scholarly journals Chinese Herbal Medicine Banxiaxiexin Decoction Treating Diabetic Gastroparesis: A Systematic Review of Randomized Controlled Trials

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
Jiaxing Tian ◽  
Min Li ◽  
Jiangquan Liao ◽  
Junling Li ◽  
Xiaolin Tong
Keyword(s):  
Methodological Quality ◽  
Large Scale ◽  
Data Extraction ◽  
Cochrane Review ◽  
Gastrointestinal Symptoms ◽  
Diabetic Gastroparesis ◽  
Future Research ◽  
Control Group ◽  
Gastric Emptying Rate ◽  
Randomized Controlled

Objective. To assess the current clinical evidence of Banxiaxiexin decoction for diabetic gastroparesis (DGP).Methods. Electronic databases were searched until December 2012. No language limitations were applied. We included RCTs using Banxiaxiexin decoction/modified Banxiaxiexin decoction for DGP. No restriction for the control group except acupuncture. Applying clinical effective rate as the main outcome index. Data extraction, analyses and quality assessment were conducted according to the Cochrane review standards.Results. 16 RCTs involving 1302 patients were finally identified, and the methodological quality was evaluated as generally low. The data showed that the effect of Banxiaxiexin decoction (BXXD) for DGP was superior to the control group (n=1302, RR 1.23, 95% CI 1.17 to 1.29,Z=8.04,P<0.00001). Only one trial recorded adverse events, no obvious adverse event occurred.Conclusions. Banxiaxiexin decoction could regain the gastric emptying rate and improve diabetic gastrointestinal symptoms. However, the methodological quality of included studies is low, and long term efficacy and safety are still uncertain, which indicates that the findings above should be read with caution. Thereby, well-designed, large-scale, and high-quality randomized controlled clinical trials with scientific rigor are warranted for stronger evidence in future research.

scholarly journals Efficacy and safety of radiofrequency ablation for treatment of knee osteoarthritis: a meta-analysis of randomized controlled trials

2021 ◽  
Vol 49 (4) ◽  
pp. 030006052110066
Author(s):  
Hua Zhang ◽  
Bo Wang ◽  
Jie He ◽  
Zhongju Du
Keyword(s):  
Radiofrequency Ablation ◽  
Knee Osteoarthritis ◽  
Randomized Controlled Trials ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cochrane Review ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Serious Adverse Events ◽  
Randomized Controlled

Objective To evaluate the efficacy and safety of radiofrequency ablation for the treatment of knee osteoarthritis. Methods A literature review was conducted using the PubMed, Cochrane Review, Embase, and Google Scholar databases. Two reviewers independently assessed the eligibility of all retrieved studies. The research was reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to ensure the reliability and verity of the results. The statistical analysis was performed using STATA version 13.0. Results Nine randomized controlled trials were collected for the data extraction and meta-analysis. Significant differences in the pain score at 4, 12, and 24 weeks were found between patients treated with radiofrequency ablation and those treated with placebo. Furthermore, the use of radiofrequency ablation was associated with an improved outcome of the Western Ontario and McMaster Universities Arthritis Index at 4, 12, and 24 weeks. No serious adverse events were observed in any patients who underwent radiofrequency ablation. Conclusion Radiofrequency ablation is efficacious and safe for reducing pain and improving knee function in patients with knee osteoarthritis, without increasing the risk of adverse effects.

scholarly journals Interventions to Improve Patient Comprehension in Informed Consent for Medical and Surgical Procedures: An Updated Systematic Review

2020 ◽  
Vol 40 (2) ◽  
pp. 119-143 ◽  
Author(s):  
Johanna Glaser ◽  
Sarah Nouri ◽  
Alicia Fernandez ◽  
Rebecca L. Sudore ◽  
Dean Schillinger ◽  
...  
Keyword(s):  
Informed Consent ◽  
Data Extraction ◽  
Meta Analysis ◽  
Size Control ◽  
Group Processes ◽  
Future Research ◽  
Control Group ◽  
Test Feedback ◽  
Patient Comprehension ◽  
Improve Patient

Background. Patient comprehension is fundamental to valid informed consent. Current practices often result in inadequate patient comprehension. Purpose. An updated review to evaluate the characteristics and outcomes of interventions to improve patient comprehension in clinical informed consent. Data Sources. Systematic searches of MEDLINE and EMBASE (2008–2018). Study Selection. We included randomized and nonrandomized controlled trials evaluating interventions to improve patient comprehension in clinical informed consent. Data Extraction. Reviewers independently abstracted data using a standardized form, comparing all results and resolving disagreements by consensus. Data Synthesis. Fifty-two studies of 60 interventions met inclusion criteria. Compared with standard informed consent, a statistically significant improvement in patient comprehension was seen with 43% (6/14) of written interventions, 56% (15/27) of audiovisual interventions, 67% (2/3) of multicomponent interventions, 85% (11/13) of interactive digital interventions, and 100% (3/3) of verbal discussion with test/feedback or teach-back interventions. Eighty-five percent of studies (44/52) evaluated patients’ understanding of risks, 69% (41/52) general knowledge about the procedure, 35% (18/52) understanding of benefits, and 31% (16/52) understanding of alternatives. Participants’ education level was reported heterogeneously, and only 8% (4/52) of studies examined effects according to health literacy. Most studies (79%, 41/52) did not specify participants’ race/ethnicity. Limitations. Variation in interventions and outcome measures precluded conduct of a meta-analysis or calculation of mean effect size. Control group processes were variable and inconsistently characterized. Nearly half of studies (44%, 23/52) had a high risk of bias for the patient comprehension outcome. Conclusions. Interventions to improve patient comprehension in informed consent are heterogeneous. Interactive interventions, particularly with test/feedback or teach-back components, appear superior. Future research should emphasize all key elements of informed consent and explore effects among vulnerable populations.

Statistical methods for unidirectional switch designs: Past, present, and future

2017 ◽  
Vol 27 (9) ◽  
pp. 2872-2882 ◽  
Author(s):  
Zhuozhao Zhan ◽  
Geertruida H de Bock ◽  
Edwin R van den Heuvel
Keyword(s):  
Statistical Methods ◽  
Large Scale ◽  
Sample Size Calculation ◽  
Complex Interventions ◽  
New Drugs ◽  
Control Treatment ◽  
Future Research ◽  
Control Group ◽  
Unified Framework ◽  
New Treatment

Clinical trials may apply or use a sequential introduction of a new treatment to determine its efficacy or effectiveness with respect to a control treatment. The reasons for choosing a particular switch design have different origins. For instance, they may be implemented for ethical or logistic reasons or for studying disease-modifying effects. Large-scale pragmatic trials with complex interventions often use stepped wedge designs (SWDs), where all participants start at the control group, and during the trial, the control treatment is switched to the new intervention at different moments. They typically use cross-sectional data and cluster randomization. On the other hand, new drugs for inhibition of cognitive decline in Alzheimer’s or Parkinson’s disease typically use delayed start designs (DSDs). Here, participants start in a parallel group design and at a certain moment in the trial, (part of) the control group switches to the new treatment. The studies are longitudinal in nature, and individuals are being randomized. Statistical methods for these unidirectional switch designs (USD) are quite complex and incomparable, and they have been developed by various authors under different terminologies, model specifications, and assumptions. This imposes unnecessary barriers for researchers to compare results or choose the most appropriate method for their own needs. This paper provides an overview of past and current statistical developments for the USDs (SWD and DSD). All designs are formulated in a unified framework of treatment patterns to make comparisons between switch designs easier. The focus is primarily on statistical models, methods of estimation, sample size calculation, and optimal designs for estimation of the treatment effect. Other relevant open issues are being discussed as well to provide suggestions for future research in USDs.

Death Anxiety Reduction as the Result of Exposure to a Death and Dying Symposium

1984 ◽  
Vol 14 (4) ◽  
pp. 323-328 ◽  
Author(s):  
David A. Waldman ◽  
Charles Davidshofer
Keyword(s):  
Undergraduate Students ◽  
Media Coverage ◽  
Death Anxiety ◽  
Large Scale ◽  
Death And Dying ◽  
Anxiety Reduction ◽  
Future Research ◽  
Control Group ◽  
Control Group Design ◽  
Colorado State University

The purpose of this study was to measure the effect of a three-week death and dying symposium at Colorado State University on attitudes and anxiety related to death, dying, and grief. A prepost control group design was employed using psychology undergraduate students as participants. Because of an overall finding of low participant attendance at the symposium events, participants who attended at least one event were assigned to the treatment group for data analyses. Results indicated lower death anxiety for students in both the treatment and control groups. The findings are discussed in terms of the widespread media coverage and informal discussions which accompany large-scale symposiums. Future research is suggested regarding the dynamic effects of such death and dying symposiums in relation to both attendants and nonattendants.

scholarly journals Sauna Yoga Superiorly Improves Flexibility, Strength, and Balance: A Two-Armed Randomized Controlled Trial in Healthy Older Adults

2019 ◽  
Vol 16 (19) ◽  
pp. 3721 ◽  
Author(s):  
Bucht ◽  
Donath
Keyword(s):  
Large Scale ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Intervention Group ◽  
Control Group ◽  
Minimization Method ◽  
Important Indicator ◽  
Randomized Controlled ◽  
Eyes Closed ◽  
Healthy Elderly

Besides strength and balance, flexibility is an important indicator of health-related physical fitness. Thus, the aim of this two-armed randomized controlled pilot trial was to investigate whether sauna yoga at a moderate temperature (50 °C) beneficially affects flexibility, strength, balance, and quality of life (QOL) in healthy elderly community dwellers. Participants were randomly assigned to an intervention group (INT, n = 11, age: 68.7 ± 5.9) or control group (CON, n = 12, age: 69.3 ± 4.9), using the minimization method. Age, physical activity, gender, and the primary outcome flexibility were used as strata for group allocation. Both groups completed similar exercises in the sauna over eight weeks. Only the INT group was exposed to moderate temperatures of 50 °C. Large and statistically significant improvement in favor of the sauna group (INT) was observed for the chair sit-and-reach test (INT: +83%, CON +3%, p = 0.028, nр² = 0.24). The shoulder and lateral spine flexibility were not relevantly affected. Strength in the lower extremities merely showed a tendency to significant changes (INT: 16%, CON: 3%, p = 0.061, nр² = 0.181). Additionally, balance abilities, with eyes closed, improved (INT: 187%, CON +58%, p = 0.056, nр² = 0.189) in favor of the INT group. QOL only improved in favor of the INT for environmental dimension (INT: +7%, CON: 0%, p = 0.034, nр² = 0.227). These first but preliminary findings indicate that sauna yoga may serve as a promising and feasible means to improve flexibility in elderly people. Strength and balance do not meaningfully benefit from a sauna environment, although strength improved to a slightly higher extent in the sauna group. Future large-scale research is needed to elucidate underlying mechanisms and corroborate these findings

scholarly journals The Effects of Hyaluronic Acid in Preventing Recurrence of Urethral Stricture after Visual Internal Urethrotomy

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H H G Hasan ◽  
M K A Tolba ◽  
M M M Shalaby
Keyword(s):  
Hyaluronic Acid ◽  
Recurrence Rate ◽  
Urethral Stricture ◽  
Large Scale ◽  
Control Group ◽  
Urethral Reconstruction ◽  
Internal Urethrotomy ◽  
Randomized Controlled ◽  
Voiding Symptoms ◽  
Number Of Patients

Abstract Background Many urologists prefer Visual internal urethrotomy (VIU)because of its ease to perform, short hospital stay, low cost, and perceived low complication rate. They may repeat VIU several times to avoid complex urethral reconstruction, because it requires significant surgical experience. Because of its effectiveness and simplicity, VIU is the primary treatment option for urethral stricture disease. However, the recurrence rate is high and the success rate is low. Aim of the Work To evaluate the effect of hyaluronic acid (HA) instillation during visual internal urethrotomy (VIU) for decreasing the incidence of recurrent urethral stricture. Patients and Methods A total of 50 patients who were treated by Visualized internal uretherotomy for urethral stricture between February 2017 and January 2019 were invited to participate in the present study. This study is a multicenter,prospective, randomized controlled, single-blinded study. Results In this study the experimental group had a better voiding symptoms than the control group six months after the surgery,The present study showed that the instillation of hyaluronic acid into the urethra during visualized internal urethrotomy didn’t significantly reduced the recurrence of urethral stricture after the operation although the number of patients who had recurrence after hyaluronic acid instillation were less than recurrence rate in the control group. The hyaluronic acid had no observed side effects and helped to improve the pain and quality of life after the surgery. Conclusion The instillation of hyaluronic into the urethra during VIU reduced postoperative pain and improved voiding symptoms in the study group , but it didn’t significantly reduce the recurrence of urethral stricture after the operation. we suggest that a large-scale, randomized controlled trial be conducted in a larger number of patients with long-term follow-up .

Psychotherapy for Psychopathology During Pregnancy and the Postpartum Period

2015 ◽  
Author(s):  
Amy Wenzel ◽  
Scott Stuart ◽  
Hristina Koleva
Keyword(s):  
Randomized Controlled Trials ◽  
Large Scale ◽  
Behavioral Therapy ◽  
Treatment Retention ◽  
Future Research ◽  
Controlled Trials ◽  
Depression And Anxiety ◽  
Randomized Controlled ◽  
Medication Exposure ◽  
Perinatal Women

Psychotherapy is often the treatment of choice for perinatal women who wish to limit their fetus’s or infant’s medication exposure. The vast majority of empirical research that has examined psychotherapy for perinatal women has focused on depression. Interpersonal psychotherapy (IPT) and cognitive behavioral therapy (CBT) have been examined in several studies to determine their efficacy in perinatal depression and anxiety. Recent research has begun to examine the manner in which psychotherapies can be delivered in alternative formats (e.g., teletherapy) in order to overcome problems with treatment retention and compliance. Suggestions for future research include large-scale randomized controlled trials that compare two active approaches to psychotherapy, mediation studies to uncover the mechanisms of change associated with the successful treatment of perinatal women, and randomized controlled trials evaluating the efficacy of psychotherapy for mental health disorders other than depression.

scholarly journals Non-Immersive Virtual Reality for Rehabilitation of the Older People: A Systematic Review into Efficacy and Effectiveness

2019 ◽  
Vol 8 (11) ◽  
pp. 1882 ◽  
Author(s):  
Bevilacqua ◽  
Maranesi ◽  
Riccardi ◽  
Donna ◽  
Pelliccioni ◽  
...  
Keyword(s):  
Systematic Review ◽  
Virtual Reality ◽  
Older People ◽  
Randomized Controlled Trials ◽  
Cognitive Abilities ◽  
Positive Impact ◽  
Data Extraction ◽  
Future Research ◽  
Controlled Trials ◽  
Randomized Controlled

: Objective: the objective of this review is to analyze the advances in the field of rehabilitation through virtual reality, while taking into account non-immersive systems, as evidence have them shown to be highly accepted by older people, due to the lowest “cibersikness” symptomatology. Data sources: a systematic review of the literature was conducted in June 2019. The data were collected from Cochrane, Embase, Scopus, and PubMed databases, analyzing manuscripts and articles of the last 10 years. Study selection: we only included randomized controlled trials written in English aimed to study the use of the virtual reality in rehabilitation. We selected 10 studies, which were characterized by clinical heterogeneity. Data extraction: quality evaluation was performed based on the Physioterapy Evidence Database (PEDro) scale, suggested for evidence based review of stroke rehabilitation. Of 10 studies considered, eight were randomized controlled trials and the PEDro score ranged from four to a maximum of nine. Data synthesis: VR (Virtual Reality) creates artificial environments with the possibility of a patient interaction. This kind of experience leads to the development of cognitive and motor abilities, which usually positively affect the emotional state of the patient, increasing collaboration and compliance. Some recent studies have suggested that rehabilitation treatment interventions might be useful and effective in treating motor and cognitive symptoms in different neurological disorders, including traumatic brain injury, multiple sclerosis, and progressive supranuclear palsy. Conclusions: as it is shown by the numerous studies in the field, the application of VR has a positive impact on the rehabilitation of the most predominant geriatric syndromes. The level of realism of the virtual stimuli seems to have a crucial role in the training of cognitive abilities. Future research needs to improve study design by including larger samples, longitudinal designs, long term follow-ups, and different outcome measures, including functional and quality of life indexes, to better evaluate the clinical impact of this promising technology in healthy old subjects and in neurological patients.

scholarly journals Proactive Telephone Smoking Cessation Counseling Tailored to Parents: Results of a Randomized Controlled Effectiveness Trial

2019 ◽  
Vol 16 (15) ◽  
pp. 2730
Author(s):  
Tessa Scheffers-van Schayck ◽  
Roy Otten ◽  
Rutger C.M.E. Engels ◽  
Marloes Kleinjan
Keyword(s):  
Smoking Cessation ◽  
Large Scale ◽  
Telephone Counseling ◽  
Future Research ◽  
Effectiveness Trial ◽  
Smoking Cessation Counseling ◽  
Post Intervention ◽  
Counseling Intervention ◽  
Randomized Controlled ◽  
Quit Smoking

A recent Dutch efficacy trial showed the efficacy of a telephone smoking cessation counseling tailored to smoking parents. Currently, it is unknown whether such telephone counseling would be effective under more real-world conditions. This study aimed to examine the effectiveness of parent-tailored telephone smoking cessation counseling in a two-arm randomized controlled effectiveness trial and whether the effectiveness depended on the recruitment approaches that were used to recruit parents (mass media vs. health care). In total, 87 parents received either telephone counseling (intervention) or a self-help brochure (control). Parents were asked to complete questionnaires at baseline and three months post-intervention. Results showed that the odds of reporting 7-day point-prevalence abstinence at three months post-intervention was 7.54 higher for parents who received telephone counseling than for parents in the control condition (53.3% vs. 13.2%, 95% CI = 2.49–22.84). Because inclusion was lower than anticipated, interaction-effects of condition and recruitment approach could not be interpreted. The present study demonstrates that the parent-tailored smoking cessation telephone counseling is effective in helping parents to quit smoking. Yet, before large-scale implementation, future research should focus on how recruitment of parents via the recruitment approaches could be improved.

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