The efficacy of psychotherapy, pharmacotherapy and their combination on functioning and quality of life in depression: a meta-analysis

BackgroundThere is growing recognition of the importance of both functioning and quality of life (QoL) outcomes in the treatment of depressive disorders, but the meta-analytic evidence is scarce. The objective of this meta-analysis of randomized controlled trials (RCTs) was to determine the absolute and relative effects of psychotherapy, pharmacotherapy and their combination on functioning and QoL in patients with depression.MethodOne hundred and fifty-three outcome trials involving 29 879 participants with depressive disorders were identified through database searches in Pubmed, PsycINFO and the Cochrane Central Register of Controlled Trials.ResultsCompared to control conditions, psychotherapy and pharmacotherapy yielded small to moderate effect sizes for functioning and QoL, ranging from g = 0.31 to g = 0.43. When compared directly, initial analysis yielded no evidence that one of them was superior. After adjusting for publication bias, psychotherapy was more efficacious than pharmacotherapy (g = 0.21) for QoL. The combination of psychotherapy and medication performed significantly better for both outcomes compared to each treatment alone yielding small effect sizes (g = 0.32 to g = 0.39). Both interventions improved depression symptom severity more than functioning and QoL.ConclusionDespite the small number of comparative trials for some of the analyses, this study reveals that combined treatment is superior, but psychotherapy and pharmacotherapy alone are also efficacious for improving functioning and QoL. The overall relatively modest effects suggest that future tailoring of therapies could be warranted to better meet the needs of individuals with functioning and QoL problems.

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The comparative effectiveness of physical exercise interventions in individuals with chronic non-specific neck pain: protocol for a network meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-034846 ◽

2020 ◽

Vol 10 (5) ◽

pp. e034846 ◽

Cited By ~ 1

Author(s):

Rutger MJ de Zoete ◽

James H McAuley ◽

Nigel R Armfield ◽

Michele Sterling

Keyword(s):

Physical Exercise ◽

Neck Pain ◽

Meta Analysis ◽

Network Effect ◽

Effect Sizes ◽

Controlled Trials ◽

Cochrane Central Register ◽

Exercise Interventions ◽

Meta Analyses

IntroductionNeck pain is a global burdensome problem, with a large proportion of neck pain cases becoming chronic. Although physical exercise is a commonly prescribed treatment, the evidence on the effectiveness of isolated exercise interventions remains limited. Traditional pairwise randomised controlled trials (RCTs) and meta-analyses are limited in only comparing two interventions. This protocol describes the design of a network meta-analysis, which enables a comparative investigation of all physical exercise interventions for which RCTs are available. We aim to systematically compare the effectiveness of different types of physical exercise in people with chronic non-specific neck pain.Methods and analysisNine electronic databases (AMED, CINAHL, Cochrane Central Register of Controlled Trials, Embase, MEDLINE, Physiotherapy Evidence Database, PsycINFO, Scopus and SPORTDiscus) were searched for RCTs from inception to 12 March 2019. Titles and abstract firstly, and full-text papers secondly, will be screened by two reviewers. Data will be extracted by two reviewers. The primary outcome measure is effectiveness of the intervention. Methodological quality of included studies will be assessed by two reviewers using the PEDro scale. The overall quality of evidence will be assessed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework, which has been adapted for network meta-analyses. The available evidence will be summarised using a network diagram. A contribution matrix will be presented to allow assessment of direct and indirect evidence. Forest plots will be constructed to visualise effects of all included exercise interventions. Pairwise effect sizes will be calculated by including all evidence available in the network. Effect measures for treatments that have not been compared in a pairwise RCT can be compared indirectly by contrasting effect sizes of comparisons with a common comparator.Ethics and disseminationThis work synthesises evidence from previously published studies and does not require ethics review or approval. A manuscript describing the findings will be submitted for publication in a peer-reviewed scientific journal.PROSPERO registration numberCRD42019126523.

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Efficacy and safety of atropine to control myopia progression: a systematic review and meta-analysis

BMC Ophthalmology ◽

10.1186/s12886-020-01746-w ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Congling Zhao ◽

Chunyan Cai ◽

Qiang Ding ◽

Hongbin Dai

Keyword(s):

Meta Analysis ◽

Optimal Dose ◽

Control Group ◽

Controlled Trials ◽

Cochrane Central Register ◽

Myopia Progression ◽

Central Register ◽

Atropine Treatment ◽

Observation Period

Abstract Background The effect and safety of atropine on delaying the progression of myopia has been extensively studied, but its optimal dose is still unclear. Therefore, the purpose of this meta-analysis is to systematically evaluate the safety and effectiveness of atropine in controlling the progression of myopia, and to explore the relationship between the dose of atropine and the effectiveness of controlling the progression of myopia. Methods This work was done through the data searched from PubMed, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. The Cochrane Handbook was also used to evaluate the quality of the included studies. In addition, a meta-analysis was performed using Revman5.3 software. Results A total of 10 randomized controlled trials (RCTs) were included. Myopia progression was mitigated greater in the atropine treatment group than that in the control group, with MD = − 0.80, 95% CI (− 0.94, − 0.66) during the whole observation period. There was a statistical difference among 0.05, 0.5, and 1.0% atropine (P = 0.004). In addition, less axial elongation was shown, with MD = − 0.26, 95% CI (− 0.33, − 0.18) during the whole observation period. Conclusion The effectiveness of atropine in controlling the progression of myopia was dose related. A 0.05% atropine was likely to be the optimal dose.

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Effect of Exercise on Quality of Life in Parkinson’s Disease: A Systematic Review and Meta-Analysis

Parkinson s Disease ◽

10.1155/2020/3257623 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Kui Chen ◽

Yan Tan ◽

You Lu ◽

Jiayan Wu ◽

Xueyuan Liu ◽

...

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Aerobic Exercise ◽

Subgroup Analysis ◽

Meta Analysis ◽

Controlled Trials ◽

Cochrane Central Register ◽

Exercise Interventions

Background. Exercise has an integral impact on the physical and mental wellbeing of patients with Parkinson’s disease (PD), yet no comprehensive and quantitative analysis has been conducted on the effect of exercise on quality of life (QoL) in these patients. This study aimed to evaluate the effect of exercise on overall QoL and different domains of QoL in people with PD, as well as investigating the influence of factors such as the exercise type and intervention period. Methods. Databases, such as PubMed, Embase, and Cochrane Central Register of Controlled Trials, were searched since inception to August 14, 2018 to identify randomized controlled trials that compare the effect of exercise versus no intervention on QoL in PD patients. Following the subgroup analysis, heterogeneity was further explored. The quality of eligible studies was assessed according to PRISMA guidelines. Results. 20 studies were included with 1,143 participants in total. A meta-analysis showed a significant improvement in QoL after exercise intervention in PD patients (SMD = −0.24, 95% CI = −0.36 to −0.12, P<0.001). A subgroup analysis of exercise types revealed significant QoL improvement with aerobic exercise, martial arts, and dance, but not anaerobic exercise and combined exercise. Interventions lasting 12 weeks or longer improved QoL significantly. Conclusions. Exercise interventions, especially aerobic exercise, dance, and Tai Chi, significantly improve QoL in PD patients. At least 12 weeks of exercise is needed to bring about significant benefits.

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Efficacy and Safety of Atropine to Control Myopia Progression: A Systematic Review and Meta-analysis

10.21203/rs.3.rs-21025/v3 ◽

2020 ◽

Author(s):

Congling Zhao ◽

Chunyan Cai ◽

Qiang Ding ◽

Hongbin Dai

Keyword(s):

Meta Analysis ◽

Optimal Dose ◽

Control Group ◽

Controlled Trials ◽

Cochrane Central Register ◽

Myopia Progression ◽

Central Register ◽

Atropine Treatment ◽

Observation Period

Abstract Background: The effect and safety of atropine on delaying the progression of myopia has been extensively studied, but its optimal effect dose is still unclear. Therefore, the purpose of this meta-analysis is to systematically evaluate the safety and effectiveness of atropine in controlling the progression of myopia, and to explore the relationship between the dose of atropine and the effect of controlling the progression of myopia. Methods: This work was done through the data search from PubMed, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. The Cochrane Handbook was also used to evaluate the quality of these included studies. In addition, a meta-analysis was performed using Revman5.3 software. Results: A total of 10 randomized controlled trials (RCTs) were included. Myopia progression was mitigated greater in the atropine treatment group than the control group, with MD = -0.80, 95% CI (-0.94, -0.66) during the whole observation period. There was a statistical difference between 0.05%, 0.5%, and 1.0% atropine (P = 0.004). In addition, less axial elongation was showed, with MD = -0.26, 95% CI (-0.33, -0.18) during the whole observation period. Conclusion: The effect of atropine in controlling the progression of myopia was dose related. A 0.05% atropine was likely to be the optimal dose.

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Medical Cannabinoids for Cancer Cachexia: A Systematic Review and Meta-Analysis

BioMed Research International ◽

10.1155/2019/2864384 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Jing Wang ◽

Yanling Wang ◽

Mengting Tong ◽

Hongming Pan ◽

Da Li

Keyword(s):

Quality Of Life ◽

Cancer Patients ◽

Cancer Cachexia ◽

Meta Analysis ◽

Life Quality ◽

Cochrane Library ◽

Cochrane Central Register ◽

Negative Effects ◽

Central Register

Objectives. Cancer cachexia (CCA) is an intractable and ineffective metabolic syndrome that attacks 50–80% of cancer patients. It reduces patient’s life quality, affects the efficacy of treatment, and then increases their mortality; however, there are no established therapeutic strategies for CCA in the world. In this study, we assess the positive and negative effects of cannabinoid in the treatment of CCA. Methods. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, Web of Science, and PubMed up to December 2017. Results. Of the 256 screened studies, three studies with a total of 592 participants were included. Compared with placebo, cannabinoid increased the appetite (MD 0.27, 95% CI -0.51 to 1.04; n= 3) but failed to improve the overall quality of life (QOL; MD -12.39, 95% CI [-24.21 to -0.57; n = 2), and a total of 441 patients had 607 adverse events (AEs; 496 in the cannabinoid group and 111 in the placebo group). Conclusions. Our analysis showed cannabinoid is effective in increasing appetite in cancer patients. However, it declines the quality of life, which may be due to the side effects of cannabinoid.

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Inhaled antibiotics therapy for stable non-cystic fibrosis bronchiectasis: a meta-analysis

Therapeutic Advances in Respiratory Disease ◽

10.1177/1753466620936866 ◽

2020 ◽

Vol 14 ◽

pp. 175346662093686 ◽

Cited By ~ 1

Author(s):

Meng-Jiao Xu ◽

Bing Dai

Keyword(s):

Quality Of Life ◽

Cystic Fibrosis ◽

Meta Analysis ◽

Bacterial Load ◽

Great Promise ◽

Controlled Trials ◽

Cochrane Central Register ◽

Life Questionnaire ◽

Inhaled Antibiotics

Background: The optimum antibiotic therapy for non-cystic fibrosis bronchiectasis (NCFB) has yet to be determined. A meta-analysis was conducted to evaluate the efficacy and safety of inhaled antibiotics in adults with stable NCFB. Methods: PubMed, EMBASE, MEDLINE and the Cochrane Central Register of Controlled Trials were searched through November 2019. Results: A total of 16 randomized controlled trials (RCTs), recruiting 2748 NCFB patients, were finally included. Inhaled antibiotics treatment significantly reduced the sputum bacterial load [standard mean difference (SMD) = –0.74, 95% CI: –1.16–0.32, p < 0.001, I2 = 68.1%], prolonged median time [hazard risk (HR) = 0.73, 95% confidence interval (CI): 0.57–0.93, p < 0.001, I2 = 53.6%] and reduced frequency [incidence rate ratio (IRR) = 0.74, 95% CI 0.63–0.87, p < 0.001, I2 = 20.5%] of exacerbations, with good tolerance. However, it failed to improve Pseudomonas aeruginosa eradication, [forced expiratory volume in 1 s (FEV1)] % predicted, quality of life questionnaire (QoL-B) and St. George’s respiratory questionnaire (SGRQ) scores, and may induce higher risk of P. aeruginosa resistance. Subgroup analysis showed Ciprofloxacin was more effective than other antibiotics in reducing bacterial load (SMD = –1.35, 95% CI: –1.85–0.85, I2 = 63.4%, p = 0.042). Conclusion: Inhaled antibiotics therapy holds great promise for stable NCFB as it is effective in reducing sputum bacterial load and the risk of acute attack, delaying disease progression, and is well tolerated. Although this study brings some constructive ideas in the field of clinical medication, further clinical trials should be carried out, particularly in solving drug-resistance and improving health-related quality of life (HRQoL), which we believe will finally provide benefits for patients suffering from bronchiectasis. The reviews of this paper are available via the supplemental material section.

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Relative effectiveness of non-surgical interventions for pain management in knee osteoarthritis: a protocol for a component network meta-analysis of randomised controlled trials

BMJ Open ◽

10.1136/bmjopen-2020-048298 ◽

2021 ◽

Vol 11 (9) ◽

pp. e048298

Author(s):

Trevor Thompson ◽

Bawan Ahmed ◽

Sharon Marie Weldon ◽

Orestis Efthimiou ◽

Brendon Stubbs

Keyword(s):

Quality Of Life ◽

Pain Management ◽

Knee Osteoarthritis ◽

Treatment Guidelines ◽

Meta Analysis ◽

Relative Effectiveness ◽

Controlled Trials ◽

Cochrane Central Register ◽

Therapeutic Goals

IntroductionKnee osteoarthritis is a chronic degenerative disease associated with significant chronic pain, disability and impaired quality of life and is the most common form of osteoarthritis. There is no cure for knee osteoarthritis, and the main therapeutic goals are pain management and improving quality of life. The objective of this study is to evaluate the relative efficacy and acceptability of available interventions using network meta-analysis (NMA) to provide a comprehensive evidence base to inform future treatment guidelines.Methods and analysisA comprehensive literature search of major electronic databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials) and clinical trial registries will identify randomised control trials (RCTs) of interventions listed in NICE guidelines for the treatment of knee osteoarthritis in adults. We will perform an NMA to estimate relative intervention effects across the whole treatment network. If any studies use multicomponent intervention packages, we will employ a component NMA model to estimate the contribution of individual components. The quality of evidence will be assessed using the Confidence in Network Meta-Analysis approach, which is based on the traditional GRADE framework adapted for NMA. Risk of bias (RoB) will be assessed using the revised Cochrane RoB 2.0 tool for RCTs.Ethics and disseminationThis study does not require ethical approval. Findings will be submitted to a peer-reviewed journal.PROSPERO registration numberCRD42020184192.

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Efficacy and Safety of Specific Immunotherapy with Aeroallergens in the Management of Atopic Dermatitis: A Systematic Review and Meta-analysis

10.21203/rs.3.rs-192958/v1 ◽

2021 ◽

Author(s):

Cita Rosita Sigit Prakoeswa ◽

Sylvia Anggraeni ◽

Damayanti Damayanti ◽

Menul Ayu Umborowati ◽

Cintya Dipta Riswanto ◽

...

Keyword(s):

Atopic Dermatitis ◽

Specific Immunotherapy ◽

Meta Analysis ◽

Placebo Control ◽

Controlled Trials ◽

Cochrane Central Register ◽

Efficacy And Safety ◽

Central Register ◽

And Gender

Abstract Background: Specific immunotherapy with standardized aeroallergens can reduce symptoms and increase the quality of life for related allergy patients. This therapy is still controversial for atopic dermatitis (AD). Hence, a meta-analysis to assess efficacy and safety of specific immunotherapy with aeroallergens on patients with AD could provide a clear oversight on advantages and limitations of such treatment.Methods: We systematically searched PubMed, DOAJ, and Cochrane Central Register of Controlled Trials databases for relevant studies published Randomized controlled trials (RCTs) up to October 2020. Studies involving all ages and gender with AD who treated with specific immunotherapy employing aeroallergens compared with placebo/control.Results: Seven studies RCTs were identified with 832 participants. Significantly decreased of SCORAD values favoring immunotherapy were observed (MD: -5.42; 95% CI - 10.31, -0.52; p=0.03). VAS score was significantly decrease (MD: -1.21; 95% CI -2.10, -0.31; p=0.008). However, immunotherapy showed no significant local and systemic adverse events ((RR 1.77; 95% CI 0.98, 3.19, p=0.06); (RR 0.69; 95% CI 0.16, 3.01, p=0.62)) and IgG4 Dermatophagoides farinae (MD: 92.36, 95% CI -89.14,273.87; p=0.32). Conclusion: Our five years meta-analysis included small number studies, indicated moderate-level evidence for immunotherapy with standardized extract of aeroallergens is effective and safe for AD patients.

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Efficacy and Safety of Atropine to Control Myopia Progression: A Systematic Review and Meta-analysis

10.21203/rs.3.rs-21025/v2 ◽

2020 ◽

Author(s):

Congling Zhao ◽

Chunyan Cai ◽

Qiang Ding ◽

Hongbin Dai

Keyword(s):

Meta Analysis ◽

Optimal Dose ◽

Control Group ◽

Controlled Trials ◽

Cochrane Central Register ◽

Myopia Progression ◽

Central Register ◽

Atropine Treatment ◽

Observation Period

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Vortioxetine treatment for generalised anxiety disorder: a meta-analysis of anxiety, quality of life and safety outcomes

BMJ Open ◽

10.1136/bmjopen-2019-033161 ◽

2019 ◽

Vol 9 (11) ◽

pp. e033161

Author(s):

Bin Qin ◽

Guangsu Huang ◽

Qian Yang ◽

Mingjun Zhao ◽

Hong Chen ◽

...

Keyword(s):

Quality Of Life ◽

Anxiety Disorder ◽

Functional Status ◽

Meta Analysis ◽

Cochrane Library ◽

Controlled Trials ◽

Cochrane Central Register ◽

Generalised Anxiety Disorder ◽

Multiple Doses

ObjectivesThe aim of this study was to investigate the efficacy, tolerability, safety, and impact on quality of life (QoL) and functional status of vortioxetine treatment for patients with generalised anxiety disorder (GAD) by performing a meta-analysis of randomised controlled trials (RCTs).DesignSystematic review and meta-analysis.Data sourcesData mining was conducted in January 2019 across PubMed, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials Cochrane Library, Web of science and ClinicalTrials.gov.Eligibility criteria for selecting studiesAll published RCTs, which assessed the effect of vortioxetine treatment for patients with GAD when compared with a placebo group, were included.Data extraction and synthesisRelevant data were extracted and synthesised narratively. Results were expressed as standardised mean differences or ORs with 95% CIs.ResultsOur meta-analysis showed that multiple doses (2.5, 5 and 10 mg/day) of vortioxetine did not significantly improve the response rates, compared with placebo (OR 1.16, 95% CI 0.84 to 1.60, p=0.38; OR 1.41, 95% CI 0.82 to 2.41, p=0.21; and OR 1.05, 95% CI 0.76 to 1.46, p=0.75). Moreover, there was no statistically significant difference regarding the remission rates, discontinuation for any reason rates, discontinuation due to adverse events rates, Short-Form 36 Health Survey scores or Sheehan Disability Scale scores between administration of multiple doses (2.5, 5 and 10 mg/day) of vortioxetine and placebo.ConclusionsAlthough our results suggest that vortioxetine did not improve the GAD symptoms, QoL and functional status impairment of patients with GAD, it was safe and well tolerated. Clinicians should interpret and translate our data with caution, as the meta-analysis was based on a limited number of RCTs.

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