Meta-Analysis of Controlled Trials of Drug Therapy in Mild Chronic Asthma: The Role of Inhaled Corticosteroids

1994 ◽  
Vol 28 (11) ◽  
pp. 1285-1289 ◽  
Author(s):  
Gary Milavetz ◽  
H. William Kelly ◽  
Hind T. Hatoum ◽  
Glen T. Schumock ◽  
Donald L. Kendzierski
Keyword(s):  
Effect Size ◽  
English Language ◽  
Inhaled Corticosteroids ◽  
Meta Analysis ◽  
Weighted Average ◽  
Chronic Asthma ◽  
Success Rates ◽  
Double Blind ◽  
Effect Size Calculation

OBJECTIVE: To determine the role of inhaled corticosteroids in the treatment of mild chronic asthma. SOURCE OF STUDIES: Searches of MEDLINE and Index Medicus for English language literature dealing with asthma and inhaled corticosteroids. DESIGN: All retrieved articles were subjected to predetermined criteria for inclusion in the meta-analysis. Inclusion criteria centered around randomized, double-blind studies reporting objective clinical endpoint(s) for subjects with mild chronic asthma who were treated for more than seven days. Studies that were included were not allowed to have any predetermined exclusion criteria. RESULTS: The literature search identified 129 articles, of which 41 satisfied some but not all of the criteria for inclusion. Five articles met all the criteria and were subjected to meta-analysis. The total number of subjects was 141. Peak expiratory flow rate (PEFR) was used as the objective endpoint for effect size calculation. Subjecting these five studies to quality review revealed a range of 0.607–0.741, with 1 as the highest attainable quality and 0 the lowest. Reported results for the different studies were found to be homogenous, thus allowing for the calculation of overall effect size. Inclusion of children in some of the studies added variance to the reported studies, but not to the point at which studies would be considered heterogenous. Effect sizes ranged between 0.41 and 0.89, and the overall weighted average effect size for PEFR was 0.59, with the calculated 95 percent confidence interval at 0.32 to 0.84. A tabulated display of binomial effect size for included trials provided ranges of success rates for treatment versus control values. Results of the studies were judged robust, as 92 studies reporting no significant effects are needed to turn the finding of the meta-analysis insignificant. CONCLUSIONS: Based on the results of the meta-analysis, the existing literature suggests a role for inhaled corticosteroids in the treatment of mild chronic asthma.

scholarly journals Impact of remdesivir on 28 day mortality in hospitalized patients with COVID-19: February 2021 Meta-analysis

2021 ◽  
Author(s):  
Robert Robinson ◽  
Vidhya Prakash ◽  
Raad Al Tamimi ◽  
Nour Albast ◽  
Basma Al-Bast ◽  
...  
Keyword(s):  
Usual Care ◽  
English Language ◽  
Meta Analysis ◽  
Severity Of Illness ◽  
Hospitalized Patients ◽  
Randomized Controlled ◽  
Analysis Process ◽  
All Cause Mortality ◽  
The Impact

AbstractBackgroundThe COVID-19 pandemic has stimulated worldwide investigation into a myriad of potential therapeutic agents, including antivirals such as remdesivir. The first RCT reporting results on the impact of remdesivir on COVID-19 in a peer reviewed journal was the ACTT-1 trial published in November, 2020. The ACTT-1 trial showed more rapid clinical improvement and a reduced risk of 28-day mortality in patients who received remdesivir.This study is a meta-analysis of peer reviewed RCTs aims to estimate the association of remdesivir therapy compared to the usual care or placebo on all-cause mortality in hospitalized patients with COVID-19. Software based tools to accelerate the analysis process.MethodsMeta-analysis of peer reviewed RCTs comparing remdesivir to usual care or placebo. The protocol for this meta-analysis was registered and published in the PROSPERO database (CRD42021229985) on February 5, 2021.ResultsFour English language RCTs were identified, including data from 7,333 hospitalized patients worldwide using remdesivir in COVID-19 positive patients.Meta-analysis of all identified RCTs showed no difference in survival in patients who received remdesivir therapy compared to usual care or placebo. The random effects meta-analysis has a summary odd ratio is 0.89 (95% CI 0.65-1.21, p = 0.30). Considerable variability in the severity of illness is noted with the rates of IMV at the time of randomization ranging from 0% to 27%.ConclusionsThis meta-analysis of randomized controlled trials published in peer-reviewed literature by February 1, 2021 did not show reduced mortality in hospitalized patients with COVID-19 who received remdesivir. Further research is needed to clarify the role of remdesivir therapy in the management of COVID-19.

Test Frequency, Stakes, and Feedback in Student Achievement: A Meta-Analysis

2019 ◽  
Vol 43 (3-4) ◽  
pp. 111-151 ◽  
Author(s):  
Richard P. Phelps
Keyword(s):  
Student Achievement ◽  
Early Childhood ◽  
Effect Size ◽  
English Language ◽  
Variance Estimation ◽  
Meta Analysis ◽  
The United States ◽  
Research Literature ◽  
Effect Sizes ◽  
Test Frequency

Background: Test frequency, stakes associated with educational tests, and feedback from test results have been identified in the research literature as relevant factors in student achievement. Objectives: Summarize the separate and joint contribution to student achievement of these three treatments and their interactions via multivariable meta-analytic techniques using a database of English-language studies spanning a century (1910–2010), comprising 149 studies and 509 effect size estimates. Research design: Analysis employed robust variance estimation. Considered as potential moderators were hundreds of study features comprising various test designs and test administration, demographic, and source document characteristics. Subjects: Subjects were students at all levels, from early childhood to adult, mostly from the United States but also eight other countries. Results: We find a summary effect size of 0.84 for the three treatments collectively. Further analysis suggests benefits accrue to the incremental addition of combinations of testing and feedback or stakes and feedback. Moderator analysis shows higher effect sizes associated with the following study characteristics: more recent year of publication, summative (rather than formative) testing, constructed (rather than selected) item response formats, alignment of subject matter between pre- and posttests, and recognition/recall (rather than core subjects, art, or physical education). Conversely, lower effect sizes are associated with postsecondary students (rather than early childhood–upper secondary), special education population, larger study population, random assignment (rather than another sampling method), use of shadow test as outcome measure, designation of individuals (rather than groups) as units of analysis, and academic (rather than corporate or government) research.

scholarly journals Recognition and Participation of Colorectal Cancer Screening in Turkey: Meta-analysis of Literature

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Aydoğan ◽  
S Metintaş ◽  
M F Önsüz
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
English Language ◽  
Meta Analysis ◽  
Group Analysis ◽  
Fecal Occult Blood ◽  
Screening Methods ◽  
Double Blind ◽  
Cross Sectional ◽  
Crc Screening

Abstract Background The aim of the study was to perform a systematic review and meta-analysis of studies about the proportion of recognition of fecal occult blood test (FOBT) and colonoscopy (CS) methods and participation to them in any period of life for colorectal cancer (CRC) screening in Turkey. Methods PubMed, Web of Science, Google Scholar, Turkey Citation Index and YOK Thesis Center databases were screened both in Turkish and English language to identify relevant studies and key words ’colorectal cancer’, ’colon cancer’, ’cancer screening’, ’information’, ’attitude’, ’behavior’, ’awareness’ and ’Turkey’ were. Criteria for inclusion in the analysis were; conducted in Turkey, original and cross-sectional, conducted CRC risky groups (having CRC in the first degree patients and 50 and above age), studies that give the number of participants and number of taking FOBT and CS screening in any period of their lives and/or the number of knowing them. The studies that met the criteria were read as double blind. The data were entered into the Open Meta Analyst demo program. Because of p < 0.001 in the heterogeneity test, random effects model was used in group analysis of the articles. The proportion and 95% confidence interval of knowing and taking FOBT and CS were calculated from the total number of cases. Results A total of 1176 articles were reached in first review. Duplications and inappropriated studies were eliminated, and 52 studies were selected. Eight studies about recognition FOBT, 16 about participation FOBT, 9 about recognition CS and 17 about participation CS were taken in analysis. After analysis it was found that 1315 of 4334 individuals (19.3%, 95%CI:6.6-32.1) recognized to FOBT, 1174 of 6825 individuals (13.2%, 8.0-18.5) participated to FOBT, 2197 of 5728 individuals (31.7%, 18.2-45.2) recognized to CS and 913 of 8860 individuals (10.0%, 8.1-12.0) participated to CS. Conclusions The proportion of recognition and participation to FOBT and CS were found less than expected. Key messages The proportion of recognition and participation CRC screening methods is low in risky groups. Awareness and participation of screening should be increased in risky groups.

Systematic Review of Local Studies Regarding Efficiency of Add-On Medications on Negative Symptoms of Schizophrenia: A Meta-Analysis

2019 ◽  
Vol 8 (2) ◽  
pp. 113-122
Author(s):  
Saeed Shoja Shafti
Keyword(s):  
Effect Size ◽  
Psychotropic Drugs ◽  
Negative Symptoms ◽  
Meta Analysis ◽  
Combined Effect ◽  
Placebo Control ◽  
Double Blind ◽  
Deficit Syndrome ◽  
Text Revision ◽  
Diagnostic And Statistical Manual

Background: While negative symptoms are connected with poor functioning and quality of life, pharmacological managements have imperfect effects on deficit syndrome and may even subsidize or aggravate secondary negative symptoms. Meanwhile, management of negative symptoms by means of add-on medications has resulted in instable consequences. Objective: In the current tryout, some of the indigenous systematic issued studies have been the theme of a new meta-analysis, to assess the effectiveness of adjunctive psychotropic drugs on deficit syndrome of schizophrenia. Methods: Twelve randomized placebo-control trials (n=433), which had been implemented in Razi psychiatric hospital in the last 14 years, had been selected for the present analysis. As a shared protocol, all cases had been selected amongst the male inpatients, who were hospitalized in chronic section of the hospice and had been diagnosed schizophrenia in line with “Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision”. In this regard, the aforesaid samples had been entered into matching-group, double-blind assessments for random assignment to a psychotropic medication (like antidepressant, benzodiazepine, psycho-stimulant, Acetyl-cholinesterase inhibitors) or placebo in addition to their current drug. In these trials, “Scale for Assessment of Negative Symptoms (SANS)” had been used as the main outcome measure for evaluation of negative symptoms. Also, response was defined as a decrease in >20% in the severity of SANS score (over-all and/or sub-scales). Results: While the heterogeneity of the present meta-analysis was intermediate, the “Combined Effect Size” of the aforesaid assessments has revealed a significant influence respecting efficiency of psychotropic drugs on negative symptoms of schizophrenia (OR = 5.40, CI=2.69- 10.85, z= 5.32, p<0.000). Similar results, as well, could be found in connection with various negative symptoms. In this regard, ‘Anhedonia-Asociality’ showed the best “Combined Effect Size”, afterwards “Affective Blunting”, “Avolitio -Apathy”, “Attention Deficit”, and last of all “Alogia”. “Heterogeneity” of all said analysis was insignificant and therefore appropriate. Conclusion: According to the findings, psychotropic drugs, as add-on medications, have valuable influence in regard to amelioration of negative symptoms of schizophrenia.

scholarly journals Meta-analysis of double-blind placebo control trials evaluating the role of coenzyme Q10 on semen parameters

2018 ◽  
Vol 110 (4) ◽  
pp. e167-e168 ◽  
Author(s):  
A. Agarwal ◽  
A. Sharma ◽  
K. Master ◽  
R. Sharma ◽  
R. Henkel
Keyword(s):  
Coenzyme Q10 ◽  
Meta Analysis ◽  
Semen Parameters ◽  
Placebo Control ◽  
Double Blind ◽  
Double Blind Placebo

scholarly journals The role of deliberate practice in expert performance: revisiting Ericsson, Krampe & Tesch-Römer (1993)

2019 ◽  
Vol 6 (8) ◽  
pp. 190327 ◽  
Author(s):  
Brooke N. Macnamara ◽  
Megha Maitra
Keyword(s):  
Individual Differences ◽  
Effect Size ◽  
Deliberate Practice ◽  
Skill Level ◽  
Expert Performance ◽  
Double Blind ◽  
The Core ◽  
Definition Of ◽  
Practice Teacher

We sought to replicate Ericsson, Krampe & Tesch-Römer's (Ericsson, Krampe & Tesch-Römer 1993 Psychol. Rev. 100 , 363–406) seminal study on deliberate practice. Ericsson et al . found that differences in retrospective estimates of accumulated amounts of deliberate practice corresponded to each skill level of student violinists. They concluded, ‘individual differences in ultimate performance can largely be accounted for by differential amounts of past and current levels of practice’ (p. 392). We reproduced the methodology with notable exceptions, namely (i) employing a double-blind procedure, (ii) conducting analyses better suited to the study design, and (iii) testing previously unanswered questions about teacher-designed practice—that is, we examined the way Ericsson et al . operationalized deliberate practice (practice alone), and their theoretical but previously unmeasured definition of deliberate practice (teacher-designed practice), and compared them. We did not replicate the core finding that accumulated amounts of deliberate practice corresponded to each skill level. Overall, the size of the effect was substantial, but considerably smaller than the original study's effect size. Teacher-designed practice was perceived as less relevant to improving performance on the violin than practice alone. Further, amount of teacher-designed practice did not account for more variance in performance than amount of practice alone. Implications for the deliberate practice theory are discussed.

Antidepressant efficacy of high-frequency transcranial magnetic stimulation over the left dorsolateral prefrontal cortex in double-blind sham-controlled designs: a meta-analysis

2008 ◽  
Vol 39 (1) ◽  
pp. 65-75 ◽  
Author(s):  
D. J. L. G. Schutter
Keyword(s):  
Prefrontal Cortex ◽  
Transcranial Magnetic Stimulation ◽  
Effect Size ◽  
High Frequency ◽  
Magnetic Stimulation ◽  
Dorsolateral Prefrontal Cortex ◽  
Meta Analysis ◽  
Double Blind ◽  
Left Dlpfc ◽  
Dorsolateral Prefrontal

BackgroundFor more than a decade high-frequency repetitive transcranial magnetic stimulation (rTMS) has been applied to the left dorsolateral prefrontal cortex (DLPFC) in search of an alternative treatment for depression. The aim of this study was to provide an update on its clinical efficacy by performing a meta-analysis involving double-blind sham-controlled studies.MethodA literature search was conducted in the databases PubMed and Web of Science in the period between January 1980 and November 2007 with the search terms ‘depression’ and ‘transcranial magnetic stimulation’. Thirty double-blind sham-controlled parallel studies with 1164 patients comparing the percentage change in depression scores from baseline to endpoint of activeversussham treatment were included. A random effects meta-analysis was performed to investigate the clinical efficacy of fast-frequency rTMS over the left DLPFC in depression.ResultsThe test for heterogeneity was not significant (QT=30.46,p=0.39). A significant overall weighted mean effect size,d=0.39 [95% confidence interval (CI) 0.25–0.54], for active treatment was observed (z=6.52,p<0.0001). Medication resistance and intensity of rTMS did not play a role in the effect size.ConclusionsThese findings show that high-frequency rTMS over the left DLPFC is superior to sham in the treatment of depression. The effect size is robust and comparable to at least a subset of commercially available antidepressant drug agents. Current limitations and future prospects are discussed.

Meta-Analysis of Parenteral Clindamycin Dosing Regimens

1995 ◽  
Vol 29 (9) ◽  
pp. 852-858 ◽  
Author(s):  
John P Rovers ◽  
A Lane Ilersich ◽  
Thomas R Einarson
Keyword(s):  
English Language ◽  
Meta Analysis ◽  
Patient Specific ◽  
Success Rates ◽  
Cure Rate ◽  
Data Synthesis ◽  
Study Selection ◽  
Dosing Regimens ◽  
Definition Of ◽  
Cure Rates

Objective: We used meta-analysis to compare clinical cure and success rates for parenteral clindamycin 600 mg q8h or 900 mg q8h therapy to treat adult intraabdominal or female pelvic infections. Data Sources: We located English-language articles describing clindamycin use in humans using MEDLINE, International Pharmaceutical Abstracts, and Embase and from personal and drug information center files, plus all article references. Study Selection: Eligible studies used parenteral clindamycin 600 mg q8h or 900 mg q8h to treat intraabdominal or pelvic infection in at least I aim of a study and provided a definition of clinical outcome. Accepted were comparative trials in adults who were not critically ill or expected to die. Data Synthesis: The DerSimonian and Laird method was used to calculate weighted overall success rates for cure and success (cure plus improved) rates along with 95% confidence intervals for each dosage in intraabdominal and pelvic infections. Regimens were compared with respect to both cure and success rates using the Mann-Whitney U test. Main Results: Twenty-three articles were eligible for inclusion. Abdominal cure rates were 75.6% and 90.5% for clindamycin 600 mg q8h and 900 mg q8h, respectively (p = 0.03); success rates were 89.8% and 92.5%, respectively (p = 0.29). Pelvic cure rates were 82.8% and 89.4%, respectively (p = 0.51); success rates were 87.2% and 89.9%, respectively (p = 0.51). Conclusions: In pelvic infections, a dosage of clindamycin 600 mg q8h appears to be clinically acceptable for all patients. Although clinical outcomes for intraabdominal infections are generally similar for both regimens, the significantly higher cure rate with a dosage of clindamycin 900 mg q8h suggests that dosage recommendations should be patient specific.

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