• Title/Summary/Keyword: RCTs Review

Search Result 501, Processing Time 0.025 seconds

Survival of surface-modified short versus long implants in complete or partially edentulous patients with a follow-up of 1 year or more: a systematic review and meta-analysis

  • Medikeri, Raghavendra Shrishail;Pereira, Marisca Austin;Waingade, Manjushri;Navale, Shwetambari
    • Journal of Periodontal and Implant Science
    • /
    • v.52 no.4
    • /
    • pp.261-281
    • /
    • 2022
  • Purpose: Short implants are a potential alternative to long implants for use with bone augmentation in atrophic jaws. This meta-analysis investigated the survival rate and marginal bone level (MBL) of surface-modified short vs. long implants. Methods: Electronic and manual searches were performed for articles published between January 2010 and June 2021. Twenty-two randomized controlled trials (RCTs) comparing surface-modified short and long implants that reported the survival rate with at least 1 year of follow-up were selected. Two reviewers independently extracted the data, and the risk of bias and quality of evidence were evaluated. A quantitative meta-analysis was performed regarding survival rate and MBL. Results: The failure rates of surface-modified short and long implants differed significantly (risk ratio, 2.28; 95% confidence interval [CI], 1.46, 3.57; P<0.000). Long implants exhibited a higher survival rate than short implants (mean follow-up, 1-10 years). A significant difference was observed in mean MBL (mean difference=-0.43, 95% CI, -0.63, -0.23; P<0.000), favoring the short implants. Regarding the impact of surface treatment in short and long implants, for hydrophilic sandblasted acid-etched (P=0.020) and titanium oxide fluoride-modified (P=0.050) surfaces, the survival rate differed significantly between short and long implants. The MBL differences for novel nanostructured calcium-incorporated, hydrophilic sandblasted acid-etched, and dual acid-etched with nanometer-scale calcium phosphate crystal surfaces (P=0.050, P=0.020, and P<0.000, respectively) differed significantly for short vs. long implants. Conclusions: Short surface-modified implants are a potential alternative to longer implants in atrophic ridges. Long fluoride-modified and hydrophilic sandblasted acid-etched implants have higher survival rates than short implants. Short implants with novel nanostructured calcium-incorporated titanium surfaces, hydrophilic sandblasted acid-etched surfaces, and dual acid-etched surfaces with nanometer-scale calcium phosphate crystals showed less marginal bone loss than longer implants. Due to high heterogeneity, the MBL results should be interpreted cautiously, and better-designed RCTs should be assessed in the future.

Sodium Picosulphate with Magnesium Citrate versus Polyethylene Glycol for Bowel Preparation in Children: A Systematic Review

  • Dziechciarz, Piotr;Ruszczynski, Marek;Horvath, Andrea
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • v.25 no.3
    • /
    • pp.228-239
    • /
    • 2022
  • Purpose: To compare the effectiveness, tolerability, acceptability, and safety of sodium picosulphate with magnesium citrate (PS/Mg) and polyethylene glycol (PEG) in children (≤18 years) preparing for colonoscopy. Methods: Three electronic databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials) were searched till July 2020. Only randomized controlled trials (RCTs) were included. At least two authors independently selected studies and performed risk of bias assessment and data extraction. Results: Four RCTs (n=390), with overall good quality were included. A meta-analysis of two trials (n=224) found no statistically significant difference between the groups with respect to the proportion of patients who had excellent and good scores (≥6 points) according to the Boston Bowel Preparation Scale (relative risk: 0.99; 95% confidence interval [CI]: 0.90 to 1.08). Excellent and good scores were observed in both groups in approximately 90% of children. A meta-analysis of two other trials (n=150) showed no significant difference between the groups with respect to the mean total score for the Ottawa Bowel Preparation Scale (mean difference: 0.20; 95% CI: -0.74 to 1.14). Both regimens provided a comparable safety profile; however, PS/Mg was significantly superior to high volume PEG in terms of tolerability (abdominal pain, nausea, vomiting, bloating/flatulence/fullness) and acceptability (ease of formulation consumption, taste acceptance, need for nasogastric tube, compliance with full dose). Conclusion: PS/Mg provides a quality and safety profile similar to PEG for bowel cleansing; however, it has better acceptance and tolerance in children preparing for colonoscopy.

Chuna Manual Therapy on Gynecologic Disease: A Systematic Review and Meta-analysis (부인과 질환에 대한 추나 요법: 체계적 문헌 고찰 및 메타분석)

  • Yeon-Woo Lee;Jae-Uk Sul;Jin-Hyun Lee;Dong-Chan Jo;Yun-Kyung Song;Man-Suk Hwang
    • The Journal of Churna Manual Medicine for Spine and Nerves
    • /
    • v.17 no.2
    • /
    • pp.27-37
    • /
    • 2022
  • Objectives This study aimed to investigate the clinical trial trends of Chuna manual therapy (CMT) on gynecologic disease and suggest the effectiveness and safety evidence for further study. Methods We searched nine electronic databases (CENTRAL, CiNii, CNKI, EMBASE, KMbase, KISS, MEDLINE PubMed, NDSL, and OASIS) using the search terms "Chuna" and "Tuina" and identified relevant literature that investigated the CMT as an intervention for gynecologic disease. All relevant papers were extracted and selected to be analyzed. Results Among the 1456 studies that were searched and screened, 18 randomized controlled trials (RCTs) satisfied the designated criteria. A meta-analysis showed that CMT had a curative effect on patients with primary dysmenorrhea, postpartum hypogalactia, breast hyperplasia, postpartum urinary retention, and pelvic pain. Conclusions Based on this study, CMT should be comprehensively considered for gynecologic disease. The treatment response was significantly enhanced after treatment; however, there were some limitations in the study. More well-designed RCTs are needed to ensure that all gynecologic patients have a safe and effective therapy.

안구건조증의 침 치료에 대한 최근 임상 연구 동향 분석 - 2010년 이후 Pubmed, Cochrane Library 검색 중심으로

  • Ji-One Im;Ji-Young Choi;Seon-Young Jee;Min Hwangbo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
    • /
    • v.36 no.2
    • /
    • pp.10-25
    • /
    • 2023
  • Objectives : The purpose of this review is to validate the effectiveness of acupuncture treatment on dry eye syndrome. Methods : Through foreign online databases(Pubmed, Cochrane Library) and domestic online databases(Science On, OASIS) we only searched for Randomized controlled trials(RCTs) that performed acupuncture for dry eye syndrome from January 2010 to December 2022. Results : The most commonly used acupoints were 風池(GB20), 贊竹(BL2) and the most commonly used meridian was the gall bladder meridian of foot-shaoyang. The most commonly used evaluation criteria was Tear Break Up Time(TBUT) followed by Schirmer Test and Ocular Surface Disease Index(OSDI). In most of 8 studies, acupuncture treatment showed significant therapeutic effects. Conclusions : According to this study results, acupuncture can be suggested to effective way for treating dry eye syndrome. More clinical studies are needed to prove the effectiveness of the acupuncture on dry eye syndrome.

Timing of laparoscopic cholecystectomy after endoscopic retrograde cholangiopancreatography in cholelithiasis patients: A systematic review and meta-analysis

  • Napaphat Poprom;Wikran Suragul;Paramin Muangkaew;Watoo Vassanasiri;Narongsak Rungsakulkij;Somkit Mingphruedhi;Pongsatorn Tangtawee
    • Annals of Hepato-Biliary-Pancreatic Surgery
    • /
    • v.27 no.1
    • /
    • pp.20-27
    • /
    • 2023
  • There are many variations and unclear definitions of the appropriate timing of laparoscopic cholecystectomy (LC) after endoscopic retrograde cholangiopancreatography (ERCP), and there is still a lack of consistency about the appropriate timing. Inappropriate timing can be associated with serious comorbidity and can affect the patients. This meta-analysis was conducted to assess the operative outcomes and morbidity to provide a benefit to the patients based on the best timing of LC after ERCP. Randomized controlled trials (RCTs) and retrospective studies were identified from the PubMed and Scopus databases from inception to July 2021. A meta-analysis was performed to estimate the treatment effects on operative outcomes and morbidity. Four RCTs and four retrospective studies met our inclusion criteria. A meta-analysis indicated that patients who received LC after ERCP on the same day or within 72 hours had about 0.354 days shorter length of hospital stay with a shorter operative time of about 0.111-1.835 minutes and a lower risk of complications around 37%-73%. Our evidence suggests that the appropriate timing of LC after ERCP is either the same day or within 72 hours for treating cholelithiasis patients based on the severity of disease.

Neoadjuvant chemoradiotherapy versus immediate surgery for resectable and borderline resectable pancreatic cancer: Meta-analysis and trial sequential analysis of randomized controlled trials

  • Shahab Hajibandeh;Shahin Hajibandeh;Christina Intrator;Karim Hassan;Mantej Sehmbhi;Jigar Shah;Eshan Mazumdar;Ambareen Kausar;Thomas Satyadas
    • Annals of Hepato-Biliary-Pancreatic Surgery
    • /
    • v.27 no.1
    • /
    • pp.28-39
    • /
    • 2023
  • We aimed to compare resection and survival outcomes of neoadjuvant chemoradiotherapy (CRT) and immediate surgery in patients with resectable pancreatic cancer (RPC) or borderline resectable pancreatic cancer (BRPC). In compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards, a systematic review of randomized controlled trials (RCTs) was conducted. Random effects modeling was applied to calculate pooled outcome data. Likelihood of type 1 or 2 errors in the meta-analysis model was assessed by trial sequential analysis. A total of 400 patients from four RCTs were included. When RPC and BRPC were analyzed together, neoadjuvant CRT resulted in a higher R0 resection rate (risk ratio [RR]: 1.55, p = 0.004), longer overall survival (mean difference [MD]: 3.75 years, p = 0.009) but lower overall resection rate (RR: 0.83, p = 0.008) compared with immediate surgery. When RPC and BRPC were analyzed separately, neoadjuvant CRT improved R0 resection rate (RR: 3.72, p = 0.004) and overall survival (MD: 6.64, p = 0.004) of patients with BRPC. However, it did not improve R0 resection rate (RR: 1.18, p = 0.13) or overall survival (MD: 0.94, p = 0.57) of patients with RPC. Neoadjuvant CRT might be beneficial for patients with BRPC, but not for patients with RPC. Nevertheless, the best available evidence does not include contemporary chemotherapy regimens. Patients with RPC and those with BRPC should not be combined in the same cohort in future studies.

Vitamin D and Risk of Respiratory Tract Infections in Children: A Systematic Review and Meta-analysis of Randomized Controlled Trials (비타민 D와 소아 호흡기 감염의 위험성: 무작위 대조 연구에 대한 체계적 문헌고찰 및 메타분석)

  • Ahn, Jong Gyun;Lee, Dokyung;Kim, Kyung-Hyo
    • Pediatric Infection and Vaccine
    • /
    • v.23 no.2
    • /
    • pp.109-116
    • /
    • 2016
  • Purpose: Recent observational studies have found that vitamin D deficiency is associated with respiratory tract infections. However, randomized controlled trials (RCTs) regarding the efficacy of vitamin D in childhood respiratory tract infection (RTI) have yield inconsistent results. We performed a systematic review and meta-analysis to evaluate the association between vitamin D supplementation and the risk of RTI. Methods: A comprehensive search was conducted using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trial. Randomized controlled trials of vitamin D supplementation for prevention of RTI in children were included for the analysis. Cochrane Collaboration's tool for assessing the risk of bias was used to assess the quality of the studies. Pooled risk ratios with 95% confidence intervals (CIs) were meta-analyzed using Review Manager 5.3. Results: A total of seven RCTs were included in the meta-analysis. According to a random-effects model, the risk ratio for vitamin D supplementation was 0.82 (95% CI: 0.69-0.98) and $I^2=62%$ for heterogeneity. On subgroup analysis, heterogeneity decreased in the subgroup with follow-up less than 1 year, participants ${\geq}5years$ of age, patients subgroup, and subgroup with dosing daily. Funnel plot showed that there might be publication bias in the field. Conclusions: The present meta-analysis supports a beneficial effect of vitamin D supplementation for the prevention of RTI in children. However, the result should be interpreted with caution due to limitations including a small number of available RCTs, heterogeneity among the studies, and potential publication bias.

Effects of Lumbar Mobilization for Lower Limb Strength in Healthy Individuals: A Protocol for Systematic Review and Meta-Analysis

  • Choi, Wansuk;Choi, Taeseok;An, Hojung;Kim, Jisung;Heo, Seoyoon
    • Journal of International Academy of Physical Therapy Research
    • /
    • v.11 no.2
    • /
    • pp.2096-2101
    • /
    • 2020
  • Background: The effect of mobilization on lumbar back pain has been fully described in several clinical aspects, but evidence for muscle strength would be still less clear. Objective: To assess the effect of lumbar mobilization on lower limb strength in healthy individuals. Methods and Analysis: Healthy people aged 18-65 will be included regardless of race or sex. Original peer-reviewed primary reporting randomized controlled trials (RCTs) will be included. Electronic databases, such as MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, Pedro, CINAHL, ClinicalTrials.gov will be searched from inception until July 30. Only studies published in English will be included in this review. Two reviewers will complete the screening for eligibility independently, and the other two reviewers will also complete the risks of data extraction and bias assessment independently. Lower Limb strength will be assessed as primary outcome, and particular intervention or participant characteristics will be assessed as the secondary outcomes. Meta-analysis will be conducted using Review Manager 5.3.3, and evidence level will be assessed using the method for Grading of Recommendations Assessment, Development and Evaluation. Outcomes will be presented as the weighted mean difference or standardized mean difference with 95% CI. If I2 ≤ 50%, P>.1, the fixed effect model will be used, otherwise, random-effects model will be used. Ethics and dissemination: This review might not be necessary ethical approval because it does not require individual patient's data; these findings will be published in conference presentations or peer-reviewed journal articles. PROSPERO registration number: CRD42020150144.

Efficacy and Safety of the Antidiabetic effect of Hwangryunhaedok-tang for Type 2 Diabetes Mellitus Patients without Complications: A Systematic Review and Meta-Analysis (합병증을 동반하지 않은 2형 당뇨병 환자에 대한 황련해독탕의 혈당 강하 효과에 대한 유효성과 안전성 : 체계적 문헌 고찰과 메타분석)

  • Baek, Ji-soo;Shin, Seon-mi;Shin, Dong-guk;Cho, Chung-sik
    • The Journal of Internal Korean Medicine
    • /
    • v.42 no.4
    • /
    • pp.605-621
    • /
    • 2021
  • Objectives: The purpose of this review is to assess the efficacy and safety of Hwangryunhaedok-tang for type 2 diabetes without complications by systemic review and meta-analysis of randomized controlled trials (RCTs). Methods: We searched the following up to March 31. 2021: PubMed, EMBASE, The Cochrane Library, CNKI, CiNii, KISS, KMBASE, OASIS, ScienceON. Data extraction and assessment of Cochrane's risk of bias (RoB) tool were performed by two independent authors, and if there was disagreement between two researchers, it was resolved through the intervention of a third researcher. Results: A total of seven trials are included in this systemic review. The treatment group (Hwangryunhaedok-tang plus conventional treatment) showed more statistically significant effects than did the control group (conventional treatment only) in fasting plasma glucose level, 2-hour postprandial plasma glucose level, glycated hemoglobin A1c, fasting insulin level, and HOMA-IR. There was no significant difference between the treatment group (Hwangryunhaedok-tang alone) and the control group (metformin alone). Conclusion: Hwangryunhaedok-tang might have efficacy and safety in controlling blood sugar level and improving insulin-resistance. However, the number of studies included in the meta-analysis was insufficient, and the Hwangryunhaedok-tang used in the included studies was not standardized. Also, the quality of the involved studies was generally low. Therefore, further studies are needed to determine the efficacy and safety of Hwangryunhaedok-tang treatment for type 2 diabetes mellitus.

A Study on the Hypoglycemic Effect and Safety of Combined-Therapy of Baekhogainsam-tang and Hypoglycemic Agent for Type 2 Diabetes Mellitus Patients without Complications: A Systematic Review and Meta-Analysis (합병증을 동반하지 않은 2형 당뇨병 환자에 대한 백호가인삼탕과 혈당강하제 병행치료의 혈당 강하 효과 및 안전성 연구 : 체계적 문헌 고찰과 메타분석)

  • Shin, Jae-ik;Baek, Ji-soo;Shin, Seon-mi;Cho, Chung-sik
    • The Journal of Internal Korean Medicine
    • /
    • v.42 no.4
    • /
    • pp.672-686
    • /
    • 2021
  • Objectives: The purpose of this study is to assess the efficacy and safety of Baekhogainsam-tang for type 2 diabetes without complications by systemic review and meta-analysis of randomized controlled trials (RCTs). Methods: For a systematic review and meta-analysis, we set a key question in accordance with PICOT-SD. We searched the following up to March 31. 2021: PubMed, EMBASE, The Cochrane Library, CNKI, CiNii, KISS, KMBASE, OASIS, and ScienceON. A meta-analysis was conducted by synthesizing the results, including fasting plasma glucose level, postprandial 2-hour plasma glucose level, and Glycated Hemoglobin (HbA1c). Results: A total of five trials are included in this systemic review. The treatment group (Baekhogainsam-tang plus conventional treatment) showed more statistically significant effect than did the control group (conventional treatment only) in fasting plasma glucose level, postprandial 2-hour plasma glucose level, and glycated hemoglobin (HbA1c). Conclusions: Baekhogainsam-tang showed statistically significant effects in hypoglycemic effect and in improving insulin resistance. However, the number of studies included in the meta-analysis was insufficient, and the BIT used in the included studies was not standardized. This topic requires further attention and more clinical research.