How Does Mindfulness Affect Cognition? A Reflection on Confounding Issues Surrounding Mindfulness-based Intervention Research Targeting Cognitive Outcomes

2018 ◽  
Author(s):  
David R Vago ◽  
Resh Gupta ◽  
Sara Lazar
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Cognitive Functioning ◽  
Cognitive Processes ◽  
Methodological Quality ◽  
Cognitive Outcomes ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Existing Data

One potential pathway by which mindfulness-based meditation improves health outcomes is through changes in cognitive functioning. A systematic review of randomized controlled trials of mindfulness-based interventions (MBIs) was conducted with a focus on assessing the state of the evidence for effects on cognitive processes and associated assays. Here, we comment on confounding issues surrounding the reporting of these and related findings, including 1) criteria that appropriately define an MBI; 2) limitations of assays used to measure cognition; and 3) methodological quality of MBI trials and reporting of findings. Because these issues contribute to potentially distorted interpretations of existing data, we offer constructive means for interpretation and recommendations for moving the field of mindfulness research forward regarding the effects on cognition.

scholarly journals Scales to Assess the Quality of Randomized Controlled Trials: A Systematic Review

2008 ◽  
Vol 88 (2) ◽  
pp. 156-175 ◽  
Author(s):  
Susan Armijo Olivo ◽  
Luciana Gazzi Macedo ◽  
Inae Caroline Gadotti ◽  
Jorge Fuentes ◽  
Tasha Stanton ◽  
...  
Keyword(s):  
Systematic Review ◽  
Physical Therapy ◽  
Randomized Controlled Trials ◽  
Methodological Quality ◽  
Health Care Research ◽  
Controlled Trials ◽  
Validity And Reliability ◽  
Randomized Controlled ◽  
Manual Search

Background and PurposeThe methodological quality of randomized controlled trials (RCTs) is commonly evaluated in order to assess the risk of biased estimates of treatment effects. The purpose of this systematic review was to identify scales used to evaluate the methodological quality of RCTs in health care research and summarize the content, construction, development, and psychometric properties of these scales.MethodsExtensive electronic database searches, along with a manual search, were performed.ResultsOne hundred five relevant studies were identified. They accounted for 21 scales and their modifications. The majority of scales had not been rigorously developed or tested for validity and reliability. The Jadad Scale presented the best validity and reliability evidence; however, its validity for physical therapy trials has not been supported.Discussion and ConclusionMany scales are used to evaluate the methodological quality of RCTs, but most of these scales have not been adequately developed and have not been adequately tested for validity and reliability. A valid and reliable scale for the assessment of the methodological quality of physical therapy trials needs to be developed.

scholarly journals Effectiveness of Text Messaging Interventions on Blood Pressure Control Among Patients With Hypertension: Systematic Review of Randomized Controlled Trials (Preprint)

2020 ◽  
Author(s):  
Hon Lon Tam ◽  
Eliza Mi Ling Wong ◽  
Kin Cheung ◽  
Siu Fung Chung
Keyword(s):  
Systematic Review ◽  
Text Messaging ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Text Message ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Reduction Effect ◽  
Text Messaging Intervention

BACKGROUND Controlling blood pressure (BP) is an international health concern, and high BP is a major contributor to cardiovascular disease mortality. Evidence has shown that educational interventions directed at patients potentially improve BP control and adherence to medications and lifestyle modifications. In addition, a text messaging intervention has a potential effect on BP control; however, the dosage of a text messaging intervention has not been determined in previous reviews, resulting in difficult application in practice. OBJECTIVE This review aimed to identify the effectiveness of a text messaging intervention on hypertension management with a specific focus on the dosage of text messaging and the type of additional interventions with text messaging. METHODS A systematic review was conducted and reported on in accordance with PRISMA guideline. Participants were aged 18 years and older and diagnosed with primary hypertension. The included studies used text messaging as a component of the intervention. We searched for randomized controlled trials published until June 30, 2020, from the following health-related electronic databases: Embase, Medline, CINAHL Complete, PsycINFO, and Scopus. Data were extracted for qualitative synthesis and meta-analysis. The Physiotherapy Evidence Database Scale was used to assess the methodological quality of each study, and the quality of the included studies was assessed independently by two authors. RESULTS Twelve studies met the inclusion criteria. The overall methodological quality was fair (mean score 5.75). The frequency of text message delivery varied from daily to biweekly. Health education was identified in 4 studies as an additional intervention with text messaging. The overall results showed that the text messaging intervention significantly reduced systolic BP (SBP) but not diastolic BP (DBP). There was no significant difference in BP reduction between studies that lasted 6 months or less and those that lasted more than 7 months. Seven studies that lasted 6 months or less involving 1428 patients with hypertension were pooled for further meta-analysis. Text messages delivered at a lower frequency (once per week or less) had a small effect on SBP reduction (effect size 0.35, <i>P</i>&lt;.01) and DBP reduction (effect size 0.28, <i>P</i>=.01). In addition, the use of a text messaging intervention halved the odds of uncontrolled BP among patients with hypertension in 6 months (odds ratio 0.46, <i>P</i>=.02). CONCLUSIONS This review found that a text messaging intervention was effective in BP control. One-way text messaging delivered in a weekly manner was suggested to be effective and required fewer resources. Future studies should use different forms of text message and be integrated into other interventions to improve adherence behaviors and BP control among patients with hypertension.

scholarly journals Moxibustion for Primary Dysmenorrhea at Different Interventional Times: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Chao-qin Gou ◽  
Jing Gao ◽  
Chen-xi Wu ◽  
Ding-xi Bai ◽  
Hong-yuan Mou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Effective Rate ◽  
Controlled Trials ◽  
Primary Dysmenorrhea ◽  
High Quality ◽  
Randomized Controlled ◽  
The Difference

Primary dysmenorrhea (PD) is one of the most common diseases in gynecology at present. Some clinical trials have reported the effects of moxibustion and confirmed temporal factors are the important elements influencing the efficacy of moxibustion. However, no systematic review has yet been conducted. In this study, we assessed the effects of moxibustion in patients with PD enrolled in randomized controlled trials (RCTs) and the difference among different intervention times to start moxibustion. We extracted data for studies searched from 10 electronic databases and evaluated the methodological quality of the included studies. We discussed three outcomes: effective rate, pain remission, and the level of PGF2αin serum. Current clinical researches showed that, compared with nonmoxibustion treatments for PD, moxibustion leads to higher effective rate and lower level of PGF2αin serum. However, there was no difference in using moxibustion to treat PD at different intervention times. Based on the theory of Chinese medicine and the results of this study, choosing 5 ± 2 days before menstruation to start moxibustion can achieve good efficacy for PD patients. However, more high-quality RCTs are needed to confirm the conclusions.

scholarly journals A Qualitative Systematic Review of the Homeopathic Outcome Studies in Patients with HIV/AIDS

2021 ◽  
Vol 12 (42) ◽  
pp. 2-12
Author(s):  
Subhranil Saha ◽  
Malay Mundle ◽  
Shubhamoy Ghosh ◽  
Munmun Koley ◽  
Sk. Intaj Hossain
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Randomized Controlled Trials ◽  
Methodological Quality ◽  
Outcome Studies ◽  
Controlled Trials ◽  
High Quality ◽  
Randomized Controlled ◽  
Hiv Aids

Background & Aim: Systematic reviews of high-quality randomized controlled trials are crucial to evidence-based medicine. The objective of this review is to test whether there is enough evidence of efficacy of homeopathy from conducted clinical trials in humans suffering from HIV/AIDS. Methods: The study design was criteria-based systematic review of cumulative research and assessment of the methodological quality of only 5 published clinical trials and one review article. Among the clinical outcome studies, 3 studies were of open-label, non-randomized, non-controlled format, 2 were randomized controlled trials and one was a set of replication study. The qualities of the trials were evaluated using a list of validated and pre-defined criteria of good methodology, and the outcomes of the trials were interpreted in relation to their quality. Main outcome measures were methodological qualities in terms of consideration of threats to external, internal, construct and statistical conclusion validity. Results: Trials were too few in number and were not of very high quality. The results showed a positive trend regardless of the quality of the trial or the variety of homeopathy used. The results of this review may be complicated by publication bias. Conclusions: At this moment, the evidences are not sufficient to draw definitive conclusions. So, further evaluation of homeopathy by well-performed controlled trials of high methodological quality is required.

Skeletal and dental effects of surgically assisted rapid palatal expansion: a systematic review of randomized controlled trials

2019 ◽  
Vol 42 (4) ◽  
pp. 434-440 ◽  
Author(s):  
Francesco Bortolotti ◽  
Livia Solidoro ◽  
Maria Lavinia Bartolucci ◽  
Serena Incerti Parenti ◽  
Corrado Paganelli ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Transverse Dimension ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Quality Of Evidence ◽  
Randomized Controlled

Summary Background Surgically assisted rapid maxillary expansion (SARME) is a surgical technique developed to correct transverse discrepancies in skeletally mature patients. However, there is limited evidence concerning the immediate skeletal and dental changes obtained only due to SARME. Objective The aim of the present systematic review is to investigate the immediate skeletal and dental effects of SARME in adult patients with transverse maxillary hypoplasia. Search Methods An electronic search of the literature in MEDLINE, The Cochrane Library, Lilacs and Scopus databases was performed. Selection Criteria Only randomized controlled trials (RCTs) studies investigating the skeletal and dental effects of SARME procedures in adult patients were included. Data Collection and Analysis The included studies received a methodological quality scoring according to the revised Cochrane risk-of-bias tool for randomized trials. The quality of evidence was assessed by means of the Grading Recommendation Assessment, Development and Evaluation (GRADE) system. For each included study and for each analysed parameter, the difference in means and 95 per cent confidence interval was calculated between baseline and immediate post-expansion. A meta-analysis of original outcome data, if possible, was conducted. Results Nine articles were selected. The methodological quality ratings indicated that one study was at low risk of bias, seven presented some concerns and only one was at high risk of bias. In all the included studies, the SARME procedure resulted in a significant expansion of the maxillary transverse dimension. The meta-analysis compared skeletal and dental inter-molar width before and after treatment: the mean difference was of 3.3 mm (2.8–3.9) and 7.0 mm (6.1–7.8), respectively (P-value less than 0.001). The quality of evidence was low-moderate. Conclusions SARME is effective in obtaining a significant expansion of the maxillary transverse dimension. However, the immediate SARME effect is mainly a molar expansion rather than a pure bone transverse widening of the maxilla. Registration The review protocol was registered at PROSPERO database with the registration number CRD42018117967.

scholarly journals Effectiveness of Particle Repositioning Maneuvers in the Treatment of Benign Paroxysmal Positional Vertigo: A Systematic Review

2010 ◽  
Vol 90 (5) ◽  
pp. 663-678 ◽  
Author(s):  
Janet Odry Helminski ◽  
David Samuel Zee ◽  
Imke Janssen ◽  
Timothy Carl Hain
Keyword(s):  
Systematic Review ◽  
Methodological Quality ◽  
Benign Paroxysmal Positional Vertigo ◽  
The Self ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Positional Vertigo ◽  
Repositioning Maneuver ◽  
Paroxysmal Positional Vertigo

Background Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo. Purpose The purpose of this systematic review was to determine whether patients diagnosed with posterior canal (PC) BPPV, based on positional testing, and treated with a particle repositioning maneuver will show the resolution of benign paroxysmal positional nystagmus (BPPN) on the Dix-Hallpike Test performed 24 hours or more after treatment. Data Sources Data were obtained from an electronic search of the MEDLINE, EMBASE, and CINAHL databases from 1966 through September 2009. Study Selection The study topics were randomized controlled trials (RCTs), quasi-RCTs, the diagnosis of PC BPPV, treatment with the particle repositioning maneuver, and outcome measured with a positional test 24 hours or more after treatment. Data Extraction Data extracted were study descriptors and the information used to code for effect size. Data Synthesis In 2 double-blind RCTs, the odds in favor of the resolution of BPPN were 22 times (95% confidence interval=3.41–141.73) and 37 times (95% confidence interval=8.75–159.22) higher in people receiving the canalith repositioning procedure (CRP) than in people receiving a sham treatment. This finding was supported by the results reported in 8 nonmasked quasi-RCTs. Studies with limited methodological quality suggested that a liberatory maneuver (LM) was more effective than a control intervention; there was no significant difference in the effectiveness of the LM and the effectiveness of the CRP; the self-administered CRP was more effective than the self-administered LM; and the CRP administered together with the self-administered CRP was more effective than the CRP administered alone. The Brandt-Daroff exercises were the least effective self-administered treatments. Limitations The limitations included the methodological quality of the studies, the lack of quality-of-life measures, and confounding factors in reporting vertigo. Conclusions Randomized controlled trials provided strong evidence that the CRP resolves PC BPPN, and quasi-RCTs suggested that the CRP or the LM performed by a clinician or with proper instruction at home by the patient resolves PC BPPN. There were no data on the effects of the maneuvers on outcomes relevant to patients.

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