be required to evaluate the effects and safety of acupuncture treatment for hypertension.

최소 침(Minimal Acupuncture)이 침 임상연구에서 적절한 대조군인가? (Is Minimal Acupuncture an Adequate Control in Clinical Trials?)

  • 채윤병;김송이;이혜정;박히준
    • Korean Journal of Acupuncture
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    • 제25권2호
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    • pp.71-85
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    • 2008
  • Objective : Acupuncture, one of the Oriental medical treatment techniques in East Asia, is growing in popularity all over the world. Based on bibliographical and clinical data, the depth of needling, i.e. superficial or deep needling, has been considered to be a variable as potential modifiers of needling effects, such as localization, manipulation of the needle, or elicitation of DeQi. The purpose of this review is to summarize clinical trials using minimal acupuncture and to evaluate its appropriateness as a control. Methods : A survey of computerized literature searches for randomized controlled trials using minimal acupuncture revealed that a total of 10 studies were published until April 2008. Results : Results obtained from clinical trials showed that acupuncture were more effective than minimal acupuncture in 3 out of 10 trials, while others were no more effective than control. However, minimal acupuncture might neither be a inert placebo nor be indiscriminable. Conclusion : Minimal acupuncture as 'placebo' controls seems misleading and scientifically unacceptable.

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Regulatory innovation for expansion of indications and pediatric drug development

  • Park, Min Soo
    • Translational and Clinical Pharmacology
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    • 제26권4호
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    • pp.155-159
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    • 2018
  • For regulatory approval of a new drug, the most preferred and reliable source of evidence would be randomized controlled trials (RCT). However, a great number of drugs, being developed as well as already marketed and being used, usually lack proper indications for children. It is imperative to develop properly evaluated drugs for children. And expanding the use of already approved drugs for other indications will benefit patients and the society. Nevertheless, to get an approval for expansion of indications, most often with off-label experiences, for drugs that have been approved or for the development of pediatric indications, either during or after completing the main drug development, conducting RCTs may not be the only, if not right, way to take. Extrapolation strategies and modelling & simulation for pediatric drug development are paving the road to the better approval scheme. Making the use of data sources other than RCT such as EHR and claims data in ways that improve the efficiency and validity of the results (e.g., randomized pragmatic trial and randomized registry trial) has been the topic of great interest all around the world. Regulatory authorities should adopt new methodologies for regulatory approval processes to adapt to the changes brought by increasing availability of big and real world data utilizing new tools of technological advancement.

골관절염(骨關節炎)의 침구치료(鍼灸治療)에 대한 최신연구경향(最新硏究傾向) - Pubmed 검색을 중심으로 - (The Study on acupuncture for osteoarthritis - In PubMed -)

  • 강미경;남상수;이윤호
    • Journal of Acupuncture Research
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    • 제20권2호
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    • pp.18-28
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    • 2003
  • Objective : To research the trends of study related to osteoarthritis with acupuncture in PubMed, and to establish he hereafter direction of acupuncture for osteoarthritis. Methods : We searthed in PubMed, with osteoarthritis and acupuncture limited by abstract, human, English. Results : 1. The pattern of study was as follow: Review article(2), Clinical Trials(13), randomized controlled trials(13). bee venom acupuncture(1), electroacupuncture(1). We further estimated 15 articles. 2. The lesion of osteoarthritis & kinds of acupuncture were as follows: knee(12), hip(2), cervical vertebral(1), bee venom acupuncture(1), electroacupuncture(1). 3. Most clinical trials are related to decrease of pain, functional improvement. 4. 10 of clinical studies provide affirmative result. And they recommend acupuncture for osteoarthritis. 5. 4 of clinical studies provide negative result. And these studies are designed by sham acupuncture method.

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PubMed 검색을 통해 살펴본 Aromatherapy의 임상연구동향에 관한 고찰 (Review of Clinical Trials on Aromatherapy in PubMed)

  • 한은정;김윤범
    • 한방안이비인후피부과학회지
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    • 제15권1호
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    • pp.276-284
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    • 2002
  • Aromatherapy is becoming increasingly popular, however there are few clear indications for its use. To systematically review the clinical studies on aromatherapy, computcrized literature searches were performed from PubMed. Fourteen trials were located. The conclusions were as follows: 1. All the trials were published after 1993. 2. To analyze the publication journals, five of fourteen trials were on nursing, three of them on neuropsychiatry and one on dermatology. 3. Most widely used indications of aromatherapy were on general physical, psychological and physiological field. 4. On the procedure of aromatherapy, eight of them were by massage, three by inhalation, one by massage & inhalation and one by bath additive. 5. To analyze the publication type, all fourteen trials were clinical trials. Twelve of them were randomized controlled trials. Two of them were using single subject design. 6. To observe the sample size, five of them were under 10, four from 10 to 50, two from 50 to 100 and three above 100. 7. Eleven of fourteen trials were using inferential statistics. Eight of the eleven trials were significantly effective, but three had no statistical significance.

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Laparoscopic Versus Open Surgery for Rectal Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials

  • Zhang, Feng-Wa;Zhou, Zhao-Yu;Wang, Hai-Lin;Zhang, Jv-Xia;Di, Bao-Shan;Huang, Wen-Hui;Yang, Ke-Hu
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권22호
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    • pp.9985-9996
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    • 2014
  • Background and Aim: Laparoscopic and open rectum surgery for rectal cancer remains controversial. This systematic review compared the short-term and long-term efficiency and complications associated with laparoscopic and open resection for rectal cancer. Materials and Methods: We searched PubMed, Embase, Cochrane Library, ISI Web of Knowledge and the China Biology Medicine Database to identify potential randomized controlled trials from their inception to March 31, 2014 without language restriction. Additional articles were identified from searching bibliographies of retrieved articles. Two reviewers independently assessed the full-text articles according to the pre-specified inclusion and exclusion criteria as well as the methodological quality of included trials. The meta-analysis was performed using RevMan 5.2. Results: A total of 16 randomized controlled trials involving 3,045 participants (laparoscopic group, 1,804 cases; open group, 1,241 cases) were reviewed. Laparoscopic surgery was associated with significantly lower intraoperative blood loss, earlier return of bowel movement and reduced length of hospital stay as compared to open surgery, although with increased operative time. It also showed an obvious advantage for minimizing late complications of adhesion-related bowel obstruction. Importantly, there were no significant differences in other postoperative complications, oncological clearance, 3-year and 5-year or 10 year recurrence and survival rates between two procedures. Conclusions: On the basis of this meta-analysis we conclude that laparoscopic surgery has advantages of earlier postoperative recovery, less blood loss and lower rates of adhesion-related bowel obstruction. In addition, oncological outcome is comparable after laparoscopic and open resection for rectal cancer.

국내 한약 처방을 이용한 무작위 배정 임상연구논문의 질 평가 (Quality Assessment of Randomized Controlled Trials using Herbal Remedies in Korea)

  • 김윤영;유종향;이수경;이시우
    • 동의생리병리학회지
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    • 제25권5호
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    • pp.927-933
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    • 2011
  • This study aimed to evaluate the quality of herbal medicine-related RCT (Randomized controlled clinical trial) papers. 79 papers were searched from the domestic Hakjin paper list, and 16 papers of them were evaluated in terms of the Jadad Quality Assessment Scale and the adequacy of allocation concealment, and ethical validity. The evaluation results from Jadad Quality Assessment Scale showed that 15 papers showed high quality with the Jadad score of 3 points or higher, and none of the papers had a problem with randomization and double-blinding. The evaluation results from adequacy of allocation concealment showed that 3 of the papers were executed proper allocation concealment, and all of them had 5 points of Jadad score. IRB (Institutional Review Board) approval and written consent was investigated for the evaluation of ethical validity, and 12 papers had the IRB approval, and 14 papers had written consent. The papers published before 2005 were absent of IRB approval and written consent, and none of the papers had IRB approval number. From the above results, it is concluded that rigorous clinical research led high quality of research papers, and the ethical aspect of clinical researches are getting more important to protect the rights of research participants.