• Title/Summary/Keyword: RCTs Review

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Chuna Manual Therapy for Headache : A Systematic Review and Meta-analysis (두통에 대한 추나요법의 효과 : 체계적 문헌고찰과 메타분석)

  • Kim, Dae-Hun;Hwang, Eui-Hyoung;Heo, In;Kim, Byung-Jun;Bae, Ji-Min;Kim, Jae-Kyu
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.10 no.2
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    • pp.1-12
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    • 2015
  • Objectives : To determine the effectiveness of Chuna manual therapy for headache Methods : We searched 6 electronic databases(Pubmed, CAJ, Oasis, RISS, DBPIA, KoreanTK) and 2 journals up to Oct 2015. We included randomized controlled trials(RCTs) using Chuna manual therapy for headache. The methodological quality of each RCT was assessed by the Cochrane risk of bias tool. Results : 9 RCT studies were eligible in our review. The meta-analysis of 6 studies showed favorable results for the use of Chuna manual therapy. High risk of bias were observed in all studies. Conclusions : Although there are favorable results with meta-analysis, our systematic review arehighly dependent on the single source of Chinese electrical database, CAJ. Now limited evidence is available tosupport Chuna manual therapy for headache and further well-designed RCTs should be encouraged.

A Systematic Review of Bee Venom Acupuncture for Knee Osteoarthritis (무릎 골관절염의 봉독 약침 치료에 대한 체계적 문헌 고찰)

  • Gu, Ji-Hyang;Kim, Eunseok;Park, Yang-Chun;Jung, In Chul;Lee, Eun-Jung
    • Journal of Korean Medicine Rehabilitation
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    • v.27 no.3
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    • pp.47-60
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    • 2017
  • Objectives The aim of this research is to assess the effects of bee venom acupuncture for knee osteoarthritis. Methods For a systematic review, we constructed a key question as the effect of bee venom acupuncture for knee osteoarthritis and selected RCTs and nRCTs. We searched the following 15 databases without a language restriction: Pubmed, EMBASE, Cochrane CENTRAL (CENTRAL), CINAHL, AMED, seven Korean medical databases (KoreaMed, Kmbase, KISS, NDSL, KISTI, Koreantk, OASIS) and three Chinese databases including CNKI, Wanfang and VIP database. Results A total of 300 potentially relevant studies were identified; only 13 studies were selected for systematic review. Almost studies showed that bee venom acupuncture has significant effect on knee osteoarthritis. 5 studies comparing bee venom acupuncture with acupuncture were included in the meta-analysis. The effect size of standardized mean difference (SMD) was analyzed as 'small effect' with 0.47 (95% CI: 0.10~0.83, Z=2.49, p=0.01). Conclusions The research showed that bee venom acupuncture can significantly reduce pain, stiffness and improve the quality of life of patients with knee osteoarthritis. However, most of the studies included in the analysis were evaluated as methodologically high risk of bias. This suggests that there is limitation applying this study. In the future, more Randomized Controlled trial should be actively conducted.

Preventive Effects of Fluoride Gel Application on Dental Caries in the Permanent Tooth: A Systematic Review of Randomized Controlled Trials

  • Do, Kyung-Yi;Lee, Eun-Sun
    • Journal of dental hygiene science
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    • v.19 no.1
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    • pp.9-22
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    • 2019
  • Background: The purpose of this systematic review was to investigate the effects of topical fluoride gel application on dental caries prevention in the permanent teeth of children and adolescents. Methods: We searched the EMBASE, PubMed, and Cochrane Library databases for randomized controlled trials (RCTs) assessing the effects of self-applied or professionally applied topical fluoride gels in patients <18 years of age; the search was completed on April 1, 2018. All included trials involved an experimental group (fluoride gel application) and a control group (placebo or no treatment). The outcome measures were the D(M)FS and D(M)FT indices, which were compared between the two groups. Review Manager software was used for quantitative synthesis of the final selected articles, and a forest plot was generated via a meta-analysis conducted using a random effects model. Results: The results showed that the D(M)FS and D(M)FT indices were lower in the fluoride application group than in the control group, thus indicating that fluoride gel application was effective in dental caries prevention. We also performed a subgroup analysis to determine whether the effects of fluoride application differed if patients received oral prophylaxis (self or professional) before fluoride gel application. Therefore, the two groups showed slightly larger differences when studies without oral prophylaxis before fluoride gel application were considered; however, the difference was not statistically significant. Conclusion: These findings should be utilized to raise awareness about the caries-prevention effects of topical fluoride application among patients and guardians. Further RCTs should evaluate the effects of fluoride application with or without preceding oral prophylaxis, and appropriate fluoride application guidelines should be developed to maximize the effects of fluoride application in clinical practice.

Effectiveness of Exercise after Lung Cancer Surgery: A Systematic Review in PubMed Database (폐암 수술 후 운동의 효과: PubMed 내 연구에 대한 체계적 문헌고찰)

  • Jerng, Ui Min
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.1
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    • pp.149-163
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    • 2021
  • Objectives This study is to review the effectiveness of exercise after lung cancer surgery. Methods Relevant randomized controlled trials (RCTs) were searched in PubMed database. The systematic review was conducted through flow diagram. The risk of biases were assessed through the Cochrane guideline. Characteristics and outcomes were extracted from each study. Meta-analyses of forced expiratory volume in one second (FEV1), 6-minute walk test (6MWT), quality of life (QoL), pulmonary complications were conducted. Results 14 RCTs were selected. In meta-analysis, exercise improved FEV1 (mean difference [MD] 0.14; 95% confidence interval [CI] 0.04 to 0.25; p=0.009; I2=55%) and mean change of FEV1 (MD 0.11; 95% CI 0.02 to 0.20; p=0.02; I2=0%). Exercise increased the distance of 6MWT, but there was considerable heterogeneity (MD 45; 95% CI 21.16 to 68.83; p=0.0002, I2=89%). There was no differences in QoL scores by 2 questionnaires (European Organisation for Research and Treatment of Cancer quality of life questionnaire, short form-36). Exercise reduced the duration of hospital stay (MD -3.32; 95% CI -5.27 to -1.36; I2=0%; 2 studies) but not duration of chest tube intubation (MD -1.37; 95% CI -2.81 to 0.06; I2=0%) and incidence of pulmonary complications (pooled risk ratio 0.54; 95% CI 0.23 to 1.30; I2=0%). Conclusions Exercise might reduce the duration of hospital stay after lung surgery. There was not enough evidence to prove improvement of lung function, aerobic capacity, muscle strength, QoL, and decline of pulmonary complications. Low-quality risk of bias, different units or estimation of outcome, different exercise type and duration, heterogeneity among studies make the evidence of effectiveness weak. Future researches are required to redeem these defects.

Electromechanically assisted walking in patients with cerebral palsy: A meta-analysis

  • Kim, Kwonhoi;Lee, Sukmin
    • Physical Therapy Rehabilitation Science
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    • v.10 no.1
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    • pp.22-31
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    • 2021
  • Objective: This review aims to analyze the effects of electromechanically assisted walking in patients with cerebral palsy(CP). Design: A systematic review and meta-analysis. Methods: We reviewed systematically using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist guidelines. The inclusion criteria for this study were all CP patients. The intervention was electromechanically assisted walking. The outcome measures included gait parameters, function, spasticity. Studies excluded from this review were excluded from the review if they were non-English languages and if the study was not published as a full report, and if they were not randomized controlled trials (RCTs) designs. The RevMan 5.4 program was used to evaluate and explain the results. The risk of bias was evaluated independently by two reviewers. The quantitative meta-analysis, including mean differences (MD) and associated standard deviations (SD) from baseline and follow-up assessments, were recorded. Results: A total of 634 articles were searched. Two hundred eighty-nine duplicate articles were excluded, and 345 of 634 originals were left for selection. Of these 74 papers, 44 were out of topic, and 19 reported no mean or standard deviation values. And one was a non-experimental study. Finally, ten studies were included. All 10 RCTs of electromechanically assisted walking were analyzed. The meta-analysis showed a significant improvement in gait cycle (95% CI (confidence intervals), 0.09 to 0.19, I2=0%), Gross Motor Function Measure (GMFM) D (95% CI, 3.27 to 13.17, I2=0%) and GMFM E (95% CI, 0.22 to 6.41, I2=0%). Conclusions: Electromechanically assisted training helps in walking in patients with CP.

Efficacy of Manual Therapy for Knee Meniscus Injuries: A Systematic Review and Meta-Analysis (반월상 연골 손상에 대한 수기치료의 효과: 체계적 고찰 및 메타분석)

  • Seok-Beom Kang;Han-Byeol Park;Woo-Seok Shon;Young-Jun Kim;Chang-Hoon Woo
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.17 no.2
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    • pp.17-25
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    • 2022
  • Objectives This study aimed to evaluate the efficacy of manual therapy for knee meniscus injuries. Methods We searched seven electronic databases (MEDLINE, Cochrane Library, CAJ, Wanfang, RISS, ScienceON, and OASIS) to collect randomized controlled trials (RCTs) using the keywords "manual therapy OR chuna OR tuina" and "meniscus injury." Results Eleven RCTs were selected based on the inclusion criteria, and all studies were conducted in China. Five studies were meta-analyzed. The systematic review revealed a positive effect of manual therapy for knee meniscus injury. Low risk of selection, attrition, and reporting bias were demonstrated in all studies. Ten studies had a high risk of performance bias. Conclusions The systematic review reported favorable results using manual therapy for knee meniscus injury. However, this study has several limitations because of the high risk of bias. Further clinical studies and reviews with higher levels of evidence are warranted.

A Systematic Review and Quality Assessment of Scalp Acupuncture for Musculoskeletal Diseases: Focused on Randomized Controlled Trials (근골격계 질환의 두침치료에 대한 체계적 문헌 고찰과 질 평가: 무작위 배정 대조 임상연구를 중심으로)

  • Do-Hun Kong;Byung-Cheul Shin
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.4
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    • pp.61-78
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    • 2023
  • Objectives This systematic review aimed to analyze the effectiveness, safety and the reporting quality of scalp acupuncture (SA) treatment for musculoskeletal disease (MSD). Methods Eleven databases were systematically searched up to July 12th 2023. Randomized controlled trials (RCTs) of SA treatment for MSD were selected manually by the inclusion criteria. The risk of bias of RCTs was assessed using the Cochrane's Risk of Bias (RoB) 1.0 and the reporting quality of studies was evaluated using Consolidated Standards of Reporting Trials (CONSORT) 2010 statement and Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) 2010 checklist. Results Ten clinical studies were met the inclusion criteria. Most of studies reported SA treatment significantly alleviated pain and functional disability of MSD patients and no serious adverse effects were reported. In RoB assessment, blinding of participants and personnel was found to have the highest RoB and allocation concealment was found to have the most unclear RoB. In CONSORT 2010 statement evaluation, all studies reported 15.3 items (41.4%) on average. In STRICTA 2010 checklist evaluation, all studies reported 11.2 items (65.9%) on average. Conclusions The systematic review found that SA treatment may alleviate pain and functional disability of MSD patients and have little severe adverse effect. The reporting quality of included studies was mainly low, therefore, further studies with strict adherence to the CONSORT and STRICTA checklist should be encouraged.

Effect of Hwanggigyejiomul-tang on Postoperative Breast Cancer-related Lymphedema (BCRL): A Systematic Review and Meta-analysis (수술 후 발생한 유방암 연관 림프 부종(BCRL)에 대한 황기계지오물탕(黃芪桂枝五物湯)의 효과 : 체계적 문헌 고찰 및 메타 분석)

  • Yeong-seo Lee;Ye-seul Kim;Young-kyun Kim;Kyoung-min Kim
    • The Journal of Internal Korean Medicine
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    • v.45 no.1
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    • pp.31-54
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    • 2024
  • Objectives: This study assessed the effectiveness of Hwanggigyejiomul-tang for postoperative breast cancer-related lymphedema (BCRL) by a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: A search was conducted using keywords such as "breast cancer", "lymphedema", "edema", "Huangqi Guizhi Wuwu decoction", "Huangqi Guizhi Wuwu tang", and "Hwanggigyejiomul tang" in 10 databases (PubMed, Cochrane, ScienceDirect, CNKI, CiNii, RISS, KISS, ScienceON, OASIS, DBpia) on February 11, 2024. There were no limits on the publication period and language, and the quality of the studies was evaluated using Cochrane's risk of bias tool. A meta-analysis was performed based on the outcome measurements, such as total effective rate (TER), increase in shoulder joint mobility (flexion, extension, abduction, adduction), Fugl-Meyer assessment (FMA), and visual analog scale (VAS) using Review Manager Web. Results: Eleven RCTs were selected. The treatment group (Hwanggigyejiomul-tang-gagambang or hapbang with control group intervention) showed a more statistically significant effect compared with the control group (physical therapy or western medicine) in TER (upper limb circumference change), TER (upper limb edema grade change), increase in flexion angle, increase in extension angle, increase in adduction angle, FMA, and VAS. Conclusions: Hwanggigyejiomul-tang is effective in treating postoperative BCRL. However, because of the low quality of the included studies, more clinical studies are required to increase the possibility of clinical use.

Herbal Medicine Treatment for Cold Urticaria: A Systematic Review and Meta-Analysis (한랭 두드러기에 대한 한약 치료: 체계적 문헌 고찰 및 메타분석)

  • Hae-Na Kim;Jeong-Hwa Oh;Hwa-Jung Yoon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.36 no.4
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    • pp.122-144
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    • 2023
  • Objectives : The purpose of this study is to evaluate the effects of herbal medicine treatment in patients with cold urticaria. Methods : We searched randomized controlled trials(RCTs) reporting the effects of herbal medicine for cold urticaria through domestic and international databases from their inception to September 2023. The results were summarized in tables. We assessed the risk of bias in included RCTs through Cochrane risk of bias tool and the data synthesis was conducted through RevMan version 5.4. Results : A total of 12 RCTs were included in this review and all trials compared herbal medicine alone treatment(treatment group) with western medicine alone treatment(control group). The total effective rate(TER) of treatment group was statistically higher than that of control group(RR: 1.49, 95% CI: 1.38 to 1.62, p<0.00001, I2=65%). On the other hand, when comparing except for 1 trial with different evaluation period, the TER of treatment group was statistically higher than that of control group and heterogeneity was very low(RR: 1.36, 95% CI: 1.26 to 1.47, p<0.00001, I2=0%). And when comparing 8 trials using the total symptom score(TSS) change index as an indicator of TER, the TER of treatment group was statistically higher than that of control group and heterogeneity was very low(RR: 1.38, 95% CI: 1.26 to 1.51, p<0.00001, I2=0%). The treatment group showed more statistically significant decrease compared to the control group in TSS(MD: -2.51, 95% CI: -2.63 to -2.40, p<0.00001, I2=99%). The relapse rate of treatment group was statistically lower than that of control group(RR: 0.19, 95% CI: 0.10 to 0.40, p<0.00001, I2=0%). Mild adverse events such as sleepiness, dizziness were reported in control group and gastric discomfort was reported in treatment group. In the risk of bias assessment, many cases were evaluated as 'Unclear risk'. Conclusions : This review found that herbal medicine alone treatment could more effective and safe than western medicine alone treatment for cold urticaria. But further well-designed researches are needed because of heterogeneity between trials and the quality of the included trials.

Literature Review on clinical studies for cold hypersensitivity of hands and feet -Focusing on journals published in Korea (수족냉증의 임상연구에 관한 문헌적 고찰 - 국내에 출판된 논문을 중심으로 -)

  • Lee, Hye-Sol;Han, In-Sik;Sun, Seung-Ho;Kim, Geun-yeob;Go, Ho-Yeon;Kim, Tae-Hoon;Lee, Jin-Moo;Jang, Jun-Bok;Song, Yun-Kyung;Ko, Seong-Gyu;Choi, You-Kyung;Jeong, Jong-Jin;Ko, Youme;Jeong, Keum Ran;Jeon, Chan-Yong
    • Journal of Society of Preventive Korean Medicine
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    • v.21 no.1
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    • pp.83-93
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    • 2017
  • Objectives : This study's aim is to investigate clinical studies of cold hypersensitivity of hands and feet (CHHF) published in Korea and to explore the direct of future research. Methods : We searched clinical studies of CHHF using the database, such as DBpia(http://www.dbpia.co.kr/), NDSL(www.ndsl.kr), OASIS(http://oasis.kiom.re.kr), and RISS(www.riss.kr). The search words were 'cold hypersensitivity(冷症)' and 'syncope(厥證)'. Inclusion criteria were randomized controlled trials (RCTs), non RCTs, Before and after clinical study (B&A) about CHHF. Selection journals and data extraction were conducted by HS Lee and SH Sun independently. Results : Total twenty-one articles were selected finally. RCTs, non-RCTs, and B&A were 3, 12, and 6, respectively. The topics for CHHF were classified into three categories: effect of treatment (n=2) characteristics (n=11), and diagnosis (n=8). Conclusions : This results showed that RCT about CHHF and treatment effect of cold hypersensitivity of hands and feet were small in number. Further systemic and larger studies about CHHF will be needed.