scholarly journals The Efficacy of Bio- and Neurofeedback for Depression: A Meta-analysis

2020 ◽  
Author(s):  
Javier Fernández-Álvarez ◽  
Massimiliano Grassi ◽  
Desirée Colombo ◽  
Desiree Colombo ◽  
Cristina Botella ◽  
...  
Keyword(s):  
Effect Size ◽  
Treatment Efficacy ◽  
Depressive Symptomatology ◽  
Meta Analysis ◽  
Group Analysis ◽  
Research Quality ◽  
Major Depressive ◽  
Publication Number ◽  
Treatment Of Depression

For many years, biofeedback and neurofeedback have been implemented in the treatment of depression. However, the effectiveness of these techniques on depressive symptomatology is still controversial. Hence, we conducted a meta-analysis of studies extracted from PubMed, Scopus, Web of Science and Embase.Two different strings were considered for each of the two objectives of the study: A first group comprising studies with Major Depressive Disorder (MDD) patients and a second group including studies targeting depressive symptomatology reduction in other mental or medical conditions.In the first group of studies including MDD patients, the within-group analyses yielded an effect size of Hedges’ g = 0.717, while the between-group analysis an effect size of Hedges’ g = 1.050. Moderator analyses indicate that treatment efficacy is only significant when accounting for experimental design, in favor of RCTs in comparison to non RCTs, whereas type of neurofeedback, trial design, year of publication, number of sessions, age, gender and quality of study did not influence treatment efficacy. In the second group of studies, a small but significant effect between groups was found (Hedges’ g = 0.303) in favor of bio- and neurofeedback against control groups. Moderator analyses revealed that treatment efficacy was not moderated by any of the sociodemographic and clinical variables.HRV Biofeedback and Neurofeedback are associated with a reduction in self-reported depression. Despite the fact that the field has still a large room for improvement in terms of research quality, the results presented in this study suggests that both modalities may become relevant complementary strategies for the treatment of MDD and depressive symptomatology in the coming years.

scholarly journals Efficacy of bio- and neurofeedback for depression: a meta-analysis

2021 ◽  
pp. 1-16
Author(s):  
J. Fernández-Alvarez ◽  
M. Grassi ◽  
D. Colombo ◽  
C. Botella ◽  
P. Cipresso ◽  
...  
Keyword(s):  
Effect Size ◽  
Treatment Efficacy ◽  
Depressive Symptomatology ◽  
Meta Analysis ◽  
Group Analysis ◽  
Research Quality ◽  
Major Depressive ◽  
Publication Number ◽  
Treatment Of Depression

Abstract Background For many years, biofeedback and neurofeedback have been implemented in the treatment of depression. However, the effectiveness of these techniques on depressive symptomatology is still controversial. Hence, we conducted a meta-analysis of studies extracted from PubMed, Scopus, Web of Science and Embase. Methods Two different strings were considered for each of the two objectives of the study: A first group comprising studies patients with major depressive disorder (MDD) and a second group including studies targeting depressive symptomatology reduction in other mental or medical conditions. Results In the first group of studies including patients with MDD, the within-group analyses yielded an effect size of Hedges' g = 0.717, while the between-group analysis an effect size of Hedges' g = 1.050. Moderator analyses indicate that treatment efficacy is only significant when accounting for experimental design, in favor of randomized controlled trials (RCTs) in comparison to non RCTs, whereas the type of neurofeedback, trial design, year of publication, number of sessions, age, sex and quality of study did not influence treatment efficacy. In the second group of studies, a small but significant effect between groups was found (Hedges' g = 0.303) in favor of bio- and neurofeedback against control groups. Moderator analyses revealed that treatment efficacy was not moderated by any of the sociodemographic and clinical variables. Conclusions Heart rate variability (HRV) biofeedback and neurofeedback are associated with a reduction in self-reported depression. Despite the fact that the field has still a large room for improvement in terms of research quality, the results presented in this study suggests that both modalities may become relevant complementary strategies for the treatment of MDD and depressive symptomatology in the coming years.

scholarly journals Predictability of rotational tooth movement with orthodontic aligners comparing software-based and achieved data: A systematic review and meta-analysis of observational studies

2021 ◽  
pp. 146531252110272
Author(s):  
Despina Koletsi ◽  
Anna Iliadi ◽  
Theodore Eliades
Keyword(s):  
Effect Size ◽  
Tooth Movement ◽  
Data Extraction ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Patient Treatment ◽  
Qualitative Synthesis ◽  
Meta Analyses ◽  
Enamel Reduction

Objective: To evaluate all available evidence on the prediction of rotational tooth movements with aligners. Data sources: Seven databases of published and unpublished literature were searched up to 4 August 2020 for eligible studies. Data selection: Studies were deemed eligible if they included evaluation of rotational tooth movement with any type of aligner, through the comparison of software-based and actually achieved data after patient treatment. Data extraction and data synthesis: Data extraction was done independently and in duplicate and risk of bias assessment was performed with the use of the QUADAS-2 tool. Random effects meta-analyses with effect sizes and their 95% confidence intervals (CIs) were performed and the quality of the evidence was assessed through GRADE. Results: Seven articles were included in the qualitative synthesis, of which three contributed to meta-analyses. Overall results revealed a non-accurate prediction of the outcome for the software-based data, irrespective of the use of attachments or interproximal enamel reduction (IPR). Maxillary canines demonstrated the lowest percentage accuracy for rotational tooth movement (three studies: effect size = 47.9%; 95% CI = 27.2–69.5; P < 0.001), although high levels of heterogeneity were identified (I2: 86.9%; P < 0.001). Contrary, mandibular incisors presented the highest percentage accuracy for predicted rotational movement (two studies: effect size = 70.7%; 95% CI = 58.9–82.5; P < 0.001; I2: 0.0%; P = 0.48). Risk of bias was unclear to low overall, while quality of the evidence ranged from low to moderate. Conclusion: Allowing for all identified caveats, prediction of rotational tooth movements with aligner treatment does not appear accurate, especially for canines. Careful selection of patients and malocclusions for aligner treatment decisions remain challenging.

Comparison of Corticosteroid and Vincristine in Treating Kaposiform Hemangioendothelioma and Tufted Angioma: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 29 (05) ◽  
pp. 401-407 ◽  
Author(s):  
Wei Yao ◽  
Kai Li ◽  
Zuopeng Wang ◽  
Jiahao Pei ◽  
Xiangqi Liu ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Adverse Reactions ◽  
Meta Analysis ◽  
Case Series ◽  
Research Quality ◽  
Cochrane Library ◽  
Kaposiform Hemangioendothelioma ◽  
Systemic Corticosteroids ◽  
Tufted Angioma

Objective To evaluate the outcome and safety of corticosteroids and vincristine (VCR) in the treatment of kaposiform hemangioendothelioma (KHE) and tufted angioma (TA). Materials and Methods Clinical studies involving corticosteroids and VCR therapies in treating KHE/TA were identified by using PubMed, Cochrane Library, OVID, EBSCO, CNKI, VIP, and Wanfang databases from their establishment date to December 2017. Randomized controlled trials, case–control, or case series with more than five cases were included. The following data were extracted: study sample, demographics, responses rate, recurrence rate, and adverse reactions. Two reviewers completed screening and extraction. Methodological quality was evaluated with quality appraisal tool. Results A total of 266 studies were found, and 27 studies were finally included in this research; quality of all studies was low. Seven studies with a total of 123 participants, which compared the effect of systemic corticosteroids with that of VCR, were performed for the meta-analysis. The results indicated that the effect of VCR was significantly higher than that of corticosteroids (relative risk [RR] = 2.08, 95% confidence interval [CI]: 1.38–3.16). The recurrence rate of VCR (11.1%) was lower than that of corticosteroids (50%), but there was no statistical difference between the two therapies (p = 0.1312). The result of pooled adverse reactions response rate for VCR was 18.2%, significantly lower than that for corticosteroids, which was 52.0%. Conclusion The present profile shows that VCR is relatively more effective and safer in treating KHE/TA than corticosteroids are. So, we believe VCR could be used as a first-line medication agent in the treatment of KHE/TA.

scholarly journals TA Treatment of Depression. A Simplified Hermeneutic Single-Case Efficacy Design. The Case of “Giovanni”

2019 ◽  
Vol 10 (2) ◽  
pp. 4-31 ◽  
Author(s):  
Mariavittoria Zanchetta ◽  
Laura Farina ◽  
Stefano Morena ◽  
Enrico Benelli
Keyword(s):  
Depressive Disorders ◽  
Depressive Symptomatology ◽  
Single Case ◽  
Case Series ◽  
Evaluation Methodology ◽  
Transactional Analysis ◽  
Major Depressive ◽  
Case Evaluation ◽  
Treatment Of Depression ◽  
Depressive Personality

This study is inspired by previous case series replications of Hermeneutic Single-Case Efficacy Design which aim was to evaluate the effectiveness of a manualized transactional analysis treatment for depressive disorders and depressive personality. We address problems and difficulties emerged in previous case series, such as: spending time in training a group of people to conduct the hermeneutic analysis, organizing the involvement of external judges to give the final adjudication, and dealing with inconsistencies between quantitative and qualitative data. For these reasons, this study suggests a simplified method to conduct the hermeneutic analysis that require one person only, maintaining its validity. Therefore, we integrated hermeneutic design with the pragmatic case evaluation methodology in order to follow pre-defined criteria in analysing qualitative material. Furthermore, we present a way to use the Script System to detect changes in depressive symptomatology and depressive personality. We tested this approach to HSCED in the case of ‘Giovanni, a 17-years old white Italian boy who attended sixteen session of transactional analysis psychotherapy with a white Italian woman specializing in psychotherapy with 2 years of clinical experience. The patient satisfied DSM-5 criteria for moderate major depressive disorder and generalized anxiety disorder.This is the second investigation which has evaluated the effectiveness of Transactional Analysis psychotherapy for depressed adolescents.  

scholarly journals Comparative clinical trials in psychotherapy: Have large effects been replicated?

2020 ◽  
Vol 29 ◽  
Author(s):  
Nickolas D. Frost ◽  
Thomas W. Baskin ◽  
Bruce E. Wampold
Keyword(s):  
Clinical Trials ◽  
Treatment Efficacy ◽  
Literature Search ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Depression And Anxiety ◽  
Inclusion Criteria ◽  
Average Quality ◽  
Meta Analyses

Abstract Aims The purpose of this review is to examine the replication attempts of psychotherapy clinical trials for depression and anxiety. We focus specifically on replications of trials that exhibit large differences between psychotherapies. The replicability of these trials is especially important for meta-analysis, where the inclusion of false-positive trials can lead to erroneous conclusions about treatment efficacy. Methods Standard replication criteria were developed to distinguish direct from conceptual replication methodologies. Next, an exhaustive literature search was conducted for published meta-analyses of psychotherapy comparisons. Trials that exhibited large effects (d > 0.8) were culled from these meta-analyses. For each trial, a cited replication was conducted to determine if the trial had been subsequently replicated by either ‘direct’ or ‘conceptual’ methods. Finally, a broader search was conducted to examine the extent of replication efforts in the psychotherapy literature overall. Results In the meta-analytic search, a total of N = 10 meta-analyses met the inclusion criteria. From these meta-analyses, N = 12 distinct trials exhibited large effect sizes. The meta-analyses containing more than two large effect trials reported evidence for treatment superiority. A cited replication search yielded no direct replication attempts (N = 0) for the trials with large effects, and N = 4 conceptual replication attempts of average or above average quality. However, of these four attempts, only two partially corroborated the results from their original trial. Conclusion Meta-analytic reviews are influenced by trials with large effects, and it is not uncommon for these reviews to contain several such trials. Since we find no evidence that trials with such large effects are directly replicable, treatment superiority conclusions from these reviews are highly questionable. To enhance the quality of clinical science, the development of authoritative replication criteria for clinical trials is needed. Moreover, quality benchmarks should be considered before trials are included in a meta-analysis, or replications are attempted.

Psychosocial Functioning and Quality of Life in Body Dysmorphic Disorder

2017 ◽  
Author(s):  
Megan M. Kelly ◽  
Megan E. Brault ◽  
Elizabeth R. Didie
Keyword(s):  
Quality Of Life ◽  
Psychosocial Functioning ◽  
Body Dysmorphic Disorder ◽  
Research Quality ◽  
Future Research ◽  
Social Avoidance ◽  
Major Depressive ◽  
Multiple Domains ◽  
Ability And Willingness

This chapter reviews the literature on quality of life and functional impairment in body dysmorphic disorder (BDD) and discusses important lines of future research. Quality of life and psychosocial functioning are often poor in individuals with BDD. This is the case across multiple domains, including social, occupational, academic, and physical functioning. BDD symptoms often directly interfere with a person’s ability and willingness to engage in activities of daily living. Individuals with BDD frequently have high levels of social avoidance, which interferes with the development and maintenance of relationships and involvement in social, work, and educational activities. Rates of unemployment and disability are high. Several clinical correlates of BDD are also associated with psychosocial functioning and quality of life—most notably, greater severity of BDD symptoms and comorbid major depressive disorder.

scholarly journals Clinical determinants associated with quality of life for people who live with HIV/AIDS: a Meta-analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Hesam Ghiasvand ◽  
Katherine M. Waye ◽  
Mehdi Noroozi ◽  
Gholamreza Ghaedamini Harouni ◽  
Bahram Armoon ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Confidence Interval ◽  
Effect Size ◽  
Meta Analysis ◽  
Random Effect Model ◽  
Cd4 Count ◽  
Co Morbidity ◽  
The Impact ◽  
Hiv Aids

Abstract Background During recent years, Quality of Life (QoL) is a significant assessment factor in clinical trials and epidemiological researches due to the advent of Antiretroviral Therapy (ART), Human Immunodeficiency Virus (HIV) has become a manageable,chronic disease. With regards, more attention must be paid to the QoL of infected patients. Limited evidence exists on the impact of ART on QoL among HIV infected patients. Due to lacking of a systematic approach to summarizing the available evidence on the clinical determinants of People Who Live with HIV/AIDS (PWLHs’) QoL, this study aimed to analyze the impact of clinical determinants (ART experience, CD4 count < 200, co-morbidities, time diagnosis and accessibility to cares) on QoL among PWLHs’. Methods This study was designed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). PubMed, Science Direct, Web of Science, and Cochrane electronic databases were searched in February 2017 to identify all past studies that discussed social and behavioral characteristics of QoL in PLWHA. To recognize effective factors on social and behavioral QoL, a meta-analysis was conducted. Polled Odds Ratios (ORs) were utilized at a 95% confidence level. Since sampling methods differed between articles in the systematic review, we evaluated pooled estimates using a random effect model. Metan, metareg, metacum, and metabias commands in STATA version 13.0 were applied to analyze the data. Results Our findings indicated that ART has a positive impact on QoL, with a pooled effect size at approximately 1.04 with a confidence interval between 0.42 to 1.66 which indicates this impact is not very considerable and may be relatively neutral. The pooled effect size for CD4 count on QoL was .29 (95%CI = .22–.35), indicating that there is a negative associate between CD4 count and QoL. The co-morbidity as a negative determinant for QoL among HIV/AIDS infected people. The pooled effect size implies on a relative neutral association, although the confidence interval is wide and ranges between 0.32 to 1.58. The pooled effect size is about 1.82 with confidence interval 1.27 to 2.37 which indicates a considerable positive association with lowest level of heterogeneity. Conclusions The results illustrated that time diagnosing and availability to hospital services had significant relationship with a higher QoL and CD4 < 200 was associated with a lower QoL. In conclusion, policy makers should set an agenda setting to provide a suitable diagnostic and therapeutic facilities to early detecting and continues monitoring the health status of People Who Live with HIV/AIDS (PWLHs’).

Effect of exercise training on quality of life in multiple sclerosis: a meta-analysis

2008 ◽  
Vol 14 (1) ◽  
pp. 129-135 ◽  
Author(s):  
R.W. Motl ◽  
J.L. Gosney
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Exercise Training ◽  
Effect Size ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Training Interventions ◽  
Manual Search ◽  
Exercise Stimulus

Using meta-analytic procedures, this study examined the overall effect of exercise training interventions on quality of life (QOL) among individuals with multiple sclerosis (MS). We searched MEDLINE, PSYCHINFO and CURRENT CONTENTS PLUS for the period of 1960 to November 2006 using the key words exercise, physical activity and physical fitness in conjunction with QOL and MS. We further conducted a manual search of bibliographies of the retrieved papers as well as literature reviews and contacted study authors about additional studies. Twenty-five journal articles were located and reviewed, and only 13 provided enough data to compute effect sizes expressed as Cohen's d. One hundred and nine effect sizes were retrieved from the 13 studies with 484 MS participants and yielded a weighted mean effect size of g = 0.23 (95% CI = 0.15, 0.31). There were larger effects associated with MS-specific measures of QOL and fatigue as an index of QOL. The nature of the exercise stimulus further influenced the magnitude of the mean effect size. The cumulative evidence supports that exercise training is associated with a small improvement in QOL among individuals with MS. Multiple Sclerosis 2008; 14: 129—135. http://msj.sagepub.com

scholarly journals Three Decades of Internet- and Computer-Based Interventions for the Treatment of Depression: Protocol for a Systematic Review and Meta-Analysis

10.2196/14860 ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. e14860 ◽  
Author(s):  
Isaac Moshe ◽  
Yannik Terhorst ◽  
Pim Cuijpers ◽  
Ioana Cristea ◽  
Laura Pulkki-Råback ◽  
...  
Keyword(s):  
Systematic Review ◽  
Effect Size ◽  
Meta Analysis ◽  
Large Body ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Temporal Dimension ◽  
The Past ◽  
Treatment Of Depression ◽  
Computer Based

Background Depression is one of the leading causes of disability worldwide. Internet- and computer-based interventions (IBIs) have been shown to provide effective, scalable forms of treatment. More than 100 controlled trials and a growing number of meta-analyses published over the past 30 years have demonstrated the efficacy of IBIs in reducing symptoms in the short and long term. Despite the large body of research, no comprehensive review or meta-analysis has been conducted to date that evaluates how the effectiveness of IBIs has evolved over time. Objective This systematic review and meta-analysis aims to evaluate whether there has been a change in the effectiveness of IBIs on the treatment of depression over the past 30 years and to identify potential variables moderating the effect size. Methods A sensitive search strategy will be executed across the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and PsycINFO. Data extraction and evaluation will be conducted by two independent researchers. Risk of bias will be assessed. A multilevel meta-regression model will be used to analyze the data and estimate effect size. Results The search was completed in mid-2019. We expect the results to be submitted for publication in early 2020. Conclusions The year 2020 will mark 30 years since the first paper was published on the use of IBIs for the treatment of depression. Despite the large and rapidly growing body of research in the field, evaluations of effectiveness to date are missing the temporal dimension. This review will address that gap and provide valuable analysis of how the effectiveness of interventions has evolved over the past three decades; which participant-, intervention-, and study-related variables moderate changes in effectiveness; and where research in the field may benefit from increased focus. Trial Registration PROSPERO CRD42019136554; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=136554 International Registered Report Identifier (IRRID) PRR1-10.2196/14860

scholarly journals Effectiveness of Digital Education on Communication Skills Among Medical Students: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration

10.2196/12967 ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. e12967 ◽  
Author(s):  
Bhone Myint Kyaw ◽  
Pawel Posadzki ◽  
Sophie Paddock ◽  
Josip Car ◽  
James Campbell ◽  
...  
Keyword(s):  
Medical Students ◽  
Communication Skills ◽  
Effect Size ◽  
Meta Analysis ◽  
Traditional Learning ◽  
Digital Education ◽  
Significant Difference ◽  
Small Effect Size ◽  
Quality Evidence

Background Effective communication skills are essential in diagnosis and treatment processes and in building the doctor-patient relationship. Objective Our aim was to evaluate the effectiveness of digital education in medical students for communication skills development. Broadly, we assessed whether digital education could improve the quality of future doctors’ communication skills. Methods We performed a systematic review and searched seven electronic databases and two trial registries for randomized controlled trials (RCTs) and cluster RCTs (cRCTs) published between January 1990 and September 2018. Two reviewers independently screened the citations, extracted data from the included studies, and assessed the risk of bias. We also assessed the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluations assessment (GRADE). Results We included 12 studies with 2101 medical students, of which 10 were RCTs and two were cRCTs. The digital education included online modules, virtual patient simulations, and video-assisted oral feedback. The control groups included didactic lectures, oral feedback, standard curriculum, role play, and no intervention as well as less interactive forms of digital education. The overall risk of bias was high, and the quality of evidence ranged from moderate to very low. For skills outcome, meta-analysis of three studies comparing digital education to traditional learning showed no statistically significant difference in postintervention skills scores between the groups (standardized mean difference [SMD]=–0.19; 95% CI –0.9 to 0.52; I2=86%, N=3 studies [304 students]; small effect size; low-quality evidence). Similarly, a meta-analysis of four studies comparing the effectiveness of blended digital education (ie, online or offline digital education plus traditional learning) and traditional learning showed no statistically significant difference in postintervention skills between the groups (SMD=0.15; 95% CI –0.26 to 0.56; I2=86%; N=4 studies [762 students]; small effect size; low-quality evidence). The additional meta-analysis of four studies comparing more interactive and less interactive forms of digital education also showed little or no difference in postintervention skills scores between the two groups (SMD=0.12; 95% CI: –0.09 to 0.33; I2=40%; N=4 studies [893 students]; small effect size; moderate-quality evidence). For knowledge outcome, two studies comparing the effectiveness of blended online digital education and traditional learning reported no difference in postintervention knowledge scores between the groups (SMD=0.18; 95% CI: –0.2 to 0.55; I2=61%; N=2 studies [292 students]; small effect size; low-quality evidence). The findings on attitudes, satisfaction, and patient-related outcomes were limited or mixed. None of the included studies reported adverse outcomes or economic evaluation of the interventions. Conclusions We found low-quality evidence showing that digital education is as effective as traditional learning in medical students’ communication skills training. Blended digital education seems to be at least as effective as and potentially more effective than traditional learning for communication skills and knowledge. We also found no difference in postintervention skills between more and less interactive forms of digital education. There is a need for further research to evaluate the effectiveness of other forms of digital education such as virtual reality, serious gaming, and mobile learning on medical students’ attitude, satisfaction, and patient-related outcomes as well as the adverse effects and cost-effectiveness of digital education.

Sign in / Sign up

Export Citation Format

Share Document