Komplementäre Therapien: Verlässliche Informationen richtig vermitteln

2020 ◽  
Vol 7 (4) ◽  
pp. 208-209
Author(s):  
Claudia M. Witt
Keyword(s):  
Standard Care ◽  
Decision Aid ◽  
Meta Analysis ◽  
Supplementary Information ◽  
Evidence Based ◽  
Healing Touch ◽  
Children With Cancer ◽  
Assessment Development ◽  
Group A ◽  
Randomized Control

<b>Purpose:</b> To develop an evidence-based decision aid for parents of children with cancer and to help guide them in the use of complementary and alternative medicine (CAM) for cancer care. <b>Methods:</b> This study had a mixed research design. The needs of parents were investigated by survey and focus group. A systematic review and meta-analysis were performed on the effectiveness of CAM using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Clinical experts were interviewed and a decision aid on CAM treatment for pain was developed. <b>Results:</b> Parents emphasized the importance of reliable information on CAM, focusing primarily on communication and a broad spectrum of complaints related to cancer treatment. The decision aid on CAM for pain included five modalities based on 11 randomized control trials (RCTs): hypnotherapy, mind-body techniques, massage, healing touch, and music therapy. Meta-analysis could be performed on hypnotherapy, which significantly reduced cancer-related procedural pain compared with standard care (MD, – 1.37; 95% CI, – 1.60, – 1.15; P &#x3c; 0.00001) and attention control (MD, – 1.13; 95% CI, – 1.34, – 0.94; P &#x3c; 0.00001), and massage, demonstrating no effect on pain compared with standard care (MD, – 0.77; 95% CI, – 1.82, 0.28; P = 0.15). Research evidence and supplementary information from clinical practice and patient were incorporated in a website-based decision aid. <b>Conclusions:</b> An evidence-based decision aid was developed to support parents of children with cancer in making decisions about CAM for pain management. Next steps will be to expand the website to include additional childhood cancer-related complaints and to evaluate its use in practice.

scholarly journals Dietary Ingredients Requiring Further Research Before Evidence-Based Recommendations Can Be Made for Their Use as an Approach to Mitigating Pain

Pain Medicine ◽  
2019 ◽  
Vol 20 (8) ◽  
pp. 1619-1632 ◽  
Author(s):  
Cindy Crawford ◽  
Courtney Boyd ◽  
Kevin Berry ◽  
Patricia Deuster ◽  
Keyword(s):  
Decision Making ◽  
Meta Analysis ◽  
Self Care ◽  
Steering Committee ◽  
Sufficient Evidence ◽  
Evidence Based ◽  
Special Operations ◽  
Assessment Development ◽  
Trade Offs ◽  
Rose Hip

Abstract Objective Approximately 55–76% of Service members use dietary supplements for various reasons; although such use has become popular, decisions are often driven by information that is not evidence-based. This work evaluates whether current research on dietary ingredients for chronic musculoskeletal pain provides sufficient evidence to inform decisions for practice and self-care, specifically for Special Operations Forces personnel. Methods A steering committee convened to develop research questions and factors required for decision-making. Key databases were searched through August 2016. Eligible systematic reviews and randomized controlled trials were assessed for methodological quality. Meta-analysis was applied where feasible. Grading of Recommendations, Assessment, Development and Evaluation was used to determine confidence in the effect estimates. The committee used a decision table to make evidence-informed judgments across decision-making factors and recommendations for practice and self-care use. Results Nineteen dietary ingredients were assessed. No recommendations were given for boswellia, ginger, rose hip, or s-adenosyl-L-methionine (SAMe); specifically, although ginger can be obtained via food, no recommendation is provided for use as a supplement due to unclear research. Further, there were insufficient strong research on boswellia and SAMe and possible compliance issues (i.e., high number of capsules required daily) associated with rose hip. Conclusions No recommendations were made when the evidence was low quality or trade-offs were so closely balanced that any recommendation would be too speculative. Research recommendations are provided to enhance the quality and body of evidence for the most promising ingredients. Clinicians and those with chronic pain can rely on evidence-based recommendations to inform their decisions.

scholarly journals An evidence-based decision aid on complementary medicine for parents of children with cancer

2018 ◽  
Vol 28 (suppl_4) ◽  
Author(s):  
M Jong ◽  
I Boers ◽  
WJE Tissing ◽  
MC Naafs ◽  
M Busch
Keyword(s):  
Complementary Medicine ◽  
Decision Aid ◽  
Evidence Based ◽  
Children With Cancer

Guideline for the Management of Fever and Neutropenia in Children With Cancer and/or Undergoing Hematopoietic Stem-Cell Transplantation

2012 ◽  
Vol 30 (35) ◽  
pp. 4427-4438 ◽  
Author(s):  
Thomas Lehrnbecher ◽  
Robert Phillips ◽  
Sarah Alexander ◽  
Frank Alvaro ◽  
Fabianne Carlesse ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Initial Presentation ◽  
Local Context ◽  
Evidence Based ◽  
Children With Cancer ◽  
Level Of Evidence ◽  
Hematopoietic Stem ◽  
Assessment Development ◽  
Patient Advocate ◽  
Evaluation Approach

PurposeTo develop an evidence-based guideline for the empiric management of pediatric fever and neutropenia (FN).MethodsThe International Pediatric Fever and Neutropenia Guideline Panel is a multidisciplinary and multinational group composed of experts in pediatric oncology and infectious disease as well as a patient advocate. The Panel was convened for the purpose of creating this guideline. We followed previously validated procedures for creating evidence-based guidelines. Working groups focused on initial presentation, ongoing management, and empiric antifungal therapy. Each working group developed key clinical questions, conducted systematic reviews of the published literature, and compiled evidence summaries. The Grades of Recommendation Assessment, Development, and Evaluation approach was used to generate summaries, and evidence was classified as high, moderate, low, or very low based on methodologic considerations.ResultsRecommendations were made related to initial presentation (risk stratification, initial evaluation, and treatment), ongoing management (modification and cessation of empiric antibiotics), and empiric antifungal treatment (risk stratification, evaluation, and treatment) of pediatric FN. For each recommendation, the strength of the recommendation and level of evidence are presented.ConclusionThis guideline represents an evidence-based approach to FN specific to children with cancer. Although some recommendations are similar to adult-based guidelines, there are key distinctions in multiple areas. Implementation will require adaptation to the local context.

Parent–Infant Interventions to Promote Parental Sensitivity During NICU Hospitalization: Systematic Review and Meta-Analysis

2021 ◽  
pp. 105381512199192
Author(s):  
Andréane Lavallée ◽  
Gwenaëlle De Clifford-Faugère ◽  
Ariane Ballard ◽  
Marilyn Aita
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Standard Care ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Parental Sensitivity ◽  
Assessment Development ◽  
Implementation Failure ◽  
Meta Analyses

This systematic review and meta-analysis examined the effectiveness of parent–infant interventions for parents of preterm infants on parental sensitivity compared to standard care or active comparators. This review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO; registration ID: CRD42016047083). Database searches were performed from inception to 2020 to identify eligible randomized controlled trials. Two review authors independently selected studies, extracted data, and assessed the risk of bias using the Cochrane risk of bias assessment tool and quality of evidence using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) guidelines. A total of 19 studies ( n = 2,111 participants) were included and 14 were suitable to be pooled in our primary outcome meta-analysis. Results show no significant effect of parent–infant interventions over standard care or basic educational programs, on parental sensitivity. Results may not necessarily be due to the ineffectiveness of the interventions but rather due to implementation failure or high risk of bias of included studies.

scholarly journals Comparative Effectiveness and Safety of 32 Pharmacological Interventions Recommended by Guidelines for COVID-19: A Systematic Review and Network Meta-Analysis Combining 66 Trials

2020 ◽  
Author(s):  
Shanshan Wu ◽  
Qingxin Zhou ◽  
Xueyang Zeng ◽  
Jingxue Zhang ◽  
Zhirong Yang ◽  
...  
Keyword(s):  
Standard Care ◽  
Meta Analysis ◽  
Antiviral Agents ◽  
Current Evidence ◽  
Cochrane Library ◽  
Cure Rate ◽  
Pharmacological Interventions ◽  
Assessment Development ◽  
Risk Of Mortality ◽  
Increased Risk

Abstract Background: To evaluate comparative efficacy and safety of pharmacological interventions in patients with coronavirus disease 2019. Methods: Medline, Embase, the Cochrane Library and clinicaltrials.gov were searched for randomized controlled trials (RCTs) in patients infected with SARS-COV-2/SARS-COV. Random-effects network meta-analysis within Bayesian framework was performed, followed by Grading of Recommendations Assessment, Development and Evaluation (GRADE) system assessing quality of evidence. The primary outcome of interest includes mortality, cure, viral negative conversion (VNC) and overall adverse events (OAE). Odds ratio (OR) with 95% confidence interval (CI) was calculated as the measure of effect size.Results: 66 RCTs with 19,095 patients were included, involving standard care (SOC), 8 different antiviral agents, 6 different antibiotics, high and low dose chloroquine (CQ_HD, CQ_LD), traditional Chinese medicine (TCM), corticosteroids and other treatments. Compared with SOC, significant reduction of mortality was observed for TCM (OR=0.34, 95%CI: 0.20-0.56, moderate quality) and corticosteroids (OR=0.84, 0.75-0.96, low quality) with improved cure rate (OR=2.16, 1.60-2.91, low quality for TCM; OR=1.17, 1.05-1.30, low quality for corticosteroids). However, increased risk of mortality was found for CQ_HD versus SOC (OR=3.20, 1.18-8.73, low quality). TCM was associated with decreased risk of OAE (OR=0.52, 0.38-0.70, very low quality) but CQ_HD (OR=2.51, 1.20-5.24) and IFN (OR=2.69, 1.02-7.08) versus SOC with very low quality) were associated with an increased risk. Conclusions: Corticosteroids and TCM may reduce mortality and increase cure rate with no increased risk of OAEs compared with standard care. CQ_HD might increase the risk of mortality. CQ, IFN and other antiviral agents could increase the risk of OAEs. The current evidence is generally uncertain with low quality and further high-quality trials are needed.

Efficacy of Alprostadil in Preventing Contrast-Induced Nephropathy: A Systematic Review and Meta-Analysis

Angiology ◽  
2021 ◽  
pp. 000331972110044
Author(s):  
Hongling Xu ◽  
Hongye Wang ◽  
Chuang Zhang ◽  
Jun Xiao ◽  
Ning Hua ◽  
...  
Keyword(s):  
Meta Analysis ◽  
China National Knowledge Infrastructure ◽  
Contrast Induced Nephropathy ◽  
Serum Cystatin ◽  
Assessment Development ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Knowledge Infrastructure ◽  
Evidence Evaluation ◽  
Biological Medicine ◽  
Neutrophil Gelatinase

This study aimed to determine the efficacy of alprostadil in preventing contrast-induced nephropathy (CIN). Eligible studies were searched using the keywords through the databases of PubMed, Cochrane, Embase, China Biological Medicine Database, China National Knowledge Infrastructure, and Vanfun. Quality evaluation of the included studies was conducted according to international evidence evaluation and recommended Grades of Recommendations Assessment, Development, and Evaluation standards. We included 29 studies with 5623 patients. Compared with hydration, 10 µg/d alprostadil or 20 µg/d alprostadil plus hydration significantly decreased the incidence of CIN. Compared with hydration, alprostadil plus hydration significantly reduced serum creatinine and blood urea nitrogen at 24, 48, and 72 hours and 7 days after coronary angiography (CAG). Alprostadil (20 µg/d) plus hydration significantly decreased serum cystatin versus hydration at 24, 48, and 72 hours after CAG. Compared with hydration, alprostadil plus hydration significantly increased glomerular filtration rate at 24 and 72 hours after CAG. Alprostadil plus hydration significantly decreased neutrophil gelatinase-associated lipocalin levels compared to hydration at 24, 48, and 72 hours after CAG. Alprostadil plus hydration significantly decreased urine macroglobulin versus hydration at 24 and 48 hours after CAG.

A preliminary systematic review and meta-analysis on the effects of heart rate variability biofeedback on heart rate variability and respiration of athletes

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Jeffrey Cayaban Pagaduan ◽  
Yung-Sheng Chen ◽  
James William Fell ◽  
Sam Shi Xuan Wu
Keyword(s):  
Systematic Review ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Web Of Science ◽  
Meta Analysis ◽  
Academic Research ◽  
Experimental Studies ◽  
Quantitative Review ◽  
Heart Rate Variability Biofeedback ◽  
Randomized Control

Abstract To date, there is no quantitative review examining the influence of heart rate variability biofeedback (HRV BFB) on the athlete population. Such an undertaking may provide valuable information on the autonomic and respiration responses of athletes when performing HRV BFB. Thus, purpose of this preliminary systematic review and meta-analysis on the effects of HRV BFB on HRV and respiration of athletes. Searches of Springerlink, SportDiscus, Web of Science, PROQUEST Academic Research Library, Google Scholar, and ScienceDirect were conducted for studies that met the following criteria: (1) experimental studies involving athletes that underwent randomized control trial; (2) availability of HRV BFB as a treatment compared with a control (CON)/placebo (PLA); (3) any pre and post HRV variable and/or breathing frequency as dependent variable/s; and, (4) peer-reviewed articles written in English. Four out of 660 studies involving 115 athletes (25 females and 90 males) ages 16–30 years old were assessed in this review. Preliminary findings suggest the promising ability of HRV BFB to improve respiratory mechanics in athlete population. More work is needed to determine the autonomic modulatory effect of HRV BFB in athletes.

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