Meta-Analysis of Randomized Controlled Trials of Acupuncture for Cancer-Related Fatigue

Size: px
Start display at page:

Download "Meta-Analysis of Randomized Controlled Trials of Acupuncture for Cancer-Related Fatigue"

Transcription

1 5024ICTXXX.1177/ Integrative Cancer TherapiesZeng et al research-article2013 Article Meta-Analysis of Randomized Controlled Trials of Acupuncture for Cancer-Related Fatigue Integrative Cancer Therapies 2014, Vol. 13(3) The Author(s) 2013 Reprints and permissions: sagepub.com/journalspermissions.nav DOI:.1177/ ict.sagepub.com Yingchun Zeng, MPhil, RN 1, Taizhen Luo, BMEd, RN 1, Jennifer Finnegan-John, MSc, RN 2, and Andy S. K. Cheng, PhD 3 Abstract Background. Fatigue is a distressing and pervasive problem for people with cancer. In recent years, acupuncture has gained increasing attention among researchers as an alternative management strategy for cancer-related fatigue (CRF). This review aimed to evaluate the effectiveness of acupuncture for CRF. Methods. Five databases (Medline, CINAHL, Scopus, the Cochrane Library, and CAJ Full-text Database) were searched up to May Randomized controlled trials (RCTs) of acupuncture for the treatment of CRF were considered for inclusion. Results. Seven RCTs were included for metaanalysis, involving a total of 689 subjects. Three studies compared acupuncture with sham acupuncture for CRF with follow-up at weeks; the standardized mean difference (SMD) for general CRF change values was 0.82 (95% confidence interval [CI] = 1.90 to 0.26). When acupuncture plus education intervention was compared with usual care, there was a statistically significant difference for the change score of general CRF (SMD = 2.12; 95% CI = 3.21 to 1.03). The SMD for general CRF change scores between acupuncture with no treatment or wait-list control was 1.46 (95% CI = 3.56 to 0.63). Finally, the SMD for general CRF change scores between acupuncture with acupressure or self-acupuncture was 1.12 (95% CI = 3.03 to 0.78). Three trials reported data for general quality of life and functioning status, reporting enough data for statistical pooling but showing no statistically significant difference (Z score = 1.15, P =.25, SMD = 0.99, 95% CI = 0.70 to 2.68 and Z score = 1.13, P =.26, SMD = 1.38, 95% CI = 1.02 to 3.79, respectively). The I 2 statistics of all statistically pooled data were higher than 50%, indicating heterogeneity between the trials. Conclusions. There were 4 sets of comparison for the effectiveness of acupuncture for CRF; statistical pooling of the reduction in CRF from baseline to follow-up showed in favor of acupuncture. However, 3 sets of comparison for the pooled estimates of effect sizes had no statistical significance. Although one set of comparison (acupuncture plus education interventions vs usual care) had statistically significant differences, it is unclear whether this pooled positive outcome is attributable to the effects of acupuncture or to the education intervention. In addition, the duration of follow-up in these included trials was up to weeks, and some RCTs had methodological flaws. Further rigorously designed RCTs adhering to acceptable standards of trial methodology are required to determine the effectiveness of acupuncture and its long-term effects on CRF. Keywords acupuncture, cancer-related fatigue, quality of life, randomized controlled trials (RCTs), meta-analysis Introduction With the advancement of medical technology and treatment of cancer, the number of cancer survivors is increasing steadily. Nearly 25 million people live with cancer worldwide. 1 Cancer-related fatigue (CRF) represents a major public health concern. 2 Prevalence estimates of individuals who experience CRF have varied across studies from 25% to 0% depending on the type and stage of cancer and treatment types. 3 The multiple and varied effects of fatigue do not dissipate once cancer treatment has been completed. 4 It is now increasingly recognized that many individuals who are disease free continue to experience fatigue for months or even years following treatment completion. 4,5 Fatigue in people with cancer is one of the most common and disabling symptoms of their condition, and is notably associated with mortality. 6 Studies have shown that CRF affects multiple aspects of individuals lives, such as 1 The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China 2 King s College London, London, UK 3 The Hong Kong Polytechnic University, Hong Kong, China Corresponding Author: Yingchun Zeng, Department of Obstetrics, The Third Affiliated Hospital of Guangzhou Medical University, No. 63 DouBao Road, Liwan District, Guangzhou, 5150, China. chloezengyc@hotmail.co.uk

2 194 Integrative Cancer Therapies 13(3) performing activities of daily living, decreasing functional status, and limiting overall quality of life. 7,8 In addition, CRF is associated with decreased survival and interferes with employment, family life, social relationships, and sex life There are limited nonpharmacologic treatment approaches for the management of CRF. However, there is growing evidence of the impact of complementary and integrative medicine on CRF. 12 Among various complementary and integrative medicine interventions, acupuncture has gained increasing attention as a tool for managing CFR. Vickers et al 13 published the first empirical study to examine the effectiveness of acupuncture for CRF. Because of their promising findings, several randomized controlled trials (RCTs) have been published reporting the efficacy of acupuncture in alleviating CRF. A recent review by Finnegan-John et al 12 comprehensively examined a range of complementary and alternative medicine interventions for CRF, while Posadzki et al 14 focused on evaluating acupuncture for CRF. However, neither of these narrative reviews quantitatively clarified the effectiveness of acupuncture for the management of CRF. Aims Because of growing interest in the use of acupuncture for CRF, this meta-analytic review aimed to quantitatively evaluate the effectiveness of acupuncture for the management of CRF based on available studies to date, to explore the effectiveness of different types of acupuncture interventions, and to identify implications for future research. Methods Data Sources and Searches Systematic searches of 5 databases were conducted in Medline (database start date to May 2013), CINAHL (database start date to May 2013), Scopus (database start date to May 2013), the Cochrane Library (database start date to May 2013), and CAJ Full-text Database (database start date to May 2013). Articles published in English and Chinese were included. RCTs of acupuncture for the treatment of CRF were considered for inclusion. The search terms included were acupuncture, acupuncture therapy, fatigue, cancer-fatigue, cancer, carcinoma, tumour or tumor, and malignance. The process of study selection consisted of 2 steps: 2 researchers independently screened the titles and abstracts of the studies (YCZ, TZL), and all potentially relevant studies meeting the predefined inclusion criteria were selected for inclusion in the review. Disagreements were resolved by a third review author (JF-J). Study Population In the planning stage, this review set out to focus on cancer survivors: those individuals who completed postprimary treatment. During the searching stage, it became clear that the number of studies on acupuncture for cancer survivors is limited. Therefore, our inclusion criteria were expanded to include cancer patients undergoing treatment. Interventions and Outcome Measures Acupuncture was defined as a process involving needles that were required to be inserted in the skin (without an injection) at classical meridian points. 15 Sham acupuncture was defined as any intervention designed to make patients believe they are receiving acupuncture by either puncturing a location near the acupoint with tingling only but not De Qi (arrival of energy), or stimulated acupuncture technique using a toothpick or other needle-like object in the needle guidetube. 16 Studies of acupuncture that did not involve needle insertion, such as laser acupuncture or electro-acupuncture without needles, were excluded. The primary outcome was cancerrelated fatigue measured by a validated scale. The secondary outcomes were quality of life and functional well-being. Data Extraction and Assessment of Risk of Bias Data were extracted by 2 authors (YCZ, TZL). Disagreements concerning data extraction were resolved by discussion. The methodological quality of all the included studies was assessed by 2 authors independently (YCX, TZL). The risk of bias of methodological quality was assessed using the Cochrane Assessment Tool, which consists of 7 domains. 17 Data Synthesis The data were analyzed using the Cochrane Collaboration s Review Manager (RevMan 5.1). 17 For continuous variables (eg, CRF reduction, functioning, or quality-of-life improvement), mean difference (MD) was calculated when outcomes were measured using the same scale, and the standardized mean difference (SMD) was used when different scales were used among different trials, with corresponding 95% confidence intervals (CI). 18 If data of standard deviations (s) were missing for statistical pooling of effect size calculation, missing s were replaced by calculating the trial data using standard error of the mean or 95% CI. 18 Clinical heterogeneity was determined by discussion among the review authors and clinically heterogeneous trials were not combined statistically. Statistical heterogeneity was calculated by using the χ 2 and Ι 2 statistics to determine whether to use the random-effects model or fixed-effects model for meta-analysis. 18 A χ 2 of P value greater than.1 and an Ι 2 value of less than 50% were considered to indicate

3 Zeng et al 195 Figure 1. PRISMA flow diagram of study selection. statistical homogeneity. 18 The random-effects model was used to combine clinically homogeneous but statistically heterogeneous clinical trials, whereas clinically and statistically homogeneous trials were combined using the fixedeffects model. Results A total of 8 RCTs were identified, but 1 study was an unpublished thesis and was therefore excluded. The selection of studies is shown in Figure 1. The characteristics of included trials are summarized in Table 1. Three trials used a small sample size (12-30 patients). Two studies 23,24 used a pragmatic RCT design and 1 study 22 adopted an open-label design. Duration of interventions ranged from 2 to 8 weeks. Outcome measures all used validated scales. Each included trial was evaluated in terms of its risk of bias (Figure 2). Three trials had a high risk of bias and 4 trials 19-21,25 had a relatively low risk of bias. Major sources of risk of bias related to allocation concealment, blinding study subjects or research personnel, and blinding outcome assessment. Assessment of risk-of-bias by individual trials is presented in Figure 3. One trial 19 had a high drop-out rate in the sham control group (27.27%) but failed to address this incomplete outcome with intention-to-treat analysis. Four trials lacked a sham control group, which would help distinguish between benefits that could be ascribed to personal attention and group interaction as opposed to the specific effects of acupuncture. Three trials failed to blind participants in relation to intervention delivery and were therefore open to bias with false-positive results. The treatment arm in 1 trial 22 was a combination of acupuncture and education interventions, and it was impossible to parse out whether it was the acupuncture or educational components causing the effects. Seven RCTs were included for meta-analysis, involving 689 subjects. Through 6 sets of statistical pooling, all change scores were assessed with a follow-up to weeks. Three studies compared acupuncture with sham acupuncture for CRF. The SMD for general CRF change values was 0.82 (95% CI = 1.90 to 0.26; Z score = 1.49, P =.14; Figure 4). Two studies compared the effects of acupuncture plus an intervention with usual care: Johnston et al 22 integrated education with acupuncture as the treatment and Molassiotis et al 23 adopted acupuncture with usual care as the treatment. Data from a meta-analysis of these 2 studies showed that, overall, acupuncture plus an intervention had statistically significant effects in reducing CRF compared with usual care. The SMD was 2.12 (95% CI = 3.21 to 1.03; Z score = 3.81, P =.0001; Figure 5). Two other trials 21,24 compared acupuncture with wait-list control or no treatment. The SMD for general CRF change scores between acupuncture with no treatment or wait-list control was 1.46 (95% CI = 3.56 to 0.63; Z score = 1.37,

4 196 Integrative Cancer Therapies 13(3) Table 1. Characteristics of Included Trials on Acupuncture for Cancer-Related Fatigue. Trials Study Participants Study Design Intervention Comparison Outcome Measures Balk et al 19 (2009) 27 female cancer patients undergoing radiation therapy Double-blind pilot RCT AT: 1-2 times per week, over 4-6 weeks Deng et al 20 (2013) 74 cancer patients Sham-controlled RCT AT: TCM style, once per week for 6 weeks Johnston et al 22 (2011) Molassiotis et al 25 (2007) Molassiotis et al 23 (2012) Molassiotis et al 24 (2013) Smith et al 21 (2013) 12 female cancer survivors completed with primary therapy for breast cancer 47 cancer patients experienced with moderate to severe fatigue 302 breast cancer patients 197 breast cancer patients 30 women with fatigue following breast cancer treatment Open-label, pilot RCT Sham-controlled RCT Pragmatic RCT Pragmatic RCT Placebo-controlled mixed method RCT AT education, once per week for 8 weeks AT: 3 times per week for 2 weeks AP: once per day for 2 weeks AT UC, once per week for 6 weeks AT: once per week for 4 weeks Self-AT: once per week for 4 weeks AT: TCM style, twice per week, over 3 weeks, then once per week for the final 3 weeks sham acupuncture sham acupuncture Acupuncture plus education intervention versus usual care Acupuncture vs acupressure or self-acupressure Acupuncture plus usual care versus usual care no treatment self-acupuncture sham acupuncture wait-list control FACIT-F SF-36 CES-D BFI FACT-G HADS BFI FACT-COG MFI MFI FACT-B MFI FACT-B HADS BFI W-BQ 12 Abbreviations: AP, acupressure; AT, acupuncture; BFI, Brief Fatigue Inventory; CES-D, Center for Epidemiological StudiesDepression Scale; HADS, Hospital Anxiety and Depression Scale; FACIT-F, Functional Assessment of Chronic Illness TherapyFatigue Subscale; FACT-B, Functional Assessment of Cancer TreatmentBreast; FACT-COG, Functional Assessment of Cancer TreatmentCognitive Function; FACT-G, Functional Assessment of Cancer TreatmentGeneral; MFI, Multidimensional Fatigue Inventory; RCT, randomized controlled trial; TCM, traditional Chinese medicine; UC, usual care; W-BQ 12, Well-Being Questionnaire. Random sequence generation (selection bias) Allocation concealment (selection bias) Blinding of participants and personnel (performance bias) Blinding of outcome assessment (detection bias) Incomplete outcome data (attrition bias) Selective reporting (reporting bias) Other bias 0% 25% 50% 75% 0% Low risk of bias Unclear risk of bias High risk of bias Figure 2. Overall risk of bias assessment using the Cochrane tool. P =.17; Figure 6), indicating no statistically significant effects of acupuncture for CRF. Two studies 24,25 compared the effects of acupuncture with other active treatment (acupressure or self-acupuncture). In a 2007 study, Molassiotis et al 25 compared the effects of acupuncture with those of acupressure, while in a more recent study, 24 the same authors conducted a comparison of acupuncture with self-acupuncture. Data from metaanalysis of these 2 trials showed no statistically significant effects in reducing CRF compared with other active treatments. The SMD was 1.12 (95% CI: 3.03 to 0.78; Z score = 1.15, P =.25; Figure 7).

5 Zeng et al 197 For general quality of life and functioning status, 3 trials reported enough data for statistical pooling, and showed no statistically significant difference between acupuncture and sham acupuncture (SMD = 0.99, 95% CI = 0.70 to 2.68; Z score = 1.15, P =.25 and SMD = 1.38, 95% CI = 1.02 to 3.79; Z score = 1.13, P =.26, respectively; Figures 8 and 9). The I 2 statistics of statistical pooling were all higher than 50%, indicating heterogeneity between the trials. Only 1 study reported safety issues related to acupuncture treatment: These included spot bleeding, bruising, feeling discomfort, and nausea. 25 In the study by Deng et al, adverse events were reported, but the authors claimed that these adverse events were proven to be unrelated to acupuncture. Therefore, acupuncture seems to be relatively safe for CRF. Discussion Random sequence generation (selection bias) Balk 2009 Deng 2013 Johnston 2011 Molassiotis 2007 Molassiotis 2012 Molassiotis 2013 Smith 2013 Allocation concealment (selection bias) To measure the effectiveness of acupuncture for CRF, 4 sets of comparisons were used as follows: acupuncture versus Blinding of participants and personnel (performance bias) Blinding of outcome assessment (detection bias) Incomplete outcome data (attrition bias) Figure 3. Risk of bias assessment by individual trials. Selective reporting (reporting bias) Other bias sham acupuncture, acupuncture plus an intervention versus usual care, acupuncture versus no treatment or wait-list control, and acupuncture versus other active treatment. Only 1 comparison (acupuncture plus usual care or education intervention vs usual care) showed a statistically significant difference (Z score = 3.81, P =.0001). All other comparisons failed to show significant differences between acupuncture and sham acupuncture, or no treatment/waitlist control, or other active treatment, although forest plots from Figures 4, 6, and 7 indicate in favor of acupuncture. With regard to general quality of life, some improvements were demonstrated but without statistically significant differences. Similarly, there was some reduction in depressive symptoms but further trials are required to test its statistical significance. This meta-analysis showed no statistically significant difference between acupuncture and sham acupuncture for CRF. This finding was consistent with a study by Azad and John, 26 which identified 25 randomized, sham-controlled studies in which acupuncture-point stimulation was used to treat a diverse range of symptoms of cancer. More than half (56%, n = 14) of these studies reported no statistically significant difference between acupuncture and sham acupuncture. 26 Consequently, the effects of acupuncture for CRF and other cancer-related symptoms may be attributed to nonspecific factors such as patient expectations and patientpractitioner interaction. The effectiveness of acupuncture for individuals with chronic low back pain was attributed to nonspecific effects by a meta-analysis of 13 RCTs. 15 In addition, there are well-established psychosocial predictors relating to the effects of acupuncture for pain. Bishop and Lewith 27 indicated that patients beliefs about acupuncture and factors related to therapeutic relationships, in particular patients perceptions of that relationship, are significant predictors of treatment outcomes. To address this issue, there is a need for larger trials, using rigorous methodology, to assess the specific effects of acupuncture. In this meta-analysis, no study was found which examined the use of different acupuncture techniques for the management of CRF. Among 7 trials, 2 studies adopted traditional Chinese medicine styles, while the others used Western acupuncture techniques. Trials comparing different acupuncture techniques are warranted, as the traditional Chinese medicine style of acupuncture and Western acupuncture techniques may be based on totally different treatment protocols, in terms of commonly used acupuncture points, total of number of needle points, duration of needle retention, treatment frequency, and total number of sessions per treatment intervention. Acupuncture is considered to be a safe technique, and evidence from this meta-analysis has demonstrated that there are no reported serious adverse events. A cumulative review estimated the risk of a serious adverse event related to acupuncture to be in the order of 0.05 per 000

6 198 Integrative Cancer Therapies 13(3) Balk 2009 Deng 2013 Smith 2013 Acupuncture Control Std. Difference Std. Difference % 38.2% 28.2% [-1.48, 0.11] 0.00 [-0.46, 0.46] -2. [-3.24, -0.96] (95% CI) Heterogeneity: Tau² = 0.74; Chi² = 12.00, df = 2 (P = 0.002); I² = 83% Test for overall effect: Z = 1.49 (P = 0.14) 0.0% [-1.90, 0.26] Favours acupuncture Favours sham acupuncture Figure 4. General cancer-related fatigue change score (acupuncture vs sham acupuncture) up to -week follow-up. Johnston 2011 Molassiotis 2012 Acupuncture Control Std. Difference Std. Difference % 65.6% [-2.68, -0.03] [-2.85, -2.19] (95% CI) % Heterogeneity: Tau² = 0.44; Chi² = 2.83, df = 1 (P = 0.09); I² = 65% Test for overall effect: Z = 3.81 (P = ) [-3.21, -1.03] Favours acupuncture Favours usual care Figure 5. General cancer-related fatigue change scores (acupuncture plus an intervention vs usual care) up to -week follow-up Molassiotis 2013 Smith 2013 Acupuncture Control Std. Difference Std. Difference % 45.8% [-0.83, -0.13] [-3.89, -1.36] (95% CI) Heterogeneity: Tau² = 2.08; Chi² =.32, df = 1 (P = 0.001); I² = 90% Test for overall effect: Z = 1.37 (P = 0.17) 0.0% [-3.56, 0.63] Favours acupuncture Favours control Figure 6. General cancer-related fatigue change scores (acupuncture vs no treatment or wait-list control) up to -week follow-up. Molassiotis 2007 Molassiotis 2013 Acupuncture Control Std. Difference Std. Difference % 52.4% [-3.05, -1.24] [-0.54, 0.15] (95% CI) % Heterogeneity: Tau² = 1.78; Chi² = 15.55, df = 1 (P < ); I² = 94% Test for overall effect: Z = 1.15 (P = 0.25) [-3.03, 0.78] Favours acupuncture Favours other treatment Figure 7. General cancer-related fatigue change scores (acupuncture vs other treatment) up to -week follow-up. treatments. 28 Zhang et al 29 conducted a systematic review of acupuncture-related adverse events, and they concluded that improper techniques of acupuncture were the main source of incidences of adverse events. One trial in this meta-analysis included a self-acupuncture arm, although the authors claimed these participants were trained by experienced acupuncturists. There is no guarantee that every participant could master the skills required to administer acupuncture, such as depth of needling and manipulation of needles in a proper way. Hence, further trials incorporating self-acupuncture as an intervention arm should be used cautiously. A careful examination of the included studies reveals some methodological flaws in the trials. Three trials failed to blind research subjects, intervention delivery, and outcome assessors, introducing a high risk of bias into these trials. Despite the difficulties of blinding of research subjects and intervention delivery, studies should blind the

7 Zeng et al 199 Balk 2009 Deng 2013 Smith 2013 Acupuncture Control Std. Difference Std. Difference % 35.7% 33.3% 3.17 [1.98, 4.37] [-0.62, 0.30] 0.19 [-0.68, 1.07] (95% CI) % Heterogeneity: Tau² = 2.04; Chi² = 26., df = 2 (P < ); I² = 92% Test for overall effect: Z = 1.15 (P = 0.25) 0.99 [-0.70, 2.68] Favours sham acupuncture Favours acupuncture Figure 8. General quality-of-life change scores up to -week follow-up. Balk 2009 Deng 2013 Smith 2013 Acupuncture Control Std. Difference Std. Difference % 35.6% 34.2% 5.54 [3.77, 7.31] 0.00 [-0.46, 0.46] [-1.77, 0.08] (95% CI) % Heterogeneity: Tau² = 4.17; Chi² = 40.32, df = 2 (P < ); I² = 95% Test for overall effect: Z = 1.13 (P = 0.26) 1.38 [-1.02, 3.79] Favours acupuncture Favours sham acupuncture Figure 9. Depressive/negative well-being change scores up to -week follow-up. outcome assessors to minimize potential methodological bias. Three trials included insufficient sample sizes, which meant there was a potential risk of overestimating positive outcomes. Four trials lacked a sham acupuncture group, which in turn meant that it was impossible to definitively attribute improved CRF in the acupuncture group solely to acupuncture itself. 26 Therefore, the reliability of the evidence presented here is clearly limited. Additionally, there were some limitations to be considered when interpreting the results of this meta-analysis. Only 7 trials were included in the meta-analysis, and most of these had a high risk of bias in methodological quality. There is a need for high-quality clinical trials to test the effectiveness of acupuncture for CRF. This meta-analysis also found significant heterogeneity among combined trials, which still attributes to the methodological weakness of the included studies. Another limitation was that some trials neglected to report baseline data, which precluded us from performing further statistical pooling (eg, follow-up CRF score comparisons). In this respect, future trials of acupuncture for CRF would benefit from reporting outcomes in a standard way. Conclusion There were 4 sets of comparison for measuring the effectiveness of acupuncture for CRF; using statistical pooling, the findings for reduction in CRF from baseline to followup were in favor of acupuncture. However, 3 sets of comparison for the pooled estimates of effect size had no statistical significance. Although 1 set of comparison (acupuncture plus education interventions versus usual care) showed a statistically significant difference, it was unclear whether this pooled positive outcome was attributable to the effects of acupuncture or the education intervention. In addition, the duration of follow-up in the included trials was up to weeks, and some RCTs had methodological flaws. Thus, further rigorously designed RCTs adhering to acceptable standards of trial methodology are required to determine the effectiveness of acupuncture and its long-term effects on CRF. Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Funding The author(s) received no financial support for the research, authorship, and/or publication of this article. References 1. Kamangar F, Dores GM, Anderson WF. Patterns of cancer incidence, mortality, and prevalence across five continents: Defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol. 2006;24: Escalante CP, Manzullo EF. Cancer-related fatigue: the approach and treatment. J Gen Intern Med. 2009;24(suppl 2):

8 200 Integrative Cancer Therapies 13(3) 3. Berger AM. Update on the state of the science: sleep-wake disturbance in adult patients with cancer. Oncol Nurs Forum. 2009;36:E165-E Rosman R. Recovered from cancer but still ill: strategies used to legitimize extreme persistent fatigue in disease free cancer patients. Eur J Cancer Care. 2009;18: Servaes P, Verhagen C, Bleijenberg G. Fatigue in cancer patients during and after treatment: Prevalence, correlates and interventions. Eur J Cancer. 2002;38: Groenvold M, Petersen MA, Idler E, Bjorner JB, Fayers PM, Mouridsen HT. Psychological distress and fatigue predicted recurrence and survival in primary breast cancer patients. Breast Cancer Res Treat. 2007;5: Borneman T. Assessment and management of cancer-related fatigue. J Hosp Palliat Nurs. 2013;15: Sood A, Barton DL, Bauer BA, Loprinzi CL. A critical review of complementary therapies for cancer-related fatigue. Integr Cancer Ther. 2007;6: Cheville AL, Shen T, Chang M, Basford JR. Appropriateness of the treatment of fatigued patients with stage IV cancer. Support Care Cancer. 2013;21: Kirshbaum M. Cancer-related fatigue: a review of nursing interventions. Br J Community Nurs. 20;15: Scott JA, Lasch KE, Barsevick AM, Piault-Louis E. Patients experience with cancer-related fatigue: a review and synthesis of qualitative research. Oncol Nurs Forum. 2011;38:E191-E Finnegan-John J, Molassiotis A, Richardson A, Ream E. A systematic review of complementary and alternative medicine interventions for the management of cancer-related fatigue. Integr Cancer Ther. 2013;12: Vickers AJ, Straus DJ, Fearon B, Cassileth BR. Acupuncture for postchemotherapy fatigue: a phase II study. J Clin Oncol. 2004;22: Posadzki P, Moon TW, Choi TY, Park TY, Lee MS, Ernst E. Acupuncture for cancer-related fatigue: a systematic review of randomized clinical trials. Support Care Cancer. 2013;21: Xu M, Yan S, Yin X, et al. Acupuncture for chronic low back pain in long-term follow-up: a meta-analysis of 13 randomized controlled trials. Am J Chin Med. 2013;41: Cherkin DC, Sherman KJ, Kahn J, et al. Effectiveness of focused structural massage and relaxation massage for chronic low back pain: protocol for a randomized controlled trial. Trials. 2009;: Review Manager (RevMan) [Computer Program]. Version 5.1. Copenhagen, Denmark: The Nordic Cochrane Centre, The Cochrane Collaboration, Higgins JPT, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions. Version (updated March 2011). The Cochrane Collaboration, Balk J, Day R, Rosenzweig M, Beriwal S. Pilot, randomized, modified, double-blind, placebo-controlled trial of acupuncture for cancer-related fatigue. J Soc Integr Oncol. 2009;7: Deng G, Chan Y, Sjoberg D, et al. Acupuncture for the treatment of post-chemotherapy chronic fatigue: a randomized, blinded, sham-controlled trial. Support Care Cancer. 2013;21: Smith C, Carmady B, Thornton C, Perz J, Ussher JM. The effect of acupuncture on post-cancer fatigue and well-being for women recovering from breast cancer: a pilot randomised controlled trial. Acupunct Med. 2013;31: Johnston MF, Hays RD, Subramanian SK, et al. Patient education integrated with acupuncture for relief of cancerrelated fatigue randomized controlled feasibility study. BMC Complement Altern Med. 2011;11: Molassiotis A, Bardy J, Finnegan-John J, et al. Acupuncture for cancer-related fatigue in patients with breast cancer: a pragmatic randomized controlled trial. J Clin Oncol. 2012;30: Molassiotis A, Bardy J, Finnegan-John J, et al. A randomized, controlled trial of acupuncture self-needling as maintenance therapy for cancer-related fatigue after therapist-delivered acupuncture. Ann Oncol. 2013;24: Molassiotis A, Sylt P, Diggins H. The management of cancer-related fatigue after chemotherapy with acupuncture and acupressure: a randomised controlled trial. Complement Ther Med. 2007;15: Azad A, John T. Do randomized acupuncture studies in patients with cancer need a sham acupuncture control arm. J Clin Oncol. 2013;31: Bishop FL, Lewith GT. A review of psychosocial predictors of treatment outcomes: what factors might determine the clinical success of acupuncture for pain? J Acupunct Meridian Stud. 2008;1: White A. A cumulative review of the range and incidence of significant adverse events associated with acupuncture. Acupunct Med. 2004;22: Zhang J, Shang H, Gao X, Ernst E. Acupuncture-related adverse events: a systematic review of the Chinese literature. Bull World Health Organ. 20;88:

Acupuncture for Depression?: A Systematic Review of Systematic Reviews

Acupuncture for Depression?: A Systematic Review of Systematic Reviews Acupuncture for Depression?: A Systematic Review of Systematic Reviews Evaluation & the Health Professions 34(4) 403-412 ª The Author(s) 2011 Reprints and permission: sagepub.com/journalspermissions.nav

More information

Drug Therapy for the Treatment of Chronic Nonspecific Low Back Pain: Systematic Review and Meta-analysis

Drug Therapy for the Treatment of Chronic Nonspecific Low Back Pain: Systematic Review and Meta-analysis Pain Physician 2013; 16:E685-E704 ISSN 2150-1149 Systematic Review Drug Therapy for the Treatment of Chronic Nonspecific Low Back Pain: Systematic Review and Meta-analysis Joanne WY Chung, PhD 1, Yingchun

More information

Systematic reviews and meta-analyses of observational studies (MOOSE): Checklist.

Systematic reviews and meta-analyses of observational studies (MOOSE): Checklist. Systematic reviews and meta-analyses of observational studies (MOOSE): Checklist. MOOSE Checklist Infliximab reduces hospitalizations and surgery interventions in patients with inflammatory bowel disease:

More information

Feng-Yi Lai, RN, MSN, Instructor Department of Nursing, Shu-Zen College of Medicine and Management, Asphodel Yang, RN, PhD, Associate Professor

Feng-Yi Lai, RN, MSN, Instructor Department of Nursing, Shu-Zen College of Medicine and Management, Asphodel Yang, RN, PhD, Associate Professor Feng-Yi Lai, RN, MSN, Instructor Department of Nursing, Shu-Zen College of Medicine and Management, Asphodel Yang, RN, PhD, Associate Professor Department of Nursing, Central Taiwan University of Science

More information

Effects of Infrared Laser Moxibustion on Cancer-Related Fatigue: A Randomized, Double-Blind, Placebo-Controlled Trial

Effects of Infrared Laser Moxibustion on Cancer-Related Fatigue: A Randomized, Double-Blind, Placebo-Controlled Trial Effects of Infrared Laser Moxibustion on Cancer-Related Fatigue: A Randomized, Double-Blind, Placebo-Controlled Trial Huijuan Mao, MD, PhD 1 ; Jun J. Mao, MD, MSCE 2 ; Menghu Guo, PhD 1 ; Ke Cheng, PhD

More information

American Journal of Internal Medicine

American Journal of Internal Medicine American Journal of Internal Medicine 2016; 4(3): 49-59 http://www.sciencepublishinggroup.com/j/ajim doi: 10.11648/j.ajim.20160403.12 ISSN: 2330-4316 (Print); ISSN: 2330-4324 (Online) The Effect of Dose-Reduced

More information

Research Article Relaxation Acupressure Reduces Persistent Cancer-Related Fatigue

Research Article Relaxation Acupressure Reduces Persistent Cancer-Related Fatigue Evidence-Based Complementary and Alternative Medicine Volume 2011, Article ID 142913, 10 pages doi:10.1155/2011/142913 Research Article Relaxation Acupressure Reduces Persistent Cancer-Related Fatigue

More information

PROSPERO International prospective register of systematic reviews

PROSPERO International prospective register of systematic reviews PROSPERO International prospective register of systematic reviews Review title and timescale 1 Review title Give the working title of the review. This must be in English. Ideally it should state succinctly

More information

Cochrane Pregnancy and Childbirth Group Methodological Guidelines

Cochrane Pregnancy and Childbirth Group Methodological Guidelines Cochrane Pregnancy and Childbirth Group Methodological Guidelines [Prepared by Simon Gates: July 2009, updated July 2012] These guidelines are intended to aid quality and consistency across the reviews

More information

Meta Analysis. David R Urbach MD MSc Outcomes Research Course December 4, 2014

Meta Analysis. David R Urbach MD MSc Outcomes Research Course December 4, 2014 Meta Analysis David R Urbach MD MSc Outcomes Research Course December 4, 2014 Overview Definitions Identifying studies Appraising studies Quantitative synthesis Presentation of results Examining heterogeneity

More information

Review Article Effect of Acupuncture on Heart Rate Variability: A Systematic Review

Review Article Effect of Acupuncture on Heart Rate Variability: A Systematic Review Evidence-Based Complementary and Alternative Medicine Volume, Article ID 819871, 19 pages http://dx.doi.org/10.15//819871 Review Article Effect of Acupuncture on Heart Rate Variability: A Systematic Review

More information

Authors' objectives To evaluate the efficacy of complementary and alternative therapies for the management of menopausal symptoms.

Authors' objectives To evaluate the efficacy of complementary and alternative therapies for the management of menopausal symptoms. Complementary and alternative therapies for the management of menopause-related symptoms: a systematic evidence review Nedrow A, Miller J, Walker M, Nygren P, Huffman L H, Nelson H D CRD summary This review

More information

PROSPERO International prospective register of systematic reviews

PROSPERO International prospective register of systematic reviews PROSPERO International prospective register of systematic reviews A systematic review of behaviour change interventions targeting physical activity, exercise and HbA1c in adults with type 2 diabetes Leah

More information

A Systematic Review of the Efficacy and Clinical Effectiveness of Group Analysis and Analytic/Dynamic Group Psychotherapy

A Systematic Review of the Efficacy and Clinical Effectiveness of Group Analysis and Analytic/Dynamic Group Psychotherapy A Systematic Review of the Efficacy and Clinical Effectiveness of Group Analysis and Analytic/Dynamic Group Psychotherapy Executive summary Aims of the review The main aim of the review was to assess the

More information

J Clin Oncol 30: by American Society of Clinical Oncology INTRODUCTION

J Clin Oncol 30: by American Society of Clinical Oncology INTRODUCTION VOLUME 30 NUMBER 36 DECEMBER 20 2012 JOURNAL OF CLINICAL ONCOLOGY O R I G I N A L R E P O R T for Cancer-Related Fatigue in Patients With Breast Cancer: A Pragmatic Randomized Controlled Trial Alexander

More information

Tammy Filby ( address: 4 th year undergraduate occupational therapy student, University of Western Sydney

Tammy Filby ( address: 4 th year undergraduate occupational therapy student, University of Western Sydney There is evidence from one RCT that an energy conservation course run by an occupational therapist decreased the impact of fatigue by 7% in persons with multiple sclerosis Prepared by; Tammy Filby (email

More information

Consumer summary: The effect of acupuncture-point stimulation for chemotherapyinduced nausea or vomiting

Consumer summary: The effect of acupuncture-point stimulation for chemotherapyinduced nausea or vomiting Consumer summary: The effect of acupuncture-point stimulation for chemotherapyinduced nausea or vomiting A of the effect of acupuncture-point stimulation for chemotherapy-induced nausea or vomiting was

More information

A research report of the therapeutic effects of yoga for health and wellbeing Prepared at ScHARR for the British Wheel of Yoga

A research report of the therapeutic effects of yoga for health and wellbeing Prepared at ScHARR for the British Wheel of Yoga A research report of the therapeutic effects of yoga for health and wellbeing Prepared at ScHARR for the British Wheel of Yoga About The British Wheel of Yoga The British Wheel of Yoga The British Wheel

More information

FATIGUE: PHARMACOLOGICAL AND NON-PHARMACOLOGICAL TREATMENT. Fausto Roila Medical Oncology Division, Terni, Italy

FATIGUE: PHARMACOLOGICAL AND NON-PHARMACOLOGICAL TREATMENT. Fausto Roila Medical Oncology Division, Terni, Italy FATIGUE: PHARMACOLOGICAL AND NON-PHARMACOLOGICAL TREATMENT Fausto Roila Medical Oncology Division, Terni, Italy CONFLICT OF INTERESTS NO CONFLICT FATIGUE: DEFINITION (ASCO, NCCN) Cancer-related fatigue

More information

Clinical Policy: Acupuncture Reference Number: PA.CP.MP.92

Clinical Policy: Acupuncture Reference Number: PA.CP.MP.92 Clinical Policy: Reference Number: PA.CP.MP.92 Effective Date: 01/18 Last Review Date: 11/18 Coding Implications Revision Log Description involves the manual and/or electrical stimulation of thin, solid,

More information

Fatigue Bigorio Professor Paddy Stone

Fatigue Bigorio Professor Paddy Stone Fatigue Bigorio 2013 Professor Paddy Stone Overview What is fatigue? How can fatigue be assessed? How can fatigue be treated? Guidelines? Fatigue is a subjective, unpleasant symptom which incorporates

More information

Cochrane Breast Cancer Group

Cochrane Breast Cancer Group Cochrane Breast Cancer Group Version and date: V3.2, September 2013 Intervention Cochrane Protocol checklist for authors This checklist is designed to help you (the authors) complete your Cochrane Protocol.

More information

Workshop: Cochrane Rehabilitation 05th May Trusted evidence. Informed decisions. Better health.

Workshop: Cochrane Rehabilitation 05th May Trusted evidence. Informed decisions. Better health. Workshop: Cochrane Rehabilitation 05th May 2018 Trusted evidence. Informed decisions. Better health. Disclosure I have no conflicts of interest with anything in this presentation How to read a systematic

More information

Integrative Medicine on Pain Management Is There Any

Integrative Medicine on Pain Management Is There Any Integrative Medicine on Pain Management Is There Any Evidence? Lixing LAO, MB, PhD Professor and Director of School of Chinese Medicine, The University of Hong Kong Overview Acupuncture Trials on Pain

More information

Acupuncture for tension-type headache (Review)

Acupuncture for tension-type headache (Review) Linde K, Allais G, Brinkhaus B, Manheimer E, Vickers A, White AR This is a reprint of a Cochrane review, prepared and maintained by The Cochrane Collaboration and published in The Cochrane Library 2009,

More information

Meta-analyses: analyses:

Meta-analyses: analyses: Meta-analyses: analyses: how do they help, and when can they not? Lee Hooper Senior Lecturer in research synthesis & nutrition l.hooper@uea.ac.uk 01603 591268 Aims Systematic Reviews Discuss the scientific

More information

T A B L E O F C O N T E N T S

T A B L E O F C O N T E N T S Short-term psychodynamic psychotherapies for anxiety, depression and somatoform disorders (Unknown) Abbass AA, Hancock JT, Henderson J, Kisely S This is a reprint of a Cochrane unknown, prepared and maintained

More information

Summaries of recent papers

Summaries of recent papers Summaries of recent papers CLINICAL EFFECTIVENESS TRIALS Effect of de qi in Bell s palsy Xu SB, Huang B, Zhang CY, et al. Effectiveness of strengthened stimulation during acupuncture for the treatment

More information

Instrument for the assessment of systematic reviews and meta-analysis

Instrument for the assessment of systematic reviews and meta-analysis Appendix II Annex II Instruments for the assessment of evidence As detailed in the main body of the methodological appendix (Appendix II, "Description of the methodology utilised for the collection, assessment

More information

Acupuncture in the Treatment of Cancer- Related Psychological Symptoms

Acupuncture in the Treatment of Cancer- Related Psychological Symptoms 520181ICTXXX10.1177/1534735413520181Integrative Cancer TherapiesHaddad and Palesh research-article2014 Article Acupuncture in the Treatment of Cancer- Related Psychological Symptoms Integrative Cancer

More information

Problem solving therapy

Problem solving therapy Introduction People with severe mental illnesses such as schizophrenia may show impairments in problem-solving ability. Remediation interventions such as problem solving skills training can help people

More information

Long term benefits of acupuncture for chronic pain: what makes a difference?

Long term benefits of acupuncture for chronic pain: what makes a difference? Long term benefits of acupuncture for chronic pain: what makes a difference? Hugh MacPherson www.hughmacpherson.com 1 Outline 1. Acupuncture for chronic pain the Acupuncture Trialists Collaboration, and

More information

Evidence profile. Physical Activity. Background on the scoping question. Population/Intervention/Comparison/Outcome (PICO)

Evidence profile. Physical Activity. Background on the scoping question. Population/Intervention/Comparison/Outcome (PICO) Evidence profile Q6: Is advice on physical activity better (more effective than/as safe as) than treatment as usual in adults with depressive episode/disorder with inactive lifestyles? Background on the

More information

Learning from Systematic Review and Meta analysis

Learning from Systematic Review and Meta analysis Learning from Systematic Review and Meta analysis Efficacy and Safety of Antiscabietic Agents: A Systematic Review and Network Meta analysis of Randomized Controlled Trials KUNLAWAT THADANIPON, MD 4 TH

More information

Alectinib Versus Crizotinib for Previously Untreated Alk-positive Advanced Non-small Cell Lung Cancer : A Meta-Analysis

Alectinib Versus Crizotinib for Previously Untreated Alk-positive Advanced Non-small Cell Lung Cancer : A Meta-Analysis Showa Univ J Med Sci 30 2, 309 315, June 2018 Original Alectinib Versus Crizotinib for Previously Untreated Alk-positive Advanced Non-small Cell Lung Cancer : A Meta-Analysis Ryo MANABE 1, Koichi ANDO

More information

Transcranial Direct-Current Stimulation

Transcranial Direct-Current Stimulation Introduction (tdcs) is a non-invasive form of brain stimulation similar to transcranial magnetic stimulation, but instead of using magnets, it uses a lowintensity, constant current applied through scalp

More information

Acupuncture for migraine prophylaxis (Review)

Acupuncture for migraine prophylaxis (Review) Linde K, Allais G, Brinkhaus B, Manheimer E, Vickers A, White AR This is a reprint of a Cochrane review, prepared and maintained by The Cochrane Collaboration and published in The Cochrane Library 2009,

More information

School of Dentistry. What is a systematic review?

School of Dentistry. What is a systematic review? School of Dentistry What is a systematic review? Screen Shot 2012-12-12 at 09.38.42 Where do I find the best evidence? The Literature Information overload 2 million articles published a year 20,000 biomedical

More information

Effects of Acupuncture on Chinese Adult Patients with Psoriatic Arthritis: A Prospective Cohort Study

Effects of Acupuncture on Chinese Adult Patients with Psoriatic Arthritis: A Prospective Cohort Study Effects of Acupuncture on Chinese Adult Patients with Psoriatic Arthritis: A Prospective Cohort Study Peiyi Chen 1, Tiantian Xin 2* and Yingchun Zeng 3,4 1 School of Nursing, Guangzhou University of Chinese

More information

GRADE. Grading of Recommendations Assessment, Development and Evaluation. British Association of Dermatologists April 2018

GRADE. Grading of Recommendations Assessment, Development and Evaluation. British Association of Dermatologists April 2018 GRADE Grading of Recommendations Assessment, Development and Evaluation British Association of Dermatologists April 2018 Previous grading system Level of evidence Strength of recommendation Level of evidence

More information

PROSPERO International prospective register of systematic reviews

PROSPERO International prospective register of systematic reviews PROSPERO International prospective register of systematic reviews The effect of probiotics on functional constipation: a systematic review of randomised controlled trials EIRINI DIMIDI, STEPHANOS CHRISTODOULIDES,

More information

PROSPERO International prospective register of systematic reviews

PROSPERO International prospective register of systematic reviews PROSPERO International prospective register of systematic reviews High-dose chemotherapy followed by autologous haematopoietic cell transplantation for children, adolescents and young adults with first

More information

Alcohol interventions in secondary and further education

Alcohol interventions in secondary and further education National Institute for Health and Care Excellence Guideline version (Draft for Consultation) Alcohol interventions in secondary and further education NICE guideline: methods NICE guideline Methods

More information

Meta-Analysis of Randomized Controlled Trial in Treating Primary Liver Cancer by Fufang Kushen Injection Combined with TACE

Meta-Analysis of Randomized Controlled Trial in Treating Primary Liver Cancer by Fufang Kushen Injection Combined with TACE 4th International Conference on Sustainable Energy and Environmental Engineering (ICSEEE 2015) Meta-Analysis of Randomized Controlled Trial in Treating Primary Liver Cancer by Fufang Kushen Injection Combined

More information

East Meets West: Treating Pain with Acupuncture

East Meets West: Treating Pain with Acupuncture East Meets West: Treating Pain with Acupuncture Lixing Lao, Ph.D., L.Ac. Professor and Director TCM Research Program, Center for Integrative Medicine University of Maryland School of Medicine Center for

More information

Migraine and Acupuncture

Migraine and Acupuncture BRIEFING PAPER No 1 Migraine and Acupuncture The evidence for effectiveness Edited and produced by the Acupuncture Research Resource Centre Published by the British Acupuncture Council June 1998 The Evidence

More information

PROSPERO International prospective register of systematic reviews

PROSPERO International prospective register of systematic reviews PROSPERO International prospective register of systematic reviews Prophylactic cranial irradiation in patients with non-small-cell lung cancer: a systematic review and meta-analysis of randomized controlled

More information

Research Article A Meta-Analysis of Randomized Controlled Trials on Acupuncture for Amblyopia

Research Article A Meta-Analysis of Randomized Controlled Trials on Acupuncture for Amblyopia Evidence-Based Complementary and Alternative Medicine Volume 2013, Article ID 648054, 6 pages http://dx.doi.org/10.1155/2013/648054 Research Article A Meta-Analysis of Randomized Controlled Trials on Acupuncture

More information

Keywords: Internet, obesity, web, weight loss. obesity reviews (2010) 11,

Keywords: Internet, obesity, web, weight loss. obesity reviews (2010) 11, obesity reviews doi: 10.1111/j.1467-789X.2009.00646.x Obesity Management Effectiveness of web-based interventions in achieving weight loss and weight loss maintenance in overweight and obese adults: a

More information

MINDFULNESS-BASED INTERVENTIONS IN EPILEPSY

MINDFULNESS-BASED INTERVENTIONS IN EPILEPSY 03 March 2016; v.1 MINDFULNESS-BASED INTERVENTIONS IN EPILEPSY AIM This review aimed to evaluate the effectiveness of mindfulness as a therapeutic intervention for people with epilepsy. METHODS Criteria

More information

The treatment of postnatal depression: a comprehensive literature review Boath E, Henshaw C

The treatment of postnatal depression: a comprehensive literature review Boath E, Henshaw C The treatment of postnatal depression: a comprehensive literature review Boath E, Henshaw C Authors' objectives To evalute treatments of postnatal depression. Searching MEDLINE, PsycLIT, Sociofile, CINAHL

More information

Background: Traditional rehabilitation after total joint replacement aims to improve the muscle strength of lower limbs,

Background: Traditional rehabilitation after total joint replacement aims to improve the muscle strength of lower limbs, REVIEWING THE EFFECTIVENESS OF BALANCE TRAINING BEFORE AND AFTER TOTAL KNEE AND TOTAL HIP REPLACEMENT: PROTOCOL FOR A SYSTEMATIC RE- VIEW AND META-ANALYSIS Background: Traditional rehabilitation after

More information

Specific question: Does acupuncture improve pain, function and quality of life for adults with fibromyalgia?

Specific question: Does acupuncture improve pain, function and quality of life for adults with fibromyalgia? Specific question: Does acupuncture improve pain, function and quality of life for adults with fibromyalgia? Clinical bottom line There is low to moderate level evidence that western and electro acupuncture

More information

Results. NeuRA Herbal medicines August 2016

Results. NeuRA Herbal medicines August 2016 Introduction have been suggested as a potential alternative treatment which may positively contribute to the treatment of schizophrenia. Herbal therapies can include traditional Chinese medicines and Indian

More information

The effects of cognitive behaviour therapy for major depression in older adults

The effects of cognitive behaviour therapy for major depression in older adults The effects of cognitive behaviour therapy for major depression in older adults Submitted by Rasika Sirilal Jayasekara RN, BA (Sri Lanka), BScN (Hons) (Sri Lanka), PG Dip Ed (Sri Lanka), MNSc (Adelaide),

More information

Review Article Wrist-Ankle Acupuncture for the Treatment of Pain Symptoms: A Systematic Review and Meta-Analysis

Review Article Wrist-Ankle Acupuncture for the Treatment of Pain Symptoms: A Systematic Review and Meta-Analysis Hindawi Publishing Corporation Evidence-Based Complementary and Alternative Medicine Volume 2014, Article ID 261709, 9 pages http://dx.doi.org/10.1155/2014/261709 Review Article Wrist-Ankle Acupuncture

More information

Study selection Study designs of evaluations included in the review Diagnosis.

Study selection Study designs of evaluations included in the review Diagnosis. Diagnosis and treatment of worker-related musculoskeletal disorders of the upper extremity: epicondylitis Chapell R, Bruening W, Mitchell M D, Reston J T, Treadwell J R Authors' objectives The objectives

More information

Appendix Document A1: Search strategy for Medline (1960 November 2015)

Appendix Document A1: Search strategy for Medline (1960 November 2015) Appendices: Appendix Document A1: Search strategy for Medline (1960 November 2015) Appendix Table A1: Detailed Risk of Bias Table Appendix Figure A1: Funnel plot Appendix Figure A2: Sensitivity analysis

More information

Database of Abstracts of Reviews of Effects (DARE) Produced by the Centre for Reviews and Dissemination Copyright 2017 University of York.

Database of Abstracts of Reviews of Effects (DARE) Produced by the Centre for Reviews and Dissemination Copyright 2017 University of York. A comparison of the cost-effectiveness of five strategies for the prevention of non-steroidal anti-inflammatory drug-induced gastrointestinal toxicity: a systematic review with economic modelling Brown

More information

Distraction techniques

Distraction techniques Introduction are a form of coping skills enhancement, taught during cognitive behavioural therapy. These techniques are used to distract and draw attention away from the auditory symptoms of schizophrenia,

More information

Background. Population/Intervention(s)/Comparison/Outcome(s) (PICO) Brief structured psychological treatment

Background. Population/Intervention(s)/Comparison/Outcome(s) (PICO) Brief structured psychological treatment updated 2012 Brief structured psychological treatment Q 3: Is brief, structured psychological treatment in non-specialist health care settings better (more effective than/as safe as) than treatment as

More information

of interventions to promote healthy lifestyle behaviours

of interventions to promote healthy lifestyle behaviours A systematic overview of reviews of the effectiveness and cost effectiveness of interventions to promote healthy lifestyle behaviours in people living with or beyond cancer. Brunel University London RAND

More information

This Sense, other Interventions that Focus on the Strengthening of. the Co-Parenting Relationship are Recommended

This Sense, other Interventions that Focus on the Strengthening of. the Co-Parenting Relationship are Recommended ISSN: 2576-4772 This Sense, other Interventions that Focus on the Strengthening of the Co-Parenting Relationship are Recommended Liping Ma, Haiyong Chen, YanboZhang and WeiMeng* Hong Kong Branch of zhu

More information

Review Article The Immediate Analgesic Effect of Acupuncture for Pain: A Systematic Review and Meta-Analysis

Review Article The Immediate Analgesic Effect of Acupuncture for Pain: A Systematic Review and Meta-Analysis Hindawi Evidence-Based Complementary and Alternative Medicine Volume 2017, Article ID 3837194, 13 pages https://doi.org/10.1155/2017/3837194 Review Article The Immediate Analgesic Effect of Acupuncture

More information

Surveillance report Published: 13 April 2017 nice.org.uk. NICE All rights reserved.

Surveillance report Published: 13 April 2017 nice.org.uk. NICE All rights reserved. Surveillance report 2017 Antisocial behaviour and conduct disorders in children and young people: recognition and management (2013) NICE guideline CG158 Surveillance report Published: 13 April 2017 nice.org.uk

More information

adherence research Introduction Breast cancer is the most common cancer diagnosis among women in the United States,

adherence research Introduction Breast cancer is the most common cancer diagnosis among women in the United States, Psychosocial factors in adjuvant hormone therapy for breast cancer: An emerging context for adherence research Introduction Breast cancer is the most common cancer diagnosis among women in the United States,

More information

Review Article The Effectiveness and Safety of Acupuncture for Patients with Chronic Urticaria: A Systematic Review

Review Article The Effectiveness and Safety of Acupuncture for Patients with Chronic Urticaria: A Systematic Review BioMed Research International Volume 2016, Article ID 5191729, 7 pages http://dx.doi.org/10.1155/2016/5191729 Review Article The Effectiveness and Safety of Acupuncture for Patients with Chronic Urticaria:

More information

Controlled Trials. Spyros Kitsiou, PhD

Controlled Trials. Spyros Kitsiou, PhD Assessing Risk of Bias in Randomized Controlled Trials Spyros Kitsiou, PhD Assistant Professor Department of Biomedical and Health Information Sciences College of Applied Health Sciences University of

More information

Animal-assisted therapy

Animal-assisted therapy Introduction Animal-assisted interventions use trained animals to help improve physical, mental and social functions in people with schizophrenia. It is a goal-directed intervention in which an animal

More information

NB: This chapter is a concise version of the full Cochrane review

NB: This chapter is a concise version of the full Cochrane review CHAPTER 5 Non-pharmacological interventions for somatoform disorders and medically unexplained physical symptoms (MUPS) in adults Nikki Claassen- van Dessel Madelon den Boeft Johannes C van der Wouden

More information

Qigong for healthcare: an overview of systematic reviews

Qigong for healthcare: an overview of systematic reviews RESEARCH Qigong for healthcare: an overview of systematic reviews Myeong Soo 1,2 Byeongsang Oh 3 Edzard Ernst 2 1 Brain Disease Research Centre, Institute of Oriental Medicine, Daejeon, South 2 Complementary

More information

Randomized controlled trials of psychological therapies for management of chronic pain in children and adolescents: An updated meta-analytic review

Randomized controlled trials of psychological therapies for management of chronic pain in children and adolescents: An updated meta-analytic review PAIN Ò 148 (2010) 387 397 www.elsevier.com/locate/pain Randomized controlled trials of psychological therapies for management of chronic pain in children and adolescents: An updated meta-analytic review

More information

PROSPERO International prospective register of systematic reviews

PROSPERO International prospective register of systematic reviews PROSPERO International prospective register of systematic reviews Effectiveness of progressive muscle relaxation training for adults diagnosed with schizophrenia: a systematic review protocol Carlos Melo-Dias,

More information

Data extraction. Specific interventions included in the review Dressings and topical agents in relation to wound healing.

Data extraction. Specific interventions included in the review Dressings and topical agents in relation to wound healing. Systematic reviews of wound care management: (2) dressings and topical agents used in the healing of chronic wounds Bradley M, Cullum N, Nelson E A, Petticrew M, Sheldon T, Torgerson D Authors' objectives

More information

PROSPERO International prospective register of systematic reviews

PROSPERO International prospective register of systematic reviews PROSPERO International prospective register of systematic reviews Closed reduction methods for acute anterior shoulder dislocation [Cochrane Protocol] Kanthan Theivendran, Raj Thakrar, Subodh Deshmukh,

More information

NeuRA Sleep disturbance April 2016

NeuRA Sleep disturbance April 2016 Introduction People with schizophrenia may show disturbances in the amount, or the quality of sleep they generally receive. Typically sleep follows a characteristic pattern of four stages, where stage

More information

2. The effectiveness of combined androgen blockade versus monotherapy.

2. The effectiveness of combined androgen blockade versus monotherapy. Relative effectiveness and cost-effectiveness of methods of androgen suppression in the treatment of advanced prostate cancer Blue Cross and Blue Shield Association, Aronson N, Seidenfeld J Authors' objectives

More information

The QUOROM Statement: revised recommendations for improving the quality of reports of systematic reviews

The QUOROM Statement: revised recommendations for improving the quality of reports of systematic reviews The QUOROM Statement: revised recommendations for improving the quality of reports of systematic reviews David Moher 1, Alessandro Liberati 2, Douglas G Altman 3, Jennifer Tetzlaff 1 for the QUOROM Group

More information

Traumatic brain injury

Traumatic brain injury Introduction It is well established that traumatic brain injury increases the risk for a wide range of neuropsychiatric disturbances, however there is little consensus on whether it is a risk factor for

More information

Citation for published version (APA): Weert, E. V. (2007). Cancer rehabilitation: effects and mechanisms s.n.

Citation for published version (APA): Weert, E. V. (2007). Cancer rehabilitation: effects and mechanisms s.n. University of Groningen Cancer rehabilitation Weert, Ellen van IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document

More information

Randomized Clinical Trials of Constitutional Acupuncture: A Systematic Review

Randomized Clinical Trials of Constitutional Acupuncture: A Systematic Review ecam 2009;6(S1)59 64 doi:10.1093/ecam/nep085 Review Randomized Clinical Trials of Constitutional Acupuncture: A Systematic Review Myeong Soo Lee 1, Byung-Cheul Shin 2, Sun-Mi Choi 1 and Jong Yeol Kim 1

More information

Follow this and additional works at: Part of the Medicine and Health Sciences Commons

Follow this and additional works at:   Part of the Medicine and Health Sciences Commons Philadelphia College of Osteopathic Medicine DigitalCommons@PCOM PCOM Physician Assistant Studies Student Scholarship Student Dissertations, Theses and Papers 2018 Is Acupuncture an Effective Adjunct Therapy

More information

Downloaded from:

Downloaded from: Arnup, SJ; Forbes, AB; Kahan, BC; Morgan, KE; McKenzie, JE (2016) The quality of reporting in cluster randomised crossover trials: proposal for reporting items and an assessment of reporting quality. Trials,

More information

Intramuscular stimulation therapy for healthcare: a systematic review of randomised controlled trials

Intramuscular stimulation therapy for healthcare: a systematic review of randomised controlled trials 1 Medical Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea 2 Department of Internal Medicine, Jaseng Hospital of Oriental Medicine, Bucheon, South Korea 3 Complementary Medicine,

More information

Results. NeuRA Mindfulness and acceptance therapies August 2018

Results. NeuRA Mindfulness and acceptance therapies August 2018 Introduction involve intentional and non-judgmental focus of one's attention on emotions, thoughts and sensations that are occurring in the present moment. The aim is to open awareness to present experiences,

More information

USDA Nutrition Evidence Library: Systematic Review Methodology

USDA Nutrition Evidence Library: Systematic Review Methodology USDA Nutrition Evidence Library: Systematic Review Methodology Julie E. Obbagy, PhD, RD USDA Center for Nutrition Policy & Promotion Meeting #2 October 17, 2016 The National Academies of Sciences, Engineering,

More information

We recommend you cite the published version. The publisher s URL is:

We recommend you cite the published version. The publisher s URL is: Cramp, F. A. and Byron-Daniel, J. Z. (2012) Exercise for the management of cancer related fatigue in adults. Cochrane Database of Systematic Reviews, 11 (131). ISSN 1469-493X Available from: http://eprints.uwe.ac.uk/18700

More information

Results. NeuRA Hypnosis June 2016

Results. NeuRA Hypnosis June 2016 Introduction may be experienced as an altered state of consciousness or as a state of relaxation. There is no agreed framework for administering hypnosis, but the procedure often involves induction (such

More information

Acupuncture and moxibustion for lateral elbow pain: a systematic review of randomized controlled trials

Acupuncture and moxibustion for lateral elbow pain: a systematic review of randomized controlled trials Gadau et al. BMC Complementary and Alternative Medicine 2014, 14:136 RESEARCH ARTICLE Open Access Acupuncture and moxibustion for lateral elbow pain: a systematic review of randomized controlled trials

More information

Systematic review: The effectiveness and safety of diclofenac for the. pain management after cesarean

Systematic review: The effectiveness and safety of diclofenac for the. pain management after cesarean Systematic review: The effectiveness and safety of diclofenac for the pain management after cesarean ABSTRACT This is the protocol of systematic review and there is no abstract. The objective is to evaluate

More information

NeuRA Obsessive-compulsive disorders October 2017

NeuRA Obsessive-compulsive disorders October 2017 Introduction (OCDs) involve persistent and intrusive thoughts (obsessions) and repetitive actions (compulsions). The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) defines

More information

Inpatient Acupuncture at a Major Cancer Center

Inpatient Acupuncture at a Major Cancer Center 685403ICTXXX10.1177/1534735416685403Integrative Cancer TherapiesGarcia et al research-article2017 Research Article Inpatient Acupuncture at a Major Cancer Center Integrative Cancer Therapies 2018, Vol.

More information

Results. NeuRA Treatments for internalised stigma December 2017

Results. NeuRA Treatments for internalised stigma December 2017 Introduction Internalised stigma occurs within an individual, such that a person s attitude may reinforce a negative self-perception of mental disorders, resulting in reduced sense of selfworth, anticipation

More information

a treatment for ED were considered for inclusion, and their methodological quality was assessed using the Jadad score.

a treatment for ED were considered for inclusion, and their methodological quality was assessed using the Jadad score. . JOURNAL COMPILATION 2009 BJU INTERNATIONAL Sexual Medicine SYSTEMATIC REVIEW OF ACUPUNCTURE FOR ERECTILE DYSFUNCTION LEE et al. BJUI BJU INTERNATIONAL Acupuncture for treating erectile dysfunction: a

More information

Evidence tabellen thema Interventies: Preventie van angst bij jeugdigen en niveau van bewijsvoering

Evidence tabellen thema Interventies: Preventie van angst bij jeugdigen en niveau van bewijsvoering Evidence tabellen thema Interventies: Preventie van angst bij jeugdigen en niveau van bewijsvoering In deze evidence tabellen word de drie meta analyses en systematische reviews beschreven die in dit hoofdstuk

More information

Acupuncture , The Patient Education Institute, Inc. amf00102 Last reviewed: 06/23/2017 1

Acupuncture , The Patient Education Institute, Inc.   amf00102 Last reviewed: 06/23/2017 1 Acupuncture Introduction Acupuncture is the practice of inserting thin needles into specific body points to improve health and well-being. It originated in China more than 2,000 years ago. Research has

More information

A Critical Review of the Effects of Medical Qigong on Quality of Life, Immune Function, and Survival in Cancer Patients

A Critical Review of the Effects of Medical Qigong on Quality of Life, Immune Function, and Survival in Cancer Patients 413268ICT11210.1177/153473541141 3268Oh et alintegrative Cancer Therapies The Author(s) 2012 Reprints and permission: http://www. sagepub.com/journalspermissions.nav A Critical Review of the Effects of

More information

Review Article Acupuncture for Low Back Pain: An Overview of Systematic Reviews

Review Article Acupuncture for Low Back Pain: An Overview of Systematic Reviews Hindawi Publishing Corporation Evidence-Based Complementary and Alternative Medicine Volume 2015, Article ID 328196, 18 pages http://dx.doi.org/10.1155/2015/328196 Review Article Acupuncture for Low Back

More information

Morbidity after lymph node dissection in patients with cancer: Incidence, risk factors, and prevention Stuiver, M.M.

Morbidity after lymph node dissection in patients with cancer: Incidence, risk factors, and prevention Stuiver, M.M. UvA-DARE (Digital Academic Repository) Morbidity after lymph node dissection in patients with cancer: Incidence, risk factors, and prevention Stuiver, M.M. Link to publication Citation for published version

More information