• 제목/요약/키워드: Meta-analyses

검색결과 499건 처리시간 0.03초

질환별 레이저 침의 임상적 효과 평가 : 체계적 문헌고찰 및 메타분석 (Evaluation of the Clinical Effectiveness of Laser Acupuncture for Disease Specific : Systematic Reviews and Meta-analyses)

  • 김대진;최병희;김태영;박수강;곽진영
    • 대한의용생체공학회:의공학회지
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    • 제45권2호
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    • pp.81-89
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    • 2024
  • Purpose : This study conducted a systematic review and meta-analysis to evaluate the clinical effectiveness of laser acupuncture for each condition using information from laser acupuncture trials registered on clinicaltrials.gov from January 2013 to June 2023. Methods : We quantitatively and qualitatively analysed the results of 16 clinical trials of laser acupuncture whose research results were confirmed. A risk of bias assessment was also carried out to assess the quality of each clinical trial. Results : A meta-analysis including three clinical trials was conducted to evaluate the comparative effectiveness of laser acupuncture and sham laser acupuncture in reducing pain and found that the laser acupuncture group had a statistically significant reduction in pain compared with the sham laser acupuncture group. In addition, 11 of the 13 trials not included in the meta-analysis showed a positive effect of laser acupuncture. Conclusion : Although laser acupuncture has a long history of clinical use and a lot of research, there is still some scepticism due to the lack of a clear mechanism of action and inconsistent reports of clinical effectiveness. In addition, there is a significant lack of systematic reviews of clinical evidence for major disease specific, and ongoing research is needed to establish an objective evidence base for the clinical effectiveness of laser acupuncture.

다제내성결핵 환자에서 메타분석을 통한 Linezolid의 효능 및 안전성 평가 (Evaluation of the Efficacy and Safety of Linezolid by Meta-analysis for Multidrug-resistant Tuberculosis Patients)

  • 정우진;성태욱;김애진;채정우;윤휘열
    • 한국임상약학회지
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    • 제33권4호
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    • pp.278-289
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    • 2023
  • Background: Linezolid has been widely used in the treatment for multidrug-resistant tuberculosis. However, there are limitations to use it such as long treatment, because of related side effects, even adequate treatment period has been needed for remission of multidrug-resistant tuberculosis (MDR-TB). Method: The meta-analysis was performed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. To choose literatures, systematic literature reviews were conducted with databases of PubMed, Web of Science, and EMBASE. Results: Efficacy and safety of Linezolid were determined by 85% (95% CI=79~89%, p<0.05) in the sputum culture conversion and 55% (95% CI=45~64%, p<0.01) in side effects related to linezolid, respectively. In addition, I2 was estimated by 72%. In the subgroup analysis, efficacy and safety by dose and region were analyzed. In the subgroup analysis, compared with the linezolid dose in groups greater than 600 mg/day and less than 600 mg/day, this study showed 85% (95% CI 79~90%, p>0.05) in 206 patients and 82% (95% CI 73~89%, p<0.05) in 297 patients, respectively. Also, in the subgroup analysis, adverse effects caused by linezolid occurred more than 50% of treated patients. Conclusion: Therapeutic efficacy of linezolid for MDR-TB patients was confirmed regardless of the initial dose of linezolid, especially for sputum culture conversion and it was recommended that the dose of linezolid has been more effective below 600 mg/day. However, it should be necessary to closely monitored for safety issues since serious side effects possibly occurred by administration of long period treatment.

고추 역병균에 대한 3-phenylisoxazole과 3-phenyl-2,5-dihydroisoxazol-5-one 유도체들의 살균 활성에 관한 비교 분자장 분석 (CoMFA) (Comparative molecular field analyses (CoMFA) on the antifungal activity against phytophthora blight fungus of 3-phenylisoxazole and 3-phenyl-2,5-dihydroisoxazol-5-one derivatives)

  • 성낙도;이희철
    • 농약과학회지
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    • 제6권2호
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    • pp.72-79
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    • 2002
  • 일련의 3-phenyl-2,5-dihydroisoxazol-5-one(A)과 3-phenylisoxazole(B)유도체 중, 치환-phenyl기가 변화함에 따라 metalaxyl 살균제에 대하여 감수성(SPC:95C C7105)이나 저항성(RPC: 95CC7303)을 나타내는 고추역병균(Phytophthora capsici)의 살균활성 에 관한 비교 분자장 분석(CoMFA) 결과를 검토하였다. 살균활성은 (A)가 (B)보다 큰 경향이었으며 활성을 나타내는 가장 안정한 기질 분자의 형태는 평면성에 가까운 구조이었다. 두 균주를 대상으로 살균 활성에 미치는 CoMFA 장을 계산한 바, 상대적인 기여도는 공히, 정전기장이 가장 우세하였고 소수성장 및 입체장은 비슷한 정도로 기여하였다. 또한, CoMFA 모델은 좋은 상관성과 높은 예측성($q^2>0.570$$r^2>0.968$)을 나타내었다. 등고도 분석으로부터 RPC에 대한 살균활성의 선택성 요소는 benzoyl-기의 ortho, meta(C14 및 C15) 위치에는 부피가 큰 치환체를 그리고 meta, para(C15 및 C16) 위치부근에는 음하전을 생성하는 전자끌게가 도입되어야 할 것으로 판단된다.

Association Between ERCC2 Polymorphisms and Glioma Risk: a Meta-analysis

  • Huang, Li-Ming;Shi, Xi;Yan, Dan-Fang;Zheng, Min;Deng, Yu-Jie;Zeng, Wu-Cha;Liu, Chen;Lin, Xue-De
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권11호
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    • pp.4417-4422
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    • 2014
  • ERCC2 is an essential component of the nucleotide excision repair pathway which is involved in the effective maintenance of genome integrity. Association studies on ERCC2 polymorphisms and glioma risk have yielded inconclusive results. This meta-analysis was performed to gain a better insight into the relationship between ERCC2 polymorphisms and glioma risk. A systematic literature search updated to December 2, 2013 was performed in the Pubmed and EMBASE databases. Crude pooled odds ratios (ORs) with their corresponding 95% confidence intervals (95% CIs) were used to estimate the association between ERCC2 polymorphisms and glioma risk under a suitable effect model according to heterogeneity. All analyses were performed using Review Manager 5 (version 5.2) and STATA (version 12.0). The combined results demonstrated rs13181 to be significantly associated with glioma risk (G allele versus T allele: OR=1.15, 95% CI=1.05-1.26, P=0.002; dominant model: OR=1.22, 95% CI=1.07-1.39, P=0.002; recessive model: OR=1.18, 95% CI=0.98-1.41, P=0.070). We also found that rs13181 acts in an allele dose-dependent manner (GG versus TT: OR=1.30, 95% CI=1.07-1.57, P=0.009; TG versus TT: OR=1.20, 95%=CI 1.05-1.37, P=0.009; trend test, P=0.004). However, no evidence was found in analyses for the association between other 3 ERCC2 polymorphisms (rs238406, rs1799793, and rs1052555) and susceptibility to glioma development. Our meta-analysis suggests that rs13181 is significantly associated with glioma risk in an allele dose-dependent manner, whereas, 3 other ERCC2 polymorphisms (rs238406, rs1799793, and rs1052555) may have no influence.

가정과수업에서 실천적추론수업의 학생성취에 대한 효과성 연구의 메타분석 (Revisited meta-analysis of the effects of practical reasoning instruction on students' achievements in Home Economics classes)

  • 유난숙
    • 한국가정과교육학회지
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    • 제30권3호
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    • pp.151-173
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    • 2018
  • 본 연구의 목적은 가정과수업에서 실천적추론수업을 적용하여 학생성취에 대한 효과를 살펴본 선행연구들을 양적으로 메타분석함으로써 효과크기를 알아보고, 실천적추론수업의 효과가 어떤 변수에 따라 달라지는 지 분석하는 데 있다. 분석대상의 기준에 맞는 선행연구를 검색한 결과, 1999년부터 2018년까지 수행된 34개 연구가 선정되었다. Becker(1988)가 제안한 방법을 이용하여 사례수를 고려한 표준화된 평균변화로부터 효과크기를 계산한 결과, 34개 분석대상 연구로부터 44개의 효과크기가 산출되었다. 분석에 앞서 출판여부에 따른 오류를 깔대기 기법을 이용하여 평가한 결과, 오류는 없었으며 연구결과는 다음과 같다. 첫째, 동질성검증 결과, 랜덤 효과 모형을 적용하였으며 실천적추론수업은 전통적 수업에 비해 학생성취에 통계적으로 의미있게 효과적인 것으로 나타났다(효과크기=0.60, SE=.074). 둘째, 조절변인을 찾기 위해 범주형 변수 및 연속형 변수 자료분석을 실행한 결과, 실천적추론수업의 효과성에 대한 선행연구들이 다룬 내용 영역과 학교소재지에 따라 효과크기가 다른 것으로 나타났다. 반면, 출판여부, 연구설계 방법, 분석대상 연도, 학교급, 연구대상자들의 성별, 학생성취의 종류, 수업시수 등에 따라서는 효과크기가 다르지 않았다.

Association Between VDR Polymorphisms and Breast Cancer: An Updated and Comparative Meta-analysis of Crude and Adjusted Odd Ratios

  • Huang, Qian-Qian;Liao, Yu-Yi;Ye, Xiao-Hua;Fu, Jin-Jian;Chen, Si-Dong
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권2호
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    • pp.847-853
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    • 2014
  • There is a lot of debate on the relationship between vitamin D receptor polymorphisms and risk of breast cancer. Herein, we quantitatively analyzed the published case-control studies on this relationship by meta-analysis, performing a bibliographic search from Pubmed and CNKI up to July 31, 2013. The included case-control studies for Fok1, Bsm1, Taq1, Apa1, Cdx2 and Poly-A were 16, 19, 20, 10, 4, 6, respectively. Crude and adjusted odd ratios and 95% confidence intervals were calculated to present and compare the strength of any associations. The results of combined analyses indicated that Fok1, Bsm1, Apa1, Cdx2 and Poly-A were not significantly associated with the risk of breast cancer. In contrast, the tt genotype of Taq1 was a modest risk factor for breast cancer development (tt vs. TT: OR = 1.21, 95% CI: 1.01-1.44). To further confirm the above results, adjusted effects for the six polymorphisms were pooled based on adjusted ORs reported in the original studies. Adjusted ORs of Fok1, Apa1, Cdx2 and Poly-A were similar to the crude ORs. However, Bsm1 and Taq1 showed inconsistent results. For Bsm1, OR for BB vs. bb was 0.85, 95% CI: 0.74-0.98; for Taq1, OR for tt vs. TT was 1.03, 95% CI: 0.92-1.15, and not associated with risk. Subgroup analyses for crude ORs showed some association between Bsm1, Taq1 and breast cancer in Caucasians only, but for adjusted ORs, no associations were found. This meta-analysis suggests that the roles that Fok1, Apa1, Cdx2 and Poly-A polymorphisms play in breast cancer risk are negligible, with Bsm1 and Taq1 as possible exceptions. To be conservative, we still assumed that they may play a modest role in determining breast cancer risk. Further studies are needed to validate our findings.

Efficacy of medications in adult patients with trigeminal neuralgia compared to placebo intervention: a systematic review with meta-analyses

  • Peterson-Houle, Georgia M.;AbdelFattah, Magda R.;Padilla, Mariela;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제21권5호
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    • pp.379-396
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    • 2021
  • Background: Trigeminal neuralgia (TN) is characterized by brief, unilateral, sharp, stabbing, and shooting pain of the fifth cranial nerve. The objective of this systematic review with meta-analysis was to determine the effect of medications compared to placebo in adult patients with TN. Methods: Review authors identified randomized placebo-controlled trials (RCTs) from PubMed, Web of Science, Cochrane, and EMBASE up to February 2021. We assessed the inclusion and exclusion criteria as well as the risk of bias of the studies based on the Cochrane Handbook. A total of 324 unduplicated references were scanned independently and reduced to eight relevant RCTs, with 89 patients included. Medications investigated included oral carbamazepine, subcutaneous sumatriptan, lidocaine (intranasal, 8% spray on the oral mucosa or intravenous), buprenorphine (ganglionic local opioid analgesia), and oral Nav1.7, a selective sodium channel blocker. Results: Meta-analyses showed that overall patients receiving lidocaine reported a significantly lower post-treatment intensity of pain -3.8 points on a 0-10 scale (95% Cl = -4.653 to -2.873; P < 0.001). Patients who received lidocaine were 8.62 times more likely to have pain improvement than patients on placebo (P < 0.001). In one RCT, patients receiving oral carbamazepine showed a significant improvement in pain intensity of -32% compared to the placebo (P < 0.001). In one trial, patients receiving 3 mg subcutaneous sumatriptan had a significantly lower intensity of pain on average -6.1 points on a scale of 0-10 compared to placebo (P < 0.001) and a significant improvement in pain intensity of -75% compared to the improvement in the placebo group (P < 0.001). Patients who received subcutaneous sumatriptan were 10 times more likely to have pain improvement than those who received placebo (P = 0.001) in one study. Due to the unclear/high risk of bias and small sample size, the quality of the evidence for lidocaine in the treatment of TN was low. Conclusion: Further studies are needed for carbamazepine, sumatriptan, buprenorphine, and oral Nav1.7 sodium channel blockers, as only one study reported outcomes.

Efficacy of alpha-lipoic acid in patients with burning mouth syndrome compared to that of placebo or other interventions: a systematic review with meta-analyses

  • Christy, Jessica;Noorani, Salman;Sy, Frank;Al-Eryani, Kamal;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제22권5호
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    • pp.323-338
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    • 2022
  • Burning mouth syndrome (BMS) is a chronic oral disorder of unknown etiology which presents therapeutic challenges. Alpha-lipoic acid (ALA) has been studied as a potential treatment for BMS. The objective of this systematic review and meta-analysis was to evaluate the effectiveness of ALA compared to that of placebo or other interventions in individuals with BMS. Randomized controlled trials (RCT) using ALA to treat BMS were identified from MEDLINE, Cochrane Library, EMBASE, and Web of Science up to February 3, 2021. The assessment of the risk of bias in the included studies was based on the Cochrane guidelines. The primary outcome evaluated was the visual analog scale (VAS) pain intensity. ALA was compared with placebo, clonazepam, gabapentin, pregabalin, ALA plus gabapentin, capsaicin, Biotène®, and laser therapy. Altogether, 137 records were scanned for inclusion/exclusion, and nine RCTs (two unclear and seven at high risk of bias) were included in the qualitative and quantitative analyses, with a total of 594 patients with BMS included in this review. All studies reported an improvement in VAS pain scores ranging from -0.72 to -2.77. Meta-analysis results showed a non-significant reduction in pain intensity for ALA (P = 0.616) compared to that of placebo on a VAS of 0-10. Patients taking ALA were 1.923 times more likely to show an improvement in self-reported BMS symptoms (P = 0.031) than those in the placebo group. Clonazepam and pregabalin showed a significant VAS pain reduction of 4.08 and 4.68 (P < 0.001), respectively, compared to that with ALA. Although ALA intervention provided a non-significant improvement in the pain score and was more likely to produce a reduction in BMS symptoms, the evidence was of low quality. Further research is needed to establish clear guidelines for the use of ALA for BMS treatment.

Firefighting and Cancer: A Meta-analysis of Cohort Studies in the Context of Cancer Hazard Identification

  • Nathan L. DeBono;Robert D. Daniels ;Laura E. Beane Freeman ;Judith M. Graber ;Johnni Hansen ;Lauren R. Teras ;Tim Driscoll ;Kristina Kjaerheim;Paul A. Demers ;Deborah C. Glass;David Kriebel;Tracy L. Kirkham;Roland Wedekind;Adalberto M. Filho;Leslie Stayner ;Mary K. Schubauer-Berigan
    • Safety and Health at Work
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    • 제14권2호
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    • pp.141-152
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    • 2023
  • Objective: We performed a meta-analysis of epidemiological results for the association between occupational exposure as a firefighter and cancer as part of the broader evidence synthesis work of the IARC Monographs program. Methods: A systematic literature search was conducted to identify cohort studies of firefighters followed for cancer incidence and mortality. Studies were evaluated for the influence of key biases on results. Random-effects meta-analysis models were used to estimate the association between ever-employment and duration of employment as a firefighter and risk of 12 selected cancers. The impact of bias was explored in sensitivity analyses. Results: Among the 16 included cancer incidence studies, the estimated meta-rate ratio, 95% confidence interval (CI), and heterogeneity statistic (I2) for ever-employment as a career firefighter compared mostly to general populations were 1.58 (1.14-2.20, 8%) for mesothelioma, 1.16 (1.08-1.26, 0%) for bladder cancer, 1.21 (1.12-1.32, 81%) for prostate cancer, 1.37 (1.03-1.82, 56%) for testicular cancer, 1.19 (1.07-1.32, 37%) for colon cancer, 1.36 (1.15-1.62, 83%) for melanoma, 1.12 (1.01-1.25, 0%) for non-Hodgkin lymphoma, 1.28 (1.02-1.61, 40%) for thyroid cancer, and 1.09 (0.92-1.29, 55%) for kidney cancer. Ever-employment as a firefighter was not positively associated with lung, nervous system, or stomach cancer. Results for mesothelioma and bladder cancer exhibited low heterogeneity and were largely robust across sensitivity analyses. Conclusions: There is epidemiological evidence to support a causal relationship between occupational exposure as a firefighter and certain cancers. Challenges persist in the body of evidence related to the quality of exposure assessment, confounding, and medical surveillance bias.

Garlic powder intake and cardiovascular risk factors: a meta-analysis of randomized controlled clinical trials

  • Kwak, Jin Sook;Kim, Ji Yeon;Paek, Ju Eun;Lee, You Jin;Kim, Haeng-Ran;Park, Dong-Sik;Kwon, Oran
    • Nutrition Research and Practice
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    • 제8권6호
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    • pp.644-654
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    • 2014
  • BACKGROUND/OBJECTIVES: Although preclinical studies suggest that garlic has potential preventive effects on cardiovascular disease (CVD) risk factors, clinical trials and reports from systematic reviews or meta-analyses present inconsistent results. The contradiction might be attributed to variations in the manufacturing process that can markedly influence the composition of garlic products. To investigate this issue further, we performed a meta-analysis of the effects of garlic powder on CVD risk factors. MATERIALS/METHODS: We searched PubMed, Cochrane, Science Direct and EMBASE through May 2014. A random-effects meta-analysis was performed on 22 trials reporting total cholesterol (TC), 17 trials reporting LDL cholesterol (LDL-C), 18 trials reporting HDL cholesterol (HDL-C), 4 trials reporting fasting blood glucose (FBG), 9 trials reporting systolic blood pressure (SBP) and 10 trials reporting diastolic blood pressure (DBP). RESULTS: The overall garlic powder intake significantly reduced blood TC and LDL-C by -0.41 mmol/L (95% confidence interval [CI], -0.69, -0.12) (-15.83 mg/dL [95% CI, -26.64, -4.63]) and -0.21 mmol/L (95% CI, -0.40, -0.03) (-8.11 mg/dL [95% CI, -15.44, -1.16]), respectively. The mean difference in the reduction of FBG levels was -0.96 mmol/L (95% CI, -1.91, -0.01) (-17.30 mg/dL [95% CI, -34.41, -0.18]). Evidence for SBP and DBP reduction in the garlic supplementation group was also demonstrated by decreases of -4.34 mmHg (95% CI, -8.38, -0.29) and -2.36 mmHg (95% CI, -4.56, -0.15), respectively. CONCLUSIONS: This meta-analysis provides consistent evidence that garlic powder intake reduces the CVD risk factors of TC, LDL-C, FBG and BP.