scholarly journals Can We Explain Heterogeneity Among Randomized Clinical Trials of Exercise for Chronic Back Pain? A Meta-Regression Analysis of Randomized Controlled Trials

2010 ◽  
Vol 90 (10) ◽  
pp. 1383-1403 ◽  
Author(s):  
Manuela L. Ferreira ◽  
Rob J.E.M. Smeets ◽  
Steven J. Kamper ◽  
Paulo H. Ferreira ◽  
Luciana A.C. Machado
Keyword(s):  
Clinical Trials ◽  
Back Pain ◽  
Randomized Clinical Trials ◽  
Chronic Back Pain ◽  
Data Extraction ◽  
Demographic Data ◽  
Patient Characteristics ◽  
Outcome Data ◽  
Effect Sizes ◽  
Meta Regression

BackgroundExercise programs may vary in terms of duration, frequency, and dosage; whether they are supervised; and whether they include a home-based program. Uncritical pooling of heterogeneous exercise trials may result in misleading conclusions regarding the effects of exercise on chronic low back pain (CLBP).PurposeThe purpose of this study was to establish the effect of exercise on pain and disability in patients with CLBP, with a major aim of explaining between-trial heterogeneity.Data SourcesSix databases were searched up to August 2008 using a computerized search strategy.Study SelectionEligible studies needed to be randomized clinical trials evaluating the effects of exercise for nonspecific CLBP. Outcomes of interest were pain and disability measured on a continuous scale.Data ExtractionBaseline demographic data, exercise features, and outcome data were extracted from all included trials.Data SynthesisUnivariate meta-regressions were conducted to assess the associations between exercise effect sizes and 8 study-level variables: baseline severity of symptoms, number of exercise hours and sessions, supervision, individual tailoring, cognitive-behavioral component, intention-to-treat analysis, and concealment of allocation.LimitationsOnly study-level characteristics were included in the meta-regression analyses. Therefore, the implications of the findings should not be used to differentiate the likelihood of the effect of exercise based on patient characteristics.ConclusionsThe results show that, in general, when all types of exercise are analyzed, small but significant reductions in pain and disability are observed compared with minimal care or no treatment. Despite many possible sources of heterogeneity in exercise trials, only dosage was found to be significantly associated with effect sizes.

Is pancreaticogastrostomy safer than pancreaticojejunostomy after pancreaticoduodenectomy? A meta-regression analysis of randomized clinical trials

Pancreatology ◽  
2017 ◽  
Vol 17 (5) ◽  
pp. 805-813 ◽  
Author(s):  
Claudio Ricci ◽  
Riccardo Casadei ◽  
Giovanni Taffurelli ◽  
Carlo Alberto Pacilio ◽  
Denis Beltrami ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Regression Analysis ◽  
Randomized Clinical Trials ◽  
Meta Regression ◽  
Meta Regression Analysis

scholarly journals EXTRACORPOREAL SHOCK WAVE THERAPY (ESWT) IN CHRONIC LOW BACK PAIN: A SYSTEMATIC REVIEW OF RANDOMIZED CLINICAL TRIALS

2020 ◽  
Vol 13 (4) ◽  
pp. 1-16
Author(s):  
Karolina Walewicz
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Randomized Clinical Trials ◽  
Extracorporeal Shock Wave Therapy ◽  
Low Back ◽  
Shock Wave Therapy ◽  
Extracorporeal Shock Wave

Background: Extracorporeal Shock Wave Therapy (ESWT) has become a popular tool to treat musculoskeletal disorders and chronic low back pain. Aim of the study: To review the current scientific literature and assess the utility of ESWT in treating chronic low back pain. Methods: This systematic review was conducted from November 2019 to January 2020. Its purpose was to determine what the effectiveness is of the various forms of ESWT for the treatment of chronic low back pain. The critical review of the literature on the use of ESWT in chronic low back was made using the scientifically recognized medical databases PubMed, MEDLINE, Physiotherapy Evidence Database (PEDro) and Web of Science Core Collection. There was no restriction by date. Exclusion criteria were experimental, in vitro, animal, review, case reports, non-randomized clinical trials or studies with healthy participants. All articles written in languages other than English have also been excluded. Results: Six studies were included in the final analysis. According to the applied PEDro classification, the average scoring for the studies was 4.83, which indicates overall low quality of the presented reports. However, this result appeared closer to the moderate (acceptable) quality range (6-8 points) than to the unacceptable range (0-2 points). Conclusion: Based on the findings in the analyzed articles, ESWT promises to be an efficient and useful procedure in chronic low back pain treatment. Unfortunately, the level of evidence is relatively weak because there are a limited number of published studies related to ESWT and the final score in the PEDro classification was low. Together, these results indicate the need for further high quality randomized clinical trials.

Asthma: Anti-Immunoglobulin E Therapy with Omalizumab for Asthma

2007 ◽  
Vol 41 (9) ◽  
pp. 1397-1410 ◽  
Author(s):  
Leslie Hendeles ◽  
Christine A Sorkness
Keyword(s):  
Clinical Trials ◽  
Cost Effectiveness ◽  
Randomized Clinical Trials ◽  
Inhaled Corticosteroids ◽  
Immunoglobulin E ◽  
Data Extraction ◽  
Symptom Control ◽  
High Dose ◽  
Search Term ◽  
Ige Mediated

Objective: To evaluate data on anti-immunoglobulin E (anti-IgE) therapy for asthma. Data Sources: Information was selected from PubMed from 1989 to May 2007 using the search term omalizumab and included randomized, controlled trials. These studies evaluated asthma treatment with omalizumab and focused on its efficacy, tolerability, and cost-effectiveness in this population. Study Selection and Data Extraction: All randomized clinical trials were reviewed (23 were identified and 19 were included; 3 were not relevant and 1 contained duplicative data). Other articles using the search words anti-IgE therapy and cost-effectiveness were evaluated; relevant information was extracted. Data Synthesis: IgE-dependent mechanisms play an important role in the development and maintenance of airway inflammation in asthma. Omalizumab is a subcutaneously administered monoclonal anti-IgE antibody that reduces unbound IgE concentrations and promotes down-regulation of IgE receptors. Results from clinical trials in adults, adolescents, and children with poorly controlled IgE-mediated asthma have shown that omalizumab improves symptom control and allows patients to be managed with lower doses of inhaled corticosteroids (ICS). It has been well tolerated in clinical trials lasting as long as 52 weeks, but injection-site reactions are common (45% in omalizumab group vs 43% in placebo group) and anaphylaxis has occurred in 0.2% of patients. A consensus expert panel has recommended that omalizumab should be considered for patients 12 years of age or older with allergic asthma who are inadequately controlled on guideline-based therapy and require maintenance therapy with systemic corticosteroids or high-dose ICSs, or who have poor adherence to ICS therapy. Conclusions: Anti-IgE therapy provides an effective and generally safe approach to the treatment of patients with IgE-mediated asthma who are not adequately controlled by conventional guideline-based medications. However, the potential benefit must be weighed against the cost and inconvenience of this new therapy.

scholarly journals Effectiveness of ozone therapy compared to other therapies for low back pain: a systematic review with meta-analysis of randomized clinical trials

2019 ◽  
Vol 69 (5) ◽  
pp. 493-501 ◽  
Author(s):  
Raul Ribeiro de Andrade ◽  
Olavo Barbosa de Oliveira-Neto ◽  
Luciano Timbó Barbosa ◽  
Isabelle Oliveira Santos ◽  
Célio Fernando de Sousa-Rodrigues ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Low Back Pain ◽  
Back Pain ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Low Back ◽  
Ozone Therapy

scholarly journals The Efficacy of Retention Appliances after Fixed Orthodontic Treatment: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 10 (9) ◽  
pp. 3107 ◽  
Author(s):  
Antonino Lo Giudice ◽  
Gaetano Isola ◽  
Lorenzo Rustico ◽  
Vincenzo Ronsivalle ◽  
Marco Portelli ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Orthodontic Treatment ◽  
Randomized Clinical Trials ◽  
Data Extraction ◽  
Meta Analysis ◽  
Mean Difference ◽  
Anterior Crowding ◽  
Study Selection ◽  
Statistical Heterogeneity ◽  
Fixed Retainers

The purpose of this article is to evaluate the amount of the relapse of anterior crowding and the efficacy of retention appliances by reviewing the best available scientific evidence. A survey of articles published up to November 2019 about the stability of dental alignment and retention after fixed orthodontic treatment was performed using seven electronic databases. Study Selection: Only randomized clinical trials investigating patients previously treated with multi-bracket appliances with a follow-up period longer than 6 months were included. Data Extraction: Two authors independently performed the study selection, data extraction, and risk of bias assessment. All pooled data analyses were performed using a random-effects model. Statistical heterogeneity was evaluated. In total, eight randomized clinical trials (RCTs) were included, grouping data from 987 patients. The ages of the patients varied across the studies, ranging between 13 and 17 years. The observation period ranged between 6 and 24 months. The data showed no significant intercanine width modifications during the retention period with both fixed and removable retainers. A significant modification of Little’s Index was found for the mandibular removable retainers with a mean difference of 0.72 mm (95% Cl, 0.47 to 0.98) and for the maxillary removable retainers with a mean difference of 0.48 mm (95% Cl, 0.27 to 0.68). No significant changes were found by evaluating Little’s Index modification for the mandibular fixed retainers. The results of this meta-analysis showed that all the considered retainers were effective in maintaining dental alignment after fixed orthodontic treatment. However, fixed retainers showed greater efficacy compared to removable retainers.

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