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Armijo-Olivo S, Barbosa-Silva J, de Castro-Carletti EM, de Oliveira-Souza AIS, Pelai EB, Mohamad N, Baghbaninaghadehi F, Dennett L, Steen JP, Kumbhare D, Ballenberger N. Intention-to-Treat Analysis in Clinical Research: Basic Concepts for Clinicians. Am J Phys Med Rehabil 2024; 103:845-857. [PMID: 38320245 DOI: 10.1097/phm.0000000000002444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
ABSTRACT This review presents a comprehensive summary and critical evaluation of intention-to-treat analysis, with a particular focus on its application to randomized controlled trials within the field of rehabilitation. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a methodological review that encompassed electronic and manual search strategies to identify relevant studies. Our selection process involved two independent reviewers who initially screened titles and abstracts and subsequently performed full-text screening based on established eligibility criteria. In addition, we included studies from manual searches that were already cataloged within the first author's personal database. The findings are synthesized through a narrative approach, covering fundamental aspects of intention to treat, including its definition, common misconceptions, advantages, disadvantages, and key recommendations. Notably, the health literature offers a variety of definitions for intention to treat, which can lead to misinterpretations and inappropriate application when analyzing randomized controlled trial results, potentially resulting in misleading findings with significant implications for healthcare decision making. Authors should clearly report the specific intention-to-treat definition used in their analysis, provide details on participant dropouts, and explain upon their approach to managing missing data. Adherence to reporting guidelines, such as the Consolidated Standards of Reporting Trials for randomized controlled trials, is essential to standardize intention-to-treat information, ensuring the delivery of accurate and informative results for healthcare decision making.
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Affiliation(s)
- Susan Armijo-Olivo
- From the University of Applied Sciences Osnabrück, Faculty of Economics and Social Sciences, Osnabrück, Germany (SA-O, AISDO-S, NB); Faculties of Rehabilitation Medicine and Medicine and Dentistry, University of Alberta, Edmonton, Canada (SA-O) Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada; Post Graduate Program in Physical Therapy, Federal University of São Carlos-UFSCar, São Carlos, Brazil (JB-S); Post Graduate Program in Human Movement Sciences, Methodist University of Piracicaba-UNIMEP, Piracicaba, Brazil (EMDC-C); Post-Graduation Program in Oral and Maxillofacial Surgery, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba (SP), Brazil (EBP); Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada (NM, FB, LD); Faculty of Health Science, Center of Physiotherapy, Universiti Teknologi MARA, Puncak Alam, Malaysia (NM); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada (JPS); Toronto Rehabilitation Institute, University Health Network, Toronto, Canada (JPS); and Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, Canada (DK)
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Yang Y, Yang S, Han Y, Zou G, Wang R, Liu L. Quality reporting of randomized controlled trials on SGLT2 inhibitors for heart failure: a comprehensive assessment. Sci Rep 2024; 14:6819. [PMID: 38514865 PMCID: PMC10958037 DOI: 10.1038/s41598-024-57514-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/19/2024] [Indexed: 03/23/2024] Open
Abstract
Randomised controlled trials (RCTs) provide clinicians with the best evidence of the effectiveness of an intervention, and complete and transparent trial reports help to critically assess and use trial results. The objective of our study was to assess the quality of reporting in RCTs of sodium-glucose co-transporter protein 2 (SGLT2) inhibitors for heart failure (HF) and identify factors associated with improved reporting quality. Two researchers conducted a comprehensive search in four databases (PubMed, Web of Science, EMBASE, and Cochrane). The quality of each report was assessed using a 25-point Overall Quality Score (OQS) based on the guidelines provided in the 2010 Consolidated Standards for Reporting of Trials (CONSORT) statement. We included a total of 58 relevant RCTs. The median OQS in the 2010 CONSORT statement was 15 (range 7.5-24). The missing items were primarily found in the 'Methods' and 'Results' sections of the 2010 CONSORT statement. Multivariate regression modeling revealed that a more recent publication year, high impact factor, and large sample size were significant predictors of OQS improvement. The findings suggest that the overall quality of reported RCTs of SGLT2 inhibitors in HF is unsatisfactory, which reduces their potential usefulness.
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Affiliation(s)
- YueGuang Yang
- Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, 150040, People's Republic of China
| | - ShunWen Yang
- Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, 150040, People's Republic of China
| | - YuBo Han
- The First Department of Cardiovascular, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, 26 Heping Road, Xiangfang, Harbin, Heilongjiang, 150040, People's Republic of China
| | - GuoLiang Zou
- The First Department of Cardiovascular, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, 26 Heping Road, Xiangfang, Harbin, Heilongjiang, 150040, People's Republic of China
| | - RuiNan Wang
- The First Department of Cardiovascular, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, 26 Heping Road, Xiangfang, Harbin, Heilongjiang, 150040, People's Republic of China
| | - Li Liu
- The First Department of Cardiovascular, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, 26 Heping Road, Xiangfang, Harbin, Heilongjiang, 150040, People's Republic of China.
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Mohamad N, de Oliveira-Souza AIS, de Castro-Carletti EM, Müggenborg F, Dennett L, McNeely ML, Armijo-Olivo S. The effectiveness of different types of acupuncture to reduce symptoms and disability for patients with orofacial pain. A systematic review and meta-analysis. Disabil Rehabil 2024:1-17. [PMID: 38357796 DOI: 10.1080/09638288.2024.2310766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 01/20/2024] [Indexed: 02/16/2024]
Abstract
PURPOSE To determine the effectiveness of different types of acupuncture in reducing pain, improving maximum mouth opening and jaw functions in adults with orofacial pain. METHODS Six databases were searched until 15 June 2023. The Cochrane risk of bias tool and GRADE were employed to evaluate bias and overall evidence certainty. RESULTS Among 52 studies, 86.5% (n = 45) exhibited high risk of bias. Common acupoints, including Hegu LI 4, Jiache ST 6, and Xiaguan ST 7, were used primarily for patients with temporomandibular disorder [TMDs]. Meta-analyses indicated that acupuncture significantly reduced pain intensity in individuals with myogenous TMD (MD = 26.02 mm, I2=89%, p = 0.05), reduced tenderness in the medial pterygoid muscle (standardised mean differences [SMD] = 1.72, I2 = 0%, p < 0.00001) and jaw dysfunction (SMD = 1.62, I2 = 88%, p = 0.010) in mixed TMD when compared to sham/no treatment. However, the overall certainty of the evidence was very low for all outcomes as evaluated by GRADE. CONCLUSION The overall results in this review should be interpreted with caution as there was a high risk of bias across the majority of randomized controlled trial (RCTs), and the overall certainty of the evidence was very low. Therefore, future studies with high-quality RCTs are warranted evaluating the use of acupuncture in patients with orofacial pain.
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Affiliation(s)
- Norazlin Mohamad
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
- Faculty of Health Sciences, Centre of Physiotherapy, Universiti Teknologi MARA, Puncak Alam Campus, Puncak Alam, Selangor, Malaysia
| | - Ana Izabela Sobral de Oliveira-Souza
- Faculty of Business and Social Sciences, University of Applied Sciences, Osnabrück, Germany
- Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Pernambuco, Brazil
| | - Ester Moreira de Castro-Carletti
- Faculty of Business and Social Sciences, University of Applied Sciences, Osnabrück, Germany
- Post Graduate Program in Human Movement Sciences, Methodist University of Piracicaba - UNIMEP, Piracicaba, Brazil
| | - Frauke Müggenborg
- Faculty of Business and Social Sciences, University of Applied Sciences, Osnabrück, Germany
| | - Liz Dennett
- Geoffrey and Robyn Sperber Health Sciences Library, University of Alberta, Edmonton, Canada
| | - Margaret L McNeely
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Susan Armijo-Olivo
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
- Faculty of Business and Social Sciences, University of Applied Sciences, Osnabrück, Germany
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Al Naimi A. Is it the surgical intervention or was it the preoperative medical preparation? Am J Obstet Gynecol 2024; 230:272. [PMID: 37852522 DOI: 10.1016/j.ajog.2023.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/12/2023] [Indexed: 10/20/2023]
Affiliation(s)
- Ammar Al Naimi
- Department of Obstetrics and Gynecology, Buergerhospital - Dr. Senckenbergische Stiftung, Nibelungenallee 37-41, D-60318 Frankfurt am Main, Hessen, Germany; Department of Obstetrics and Gynecology, Goethe University of Frankfurt, Hessen, Germany.
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Wendel K, Rossholt ME, Gunnarsdottir G, Aas MF, Westvik ÅS, Pripp AH, Carlsen KCL, Fugelseth D, Stiris T, Moltu SJ. Lung function in preterm infants at 3 months corrected age after neonatal LC-PUFA supplementation. Pediatr Pulmonol 2024; 59:389-398. [PMID: 37975489 DOI: 10.1002/ppul.26760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/17/2023] [Accepted: 11/05/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE To test the hypothesis that long-chain polyunsaturated fatty acid (LC-PUFA) supplementation improves lung function at 3 months corrected age (CA) compared with standard treatment in very preterm infants. We also aimed to investigate the association between bronchopulmonary dysplasia (BPD), longitudinal growth, and lung function at 3 months CA. METHODS A secondary analysis from the ImNuT trial, in which 121 infants with gestational age <29 weeks were randomized to a daily supplement with arachidonic acid (ARA) and docosahexaenoic acid (DHA) (ARA:DHA group) or MCT-oil (control group) from birth up to 36 weeks postmenstrual age (PMA). Lung function was assessed at 3 months CA by tidal flow volume loops and the outcomes were the ratio of time to peak tidal expiratory flow to expiratory time (tPTEF /tE ) and tidal volume (VT ) per body weight (mL/kg). RESULTS Thirty-nine infants in the ARA:DHA group versus 51 in the control group had a successful lung function test. There was no mean difference (MD) in tPTEF /tE ratio (MD: 0.01, 95% confidence interval [CI]: -0.04 to 0.05; p = .77) or VT (MD: 0.09 mL/kg, 95% CI: -0.79 to 0.62; p = .81) between the study groups. The multivariable regression model showed that BPD was associated with tPTEF /tE ratio ≤ 0.25 (p = .03) and that an increase in z score for length after 36 weeks PMA correlated positively with VT (mL/kg) (p = .03). CONCLUSION Neonatal LC-PUFA supplementation did not improve lung function at 3 months CA in very preterm infants. BPD was independently associated with reduced lung function, while improved linear growth correlated with higher tidal volumes.
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Affiliation(s)
- Kristina Wendel
- Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Madelaine Eloranta Rossholt
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Pediatric and Adolescence Medicine, Oslo University Hospital, Oslo, Norway
| | - Gunnthorunn Gunnarsdottir
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Pediatric Neurology, Oslo University Hospital, Oslo, Norway
| | - Marlen Fossan Aas
- Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Åsbjørn Schumacher Westvik
- Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Are Hugo Pripp
- Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Karin C Lødrup Carlsen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Pediatric and Adolescence Medicine, Oslo University Hospital, Oslo, Norway
| | - Drude Fugelseth
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tom Stiris
- Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Sissel Jennifer Moltu
- Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Vieira MDA, de Oliveira-Souza AIS, Hahn G, Bähr L, Armijo-Olivo S, Ferreira APDL. Effectiveness of Biofeedback in Individuals with Awake Bruxism Compared to Other Types of Treatment: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1558. [PMID: 36674315 PMCID: PMC9863342 DOI: 10.3390/ijerph20021558] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/04/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
Excessive masticatory muscle activity is generally present in awake bruxism, which is related to increased anxiety and stress. It has been hypothesized that biofeedback could potentially manage awake bruxism, however, its effectiveness has not been empirically analyzed in a systematic manner. Therefore, this systematic review was designed to determine the effectiveness of biofeedback compared to other therapies in adults with awake bruxism. Extensive searches in five databases looking for randomized controlled trials (RCTs) that included biofeedback to manage awake bruxism were targeted. The risk of bias (RoB) assessment was conducted using the Cochrane RoB-2 tool. Overall, four studies were included in this systematic review, all of which used the electromyographic activity of the masticatory muscles during the day and night as the main endpoint. Auditory and visual biofeedback could reduce the excessive level of masticatory muscle activity in a few days of intervention. The majority of the included studies had a high RoB and only one study had a low RoB. The standardization of the biofeedback protocols was also inconsistent, which makes it difficult to establish the ideal protocol for the use of biofeedback in awake bruxism. Thus, it is proposed that future studies seek to reduce methodological risks and obtain more robust samples.
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Affiliation(s)
- Maryllian de Albuquerque Vieira
- Kinesiotherapy and Manual Therapeutic Resources Laboratory, Department of Physical Therapy, Federal University of Pernambuco, Recife 50740-560, Brazil
| | | | - Gesa Hahn
- Faculty of Business and Social Sciences, University of Applied Sciences, Hochschule Osnabrück, 49076 Osnabrück, Germany
| | - Luisa Bähr
- Faculty of Business and Social Sciences, University of Applied Sciences, Hochschule Osnabrück, 49076 Osnabrück, Germany
| | - Susan Armijo-Olivo
- Faculty of Business and Social Sciences, University of Applied Sciences, Hochschule Osnabrück, 49076 Osnabrück, Germany
- Faculty of Rehabilitation Medicine/Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Ana Paula de Lima Ferreira
- Kinesiotherapy and Manual Therapeutic Resources Laboratory, Department of Physical Therapy, Federal University of Pernambuco, Recife 50740-560, Brazil
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