• Title/Summary/Keyword: randomized and sensitivity analysis

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Hepatic Re-resection Versus Transarterial Chemoembolization for the Treatment of Recurrent Hepatocellular Carcinoma after Initial Resection: a Systematic Review and Meta-analysis

  • Wang, Di-Ya;Liu, Lei;Qi, Xing-Shun;Su, Chun-Ping;Chen, Xue;Liu, Xu;Chen, Jiang;Li, Hong-Yu;Guo, Xiao-Zhong
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.13
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    • pp.5573-5578
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    • 2015
  • Background: A systematic review and meta-analysis were performed to compare the post-recurrence survival with hepatic re-resection versus transarterial chemoembolization (TACE) for recurrent hepatocellular carcinoma (HCC) after initial resection. Materials and Methods: All relevant papers were searched via PubMed, EMBASE, and Cochrane Library databases. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Subgroup analysis was performed according to country. Sensitivity analysis was performed in studies which clearly reported the recurrent regions, in moderate/high-quality studies, in studies published in full-text form, and in studies published after 2005. Results: In total, twelve papers were included in our study. Five and seven of them were of moderate- and poor-quality, respectively. The overall meta-analysis demonstrated a statistically significantly higher post-recurrence survival in the hepatic re-resection group than in those undergoing TACE (HR=0.64, 95%CI=0.52-0.79, P<0.0001). Heterogeneity was statistically significant and statistical significance remained in the subgroup analysis. Sensitivity analyses were also consistent with the overall analysis. Conclusions: Hepatic re-resection might provide a better post-recurrence survival than TACE for recurrent HCC after initial resection. However, considering the low quality of published studies and the potential bias of treatment selection, further randomized trials should be warranted to confirm these findings.

A sensitivity analysis on AS/RS storage policy with production quantity changes (AS/RS 저장정책의 생산량 변동에 대한 민감도분석)

  • Mun, Gee-Ju;Kim, Gwang-Pil;Ha, Joung-Jin;Lee, Byung-Ho
    • IE interfaces
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    • v.9 no.2
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    • pp.219-229
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    • 1996
  • Most studies on the operation policy for AS/RS concluded that the class-based storage policy has better performance than random storage policy does. However ASRS performances are examined only with the assumption of fixed production quantity in the studies. It is true that production quantity of each item changes frequently in practice. If an ASRS keeps the current storage policy regardless of production quantity variation, the performance of present storage policy will be worse. The effect of production quantity variation per product between 10 and 80% with random storage policy and class-based storage policy with reassignment and relocation are studied. The results are compared with both of the randomized and class-based storage policies without reassignment nor relocation cases. A typical ASRS system is developed using GPSS/PC for operation policy evaluation purposes.

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Cost-effectiveness Analysis of Bojungikgitang and Banhabaekchulchonmatang in Chronic Tinnitus Patients (이명증에 대한 보중익기탕과 반하백출천마탕의 비용효과 분석 연구)

  • Kim, Nam-Kwen;Oh, Yong-Leol;Seo, Eun-Sung;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.23 no.1
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    • pp.260-269
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    • 2010
  • Background : Bojungikgitang(BJT) and Banhabaekchulchonmatang(BBT) are known to treat the tinnitus patients, which were registered Korean National Health Insurance coverage lists. Objective : Few studies have evaluated economic benefits of both herbal medicines. This research is to investigate the cost-effectiveness of Bojungikgitang(BJT) and Banhabaekchulchonmatang(BBT) in chronic tinnitus patients over nineteen years old. Method : We built the decision tree model of chronic tinnitus and executed the deterministic analysis and threshold sensitivity analysis based on randomized clinical trial. Effectiveness was measured in quality-adjusted life-years(QALYs), and costs were in 2009 KRW(South Korean Currency). The perspective is societal, time horizon is 10 weeks, and Korean willingness to pay threshold is assumed to 20,000,000KRW. Results : In the base case analysis, BJT treatment resulted is better outcomes as low cost, so BJT is dominant medicine and BBT is dominated. But both cost per QALYs (BJT is 3,120,339KWN per QALY, BBT is 3,505,780KWN per QALY) are lower than the threshold, that could be covered by Korean National Health Insurance(KNHI). Conclusion : This study results showed that BJT was more cost-effective than BBT treating tinnitus patients for 10 weeks, and the cost per QALYs of both alternatives were lower than Korean national threshold.

A SELF-ADMINISTERED QUALITY-OF-LIFE QUESTIONNAIRE AFTER ACUTE MYOCARDIAL INFARCTION

  • Lim L. L-Y.;Valenti L.A.;Knapp J.C.;Dobson A.J.;Plotnikoff R.;Higginbotham N.;Heller R.F.
    • 대한예방의학회:학술대회논문집
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    • 1994.02b
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    • pp.180-187
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    • 1994
  • A slightly modified version of the Quality-of-Life after Myocardial Infarction (QLMI) questionnaire developed by Oldridge and colleagues was applied in a self-administered mode to patients with suspected acute myocardial infarction (AMI) in a randomized controlled trial of secondary prevention. Acceptability of the questionnaire was good, with 93% of responders answering all items. Factor analysis suggested three quality-of-life (QL) dimensions which we called 'emotional', 'physical' and 'social'. These differed somewhat from the dimensions proposed by Oldtidge and colleagues. However, a sensitivity analysis showed relative invariance of results to weighting schemes. Scores on our three dimensions were responsive to differences between the treatment groups, and demonstrated construct validity based on associations between the measured QL and variables expected to affect QL. We conclude that the QLMI questionnaire has good potential as an instrument for assessing QL in post-AMI patients and that it can be successfully self-administered.

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Efficacy comparison of high-genetic barrier nucleos(t)ide analogues in treatment-naïve chronic hepatitis B patients: a network meta-analysis

  • Jaejun Lee;Ahlim Lee;Pil Soo Sung;Jeong Won Jang;Si Hyun Bae;Jong Young Choi;Seung Kew Yoon;Hyun Yang
    • The Korean journal of internal medicine
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    • v.39 no.4
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    • pp.577-589
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    • 2024
  • Background/Aims: Four high-genetic barrier nucleos(t)ide analogues (NAs) for chronic hepatitis B (CHB), namely entecavir (ETV), tenofovir disoproxil fumarate (TDF), tenofovir alafenamide (TAF), and besifovir dipivoxil maleate (BSV), have been established. The aim of this study is to investigate the efficacy of four high-genetic barrier NAs using a network meta-analysis of randomized trials and propensity score-matched cohorts. Methods: Systematic search was performed using PubMed, Cochrane library, and EMBASE and included randomized controlled trials and cohort studies that used propensity score matching. Studies on treatment-naïve CHB patients treated with ETV, TDF, TAF, or BSV were included. Outcomes included alanine aminotransferase normalization and hepatitis B e antigen seroclearance at week 48 and undetectable hepatitis B virus DNA at weeks 48 and 96. Network meta-analysis was performed to synthesize the results. Results: In total, 15,000 patients from 16 studies were included. In terms of 48- and 96-week virologic response (VR), TDF outperformed ETV with statistical significance (48 weeks: odds ratio [OR], 1.38; p < 0.001; 96 weeks: OR, 1.57; p = 0.004). ETV was ranked first for 48-week biochemical response (BR) and outperformed TDF (OR, 0.76; p = 0.028). In the sensitivity analyses, 48-week VR from randomized-controlled trials were compiled, and the same trend toward the superiority of TDF over ETV was found (OR, 1.51; p = 0.030). Conclusions: Four high-genetic barrier NAs were compared, and TDF was more likely to achieve a VR after 48 weeks, while ETV provided a superior BR after 48 weeks.

The clinical effects of a hydroxyapatite containing toothpaste for dentine hypersensitivity (민감성 치아에 대한 수산화인회석 함유 치약의 임상적 효과)

  • Kim, Su-Hwan;Park, Jun-Beom;Lee, Chul-Woo;Koo, Ki-Tae;Kim, Tae-Il;Seol, Yang-Jo;Lee, Yong-Moo;Ku, Young;Chung, Chong-Pyung;Rhyu, In-Chul
    • Journal of Periodontal and Implant Science
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    • v.39 no.1
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    • pp.87-94
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    • 2009
  • Purpose: The aim of this study was to compare the effectiveness of hydroxyapatite containing toothpaste with positive control toothpastes in reducing dentine hypersensitivity. Materials and methods: This clinical trial was a double-blind, randomized, parallel group comparison of two, namely hydroxyapatite containing toothpaste and strontium chloride containing toothpaste. A total of 55 subjects were included in this study. The subjects were given randomly assigned one of the two toothpastes after received tooth brushing instruction at baseline. Some clinical indices(PI, GI, PD), verbal rating score(VRS) for sensitivity to stimulus, the effect in relieving sensitivity and visual analogue scale(VAS) for sensitivity at baseline, week 2, week 4 and week 8 were assessed. All data were evaluated by intention-to-treat analysis. Results: Overall, PI and GI scores were significantly reduced compare baseline in all groups(p<0.05). In addition, there was significant difference in PI at 4 weeks and in GI at 4, 8 weeks between groups. The proportions of subjects relieved sensitivity were 70.4% in experimental group and 57.1% in control group at 8 weeks respectively. The VRS for sensitivity to three kinds of stimuli and VAS for sensitivity decreased according to time, there was no overall difference between two groups(p>0.05). Conclusion: This study demonstrated that the new hydroxyapatite containing toothpaste was similarly effective in reducing dentine hypersensitivity with pre-existing benchmark toothpaste.

Effects of Manual Therapy on Musculoskeletal Diseases : A Meta-Analysis (근육뼈대계 질환에 대한 도수치료의 효과: 메타분석)

  • Lee, Jeong-Woo;Gong, Gwang-Sik;Kim, Dong-Yeon;Koh, Un
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.1
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    • pp.203-217
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    • 2021
  • Purpose: The purpose of this meta-analysis was to examine the high-level evidence of the effects of manual therapy on musculoskeletal diseases. Methods: Domestic databases were searched for studies that conducted clinical trials associated with manual therapy on chronic musculoskeletal diseases. A total of 591 studies published between 2005 and 2018 were identified, with 18 studies satisfying the inclusion data. The studies were classified according to patient, intervention, comparison, and outcome (PICO). The search outcomes were items associated with pain and physical function. The 18 studies included in the study were evaluated by using the R meta-analysis (version 4.0). The quality of 18 randomized control trials was evaluated by using the Cochrane risk of bias (ROB). The effect sizes were computed as the corrected standardized mean difference (SMD). Subgroup and meta-regression analyses were also used. Egger's regression test was carried out in order to analyze the publication bias. Cumulative meta-analysis and sensitivity analysis were also conducted in order to analyze the data error. Results: The following factors showed the large effect size of manual therapy on chronic musculoskeletal diseases: pain (Hedges's g = 2.66; 95% CI = 1.47 ~ 3.85), and physical function (Hedges's g = 2.15; 95% CI: 1.22 ~ 3.08). The subgroup analysis only showed a statistical difference in the type of manual therapy (pain) and outcome (physical function). No statistically significant difference was found in the meta-regression analysis. Publication bias was found in the data, but the results of the trim-and-fill method showed that such bias did not largely affect the obtained data. Furthermore, there were no data errors in the cumulative meta-analysis and sensitivity analysis. Conclusion: This study provides evidence for the effectiveness of manual therapy on chronic musculoskeletal diseases in pain and physical function. Subgroup analysis suggests that only the type of manual therapy for pain and the type of outcome for physical function differed in effect size.

Epigallocatechin-3-gallate prior to composite resin in abfraction lesions: a split-mouth randomized clinical trial

  • Luisa Valente Gotardo Lara Alves;Lisiane Martins Fracasso;Thiago Vinicius Cortez;Aline Evangelista Souza-Gabriel;Silmara Aparecida Milori Corona
    • Restorative Dentistry and Endodontics
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    • v.48 no.2
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    • pp.13.1-13.11
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    • 2023
  • Objectives: Natural extracts have been investigated as a biomimetic strategy to mechanically strengthen the collagen network and control the biodegradation of extracellular matrix. This study evaluated the effect of epigallocatechin-3-gallate (EGCG) on abfraction lesions prior to the composite resin. Materials and Methods: The sample consisted of 30 patients (aged between 28 and 60 years) with abfraction lesions located in 2 homologous premolars. The teeth were randomly assigned according to dentin treatment: 0.02% EGCG solution or distilled water (control). After enamel acid etching, the solutions were applied immediately for 1 minute. The teeth were restored with Universal Adhesive (3M) and Filtek Z350 XT (3M). Analyzes were done by 2 independent examiners using modified USPHS (retention, secondary caries, marginal adaptation, and postoperative sensitivity) and photographic (color, marginal pigmentation, and anatomical form) criteria at baseline (7 days) and final (18 months). The data analysis used Friedman and Wilcoxon signed-rank tests (α = 0.05). Results: At baseline, all restorations were evaluated as alpha for all criteria. After 18 months, restorations were evaluated as alpha for secondary caries, color, and marginal pigmentation. There was significant difference between baseline and 18 months (p = 0.009) for marginal adaptation and postoperative sensitivity (p = 0.029), but no significant difference were verified between treatments (p = 0.433). The EGCG group had a restoration retention rate of 93.3%, while the control group had 96.7%. Conclusions: The application of EGCG solution on abfraction lesions did not significantly influence the survival of the restorations based on clinical and photographic criteria.

Single-session associative protocol for dentin hypersensitivity management: a 1-year randomized, blinded clinical study

  • Thayna Carolina Zeni;Poliana Maria de Faveri Cardoso;Rafael da Silva Vanolli;Marcio Jose Mendonca;Julio Katuhide Ueda;Veridiana Camilotti
    • Restorative Dentistry and Endodontics
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    • v.49 no.2
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    • pp.15.1-15.11
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    • 2024
  • Objectives: This study aimed to establish a single-session associative protocol for nonrestorative management of dentin hypersensitivity (DH). Materials and Methods: Twenty-four individuals with DH and a minimum sensitivity level of 4 on the visual analog scale (VAS) were selected. The study was conducted in a split-mouth design, with each participant (n = 20) having at least 1 affected tooth in all quadrants. The management protocols consisted of control group: universal adhesive, Neural Desensitizing Protocol group: 5% potassium nitrate, Mixed Desensitizing Protocol (PAM) group: 5% sodium fluoride and 5% potassium nitrate, Remineralizing Desensitizing Protocol (PDR) group: surface-partially reacted glass technology photopolymerizable varnish. Evaluations were performed immediately after application, at 1 week, 1 month, 2 months, and 12 months using the VAS sensitivity test. Results: The scores were subjected to statistical analysis using the Friedman test (p < 0.05), Durbin-Conover test (p < 0.05), and Wilcoxon test (p < 0.05). At the 12-month evaluation, all groups showed statistically significant differences compared to the initial assessment. For the evaluation after 12 months, there was a statistically significant difference between the PAM group, the control group, and the PDR group. Conclusions: It can be concluded that all groups were effective in controlling DH, but there were significant results in the control group and PDR group. The clinical relevance of this study is to demonstrate that the application of single-session desensitizing protocols can be effective in controlling DH for up to 12 months.

Effects of Electrical Stimulation on Patients with Non-Specific Low Back Pain : A Meta-Analysis of Domestic Database (비특이적 만성 허리통증 환자에 대한 전기자극의 효과 : 국내 데이터베이스의 메타분석)

  • Lee, Jeong-Woo;Cho, Sung-Hyoun
    • Journal of The Korean Society of Integrative Medicine
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    • v.10 no.3
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    • pp.37-52
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    • 2022
  • Purpose : The purpose of this meta-analysis was to evaluate the effects of electrical stimulation on patients with non-specific low back pain. Methods : Domestic databases were gathered from studies that conducted clinical trials associated with electrical stimulation and its impact on pain of non-specific low back patients. A total of 681 studies were identified, with 12 studies satisfying the inclusion data. The studies consisted of patient, intervention, comparison, outcome, and study design (PICO-SD). The search outcomes were items associated with low back pain. Cochrane risk of bias 2 (RoB 2) was used to evaluate the quality of 12 randomized controlled trials. Effect sizes (Hedges's g) in this study were computed as the corrected standard mean difference (SMD). A random-effect model was used to analyze the effect size because of the high heterogeneity among the studies. Egger's regression and 'trim-and-fill' tests were carried out to analyze the publication bias. Cumulative meta-analysis and sensitivity analysis were conducted to analyze the effect according to the sample size and the consistency of the effect size. Results : The following factors had a large overall effect size (Hedges's g=1.28, 95 % CI=.20~2.36) involving electrical stimulation on non-specific low back pain. The subgroup analysis all showed a statistical difference in the types of study design, electrical stimulation, and assessment tool. No statistically significant difference was found in the meta-regression analysis. Publican bias was found in the data. Conclusion : The findings in this study indicate that electrical stimulation interventions have a positive effect on patients with non-specific low back pain. However, due to the low quality of studies and publication bias, the results of our study should be interpreted cautiously.