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Ma YY, Hao Z, Chen ZY, Shen YX, Liu HR, Wu HG, Bao CH. Acupuncture and moxibustion for irritable bowel syndrome: An umbrella systematic review. J Integr Med 2024; 22:22-31. [PMID: 38199885 DOI: 10.1016/j.joim.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 11/09/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is a functional bowel disease characterized by abdominal pain or discomfort associated with altered bowel habits. Several clinical studies have demonstrated the effectiveness of acupuncture and moxibustion for IBS. Many systematic reviews of acupuncture and moxibustion for IBS have been published in recent years, but their results are not entirely consistent. OBJECTIVE To evaluate the methodological, reporting, and evidence quality of systematic reviews of acupuncture and moxibustion for IBS. SEARCH STRATEGY Systematic reviews of acupuncture and moxibustion for IBS published before February 20, 2023 were searched in eight databases: PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Data, VIP Database for Chinese Technical Periodicals, and China Biology Medicine. The keywords used for literature search were acupuncture, moxibustion, systematic review, meta-analysis, and irritable bowel syndrome. INCLUSION CRITERIA Systematic reviews and meta-analyses of randomized controlled trials of acupuncture and moxibustion for IBS were included. DATA EXTRACTION AND ANALYSIS Relevant information was independently extracted by two investigators. The A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR 2), Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020), and Grading of Recommendations Assessment, Development and Evaluation (GRADE) were used to evaluate the methodological quality, reporting quality and evidence quality, respectively. RESULTS A total of 342 studies were retrieved and 15 systematic reviews were included. The results of AMSTAR 2 showed low methodological quality in 2 studies and very low methodological quality in the remaining 13 studies, with main issues being failure to register a protocol, incomplete search strategy, not providing a list of excluded studies, incomplete consideration of the risk of bias in the included studies, and a failure to assess the publication bias. The results of PRISMA 2020 showed seriously deficient reporting quality of 2 studies, somewhat deficient reporting quality of 12 studies, and relatively complete reporting quality of 1 study, with the main problems being lack of a complete search strategy, non-availability of a list of excluded studies with justification for their exclusion, not conducting heterogeneity and sensitivity analyses, not evaluating the credibility of the evidence, and not registering the protocol. The results of GRADE showed that the quality of the evidence is low or very low. CONCLUSION Most included systematic reviews interpreted findings to suggest that acupuncture and moxibustion have benefits for IBS. However, there is a need to improve the methodological, reporting and evidence quality of the systematic reviews. Larger, multicenter, rigorously designed randomized controlled trials and high-quality systematic reviews are required to obtain more robust evidence. PLEASE CITE THIS ARTICLE AS Ma YY, Hao Z, Chen ZY, Shen YX, Liu HR, Wu HG, Bao CH. Acupuncture and moxibustion for irritable bowel syndrome: An umbrella systematic review. J Integr Med. 2024; 22(1): 22-31.
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Affiliation(s)
- Yue-Ying Ma
- Shanghai Clinical Research Centre for Acupuncture and Moxibustion, Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Zhou Hao
- Shanghai Clinical Research Centre for Acupuncture and Moxibustion, Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Zi-Yi Chen
- Shanghai Clinical Research Centre for Acupuncture and Moxibustion, Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Key Laboratory of Acupuncture and Immunological Effects, Shanghai University of Traditional Chinese Medicine, Shanghai 200030, China
| | - Yan-Xi Shen
- Shanghai Clinical Research Centre for Acupuncture and Moxibustion, Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Hui-Rong Liu
- Shanghai Clinical Research Centre for Acupuncture and Moxibustion, Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Key Laboratory of Acupuncture and Immunological Effects, Shanghai University of Traditional Chinese Medicine, Shanghai 200030, China
| | - Huan-Gan Wu
- Shanghai Clinical Research Centre for Acupuncture and Moxibustion, Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Key Laboratory of Acupuncture and Immunological Effects, Shanghai University of Traditional Chinese Medicine, Shanghai 200030, China.
| | - Chun-Hui Bao
- Shanghai Clinical Research Centre for Acupuncture and Moxibustion, Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Key Laboratory of Acupuncture and Immunological Effects, Shanghai University of Traditional Chinese Medicine, Shanghai 200030, China.
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Aleksovska K, Puggina A, Giraldi L, Buck C, Burns C, Cardon G, Carlin A, Chantal S, Ciarapica D, Colotto M, Condello G, Coppinger T, Cortis C, D'Haese S, De Craemer M, Di Blasio A, Hansen S, Iacoviello L, Issartel J, Izzicupo P, Jaeschke L, Kanning M, Kennedy A, Ling F, Luzak A, Napolitano G, Nazare JA, Perchoux C, Pischon T, Polito A, Sannella A, Schulz H, Sohun R, Steinbrecher A, Schlicht W, Ricciardi W, MacDonncha C, Capranica L, Boccia S. Biological determinants of physical activity across the life course: a "Determinants of Diet and Physical Activity" (DEDIPAC) umbrella systematic literature review. Sports Med Open 2019; 5:2. [PMID: 30617718 PMCID: PMC6325050 DOI: 10.1186/s40798-018-0173-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 11/30/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Despite the large number of studies and reviews available, the evidence regarding the biological determinants of physical activity (PA) is inconclusive. In this umbrella review, we summarized the current evidence on the biological determinants of PA across the life course, by pooling the results of the available systematic literature reviews (SLRs) and meta-analyses (MAs). METHODS We conducted an online search on MEDLINE, ISI Web of Science, Scopus, and SPORTDiscus databases up to January 2018. SLRs and MAs of observational studies that investigated the association between biological determinants of PA and having PA as outcome were considered eligible. The extracted data were assessed based on the importance of the determinants, the strength of evidence, and the methodological quality. RESULTS We identified 19 reviews of which most were of moderate methodological quality. Determinants that were studied most frequently among all ages and demonstrated evidence suggesting a positive association to PA were younger age, being male, higher health status, and higher physical fitness levels. Among adults, normal birth weight was found to be positively associated to PA with convincing strength of evidence, while findings among adolescents were inconsistent and with limited strength of evidence. CONCLUSIONS Different social or behavioral factors may contribute to the decrease of PA with age and among females versus males, and creating programmes targeted at diverse ages, female population, and adults with abnormal birth weight is recommended. Future studies should use prospective study designs, standardized definitions of PA, and objective measurement methods of PA assessment.
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Affiliation(s)
- Katina Aleksovska
- Università Cattolica del Sacro Cuore, Sezione di Igiene, Istituto di Sanità Pubblica, Rome, Italy
| | - Anna Puggina
- Università Cattolica del Sacro Cuore, Sezione di Igiene, Istituto di Sanità Pubblica, Rome, Italy.
| | - Luca Giraldi
- Università Cattolica del Sacro Cuore, Sezione di Igiene, Istituto di Sanità Pubblica, Rome, Italy
| | - Christoph Buck
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Con Burns
- Department of Sport, Leisure and Childhood Studies, Cork Institute of Technology, Cork, Munster, Ireland
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Angela Carlin
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Simon Chantal
- Department of Applied Sciences in Physical Activity and Management, Catholic University of Valencia "San Vicente Mártir", Valencia, Spain
| | - Donatella Ciarapica
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome, Italy
| | - Marco Colotto
- Università Cattolica del Sacro Cuore, Sezione di Igiene, Istituto di Sanità Pubblica, Rome, Italy
| | - Giancarlo Condello
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - Tara Coppinger
- Department of Sport, Leisure and Childhood Studies, Cork Institute of Technology, Cork, Munster, Ireland
| | - Cristina Cortis
- Department of Human Sciences, Society, and Health, University of Cassino and Lazio Meridionale, Cassino, Italy
| | - Sara D'Haese
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Marieke De Craemer
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Andrea Di Blasio
- Department of Medicine and Aging Sciences, G. d'Annunzio' University of Chieti-Pescara, Chieti and Pescara, Italy
| | - Sylvia Hansen
- Department of Sport and Exercise Sciences, University of Stuttgart, Stuttgart, Germany
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo: NEUROMED, Pozzilli, Italy
| | - Johann Issartel
- School of Health and Human Performance, Multisensory Motor Learning Lab, Dublin City University, Dublin, Ireland
| | - Pascal Izzicupo
- Department of Medicine and Aging Sciences, G. d'Annunzio' University of Chieti-Pescara, Chieti and Pescara, Italy
| | - Lina Jaeschke
- Molecular Epidemiology Group, Max Delbruck Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Martina Kanning
- Department of Sport and Exercise Sciences, University of Stuttgart, Stuttgart, Germany
| | - Aileen Kennedy
- Centre for Preventive Medicine, School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Fiona Ling
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland.,Institute of Sport, Exercise & Active Living, Victoria University, Melbourne, Australia
| | - Agnes Luzak
- Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Giorgio Napolitano
- Department of Medicine and Aging Sciences, G. d'Annunzio' University of Chieti-Pescara, Chieti and Pescara, Italy
| | - Julie-Anne Nazare
- Centre de Recherche en Nutrition Humaine Rhône-Alpes, CarMeN INSERM U1060, University of Lyon1, Lyon, France
| | - Camille Perchoux
- Centre de Recherche en Nutrition Humaine Rhône-Alpes, CarMeN INSERM U1060, University of Lyon1, Lyon, France
| | - Tobias Pischon
- Molecular Epidemiology Group, Max Delbruck Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Angela Polito
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome, Italy
| | - Alessandra Sannella
- Department of Human Sciences, Society, and Health, University of Cassino and Lazio Meridionale, Cassino, Italy
| | - Holger Schulz
- Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Rhoda Sohun
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Astrid Steinbrecher
- Molecular Epidemiology Group, Max Delbruck Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Wolfgang Schlicht
- Department of Sport and Exercise Sciences, University of Stuttgart, Stuttgart, Germany
| | - Walter Ricciardi
- Università Cattolica del Sacro Cuore, Sezione di Igiene, Istituto di Sanità Pubblica, Rome, Italy.,Italian National Institute of Health, (Istituto Superiore di Sanita - ISS), Rome, Italy
| | - Ciaran MacDonncha
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Laura Capranica
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - Stefania Boccia
- Università Cattolica del Sacro Cuore, Sezione di Igiene, Istituto di Sanità Pubblica, Rome, Italy.,Fondazione Policlinico Universitario A.Gemelli IRCCS, UOC Igiene Ospedaliera, Roma, Italia
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Thomson K, Bambra C, McNamara C, Huijts T, Todd A. The effects of public health policies on population health and health inequalities in European welfare states: protocol for an umbrella review. Syst Rev 2016; 5:57. [PMID: 27059307 PMCID: PMC4826536 DOI: 10.1186/s13643-016-0235-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 04/04/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The welfare state is potentially an important macro-level determinant of health that also moderates the extent, and impact, of socio-economic inequalities in exposure to the social determinants of health. The welfare state has three main policy domains: health care, social policy (e.g. social transfers and education) and public health policy. This is the protocol for an umbrella review to examine the latter; its aim is to assess how European welfare states influence the social determinants of health inequalities institutionally through public health policies. METHODS/DESIGN A systematic review methodology will be used to identify systematic reviews from high-income countries (including additional EU-28 members) that describe the health and health equity effects of upstream public health interventions. Interventions will focus on primary and secondary prevention policies including fiscal measures, regulation, education, preventative treatment and screening across ten public health domains (tobacco; alcohol; food and nutrition; reproductive health services; the control of infectious diseases; screening; mental health; road traffic injuries; air, land and water pollution; and workplace regulations). Twenty databases will be searched using a pre-determined search strategy to evaluate population-level public health interventions. DISCUSSION Understanding the impact of specific public health policy interventions will help to establish causality in terms of the effects of welfare states on population health and health inequalities. The review will document contextual information on how population-level public health interventions are organised, implemented and delivered. This information can be used to identify effective interventions that could be implemented to reduce health inequalities between and within European countries. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016025283.
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Affiliation(s)
- Katie Thomson
- Centre for Health and Inequalities Research, Department of Geography, Durham University, Lower Mountjoy, South Road, Durham, DH1 3LE, UK.
| | - Clare Bambra
- Centre for Health and Inequalities Research, Department of Geography, Durham University, Lower Mountjoy, South Road, Durham, DH1 3LE, UK
| | - Courtney McNamara
- Department of Sociology and Political Science, Norwegian University of Science and Technology, Dragvoll, Building 9, Level 5, 7491, Trondheim, Norway
| | - Tim Huijts
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Yvonne Carter Building, 58 Turner Street, Whitechapel, London, E1 2AB, UK
| | - Adam Todd
- Centre for Health and Inequalities Research, Department of Geography, Durham University, Lower Mountjoy, South Road, Durham, DH1 3LE, UK.,Division of Pharmacy, School of Medicine, Pharmacy and Health, Durham University, Stockton-on-Tees, TS17 6BH, UK
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Murad MH, Altayar O, Bennett M, Wei JC, Claus PL, Asi N, Prokop LJ, Montori VM, Guyatt GH. Using GRADE for evaluating the quality of evidence in hyperbaric oxygen therapy clarifies evidence limitations. J Clin Epidemiol 2013; 67:65-72. [PMID: 24189086 DOI: 10.1016/j.jclinepi.2013.08.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 07/26/2013] [Accepted: 08/15/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The current evidence rating for hyperbaric oxygen therapy indications uses the American Heart Association system, which mainly depends on the study design. STUDY DESIGN AND SETTING We systematically reviewed the literature and applied the Grading of Evidence, Assessment, Development and Evaluation (GRADE) approach to the main patient-important outcomes in each indication. RESULTS We included 17 systematic reviews that synthesized 44 randomized trials and 131 observational studies enrolling 8,145 participants. The quality of evidence for seven indications with category A was high (1), moderate (2), low (2), and very low (2); for 10 indications with category B, it was moderate (1), low (5), and very low (4); and for 1 indication with category C, it was high. The quality of evidence was rated down for the risk of bias and imprecision for most indications and rated up because of large effect size for some indications. Most discrepant ratings were in the indications of decompression illness (C, high), carbon monoxide poisoning (A, very low), and later presentations of idiopathic sudden hearing loss (A, very low). CONCLUSION The GRADE approach uncovered factors affecting the quality of evidence that were otherwise implicit. Knowing these factors can influence clinicians' confidence in applying hyperbaric oxygen therapy and orient the research agenda.
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Affiliation(s)
- Mohammad Hassan Murad
- Division of Preventive, Occupational and Aerospace Medicine, Mayo Clinic, 200 1st Street, Rochester, MN 55902, USA; Knowledge and Evaluation Research Unit, Mayo Clinic, 200 1st Street, Rochester, MN 55902, USA.
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