• Title/Summary/Keyword: Meta-analyses

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A Meta-analysis of the Effectiveness of Acupuncture for the Treatment of Essential Tremors (본태성 떨림의 침치료 효과에 대한 메타분석)

  • Sohn, Yu-jin;Jung, Seo-yoon;Kang, Ki-wan;Jeong, Min-jeong;Jang, In-soo
    • The Journal of Internal Korean Medicine
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    • v.38 no.4
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    • pp.419-432
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    • 2017
  • Objectives: This study provides an evaluation of the effectiveness of acupuncture for the treatment of essential tremors (ETs) using randomized controlled trials (RCTs). Methods: Nine databases (PubMed, CINAHL, EMBASE, OASIS, NDSL, CNKI, Wanfang, J-STAGE, and CiNii) and the keywords "Essential tremor", "Benign tremor", "Familial tremor", and "Acupuncture" were used to compile RCTs that used acupuncture to treat ETs. Studies that were not RCTs, such as case studies, reviews, and essays, were excluded. The methodological quality of each RCT was assessed using the Cochrane risk-of-bias tool, and where appropriate, meta-analyses were performed. Results: Initially, 819 studies were found, but 773 were excluded after title and abstract screening. After further screening of the resulting 46 papers, eight RCTs were selected that had been published between 2003 and 2016, and the total effective rate (TER) was used as the primary evaluation method for all eight studies. It was found that the TER was significantly higher in treatment groups (83.33-96.7%) than in control groups (56.5-80.0%), and seven studies included in the meta-analysis showed positive results for acupuncture for ETs (Risk Ratio: 1.43, 95% Confidence Interval: 1.21-1.69, P<0.0001) Confidence Interval. Conclusions: This meta-analysis of clinical trials suggests that acupuncture is effective for treating ET patients; however, further studies are needed or larger populations to prove its effectiveness.

Predictors of Mortality in Patients with COVID-19: A Systematic Review and Meta-analysis (코로나바이러스감염증-19 (COVID-19) 환자들의 사망관련 인자에 대한 연구: 체계적 문헌고찰 및 메타분석)

  • Kim, Woorim;Han, Ji Min;Lee, Kyung Eun
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.3
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    • pp.169-176
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    • 2020
  • Background: Most meta-analyses of risk factors for severe or critical outcomes in patients with COVID-19 only included studies conducted in China and this causes difficulties in generalization. Therefore, this study aimed to systematically evaluate the risk factors in patients with COVID-19 from various countries. Methods: PubMed, Embase, and Web of Science were searched for studies published on the mortality risk in patients with COVID-19 from January 1 to May 7, 2020. Pooled estimates were calculated as odds ratio (OR) with 95% confidence interval (CI) using the random-effects model. Results: We analyzed data from seven studies involving 26,542 patients in total in this systematic review and meta-analysis. Among the patients, 2,337 deaths were recorded (8.8%). Elderly patients and males showed significantly higher mortality rates than young patients and females; the OR values were 3.6 (95% CI 2.5-5.1) and 1.2 (95% CI 1.0-1.3), respectively. Among comorbidities, hypertension (OR 2.3, 95% CI 1.1-4.6), diabetes (OR 2.2, 95% CI 1.2-3.9), cardiovascular disease (OR 3.1, 95% CI 1.5-6.3), chronic obstructive pulmonary disease (OR 4.4, 95% CI 1.7-11.5), and chronic kidney disease (OR 4.2, 95% CI 2.0-8.6) were significantly associated with increased mortalities. Conclusion: This meta-analysis, involving a huge global sample, employed a systematic method for synthesizing quantitative results of studies on the risk factors for mortality in patients with COVID-19. It is helpful for clinicians to identify patients with poor prognosis and improve the allocation of health resources to patients who need them most.

Whole Brain Radiotherapy Plus Chemotherapy in the Treatment of Brain Metastases from Lung Cancer: A Meta-analysis of 19 Randomized Controlled Trails

  • Liu, Wen-Jing;Zeng, Xian-Tao;Qin, Hai-Feng;Gao, Hong-Jun;Bi, Wei-Jing;Liu, Xiao-Qing
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3253-3258
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    • 2012
  • Objective: To evaluate the efficacy and safety of whole brain radiotherapy (WBRT) plus chemotherapy versus WBRT alone for treating brain metastases (BM) from lung cancer by performing a meta-analysis based on randomized controlled trials (RCTs). Methods: The PubMed, Embase, CENTRAL, ASCO, ESMO, CBM, CNKI, and VIP databases were searched for relevant RCTs performed between January 2000 and March 2012. After quality assessment and data extraction, the meta-analysis was performed using the RevMan 5.1 software, with funnel plot evaluation of publication bias. Results: 19 RCTs involving 1,343 patients were included. The meta-analyses demonstrated that compared to WBRT alone, WBRT plus chemotherapy was more effective with regard to the objective response rate (OR = 2.30, 95% CI = 1.79 - 2.98; P < 0.001); however, the incidences of gastrointestinal reactions (RR = 3.82, 95% CI = 2.33 - 6.28, P <0.001), bone marrow suppression (RR = 5.49, 95% CI = 3.65 - 8.25, P < 0.001), thrombocytopenia (RR = 5.83, 95% CI = 0.39 - 86.59; P = 0.20), leukopenia (RR = 3.13, 95% CI = 1.77 - 5.51; P < 0.001), and neutropenia (RR = 2.75, 95% CI = 1.61 - 4.68; P < 0.001) in patients treated with WBRT plus chemotherapy were higher than with WBRT alone. There was no obvious publication bias detected. Conclusion: WBRT plus chemotherapy can obviously improve total efficacy rate, butalso increases the incidence of adverse reactions compared to WBRT alone. From the limitations of this study, more large-scale, high-quality RCTs are suggested for further verification.

Association of Functional Polymorphisms of the XRCC4 Gene with the Risk of Breast Cancer: A Meta-analysis

  • Zhou, Li-Ping;Luan, Hong;Dong, Xi-Hua;Jin, Guo-Jiang;Ma, Dong-Liang;Shang, Hong
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3431-3436
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    • 2012
  • Objective: X-ray cross-complementing group 4 (XRCC4) is a major repair gene for DNA double-strand breaks (DSB) in the non-homologous end-joining (NHEJ) pathway. Several potentially functional polymorphisms of the XRCC4 gene have been implicated in breast cancer risk, but individually published studies showed inconclusive results. The aim of this meta-analysis was to investigate the association between XRCC4 polymorphisms and the risk of breast cancer. Methods: The MEDLINE, EMBASE, Web of science and CBM databases were searched for all relevant articles published up to June 20, 2012. Potential associations were assessed with comparisons of the total mutation rate (TMR), complete mutation rate (CMR) and partial mutation rate (PMR) in cases and controls. Statistical analyses were performed using RevMan 5.1.6 and STATA 12.0 software. Results: Five studies were included with a total of 5,165 breast cancer cases and 4,839 healthy controls. Meta-analysis results showed that mutations of rs2075686 (C>T) and rs6869366 (G>T) in the XRCC4 gene were associated with increased risk of breast cancer, while rs2075685 (G>T) and rs10057194 (A>G) might decrease the risk of breast cancer. However, rs1805377 (A>G), rs1056503 (G>T), rs28360317 (ins>del) and rs3734091 (A>G) polymorphisms of XRCC4 gene did not appear to have an influence on breast cancer susceptibility. Conclusion: Results from the current meta-analysis suggest that the rs2075685 (G>T) and rs6869366 (G>T) polymorphisms of the XRCC4 gene might increase the risk of breast cancer, whereas rs2075685 (G>T) and rs10057194 (A>G) might be protective factors.

Lack of Associations of the COMT Val158Met Polymorphism with Risk of Endometrial and Ovarian Cancer: a Pooled Analysis of Case-control Studies

  • Liu, Jin-Xin;Luo, Rong-Cheng;Li, Rong;Li, Xia;Guo, Yu-Wu;Ding, Da-Peng;Chen, Yi-Zhi
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6181-6186
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    • 2014
  • This meta-analysis was conducted to examine whether the genotype status of Val158Met polymorphism in catechol-O-methyltransferase (COMT) is associated with endometrial and ovarian cancer risk. Eligible studies were identified by searching several databases for relevant reports published before January 1, 2014. Pooled odds ratios (ORs) were appropriately derived from fixed-effects or random-effects models. In total, 15 studies (1,293 cases and 2,647 controls for ovarian cancer and 2,174 cases and 2,699 controls for endometrial cancer) were included in the present meta-analysis. When all studies were pooled into the meta-analysis, there was no evidence for significant association between COMT Val158Met polymorphism and ovarian cancer risk (Val/Met versus Val/Val: OR=0.91, 95% CI=0.76-1.08; Met/Met versus Val/Val: OR=0.90, 95% CI=0.73-1.10; dominant model: OR=0.90, 95% CI=0.77-1.06; recessive model: OR=0.95, 95% CI=0.80-1.13). Similarly, no associations were found in all comparisons for endometrial cancer (Val/Met versus Val/Val: OR 0.97, 95% CI=0.77-1.21; Met/Met versus Val/Val: OR=1.02, 95% CI=0.73-1.42; dominant model: OR=0.98, 95% CI=0.77-1.25; recessive model: OR=1.02, 95% CI=0.87-1.20). In the subgroup analyses by source of control and ethnicity, no significant associations were found in any subgroup of population. This meta-analysis strongly suggests that COMT Val158Met polymorphism is not associated with increased endometrial and ovarian cancer risk.

Alcohol Consumption and Breast Cancer Survival: A Metaanalysis of Cohort Studies

  • Gou, Yun-Jiu;Xie, Ding-Xiong;Yang, Ke-Hu;Liu, Ya-Li;Zhang, Jian-Hua;Li, Bin;He, Xiao-Dong
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4785-4790
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    • 2013
  • Background and Objectives: Evidence for associations between alcohol consumption with breast cancer survival are conflicting, so we conducted the present meta-analysis. Methods: Comprehensive searches were conducted to find cohort studies that evaluated the relationship between alcohol consumption with breast cancer survival. Data were analyzed with meta-analysis software. Results: We included 25 cohort studies. The meta-analysis results showed that alcohol consumption was not associated with increased breast cancer mortality and recurrence after pooling all data from highest versus lowest comparisons. Subgroup analyses showed that pre-diagnostic or post-diagnostic consumpotion, and ER status did not affect the relationship with breast cancer mortality and recurrence. Although the relationships of different alcohol consumption with breast cancer mortality and recurrence were not significant, there seemed to be a dose-response relationship of alcohol consumption with breast cancer mortality and recurrence. Only alcohol consumption of >20 g/d was associated with increased breast cancer mortality, but not with increased breast cancer recurrence. Conclusion: Although our meta-analysis showed alcohol drinking was not associated with increased breast cancer mortality and recurrence, there seemed to be a dose-response relationship of alcohol consumption with breast cancer mortality and recurrence and alcohol consumption of >20 g/d was associated with increased breast cancer mortality.

Vitamin B2 Intake and the Risk of Colorectal Cancer: a Meta-Analysis of Observational Studies

  • Liu, Yan;Yu, Qiu-Yan;Zhu, Zhen-Li;Tang, Ping-Yi;Li, Ke
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.909-913
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    • 2015
  • Background: A systematic review and meta-analysis of observational studies evaluated the association of intake of vitamin B2 with the incidence of colorectal cancer. Materials and Methods: Relevant studies were identified in MEDLINE via PubMed (published up to April 2014). We extracted data from articles on vitamin B2 and used multivariable-adjusted odds ratio (OR) and a random-effects model for analysis. Results: We found 8 articles meeting the inclusion criteria (4 of cohort studies and 4 of case-control studies) and a total of 7,750 colorectal cancer cases were included in this meta-analysis. The multivariable-adjusted OR for pooled studies for the association of the highest versus lowest vitamin B2 intake and the risk of colorectal cancer was 0.83 (95% confidence interval [95%CI]:0.75,0.91). We performed a sensitivity analysis for vitamin B2. If we omitted the study by Vecchia et al., the pooled OR was 0.86 (95%CI, 0.77,0.96). Conclusions: This is the first meta-analysis to study links between vitamin B2 and colorectal cancer. We found vitamin B2 intake was inversely associated with risk of colorectal cancer. However, further research and large sample studies need to be conducted to better validate the result.

Meta-analysis of the Association Between GSTM1 and GSTT1 Gene Polymorphisms and Cervical Cancer

  • Zhang, Zhen-Yong;Jin, Xue-Ying;Wu, Rong;Wu, Li-Na;Xing, Rui;Yang, Shu-Juan;Xie, Yao
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.3
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    • pp.815-819
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    • 2012
  • Aim: We conducted a meta-analysis to analyze the influence of GSTM1 and GSTT1 gene polymorphisms on cervical cancer risk, and explore gene-environment interactions. Methods: Identification of relevant studies was carried out through a search of Medline and the EMbase up to Oct. 2011. All case-control studies that investigated the association between GSTM1 and GSTT1 gene polymorphisms and risk of cervical cancer were included. The pooled odds ratio (OR) was used for analyses of results and the corresponding 95% confidence intervals (CI) were estimated. Results: A total of 21 case-control studies were included in the meta-analysis of GSTM1 (2,378 cases and 2,639 controls) and GSTT1 (1,229 cases and 1,223 controls) genotypes. The overall results showed that the GSTM1 null was related to an increased risk of cervical cancer (OR=1.50, 95% CI=1.21-1.85). Subgroup analysis were performed based on smoking and ethnicity. Our results showed that smokers with null GSTM1 genotype had a moderate increased risk of cervical cancer (OR=1.85, 95% CI=1.07-3.20). For the ethnicity stratification, moderate significantly increased risk of null GSTM1 genotype was found in Chinese (OR=2.12, 95% CI=1.43-3.15) and Indian populations (OR=2.07, 95% CI=1.49-2.88), but no increased risk was noted in others. Conclusion: This meta-analysis provided strong evidence that the GSTM1 genotype is associated with the development of cervical cancer, especially in smokers, and Chinese and Indian populations. However, no association was found for GSTT1 null genotype carriers.

Associations Between XRCC1 Arg399Gln, Arg194Trp, and Arg280His Polymorphisms and Risk of Differentiated Thyroid Carcinoma: A Meta-analysis

  • Du, Yang;Han, Li-Yuan;Li, Dan-Dan;Liu, Hui;Gao, Yan-Hui;Sun, Dian-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5483-5487
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    • 2013
  • Background: Associations between Arg399Gln, Arg194Trp and Arg280His polymorphisms of the XRCC1 gene and risk of differentiated thyroid carcinoma (DTC) have been widely studied but the findings are contradictory. Methods: We performed a meta-analysis in the present study using STATA 11.0 software to clarify any associations. Electronic literature databases and reference lists of relevant articles revealed a total of 10, 6 and 6 published studies for the Arg399Gln, Arg194Trp and Arg280His polymorphisms, respectively. Results: No significant associations were observed between Arg399Gln and DTC risk in all genetic models within the overall and subgroup meta-analyses, while the Trp/Trp vs Arg/Arg and recessive model of the Arg194Trp polymorphism was associated with DTC susceptibility, and the dominant model of Arg280His polymorphism contributed to DTC susceptibility in Caucasians. Conclusions: Our meta-analysis suggests that XRCC1 Arg194Trp may be a risk factor for DTC development.

Work-Related Musculoskeletal Disorders in Iranian Dentists: A Systematic Review and Meta-analysis

  • ZakerJafari, Hamid Reza;YektaKooshali, Mohammad Hossein
    • Safety and Health at Work
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    • v.9 no.1
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    • pp.1-9
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    • 2018
  • Background: Work-related musculoskeletal disorders are the most important problems among professions particularly, dentists. This study was conducted to determine the prevalence of musculoskeletal disorders in various parts of the body in Iranian dentists by using systematic review and meta-analysis. Methods: This systematic review and meta-analysis was based on preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and searching in national databases such as SID, Magiran, Irandoc, IranMedex, and Medlib, and international databases such as MedLine, Web of Sciences, Scopus, PubMed, ScienceDirect, Cochrane, Embase, Springer, Wiley Online Library, Ebsco, CEBM, and Google Scholar search engine which were published by January 1, 2017. Researched keywords were in Persian and their standard English equivalents were in accordance with their MeSH. The obtained documents were analyzed using Comprehensive Meta-analysis version 2. Results: According to 23 studies through 2,531 Iranian dentists which took part in this study, prevalence of skeletal disorders in Iranian dentists has been 17.6% [confidence interval (CI) 95%:11.7-25.5] in knees, 33.2% (CI 95%:24.1-43.8) in shoulders, 33.4% (CI 95%: 26.8-40.8) in the thorax, 51.9% (CI 95%:46.7-57.2) in necks, 33.7% (CI 95%:28.2-39.6) in wrists/hands, 12.9% (CI 95%:7.7-20.6) in elbows, 37.3% (CI 95%: 31.5-43.5) in lower back, 11.9% (CI 95%:8.7-16.1) in thighs, 12.9% (CI 95%:3.8-36) in the foot, and 10.5% (CI 95%:7-15.4) in legs. Conclusion: Considering the high prevalence of musculoskeletal disorders in Iranian dentists, ergonomics should be included as a lesson in preclinic and also, reeducation courses for ergonomics basics should be executed for graduate dentists.