Intravenous administration of dexmedetomidine and quality of recovery after elective surgery in adult patients: A meta-analysis of randomized controlled trials

2020 ◽  
Vol 65 ◽  
pp. 109849 ◽  
Author(s):  
Mengrong Miao ◽  
Yuehua Xu ◽  
Bing Li ◽  
Enqiang Chang ◽  
Liyuan Zhang ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Intravenous Administration ◽  
Elective Surgery ◽  
Meta Analysis ◽  
Adult Patients ◽  
Controlled Trials ◽  
Quality Of Recovery ◽  
Randomized Controlled

scholarly journals EXPRESS: The benefit of exercise-based rehabilitation programmes in patients with pulmonary hypertension: a systematic review and meta-analysis of randomized controlled trials

2021 ◽  
pp. 204589402110078
Author(s):  
Lu Yan ◽  
Wence Shi ◽  
Zhi-hong Liu ◽  
Qin Luo ◽  
Zhihui Zhao ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pulmonary Hypertension ◽  
Randomized Controlled Trials ◽  
Exercise Capacity ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
The Mean ◽  
Quality Evidence

Background: Several studies have suggested that exercise capacity and quality of life are reduced in patients with pulmonary hypertension (PH), and exercise-based rehabilitation can improve exercise capacity and quality of life in patients with PH. The aim of this study is to assess the efficacy and safety of exercise-based rehabilitation in patients with PH through a meta-analysis of randomized controlled trials. Methods: We searched PubMed, Embase, Medline, and the Cochrane Central Register of Controlled Trials up to November 2018. All randomized controlled trials (RCTs) comparing exercise capacity and quality of life between patients undergoing exercise-based rehabilitation and those undergoing non-exercise training were included. Data were extracted separately and independently by two investigators, and discrepancies were arbitrated by the third investigator. We used the random-effects model to analyze the results, the GRADE to assess the risk of bias in the included studies, and I ² statistic to estimate the degree of heterogeneity. Results: Nine RCTs are included, however, only seven RCTs were able to extract data. Including inpatients and outpatients, the total number of participants was 234, most of whom were diagnosed as pulmonary artery hypertension (PAH). The study duration ranged from 3 to15 weeks. The mean six-minute walk distance after exercise training was 51.94 metres higher than control (27.65 to 76.23 metres, n=234, 7 RCTs, low quality evidence), the mean peak oxygen uptake  was 2.96 ml/kg/minute higher (2.49 to 3.43 ml/kg/minute, n=179, 4 RCTs, low-quality evidence) than in the control group . Concluded: Our finding suggest that an exercise-based training program positively influences exercise capacity in patients with PH.

scholarly journals Technology-Based Interventions in Oral Anticoagulation Management: Meta-Analysis of Randomized Controlled Trials (Preprint)

2020 ◽  
Author(s):  
Caiyun Zheng ◽  
Hengfen Dai ◽  
Chun Lin ◽  
Yan Zhang ◽  
Hong Zhang ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Oral Anticoagulation ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Minor Bleeding ◽  
Bleeding Events ◽  
Anticoagulation Management ◽  
Randomized Controlled ◽  
Clinical Benefits

BACKGROUND An increasing number of patients have received prophylactic or therapeutic oral anticoagulants (OACs) for thromboembolic complications of diseases. The use of OACs is associated with both clinical benefits and risks. Considering the challenges imposed by this class of drugs, as well as the enormous progress made in portable device technology, it is possible that technology-based interventions may improve clinical benefits for patients and optimize anticoagulation management. OBJECTIVE This study was designed to comprehensively evaluate the role of technology-based interventions in the management of OACs. METHODS We searched 6 databases—PubMed, EMBASE, Cochrane, Cumulative Index to Nursing and Allied Health Literature, Scopus, and PsycINFO—to retrieve relevant studies published as of November 1, 2019, to evaluate the effect of technology-based interventions on oral anticoagulation management. RevMan (version 5.3; Cochrane) software was used to evaluate and analyze clinical outcomes. The methodological quality of studies was assessed by the Cochrane risk of bias tool. RESULTS A total of 15 randomized controlled trials (RCTs) were selected for analysis. They reported data for 2218 patients (1110 patients in the intervention groups and 1108 patients in the control groups). A meta-analysis was performed on the effectiveness and safety data reported in the RCTs. Technology-based interventions significantly improved the effectiveness of oral anticoagulation management (mean difference [MD]=6.07; 95% CI 0.84-11.30; I<sup>2</sup>=72%; <i>P</i>=.02). The safety of oral anticoagulation management was also improved, but the results were not statistically significant. Bleeding events were reduced (major bleeding events MD=1.02; 95% CI 0.78-1.32; I<sup>2</sup>=0%; <i>P</i>=.90; minor bleeding events MD=1.06, 95% CI 0.77-1.44; I<sup>2</sup>=41%; <i>P</i>=.73) and thromboembolism events were reduced (MD=0.71; 95% CI 0.49-1.01; I<sup>2</sup>=0%; <i>P</i>=.06). In general, patients were more satisfied with technology-based interventions, which could also improve their knowledge of anticoagulation management, improve their quality of life, and reduce mortality and hospitalization events. CONCLUSIONS Using technology to manage OACs can improve the effectiveness and safety of oral anticoagulation management, result in higher patient satisfaction, and allow greater understanding of anticoagulation.

scholarly journals Quality of Randomized Controlled Trials Reporting in the Treatment of Adult Patients with High‐Grade Gliomas

2017 ◽  
Vol 23 (3) ◽  
pp. 337-345 ◽  
Author(s):  
Magalie P. Tardy ◽  
Jocelyn Gal ◽  
Emmanuel Chamorey ◽  
Fabien Almairac ◽  
Fanny Vandenbos ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Adult Patients ◽  
Controlled Trials ◽  
High Grade ◽  
Randomized Controlled ◽  
High Grade Gliomas

scholarly journals Lower Risk of Recurrence After Mesh Repair Versus Non-Mesh Sutured Repair in Open Umbilical Hernia Repair: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2018 ◽  
Vol 108 (3) ◽  
pp. 187-193 ◽  
Author(s):  
T. Bisgaard ◽  
R. Kaufmann ◽  
M. W. Christoffersen ◽  
P. Strandfelt ◽  
L. L. Gluud
Keyword(s):  
Relative Risk ◽  
Confidence Interval ◽  
Randomized Controlled Trials ◽  
Mesh Repair ◽  
Umbilical Hernia ◽  
Meta Analysis ◽  
Seroma Formation ◽  
Controlled Trials ◽  
Randomized Controlled

Background and Aims: The use of mesh repair in a small- or middle-sized umbilical hernia remains controversial, and evidence is based on only few and small heterogeneous randomized trials. The primary aim was to assess differences, if any, in recurrence (clinical and reoperation), and secondary aim was to assess differences in infections, seroma formation, hematomas, chronic pain, cosmetic result, and quality of life. Method: A systematic review (predefined search strategy) and meta-analyses were conducted based on pre-study strict and well-defined methodology. The literature search was completed on 1 January 2018. The study protocol was registered in PROSPERO. Results: Five randomized controlled trials were identified (mesh repair, n = 326 versus non-mesh sutured repair, n = 330) and 602 records were excluded. Randomized controlled trials included patients with defect diameters of ⩾1 to 4 cm. Mesh repair reduced the risk of recurrence compared with sutured repair with a relative risk of 0.28 (95% confidence interval = 0.13–0.58, I2 = 0%, number needed to treat = 13 patients). Additional analyses found no differences between the two surgical techniques regarding infection (relative risk = 0.80, 95% confidence interval = 0.36–1.79), seroma formation (relative risk = 1.38, 95% confidence interval = 0.57–3.32), or hematomas (relative risk = 0.55, 95% confidence interval = 0.23–1.30). Lack of sufficient data precluded meta-analysis evaluating risk of seroma formation, hematomas, chronic pain, cosmetic result, and quality of life. Conclusion: Mesh repair is recommended for umbilical hernia of ⩾1 to 4 cm. More evidence is needed for the optimal placement of the mesh (sublay or onlay) and the role of mesh in patients with an umbilical hernia <1 cm.

scholarly journals The Effectiveness and Safety of Moxibustion for Treating Knee Osteoarthritis: A PRISMA Compliant Systematic Review and Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 2019 ◽  
pp. 1-16 ◽  
Author(s):  
Ting Yuan ◽  
Jun Xiong ◽  
Xue Wang ◽  
Jun Yang ◽  
Yunfeng Jiang ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Western Medicine ◽  
Adverse Reactions ◽  
Meta Analysis ◽  
Negative Control ◽  
Lysholm Score ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Jadad Scale

Background. Knee osteoarthritis (KOA) seriously affects people’s life. Therefore, it has already become a worldwide health concern. Moxibustion has a significant clinical effect on KOA. This systematic review and meta-analysis is performed to renew previous studies and strictly evaluate the quality of RCT and thus test the effect and safety of moxibustion for KOA. Objective. To evaluate the effectiveness and safety of moxibustion treatment for alleviating pain and improving lower limb function for patients with KOA. Materials and Methods. CNKI (1979∼2019), CBM (1979∼2019), VIP (1989∼2019), WF (1998∼2019), PubMed (1966∼2019), Embase (1980∼2019), Cochrane Library, and Web of Science (1900∼2019) were all retrieved by a computer from their inception to June 02, 2019, replenished by manual retrieval of relevant bibliographies. Randomized controlled trials (RCTs) were included if moxibustion was compared to western medicine or negative control (placebo moxibustion or no treatment or UC) for treating KOA. The primary outcomes were the total effect and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC scale). The secondary outcomes include VAS, Symptom score, Lysholm score, and Lequesne score. RCTs were collected, and the quality of evidence was evaluated by using the Jadad scale and Cochrane risk assessment tools. We used RevMan5.3.0 software for meta-analysis. Results. A total of 39 RCTs were included, including 3293 patients. In the assessment of the quality, the evidence differs from low to high based on the Cochrane Bias Evaluation Tools and Jadad scale. Fourteen trials were of high quality, ten were of moderate quality, and 15 were of low quality. Therefore, the quality of the included studies was moderate. In this study, there were 66.67% of the literature, and only 17.95% of the literature correctly reported randomized grouping and allocation of hidden information, respectively. In adverse reactions, only 13 trials included were reported in the study. The main adverse reactions of moxibustion are burns and blisters, whereas the western medicine group was in epigastric discomfort. As for the total effective rate, the meta-analysis of 27 RCTs showed a significant effect of moxibustion VS western medicine (RR = 1.20, 95% CI = 1.16 to 1.25, I2 = 45%, P=0.007); as for the WOMAC scale, the subgroup meta-analysis of 13 trials showed that there was a statistically significant effect of moxibustion VS western medicine (MD = −11.08, 95% CI = −11.72 to −10.44, I2 = 98%, P<0.00001) and 2 trials on moxibustion VS negative control (MD = −8.38, 95% CI = −12.69 to −4.06, I2 = 0%, P=0.77); as for the VAS score, the meta-analysis of 6 trials showed that there was a significant effect of moxibustion VS western medicine (MD = −2.12, 95% CI = −2.30 to −1.93, I2 = 98%, P<0.00001); as for the symptom score, the meta-analysis of 7 trials showed that there was a significant effect of moxibustion VS western medicine (MD = −0.81, 95% CI = −1.24 to −0.37, I2 = 50%, P=0.06); as for the Lysholm score, the meta-analysis of 5 trials showed that there was a significant effect of moxibustion VS western medicine (MD = 7.61, 95% CI = 6.04 to 9.17, I2 = 95%, P<0.00001); and as for the Lequesne score, the meta-analysis of 3 trials showed that there was a significant effect of moxibustion VS western medicine (MD = 3.29, 95% CI = 2.93 to 3.65, I2 = 99%, P<0.00001). Conclusion. Moxibustion treatment for KOA is more effective than the positive control (western medicine) or negative control (placebo moxibustion or no treatment or UC), and there were fewer adverse reactions to moxibustion. Due to the universally low quality of the eligible trials, it still needs further large-scale and high-quality randomized controlled trials to verify the effectiveness and safety of moxibustion in the treatment of KOA.

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