scholarly journals Identification and assessment of the current scientific evidence on percutaneous needle electrolysis

2019 ◽  
Vol 02 (02) ◽  
pp. 117-118
Author(s):  
Valera Garrido F. ◽  
Minaya Muñoz F. ◽  
Martínez Ramírez P. ◽  
Espinola Marcos A.
Keyword(s):  
Clinical Trials ◽  
Full Text ◽  
Task Force ◽  
Scientific Evidence ◽  
Scientific Journal ◽  
Current Evidence ◽  
Kappa Index ◽  
Scientific Publications ◽  
Level Of Evidence ◽  
Manual Search

Abstract Introduction Percutaneous needle electrolysis is an invasive physical therapy technique which was first published in a scientific journal in the year 2008. The aim of the present study was to evaluate the current scientific evidence on percutaneous needle electrolysis in neuro-musculoskeletal system disorders. Material and Methods A retrospective observational study of scientific publications on percutaneous needle electrolysis. An online search was performed in the following databases to access abstracts: MEDLINE, PEDro, COCHRANE, IME, ENFISPO, in addition non-indexed journals were revised, using the following key words: [(“percutaneous electrolysis,” “galvanic electrolysis,” “percutaneous direct current stimulation,” “percutaneous microelectrolysis” and the Spanish terms “electrolisis,” “electrolisis percutánea,” “microelectrolisis”)]. The search period ranged from the year the database was created until the time of the study (September 2018) with no other search limitation and including publications in any language. Furthermore, a manual search was performed based on the citations included in the articles. A first screen was performed based on the retrieved abstracts, and the full-text of each article was evaluated to analyze the scientific evidence of each study, based on the scale described by the US Preventive Task Force, which assigns level I to those studies with a greater quality design and scientific rigor, whereas level III is assigned to those of poorer quality. The assignment of the level of evidence of each study was independently and simultaneously evaluated by two observers with no communication between each other. To determine reliability, the Kappa index was used (K) with a 95% CI. The score reached by the clinical trials and systematic reviews was also revised based on the Pedro Score Database. Results In total, 64 documents were identified related with electrolysis, following the PRISMA recommendations for the search and selection of primary studies. Concretely, 39 papers were retrieved directly from database searches (Medline, PEDro, Cochrane, ENFISPO), whereas 25 were indirectly accessed via other sources based on internet searches and citation searches. Eight papers were excluded after filtering by title and abstract. After reading the full-text of the 56 articles selected, one further article was excluded. Finally, 55 articles were included in the review. The evidence of the studies retrieved was evaluated. The reliability analysis obtained an acceptable Kappa index (0.6–0.8). Based on criteria regarding the quality of evidence, the studies were classified into three groups:a) High-level of evidence. This group included clinical trials (of which there were 9, which constitute 16.7% of the total) (77.8% were published after 2017).b) Medium-level of evidence, identified in 35.2% of papers.c) Low evidence was provided in 48.1% of papers. Conclusions In recent years, there has been a considerable increase in the current evidence available on percutaneous needle electrolysis. However, many of these studies are part of the gray literature and are difficult to access. High quality evidence was identified in 16.7% of papers. The remaining 83.3% papers were of low to medium quality.

scholarly journals Cannabidiol as a Treatment for Mood Disorders: A Systematic Review

2019 ◽  
Vol 65 (4) ◽  
pp. 213-227 ◽  
Author(s):  
Jairo Vinícius Pinto ◽  
Gayatri Saraf ◽  
Christian Frysch ◽  
Daniel Vigo ◽  
Kamyar Keramatian ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Mood Disorders ◽  
Observational Studies ◽  
Case Reports ◽  
Health Conditions ◽  
Current Evidence ◽  
Cochrane Central Register ◽  
Level Of Evidence ◽  
Mood Symptoms ◽  
Affective Symptoms

Objective: To review the current evidence for efficacy of cannabidiol in the treatment of mood disorders. Methods: We systematically searched PubMed, Embase, Web of Science, PsychInfo, Scielo, ClinicalTrials.gov , and The Cochrane Central Register of Controlled Trials for studies published up to July 31, 2019. The inclusion criteria were clinical trials, observational studies, or case reports evaluating the effect of pure cannabidiol or cannabidiol mixed with other cannabinoids on mood symptoms related to either mood disorders or other health conditions. The review was reported in accordance with guidelines from Preferred Reporting Items for Systematic reviews and Meta-Analyses protocol. Results: Of the 924 records initially yielded by the search, 16 were included in the final sample. Among them, six were clinical studies that used cannabidiol to treat other health conditions but assessed mood symptoms as an additional outcome. Similarly, four tested cannabidiol blended with Δ-9-tetrahydrocannabinol in the treatment of general health conditions and assessed affective symptoms as secondary outcomes. Two were case reports testing cannabidiol. Four studies were observational studies that evaluated the cannabidiol use and its clinical correlates. However, there were no clinical trials investigating the efficacy of cannabidiol, specifically in mood disorders or assessing affective symptoms as the primary outcome. Although some articles point in the direction of benefits of cannabidiol to treat depressive symptoms, the methodology varied in several aspects and the level of evidence is not enough to support its indication as a treatment for mood disorders. Conclusions: There is a lack of evidence to recommend cannabidiol as a treatment for mood disorders. However, considering the preclinical and clinical evidence related to other diseases, cannabidiol might have a role as a treatment for mood disorders. Therefore, there is an urgent need for well-designed clinical trials investigating the efficacy of cannabidiol in mood disorders.

scholarly journals Current Evidence on Auricular Therapy for Chemotherapy-Induced Nausea and Vomiting in Cancer Patients: A Systematic Review of Randomized Controlled Trials

2014 ◽  
Vol 2014 ◽  
pp. 1-18 ◽  
Author(s):  
Jing-Yu Tan ◽  
Alexander Molassiotis ◽  
Tao Wang ◽  
Lorna K. P. Suen
Keyword(s):  
Randomized Controlled Trials ◽  
Cancer Patients ◽  
Pharmacological Therapy ◽  
Nausea And Vomiting ◽  
Current Evidence ◽  
Controlled Trials ◽  
Level Of Evidence ◽  
Randomized Controlled ◽  
Manual Search ◽  
Auricular Therapy

Auricular therapy (AT) has been historically viewed as a convenient approach adjunct to pharmacological therapy for cancer patients with chemotherapy-induced nausea and vomiting (CINV). The aim of this study was to assess the evidence of the therapeutic effect of AT for CINV management in cancer patients. Relevant randomized controlled trials were retrieved from 12 electronic databases without language restrictions. Meanwhile, manual search was conducted for Chinese journals on complementary medicine published within the last five years, and the reference lists of included studies were also checked to identify any possible eligible studies. Twenty-one studies with 1713 participants were included. The effect rate of AT for managing acute CINV ranged from 44.44% to 93.33% in the intervention groups and 15% to 91.67% in the control groups. For delayed CINV, it was 62.96% to 100% and 25% to 100%, respectively. AT seems to be a promising approach in managing CINV. However, the level of evidence was low and the definite effect cannot be concluded as there were significant methodological flaws identified in the analyzed studies. The implications drawn from the 21 studies put some clues for future practice in this area including the need to conduct more rigorously designed randomized controlled trials.

Level of scientific evidence supporting NCCN guidelines: Is there evidence of progress?

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 14-14
Author(s):  
Aakash Desai ◽  
Ronald S. Go ◽  
Thejaswi Poonacha
Keyword(s):  
Scientific Evidence ◽  
Clinical Care ◽  
Uterine Cancer ◽  
Evidence Base ◽  
Current Evidence ◽  
Level Of Evidence ◽  
Nccn Guidelines ◽  
Current Evidence Base ◽  
The Us ◽  
Therapeutic Recommendations

14 Background: National Comprehensive Cancer Network (NCCN) guidelines are the most comprehensive and widely used standard for clinical care in oncology by clinicians and payors in the US. The level of scientific evidence in NCCN guidelines has not been studied since it’s last review in 2010. We describe the categories of evidence and consensus (EC) among the 10 most common cancers in the US as of 2019 and compare them with 2010 guidelines. Methods: We obtained the 2019 version of NCCN guidelines. The definitions for various categories of EC used were: Category 1 (high level evidence such as randomized controlled trials with uniform consensus), 2A (lower level of evidence with uniform consensus), 2B (lower level of evidence without a uniform consensus but with no major disagreement) and 3 (any level of evidence but with major disagreement). We compared our results with previously published results from 2010 guidelines. Results: Total recommendations increased by 77% from 1023 (2010) to 1818 (2019). Of the 1818 recommendations, Category 1, 2A, 2B and 3 EC were 7%, 87%, 6% and 0% while in 2010 they were 5%, 85%, 9% and 1% respectively. Recommendations with category 1 EC were found in lung (13%), prostate (11%), melanoma (8%), breast (7%), NHL (5%), kidney (2%), bladder (2%) and colorectal (2%) guidelines. Pancreatic and uterine cancer guidelines had no recommendations with category 1 EC. 19% of therapeutic recommendations were category 1 EC with the majority (65%) pertaining to initial therapy. Guidelines with highest proportions of therapeutic recommendations with category 1 EC were breast (30%), lung (10%), and kidney (10%) cancers. No category 1 EC recommendations existed in screening or surveillance. Although we found an increase in the total number of recommendations, the distribution of different types of categories of EC are largely similar to 2010. Conclusions: Recommendations in 2019 NCCN guidelines are largely derived from lower levels of evidence with uniform expert opinion. Despite the major advances in oncology in the past decade, this is largely unchanged. Our study underscores the urgent need and available opportunities to expand the current evidence base in oncology which forms the platform for clinical practice guidelines.

Challenges to Conducting Multicenter Clinical Research

2008 ◽  
Vol 19 (2) ◽  
pp. 164-169
Author(s):  
Sharon Y. Irving ◽  
Martha A.Q. Curley
Keyword(s):  
Clinical Trials ◽  
Clinical Research ◽  
Quantitative Research ◽  
Scientific Evidence ◽  
Internal Validity ◽  
Controlled Clinical Trials ◽  
Level Of Evidence ◽  
Randomized Controlled Clinical Trials ◽  
Randomized Controlled ◽  
Multicenter Clinical Trials

Nursing care provided to patients and their families should be based on strong scientific evidence. In the quantitative research paradigm, the highest level of evidence is derived from conclusive randomized controlled clinical trials. Multicenter clinical research allows the accrual of sufficient numbers of diverse participants in a shorter period of time and improves the generalizability of the study findings. Clinical research is inherently complex; the complexity exponentially increases when conducting multicenter clinical trials. Investigators are challenged to maintain the internal validity of the study and the sustained commitment and collaboration of numerous disciplines over the study period. This article presents 10 essential points to consider when conducting multicenter clinical research.

scholarly journals A Systematic Literature Review of Brain Neurostimulation Therapies for the Treatment of Pain

Pain Medicine ◽  
2020 ◽  
Vol 21 (7) ◽  
pp. 1415-1420
Author(s):  
Timothy R Deer ◽  
Steven Falowski ◽  
Jeff E Arle ◽  
Jan Vesper ◽  
Julie Pilitsis ◽  
...  
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Task Force ◽  
Work Group ◽  
The United States ◽  
Risk Of Bias ◽  
Current Evidence ◽  
Level Of Evidence ◽  
Bias Assessment ◽  
Moderate Evidence

Abstract Objective To conduct a systematic literature review of brain neurostimulation for pain. Design Grade the evidence for deep brain neurostimulation (DBS). Methods An international, interdisciplinary work group conducted a literature search for brain stimulation. Abstracts were reviewed to select studies for grading. Randomized controlled trials (RCTs) meeting inclusion/exclusion criteria were graded by two independent reviewers. General inclusion criteria were prospective trials (RCTs and observational) that were not part of a larger or previously reported group. Excluded studies were retrospective or existed only as abstracts. Studies were graded using the modified Interventional Pain Management Techniques–Quality Appraisal of Reliability and Risk of Bias Assessment, the Cochrane Collaborations Risk of Bias assessment, and the United States Preventative Services Task Force level-of-evidence criteria. Results Two high-quality RCTs and three observational trials supported DBS, resulting in Level II (moderate) evidence. Conclusion Moderate evidence supports DBS to treat chronic pain. Additional Level I RCTs are needed to further the strength of the evidence in this important area of medicine, but the current evidence suggests that DBS should be considered as an option in treating complex pain cases.

Funding sources are under-reported in randomised clinical trials of biological treatments in sports medicine: a systematic review

2020 ◽  
Vol 5 (6) ◽  
pp. 371-377
Author(s):  
Hayden A Anz ◽  
Heba A Ahmad ◽  
Adam M Kozemchak ◽  
Mayank Rao ◽  
Ryan J Warth ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Sports Medicine ◽  
Biological Treatment ◽  
Clinical Results ◽  
Randomised Clinical Trials ◽  
Clinical Effects ◽  
Scientific Publications ◽  
Level Of Evidence ◽  
Funding Sources ◽  
Biological Treatments

ImportanceThere have been numerous publications involving the use of biologics in sports medicine injuries. However, a lack of clarity exists with reporting industry affiliations and sources of funding.ObjectiveThe purposes of this study were (1) to determine the frequency of reporting of funding sources in randomised clinical trials evaluating the clinical effects of biological treatments in sports medicine and (2) to evaluate potential relationships between reported clinical results and affiliated funding sources. We hypothesised that funding sources would be under-reported and the favourability of the results would be associated with the specific type of funding received.Evidence reviewA systematic search of MEDLINE and Embase databases was performed to identify funding sources and favourability of conclusions reported for all randomised clinical trials that compared a biological treatment to a standard treatment for sports medicine-related injuries. Industry affiliation was defined as a funding source or author affiliation with the company that provided the biological product being studied. Extracted data included the reported purpose, conclusion, funding sources, researcher industry affiliations, sample size, minimum follow-up (FU) and the outcome metrics used. Two-tailed t-tests and logistic regression analyses were performed for analysis.FindingsNinety-eight studies met our inclusion criteria and included a total of 5898 subjects with a minimum FU of 6 weeks–24 months. These studies investigated shoulder, knee, foot and ankle, and elbow issues. Forty-eight of the 98 studies (49%) did not report the source of study funding. In total, 47 of the 98 studies (48%) reported favourable results, and 5 of these studies (10.6%) reported industry affiliations. Published studies with unknown funding sources reported conclusions in favour of the biological treatment significantly more often than those with reported funding sources (p=0.015).Conclusions and relevanceNearly half of the included studies did not disclose funding sources, and studies with unknown funding sources more frequently reported results in favour of the biological treatment. Clinical reports of randomised trials should emphasise reporting of funding sources to ensure data transparency and interpretability of results. Future initiatives should focus on developing standard international criteria for reporting research funding in scientific publications.Level of evidenceII

scholarly journals Acidentes de trabalho e suas interfaces no contexto da atenção primária à saúde

2017 ◽  
Vol 11 (12) ◽  
pp. 5037
Author(s):  
Ana Patrícia Batista Silva ◽  
Marislei Espíndula Brasileiro ◽  
Marinésia Aparecida Do Prado ◽  
Ludimila Cristina Souza Silva ◽  
Lorena Zenha Andrade ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
American Literature ◽  
Latin American ◽  
Scientific Evidence ◽  
Worker Safety ◽  
Scientific Publications ◽  
Level Of Evidence ◽  
Primary Health ◽  
Work Accidents

RESUMO Objetivo: analisar as evidências, na literatura nacional e internacional, relacionadas aos acidentes de trabalho na Atenção Primária à Saúde. Método: revisão integrativa norteada pela questão <<Quais as evidências científicas disponíveis na literatura latino-americana sobre os acidentes de trabalho no âmbito da atenção primária à saúde?>>. A busca foi realizada nas bases de dados LILACS, MEDLINE, BDENF, REPIDISCA e IBECS, durante os meses de dezembro de 2015 e janeiro de 2016. Adotou-se o nível de evidências, segundo Stetler, para a análise dos estudos. Resultados: Da análise das publicações científicas, emergiram três categorias temáticas: principais fatores relacionados à ocorrência de acidente de trabalho na atenção primária à saúde; impacto dos acidentes de trabalho sobre a saúde do trabalhador e papel da atenção primária à saúde no campo da saúde do trabalhador. Conclusão: Faz-se premente a implementação de políticas de saúde no trabalho, em conformidade com as diretrizes de segurança do trabalhador. Descritores: Acidentes de Trabalho; Atenção Primária à Saúde; Saúde do Trabalhador.ABSTRACTObjective: to analyze the evidence, in the national and international literature, related to work accidents in Primary Health Care. Method: integrative review guided by the question << What scientific evidence available in the Latin American literature on work accidents in the field of primary health care? " The search was performed in the databases LILACS, MEDLINE, BDENF, REPIDISCA and IBECS during the months of December 2015 and January 2016. The level of evidence was adopted, according to Stetler, for the analysis of the studies. Results: from the analysis of the scientific publications, three thematic categories emerged: main factors related to the occurrence of work accidents in primary health care; impact of work accidents on workers' health and the role of primary health care in the field of worker health. Conclusion: the implementation of occupational health policies is urgent, in accordance with the worker safety guidelines. Descriptors: Work Accidents; Primary Health Care; Worker's Health.RESUMENObjetivo: analizar las evidencias, en la literatura nacional e internacional, relacionada a los accidentes de trabajo en la Atención Primaria a la Salud. Método: revisión integrativa orientada por la cuestión << ¿Cuáles son las evidencias científicas disponibles en la literatura latinoamericana sobre los accidentes de trabajo en el ámbito de la atención primaria ¿la salud? >>. La búsqueda se realizó en las bases de datos LILACS, MEDLINE, BDENF, REPIDISCA e IBECS, durante los meses de diciembre de 2015 y enero de 2016. Se adoptó el nivel de evidencias, según Stetler, para el análisis de los estudios. Resultados: del análisis de las publicaciones científicas, surgieron tres categorías temáticas: principales factores relacionados con la ocurrencia de accidentes de trabajo en la atención primaria a la salud; el impacto de los accidentes de trabajo bajo la salud del trabajador y el papel de la atención primaria a la salud en el campo de la salud del trabajador. Conclusión: se hace urgente la implementación de políticas de salud en el trabajo, de conformidad con las directrices de seguridad del trabajador. Descriptores: Accidentes de Trabajo; Atención Primaria a la Salud; Salud del Trabajador.

scholarly journals The Value of Systematic Reviews and Meta-Analyses in Surgery

2021 ◽  
pp. 1-8
Author(s):  
Simon R. Knight
Keyword(s):  
Clinical Trials ◽  
Systematic Reviews ◽  
Practice Guidelines ◽  
Statistical Power ◽  
Clinical Decision Making ◽  
Learning Curves ◽  
Current Evidence ◽  
Level Of Evidence ◽  
Surgical Interventions ◽  
Meta Analyses

<b><i>Background:</i></b> Systematic reviews and meta-analyses are generally regarded as sitting atop the hierarchy of clinical evidence. The unbiased summary of current evidence that a systematic review provides, along with the increased statistical power from larger numbers of patients, is invaluable in guiding clinical decision-making and development of practice guidelines. Surgical specialties have historically lagged behind other areas of medicine in the application of evidence-based medicine, perhaps due to the unique challenges faced in the conduct of surgical clinical trials. These challenges extend to the conduct of systematic reviews, due to issues with the quality and heterogeneity of the underlying literature. <b><i>Summary:</i></b> Recent years have seen an improvement in the quality of randomized controlled trials in surgical topics and an explosion in the publication of systematic reviews. This review explores recent trends in systematic reviews in surgery and discussed some of the aspects in conducting and interpreting reviews that are unique to surgical topics, including blinding, surgical heterogeneity and learning curves, patient and clinician preference, and industry involvement. <b><i>Key Messages:</i></b> Clinical trials, and therefore systematic reviews, of surgical interventions pose unique challenges which are important to consider when conducting them or applying the findings to clinical practice. Despite the challenges, systematic reviews still represent the best level of evidence for development of surgical practice guidelines.

scholarly journals Alternate nostril breathing: a systematic review of clinical trials

2017 ◽  
Vol 5 (8) ◽  
pp. 3273 ◽  
Author(s):  
Shreya Ghiya
Keyword(s):  
Clinical Trials ◽  
Cognitive Functioning ◽  
Scientific Evidence ◽  
Systemic Review ◽  
Memory Retention ◽  
Level Of Evidence ◽  
Safety Issues ◽  
Autonomic Nervous ◽  
High Level ◽  
Clinical Populations

Anulom-vilom Pranayama/ alternate nostril breathing (ANB)/Nadi-suddhi pranayama is one of the common yogic breathing techniques and involves breathing through one nostril at a time while closing the other nostril manually. This study aimed to summarize effects of independent ANB on various physiological parameters, to evaluate safety issues in clinical populations and collect published primary scientific evidence on the benefits of ANB. PubMed/Medline, Cinahl, Web of Science and Google Scholar were searched using the following terms: Alternate nostril breathing, Anulom-vilom/ anuloma-viloma pranayama, Nadi-shodhan/Nadi-shodhana pranayama. Forty-four randomized controlled trials were included in this review paper. These studies evaluated the effects of alternate nostril breathing on parameters of the autonomic nervous system, cardiopulmonary system, cognitive functioning, problem solving and motor memory retention. Of the studies, ten showed a high level of bias; twenty-nine showed a low level of bias and five showed an unknown level of bias as per Cochrane systemic review guidelines. Most of the studies included healthy subjects and age range was eight to seventy years. Alternate nostril breathing has few variations and standardization of the technique is yet to be established. This technique provides high level evidence for positive outcomes for the autonomic nervous and cardiopulmonary systems. There is also high level of evidence regarding improvement in cognitive functioning with regular practice of alternate nostril breathing. More clinical trials are required to evaluate the effects of alternate nostril breathing in clinical populations and to synthesize effective frequency and duration parameters.

Milk Oligosaccharides and Lectins as Candidates for Clinical Trials Against Covid-19

2020 ◽  
Vol 16 ◽  
Author(s):  
Mourad Errasfa
Keyword(s):  
Clinical Trials ◽  
Molecular Species ◽  
Global Economy ◽  
Therapeutic Potential ◽  
Scientific Evidence ◽  
Research Work ◽  
Camel Milk ◽  
Milk Oligosaccharides ◽  
Binding Properties ◽  
Scientific Publications

Background: Covid-19 pandemia is causing a very high death toll around the world and a serious fall in the global economy. Many clinical trials are currently underway to check the effectiveness of some known drugs. The physiopathology associated with the virus infection is currently better understood and good prophylactic drug therapies are implemented, such as antibiotics and blood thinners, though, no specific drugs against SARS-Cov-2 were developed yet. Objective: In the present research work, it is aimed to carry out a bibliographic investigation on some active molecular species that could be used against Covid-19, based on their chemical properties to bind to glycoproteins. In the case of SARS-Cov-2, the targeted glycoprotein is the surface virus spike S glycoprotein, that the virus uses to attach to and invade human cells. It is of high pharmacological value to investigate possible active natural substances endowed with a property to bind glycoproteins. In this line of research, oligosaccharides and lectins are two molecular species that have glycoprotein binding properties. Methods: A bibliographic research was carried out on oligosaccharides and lectins in various sources of scientific publications. Relevant chemical and pharmacological properties of oligosaccharides and lectins were searched and their main natural sources were identified. Results: In the present paper, I summarize some scientific evidence to support the therapeutic potential of camel milk as a source of oligosaccharides and its possible use as a functional diet in parallel to drug therapies of Covid-19. On the other hand, sugar- and glycoprotein binding properties of some lectins of plant and seaweed origin are reported, and their pharmaceutical use is underlined. Conclusion: In the present study, scientific evidence was documented that encouraged further clinical investigations on camel milk oligosaccharides and lectins of plant and seaweed origin in the management of Covid-19 physiopathology.

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