• Title/Summary/Keyword: RCTs Review

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Short-course Versus Long-course Preoperative Radiotherapy plus Delayed Surgery in the Treatment of Rectal Cancer: a Meta-analysis

  • Liu, Shi-Xin;Zhou, Zhi-Rui;Chen, Ling-Xiao;Yang, Yong-Jing;Hu, Zhi-De;Zhang, Tian-Song
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5755-5762
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    • 2015
  • Background: Short-course preoperative radiation (SCRT) with delayed surgery was found to increase pathologic complete response (pCR) rates in several trials. However, there was no clear answer on whether SCRT or long-course chemo-radiotherapy (LCRT) is more effective. Therefore we conducted this meta-analysis to evaluate the safety and efficacy of SCRT versus LCRT, both with delayed surgery, for treatment of rectal cancer. Materials and Methods: The literature was searched from PubMed, EMBASE, Web of Science, Cochrane Library and clinicaltrials.gov up to November, 2014. Quality of the randomized controlled trials (RCTs) was evaluated according to the Cochrane's risk of bias tool of RCT. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to rate the level of evidence. Review Manager 5.3 was employed for statistical analysis. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated. Results: Three RCTs, with a total of 357 rectal cancer patients, were included in this systematic review. Metaanalysis results demonstrated there were no significantly differences in sphincter preservation rate, local recurrence rate, grade 3~4 acute toxicity, R0 resection rate and downstaging rate. Compared with SCRT, LCRT was associated with significant increase in the pCR rate [RR=0.49, 95%CI (0.31, 0.78), P=0.003]. Conclusions: In terms of sphincter preservation rate, local recurrence rate, grade 3~4 acute toxicity, R0 resection rate and downstaging rate, SCRT with delayed surgery is as effective as LCRT with delayed surgery for management of rectal cancer. LCRT significantly increased pCR rate compared with SCRT. Due to risk of bias and imprecision, further multi-center large sample RCTs were needed to confirm this conclusion.

A Systematic Review on Antihypertensive Effects of Oryeong-san (오령산의 고혈압 치료 효과에 대한 체계적 고찰 : 임상 논문을 중심으로)

  • Lee, Hye-Yoon;Kang, Ki-Wan;Lee, Eun;Lee, Seung-Ho;Han, Chang-Ho;Jang, In-Soo
    • The Journal of Internal Korean Medicine
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    • v.34 no.3
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    • pp.289-297
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    • 2013
  • Objectives : The purpose of this study was to review the clinical studies on antihypertensive effects of Oryeong-san. Methods : We searched papers using KTKP, Oasis, CNKI, PubMed, Embase, Science Direct, CINAHL, J STAGE and CiNii, and the key words "Oryeong-san (韓)", "Wuling-san (中)", "Gorei-san (日)", and "Hypertension" were used. Search range included randomized controlled trials (RCTs), clinical reports, reviews and animal experiments. Papers not matched with inclusion criteria were excluded. Results : A total 479 studies were found, with 457 excluded during title and screening. After scanning 22 papers, a final 3 RCTs and 6 case reports were selected and analyzed. In the 3 RCTs, the number of patients varied between 65 and 156. Patients with hypertension were randomized into groups for treatment group and control group. They were all treated with antihypertensive drugs (Vamlodipine Besylate, Benazepril, Perindopril); the treatment group was also given modified Oryeong-san. After treatment, results were that blood pressure was significantly decreased in the treatment group, compared to the control. The other 6 case reports reported that modified Oryeong-san alone or the combination of Oryeong-san plus antihypertensive drugs had beneficial effects on blood pressure. Conclusions : Oryeong-san appears to be effective in improving blood pressure and hypertension-related symptoms. The results of this study could be applied to clinical treatment of hypertension. Further large-scale clinical researches should be conducted.

Intranasal Phototherapy for Allergic Rhinitis : a systematic review (알레르기 비염의 비강 내 광 치료 : 체계적 문헌고찰)

  • Kang, Jeong-In;Min, Kyung-Jin;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.33 no.4
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    • pp.55-73
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    • 2020
  • Objectives : We investigated the effectiveness and safety of intranasal phototherapy for allergic rhinitis (AR). Methods : We searched 8 electronic databases (PubMed, Cochrane Library, CNKI, CiNii Articles, OASIS, NDSL, KISS, KMbase) to identify randomized controlled trials (RCTs) that reported the use of intranasal phototherapy for AR from their inception until May 30, 2020. Two investigators independently searched, collected, and screened the RCTs. We performed data extraction and evaluation for risk of bias using the Cochrane risk-of-bias tool. Results : This study included 12 RCTs; six studies compared intranasal and sham phototherapy, of which four studies reported a significant inter group difference and two studies reported a significant difference partially. No significant changes in symptoms were observed between the phototherapy and conventional therapy groups. The phototherapy and concurrent acupuncture treatment group showed a significantly higher effectiveness rate compared with the group that received only acupuncture. Both the phototherapy and laser acupuncture group showed significant improvement in the symptom severity scale scores. Six studies reported mild adverse effects, such as dryness and nasal pain in the intranasal phototherapy group; however, no severe adverse effects were reported. Conclusions : This study confirmed the safety and effectiveness of intranasal phototherapy for symptom relief and improved quality of life in patients with AR. However, further studies are needed on this topic in order to demonstrate it clearly.

Consolidated Standards of Reporting Trials: The Reporting Guideline for Randomized Controlled Trials (Consolidated Standards of Reporting Trials의 소개: 무작위 대조군 연구의 보고 지침)

  • Jung, Hoi-In;Kim, Hee-Eun
    • Journal of dental hygiene science
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    • v.14 no.3
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    • pp.269-275
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    • 2014
  • Recently, there are lots methodologies to improve the quality of research in medical and public health fields. One of them is to checking a process of research with a reporting guideline before reporting paper. Especially, reporting guideline for randomized controlled trials (RCTs) is the consolidated standards of reporting trials (CONSORT). Therefore, this review describes the latest version of the CONSORT statement, CONSORT 2010, including intent, background, and contents of this. The CONSORT statement comprises a checklist of essential items that should be included in reports of RCTs and a diagram for documenting the flow of participants through a trial. This report guideline aims at providing guidance to authors about how to improve the reporting of their trials. As consulting the CONSORT, authors could be strictly reported about research methods and results. From this review, we expect to elevate the quality of such research about dental hygiene and to establish the foundation for evidence-based dental hygiene.

Efficacy of intralipid administration to improve in vitro fertilization outcomes: A systematic review and meta-analysis

  • Han, E Jung;Lee, Hye Nam;Kim, Min Kyoung;Lyu, Sang Woo;Lee, Woo Sik
    • Clinical and Experimental Reproductive Medicine
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    • v.48 no.3
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    • pp.203-210
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    • 2021
  • We performed a systematic review and meta-analysis to evaluate whether intralipid administration improved the outcomes of in vitro fertilization. Online databases (PubMed, Cochrane Library, Medline, and Embase) were searched until March 2020. Only randomized controlled trials (RCTs) that assessed the role of intralipid administration during in vitro fertilization were considered. We analyzed the rates of clinical pregnancy and live birth as primary outcomes. Secondary outcomes included the rates of chemical pregnancy, ongoing pregnancy, and missed abortion. We reviewed and assessed the eligibility of 180 studies. Five RCTs including 840 patients (3 RCTs: women with repeated implantation failure, 1 RCT: women with recurrent spontaneous abortion, 1 RCT: women who had experienced implantation failure more than once) met the selection criteria. When compared with the control group, intralipid administration significantly improved the clinical pregnancy rate (risk ratio [RR], 1.48; 95% confidence interval [CI], 1.23-1.79), ongoing pregnancy rate (RR, 1.82; 95% CI, 1.31-2.53), and live birth rate (RR, 1.85; 95% CI, 1.44-2.38). However, intralipid administration had no beneficial effect on the miscarriage rate (RR, 0.75; 95% CI, 0.48-1.17). A funnel plot analysis revealed no publication bias. Our findings suggest that intralipid administration may benefit women undergoing in vitro fertilization, especially those who have experienced repeated implantation failure or recurrent spontaneous abortion. However, larger, well-designed studies are needed to confirm these findings.

The Effect of Banhabaekchulcheonma-tang on Benign Paroxysmal Positional Vertigo: A Systematic Review Using the CNKI Database (양성 돌발성 두위 현훈에 대한 반하백출천마탕(半夏白朮天麻湯)의 효과 : 체계적 문헌고찰 - CNKI 검색을 중심으로)

  • Gwon, Gi-hyeon;Oh, Seo-hye;Park, Eun-soo;Kim, Mi-hyeon;Hong, Seung-hyo;Song, Geum-ju;Park, Eun-young
    • The Journal of Internal Korean Medicine
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    • v.42 no.4
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    • pp.572-589
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    • 2021
  • Objectives: This study examines the effect of Banhabaekchulcheonma-tang on Benign Paroxysmal Positional Vertigo (BPPV) through a systematic review of randomized controlled trials (RCTs) in the Chinese National Knowledge Infrastructure Database (CNKI). Methods: RCTs were included that tested the effect of Banhabaekchulcheonma-tang on BPPV. A study of the literature in the CNKI was performed for papers published from January 1, 2011 to June 30, 2021. Results: A total of eight RCTs met the inclusion criteria. All studies identified the effect of Banhabaekchulcheonma-tang in the treatment of BPPV. The effectiveness of treatment was higher in the intervention group than in the control group, as shown through evaluation indicators, including the total effective rate, dizziness handicap inventory (DHI), and blood lipids. Conclusion: Treatment with Banhabaakchulcheonma-tang was found to be effective in treating BPPV. However, due to the low quality of available studies, the significance of this conclusion is somewhat limited. Further clinical studies are needed on the development of diagnosis and treatment methods for BPPV based on Korean medicine.

The Effectiveness of Non-pharmacological Interventions on Anxiety in Children Undergoing Surgery: A Systematic Review and Meta-analysis (수술 환아의 불안에 적용한 비약물적 중재의 효과: 체계적 문헌고찰 및 메타분석)

  • Kim, Hyeon-Young;Shin, Sun Hwa
    • Journal of East-West Nursing Research
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    • v.27 no.1
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    • pp.1-13
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    • 2021
  • Purpose: The purpose of this study was to examine the effectiveness of non-pharmacological interventions for reducing perioperative anxiety in children undergoing surgery. Methods: A systematic review of randomized controlled trials (RCTs) with the primary outcome of children's perioperative anxiety was conducted. The literature search was performed using various databases, including Cochrane Library, CINAHL, EMBASE, PubMed, and Korean electronic databases with confined to RCTs between 2000 and 2020. A total of sixteen studies were suitable the inclusion criteria and were systematically reviewed. The bias risk of randomized studies was evaluated using Cochrane's risk of bias tool. For the meta-analysis, RevMan 5.4 was used to analyze effect sizes of interventional factors. Results: Finally, twelve RCTs studies were used for meta-analysis. The non-pharmacological interventions implemented to reduce perioperative anxiety in children were therapeutic play, clown therapy and information provision. First, therapeutic play had a significant effect on reducing preoperative anxiety, with an effect size of -1.46 (95% CI=-1.78~-1.14). Second, clown therapy had a significant effect on reducing preoperative anxiety, with an effect size of -0.97 (95% CI=-1.45~-0.49). Finally, the provision of information had a significant effect on reducing preoperative anxiety, with an effect size of -0.75 (95% CI=-0.99~-0.51). Conclusion: This meta-analysis suggests that non-pharmaceutical interventions provide effective methods of reducing perioperative anxiety in children. Therefore, the findings verify evidence that various non-pharmacological interventions are effective means for reducing children's preoperative anxiety.

The Effect of Opae-san for Peptic Ulcer Disease: A Systematic Review and Meta-Analysis (소화성 궤양에 대한 오패산의 치료효과 : 체계적 문헌고찰과 메타분석)

  • Lee, Yu-ri;Cho, Na-kyung;Kim, Kyung-soon;Choi, Hong-sik;Kim, Seung-mo
    • The Journal of Internal Korean Medicine
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    • v.39 no.6
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    • pp.1136-1149
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    • 2018
  • Objectives: The aim of this study was to perform a meta analysis of randomized controlled trials (RCTs) that applied Opae-san to peptic ulcer. Methods: The databases NDSL, RISS, KISS, KISTI, Oasis, DBpia, Cochrane, EMBASE, Pubmed, and CNKI were searched to identify RCTs that evaluated the therapeutic response to Opae-san on peptic ulcer. The selected studies were assessed using Cochrane Group's risk of bias tool. Results: 12 RCTs were selected from a total of 312 identified. Combined therapies of Opae-san plus triple therapy were superior to only triple therapy in achieving the effective rate (risk ratio=1.26, 95% CI: 1.17 to 1.35, p<0.001, I2=0%), the helicobacter pylori eradication rate (risk ratio=1.23, 95% CI: 1.12 to 1.34, p<0.001, I2=7%) and the recurrence rate (risk ratio=0.31, 95% CI: 0.12 to 0.82, p=0.02, I2=0%). But only Opae-san was not superior in achieving the effective rate compared to anti gastric secretion drugs. Conclusions: The current evidence suggests that combined therapies of Opae-san plus triple therapy yield a higher effective rate, and helicobacter pylori eradication rate and a lower recurrence rate. However, in most of these studies, it is difficult to evaluate the bias and therefore better designed studies are needed.

Banhabaeckchulchunma-tang for Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-analysis (양성 발작성 자세변환성 현훈에 대한 반하백출천마탕(半夏白朮天麻湯)의 효과: 체계적 문헌고찰과 메타분석)

  • Kim, Geun-Lip;Hong, Chul-Hee;Lee, Kyou-Young
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.34 no.4
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    • pp.71-89
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    • 2021
  • Objectives : The purpose of this study is to evaluate the effect of Banhabaeckchulchunm a-tang(BBCT) for Benign Paroxysmal Positional Vertigo(BPPV) Methods : We searched randomized controlled trials(RCTs) which assess the effect of BB CT for BPPV through 8 electronic databases from their inception to July 2021. RevMan 5.4 was used to evaluate the risk of bias. Results : 12 RCTs with 901 subjects were included. The BBCT treatment group had significantly higher total effetive rate(TER) than the western medicine treatment group(P=0.0001), and the Dizziness Handicap Inventory(DHI) score(P=0.003), traditional chinese medicine syndrome(TCM syn.) score(P<0.00001), and Visual analog scale(VAS)(P=0.0006) were significantly lower than the western medicine treatment group. The combined treatment of BBCT and canalith repositioning procedure(CRP) group had significantly higher TER than only CRP treatment group(P=0.02), and there was no significant difference in DHI score(P=0.12). TG(P=0.006) and TC(P=0.04) were significantly lower, and ApoA1 was significantly higher(P=0.0001). There was no significant difference in LDL(P=0.24). Conclusions : These results demonstrate that BBCT could be effective for BPPV especially after CRP. However, because of limits of included studies such as high heterogeneity between the literatures, unclear risk of bias, insufficient reports of adverse events(AEs), a well-designed RCTs with a low risk of bias in more diverse countries are needed in the future.

Effects of Samryungbaekchul-san on Childhood Anorexia: A Systematic Review and Meta-Analysis (소아 식욕부진에 대한 삼령백출산(蔘苓白朮散)의 효과: 체계적 문헌고찰 및 메타분석)

  • Hesol, Lee;Sun Haeng, Lee;Gyu Tae, Chang;Boram, Lee
    • The Journal of Pediatrics of Korean Medicine
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    • v.37 no.1
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    • pp.1-14
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    • 2023
  • Objectives This study aimed to evaluate the effect of Samryungbaekchul-san on childhood anorexia. Methods We searched 11 English, Korean, Chinese, and Japanese databases for studies published up to May 30, 2022. Randomized controlled trials (RCTs) assessing the effect of Samryungbaekchul-san on childhood anorexia were included. In the meta-analysis, relative risk (RR) and 95% confidence intervals (CI) were indicated as dichotomous variables, and mean difference (MD) or standardized mean difference (SMD) and 95% CIs were indicated as continuous variables. Results We included 12 RCTs with 1345 participants. The Samryungbaekchul-san treatment group had a significantly higher total effective rate (TER) than that of the western medicine control group (RR 1.42, 95% CI 1.23-1.64, I2 = 0%). The combined Samryungbaekchul-san and western medicine treatment group had significantly higher TER (RR 1.31, 95% CI 1.23 to 1.40, I2 = 0%) and levels of neuropeptide Y (SMD 0.93, 95% CI 0.47-1.39, I2 = 70%) and ghrelin (SMD 1.45, 95% CI 1.14-1.76, I2 = 0%) than those of the western medicine alone group. Additionally, leptin levels were significantly lower in the combined treatment group (SMD -1.19, 95% CI -1.88 to -0.51, I2 = 86%) compared with the western medicine alone group, although statistical heterogeneity was substantial. Conclusions Samryungbaekchul-san may be effective for childhood anorexia. However, owing to limitations such as high clinical heterogeneity between the studies, unclear risks of biases, and insufficient reports of adverse events and follow-ups, well-designed RCTs with a low risk of bias are needed in the future.