Conclusiveness of the Cochrane Reviews in Palliative and Supportive Care for Cancer

2016 ◽  
Vol 34 (1) ◽  
pp. 53-56 ◽  
Author(s):  
Xia Zhang ◽  
Zhiyong Wu ◽  
Haiqing Zhao ◽  
Chenxi Li ◽  
Jianyu Wu ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Supportive Care ◽  
Clinical Decision ◽  
Cochrane Library ◽  
Care Group ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Cochrane Reviews ◽  
Supportive Oncology ◽  
The Cochrane Library

To assess the conclusiveness of the Cochrane reviews (CRs) in the field of palliative and supportive care for cancer. We searched the CRs on Pain, Palliative, and Supportive Care Group available in the Cochrane library on February 01, 2015, to analyze whether a CR could reach a clinical decision. Each CR was analyzed for conclusiveness, number of randomized controlled trials (RCTs) enrolled, number of participants enrolled, the need for further studies, and the reasons. Only 45% (30 of 66) of the CRs reached definitive clinical recommendations. The number of RCTs and participants enrolled in conclusive CRs were significantly higher than those in inconclusive CRs. Nearly all CRs recognized the need for further studies. The conclusiveness was not affected by the year of publication. We concluded that a large number of clinical trials were not carried out well in the palliative and supportive oncology.

LITERATURE SEARCHING FOR RANDOMIZED CONTROLLED TRIALS USED IN COCHRANE REVIEWS: RAPID VERSUS EXHAUSTIVE SEARCHES

2003 ◽  
Vol 19 (4) ◽  
pp. 591-603 ◽  
Author(s):  
Pamela Royle ◽  
Ruairidh Milne
Keyword(s):  
Randomized Controlled Trials ◽  
Allocation Concealment ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Cochrane Reviews ◽  
Literature Searches ◽  
Significant Difference ◽  
The Cochrane Library

Objectives:To analyze sources searched in Cochrane reviews, to determine the proportion of trials included in reviews that are indexed in major databases, and to compare the quality of these trials with those from other sources.Methods:All new systematic reviews in the Cochrane Library, Issue1 2001, that were restricted to randomized controlled trials (RCTs) or quasi-RCTs were selected. The sources searched in the reviews were recorded, and the trials included were checked to see whether they were indexed in four major databases. Trials not indexed were checked to determine how they could be identified. The quality of trials found in major databases was compared with those found from other sources.Results:The range in the number of databases searched per review ranged between one and twenty-seven. The proportion of the trials in the four databases were Cochrane Controlled Trials Register=78.5%, MEDLINE=68.8%, Embase=65.0%, and Science/Social Sciences Citation Index=60.7%. Searching another twenty-six databases after Cochrane Controlled Trials Register (CCTR), MEDLINE, and Embase only found 2.4% additional trials. There was no significant difference between trials found in the CCTR, MEDLINE, and Embase compared with other trials, with respect to adequate allocation concealment or sample size.Conclusions:There was a large variation between reviews in the exhaustiveness of the literature searches. CCTR was the single best source of RCTs. Additional database searching retrieved only a small percentage of extra trials. Contacting authors and manufacturers to find unpublished trials appeared to be a more effective method of obtaining the additional better quality trials.

scholarly journals A Review of Marital Intimacy-Enhancing Interventions among Married Individuals

2015 ◽  
Vol 8 (8) ◽  
pp. 74 ◽  
Author(s):  
Maryam Kardan-Souraki ◽  
Zeinab Hamzehgardeshi ◽  
Ismail Asadpour ◽  
Reza Ali Mohammadpour ◽  
Soghra Khani
Keyword(s):  
Clinical Trials ◽  
Randomized Controlled Trials ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Main Concern ◽  
Care Providers ◽  
Marital Intimacy ◽  
Randomized Controlled ◽  
The Impact

<p><strong>BACKGROUND:</strong> Lack of intimacy is currently the main concern rather than main concern of the experts in psychology and counseling. It is considered as one of the most important causes for divorce and as such to improve marital intimacy a great number of interventions have been proposed in the literature. Intimacy training and counseling make the couples take effective and successful steps to increase marital intimacy. No study has reviewed the interventions promoting marital intimacy after marriage. Thus, this review study aimed to classify the articles investigating the impact of interventional programs on marital intimacy after marriage.</p><p><strong>SEARCH METHODS:</strong> In April 2015, we performed a general search in Google Scholar search engines, and then we did an advanced search the databases of Science Direct, ProQuest, SID, Magiran, Irandoc, Pubmed, Scopus, <a href="http://www.cochranelibrary.com/">Cochrane Library</a>, and Psych info; Cumulative Index to Nursing and Allied Health Literature (CINAHL). Also, lists of the references of the relevant articles were reviewed for additional citations. Using Medical Subject Headings (MESH) keywords: Intervention (Clinical Trials, Non-Randomized Controlled Trials, Randomized Controlled Trials, Education), intimacy, marital (Marriage) and selected related articles to the study objective were from 1995 to April 2015. Clinical trials that evaluated one or more behavioral interventions to improve marital intimacy were reviewed in the study.</p><p><strong>MAIN RESULTS:</strong> 39 trials met the inclusion criteria. Eleven interventions had follow-up, and 28 interventions lacked follow-up. The quality evidence for 22 interventions was low, for 15 interventions moderate, and for one intervention was considered high. Findings from studies were categorized in 11 categories as the intimacy promoting interventions in dimensions of emotional, psychological, physical, sexual, temporal, communicational, social and recreational, aesthetic, spiritual, intellectual intimacy, and total intimacy.</p><p><strong>AUTHORS’ CONCLUSIONS:</strong> Improving and promoting communication, problem solving, self-disclosure and empathic response skills and sexual education and counseling in the form of cognitive-behavioral techniques and based on religious and cultural context of each society, an effective step can be taken to enhance marital intimacy and strengthen family bonds and stability. Health care providers should consider which interventions are appropriate to the couple characteristics and their relationships.</p>

scholarly journals Impact of Ketamine on Pain Management in Cesarean Section: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2;23 (4;2) ◽  
pp. 135-148
Author(s):  
Zifeng Xu
Keyword(s):  
Cesarean Section ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Control Effect ◽  
Randomized Controlled ◽  
Time Required ◽  
The Cochrane Library

Background: The pain control effect of ketamine versus control in women during cesarean operation is not well determined. Objectives: The present meta-analysis aimed to evaluate the clinical efficacy of ketamine versus control in cesarean section anesthesia for reducing the postoperative pain and analgesia. Study Design: We used meta-analysis to address this concern. Setting: Meta-analysis-based study. Methods: The databases PubMed, Embase, and the Cochrane Library were systematically searched to identify the relevant randomized controlled trials (RCTs) of ketamine versus control in controlling pain after cesarean section from inception to August 2018. Based on the Cochrane Handbook, the combined analysis was performed using Revman 5.3 software. Results: A total of 20 RCTs with 1,737 patients who underwent cesarean section were included. Meta-analysis showed that the pain score in the ketamine group was less than that of the control group (mean difference [MD], –1.10; 95% confidence interval [CI], –1.61, –0.59; P < 0.0001). Application of ketamine during cesarean section also resulted in decreased consumption of morphine when compared with the control group (MD, –6.11 mg; 95% CI, –9.93, –2.29; P = 0.002). In addition, the first time required for analgesia was significantly longer in the ketamine group than that of the control group (MD, 72.48 minutes; 95% CI, 50.85, 94.11; P < 0.00001). Limitations: Limited patients were included with moderate strength. Conclusions: Ketamine supplementation during cesarean section reduces pain and morphine consumption and prolongs the postoperative analgesia. Key words: Ketamine, cesarean section, randomized controlled trials, meta-analysis

scholarly journals Hepatotoxicity of Nonsteroidal Anti-Inflammatory Drugs: A Systematic Review of Randomized Controlled Trials

2018 ◽  
Vol 2018 ◽  
pp. 1-13 ◽  
Author(s):  
Pajaree Sriuttha ◽  
Buntitabhon Sirichanchuen ◽  
Unchalee Permsuwan
Keyword(s):  
Side Effects ◽  
Randomized Controlled Trials ◽  
Cochrane Library ◽  
Bibliographic Databases ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Clinically Significant ◽  
The Cochrane Library

Background. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most widely used medication in several countries, including Thailand. NSAIDs have been associated with hepatic side effects; however, the frequency of these side effects is uncertain. Aim of the Review. To systematically review published literature on randomized, controlled trials that assessed the risk of clinically significant hepatotoxicity associated with NSAIDs. Methods. Searches of bibliographic databases EMBASE, PubMed, and the Cochrane Library were conducted up to July 30, 2016, to identify randomized controlled trials of ibuprofen, naproxen, diclofenac, piroxicam, meloxicam, mefenamic acid, indomethacin, celecoxib, and etoricoxib in adults with any disease that provide information on hepatotoxicity outcomes. Results. Among the 698 studies, 18 studies met the selection criteria. However, only 8 studies regarding three NSAIDs (celecoxib, etoricoxib, and diclofenac) demonstrated clinically significant hepatotoxic evidence based on hepatotoxicity justification criteria. Of all the hepatotoxicity events found from the above-mentioned three NSAIDs, diclofenac had the highest proportion, which ranged from 0.015 to 4.3 (×10−2), followed by celecoxib, which ranged from 0.13 to 0.38 (×10−2), and etoricoxib, which ranged from 0.005 to 0.930 (×10−2). Conclusion. Diclofenac had higher rates of hepatotoxic evidence compared to other NSAIDs. Hepatotoxic evidence is mostly demonstrated as aminotransferase elevation, while liver-related hospitalization or discontinuation was very low.

scholarly journals Pharmacological treatment for bipolar mania: a systematic review and network meta-analysis of double-blind randomized controlled trials

2021 ◽  
Author(s):  
Taro Kishi ◽  
Toshikazu Ikuta ◽  
Yuki Matsuda ◽  
Kenji Sakuma ◽  
Makoto Okuya ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Response To Treatment ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Double Blind ◽  
Randomized Controlled ◽  
Bipolar Mania ◽  
The Cochrane Library

AbstractA systematic review and random-effects model network meta-analysis was conducted to compare the efficacy, acceptability, tolerability, and safety of pharmacological interventions for adults with acute bipolar mania. We searched PubMed, the Cochrane Library, and Embase databases for eligible studies published before March 14, 2021. Randomized controlled trials (RCTs) of oral medication monotherapy lasting ≥10 days in adults with mania were included, and studies that allowed the use of antipsychotics as a rescue medication during a trial were excluded. The primary outcomes were response to treatment (efficacy) and all-cause discontinuation (acceptability). The secondary outcomes were the improvement of mania symptoms and discontinuation due to inefficacy. Of the 79 eligible RCTs, 72 double-blind RCTs of 23 drugs and a placebo were included in the meta-analysis (mean study duration = 3.96 ± 2.39 weeks, n = 16442, mean age = 39.55 years, with 50.93% males). Compared with the placebo, aripiprazole, asenapine, carbamazepine, cariprazine, haloperidol, lithium, olanzapine, paliperidone, quetiapine, risperidone, tamoxifen, valproate, and ziprasidone outperformed response to treatment (N = 56, n = 14503); aripiprazole, olanzapine, quetiapine, and risperidone had lower all-cause discontinuation; however, topiramate had higher all-cause discontinuation (N = 70, n = 16324). Compared with the placebo, aripiprazole, asenapine, carbamazepine, cariprazine, haloperidol, lithium, olanzapine, paliperidone, quetiapine, risperidone, tamoxifen, valproate, and ziprasidone outperformed the improvement of mania symptoms (N = 61, n = 15466), and aripiprazole, asenapine, carbamazepine, cariprazine, haloperidol, lithium, olanzapine, paliperidone, quetiapine, risperidone, valproate, and ziprasidone had lower discontinuation due to inefficacy (N = 50, n = 14284). In conclusions, these antipsychotics, carbamazepine, lithium, tamoxifen, and valproate were effective for acute mania. However, only aripiprazole, olanzapine, quetiapine, and risperidone had better acceptability than the placebo.

scholarly journals Quality Evaluation of Randomized Controlled Trials of Rhodiola Species: A Systematic Review

2021 ◽  
Vol 2021 ◽  
pp. 1-17
Author(s):  
Xiuzhu Li ◽  
Weijie Chen ◽  
Yingqi Xu ◽  
Zuanji Liang ◽  
Hao Hu ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Reporting Quality ◽  
Consort Statement ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Controlled Trials ◽  
China National Knowledge Infrastructure ◽  
Randomized Controlled ◽  
The Consort Statement ◽  
The Cochrane Library

Background. Rhodiola is a worldwide used medicinal plant for its various medicinal functions, and the number of randomized controlled trials (RCTs) of Rhodiola is increasing in recent years. This study aims to evaluate the reporting quality and risk of bias of the current RCT reports of different Rhodiola species. Methods. Six databases including Embase, PubMed, Web of Science, the Cochrane Library, ClinicalTrial.gov, and China National Knowledge Infrastructure were searched to identify RCTs that used Rhodiola as a single intervention and were published in English or Chinese from inception to December 2020. The Consolidated Standards of Reporting Trials (CONSORT) 2010 statement was used as the checklist for assessment, and a scoring system was applied to the evaluation of RCTs. Score 0 represents no reporting or inadequate reporting, and score 1 represents adequate reporting. The risk of bias of the included studies was also assessed using the Cochrane Risk of Bias tool. Results. A total of 39 RCTs were included in this study, including 23 RCTs of Rhodiola rosea (R. rosea), 8 RCTs of Rhodiola crenulata (R. crenulata), and 8 RCTs of Rhodiola wallichiana (R. wallichiana). None of the included studies met all the CONSORT statement criteria, and the reporting quality of RCTs of the three Rhodiola species was all generally poor. Based on the risk of bias assessment, the majority of included studies were judged to have an unclear risk of bias in most domains due to inadequate reporting. Conclusions. There is inadequate reporting among the included RCTs of different Rhodiola species, and RCTs of Rhodiola with higher reporting quality and better methodological quality are needed.

scholarly journals Effects of Electroencephalogram Guided Anesthesia on Postoperative Delirium: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Lin Ding ◽  
DongXu Chen ◽  
Qian Li
Keyword(s):  
Randomized Controlled Trials ◽  
Large Scale ◽  
Postoperative Delirium ◽  
Continuous Variable ◽  
Cochrane Library ◽  
Care Group ◽  
Controlled Trials ◽  
Eeg Monitoring ◽  
Randomized Controlled ◽  
Significant Difference

Abstract Background: Postoperative delirium is a common complication characterized by confusion, inattentiveness and other mental symptoms. It is still unclear whether the use of electroencephalogram (EEG) monitoring during surgery can decrease the incidence of postoperative delirium. The purpose of this study was to evaluate the effectiveness of EEG guided anesthesia on postoperative delirium (POD) based on randomized controlled trials (RCTs). Methods: The electronic databases of Ovid MEDLINE, PubMed, EMBASE, Cochrane Library database, CNKI and other local databases were systematically searched for RCTs from their inception until October 2019. The odds ratios (ORs) and the mean differences (MDs) with a 95% confidence intervals (CIs) were calculated to evaluate the correlation between EEG and itemized categories and continuous variable, respectively. Results: Seven RCTs with 3859 patients were included in the final analysis. The summary OR indicated that patients receiving EEG monitoring had a lower incidence rate of postoperative delirium (OR: 0.65; 95% CI: 0.46- 0.92; P = 0.01). In addition, no significant difference was found between the EEG monitoring group and the routine care group with respects to the length of hospitalization (MD: -0.59; 95%CI: -1.26 to 0.07; P=0.08). Conclusions: The findings of this study indicated that intraoperative use of electroencephalogram monitoring could decrease the risk of postoperative delirium. But for high risk patients, we should take a multi-component strategy to prevent delirium. Further large-scale, randomized controlled trials should be conducted to verify the treatment effect of intraoperative use of electroencephalogram monitoring on patients.

scholarly journals Perspectives of People Who Are Overweight and Obese on Using Wearable Technology for Weight Management: Systematic Review

10.2196/12651 ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. e12651 ◽  
Author(s):  
Ruiqi Hu ◽  
Michelle Helena van Velthoven ◽  
Edward Meinert
Keyword(s):  
Randomized Controlled Trials ◽  
Weight Management ◽  
Data Extraction ◽  
Wearable Technology ◽  
Risk Of Bias ◽  
Qualitative Studies ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
The Cochrane Library

Background Obesity is a large contributor to preventable chronic diseases and health care costs. The efficacy of wearable devices for weight management has been researched; however, there is limited knowledge on how these devices are perceived by users. Objective This study aimed to review user perspectives on wearable technology for weight management in people who are overweight and obese. Methods We searched the online databases Pubmed, Scopus, Embase, and the Cochrane library for literature published from 2008 onward. We included all types of studies using a wearable device for delivering weight-loss interventions in adults who are overweight or obese, and qualitative data were collected about participants' perspectives on the device. We performed a quality assessment using criteria relevant to different study types. The Cochrane risk of bias tool was used for randomized controlled trials. The Risk of Bias in Non-randomized Studies - of Interventions (ROBINS-I) was used for nonrandomized studies. The Oxman and Guyatt Criteria were used for systematic reviews. We used the critical appraisal checklist for qualitative studies. Data were extracted into a data extraction sheet and thematically analyzed. Results We included 19 studies: 5 randomized controlled trials, 6 nonrandomized studies, 5 qualitative studies, and 3 reviews. Mixed perceptions existed for different constructs of wearable technologies, which reflects the differences in the suitability of wearable technology interventions for different individuals in different contexts. This also indicates that interventions were not often tailored to participants' motivations. In addition, very few wearable technology interventions included a thorough qualitative analysis of the participants' view on important features of the intervention that made it successful. Conclusions This study highlights the importance of determining the type of intervention most suitable for an individual before the intervention is used. Our findings could help participants find a suitable intervention that is most effective for them. Further research needs to develop a user-centered tool for obtaining comprehensive user feedback. Trial Registration PROSPERO CRD42018096932; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=96932

American Society of Clinical Oncology Clinical Practice Guideline Update on the Use of Chemotherapy Sensitivity and Resistance Assays

2011 ◽  
Vol 29 (24) ◽  
pp. 3328-3330 ◽  
Author(s):  
Harold J. Burstein ◽  
Pamela B. Mangu ◽  
Mark R. Somerfield ◽  
Deborah Schrag ◽  
David Samson ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Randomized Controlled Trials ◽  
Clinical Oncology ◽  
Chemotherapeutic Agents ◽  
Cochrane Library ◽  
Treatment Preferences ◽  
Controlled Trials ◽  
Chemotherapy Sensitivity ◽  
Randomized Controlled ◽  
American Society

Purpose To update the American Society of Clinical Oncology (ASCO) Technology Assessment guidelines on chemotherapy sensitivity and resistance assays (CSRAs) published in 2004. Methods An Update Working Group reviewed data published between December 1, 2003, and May 31, 2010. MEDLINE and the Cochrane Library were searched. The literature search yielded 11,313 new articles. The limits for “human and English” were used, and then standard ASCO search strings for randomized controlled trials, meta-analyses, guidelines, and reviews were added, yielding 1,298 articles for abstract review. Of these, only 21 articles met predefined inclusion criteria and underwent full text review, and five reports of randomized controlled trials were included for data extraction. Results Review of the literature does not identify any CSRAs for which the evidence base is sufficient to support use in oncology practice. Recommendations The use of CSRAs to select chemotherapeutic agents for individual patients is not recommended outside of the clinical trial setting. Oncologists should make chemotherapy treatment recommendations based on published reports of clinical trials and a patient's health status and treatment preferences. Because the in vitro analytic strategy has potential importance, participation in clinical trials evaluating these technologies remains a priority.

scholarly journals 5-HT3 receptor antagonists for the prevention of postoperative shivering: a meta-analysis

2016 ◽  
Vol 44 (6) ◽  
pp. 1174-1181 ◽  
Author(s):  
Chengmao Zhou ◽  
Yu Zhu ◽  
Zhen Liu ◽  
Lin Ruan
Keyword(s):  
Relative Risk ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Comparable Efficacy ◽  
Controlled Trials ◽  
Receptor Antagonists ◽  
Exclusion Criteria ◽  
Randomized Controlled ◽  
Significant Difference ◽  
The Cochrane Library

Objective We evaluated the efficacy of 5-HT3 receptor antagonists for the prevention of postoperative shivering. Methods We searched PubMed, the Cochrane Library, EMBASE and Web of Knowledge to find randomized controlled trials (RCT) of 5-HT3 receptor antagonists for the prevention of postoperative shivering. Two researchers independently screened studies, extracted data, and assessed quality in accordance with the inclusion and exclusion criteria, and then conducted a meta-analysis using RevMan 5.2. Results Ultimately, 14 RCTs that included 980 patients were included in the analysis. We found that: 1) the incidence of shivering was significantly lower in 5-HT3 groups than placebo groups (relative risk, [RR] = 0.48, 95% confidence interval [CI] 0.40 – 0.58); 2) there was no significant difference in the incidence of shivering between 5-HT3 groups and meperidine groups (RR = 0.89, 95% CI 0.60 – 1.34). Conclusion 5-HT3 receptor antagonists appear to prevent postoperative shivering, with a broadly comparable efficacy to meperidine.

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