• 제목/요약/키워드: reporting bias

검색결과 107건 처리시간 0.026초

여드름 한약 치료의 무작위 대조군 임상연구에 관한 분석 (Analysis of Randomized Controlled Trial Study of Korean Herbal Medicine Treatment for Acne)

  • 이마음;권강;지선영;황보민;김철윤;서형식
    • 한방안이비인후피부과학회지
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    • 제35권4호
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    • pp.139-162
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    • 2022
  • Objectives : The review was conducted to validate the effectiveness of herbal medicines on acne. Methods : Randomized controlled trials(RCTs) reporting the effects of herbal medicine treatment on acne were searched through seven electronic databases from the time of application of the material to October 2021. Cochrane Collaboration's Risk of Bias was used to assess the risk of bias. Analysis was performed using Review Manager 5.4 and R 4.1.0 Meta, Metafor program. Results : 34 RCTs was selected and meta-analysis was performed with 30 studies. The inflammatory lesion count of the herbal medicine(MD=0.29, 95% CI:-0.59-0.01, p<0.01, I2=80%) and the non inflammatory lesion count of herbal medicine(MD=-0.30, 95% CI:-0.70-0.10, p<0.01, I2=78%) were seen. The score of IGA(RR=1.43, 95% CI:0.90-2.27, p<0.91, I2=0%), VISIA(MD=0.36, 95% CI:0.21-0.51, p=0.07, I2=40%), effective rate(RR=1.23, 95% CI:1.05-1.44, p<0.01, I2=98%), DLQI(MD : 0.59, 95% CI:0.14-1.04, p=0.07, I2=63%) and recurrence rate(RR=0.36, 95% CI:0.23-0.58, p=0.73, I2=0%) were seen. The effective rate of herbal medicine were statistically higher that of the control group(WM)(RR=1.19, 95% CI:1.04-1.37, p<0.01, I2=97%). As a result of dividing the treatment groups into OHM, EHM, and OEHM, the EHM group(RR=1.17, 95% CI:0.79-1.72, p<0.01, I2=99%) showed the most statistically significant effect. The overall risk of bias of the included studies was some concerns. No serious adverse effects were observed. Conclusions : This review found the effectiveness of herbal medicine for acne.

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

  • 김혜나;오정화;윤화정
    • 한방안이비인후피부과학회지
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    • 제36권4호
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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.

Role of HER2 in Brain Metastasis of Breast Cancer: a Systematic Review and Meta-Analysis

  • Hedayatizadeh-Omran, Akbar;Rafiei, Alireza;Alizadeh-Navaei, Reza;Tehrani, Mohsen;Valadan, Reza;Moradzadeh, Kambiz;Panbechi, Mohammad;Taghavi, Seyed Mehdi
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권4호
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    • pp.1431-1434
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    • 2015
  • Background: Breast cancer is one of the most common cancers among women worldwide and the HER2 receptor plays an important role in its development and progression. This systematic review aimed to summarize the role of HER2 in brain metastasis in patients with breast cancer. Materials and Methods: We conducted a literature search by advanced search in title field using the Scopus, Pubmed, and Google scholar databases until the end of June 2014. With metastasis, metastatic, HER2, brain, and breast cancer, as terms of search we selected 31 articles, which were reviewed by two independent and blinded expert reviewers. The studies were first selected according to their titles and abstracts. Quality of the studies were then assessed using the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) protocol for observational studies and CONSORT(Consolidation of Standards for Reporting Trials) protocol for clinical trials. For statistical analyses, we used STATA, version 11.0 software. Forest and funnel diagrams were drawn and for heterogeneity, index was also considered. Also we used meta regression analysis. Results: Finally, we reviewed 10 studies. The prevalence of brain metastasis in HER2-positive breast cancer patients was 24.9%. There was publication bias in the reviewed studies. Meta regression analysis showed that follow up time had no significant effect (p=0.396) on the prevalence of brain metastasis. Conclusions: The results showed a high prevalence of brain metastasis in HER2 positive breast cancer patients.

소아 식욕부진에 대한 이공산(異功散) 치료의 효과 : 체계적 문헌고찰 및 메타분석 (Effects of Yigong-san for the Treatment of Anorexia in Children: A Systematic Review and Meta-Analysis)

  • 이보람;하다정;허태영;박상은;이선행;장규태
    • 대한한방내과학회지
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    • 제43권4호
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    • pp.542-558
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    • 2022
  • Objectives: The purpose of this study was to assess the effect of Yigong-san on anorexia in children by conducting a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: Eleven electronic databases were searched on May 30, 2022 to collect relevant studies. All studies published up to the search date were considered. RCTs reporting the effect of Yigong-san on the treatment of anorexia in children were included. The primary outcome was an improvement in clinical anorexia symptoms after treatment. In this meta-analysis, continuous and binary outcomes were assessed, and the data were presented as the mean difference and risk ratio with their 95% confidence intervals. The risk of bias was assessed using the Cochrane Collaboration's risk of bias tool. Results: A total of nine studies were included in this systematic review. The treatment group (Yigong-san only or Yigong-san plus conventional treatment) showed a statistically significant effect compared to the control group (conventional treatment only) in total effective rate (Yigong-san only: RR 1.26, 95% CI 1.17, 1.36, I2=0%; Yigong-san plus conventional treatment: RR 1.32, 95% CI 1.18, 1.47, I2=0%), clinical symptoms, some of the anthropometric outcomes, and biological markers related to appetite and growth in children with anorexia. No serious adverse events related to Yigong-san were reported. Conclusions: Yigong-san showed statistically significant effects as a treatment for anorexia in children. However, the number of studies included in the meta-analysis was insufficient, and the herbs contained in the Yigong-san used in the included studies were not standardized. Future research should focus on the implementation of methodologically robust clinical research.

청소년 흡연 자가보고와 요코티닌 검사간의 일치도 (Agreement between Smoking Self-report and Urine Cotinine among Adolescents)

  • 박노례;함진경;정인숙
    • Journal of Preventive Medicine and Public Health
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    • 제37권2호
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    • pp.127-132
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    • 2004
  • Objectives : Cotinine, the major metabolite of nicotine, is a useful marker of exposure to tobacco smoke and self-reporting of smoking status is thought not to be reliable. This study aimed to evaluate the agreement between the smoking self-report among adolescents and the urinary cotinine test. Methods : The study subjects were 1226 middle and high school students in Hanam city, who were selected by stratified random sampling. The self-report about smoking behavior was compared with urine cotinine value measured with PBM $AccuSign^{\circledR}fi$ Nicotine(Princeton BioMeditech Corporation, USA). The percentage agreement, kappa and 95% confidence interval(CI) were calculated. Results : The overall percentage agreement was 88.6%, and those for boys, girls, middle school, general school and vocational school students were 87.3%, 90.1%, 93.7%, 85,5%, 90.7%, and 78.4%, respectively. The overall kappa index was 0.46(95% CI=0.39-0.54)for overall, .and those for boys, girls, middle school, general school and vocational school students were 0.56(95% CI=0.48-0.65), 0.20(95% CI=0.07-0.32), 0.21(95% CI=0.09-0.34), 0.55(95% CI=0.47-0.64), 0.42(95% CI=0.33-0.52), and 0.48(95% CI=0.36-0.60), respectively. Conclusion : The percentage agreement was relatively high but the kappa values very low for girls, and middle school students. Though the prevalence bias can be influenced by these results, the self-report was not a sufficient tool for the evaluation of adolescents' smoking status, especially in girls or middle school students.

Metformin Association with Lower Prostate Cancer Recurrence in Type 2 Diabetes: a Systematic Review and Meta-analysis

  • Hwang, In Cheol;Park, Sang Min;Shin, Doosup;Ahn, Hong Yup;Rieken, Malte;Shariat, Shahrokh F.
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권2호
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    • pp.595-600
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    • 2015
  • Background: Accumulating evidence suggests that metformin possesses anticarcinogenic properties, and its use is associated with favorable outcomes in several cancers. However, it remains unclear whether metformin influences prognosis in prostate cancer (PCa) with concurrent type 2 diabetes (T2D). Materials and Methods: We searched PubMed, EMBASE, and the Cochrane Library from database inception to April 16, 2014 without language restrictions to identify studies investigating the effect of metformin treatment on outcomes of PCa with concurrent T2D. We conducted a meta-analysis to quantify the risk of recurrence, progression, cancer-specific mortality, and all-cause mortality. Summary relative risks (RRs) with corresponding 95% confidence intervals (CIs) were calculated. Publication bias was assessed by Begg's rank correlation test. Results: A total of eight studies fulfilled the eligibility criteria. We found that diabetic PCa patients who did not use metformin were at increased risk of cancer recurrence (RR, 1.20; 95%CI, 1.00-1.44), compared with those who used metformin. A similar trend was observed for other outcomes, but their relationships did not reach statistical significance. Funnel plot asymmetry was not observed among studies reporting recurrence (p=0.086). Conclusions: Our results suggest that metformin may improve outcomes in PCa patients with concurrent T2D. Well-designed large studies and collaborative basic research are warranted.

동영상 촬영과 피드백을 이용한 실습교육이 보건의료전공 대학생의 술기수행능력에 미치는 효과: 메타분석 (Effectiveness of Education Program Using Video Recording and Feedback on Skill Competency for Students of Majors in Health Care: A Meta-Analysis)

  • 신윤희;김선경;김현주
    • 기본간호학회지
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    • 제25권2호
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    • pp.120-133
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    • 2018
  • Purpose: A meta-analysis was conducted to evaluate effectiveness of education programs using video recording and feedback in the improvement of competency in clinical skills for health care majors. Methods: Six databases were searched and inclusion criteria were randomized controlled trials (RCTs) or non-randomized controlled trials (NRTs) reporting level of skill competency using numerical measurements. Data analysis and synthesis were performed using Comprehensive Meta-Analysis software and Revman program. Results: Of 1,568 records, 11 studies met inclusion criteria. Statistically significant effectiveness of education programs using video recording and feedback was identified. A low risk of bias was detected among both RCTs and NRTs. Meta-analysis showed that the intervention groups had more effective improvements in skill competency (standardized mean difference [SMD]: 0.74; 95% CI: 0.33~1.16). Results of subgroup analysis showed higher effects when interventions dealt with one skill, used self-reflection with expert feedback, and included instruction from instructor in the education programs. Conclusion: Findings suggest that schools for health care majors should actively adopt video and feedback based skill training allowing educators to design effective programs. Potential is higher for students to achieve higher competency when they train with one skill at a time, use of instruction and receive feedback from experts.

유착성 관절낭염에 대한 추나요법의 효과: 체계적 문헌고찰과 메타분석 (Chuna Manual Therapy for Adhesive Capsulitis : A Systematic Review and Meta Analysis)

  • 조주찬;허인;박선영;신병철
    • 척추신경추나의학회지
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    • 제14권2호
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    • pp.1-14
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    • 2019
  • Objectives : To evaluate the effectiveness of Chuna Manual Therapy for adhesive capsulitis by a systematic review manner. Methods : Five foreign electronic databases (Pubmed, Ovid-medline, Embase, Cochrane library, Chinese Academic Journals (CAJ)) and two Korean medical electronic databases (Oriental Medicine Advanced Searching Integrated System (OASIS) and Research Information Sharing Service (RISS)) were searched to find all randomized controlled trials (RCTs) using Chuna Manual Therapy as a treatment for adhesive capsulitis. The methodological quality of each RCT was assessed using the Cochrane risk of bias tool. Results : Twenty-one RCTs met our inclusion criteria. The meta-analysis showed positive results on the use of Chuna Manual Therapy combined with acupuncture or exercise therapy in terms of the efficacy rate and pain using the Visual Analogue Scale (VAS), compared to acupuncture or exercise alone [SMD-1.81 (95% CI & -2.54, -1.08), P<0.001, RR 1.19 (95% CI 1.14, 1.23), P<0.001)]. Positive results in terms of efficacy rate were also obtained comparing Chuna Manual Therapy to acupuncture alone [RR 1.10 (95% CI 1.02, 1.18), P=0.01]. Conclusions : Our systematic review found favorable results on the effectiveness of Chuna Manual Therapy for pain and efficacy rate of adhesive capsulitis. However, evidence was limited due to the lack of well-designed RCTs. More qualified clinical trials are needed to obtain stronger evidence.

Global Adult Tobacco Survey (GATS): A Case for Change in Definition, Analysis and Interpretation of "Cigarettes" and "Cigarettes Per Day" in Completed and Future Surveys

  • Jena, Pratap Kumar;Kishore, Jugal;Sarkar, Bidyut K.
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권5호
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    • pp.3299-3304
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    • 2013
  • Background: The Global Adult Tobacco Survey has 15 key indicators, cigarettes smoked per day (CPD) among daily smokers being one of them. The first wave of GATS in 14 countries indicated that mean CPD use is higher in women than men in India only, which is contrary to the current understanding of tobacco use globally. This study was undertaken to understand the unusual findings for mean CPD use in the GATS-India survey. Materials and Methods: Items B06a and B06b of the GATS India survey questionnaire that collected information on daily consumption of manufactured and rolled cigarettes were analyzed using SPSS software. Exclusive users were identified from these items after excluding the concurrent users of other tobacco products. Cigarette type, exclusive use and gender stratified analyses were made. Consumption of different types of cigarettes among the mixed users of manufactured and rolled cigarettes were correlated. Results: Higher mean number of CPD use among male daily-smokers was observed than their female counterparts in product specific analysis. Mean CPD as per GATS cigarette definition was higher in males than females for exclusive users but a reverse trend was observed in case of non-exclusive users. Use of manufactured cigarettes increased with increase in use of rolled cigarette among the mixed users and around half of these users reported equal CPD frequency for the both types of cigarettes. Conclusions: The anomaly in mean CPD estimate in GATS-India data was due to inclusion of two heterogeneous products to define cigarettes, variation in cigarette product specific user proportions contributing to the average and non-exclusive concurrent use of other tobacco products. The consumption pattern of cigarettes among the mixed users highlights bias in CPD reporting. Definition, analysis and interpretation of 'cigarettes per day' in the GATS India survey need to be improved by redefining cigarettes and making product specific analyses.

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
    • 국제물리치료학회지
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    • 제11권2호
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    • pp.2096-2101
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    • 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.