• Title/Summary/Keyword: Risk of Bias

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Herbal Medicine for Cervical Intraepithelial Neoplasia After Loop Electrosurgical Excision Procedure: A Systematic Review and Meta-Analysis (자궁경부 상피내종양의 환상투열요법 후 한약치료의 효과 : 체계적 문헌고찰 및 메타분석)

  • Lee, Su-Jeong;Ji, Hae-Ri;Lee, Hye-Jung;Hwang, Deok-Sang;Lee, Chang-Hoon;Jang, Jun-Bock;Lee, Jin-Moo
    • The Journal of Korean Obstetrics and Gynecology
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    • v.33 no.2
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    • pp.44-62
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    • 2020
  • Objectives: The purpose of this study is to evaluate the effectiveness of herbal medicine for recovery and treatment of cervical intraepithelial neoplasia (CIN) after loop electrosurgical excision procedure (LEEP). Methods: We searched two english, one chinese and four korean database up to November 4, 2019. Randomised controlled trials (RCTs) were eligible. Primary outcome included Human papilloma virus (HPV) clearance rate and the effective ratio of treatment. And vaginal bleeding time and volume, improvement of symptoms, and recovery of wound were regarded as secondary outcomes. The risk of bias was assessed by two independent authors using the Cochrane risk of bias tool. Results: Of 47 screened, 10 RCTs were included. Number of participants per study ranged from 58 to 360. The studies which used HPV clearance rate as primary outcome were considered as low risk of bias. Most of the studies had considerable heterogeneity in terms of type of intervention, comparison and time-points for outcome measurement. Compared to LEEP alone, herbal vaginal suppository combined group showed favorable results for HPV clearance in patients (5 studies, n=627, 95% CI 1.26 to 1.55, I2=75%). And compared to LEEP alone, herbal external application also showed favorable results for HPV clearance in patients (2 studies, n=252, 95% CI 1.19 to 1.61, I2=86%). Three studies reported mild and temporary adverse events, and no serious adverse events were reported. Conclusions: The studies showed that herbal medicine can significantly effective on recovery of CIN after LEEP. However, included studies suffered from incomplete reporting, high or unclear risk of bias and substantial heterogeneity between studies. In the Future, further high-quality RCTs are needed to prove effectiveness of herbal medicine for CIN after LEEP and reduce the risk of bias.

Korean Medicine for Thoracolumbar Compression Fracture in Korean Literature : a Systematic Review (흉요추 압박 골절의 한의학적 치료에 대한 국내 임상 근거 : 체계적 문헌 고찰)

  • Bae, Ji Min;Kim, Dae Hun;Kim, Jae Kyu;Lee, Byung Ryul;Yang, Gi Young;Kim, Kun Hyung
    • Journal of Acupuncture Research
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    • v.32 no.4
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    • pp.147-156
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    • 2015
  • Objectives : This study aims to evaluate the effectiveness and safety of Korean medicine for a thoracolumbar compression fracture. Methods : We searched six Korean databases (DBPIA, Korean Studies Information Service System, Oriental Medicine Advanced Searching Integrated System, National Digital Science Library, Research Information Sharing Service, KoreaMed) (up to June 2015) and the Journal of Korean Acupuncture and Moxibustion Society. Unpublished studies were also searched. Clinical research, other than case reports involving less than 10 patients, were eligible. The effectiveness and safety of Korean Medicine was analyzed. The 'Risk of Bias' was assessed using the 'Risk of Bias' assessment tool for non-randomized studies as well as the Cochrane Collaboration's 'Risk of Bias' tool. Results : We found 12 before-after studies (374 patients). There was no randomized trial. All studies combined at least three different types of Korean medicine treatments. The period of treatment varied between less a week and 154 days. All the included studies reported improvements in pain, functional disability related to lower back pain, global assessment, and benefits in the compression ratio of a fractured vertebrae and skin temperature measured by digital infrared thermal imaging in comparison with the baseline. However, all studies had a high risk of bias and three studies reported mild adverse events. Conclusions : There is no randomized trial for the role of Korean medicine for patients with a thoracolumbar compression fracture. The effectiveness and safety of Korean medicine for this population remains unclear. Findings in this review are seriously biased due to observational design and a high risk of bias included in the studies. Future high-quality randomized trials are warranted.

Clinical Effect of Gyeongok-go: A Systematic Review of Randomized Controlled Trials (경옥고의 임상 효능 : 체계적 고찰)

  • Kang, Heekyung;Han, Changwoo
    • The Journal of Internal Korean Medicine
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    • v.43 no.3
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    • pp.423-435
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    • 2022
  • Purpose: The purpose of this study was to confirm the clinical efficacy of Gyeongok-go. Methods: Public/Publisher MEDLINE (PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), Excerpta Medica dataBASE (EMBASE), Research Information Sharing Service (RISS), ScienceON, Korean Traditional Knowledge Portal (KTKP), and China National Knowledge Infrastructure (CNKI) were searched for randomized controlled clinical trials administering Gyeongok-go as an intervention, published from inception to December 31, 2021. The risk-of-bias of the included trials was assessed with the Cochrane risk-of-bias tool for randomized trials version 2. From the experimental and control groups of the selected trials, the mean value (or rate) of each outcome was extracted and statistically compared. Results: Statistically significant mean differences were in VO2max (MD 6.82), post-exercise heart rate (MD -8.76 at 5 min, -11.58 at 30 min, -14.6 at 60 min), senescence scale (MD -6.52), Th1 cells and Th2 cells in pulmonary tuberculosis (MD 2.79 and -1.64), yin-deficient and qi-deficient score (MD -9.64 and -9.76), and phlegm-dampness score (MD 5.56). Overall risk-of-bias was 20% low risk, 80% some concerns, and 0% high risk. There were no reports of adverse events. Conclusions: Gyeongok-go is likely to have the effect of improving cardiorespiratory endurance, increasing fatigue recovery ability, reducing senescence, and enhancing immune function in tuberculosis patients. Also, it is more suitable for those who are yin-deficient or qi-deficient, and those with phlegm-dampness probably need caution.

East Asian Traditional Medicine Treatment for Patients after Heart Valve Replacements: A Systematic Review with Meta-Analysis (심장판막 치환술 후 한의학적 치료에 대한 체계적 문헌고찰 및 메타분석)

  • Ahn, Mu-hyeok;Kim, Ji-ho;Shin, Bong-jin;Kwon, Jung-nam
    • The Journal of Internal Korean Medicine
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    • v.43 no.4
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    • pp.720-737
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    • 2022
  • Objectives: To compare the effectiveness and safety of East Asian traditional medicine treatments (EATMT) versus conventional management in patients following heart valve replacement surgery. Methods: We searched several databases, including the Korean Studies Information Service System, PubMed, China National Knowledge Infrastructure, and Citation Information by NII. The search range included randomized controlled trials from each first issue until June 27, 2021. Two review authors independently extracted the data. We assessed the risk of systematic errors by evaluating risk domains using the "Risk of bias" tool. Results: We included 5 trials in the review. In the EATMT, the investigators reported significant improvements in reshaping of the heart structure: left ventricular end diastolic diameter (MD -4.43, 95% CI -6.06 to -2.79; 130 participants; 2 studies; high evidence). Comparisons with usual care revealed a significant decrease in gastrointestinal complications rate (OR 0.30, 95% CI 0.20 to 0.47; 503 participants; 2 studies; high evidence). We assessed 4 studies as having a low risk of bias and 1 study as having a high risk of bias. Conclusion: This systematic review suggests that East Asian traditional medicine interventions may be effective in preventing and alleviating complications, but we found evidence of important trade-offs between known benefits and known adverse effects in cardiac dysfunction and inflammation following heart valve replacement. Consequently, additional high-quality studies should be conducted.

A comparison study on the estimation of the relative risk for the unemployed rate in small area (소지역의 실업률에 대한 상대위험도의 추정에 관한 비교연구)

  • Park, Jong-Tae
    • Journal of the Korean Data and Information Science Society
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    • v.20 no.2
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    • pp.349-356
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    • 2009
  • In this study, we suggest the estimation method of the relative risk for the unemployment statistics of a small area such as si, gun, gu in Korea. The considered method are the usual pooled estimator, weighted estimator with the inverse of log-variance as weights, and the Jackknife estimator. And we compare with the efficiency of the three estimators by estimating the bias and mean square errors using real data from the 2002 Economically Active Population Survey of Gyeonggi-do. We compute the unemployed rate of male and female in small areas, and then estimate the common relative risk for the unemployed rate between male and female. Also, the stability and reliability of the three estimators for the common relative risk was evaluated using the RB(relative bias) and the RRMSE(relative root mean square error) of these estimators. Finally, the Jackknife estimator turned out to be much more efficient than the other estimators.

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Improving Security Awareness about Smishing through Experiment on the Optimistic Bias on Risk Perception (위험인식의 낙관적 편향 실험을 통한 스미싱 보안인식 개선)

  • Kang, Ji Won;Lee, Ae Ri;Kim, Beomsoo
    • Journal of the Korea Institute of Information Security & Cryptology
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    • v.26 no.2
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    • pp.475-487
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    • 2016
  • Recently, various risks of smartphone hacking are emerging. Smishing crime techniques become more cunning and its damage has been increasing, thereby requiring effective ways of preventing and coping with smishing. Especially, it is emphasized the need for smartphone users' security awareness and training besides technological approach. This study investigates the effective method for providing news messages in order to improve the perception of risk from smishing. This research empirically examines that the degree of optimistic bias on risk perception can vary depending on news frame, topic type, and involvement regarding smishing. Based on the findings, it identifies the factors influencing risk perception and verifies effective ways of promoting individual security awareness on smishing. The results of this study provide implications that assist in educating, campaigning and promoting information security awareness for smart device users.

Understanding and Exploring Weight-Based Bias, Stigma, and Discrimination (비만에 대한 편견, 낙인, 차별 및 이에 대한 개선 방안)

  • Kayoung Lee
    • Archives of Obesity and Metabolism
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    • v.2 no.1
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    • pp.1-5
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    • 2023
  • The importance of weight discrimination for people with obesity has been highlighted by research which has found that more than 40% of those living with obesity have experienced weight discrimination. Evidence suggests that weight bias among obese individuals puts their health at risk more than health issues caused by obesity itself. Although bias, stigma, and discrimination towards individuals living with obesity are factors that make it difficult for them to lose weight, weight bias and stigma among healthcare professionals are common, causing individuals living with obesity to avoid treatment and potentially exacerbating obesity-related health issues. The concept that one's own efforts matter contributes to stigma, discrimination, and bias. This issue will be more frequent among primary care providers treating individuals living with obesity; thus, it is important to acknowledge the issues of bias, stigma, and discrimination towards individuals living with obesity and to seek out solutions. In this review, I will discuss the concept of weight bias, stigma, and discrimination, the problems they cause, and seek solutions to weight prejudice, stigma, and discrimination.

Effect of endodontic sealer on postoperative pain: a network meta-analysis

  • Cynthia Maria Chaves Monteiro;Ana Cristina Rodrigues Martins;Alessandra Reis;Juliana Larocca de Geus
    • Restorative Dentistry and Endodontics
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    • v.48 no.1
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    • pp.5.1-5.22
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    • 2023
  • This systematic review and network meta-analysis aimed to answer the following focused research question: "Does the type of endodontic sealer affect the postoperative pain in patients who received endodontic treatment?" Different databases and grey literature were surveyed. Only one randomized controlled trial were included. The risk of bias in the studies was evaluated by using the Cochrane Collaboration's tool. A random-effects meta-analysis was conducted to compare the risk and intensity of postoperative pain. The quality of the body of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Out of 11,601 studies, 15 remained for qualitative analyses and 12 for meta-analysis. Seven studies were classified at high risk of bias, and 8 studies raised some concerns. No significant differences between the endodontic materials were observed in the direct comparisons, both in risk and in intensity of postoperative pain (pairwise comparisons with 2 studies: I2 = 0%; p > 0.05 and 8 studies: I2 = 23%; p > 0.05, respectively). The certainty of the evidence was graded as low or moderate. There was no difference in the risk and intensity of postoperative pain after filling with different endodontic sealers. Further systematic reviews should be conducted.

The prevalence of apical periodontitis in patients prior to hematopoietic cell transplantation: a systematic review

  • Letícia Taina de Oliveira Lemes;Carolina Horn Troian-Michel;Theodoro Weissheimer;Marcus Vinicius Reis So
    • Restorative Dentistry and Endodontics
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    • v.49 no.2
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    • pp.22.1-22.12
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    • 2024
  • Objectives: This systematic review addressed the question: "What is the prevalence of apical periodontitis in patients prior to hematopoietic cell transplantation?" Materials and Methods: A systematic search was conducted in MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Grey Literature Report. Eligibility criteria were based on the condition, content, and population strategy: the condition was the radiographic prevalence of apical periodontitis, the content comprised patients scheduled for hematopoietic stem cell transplantation, and the population consisted of adult and pediatric patients. The revised Risk of Bias in Nonrandomized Studies of Exposure tool was used to assess the quality of studies. The Grading Recommendations Assessments, Development, and Evaluation (GRADE) tool was used to assess the quality of evidence. Results: Eight studies were included in this review. The average number of patients with apical periodontitis was 15.65% (range, 2.1%-43.34%). One study was classified as having a very high risk of bias, 1 with a high risk of bias, and 6 with some concern for bias. GRADE analysis showed a very low certainty of evidence. Significant limitations concerning the absence of control over confounding variables were identified. Conclusions: With the caveat of the very low quality of evidence in the studies reviewed, there was a low to moderate prevalence of apical periodontitis in patients prior to undergoing hematopoietic cell transplantation.

Systematic Review and Meta-analysis of Chuna Therapy for Sciatica (좌골신경통에 적용한 추나 치료에 대한 체계적 문헌 고찰 및 메타 분석)

  • Hong, Su Min;Oh, Seung Joon;Lee, Eun Jung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.34 no.6
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    • pp.299-308
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    • 2020
  • This study aimed to evaluate the effects of Chuna therapy for Sciatica. We searched the following 16 online databases without a language restriction (Pubmed, Cochrane, Embase, CINAHL, Ovid, Kmbase, RISS, NDSL, OASIS, KISS, KNAL, KTKP, DBpia, CNKI, Wangfang, J-stage) to find randomized controlled clinical trials that used Chuna therapy for Sciatica. The methodological quality of randomized controlled clinical trials (RCTs) were assessed using the Cochrane risk of bias tool and meta-analysis were performed. Among 496 articles that were searched, 15 RCTs were finally selected for systematic review. 14 studies showed that Chuna therapy has positive effect on sciatica. Two studies noted that there were side effects, and the difference between the intervention group and the control group was statistically insignificant. One study noted no side effects and the rest of the study, there was no mention of side effects. Meta-analysis showed positive results for Chuna single therapy in terms of efficiency rate compared to painkiller, herb medicine excepting acupuncture. When comparing Chuna therapy plus acupuncture and acupuncture, Chuna therapy plus acupuncture had a more positive result than acupuncture in terms of efficiency rate. Cochrane Risk of Bias (RoB)evaluation method, most of the studies's selection, performance, detection and reporting bias were unclear. The studies showed that Chuna therapy can significantly effective on sciatica. However, most of the studies's Risk of Bias included in the analysis were not low enough. In the future, to prove the level of evidence of Chuna therapy, more high-quality studies will be needed.