Teledentistry and mHealth for Promotion and Prevention of Oral Health: A Systematic Review and Meta-analysis

2021 ◽  
pp. 002203452110038
Author(s):  
C.E. Fernández ◽  
C.A. Maturana ◽  
S.I. Coloma ◽  
A. Carrasco-Labra ◽  
R.A. Giacaman
Keyword(s):  
Systematic Review ◽  
Oral Health ◽  
Randomized Controlled Trials ◽  
Communication Systems ◽  
Text Messages ◽  
Mean Difference ◽  
Controlled Trials ◽  
Large Reduction ◽  
Randomized Controlled ◽  
Standardized Mean Difference

The dental profession has experienced a dramatic acceleration in the use of communication systems and information-based technologies over recent years, originating new paradigms for the prevention and promotion of oral health. The purpose of this systematic review was to determine the effect of teledentistry-based (telematic) strategies, reported in randomized controlled trials and quasi-randomized trials, with a focus on oral health prevention and promotion–related outcomes in patients of all ages. We searched Medline via PubMed, SCOPUS, and Web of Science from inception until August 2020, regardless of the language of publication. We selected studies for inclusion and conducted data extraction, assessed risk of bias (Cochrane tool), and evaluated the certainty of the evidence (GRADE approach) in duplicate and independently. Out of 898 potentially eligible references, we selected 43 for full-text screening, of which 19 studies proved eligible: 18 randomized controlled trials and 1 quasi-randomized study. Virtual interventions were mostly asynchronous via apps ( n = 9), text messages ( n = 9), or computer-aided learning ( n = 1). The use of teledentistry as compared with conventional strategies may result in a large reduction in the plaque index (standardized mean difference, −1.18; 95% CI, −1.54 to −0.82; I2 = 92%; low certainty) and will likely result in a large reduction in the gingival index (standardized mean difference, −2.17; 95% CI, −3.15 to −1.19; I2 = 97%; moderate certainty) and in the incidence of white spot lesions (risk ratio, 0.48; 95% CI, 0.35 to 0.66; I2 = 0%; moderate certainty), with an increased effect over time. Evidence suggests that teledentistry, particularly mHealth (messages and apps), is a promising clinical tool for preventing and promoting oral health, especially under the accelerated virtualization of dentistry. Future studies should include a broader spectrum of the population, including adults and elders, to better inform policy and implementation of teledentistry (PROSPERO: CRD42020192685).

scholarly journals Melatonin and Cardioprotection in Humans: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 8 ◽  
Author(s):  
Alberto Domínguez-Rodríguez ◽  
Pedro Abreu-González ◽  
Néstor Báez-Ferrer ◽  
Russel J. Reiter ◽  
Pablo Avanzas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Mean Difference ◽  
Left Ventricular Ejection ◽  
Favorable Effect ◽  
Controlled Trials ◽  
Weighted Mean ◽  
Randomized Controlled ◽  
Mean Differences

Myocardial ischemia/reperfusion (IR) injury represents a critical problem associated with interventional approaches for coronary reperfusion. Pharmacological cardioprotective interventions are advocated to ameliorate IR injury. Melatonin is an anti-inflammatory and antioxidant agent with a wide range of therapeutic properties that may contribute to its cardioprotective effects. No systematic review or meta-analysis has compared melatonin vs. placebo as a cardioprotective agent in humans. The present study, based on a systematic review and meta-analysis, was carried out to assess melatonin's efficacy as a cardioprotective treatment. We performed a systematic review of the available literature. Randomized controlled trials (RCTs) were identified and information was extracted using predefined data extraction forms. The primary outcomes were (a) left ventricular ejection fraction (LVEF) and (b) blood troponin levels in patients who underwent myocardial revascularization and were randomized to melatonin or placebo. The inverse-variance random-effects method was used to pool the estimates. Heterogeneity and publication bias were assessed. Weighted mean differences or standardized mean differences were calculated. A total of 283 records were screened and seven RCTs met all the inclusion criteria. After the pooled analysis, the results on LVEF were consistent across all studies, and a significant heterogeneity was found in the results on troponin levels. The melatonin-treated patients had on average higher LVEF than the placebo-treated individuals with a weighted mean difference = 3.1% (95% CI 0.6–5.5, p = 0.01). Five works compared the levels of troponin after melatonin or placebo treatment. The melatonin-treated patients had lower levels of troponin with a standardized mean difference = −1.76 (95% CI −2.85 to −0.67, p = 0.002). The findings of this meta-analysis revealed that melatonin administration in humans as a cardioprotective agent attenuated heart dysfunction with a favorable effect on the LVEF.

scholarly journals Adjuvant Effects of Health Education of Chinese Medicine for Chronic Diseases: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
An-Lu Wang ◽  
He Zhang ◽  
Jie Zhang ◽  
Yan Zhang ◽  
Hui-Juan Cao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chinese Medicine ◽  
Health Education ◽  
Randomized Controlled Trials ◽  
Conventional Therapy ◽  
Mean Difference ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Adjuvant Effects ◽  
Quality Evidence

Objective. To evaluate the adjuvant effects of health education of Chinese medicine (HECM) for patients with three types of common noncommunicable diseases (NCD-hypertension, diabetes, and coronary heart disease (CHD)). Methods. The protocol of this review was registered in the PROSPERO website (CRD42017058325). Six databases were searched till Sep. 30, 2019. Randomized controlled trials (RCTs) comparing HECM plus conventional therapy with conventional therapy were retrieved. Participants were diagnosed as one of the 3 above NCDs. HECM is regarded as lectures and classes about diet therapy, exercise therapy, emotion balance, and other knowledge according to Chinese medicine theory. The control rate of the disease was defined as a primary outcome in this review. Outcomes were synthesized using meta-analyses where reporting was sufficiently homogeneous or alternatively synthesized in a systematic review. Results. In total, 12 trials with 1142 patients were included in this review. Since all the trials may have unclear or high risk of bias, only low quality evidence could be found for supporting the adjunctive effect of HECM in treating hypertension, diabetes, and CHD, to reduce the control rate (risk ratio −1.58), the blood pressure level (mean difference −9.38 mmHg), the fasting plasma glucose level (mean difference −1.26 mmol/L), and the symptoms of angina. Conclusion. The adjunctive effect of HECM on increasing the control rate of hypertension, improving the symptoms of diabetes and CHD, was only supported by low-quality evidence in this review. More rigorous trials with larger sample sizes and higher quality are warranted to provide a high quality of evidence.

Motivational Interviewing in Improving Oral Health: A Systematic Review of Randomized Controlled Trials

2014 ◽  
Vol 85 (3) ◽  
pp. 426-437 ◽  
Author(s):  
Xiaoli Gao ◽  
Edward Chin Man Lo ◽  
Shirley Ching Ching Kot ◽  
Kevin Chi Wai Chan
Keyword(s):  
Systematic Review ◽  
Oral Health ◽  
Motivational Interviewing ◽  
Randomized Controlled Trials ◽  
Controlled Trials ◽  
Randomized Controlled

scholarly journals Sulfotanshinone Sodium Injection for Unstable Angina Pectoris: A Systematic Review of Randomized Controlled Trials

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Xuelan Qiu ◽  
Andrew Miles ◽  
Xuehua Jiang ◽  
Xin Sun ◽  
Nan Yang
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Unstable Angina ◽  
Large Scale ◽  
Clinical Symptoms ◽  
Mean Difference ◽  
Controlled Trials ◽  
High Quality ◽  
Randomized Controlled ◽  
Unpublished Studies

Objective. To assess the effect of sulfotanshinone sodium injection for unstable angina.Methods. We searched for published and unpublished studies up to June 2011. We included randomized controlled trials that confoundedly addressed the effect of sulfotanshinone sodium injection in the treatment of unstable angina.Results. Twenty-five studies involving 2,377 people were included. There was no evidence that sulfotanshinone sodium alone had better or worse effects to routine western medicine treatments in improving clinical symptoms (RR 1.00, 95% CI 0.90 to 1.11) and ECG (RR 0.97, 95% CI 0.87 to 1.09). However, there was evidence that sulfotanshinone sodium combined with western medications was a better treatment option than western medications alone in improving clinical symptoms (RR 1.28, 95% CI 1.23 to 1.3), ECG (RR 1.26, 95% CI 1.18 to 1.35), C-reaction protein (mean difference 2.10, 95% CI 1.63 to 2.58), and IL-6 (mean difference −3.85, 95% CI −4.10 to −3.60). There was no difference between sulfotanshinone sodium plus western medications and western medications alone affecting mortality (RR 0.50, 95% CI 0.02 to 12.13).Conclusion. Compared with western medications alone, sulfotanshinone sodium combined with western medications may provide more benefits for patients with unstable angina. Further large-scale high-quality trials are warranted.

scholarly journals Mindfulness-based stress reduction for treating chronic headache: A systematic review and meta-analysis

Cephalalgia ◽  
2018 ◽  
Vol 39 (4) ◽  
pp. 544-555 ◽  
Author(s):  
Dennis Anheyer ◽  
Matthew J Leach ◽  
Petra Klose ◽  
Gustav Dobos ◽  
Holger Cramer
Keyword(s):  
Confidence Interval ◽  
Randomized Controlled Trials ◽  
Cognitive Therapy ◽  
Stress Reduction ◽  
Tension Type Headache ◽  
Mean Difference ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Standardized Mean Difference ◽  
Mindfulness Based Stress Reduction

Background Mindfulness-based stress reduction/cognitive therapy are frequently used for pain-related conditions, but their effects on headache remain uncertain. This review aimed to assess the efficacy and safety of mindfulness-based stress reduction/cognitive therapy in reducing the symptoms of chronic headache. Data sources and study selection MEDLINE/PubMed, Scopus, CENTRAL, and PsychINFO were searched to 16 June 2017. Randomized controlled trials comparing mindfulness-based stress reduction/cognitive therapy with usual care or active comparators for migraine and/or tension-type headache, which assessed headache frequency, duration or intensity as a primary outcome, were eligible for inclusion. Risk of bias was assessed using the Cochrane Tool. Results Five randomized controlled trials (two on tension-type headache; one on migraine; two with mixed samples) with a total of 185 participants were included. Compared to usual care, mindfulness-based stress reduction/cognitive therapy did not improve headache frequency (three randomized controlled trials; standardized mean difference = 0.00; 95% confidence interval = −0.33,0.32) or headache duration (three randomized controlled trials; standardized mean difference = −0.08; 95% confidence interval = −1.03,0.87). Similarly, no significant difference between groups was found for pain intensity (five randomized controlled trials; standardized mean difference = −0.78; 95% confidence interval = −1.72,0.16). Conclusions Due to the low number, small scale and often high or unclear risk of bias of included randomized controlled trials, the results are imprecise; this may be consistent with either an important or negligible effect. Therefore, more rigorous trials with larger sample sizes are needed.

scholarly journals Effects of Phytoestrogen Supplement on Quality of Life of Postmenopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Ching-Ching Peng ◽  
Chia-Yu Liu ◽  
Nai-Rong Kuo ◽  
Tao-Hsin Tung
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Postmenopausal Women ◽  
Meta Analysis ◽  
Mean Difference ◽  
Current Evidence ◽  
Controlled Trials ◽  
Randomized Controlled

Background. The effect of phytoestrogen on postmenopausal quality of life is unclear. This study evaluated the effects of phytoestrogen supplement on quality of life for postmenopausal women. Methods. We conducted a systematic review and meta-analysis of randomized controlled trials on the effects of phytoestrogen supplements on the quality of life of postmenopausal women. We searched PubMed, MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials on March 31, 2018, for relevant randomized controlled trials. Two authors independently selected studies, assessed risk of bias, and extracted data. Disagreement was resolved through discussion with a third author. Results. We involved 10 articles in the systematic review. 8 studies and a total of 1,129 subjects were included in the meta-analysis. The questionnaires used in the evaluation of quality of life were as follows: SF-36, 4 studies; MENQOL, 4 studies; For Short Form 36 surveys, phytoestrogen groups scored significantly higher for body pain (mean difference = 3.85, 95% confidence interval [CI] = [1.14, 6.57], P < 0.01), mental health (mean difference = 4.01, 95% CI = [1.49, 6.57], P < 0.01), and role limitations caused by emotional problems domains (mean difference = 3.83, 95% CI = [1.81, 5.85], P < 0.01). No statistically significant difference was obtained from Menopause-Specific Quality of Life surveys (vasomotor domain mean difference 0.14, 95% CI = [−0.08, 0.36], P = 0.20; physical domain mean difference 0.20, 95% CI [−0.08, 0.48], P = 0.15; psychological domain mean difference −0.10, 95% CI [−0.26, 0.07], P = 0.27; sexual domain mean difference −0.17, 95% CI [−0.42, 0.09], P = 0.19). Conclusion. Current evidence does not support phytoestrogen supplementation improving postmenopausal quality of life. Further comprehensive trials or long-term follow-up studies are warranted.

scholarly journals Electroacupuncture for post-thoracotomy pain: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254093
Author(s):  
Sohyeon Park ◽  
Yee Ran Lyu ◽  
So Jung Park ◽  
Min Seok Oh ◽  
In Chul Jung ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Total Dose ◽  
Meta Analysis ◽  
Opioid Analgesics ◽  
Sham Acupuncture ◽  
Mean Difference ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Standard Mean Difference

Background Thoracotomy is an invasive surgical procedure that produces intense postoperative pain. Electroacupuncture has been used to induce analgesia in various situations, including after surgery. The aim of the following systematic review and meta-analysis was to evaluate the effect of electroacupuncture on post-thoracotomy pain. Methods The studies for the systematic review were searched using the following 9 databases: PubMed, Cochrane Library, EMBASE, MEDLINE Complete, Google Scholar, China National Knowledge Infrastructure (CNKI), Korean Medical Database (KMBASE), Koreanstudies Information Service System (KISS), and OASIS, without language restriction. Randomized controlled trials (RCTs) that met the inclusion criteria were selected. The quality assessment was performed using the Cochrane risk-of-bias tool, and RevMan 5.3 was used for meta-analysis. The review protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO) as CRD42019142157. Results Eleven randomized controlled trials were included in the systematic review. The meta-analysis was performed for two outcome measures: pain score 24 hours after surgery and total dose of opioid analgesics. A subgroup analysis was performed according to the control group: sham acupuncture and conventional analgesia group. Pain score 24 hours after surgery of electroacupuncture group showed a standard mean difference of -0.98 (95% CI: -1.62 to -0.35) compared to sham acupuncture. The standard mean difference was -0.94 (95% CI: -1.33 to -0.55) compared to conventional analgesia. The total dose of opioid analgesics of electroacupuncture group showed a standard mean difference values of -0.95 (95% CI: -1.42 to -0.47) compared to sham acupuncture. The standard mean difference was -1.96 (95% CI: -2.82 to -1.10) compared to conventional analgesia. Conclusion Current evidence suggests that electroacupuncture might provide useful pain relieving effect on post-thoracotomy patients. However, due to low quality and high heterogeneity of existing data, further rigorously designed studies should be performed to confirm the safety and efficacy.

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