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Vassou C, D'Cunha NM, Naumovski N, Panagiotakos DB. Hostile personality as a risk factor for hyperglycemia and obesity in adult populations: a systematic review. J Diabetes Metab Disord 2021; 19:1659-1669. [PMID: 33520858 DOI: 10.1007/s40200-020-00551-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 05/14/2020] [Accepted: 05/21/2020] [Indexed: 12/12/2022]
Abstract
Purpose Several studies have already provided valuable insights into the physiological and genetic causes of hyperglycemia and obesity. Concurrently, personality traits, such as hostility, have been suggested to have an impact on health and illness (i.e., self-reported general health, coronary artery disease, and overall mortality). The present systematic review investigated possible effects of hostility upon metabolic markers, such as high plasma glucose level and obesity among adults. We also attempted to reveal current gaps in knowledge and provide insights for future directions. Methods This systematic review was performed following the PRISMA 2009 guidelines to examine current evidence arising from observational studies regarding the potential impact of hostile behavior on hyperglycemia and obesity among adults. Of the initial 139 articles, 13 studies were included. Results The evidence supports an association between pre-diabetes and obesity with a hostile temperament in certain populations. The relationship between hostility and hyperglycemia was most common in African American women, in women with a family history of diabetes, in unmarried individuals, in White men, as well as in middle-aged and older people. Regarding obesity, high body mass index (BMI) was associated with a hostile personality, particularly among men. However, the paths by which hostile temperament affects glucose levels and BMI, as well as potential mediating and moderating mechanisms, are not entirely understood. Conclusions There is a need for research to enhance the understanding of biological, psychological and social factors related to hostility with a view to prevention and effective intervention.
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Affiliation(s)
- Christina Vassou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El. Venizelou Ave, Athens, 176 71 Greece
| | - Nathan M D'Cunha
- Faculty of Health, University of Canberra, Canberra, 2601 Australia
| | - Nenad Naumovski
- Faculty of Health, University of Canberra, Canberra, 2601 Australia
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El. Venizelou Ave, Athens, 176 71 Greece.,Faculty of Health, University of Canberra, Canberra, 2601 Australia
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Cramer H, Klose P, Teut M, Rotter G, Ortiz M, Anheyer D, Linde K, Brinkhaus B. Cupping for Patients With Chronic Pain: A Systematic Review and Meta-Analysis. THE JOURNAL OF PAIN 2020; 21:943-956. [PMID: 31982686 DOI: 10.1016/j.jpain.2020.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 11/25/2019] [Accepted: 01/20/2020] [Indexed: 10/25/2022]
Abstract
There is a growing interest in nonpharmacological pain treatment options such as cupping. This meta-analysis aimed to assess the effectiveness and safety of cupping in chronic pain. PubMed, Cochrane Library, and Scopus were searched through November 2018 for randomized controlled trials on effects of cupping on pain intensity and disability in patients with chronic pain. Risk of bias was assessed using the Cochrane risk of bias tool. Of the 18 included trials (n =1,172), most were limited by clinical heterogeneity and risk of bias. Meta-analyses found large short-term effects of cupping on pain intensity compared to no treatment (standardized mean difference [SMD] = -1.03; 95% confidence interval [CI] = -1.41, -.65), but no significant effects compared to sham cupping (SDM = -.27; 95% CI = -.58, .05) or other active treatment (SMD = -.24; 95% CI = -.57, .09). For disability, there were medium-sized short-term effects of cupping compared to no treatment (SMD = -.66; 95% CI = -.99, -.34), and compared to other active treatments (SMD = -.52; 95% CI = -1.03, -.0028), but not compared to sham cupping (SMD = -.26; 95% CI = -.57,.05). Adverse events were more frequent among patients treated with cupping compared to no treatment; differences compared to sham cupping or other active treatment were not statistically significant. Cupping might be a treatment option for chronic pain, but the evidence is still limited by the clinical heterogeneity and risk of bias. Perspective: This article presents the results of a meta-analysis aimed to assess the effectiveness and safety of cupping with chronic pain. The results suggest that cupping might be a treatment option; however, the evidence is still limited due to methodical limitations of the included trials. High-quality trials seem warranted.
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Affiliation(s)
- Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Petra Klose
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Michael Teut
- Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Gabriele Rotter
- Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Miriam Ortiz
- Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Dennis Anheyer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Klaus Linde
- Institute of General Practice, Technical University of Munich, TUM Medical School, Munich, Germany
| | - Benno Brinkhaus
- Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
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Neimann Rasmussen L, Montgomery P. The prevalence of and factors associated with inclusion of non-English language studies in Campbell systematic reviews: a survey and meta-epidemiological study. Syst Rev 2018; 7:129. [PMID: 30139391 PMCID: PMC6107944 DOI: 10.1186/s13643-018-0786-6] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 07/27/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Studies published in languages other than English are often neglected when research teams conduct systematic reviews. Literature on how to deal with non-English studies when conducting reviews have focused on the importance of including such studies, while less attention has been paid to the practical challenges of locating and assessing relevant non-English studies. We investigated the factors which might predict the inclusion of non-English studies in systematic reviews in the social sciences, to better understand how, when and why these are included/excluded. METHODS We appraised all Campbell Collaboration systematic reviews (n = 123) published to July 2016, categorising each by its language inclusiveness. We sought additional information from review authors via a questionnaire and received responses concerning 47 reviews. Data were obtained for 17 factors and we explored correlations with the number of non-English studies in the reviews via statistical regression models. Additionally, we asked authors to identify factors that support or hinder the inclusion of non-English studies. RESULTS Of 123 reviews, 108 did not explicitly exclude, and of these, 17 included non-English language studies. One factor correlated with the number of included non-English studies across all models: the number of countries in which the members of the review team work (B-value = 0.56; SE B = 0.24; 95% CI = 0.07-1.03; p = 0.02). This indicates that reviews which included non-English studies were more likely to be produced by international review teams. Our survey showed a dominance of researchers from English-speaking countries (52.9%) and review teams consisting only of team members from these countries (65.9%). The most frequently mentioned challenge to including non-English studies was a lack of resources (funding and time) followed by a lack of language resources (e.g. professional translators). CONCLUSION Our findings may indicate a connection between the limited inclusion of non-English studies and a lack of resources, which forces review teams to rely on their limited language skills rather than the support of professional translators. If unaddressed, review teams risk ignoring key data and introduce bias in otherwise high-quality reviews. However, the validity and interpretation of our findings should be further assessed if we are to tackle the challenges of dealing with non-English studies.
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Affiliation(s)
| | - Paul Montgomery
- Department of Social Policy, Sociology and Criminology, University of Birmingham, Birmingham, UK
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Ormsby SM, Dahlen HG, Ee CC, Keedle H, Smith CA. ‘Acupuncture for antenatal depression: It’s worth giving it a go’ — A qualitative study. Women Birth 2018; 31:166-176. [DOI: 10.1016/j.wombi.2017.09.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 09/15/2017] [Accepted: 09/19/2017] [Indexed: 12/18/2022]
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Adherence to the CONSORT Statement in the Reporting of Randomized Controlled Trials on Pharmacological Interventions Published in Iranian Medical Journals. IRANIAN JOURNAL OF MEDICAL SCIENCES 2017; 42:532-543. [PMID: 29184261 PMCID: PMC5684374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND Among manuscripts submitted to biomedical journals, randomized controlled trials (RCTs) form the backbone of evidence-based medicine. Hence, their protocol should be designed rigorously and their results should be reported clearly. To improve the quality of RCT reporting, researchers developed the CONSORT Statement in 1996 and updated it in 2010. This study was designed to assess the quality of RCT reporting vis-à-vis adherence to CONSORT among articles published in Iranian medical journals (English, Persian, CONSORT-endorsing, and non-CONSORT-endorsing). METHODS In this cross-sectional study, all RCTs published in all Iranian medical journals from September 2012 to September 2013 were retrieved to evaluate their adherence to CONSORT. The journals' instructions for authors were also reviewed to find out whether or not they endorsed CONSORT. The CONSORT 2010 Checklist was used. Microsoft Excel 2007 was applied to analyze the data, and MedCalc was employed to compare the groups. RESULTS Totally, 492 pharmacological RCTs that met our inclusion criteria were identified. Twenty-five items were reported in fewer than 50% of the articles. The differences between the articles published in Persian and English language journals were statistically significant in 17 items. The differences between the articles published in the CONSORT-endorsing and non-CONSORT-endorsing journals were significant in 8 items. CONCLUSION Our findings showed very weak adherence to CONSORT. Authors, reviewers, and editors should be trained to use standards expressed by the CONSORT Group in reporting RCTs.
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Naumann K. A Quantitative Assessment of the Reporting Quality of Herbal Medicine Research: The Road to Improvement. J Altern Complement Med 2017; 24:168-181. [PMID: 28915066 DOI: 10.1089/acm.2017.0085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES To quantify different aspects of the quality of reporting of herbal medicine clinical trials, to determine how that quality is affecting the conclusions of meta-analyses, and to target areas for improvement in future herbal medicine research reporting. STUDY DESIGN The Electronic databases PubMed, Academic Search Premier, ScienceDirect, and Alt HealthWatch were searched for meta-analyses of herbal medicines in refereed journals and Cochrane Reviews in the years 2000-2004 and 2010-2014. The search was limited to meta-analyses of randomized controlled trials involving humans and published in English. Judgments and descriptions within the meta-analyses were used to report on risks of bias in the included clinical trials and the meta-analyses themselves. RESULTS Out of 3264 citations, 9 journal-published meta-analyses were selected from 2000 to 2004, 116 from 2010 to 2014, and 44 Cochrane Reviews from 2010 to 2014. Across both time frames and categories of publication, <42% of the trials included in the meta-analyses described adequate randomization; <19% described concealment methods; <26% described double blinding; <29% described outcome assessment blinding, ≤53% discussed incomplete data, and <36% were nonselective in their reporting. Less than 54% of trials reported on adverse events and 64% of meta-analyses did not include a single trial with a low risk of bias. Taxonomic verification and chemical characterization of test products were infrequent in trials. Only 40% of meta-analyses considered publication bias and, of those that did, 90% found evidence for it. Cochrane Reviews were more likely than other sources to make negative conclusions of efficacy or to defer conclusions because of the absence of high quality trials. CONCLUSIONS Meta-analyses of herbal medicines include a significant number of clinical trials that do not meet the recommended standards for clinical trial reporting. This quantitative assessment identified significant publication bias and other bias risks that may be due to inadequate trial design or incomplete reporting of outcomes. Suggested improvements to herbal medicine clinical trial reporting are discussed.
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Affiliation(s)
- Ken Naumann
- Departments of Biology and Health Sciences, Langara College , Vancouver, Canada
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Gautier I, Janiaud P, Rollet N, André N, Tsimaratos M, Cornu C, Malik S, Gentile S, Kassaï B. Trends in the number and the quality of trial protocols involving children submitted to a French Institutional Review Board. BMC Med Res Methodol 2017; 17:130. [PMID: 28835231 PMCID: PMC5569539 DOI: 10.1186/s12874-017-0395-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 08/02/2017] [Indexed: 02/07/2023] Open
Abstract
Background There is a great need for high quality clinical research for children. The European Pediatric Regulation aimed to improve the quality of clinical trials in order to increase the availability of treatments for children. The main purpose of this study was to assess the evolution of both the number and the quality of pediatric trial protocols that were submitted to a French Institutional Review Board (IRB00009118) before and after the initiation of the EU Pediatric Regulation. Methods All protocols submitted to the IRB00009118 between 2003 and 2014 and conducting research on subjects under eighteen years of age were eligible. The quality of randomized clinical trials was assessed according to the guidelines developed by the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network and ranked using the Jadad score. Results Out of 622 protocols submitted to the Institutional Review Board (IRB), 21% (133/622) included children. Among these 133 pediatric protocols, the number of submitted pediatric protocols doubled between the two studied periods. From 2003 to 2008, 47 protocols including 21 institutionally sponsored were submitted to the IRB and from 2009 until 2014, 86 protocols including 48 institutionally sponsored were submitted. No significant trend was observed on the quality of RCTs. The overall median score of RCTs on the Jadad scale was high (3.5), 70.0% of protocols had a Jadad score ≥ 3, and 30.0% had a score < 3. Conclusion Following the EU Pediatric Regulation, the number of pediatric protocols submitted to the IRB00009118 tends to increase, but no change was noticed regarding their quality.
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Affiliation(s)
- Isabelle Gautier
- Centre d'investigation Clinique Pédiatrique, INSERM CIC 9502, Hôpital d'Enfants de la Timone, AP-HM, 264, rue Saint-Pierre, 13005, Marseille, France. .,EA3279 - Santé Publique: Maladies Chroniques et Qualité de Vie, Aix-Marseille Université, 13385, Marseille, France.
| | - Perrine Janiaud
- Evolutive Biology and Biometric Laboratory UMR5558 CNRS, Université Claude Bernard Lyon 1, 8 rue Guillaume Paradin, BP8071, 69376-CEDEX-08, Lyon, France
| | - Nelly Rollet
- Evolutive Biology and Biometric Laboratory UMR5558 CNRS, Université Claude Bernard Lyon 1, 8 rue Guillaume Paradin, BP8071, 69376-CEDEX-08, Lyon, France
| | - Nicolas André
- Centre d'investigation Clinique Pédiatrique, INSERM CIC 9502, Hôpital d'Enfants de la Timone, AP-HM, 264, rue Saint-Pierre, 13005, Marseille, France
| | - Michel Tsimaratos
- Centre d'investigation Clinique Pédiatrique, INSERM CIC 9502, Hôpital d'Enfants de la Timone, AP-HM, 264, rue Saint-Pierre, 13005, Marseille, France
| | - Catherine Cornu
- Evolutive Biology and Biometric Laboratory UMR5558 CNRS, Université Claude Bernard Lyon 1, 8 rue Guillaume Paradin, BP8071, 69376-CEDEX-08, Lyon, France.,EPICIME, Centre d'Investigation Clinique, INSERM CIC 1407, Hospices Civils de Lyon, 28 Avenue du Doyen Lépine, 69677-CEDEX, Bron, France
| | - Salma Malik
- Evolutive Biology and Biometric Laboratory UMR5558 CNRS, Université Claude Bernard Lyon 1, 8 rue Guillaume Paradin, BP8071, 69376-CEDEX-08, Lyon, France.,EPICIME, Centre d'Investigation Clinique, INSERM CIC 1407, Hospices Civils de Lyon, 28 Avenue du Doyen Lépine, 69677-CEDEX, Bron, France
| | - Stéphanie Gentile
- EA3279 - Santé Publique: Maladies Chroniques et Qualité de Vie, Aix-Marseille Université, 13385, Marseille, France
| | - Behrouz Kassaï
- Evolutive Biology and Biometric Laboratory UMR5558 CNRS, Université Claude Bernard Lyon 1, 8 rue Guillaume Paradin, BP8071, 69376-CEDEX-08, Lyon, France.,EPICIME, Centre d'Investigation Clinique, INSERM CIC 1407, Hospices Civils de Lyon, 28 Avenue du Doyen Lépine, 69677-CEDEX, Bron, France
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Complementary and alternative medicine use by diabetes patients in Kerala, India. GLOBAL HEALTH EPIDEMIOLOGY AND GENOMICS 2017; 2:e6. [PMID: 29868217 PMCID: PMC5870440 DOI: 10.1017/gheg.2017.6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 02/19/2017] [Accepted: 04/06/2017] [Indexed: 02/02/2023]
Abstract
The study assessed: (1) the prevalence of exclusive use of complementary and alternative medicine (CAM), exclusive use of modern medicine and combined use; (2) the factors associated with exclusive CAM use; and (3) the expenditure for CAM use among type-2 diabetes patients in rural Kerala. We surveyed 400 diabetes patients selected by multi-stage cluster sampling. Exclusive CAM use was reported by 9%, exclusive modern medicine by 61% and combined use by 30%. Patients without any co-morbidity were four times, those having regular income were three times and those who reported regular exercise were three times more likely to use exclusive CAM compared with their counterparts. Expense for medicines was not significantly different for CAM compared with modern medicine both in government and private sector. Patients with any co-morbidity were less likely to use CAM indicating that CAM use was limited to milder cases of diabetes.
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Ooi SL, Rae J, Pak SC. Implementation of evidence-based practice: A naturopath perspective. Complement Ther Clin Pract 2016; 22:24-8. [DOI: 10.1016/j.ctcp.2015.11.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 11/26/2015] [Indexed: 10/22/2022]
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Hufford DJ, Sprengel M, Ives JA, Jonas W. Barriers to the Entry of Biofield Healing Into "Mainstream" Healthcare. Glob Adv Health Med 2015; 4:79-88. [PMID: 26665046 PMCID: PMC4654786 DOI: 10.7453/gahmj.2015.025.suppl] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In this article, we describe barriers to the entry of biofield healing into mainstream contemporary science and clinical practice. We focus on obstacles that arise from the social nature of the scientific enterprise, an aspect of science highlighted by the influential work of Thomas Kuhn (1922-1996), one of the most important- and controversial-philosophers of science in the 20th century. Kuhn analyzed science and its revolutionary changes in terms of the dynamics within scientific communities. Kuhn's approach helps us understand unconventional medical theories and practices such as biofield healing. For many years, these were called "complementary and alternative medicine" (CAM). However, because most people use nonmainstream approaches in conjunction with conventional treatments, the National Institutes of Health and many practitioners now prefer "Complementary and Integrative Medicine" (CIM) where integrative implies "bringing conventional and complementary approaches together in a coordinated way."(1) Biofield healing fits the integrative model well, provides a novel approach to therapeutic intervention, and is developing in a manner that can integrate with current medical science in simple ways. Yet, it still remains outside the conventional framework because of its conceptual bases, which contrast sharply with conventional assumptions regarding the nature of reality.
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Affiliation(s)
- David J Hufford
- Samueli Institute, Alexandria, Virginia (Dr Hufford [retired])
| | | | - John A Ives
- Samueli Institute, Alexandria, Virginia (Dr Ives)
| | - Wayne Jonas
- Samueli Institute, Alexandria, Virginia (Dr Jonas)
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Gutierrez E, Silbert-Flagg J, Vohra S. Natural health product use and management in pediatrics: An integrative review. Eur J Integr Med 2014. [DOI: 10.1016/j.eujim.2013.12.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Ferraresi M, Clari R, Moro I, Banino E, Boero E, Crosio A, Dayne R, Rosset L, Scarpa A, Serra E, Surace A, Testore A, Colombi N, Piccoli BG. Reiki and related therapies in the dialysis ward: an evidence-based and ethical discussion to debate if these complementary and alternative medicines are welcomed or banned. BMC Nephrol 2013; 14:129. [PMID: 23799960 PMCID: PMC3694469 DOI: 10.1186/1471-2369-14-129] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Accepted: 06/03/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Complementary and Alternative Medicines (CAMs) are increasingly practiced in the general population; it is estimated that over 30% of patients with chronic diseases use CAMs on a regular basis. CAMs are also used in hospital settings, suggesting a growing interest in individualized therapies. One potential field of interest is pain, frequently reported by dialysis patients, and seldom sufficiently relieved by mainstream therapies. Gentle-touch therapies and Reiki (an energy based touch therapy) are widely used in the western population as pain relievers.By integrating evidence based approaches and providing ethical discussion, this debate discusses the pros and cons of CAMs in the dialysis ward, and whether such approaches should be welcomed or banned. DISCUSSION In spite of the wide use of CAMs in the general population, few studies deal with the pros and cons of an integration of mainstream medicine and CAMs in dialysis patients; one paper only regarded the use of Reiki and related practices. Widening the search to chronic pain, Reiki and related practices, 419 articles were found on Medline and 6 were selected (1 Cochrane review and 5 RCTs updating the Cochrane review). According to the EBM approach, Reiki allows a statistically significant but very low-grade pain reduction without specific side effects. Gentle-touch therapy and Reiki are thus good examples of approaches in which controversial efficacy has to be balanced against no known side effect, frequent free availability (volunteer non-profit associations) and easy integration with any other pharmacological or non pharmacological therapy. While a classical evidence-based approach, showing low-grade efficacy, is likely to lead to a negative attitude towards the use of Reiki in the dialysis ward, the ethical discussion, analyzing beneficium (efficacy) together with non maleficium (side effects), justice (cost, availability and integration with mainstream therapies) and autonomy (patients' choice) is likely to lead to a permissive-positive attitude. SUMMARY This paper debates the current evidence on Reiki and related techniques as pain-relievers in an ethical framework, and suggests that physicians may wish to consider efficacy but also side effects, contextualization (availability and costs) and patient's requests, according also to the suggestions of the Society for Integrative Oncology (tolerate, control efficacy and side effects).
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Affiliation(s)
- Martina Ferraresi
- SS Nephrology ASOU, san Luigi (regione Gonzole 10), Orbassano 10043, Torino, Italy.
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Impact of including Korean randomized controlled trials in Cochrane reviews of acupuncture. PLoS One 2012; 7:e47619. [PMID: 23071826 PMCID: PMC3469498 DOI: 10.1371/journal.pone.0047619] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 09/19/2012] [Indexed: 11/19/2022] Open
Abstract
Objective Acupuncture is commonly practiced in Korea and is regularly evaluated in clinical trials. Although many Cochrane reviews of acupuncture include searches of both English and Chinese databases, there is no information on the value of searching Korean databases. This study aimed to investigate the impact of searching Korean databasesand journals for trials eligible for inclusion in existing Cochrane acupuncture reviews. Methods We searched 12 Korean databases and seven Korean journals to identify randomised trials meeting the inclusion criteria for acupuncture reviews in the Cochrane Database of Systematic Reviews. We compared risk of bias assessments of the Korean trials with the trials included in the Cochrane acupuncture reviews. Where possible, we added data from the Korean trials to the existing meta-analyses in the relevant Cochrane review and conducted sensitivity analyses to test the robustness of the results. Results Sixteen Korean trials (742 participants) met the inclusion criteria for eight Cochrane acupuncture reviews (125 trials; 13,041 participants). Inclusion of the Korean trials provided data for 20% of existing meta-analyses (24 out of 120). Inclusion of the Korean trials did not change the direction of effect in any of the existing meta-analyses. The effect size and heterogeneity remained mostly unchanged. In only one meta-analysis did the significance change. Compared to the studies included in the Cochrane acupuncture reviews, the risk of bias in the Korean trials was higher in terms of outcome assessor blinding and allocation concealment. Conclusions Many Korean studies contributed additional data to the existing meta-analyses in Cochrane acupuncture reviews. Although inclusion of these studies did not alter the results of the meta-analyses, comprehensive searches of the literature are important to avoid potential language bias. The identification and inclusion of eligible Korean trials should be considered for reviews of acupuncture.
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Ali-Shtayeh MS, Jamous RM, Jamous RM. Complementary and alternative medicine use amongst Palestinian diabetic patients. Complement Ther Clin Pract 2011; 18:16-21. [PMID: 22196568 DOI: 10.1016/j.ctcp.2011.09.001] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Revised: 09/09/2011] [Accepted: 09/13/2011] [Indexed: 10/17/2022]
Abstract
OBJECTIVES To measure the frequency of herbal medicine use among patients with diabetes mellitus in Palestine; to determine demographic characteristics that may increase the likelihood of Complementary and Alternative Medicine (CAM) use and to find out how benefits, if any, were perceived by patients. METHOD Cross-sectional survey of patients attending the outpatient diabetes departments at 7 Governmental Hospitals. The method was based on semi-structured questionnaires. RESULTS A total of 1883 patients with diabetes were interviewed. Of the participants, 51.9% (n = 977) reported taking herbs primarily bought from Palestine (98%) and used in crude form mainly as decoctions (44.1%). The five most common herbal products used were: Trigonella berythea (Fabaceae) (n = 191, 19.6%), Rosmarinus officinalis (Lamiaceae) (n = 132, 13.5%), Olea europaea (Oleaceae) (n = 131, 13.4%), Teucrium capitatum (Lamiaceae) (n = 111, 11.4%), and Cinnamomum zeylanicum (Lauraceae) (n = 105, 10.8%). Most CAM users were above 40 years old 79.6% (n = 778), predominantly female (53.2%) and residents of refugee camps and rural areas (59.3, and 53.5, respectively). The recommendations of a family member or friend was the main factor prompting the use of CAM (40.2 and 37.1%). Most CAM users (71.7%) were satisfied with the perceived effects. Interestingly, 68% of patients recruited in the study did not disclose CAM use to their physicians or pharmacists. CONCLUSION Use of herbal therapies in diabetes is highly prevalent in Palestine. More than 70% of those using CAM (977, 51.9%) reported positive benefits including a feeling of slowing down disease progression, symptom relief, disease resolution or a reduction in the side effects of allopathic medication. Use of CAM should be explored with patients before clinical decisions are made. There is a need for health education relating to herbal use in conjunction with conventional medicines in diabetes.
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Cochrane ZR, Gregory P, Wilson A. Quality of Natural Product Clinical Trials: A Comparison of Those Published in Alternative Medicine Versus Conventional Medicine Journals. J Diet Suppl 2011; 8:135-43. [DOI: 10.3109/19390211.2011.561823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Wazaify M, Afifi FU, El-Khateeb M, Ajlouni K. Complementary and alternative medicine use among Jordanian patients with diabetes. Complement Ther Clin Pract 2011; 17:71-5. [PMID: 21457894 DOI: 10.1016/j.ctcp.2011.02.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE This study explores the prevalence, type, frequency, purpose and pattern of herbal preparation use as complementary and alternative medicine (CAM) in a cohort of patients with diabetes in Jordan. METHOD The study took the form of a cross-sectional survey of patients attending the outpatient departments at The National Centre for Diabetes, Endocrine and Genetics (NCDEG), in Amman. The method was based on semi-structured questionnaire. RESULTS A total of 1000 diabetes patients were interviewed. Of the participants, 16.6% (n=166) reported using herbs. Most of CAM users were in the age group 51-60 years (n=73, 44.0%) and predominantly female (59.6%). 139 of the CAM users (83.7%) had at least obtained a high school degree. The most common herbal product to be used was green tea (20.5%). CONCLUSION This study confirmed that there is an appreciable prevalence of herbal use among patients with diabetes in Jordan.
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Affiliation(s)
- Mayyada Wazaify
- Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Jordan
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Chen Y, Li J, Ai C, Duan Y, Wang L, Zhang M, Hopewell S. Assessment of the quality of reporting in abstracts of randomized controlled trials published in five leading Chinese medical journals. PLoS One 2010; 5:e11926. [PMID: 20689853 PMCID: PMC2914031 DOI: 10.1371/journal.pone.0011926] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Accepted: 07/06/2010] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Clear, transparent and sufficiently detailed abstracts of randomized trials (RCTs), published in journal articles are important because readers will often base their initial assessment of a trial on such information. However, little is known about the quality of reporting in abstracts of RCTs published in medical journals in China. METHODS We identified RCTs abstracts from 5 five leading Chinese medical journals published between 1998 and 2007 and indexed in MEDLINE. We assessed the quality of reporting of these abstracts based on the Consolidated Standards of Reporting Trials (CONSORT) abstract checklist. We also sought to identify whether any differences exist in reporting between the Chinese and English language version of the same abstract. RESULTS We identified 332 RCT abstracts eligible for examination. Overall, the abstracts we examined reported 0-8 items as designated in the CONSORT checklist. On average, three items were reported per abstract. Details of the interventions (288/332; 87%), the number of participants randomized (216/332; 65%) and study objectives (109/332; 33%) were the top three items reported. Only two RCT abstracts reported details of trial registration, no abstracts reported the method of allocation concealment and only one mentioned specifically who was blinded. In terms of the proportion of RCT abstracts fulfilling a criterion, the absolute difference (percentage points) between the Chinese and English abstracts was 10% (ranging from 0 to 25%) on average, per item. CONCLUSIONS The quality of reporting in abstracts of RCTs published in Chinese medical journals needs to be improved. We hope that the introduction and endorsement of the CONSORT for Abstracts guidelines by journals reporting RCTs will lead to improvements in the quality of reporting.
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Affiliation(s)
- Yaolong Chen
- Chinese Cochrane Centre, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Jing Li
- Chinese Cochrane Centre, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Changlin Ai
- Chinese Cochrane Centre, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yurong Duan
- Chinese Cochrane Centre, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ling Wang
- Chinese Cochrane Centre, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Mingming Zhang
- Chinese Cochrane Centre, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Akins RS, Angkustsiri K, Hansen RL. Complementary and alternative medicine in autism: an evidence-based approach to negotiating safe and efficacious interventions with families. Neurotherapeutics 2010; 7:307-19. [PMID: 20643384 PMCID: PMC5084235 DOI: 10.1016/j.nurt.2010.05.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2010] [Revised: 05/10/2010] [Accepted: 05/18/2010] [Indexed: 01/01/2023] Open
Abstract
This review focuses on helping clinicians identify resources and develop strategies they may use to effectively negotiate safe and effective use of complementary and alternative medicine (CAM) treatments with families of children with autism spectrum disorders (ASD), as well as other neurodevelopmental disorders. Since new types of CAM continue to be introduced into the autism community, emphasis is placed on providing clinicians with tools to help families negotiate the myriad of available treatments and make decisions based on current safety and efficacy data, while remaining mindful of the reasons families may be considering these treatments. We familiarize readers with high-quality, evidence-based resources that providers and families may use to ascertain current information about specific types of CAM, verify the content of biologically-based treatments, identify ongoing CAM research and obtain toolkits designed to help healthcare providers raise the topic of CAM usage and facilitate disclosure and discussion of CAM use with patients and their families.
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Affiliation(s)
- R Scott Akins
- The MIND Institute, Pediatrics, University of California, Davis, 2825 50th Street, Sacramento, California 95817, USA.
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Oh K, Kim KS, Park JW, Kang J. Quality evaluation of randomized controlled trials on complementary and alternative medicine. Asian Nurs Res (Korean Soc Nurs Sci) 2008; 1:153-64. [PMID: 25030883 DOI: 10.1016/s1976-1317(08)60018-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
PURPOSE This study aims to describe the research characteristics and analyze the methodological quality of randomized clinical trials on complementary and alternative medicine (CAM). METHODS A total of 76 studies using randomized controlled trials (RCTs) on CAM (16 by Koreans, 60 by internationals) published in the 6 years from 2000 to 2005 were reviewed systematically and analyzed with assessment criteria developed by the researchers on the basis of Jadad guidelines. RESULTS Most of the studies were carried out in the area of medicine, nursing and CAM. More than 80% of the study subjects were patients. CAM modalities for independent variables were mainly on energy medicine, mind-body medicine and manipulative and body-based practices, while dependent variables were mostly physiological and psychological indexes. Most of the studies utilized randomization (93.4%) and identified the dropout rate (90.8%), whereas allocation concealment (49.3%) and double-blinding (18.9%) were specified in a small number of studies. The overall quality of RCTs based on the assessment criteria of this study was satisfactory. However, the quality score of the Korean studies (2.87) was lower than that of the international studies (3.37). CONCLUSION The methodological objectivity of CAM studies has been improving in spite of controversy over the scientific bases of CAM. More Korean studies with rigorous experimental design are needed to build up the evidence-based practice of CAM.
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Affiliation(s)
- Kasil Oh
- College of Nursing, Yonsei University, Seoul, Korea
| | - Keum-Soon Kim
- College of Nursing, Seoul National University, Seoul, Korea
| | - Jee-Won Park
- College of Nursing, Ajou University, Suwon, Korea
| | - Jiyeon Kang
- Department of Nursing, Dong-A University, Busan, Korea
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Kemper KJ, Vohra S, Walls R. American Academy of Pediatrics. The use of complementary and alternative medicine in pediatrics. Pediatrics 2008; 122:1374-86. [PMID: 19047261 DOI: 10.1542/peds.2008-2173] [Citation(s) in RCA: 191] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The American Academy of Pediatrics is dedicated to optimizing the well-being of children and advancing family-centered health care. Related to these goals, the American Academy of Pediatrics recognizes the increasing use of complementary and alternative medicine in children and, as a result, the need to provide information and support for pediatricians. From 2000 to 2002, the American Academy of Pediatrics convened and charged the Task Force on Complementary and Alternative Medicine to address issues related to the use of complementary and alternative medicine in children and to develop resources to educate physicians, patients, and families. One of these resources is this report describing complementary and alternative medicine services, current levels of utilization and financial expenditures, and associated legal and ethical considerations. The subject of complementary and alternative medicine is large and diverse, and consequently, an in-depth discussion of each method of complementary and alternative medicine is beyond the scope of this report. Instead, this report will define terms; describe epidemiology; outline common types of complementary and alternative medicine therapies; review medicolegal, ethical, and research implications; review education and training for complementary and alternative medicine providers; provide resources for learning more about complementary and alternative medicine; and suggest communication strategies to use when discussing complementary and alternative medicine with patients and families.
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Lüdtke R, Rutten ALB. The conclusions on the effectiveness of homeopathy highly depend on the set of analyzed trials. J Clin Epidemiol 2008; 61:1197-1204. [PMID: 18834714 DOI: 10.1016/j.jclinepi.2008.06.015] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2006] [Revised: 09/21/2007] [Accepted: 06/18/2008] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Shang's recently published meta-analysis on homeopathic remedies (Lancet) based its main conclusion on a subset of eight larger trials out of 21 high quality trials (out of 110 included trials). We performed a sensitivity analysis on various other meaningful trial subsets of all high quality trials. STUDY DESIGN Subsets were defined according to sample size, type of homeopathy, type of publication, and treated disease/condition. For each subset, we estimated the overall odds ratios (ORs) from random effect meta-analyses. RESULTS All trials were highly heterogeneous (I2=62.2%). Homeopathy had a significant effect beyond placebo (OR=0.76; 95% CI: 0.59-0.99; p=0.039). When the set of analyzed trials was successively restricted to larger patient numbers, the ORs varied moderately (median: 0.82, range: 0.71-1.02) and the P-values increased steadily (median: 0.16, range: 0.03-0.93), including Shang's results for the eight largest trials (OR=0.88, CI: 0.66-1.18; P=0.41). Shang's negative results were mainly influenced by one single trial on preventing muscle soreness in 400 long-distance runners. CONCLUSIONS The meta-analysis results change sensitively to the chosen threshold defining large sample sizes. Because of the high heterogeneity between the trials, Shang's results and conclusions are less definite than had been presented.
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Affiliation(s)
- R Lüdtke
- Karl und Veronica Carstens-Stiftung, Essen, Germany.
| | - A L B Rutten
- Commissie Methode en Validering, Artsenvereniging voor homeopathie VHAN (Association of Dutch homeopathic physicians), Breda, The Netherlands
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Szczurko O, Boon HS. A systematic review of natural health product treatment for vitiligo. BMC DERMATOLOGY 2008; 8:2. [PMID: 18498646 PMCID: PMC2432048 DOI: 10.1186/1471-5945-8-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2008] [Accepted: 05/22/2008] [Indexed: 12/16/2022]
Abstract
BACKGROUND Vitiligo is a hypopigmentation disorder affecting 1 to 4% of the world population. Fifty percent of cases appear before the age of 20 years old, and the disfigurement results in psychiatric morbidity in 16 to 35% of those affected. METHODS Our objective was to complete a comprehensive, systematic review of the published scientific literature to identify natural health products (NHP) such as vitamins, herbs and other supplements that may have efficacy in the treatment of vitiligo. We searched eight databases including MEDLINE and EMBASE for vitiligo, leucoderma, and various NHP terms. Prospective controlled clinical human trials were identified and assessed for quality. RESULTS Fifteen clinical trials were identified, and organized into four categories based on the NHP used for treatment. 1) L-phenylalanine monotherapy was assessed in one trial, and as an adjuvant to phototherapy in three trials. All reported beneficial effects. 2) Three clinical trials utilized different traditional Chinese medicine products. Although each traditional Chinese medicine trial reported benefit in the active groups, the quality of the trials was poor. 3) Six trials investigated the use of plants in the treatment of vitiligo, four using plants as photosensitizing agents. The studies provide weak evidence that photosensitizing plants can be effective in conjunction with phototherapy, and moderate evidence that Ginkgo biloba monotherapy can be useful for vitiligo. 4) Two clinical trials investigated the use of vitamins in the therapy of vitiligo. One tested oral cobalamin with folic acid, and found no significant improvement over control. Another trial combined vitamin E with phototherapy and reported significantly better repigmentation over phototherapy only. It was not possible to pool the data from any studies for meta-analytic purposes due to the wide difference in outcome measures and poor quality ofreporting. CONCLUSION Reports investigating the efficacy of NHPs for vitiligo exist, but are of poor methodological quality and contain significant reporting flaws. L-phenylalanine used with phototherapy, and oral Ginkgo biloba as monotherapy show promise and warrant further investigation.
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Affiliation(s)
- Orest Szczurko
- Leslie Dan Faculty of Pharmacy, University of Toronto, Canada
| | - Heather S Boon
- Leslie Dan Faculty of Pharmacy, University of Toronto, Canada
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Xu L, Li J, Zhang M, Ai C, Wang L. Chinese authors do need CONSORT: reporting quality assessment for five leading Chinese medical journals. Contemp Clin Trials 2008; 29:727-31. [PMID: 18579449 DOI: 10.1016/j.cct.2008.05.003] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2008] [Revised: 04/30/2008] [Accepted: 05/13/2008] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Only a few Chinese medical journals have recommended CONSORT in their "Instruction for authors or Guide for authors". This study aims to evaluate the reporting quality of randomized controlled trials (RCTs) published in the five leading Chinese medical journals indexed by MEDLINE. METHODS We identified RCTs published from 2004 to January 2007 in five leading Chinese medical journals by searching three important Chinese databases systematically, namely CNKI (China National Knowledge Infrastructure/Chinese Academic Journals full text Database), VIP (a full text database of China) and CBM disc (China Biomedicine Database Disc) and assessed the quality of each RCT by using the Consolidated Standards for Reporting of Trials (CONSORT) and the 5-point Jadad scale. RESULTS One hundred and forty two RCTs were included. Based on the items in the revised CONSORT statement, 130 (91.55%) of the 142 RCTs mentioned "randomization" in the title or abstract, but only 38 (26.76%) RCTs described the method to generate the random sequence; only 6 RCTs had adequate allocation concealment; 24 (17.61%) RCTs mentioned "masking", but only 7 described the process of masking. Three out of 40 items were reported clearly in all included trials, while five items were not mentioned at all. The quality of RCTs was low as assessed by the Jadad scale and 22 RCTs were high-quality research (>/=3 points). CONCLUSIONS The reporting quality of RCTs published in the five leading Chinese medical journals is low. Chinese journals should adopt the CONSORT statement to improve the reporting quality of Chinese randomized controlled trials.
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Affiliation(s)
- Lin Xu
- Chinese Cochrane Centre, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
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Parés D, Norton C, Chelvanayagam S. Fecal incontinence: the quality of reported randomized, controlled trials in the last ten years. Dis Colon Rectum 2008; 51:88-95. [PMID: 18085335 DOI: 10.1007/s10350-007-9146-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE This study was designed to analyze the characteristics and the quality of reporting of randomized, controlled trials published during the last ten years on fecal incontinence. METHODS An electronic search for all randomized, controlled trials on fecal incontinence was undertaken by using the MEDLINE database via PubMed. The data collected were divided into general data, characteristics of reporting, methodology quality assessment using the Jadad scale and a validated methodology quality score (MINCIR score), evaluation of the items published in the CONSORT statement, and the journal impact factor. Reports were divided into two groups: published articles from 1996 to 2000 (Group 1), and from 2001 to 2005 (Group 2). RESULTS Forty-two trials fulfilled the inclusion criteria of the study (Group 1, n = 15; and Group 2, n = 27). There were no significant differences in general characteristics of randomized, controlled trials between the two groups. In Group 2, there were a statistically significant higher number of studies that reported a flow chart (P < 0.001), written informed consent (P = 0.008), sample size calculation (P = 0.023), and withdrawals and dropouts (P < 0.001). We found a statistically significant higher score in Jadad scale (P = 0.046) and MINCIR score (P = 0.016) in the published studies in Group 2. Also we found higher journal impact factor of journals that published these randomized, controlled trials during the most recent years (P = 0.04). CONCLUSIONS There is a lack of high-quality reported randomized, controlled trials on fecal incontinence during the last ten years. Reports of randomized, controlled trials involving patients with fecal incontinence published after 2001 were better reported than in the previous five years.
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Affiliation(s)
- David Parés
- Department of Physiology, St. Mark's Hospital, Watford Road, Harrow, London, United Kingdom
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Singh BB, Khorsan R, Vinjamury SP, Der-Martirosian C, Kizhakkeveettil A, Anderson TM. Herbal treatments of asthma: a systematic review. J Asthma 2007; 44:685-98. [PMID: 17994396 DOI: 10.1080/02770900701247202] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Asthma is a condition, often chronic, characterized by respiratory symptoms, variable airflow limitation and/or airway hyper-reactivity with symptoms causally related to family history, environmental influences, exposure to viruses and allergens as examples. The high economic burden associated with asthma is associated primarily with health care costs, missed work or school days. This systematic review was conducted to determine the study quality of articles investigating ayurvedic/collateral herbs, the effectiveness/efficacy and safety profile, as reported in the studies. METHODS Literature searches were conducted using PubMed, EMBASE, Mantis, Ovid, Annotated Bibliography of Indian Medicine, and Cochrane library to identify published trials on herbal medicines for asthma of which Ayruvedic herbals are a subset. Randomized Controlled Trials (RCTs) and Quasi-Experimental Designs (QEDs) were included in this systematic review. The classic Jadad Scale, Singh RCT Scale with additional domains than Jadad, Safety Scoring Scale for clinical trials and the Singh QED Scale based on expanded features of QEDs were used to assess study quality. Herbs included in Traditional Chinese Medicine were excluded from this review. Forty-two articles were retrieved and 37 studies were ultimately reviewed utilizing 3 independent evaluators/1 arbitrator. RESULTS Articles reviewed indicated benefit from most of the herbs used either as a primary or adjunctive treatment for Asthma. Study quality was mixed and therefore caution in interpretation of findings of usefulness of these herbals must be suggested. Limited safety information was mixed and generally was related to GI symptoms, though one herbal investigated reported more serious side effects. CONCLUSIONS Herbs may be useful in treatment of asthma. There is insufficient evidence to make recommendations for or against the use of these herbals. Established effectiveness must be balanced with study quality and safety profile for the herb.
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Affiliation(s)
- Betsy B Singh
- International Clinical Research Associates, Richmond, USA.
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Gagnier JJ, DeMelo J, Boon H, Rochon P, Bombardier C. Quality of reporting of randomized controlled trials of herbal medicine interventions. Am J Med 2006; 119:800.e1-11. [PMID: 16945616 DOI: 10.1016/j.amjmed.2006.02.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2005] [Revised: 02/06/2006] [Accepted: 02/06/2006] [Indexed: 10/24/2022]
Abstract
BACKGROUND Public interest in herbal medicines has generated an increasing number of trials evaluating their efficacy. Trials with poor methodologic quality have exaggerated estimates of treatment effect, and incomplete reporting of trials causes difficulties in assessing trial methodologic quality. The objective of this project was to examine the quality of reporting of randomized controlled intervention trials of herbal medicine. METHODS MEDLINE (1966 to September 2003) was searched for randomized controlled trials of 10 herbal medicines. Two individuals (J. G. and J. D.) independently assessed trials using the Consolidated Standard of Reporting Trials checklist. Disagreements were resolved by consensus. The mean number of checklist items reported across all and for individual herbal medicines was calculated. The influence of decade of publication and species of herbal medicine tested was explored using an analysis of variance. RESULTS A total of 206 randomized controlled trials of herbal medicine were included. Interrater reliability on reporting quality assessment was high. A total of 45% of items were reported across all trials. The quality of reporting improved across decades from the 1970s to the 2000s. Individual herbal species differed in the total number of items reported, with echinacea, ginkgo, St. John's wort, and kava trials reporting the most items. CONCLUSIONS Important methodologic components of randomized controlled trials of herbal medicines are incompletely reported including allocation concealment, method used to generate the allocation sequence, and whether an intention-to-treat analysis was used. Also, key information unique to these trials may be missing, such as percentage of active constituents and type or form of the herbal medicine preparation. We suggest trialists consult a recent extension of the Consolidated Standard of Reporting Trials statement specific to herbal medicine trials when designing and reporting randomized controlled intervention trials of herbal medicines.
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Affiliation(s)
- Joel J Gagnier
- Department of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Ontario, Canada
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Gagnier J, Boon H, Rochon P, Barnes J, Moher D, Bombardier C. Improving the quality of reporting of randomized controlled trials evaluating herbal interventions: implementing the CONSORT statement [corrected]. Explore (NY) 2006; 2:143-9. [PMID: 16781628 DOI: 10.1016/j.explore.2005.12.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2005] [Indexed: 11/22/2022]
Abstract
BACKGROUND Given that herbal medicinal products are widely used, vary greatly in content and quality, and are actively tested in randomized controlled trials (RCTs), such RCTs must clearly report the specifics of the intervention. OBJECTIVE Our objective was to develop recommendations for reporting RCTs of herbal medicine interventions. METHODS We identified and invited potential participants with expertise in clinical trial methodology, clinical trial reporting, pharmacognosy, herbal medicinal products, medical statistics, and/or herbal product manufacturing to participate in phone calls and a consensus meeting. Three phases were conducted: (1) Premeeting item generation via telephone calls, (2) Consensus meeting, and (3) Postmeeting feedback. Sixteen experts participated in premeeting phone calls for item generation, and 14 participants attended a consensus meeting in Toronto, Ontario, Canada, in June of 2004. During the consensus meeting, a modified Delphi technique was used to aid discussion and debate of information required for reporting RCTs of herbal medicines. RESULTS After extensive discussion, the group decided that context-specific elaborations of nine Consolidated Standards of Reporting Trials (CONSORT) items to RCTs of herbal medicines were necessary: Item 1 (Title and Abstract), 2 (Background), 3 (Participants), 4 (Interventions), 6 (Outcomes), 15 (Baseline data), 20 (Interpretation), 21 (Generalizability), and 22 (Overall evidence). DISCUSSION The elaboration of item 4 of the CONSORT statement outlines specific information required for complete reporting of the herbal medicine intervention. The reporting suggestions presented will support clinical trialists, editors, and reviewers in reporting and reviewing RCTs of herbal medicines and readers in interpreting the results.
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Affiliation(s)
- Joel Gagnier
- Department of Health Policy, Management and Evaluation, Department of Medicine, Univerity of Toronto, Toronto, Canada.
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Efficace F, Horneber M, Lejeune S, Van Dam F, Leering S, Rottmann M, Aaronson NK. Methodological quality of patient-reported outcome research was low in complementary and alternative medicine in oncology. J Clin Epidemiol 2006; 59:1257-65. [PMID: 17098568 DOI: 10.1016/j.jclinepi.2006.03.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2005] [Revised: 02/17/2006] [Accepted: 03/23/2006] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the methodological robustness of patient-reported outcomes (PROs) evaluation in complementary and alternative medicine (CAM) randomized controlled trials (RCTs) in oncology. STUDY DESIGN AND SETTING CAM RCTs with a PRO endpoint were retrieved from a number of electronic databases. CAM interventions were defined according to the five major categories of the National Center for Complementary and Alternative Medicine. The "Minimum Standard Checklist for Evaluating HRQOL Outcomes in Cancer Clinical Trials" was used to assess the quality of the PRO reporting in these trials. RESULTS Forty-four RCTs enrolling 4,912 patients were identified: six studies involved alternative medical systems, 14 involved mind body interventions, 15 dealt with biologically-based therapies, seven involved manipulative and body-based methods, and two energy therapies. Eighty-nine percent of studies used a PRO as a primary endpoint and 59% documented PRO missing data. Although 84% of the studies used a validated PRO questionnaire, only 37% stated an a priori hypothesis and 20% addressed clinical significance of the outcomes. Overall, 64% of the studies analyzed exhibited a number of methodological drawbacks. CONCLUSIONS To facilitate the interpretation of results from such CAM RCTs, investigators are encouraged to pay greater attention to key methodological issues as identified in this study.
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Affiliation(s)
- Fabio Efficace
- European Organisation for Research and Treatment of Cancer (EORTC), EORTC Data Center, Quality of Life Unit, Avenue E. Mounier, 83, 1200 Brussels, Belgium.
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Berger VW. Response to Klassen et al: Missing data should be more heartily penalized. J Clin Epidemiol 2006; 59:759-60. [PMID: 16765281 DOI: 10.1016/j.jclinepi.2006.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2005] [Accepted: 01/06/2006] [Indexed: 11/17/2022]
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Ernst E. Complementary or alternative therapies for osteoarthritis. ACTA ACUST UNITED AC 2006; 2:74-80. [PMID: 16932660 DOI: 10.1038/ncprheum0093] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2005] [Accepted: 10/31/2005] [Indexed: 11/09/2022]
Abstract
Complementary or alternative therapies for osteoarthritis are commonly used and therefore it is important that health-care providers and patients are aware of the evidence for or against these approaches. In this article, the best available evidence is reviewed. The results suggest that, for several treatments, the risk-benefit profile is encouraging: acupuncture, several herbal medicines and capsaicin cream. For other therapies the evidence is weak or contradictory: homeopathy, magnet therapy, tai chi, leech therapy, music therapy, yoga, imagery and therapeutic touch. Many other treatments have not been scientifically tested. It is concluded that some complementary or alternative therapies have generated sufficiently promising results to warrant further investigation in large-scale, definitive, randomized clinical trials.
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Affiliation(s)
- Edzard Ernst
- Complementary Medicine Peninsula Medical School, Universities of Exeter & Plymouth, UK.
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