• Title/Summary/Keyword: comparison of efficacy

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Simultaneous Comparison of Efficacy and Adverse Events of Interventions for Patients with Esophageal Cancer: Protocol for a Systematic Review and Bayesian Network Meta-analysis

  • Doosti-Irani, Amin;Mansournia, Mohammad Ali;Rahimi-Foroushani, Abbas;Cheraghi, Zahra;Holakouie-Naieni, Kourosh
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.867-872
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    • 2016
  • Background: Esophageal cancer is one of the most serious malignancies. Due to the aggressive nature of this cancer, the prognosis is poor. A network meta-analysis with simultaneous comparison of multiple treatments can help determine better treatment options that have higher effects on overall survival of patients with lower adverse events. The aim of this review is to simultaneously compare efficacy and adverse events of treatment interventions for esophageal cancer. Materials and Methods: In this review, only randomized control trials (RCT) will be considered for network meta-analysis. All international electronic databases including Medline, Web of Sciences, Scopus, Cochran's library, EMBASE and Cancerlit will be searched to find randomized control trials which compared two or more treatment interventions for esophageal cancer. A network plot will be drawn for visual representation of all available treatment interventions. Bayesian approach will be used to combine the direct and indirect evidence. Treatment effects (e.g. hazard ratio for time to event outcomes, risk ratio for binary outcomes, and rate ratio for count outcomes with 95% credible interval) will be reported. Moreover, cumulative probability of the treatment ranks will be reported using the surface under the cumulative ranking (SUCRA) graphs. Consistency assumption will be assessed by the loop-specific and design-by-treatment interaction approaches. Conclusions: The results of this study may be helpful for the patients, clinicians and health policy makers in selecting treatments that have the best effect on survival and lowest adverse events.

A Clinical Trial to Verity the Quality of Life Improvement Efficacy of Dangguijakyak-san and Gyejibongnyeong-hwan Granulation in Postmenopausal Women. (한방 과립제의 폐경 후 삶의 질 개선 효과에 관한 연구 - 당귀작약산 및 계지복령환 과립제의 폐경후 삶의 질 개선에 대한 임상연구)

  • Park, Jea-Min;Yang, Jeong-Min;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.20 no.3
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    • pp.213-228
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    • 2007
  • Purpose: This master‘s thesis to evaluate the grade of life after medication a Dangguijakyak-san(pasabu) and Gyejibongnyeong-hwan(cheongwal) with in postmenopausal women get lowering quality of life caused by vasomotor symptoms with hot flush. Methods: A subject who signing on the clinical trial written consent by self-will is registered this clinical trial after decided suitable by selection and exception standard, after take a medical experiment and checkup according to clinical trial plan. Registered subject should valuated by settled schedule after take the testing medicine 1,2 during thirty-day. In this period, a subject allocated at relatively better suited experimental group by oriental doctor after consideration of general efficacy and nature of a medicine at second visiting. Results: The result of comparison in the remedial value with sixteen patients who ended the experiment is like next list. 1. There's no regarded difference of comparison in general conditions between two patient groups. 2. There's no regarded difference during observation period before take medicine. 3. By period of measurement, there's something regarded differences most of patients of two parts after taking medicine. 4. There's no regarded difference at alteration phase of each standard according to kind of medicine. 5. There's no abnormal views reflected at allergy, Laboratory and Physical Examination during experiment. Conclusion: This experiment evidence a Dangguijakyak-san and Gyejibongnyeong-hwan can help for improvement generally life quality of postmenopausal women and certify safety of herbs.

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A Comparison Between the Korean Digits-in-Noise Test and the Korean Speech Perception-in-Noise Test in Normal-Hearing and Hearing-Impaired Listeners

  • Kim, Subin;You, Sungwha;Sohn, Myoung Eun;Han, Woojae;Seo, Jae-Hyun;Oh, Yonghee
    • Journal of Audiology & Otology
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    • v.25 no.4
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    • pp.171-177
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    • 2021
  • Background and Objectives: The purpose of the present study was to validate the performance and diagnostic efficacy of the Korean digits-in-noise (K-DIN) test in comparison to the Korean speech perception-in-noise (K-SPIN) test, which is the representative speech-in-noise test in clinical practice. Subjects and Methods: Twenty-seven subjects (15 normal-hearing and 12 hearing-impaired listeners) participated. The recorded Korean 0-9 digits were used to form quasirandom digit triplets; 50 target digit triplets were presented at the most comfortable level of each subject while presenting speech-shaped background noise at various levels of signal-to-noise ratios (-12.5, -10, -5, or +5 dB). Subjects were then instructed to listen to both target and noise masker unilaterally and bilaterally through a headphone. K-SPIN test was also conducted using the same procedure as the K-DIN. After calculating their percent correct responses, K-DIN and K-SPIN results were compared using a Pearson-correlation test. Results: Results showed a statistically significant correlation between K-DIN and K-SPIN in all hearing conditions (left: r=0.814, p<0.001; right: r=0.788, p<0.001; bilateral: r=0.727, p<0.001). Moreover, the K-DIN test achieved better testing efficacy, shorter average listening time (5 min vs. 30 min), and easier performance of task according to participants' qualitative reports than the K-SPIN test. Conclusions: In this study, the Korean version of digit triplet test was validated in both normal-hearing and hearing-impaired listeners. The findings suggest that the K-DIN test can be used as a simple and time-efficient hearing-in-noise test in audiology clinics in Korea.

A Comparison Between the Korean Digits-in-Noise Test and the Korean Speech Perception-in-Noise Test in Normal-Hearing and Hearing-Impaired Listeners

  • Kim, Subin;You, Sungwha;Sohn, Myoung Eun;Han, Woojae;Seo, Jae-Hyun;Oh, Yonghee
    • Korean Journal of Audiology
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    • v.25 no.4
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    • pp.171-177
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    • 2021
  • Background and Objectives: The purpose of the present study was to validate the performance and diagnostic efficacy of the Korean digits-in-noise (K-DIN) test in comparison to the Korean speech perception-in-noise (K-SPIN) test, which is the representative speech-in-noise test in clinical practice. Subjects and Methods: Twenty-seven subjects (15 normal-hearing and 12 hearing-impaired listeners) participated. The recorded Korean 0-9 digits were used to form quasirandom digit triplets; 50 target digit triplets were presented at the most comfortable level of each subject while presenting speech-shaped background noise at various levels of signal-to-noise ratios (-12.5, -10, -5, or +5 dB). Subjects were then instructed to listen to both target and noise masker unilaterally and bilaterally through a headphone. K-SPIN test was also conducted using the same procedure as the K-DIN. After calculating their percent correct responses, K-DIN and K-SPIN results were compared using a Pearson-correlation test. Results: Results showed a statistically significant correlation between K-DIN and K-SPIN in all hearing conditions (left: r=0.814, p<0.001; right: r=0.788, p<0.001; bilateral: r=0.727, p<0.001). Moreover, the K-DIN test achieved better testing efficacy, shorter average listening time (5 min vs. 30 min), and easier performance of task according to participants' qualitative reports than the K-SPIN test. Conclusions: In this study, the Korean version of digit triplet test was validated in both normal-hearing and hearing-impaired listeners. The findings suggest that the K-DIN test can be used as a simple and time-efficient hearing-in-noise test in audiology clinics in Korea.

Pre-emptive analgesic efficacy of injected ketorolac in comparison to other agents for third molar surgical removal: a systematic review

  • Tirupathi, Sunnypriyatham;Rajasekhar, Srinitya;Maloth, Sardhar Singh;Arya, Aishwarya;Tummalakomma, Pushpalatha;Lanke, Rama Brahman
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.1
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    • pp.1-14
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    • 2021
  • This study aimed to evaluate and compare the pre-emptive analgesic efficacy of injected ketorolac to that of other agents for impacted third molar surgical removal in a healthy population. PubMed, Ovid SP, Cochrane databases were filtered from 1980 to July 2020 for potential papers using relevant MeSH terms and pre-specified inclusion and exclusion criteria independently by reviewers. Studies that compared pre-emptive intramuscular or intravenous administration of ketorolac to other agents were evaluated. The outcomes sought were self-reported postoperative pain (patient-perceived pain), median duration for rescue analgesic medication, total number of analgesics consumed in the recovery period, and global assessment (overall patient satisfaction) after the recovery period. Six studies were included in the final evaluation. The outcome of pain perception and the number of analgesics taken were significantly lower in the ketorolac group (intramuscular or intravenous) in most of the studies (n=5) than in the group of other drugs. The mean time for rescue analgesia intake was higher for the ketorolac group, and global assessment scores were also better in the ketorolac group. Although the included studies show significantly better outcomes such as postoperative pain, median time taken for rescue medication, total number of analgesics taken, and overall patient satisfaction with injected ketorolac group in comparison to injected diclofenac, dexamethasone, and tramadol, definitive conclusions cannot be made regarding the superiority of injected Ketorolac as a pre-emptive agent. A greater number of randomized control trials with a proper protocol are needed to make definitive conclusions.

Comparison of Thermal Ablation and Surgery for Low-Risk Papillary Thyroid Microcarcinoma: A Systematic Review and Meta-Analysis

  • Hyun Jin Kim;Se Jin Cho;Jung Hwan Baek
    • Korean Journal of Radiology
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    • v.22 no.10
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    • pp.1730-1741
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    • 2021
  • Objective: Although thermal ablation is effective in treating low-risk papillary thyroid microcarcinomas (PTMCs), comparison of treatment outcomes between thermal ablation and surgery has not yet been systematically evaluated. This study aimed to compare the efficacy and safety of thermal ablation and surgery for the treatment of low-risk PTMCs. Materials and Methods: Ovid-MEDLINE and EMBASE databases were searched for studies reporting comparisons of treatment results between thermal ablation and surgery for patients with low-risk PTMC published up to April 6, 2020. The analysis evaluated the efficacy (local tumor recurrence, occurrence of new tumor, metastasis, and rescue surgery) and safety (complication rate) of thermal ablation and surgery. Results: This systematic review included four studies with a total of 339 PTMCs in 339 patients who underwent thermal ablation and 320 PTMCs in 314 patients who underwent surgery. There was no local tumor recurrence or distant metastasis in either group. There was no significant difference in the pooled proportion of lymph node metastasis (2.6% with thermal ablation vs. 3.3% with surgery, p = 0.65), occurrence of new tumors (1.4% with thermal ablation vs. 1.3% with surgery, p = 0.85), or rescue surgery (2.6% with thermal ablation vs. 1.6% with surgery, p = 0.62). However, the pooled complication rate was significantly higher in the surgery group than in the ablation group (3.3% with thermal ablation vs. 7.8% with surgery, p = 0.03). Conclusion: Both thermal ablation and surgery are effective and safe options for the management of low-risk PTMCs, with thermal ablation achieving a lower complication rate. Therefore, thermal ablation may be considered as an alternative treatment option for low-risk PTMC in patients who refuse surgery and active surveillance or are ineligible for surgery.

Comparison of clinical efficacy of ropivacaine and lignocaine with adrenaline for implant surgery anesthesia: a split-mouth randomized controlled clinical trial

  • Kalath, Remya Nath;Kulal, Rithesh;Gopinath, Sharika
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.4
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    • pp.337-344
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    • 2021
  • Background: The primary indication for using long-acting anesthetics in dentistry is extensive dental procedures that require pulpal anesthesia beyond 90 min and management of postoperative pain. Ropivacaine is an amide local anesthetic that is available at various concentrations with inherent vasoconstrictive properties at low concentrations. Ropivacaine has a 75% greater margin of safety than bupivacaine. Ropivacaine can be a good alternative to bupivacaine as a local anesthetic in dental implant surgery as it provides a longer duration of both pulpal and soft tissue anesthesia after mandibular nerve block and lowers CNS and cardiovascular toxicity. This study aimed to evaluate and compare the clinical efficacy of ropivacaine and lignocaine for implant surgery anesthesia. Methods: Fifteen patients with bilateral edentulous sites indicated for implant placement were recruited for this study. Patients aged 20-60 years of both sexes were randomly recruited. Thirty implant placements were performed in the test and control groups using ropivacaine and lignocaine with adrenaline as local anesthetics, respectively. Results: The results were analyzed statistically. The duration of anesthesia was significantly higher in the test group than in the control group. Ropivacaine was found to be superior to lignocaine in terms of the quality of anesthesia. The comparison of mean visual analog scale scores showed ropivacaine to have better anesthetic and analgesic effects than the control group. Conclusion: Ropivacaine 0.75% provides a significantly longer duration of anesthesia than lignocaine 2% with adrenaline. Ropivacaine 0.75% decreased intraoperative and postoperative analgesia compared to lignocaine 2% with adrenaline. Hence, ropivacaine 0.75% can be used as an alternative to lignocaine in implant surgeries and other intraoral surgical procedures that require a longer duration of anesthesia and analgesia.

Efficacy Comparison of Different Acupuncture Treatments for Hot Flashes: A Systematic Review with Network Meta-Analysis

  • Jo, Hyo Rim;Choi, Seong Kyeong;Sung, Won Suk;Kim, Eun Jung;Choi, Su Ji;Kim, Dong Il;Noh, Eun Ji
    • Journal of Acupuncture Research
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    • v.38 no.2
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    • pp.110-121
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    • 2021
  • The objective of this study was to conduct a systematic review and network meta-analysis to evaluate and compare the effectiveness of various types of acupuncture for menopausal hot flashes (HF). Randomized controlled trials (RCTs) were retrieved from 8 electronic databases, and the risk of bias was evaluated for the included studies. Pairwise meta-analysis and network meta-analysis were performed using Review Manager and R software for indirect comparison and ranking, respectively. In total, 23 RCTs (2,302 patients) were eligible for systematic review, of which 10 were included in network meta-analysis. Network meta-analysis showed manual acupuncture (MA) had the highest probability of reducing HF frequency and severity, followed by sham acupuncture (SA), electroacupuncture, usual care, or no treatment; furthermore, warm acupuncture significantly improved menopause-specific quality of life compared with MA or electroacupuncture. Compared with hormone replacement therapy, acupuncture had less efficacy in reducing HF frequency but enhanced menopause-specific quality of life. There was no significant difference between MA and SA in mitigating HF. The existing evidence showed that MA could be used for alleviating menopausal HF. However, it is recommended that more high-quality RCTs should be performed.

Comparison of Efficacy between Medial Branch Block and Collaborative Treatment with Acupuncture on Acute Low Back Pain (급성 요통의 내측지 차단술 단독 치료와 침을 병행한 협진 치료의 효과 비교)

  • Yi, Joo-Il;Na, Yu-Jin;Kim, Byung-Hean;Ryu, Eun-Kyung
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.2
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    • pp.151-161
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    • 2013
  • Objectives : The purpose of this study was to compare the effects of acupuncture and medial branch block(collaborative treatment) with just medial branch block regarding acute low back pain. Methods : Forty inpatients who received treatment between January 2012 and February 2013 were divided into 2 groups. The East-West treatment group(EW group, n=20) received one treatment of medial branch block and then acupuncture afterwards. The Western treatment group(W group, n=20) received one treatment of medial branch block. Both groups continued to receive manual therapy 3 times a week. Evaluations were made before medial branch block, 7 days after, and 14 days after using the Numerical Rating Scale(NRS). Results : Compared to before treatment, the NRS score of both EW and W groups after 7 and 14 days of treatment significantly decreased(p=0.0001). But only the EW group showed additional improvement between days 7 and 14(p=0.005). Regarding group comparison, the NRS score of the EW group was significantly lower than the W group at 7 days(p=0.037), and even more at 14 days(p<0.0001). Conclusions : Although medial branch block alone significantly improved acute low back pain, collaborative treatment with acupuncture was even more effective, with increased efficacy as time passed. Further research is recommended regarding the effects of collaborative treatment with acupuncture on acute low back pain.

Evaluation of polyherbal formulation and synthetic choline chloride on choline deficiency model in broilers: implications on zootechnical parameters, serum biochemistry and liver histopathology

  • Selvam, Ramasamy;Saravanakumar, Marimuthu;Suresh, Subramaniyam;Chandrasekeran, CV;Prashanth, D'Souza
    • Asian-Australasian Journal of Animal Sciences
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    • v.31 no.11
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    • pp.1795-1806
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    • 2018
  • Objective: The study was designed to establish choline deficiency model (CDM) in broilers for evaluating efficacy of polyherbal formulation (PHF) in comparison with synthetic choline chloride (SCC). Methods: A total of 2,550 one-day-old Cobb 430 broiler chicks were randomly assigned to different groups in three experiments. In experiment 1, G1 and G2 served as normal controls and were fed a basal diet with 100% soybean meal (SBM) as a major protein source supplemented with and without SCC, respectively. In G3, G4, G5, and G6 groups, SBM was replaced at 25%, 50%, 75%, and 100% by soy protein isolate (SPI) to induce a graded level of choline deficiency. In experiment 2, PHF (500 and 1,000 g/ton) in comparison with SCC (1,000 g/ton) were evaluated. In experiment 3, dose-response of PHF (200, 400, and 500 g/ton) with SCC (400 g/ton) was determined. Results: Replacement of SBM by SPI produced a linear decrease in body weight gain (BWG) with a poor feed conversion ratio (FCR). 25% SBM replacement by SPI yielded an optimum negative impact on BWG and FCR; hence, it is considered for further studies. In experiment 2, PHF (500 and 1,000 g/ton) and SCC (1,000 g/ton) showed a similar performance in BWG, FCR and relative liver weight. In experiment 3, PHF produced an optimum efficacy at 400 g/ton and was comparable to SCC in the restoration of serum aspartate aminotransferase activity, abdominal fat, breast muscle lipid content and liver histopathological abnormalities. Conclusion: Replacement of SBM by SPI caused choline deficiency characterised by worsening of BWG, FCR, elevation in liver enzymes and histopathological changes indicating fatty liver. CDM was found valid for evaluating SCC and PHF. It is concluded that PHF has the potential to mimic biological activities of SCC through the restoration of negative effects caused by CDM.