Are the clinical effects of homoeopathy placebo effects? A meta-analysis of placebo-controlled trials

The Lancet ◽  
1997 ◽  
Vol 350 (9081) ◽  
pp. 834-843 ◽  
Author(s):  
Klaus Linde ◽  
Nicola Clausius ◽  
Gilbert Ramirez ◽  
Dieter Melchart ◽  
Florian Eitel ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Controlled Trials ◽  
Clinical Effects ◽  
Placebo Effects

scholarly journals St John's wort for depression

2005 ◽  
Vol 186 (2) ◽  
pp. 99-107 ◽  
Author(s):  
Klaus Linde ◽  
Michael Berner ◽  
Matthias Egger ◽  
Cynthia Mulrow
Keyword(s):  
Major Depression ◽  
Depressive Disorders ◽  
Meta Analysis ◽  
Current Evidence ◽  
Controlled Trials ◽  
Clinical Effects ◽  
Double Blind ◽  
Beneficial Effects ◽  
St John’S Wort ◽  
St John's Wort

BackgroundExtracts of Hypericum perforatum (St John's wort) are widely used to treat depression. Evidence for its efficacy has been criticised on methodological grounds.AimsTo update evidence from randomised trials regarding the effectiveness of Hypericum extracts.MethodsWe performed a systematic review and meta-analysis of 37 double-blind randomised controlled trials that compared clinical effects of Hypericum monopreparation with either placebo or a standard antidepressant in adults with depressive disorders.ResultsLarger placebo-controlled trials restricted to patients with major depression showed only minor effects over placebo, while older and smaller trials not restricted to patients with major depression showed marked effects. Compared with standard antidepressants Hypericum extracts had similar effects.ConclusionsCurrent evidence regarding Hypericum extracts is inconsistent and confusing. In patients who meet criteria for major depression, several recent placebo-controlled trials suggest that Hypericum has minimal beneficial effects while other trials suggest that Hypericum and standard antidepressants have similar beneficial effects.

scholarly journals Comparing Several Treatments with Antibiotics for CommunityAcquired Pneumonia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Author(s):  
Fusheng Bai ◽  
Xinming Li
Keyword(s):  
Randomized Controlled Trials ◽  
Subgroup Analysis ◽  
Clinical Cure ◽  
Clinical Cure Rate ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Clinical Effects ◽  
Cure Rate ◽  
Ceftaroline Fosamil ◽  
Randomized Controlled

Background: We aimed to review relevant randomized controlled trials to assess the relative clinical effects of antibiotic treatment of patients with community-acquired pneumonia (CAP). Methods: In this meta-analysis, we identified relevant studies from PubMed, Cochrane, and Embase using appropriate keywords. Key pertinent sources in the literature were also reviewed and all articles published through Oct 2019 were considered for inclusion. For each study, we assessed the risk ratios (RRs) or mean difference combined with the 95% confidence interval (CI) to assess and synthesize outcomes. Results: Overall, 36 studies were consistent with the meta-analysis, involving 17,076 patients. There was no significant difference in the mortality after subgroup analysis: individualized treatment vs. standard treatment; β-lactams plus macrolides vs. β-lactam and/or fluoroquinolone; ceftaroline fosamil vs. ceftriaxone; combination therapy vs. monotherapy or high-dose vs. low-dose. The drug-related adverse event incidence was significantly higher in the ceftriaxone group than in the other drug groups (P<0.05) and also higher in the tigecyline group than in the levofloxacin group (P<0.05). Compared with ceftriaxone, ceftaroline fosamil significantly increased the clinical cure rate at the test-of-cure (TOC) visit in the clinically evaluable population, modified intent-to-treat efficacy (MITTE) population, microbiologically evaluable (ME) population and the microbiological MITTE (mMITTE) population (all P<0.05). Compared with ceftriaxone, ceftaroline fosamil significantly increased the clinical cure rate at the TOC visit in the mMITTE population of Gram positiveStreptococcus pneumoniae (P<0.05) and multidrug-resistant S. pneumoniae (P<0.05). Conclusion: There was a limited number of included studies in the subgroup analysis, but it will still be necessary to conduct more high-quality randomized controlled trials to confirm the clinical efficacy of different antibiotics used to treat CAP.

scholarly journals Clinical effects of low-dose intravenous ketamine in obstetrics: a systematic review

2020 ◽  
pp. 104-121
Author(s):  
N. V Shindyapina ◽  
D. V Marshalov ◽  
E. M Shifman ◽  
A. V Kuligin
Keyword(s):  
Systematic Review ◽  
Cesarean Section ◽  
Meta Analysis ◽  
Postoperative Nausea And Vomiting ◽  
Perioperative Period ◽  
Controlled Trials ◽  
Bolus Administration ◽  
Cochrane Central Register ◽  
Clinical Effects ◽  
Low Doses

Introduction. Over the past decade, there has been increased attention to ketamine, which is associated with the identification of its new effects when using low (less than 1 mg/kg for bolus administration and less than 20 g/kg/min for prolonged infusion) doses of the drug. In pregnant women, the pharmacokinetics of most drugs change, so the results of studies of low doses of ketamine obtained in other categories of patients may not be reproduced in the obstetric population. Objectives. Assessment of the clinical effects of various doses and regimens of ketamine administration, within the subanesthetic range, in the perioperative period of cesarean section. Material and Methods. Publications were searched in the electronic databases PubMed, MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) by four reviewers independently. The date of the last search query was December 31, 2019. Results. A total of 18 randomized controlled trials (RCTs) involving 2703 patients were included in the review. The results of this systematic review showed that the administration of low doses of ketamine (in the range of 0.15-0.5 mg/kg) in the perioperative period of cesarean section performed under spinal anesthesia can reduce the intensity of pain and the need for analgesics in the postoperative period. The use of low doses of ketamine under these conditions can also be useful to reduce the severity of chills, itching, and the prevention of postoperative nausea and vomiting, post-puncture headache, and postpartum depression. Doses of less than 0.5 mg/kg appear to be safer and comparatively effective in the prevention of the above complications. However, the small number and high heterogeneity of research does not allow us to draw unambiguous conclusions. The effectiveness of low doses of ketamine in the prevention of these complications with general anesthesia also remains unclear. Conclusion. Further research and a meta-analysis of the data are necessary to obtain final conclusions.

The clinical effects of sleep restriction therapy for insomnia: A meta-analysis of randomised controlled trials

2021 ◽  
pp. 101493
Author(s):  
Leonie F. Maurer ◽  
Jules Schneider ◽  
Christopher B. Miller ◽  
Colin A. Espie ◽  
Simon D. Kyle
Keyword(s):  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Sleep Restriction ◽  
Controlled Trials ◽  
Clinical Effects ◽  
Randomised Controlled

scholarly journals Acupuncture for Arthralgia Induced by Aromatase Inhibitors in Patients with Breast Cancer: A Systematic Review and Meta-analysis

2021 ◽  
Vol 20 ◽  
pp. 153473542098081
Author(s):  
Xiaomeng Liu ◽  
Jing Lu ◽  
Guoxin Wang ◽  
Xiu Chen ◽  
Haiping Xv ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Aromatase Inhibitors ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Common Side Effect ◽  
Clinical Effects ◽  
Breast Cancer Patients ◽  
Placebo Effects ◽  
China National Knowledge Infrastructure

Background: Aromatase inhibitor-induced arthralgia (AIA) is the most common side effect of aromatase inhibitors (AIs) used in breast cancer patients and is related to the rate of adherence to AIs. The clinical effects of acupuncture on AIA have been assessed by some randomized controlled trials (RCTs). However, some studies reported that acupuncture was effective, while others claimed that it was ineffective. To clarify the clinical and placebo effects of acupuncture in treating AIA, we conducted this meta-analysis. Methods: Two reviewers (XL and GW) independently searched for RCTs in 5 English databases (PubMed, Web of Science, Embase, Springer, Cochrane Library) and 4 Chinese databases (China National Knowledge Infrastructure Database (CNKI), SinoMed, VIP and Wanfang Database) from their inception to 30 November 2019. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this meta-analysis was performed by fixed or random-effects models, and data were pooled with mean differences (MDs). Results: Seven trials involving 603 patients were reviewed. The primary outcome, the Brief Pain Inventory (BPI) score, significantly differed between the acupuncture and control groups [pain-related interference: MD = −1.89, 95% confidence interval (CI) [−2.99, −0.79], Z = 3.36 ( P = .008 < .05), pain severity: MD = −1.57, 95% CI [−2.46, −0.68], Z = 3.45 ( P = .0006 < .05), worst pain: MD = −2.31, 95% CI [−3.15, −1.48], Z = 5.47 ( P < .0001 < .05)]. No severe adverse events were reported in any study. Conclusion: This meta-analysis showed that acupuncture is a safe and effective treatment for breast cancer patients with AIA. Additional research with improved blinding methods is warranted to further explore the nature of non-specific and placebo effects in true and sham acupuncture.

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