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Nault D, Machingo TA, Shipper AG, Antiporta DA, Hamel C, Nourouzpour S, Konstantinidis M, Phillips E, Lipski EA, Wieland LS. Zinc for prevention and treatment of the common cold. Cochrane Database Syst Rev 2024; 5:CD014914. [PMID: 38719213 PMCID: PMC11078591 DOI: 10.1002/14651858.cd014914.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
BACKGROUND The common cold is an acute, self-limiting viral respiratory illness. Symptoms include nasal congestion and mucus discharge, sneezing, sore throat, cough, and general malaise. Given the frequency of colds, they are a public health burden and a significant cause of lost work productivity and school absenteeism. There are no established interventions to prevent colds or shorten their duration. However, zinc supplements are commonly recommended and taken for this purpose. OBJECTIVES To assess the effectiveness and safety of zinc for the prevention and treatment of the common cold. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, and LILACS to 22 May 2023, and searched Web of Science Core Collection and two trials registries to 14 June 2023. We also used reference checking, citation searching, and contact with study authors to identify additional studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) in children or adults that tested any form of zinc against placebo to prevent or treat the common cold or upper respiratory infection (URTI). We excluded zinc interventions in which zinc was combined with other minerals, vitamins, or herbs (e.g. a multivitamin, or mineral supplement containing zinc). DATA COLLECTION AND ANALYSIS We used the Cochrane risk of bias tool to assess risks of bias, and GRADE to assess the certainty of the evidence. We independently extracted data. When necessary, we contacted study authors for additional information. We assessed zinc (type and route) with placebo in the prevention and treatment of the common cold. Primary outcomes included the proportion of participants developing colds (for analyses of prevention trials only), duration of cold (measured in days from start to resolution of the cold), adverse events potentially due to zinc supplements (e.g. unpleasant taste, loss of smell, vomiting, stomach cramps, and diarrhoea), and adverse events considered to be potential complications of the common cold (e.g. respiratory bacterial infections). MAIN RESULTS We included 34 studies (15 prevention, 19 treatment) involving 8526 participants. Twenty-two studies were conducted on adults and 12 studies were conducted on children. Most trials were conducted in the USA (n = 18), followed by India, Indonesia, Iran, and Turkey (two studies each), and Australia, Burkina Faso, Colombia, Denmark, Finland, Tanzania, Thailand, and the UK (one study each). The 15 prevention studies identified the condition as either common cold (n = 8) or URTI (n = 7). However, almost all therapeutic studies (17/19) focused on the common cold. Most studies (17/34) evaluated the effectiveness of zinc administered as lozenges (3 prevention; 14 treatment) in acetate, gluconate, and orotate forms; gluconate lozenges were the most common (9/17). Zinc gluconate was given at doses between 45 and 276 mg/day for between 4.5 and 21 days. Five (5/17) lozenge studies gave acetate lozenges and two (2/17) gave both acetate and gluconate lozenges. One (1/17) lozenge study administered intranasal (gluconate) and lozenge (orotate) zinc in tandem for cold treatment. Of the 17/34 studies that did not use lozenges, 1/17 gave capsules, 3/17 administered dissolved powders, 5/17 gave tablets, 4/17 used syrups, and 4/17 used intranasal administration. Most studies were at unclear or high risk of bias in at least one domain. There may be little or no reduction in the risk of developing a cold with zinc compared to placebo (risk ratio (RR) 0.93, 95% CI 0.85 to 1.01; I2 = 20%; 9 studies, 1449 participants; low-certainty evidence). There may be little or no reduction in the mean number of colds that occur over five to 18 months of follow-up (mean difference (MD) -0.90, 95% CI -1.93 to 0.12; I2 = 96%; 2 studies, 1284 participants; low-certainty evidence). When colds occur, there is probably little or no difference in the duration of colds in days (MD -0.63, 95% CI -1.29 to 0.04; I² = 77%; 3 studies, 740 participants; moderate-certainty evidence), and there may be little or no difference in global symptom severity (standardised mean difference (SMD) 0.04, 95% CI -0.35 to 0.43; I² = 0%; 2 studies, 101 participants; low-certainty evidence). When zinc is used for cold treatment, there may be a reduction in the mean duration of the cold in days (MD -2.37, 95% CI -4.21 to -0.53; I² = 97%; 8 studies, 972 participants; low-certainty evidence), although it is uncertain whether there is a reduction in the risk of having an ongoing cold at the end of follow-up (RR 0.52, 95% CI 0.21 to 1.27; I² = 65%; 5 studies, 357 participants; very low-certainty evidence), or global symptom severity (SMD -0.03, 95% CI -0.56 to 0.50; I² = 78%; 2 studies, 261 participants; very low-certainty evidence), and there may be little or no difference in the risk of a change in global symptom severity (RR 1.02, 95% CI 0.85 to 1.23; 1 study, 114 participants; low-certainty evidence). Thirty-one studies reported non-serious adverse events (2422 participants). It is uncertain whether there is a difference in the risk of adverse events with zinc used for cold prevention (RR 1.11, 95% CI 0.84 to 1.47; I2 = 0%; 7 studies, 1517 participants; very low-certainty evidence) or an increase in the risk of serious adverse events (RR 1.67, 95% CI 0.78 to 3.57; I2 = 0%; 3 studies, 1563 participants; low-certainty evidence). There is probably an increase in the risk of non-serious adverse events when zinc is used for cold treatment (RR 1.34, 95% CI 1.15 to 1.55; I2 = 44%; 2084 participants, 16 studies; moderate-certainty evidence); no treatment study provided information on serious adverse events. No study provided clear information about adverse events considered to be potential complications of the common cold. AUTHORS' CONCLUSIONS The findings suggest that zinc supplementation may have little or no effect on the prevention of colds but may reduce the duration of ongoing colds, with an increase in non-serious adverse events. Overall, there was wide variation in interventions (including concomitant therapy) and outcomes across the studies, as well as incomplete reporting of several domains, which should be considered when making conclusions about the efficacy of zinc for the common cold.
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Affiliation(s)
- Daryl Nault
- Maryland University of Integrative Health, Laurel, MD, USA
| | - Taryn A Machingo
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Andrea G Shipper
- Health Sciences and Human Services Library, University of Maryland, Baltimore, Baltimore, MD, USA
| | | | - Candyce Hamel
- Canadian Association of Radiologists, Ottawa, Canada
| | | | - Menelaos Konstantinidis
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada
| | - Erica Phillips
- Department of Nutritional Sciences, University of Wisconsin - Madison, Madison, Wisconsin, USA
| | | | - L Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Rasich G, Wieland LS. Synbiotics, prebiotics and probiotics for people with chronic kidney disease: Summary of a Cochrane review. Explore (NY) 2024; 20:462-463. [PMID: 38461124 DOI: 10.1016/j.explore.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2024]
Affiliation(s)
- Gus Rasich
- University of Maryland, Baltimore, United States.
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Wieland LS. Synopses of Cochrane Reviews from Cochrane Library Issue 10 2023 Through Issue 1 2024. J Integr Complement Med 2024. [PMID: 38587262 DOI: 10.1089/jicm.2024.0179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Affiliation(s)
- L Susan Wieland
- Department of Family and Community Medicine, University of Maryland, Baltimore, Maryland, USA
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Lopez-Alcalde J, Susan Wieland L, Barth J, Grainger R, Baxter N, Heron N, Triantafyllidis A, Carrion C, Trecca EMC, Holl F, Maria Wägner A, Edney S, Yan Y, Campos-Asensio C, Villanueva G, Ramsey RR, Witt CM. Methodological challenges in systematic reviews of mHealth interventions: Survey and consensus-based recommendations. Int J Med Inform 2024; 184:105345. [PMID: 38309237 DOI: 10.1016/j.ijmedinf.2024.105345] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/05/2024]
Abstract
OBJECTIVE Mobile Health (mHealth) refers to using mobile devices to support health. This study aimed to identify specific methodological challenges in systematic reviews (SRs) of mHealth interventions and to develop guidance for addressing selected challenges. STUDY DESIGN AND SETTING Two-phase participatory research project. First, we sent an online survey to corresponding authors of SRs of mHealth interventions. On a five-category scale, survey respondents rated how challenging they found 24 methodological aspects in SRs of mHealth interventions compared to non-mHealth intervention SRs. Second, a subset of survey respondents participated in an online workshop to discuss recommendations to address the most challenging methodological aspects identified in the survey. Finally, consensus-based recommendations were developed based on the workshop discussion and subsequent interaction via email with the workshop participants and two external mHealth SR authors. RESULTS We contacted 953 corresponding authors of mHealth intervention SRs, of whom 50 (5 %) completed the survey. All the respondents identified at least one methodological aspect as more or much more challenging in mHealth intervention SRs than in non-mHealth SRs. A median of 11 (IQR 7.25-15) out of 24 aspects (46 %) were rated as more or much more challenging. Those most frequently reported were: defining intervention intensity and components (85 %), extracting mHealth intervention details (71 %), dealing with dynamic research with evolving interventions (70 %), assessing intervention integrity (69 %), defining the intervention (66 %) and maintaining an updated review (65 %). Eleven survey respondents participated in the workshop (five had authored more than three mHealth SRs). Eighteen consensus-based recommendations were developed to address issues related to mHealth intervention integrity and to keep mHealth SRs up to date. CONCLUSION mHealth SRs present specific methodological challenges compared to non-mHealth interventions, particularly related to intervention integrity and keeping SRs current. Our recommendations for addressing these challenges can improve mHealth SRs.
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Affiliation(s)
- Jesus Lopez-Alcalde
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland; Faculty of Medicine, Universidad Francisco de Vitoria (UFV), Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Unidad de bioestadística clínica, Hospital Universitario Ramón y Cajal, (CIBERESP), Madrid, Spain.
| | - L Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Jürgen Barth
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Rebecca Grainger
- Department of Medicine, University of Otago Wellington, New Zealand
| | - Nancy Baxter
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Neil Heron
- Centre for Public Health, Queen's University Belfast, Northern Ireland, School of Medicine, Keele University, Staffordshire, England, United Kingdom
| | - Andreas Triantafyllidis
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Carme Carrion
- eHealth Lab Research Group, Universitat Oberta de Catalunya (UOC), Spain
| | - Eleonora M C Trecca
- Department of Otorhinolaryngology and Maxillofacial Surgery, IRCCS Hospital Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy; Department of Otorhinolaryngology, University Hospital of Foggia, Foggia, Italy
| | - Felix Holl
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany
| | - Ana Maria Wägner
- Endocrinology and Nutrition Department, Complejo Hospitalario Universitario Insular Materno-Infantil, Instituto de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Sarah Edney
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Yuqian Yan
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | | | | | - Rachelle R Ramsey
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Claudia M Witt
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, United States; Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Bethel K, Faciszewski H, Ballis S, Sullivan M, Wieland LS. Determining the Completeness of Registration and Reporting in Systematic Reviews of Yoga for Health. J Integr Complement Med 2024; 30:336-344. [PMID: 37967461 PMCID: PMC11001950 DOI: 10.1089/jicm.2022.0785] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Introduction: Yoga is a mind-body practice often used to improve health. Systematic reviews (SRs) of randomized controlled trials on yoga for health are foundational to evidence-based yoga interventions and require rigorous and transparent methods, including preparation of a protocol (e.g., PROSPERO) and following SR reporting guidelines (e.g., Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA]). Objective: To evaluate the availability of protocols and the completeness of reporting for SRs on yoga for health. Methods: We used a previously assembled database of SRs focused on the use of yoga for health. The authors independently extracted data on protocol availability, PROSPERO registration, and reporting for each PRISMA 2009 checklist item. Discrepancies were discussed or referred to a third author. We used Stata 10 software to produce descriptive statistics and tests for relationships between registration, reporting, and publication year, country, and journal type. Results: We included 147 reviews published between 2005 and 2019. The most common first author country was the United States or Germany (total 67/147; 46%), and the most common journal type was specialty journals (71/147; 48%). Most reviews (116/147; 79%) made no mention of a protocol or registration, and only 15/147 (10%) reviews were linked to an accessible protocol or registration. Most SRs published in 2010 or later mentioned or cited PRISMA (97/139; 70%), and individual PRISMA items were addressed between 10% and 100% of the time. PRISMA reporting improved; over time, but there was no relationship with country or journal type. Discussion: This study identifies a need for increased SR registration for yoga research. The assessment of PRISMA reporting did not evaluate the comprehensiveness with which each item was reported, and while trends are encouraging, there is likely room for improvement. We recommend registering all yoga SRs and following updated PRISMA and recent yoga-specific guidelines for reporting. This may increase transparency, minimize bias, and produce high-quality data to inform evidence-based yoga practices.
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Affiliation(s)
- Kelli Bethel
- Department of Yoga Therapy, Maryland University of Integrative Health, Laurel, MD, USA
| | - Hallie Faciszewski
- Division of Physical Therapy, Emory School of Medicine, Emory University, Atlanta, GA, USA
| | - Stephanie Ballis
- Division of Physical Therapy, Emory School of Medicine, Emory University, Atlanta, GA, USA
| | - Marlysa Sullivan
- Department of Yoga Therapy, Maryland University of Integrative Health, Laurel, MD, USA
| | - L. Susan Wieland
- Department of Family Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
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Lee B, Kwon CY, Lee HW, Nielsen A, Wieland LS, Kim TH, Birch S, Alraek T, Lee MS. The effect of sham acupuncture can differ depending on the points needled in knee osteoarthritis: A systematic review and network meta-analysis. Heliyon 2024; 10:e25650. [PMID: 38380038 PMCID: PMC10877264 DOI: 10.1016/j.heliyon.2024.e25650] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 01/26/2024] [Accepted: 01/31/2024] [Indexed: 02/22/2024] Open
Abstract
Objective In sham acupuncture-controlled acupuncture clinical trials, although sham acupuncture techniques are different from those of verum acupuncture, the same acupuncture points are often used for verum and sham acupuncture, raising the question of whether sham acupuncture is an appropriate placebo. We aimed to examine the effects of sham and verum acupuncture according to the points needled (same or different between verum and sham acupuncture) in knee osteoarthritis. Methods Ten databases were searched to find randomized controlled clinical trials (RCTs) assessing the effects of verum acupuncture with sham acupuncture or waiting lists on knee osteoarthritis. Sham acupuncture was classified as using the same acupuncture points as those in verum acupuncture (SATV) or using sham points (SATS). A frequentist network meta-analysis (NMA) was conducted, and the certainty of evidence was evaluated. Results A total of 10 RCTs involving 1628 participants were included. Verum acupuncture was significantly superior to SATS but not different from SATV in terms of pain reduction. Additionally, SATV was significantly superior to the waiting list. For physical function, no difference were found between verum acupuncture, SATV, and SATS. The certainty of evidence was low to moderate. Conclusion For knee osteoarthritis, the pain reduction effect of acupuncture may differ according to the needling points of sham acupuncture, and the control group should be established according to the specific aim of the study design and treatment mechanism.
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Affiliation(s)
- Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-eui University College of Korean Medicine, Busan, Republic of Korea
| | - Hye Won Lee
- KM Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Arya Nielsen
- Department of Family Medicine & Community Health, Icahn School of Medicine at Mount Sinai, New York, USA
| | - L Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Tae-Hun Kim
- Korean Medicine Clinical Trial Center, Korean Medicine Hospital, Kyung Hee University, Seoul, Republic of Korea
| | - Stephen Birch
- Kristiania University College, School of Health Sciences, Oslo, Norway
| | - Terje Alraek
- Kristiania University College, School of Health Sciences, Oslo, Norway
- Department of Community Medicine, Faculty of Health Sciences, National Research Center in Complementary and Alternative Medicine (NAFKAM), Institute of Health Sciences, Tromsø, Norway
| | - Myeong Soo Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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Metzendorf MI, Wieland LS, Richter B. Mobile health (m-health) smartphone interventions for adolescents and adults with overweight or obesity. Cochrane Database Syst Rev 2024; 2:CD013591. [PMID: 38375882 PMCID: PMC10877670 DOI: 10.1002/14651858.cd013591.pub2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
BACKGROUND Obesity is considered to be a risk factor for various diseases, and its incidence has tripled worldwide since 1975. In addition to potentially being at risk for adverse health outcomes, people with overweight or obesity are often stigmatised. Behaviour change interventions are increasingly delivered as mobile health (m-health) interventions, using smartphone apps and wearables. They are believed to support healthy behaviours at the individual level in a low-threshold manner. OBJECTIVES To assess the effects of integrated smartphone applications for adolescents and adults with overweight or obesity. SEARCH METHODS We searched CENTRAL, MEDLINE, PsycINFO, CINAHL, and LILACS, as well as the trials registers ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform on 2 October 2023 (date of last search for all databases). We placed no restrictions on the language of publication. SELECTION CRITERIA Participants were adolescents and adults with overweight or obesity. Eligible interventions were integrated smartphone apps using at least two behaviour change techniques. The intervention could target physical activity, cardiorespiratory fitness, weight loss, healthy diet, or self-efficacy. Comparators included no or minimal intervention (NMI), a different smartphone app, personal coaching, or usual care. Eligible studies were randomised controlled trials of any duration with a follow-up of at least three months. DATA COLLECTION AND ANALYSIS We used standard Cochrane methodology and the RoB 2 tool. Important outcomes were physical activity, body mass index (BMI) and weight, health-related quality of life, self-efficacy, well-being, change in dietary behaviour, and adverse events. We focused on presenting studies with medium- (6 to < 12 months) and long-term (≥ 12 months) outcomes in our summary of findings table, following recommendations in the core outcome set for behavioural weight management interventions. MAIN RESULTS We included 18 studies with 2703 participants. Interventions lasted from 2 to 24 months. The mean BMI in adults ranged from 27 to 50, and the median BMI z-score in adolescents ranged from 2.2 to 2.5. Smartphone app versus no or minimal intervention Thirteen studies compared a smartphone app versus NMI in adults; no studies were available for adolescents. The comparator comprised minimal health advice, handouts, food diaries, smartphone apps unrelated to weight loss, and waiting list. Measures of physical activity: at 12 months' follow-up, a smartphone app compared to NMI probably reduces moderate to vigorous physical activity (MVPA) slightly (mean difference (MD) -28.9 min/week (95% confidence interval (CI) -85.9 to 28; 1 study, 650 participants; moderate-certainty evidence)). We are very uncertain about the results of estimated energy expenditure and cardiorespiratory fitness at eight months' follow-up. A smartphone app compared with NMI probably results in little to no difference in changes in total activity time at 12 months' follow-up and leisure time physical activity at 24 months' follow-up. Anthropometric measures: a smartphone app compared with NMI may reduce BMI (MD of BMI change -2.6 kg/m2, 95% CI -6 to 0.8; 2 studies, 146 participants; very low-certainty evidence) at six to eight months' follow-up, but the evidence is very uncertain. At 12 months' follow-up, a smartphone app probably resulted in little to no difference in BMI change (MD -0.1 kg/m2, 95% CI -0.4 to 0.3; 1 study; 650 participants; moderate-certainty evidence). A smartphone app compared with NMI may result in little to no difference in body weight change (MD -2.5 kg, 95% CI -6.8 to 1.7; 3 studies, 1044 participants; low-certainty evidence) at 12 months' follow-up. At 24 months' follow-up, a smartphone app probably resulted in little to no difference in body weight change (MD 0.7 kg, 95% CI -1.2 to 2.6; 1 study, 245 participants; moderate-certainty evidence). A smartphone app compared with NMI may result in little to no difference in self-efficacy for a physical activity score at eight months' follow-up, but the results are very uncertain. A smartphone app probably results in little to no difference in quality of life and well-being at 12 months (moderate-certainty evidence) and in little to no difference in various measures used to inform dietary behaviour at 12 and 24 months' follow-up. We are very uncertain about adverse events, which were only reported narratively in two studies (very low-certainty evidence). Smartphone app versus another smartphone app Two studies compared different versions of the same app in adults, showing no or minimal differences in outcomes. One study in adults compared two different apps (calorie counting versus ketogenic diet) and suggested a slight reduction in body weight at six months in favour of the ketogenic diet app. No studies were available for adolescents. Smartphone app versus personal coaching Only one study compared a smartphone app with personal coaching in adults, presenting data at three months. Two studies compared these interventions in adolescents. A smartphone app resulted in little to no difference in BMI z-score compared to personal coaching at six months' follow-up (MD 0, 95% CI -0.2 to 0.2; 1 study; 107 participants). Smartphone app versus usual care Only one study compared an app with usual care in adults but only reported data at three months on participant satisfaction. No studies were available for adolescents. We identified 34 ongoing studies. AUTHORS' CONCLUSIONS The available evidence is limited and does not demonstrate a clear benefit of smartphone applications as interventions for adolescents or adults with overweight or obesity. While the number of studies is growing, the evidence remains incomplete due to the high variability of the apps' features, content and components, which complicates direct comparisons and assessment of their effectiveness. Comparisons with either no or minimal intervention or personal coaching show minor effects, which are mostly not clinically significant. Minimal data for adolescents also warrants further research. Evidence is also scarce for low- and middle-income countries as well as for people with different socio-economic and cultural backgrounds. The 34 ongoing studies suggest sustained interest in the topic, with new evidence expected to emerge within the next two years. In practice, clinicians and healthcare practitioners should carefully consider the potential benefits, limitations, and evolving research when recommending smartphone apps to adolescents and adults with overweight or obesity.
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Affiliation(s)
- Maria-Inti Metzendorf
- Institute of General Practice, Medical Faculty of the Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - L Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Bernd Richter
- Institute of General Practice, Medical Faculty of the Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Wieland LS. Synopses of Cochrane Reviews from Cochrane Library Issue 6 2023 through Issue 9/10 2023. J Integr Complement Med 2024; 30:8-10. [PMID: 38150326 DOI: 10.1089/jicm.2023.0713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
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Lee B, Kwon CY, Lee HW, Nielsen A, Wieland LS, Kim TH, Birch S, Alraek T, Lee MS. Different Outcomes According to Needling Point Location Used in Sham Acupuncture for Cancer-Related Pain: A Systematic Review and Network Meta-Analysis. Cancers (Basel) 2023; 15:5875. [PMID: 38136419 PMCID: PMC10741764 DOI: 10.3390/cancers15245875] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open
Abstract
Numerous acupuncture studies have been conducted on cancer-related pain; however, its efficacy compared to sham acupuncture remains controversial. We confirmed whether the outcome of acupuncture differs according to the needling points of sham acupuncture for cancer-related pain. We searched 10 databases on 23 May 2023 to screen acupuncture trials using sham acupuncture or waiting list as controls for cancer-related pain. Sham acupuncture was classified into two types, depending on whether the needling was applied at the same locations as verum acupuncture (SATV) or not (SATS). A network meta-analysis (NMA) was performed on the basis of a frequentist approach to assess pain severity. Eight studies (n = 574 participants) were included in the review, seven of which (n = 527 participants) were included in the NMA. The pain severity was not significantly different between SATV and verum acupuncture, but verum acupuncture significantly improved pain severity compared to SATS. The risk of bias affecting the comparisons between the verum and sham acupuncture was generally low. Previous acupuncture trials for cancer-related pain showed differing outcomes of sham and verum acupuncture, depending on the needling points of sham acupuncture. The application of SATV cannot be considered a true placebo, which leads to an underestimation of the efficacy of verum acupuncture.
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Affiliation(s)
- Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea;
| | - Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-Eui University College of Korean Medicine, Busan 47227, Republic of Korea;
| | - Hye Won Lee
- KM Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea;
| | - Arya Nielsen
- Department of Family Medicine & Community Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - L. Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
| | - Tae-Hun Kim
- Korean Medicine Clinical Trial Center, Korean Medicine Hospital, Kyung Hee University, Seoul 02447, Republic of Korea;
| | - Stephen Birch
- Kristiania University College, School of Health Sciences, 0317 Oslo, Norway; (S.B.); (T.A.)
| | - Terje Alraek
- Kristiania University College, School of Health Sciences, 0317 Oslo, Norway; (S.B.); (T.A.)
- Department of Community Medicine, Faculty of Health Sciences, National Research Center in Complementary and Alternative Medicine (NAFKAM), Institute of Health Sciences, 9037 Tromsø, Norway
| | - Myeong Soo Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea;
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Ng JY, Dhawan T, Fajardo RG, Masood HA, Sunderji S, Wieland LS, Moher D. The Brief History of Complementary, Alternative, and Integrative Medicine Terminology and the Development and Creation of an Operational Definition. Integr Med Res 2023; 12:100978. [PMID: 37927333 PMCID: PMC10623279 DOI: 10.1016/j.imr.2023.100978] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/21/2023] [Accepted: 07/27/2023] [Indexed: 11/07/2023] Open
Abstract
The definition of complementary, alternative, and integrative medicine (CAIM) remains dynamic and complex despite a steady increase in the popularity/usage of CAIM therapies across the globe. A lack of consistency in how these terms are defined remains a challenge for researchers, clinicians, and national and international organizations (e.g., World Health Organization, National Center for Complementary and Integrative Health) alike. In the present article, we provide a brief history of the use of these terminologies, and then outline the process we took to develop and create an operational definition of complementary, alternative, and integrative medicine. Our operational definition is the first to be informed by a systematic search of four quality-assessed information resource types, ultimately yielding 604 unique CAIM therapies. We then developed a single search string for the most common bibliographic databases using the finalized operational definition list of CAIM therapies. These CAIM therapies were searched against the Therapeutic Research Center's "Natural Medicines" database for all 604 therapies, whereby each item's scientific name and/or synonym was included as a keyword or phrase in the search string. While the current definition is not without limitations and ongoing debates still surround the field, this work is arguably a steppingstone towards enabling increased collaboration and communication amongst healthcare clinicians, researchers, and the public. This operational definition provides a foundation for developing well-coordinated research efforts that will assist in the acceptance and understanding of this field, while also focusing on adopting knowledge translation techniques and efforts for further research advancement and use.
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Affiliation(s)
- Jeremy Y. Ng
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Tushar Dhawan
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Renee-Gabrielle Fajardo
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Hooriya A. Masood
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Samira Sunderji
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - L. Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, Maryland, United States
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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11
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Ng JY, Liu H, Shah AQ, Wieland LS, Moher D. Characteristics of bibliometric analyses of the complementary, alternative, and integrative medicine literature: A scoping review protocol. F1000Res 2023; 12:164. [PMID: 38434671 PMCID: PMC10905119 DOI: 10.12688/f1000research.130326.1] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 03/05/2024] Open
Abstract
Background: There is a growing body of literature on complementary, alternative, and integrative medicine (CAIM), which offers a holistic approach to health and the maintenance of social and cultural values. Bibliometric analyses are an increasingly commonly used method employing quantitative statistical techniques to understand trends in a particular scientific field. The objective of this scoping review is to investigate the quantity and characteristics of evidence in relation to bibliometric analyses of CAIM literature. Methods: The following bibliographic databases will be searched: MEDLINE, EMBASE, PsycINFO, AMED, CINAHL, Scopus and Web of Science. Studies published in English, conducting any type of bibliometric analysis involving any CAIM therapies, as detailed by an operational definition of CAIM adopted by Cochrane Complementary Medicine, will be included. Conference abstracts and study protocols will be excluded. The following variables will be extracted from included studies: title, author, year, country, study objective, type of CAIM, health condition targeted, databases searched in the bibliometric analysis, the type of bibliometric variables assessed, how bibliometric information was reported, main findings, conclusions, and limitations. Findings will be summarized narratively, as well as in tabular and graphical format. Conclusions: To the best of our knowledge, this scoping review will be the first to investigate the characteristics of evidence in relation to bibliometric analyses on CAIM literature. The findings of this review may be useful to identify variations in the objectives, methods, and results of bibliometric analyses of CAIM research literature.
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Affiliation(s)
- Jeremy Y. Ng
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Henry Liu
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Aimun Qadeer Shah
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - L. Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Patwardhan B, Wieland LS, Aginam O, Chuthaputti A, Ghelman R, Ghods R, Soon GC, Matsabisa MG, Seifert G, Tu'itahi S, Chol KS, Kuruvilla S, Kemper K, Cramer H, Nagendra HR, Thakar A, Nesari T, Sharma S, Srikanth N, Acharya R. Evidence-based traditional medicine for transforming global health and well-being. Complement Ther Med 2023; 77:102970. [PMID: 37591416 DOI: 10.1016/j.ctim.2023.102970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023] Open
Affiliation(s)
- Bhushan Patwardhan
- Journal of Ayurveda and Integrative Medicine, Ramkumar Rathi Patanjali Yoga Chair at School of Health Sciences, Savitribai Phule Pune University, Pune, India; External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland.
| | - L Susan Wieland
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland; Department of Family & Community Medicine, School of Medicine, University of Maryland, Baltimore, MD, United States
| | - Obijiofor Aginam
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland; United Nations University International Institute for Global Health, Kuala Lumpur, Malaysia
| | - Anchalee Chuthaputti
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland; Institute of Thai Traditional Medicine, Nonthaburi, Thailand
| | - Ricardo Ghelman
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland; Department of Medicine and Primary Care, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Roshanak Ghods
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland; Department of Persian Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Goh Cheng Soon
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland; Traditional and Complementary Medicine Division, Ministry of Health, Kuala Lumpur, Malaysia
| | - Motlalepula G Matsabisa
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland; Department of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Georg Seifert
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland; Department of Pediatrics, Division of Oncology and Hematology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Sione Tu'itahi
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland; Health Promotion Forum, Auckland, New Zealand
| | - Kim Sung Chol
- TCI Unit, World Health Organization, Geneva, Switzerland
| | | | - Kathi Kemper
- Journal Editors endorsing Editorial, USA; Complementary Therapies in Medicine, Ohio State University College of Medicine, Columbus, OH, United States
| | - Holger Cramer
- Journal Editors endorsing Editorial, USA; Journal of Complementary and Integrative Medicine, University of Duisburg-Essen Chair of Complementary and Integrative Medicine, Essen, Germany
| | - H R Nagendra
- Journal Editors endorsing Editorial, USA; Indian Journal of Traditional Knowledge, S-VYASA Yoga University, Bengaluru, India
| | - Anup Thakar
- Journal Editors endorsing Editorial, USA; AYU Journal, Institute of Teaching and Research in Ayurveda, Jamnagar, India
| | - Tanuja Nesari
- Journal Editors endorsing Editorial, USA; International Journal of Ayurveda Research, All India Institute of Ayurveda, New Delhi, India
| | - Sanjeev Sharma
- Journal Editors endorsing Editorial, USA; Journal of Ayurveda, National Institute of Ayurveda, Jaipur, India
| | - Narayanam Srikanth
- Journal Editors endorsing Editorial, USA; Journal of Research in Ayurvedic Sciences, Central Council for Research in Ayurvedic Sciences, New Delhi, India
| | - Rabinarayan Acharya
- Journal Editors endorsing Editorial, USA; Journal of Drug Research in Ayurvedic Sciences, Central Council for Research in Ayurvedic Sciences, New Delhi, India
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Lee B, Kwon CY, Lee HW, Nielsen A, Wieland LS, Kim TH, Birch S, Alraek T, Lee MS. Needling Point Location Used in Sham Acupuncture for Chronic Nonspecific Low Back Pain: A Systematic Review and Network Meta-Analysis. JAMA Netw Open 2023; 6:e2332452. [PMID: 37672270 PMCID: PMC10483312 DOI: 10.1001/jamanetworkopen.2023.32452] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 07/31/2023] [Indexed: 09/07/2023] Open
Abstract
Importance When sham acupuncture is set as a control in evaluating acupuncture, the sham needling technique is usually different from acupuncture. However, the sham procedure is conducted either at the same points that are used for the acupuncture group or at nonindicated points. Objective To assess whether the outcome of sham acupuncture varies according to the needling points in sham-controlled trials of acupuncture for chronic nonspecific low back pain (CLBP) as an example. Data sources Searches of MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and the Allied and Complementary Medicine Database were conducted on February 12, 2023. Study selection Randomized clinical trials (RCTs) assessing the outcomes of acupuncture in sham acupuncture-controlled or waiting list-controlled trials on CLBP were included. Data extraction and synthesis Two researchers independently extracted data on study characteristics and outcomes and assessed quality. Sham acupuncture was classified according to whether it was conducted at the same acupuncture points used in the acupuncture group, referred to as sham acupuncture therapy (verum) (SATV) or at different points, referred to as sham acupuncture therapy (sham) (SATS). Clinical similarity, transitivity, and consistency tests were conducted, followed by a random-effects frequentist network meta-analysis (NMA). Main outcomes and measures The primary outcome was pain, and the secondary outcome was back-specific function. The first assessment after the end of treatment was chosen for analysis. Effect sizes are reported as standardized mean differences (SMD) with 95% CIs. The risk of bias was assessed using the Cochrane risk of bias tool, and the certainty of evidence for findings was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results Ten RCTs involving 4379 participants were included. In comparison with SATS, acupuncture was significantly associated with improvements in both pain (SMD, -0.33; 95% CI, -0.52 to -0.15) and function outcomes (SMD, -0.13; 95% CI, -0.25 to -0.02); however, there were no differences between acupuncture and SATV. In comparison with SATS, SATV was significantly associated with better pain (SMD, -0.45; 95% CI, -0.88 to -0.03) and function outcomes (SMD, -0.30; 95% CI, -0.56 to -0.05). The risk of bias that could affect the interpretation of the results was usually low, and the certainty of evidence was moderate to low. Conclusions and relevance In this NMA, sham acupuncture needling at the same points as those in acupuncture was not a true placebo control for assessing the efficacy of acupuncture for CLBP and might underestimate the outcome of acupuncture in clinical settings.
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Affiliation(s)
- Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-Eui University College of Korean Medicine, Busan, Republic of Korea
| | - Hye Won Lee
- KM Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Arya Nielsen
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - L. Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Tae-Hun Kim
- Korean Medicine Clinical Trial Center, Korean Medicine Hospital, Kyung Hee University, Seoul, Republic of Korea
| | - Stephen Birch
- Kristiania University College, School of Health Sciences, Oslo, Norway
| | - Terje Alraek
- Kristiania University College, School of Health Sciences, Oslo, Norway
- Department of Community Medicine, Faculty of Health Sciences, National Research Center in Complementary and Alternative Medicine, Institute of Health Sciences, Tromsø, Norway
| | - Myeong Soo Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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14
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Wieland LS. Synopses of Cochrane Reviews from Cochrane Library Issue 2 2023 Through Issue 5 2023. Journal of Integrative and Complementary Medicine 2023; 29:536-537. [PMID: 37638800 DOI: 10.1089/jicm.2023.0365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
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15
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Patwardhan B, Wieland LS, Aginam O, Chuthaputti A, Ghelman R, Ghods R, Soon GC, Matsabisa MG, Seifert G, Tu'itahi S, Chol KS, Kuruvilla S, Kemper K, Cramer H, Nagendra HR, Thakar A, Nesari T, Sharma S, Srikanth N, Acharya R. Evidence-Based Traditional Medicine for Transforming Global Health and Well-Being. J Integr Complement Med 2023; 29:527-530. [PMID: 37713586 DOI: 10.1089/jicm.2023.29121.editorial] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/17/2023]
Affiliation(s)
- Bhushan Patwardhan
- Journal of Ayurveda and Integrative Medicine, Ramkumar Rathi Patanjali Yoga Chair at School of Health Sciences, Savitribai Phule Pune University, Pune, India
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
| | - L Susan Wieland
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- Department of Family & Community Medicine, School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Obijiofor Aginam
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- United Nations University International Institute for Global Health, Kuala Lumpur, Malaysia
| | - Anchalee Chuthaputti
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- Department of Thai Traditional and Alternative Medicine, Nonthaburi, Thailand
| | - Ricardo Ghelman
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- Department of Medicine to Primary Care, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Roshanak Ghods
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- Department of Traditional Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Goh Cheng Soon
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- Traditional and Complementary Medicine Division, Ministry of Health, Kuala Lumpur, Malaysia
| | - Motlalepula G Matsabisa
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- African Medicines Innovations and Technologies Development, Department of Pharmacology, School of Clinical Medicine, Faculty of Health Sciences, University of Free State, Bloemfontein, South Africa
| | - Georg Seifert
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- Department of Pediatrics, Division of Oncology and Hematology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Sione Tu'itahi
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- Health Promotion Forum, Auckland, New Zealand
| | - Kim Sung Chol
- TCI Unit, World Health Organization, Geneva, Switzerland
| | | | - Kathi Kemper
- Complementary Therapies in Medicine, Ohio State University College of Medicine, Columbus, OH, USA
| | - Holger Cramer
- Journal of Complementary and Integrative Medicine, University of Duisburg-Essen Chair of Complementary and Integrative Medicine, Essen, Germany
- Journal of Integrative and Complementary Medicine; Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
- Robert Bosch Center for Journal of Integrative and Complementary Medicine, Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
- Robert Bosch Center for Integrative Medicine and Health, Bosch Health Campus, Stuttgart, Germany
| | - H R Nagendra
- Indian Journal of Traditional Knowledge, S-VYASA Yoga University, Bengaluru, India
| | - Anup Thakar
- AYU Journal, Institute of Teaching and Research in Ayurveda, Jamnagar, India
| | - Tanuja Nesari
- International Journal of Ayurveda Research, All India Institute of Ayurveda, New Delhi, India
| | - Sanjeev Sharma
- Journal of Ayurveda, National Institute of Ayurveda, Jaipur, India
| | - Narayanam Srikanth
- Journal of Research in Ayurvedic Sciences, Central Council for Research in Ayurvedic Sciences, New Delhi, India
| | - Rabinarayan Acharya
- Journal of Drug Research in Ayurvedic Sciences, Central Council for Research in Ayurvedic Sciences, New Delhi, India
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16
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Ijaz N, Wieland LS, Gallego-Pérez DF. Correspondence on 'The limits of shared decision making' by Elwyn et al: We call for a more nuanced approach. BMJ Evid Based Med 2023; 28:283. [PMID: 37130741 DOI: 10.1136/bmjebm-2023-112343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/28/2023] [Indexed: 05/04/2023]
Affiliation(s)
- Nadine Ijaz
- Department of Law & Legal Studies, Carleton University, Ottawa, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - L Susan Wieland
- Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Daniel F Gallego-Pérez
- Department of Physical Medicine and Rehabilitation, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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17
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Patwardhan B, Wieland LS, Kuruvilla S. WHO: a global boost for evidence-based traditional medicine. Nature 2023; 620:950. [PMID: 37644204 DOI: 10.1038/d41586-023-02699-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
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18
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Patwardhan B, Wieland LS, Aginam O, Chuthaputti A, Ghelman R, Ghods R, Soon GC, Matsabisa MG, Seifert G, Tu’itahi S, Chol KS, Kuruvilla S, Kemper K, Cramer H, Nagendra HR, Thakar A, Nesari T, Sharma S, Srikanth N, Acharya R. Evidence-based traditional medicine for transforming global health & wellbeing. Indian J Med Res 2023; 158:101-105. [PMID: 37675685 PMCID: PMC10645034 DOI: 10.4103/ijmr.ijmr_1574_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Indexed: 09/08/2023] Open
Affiliation(s)
- Bhushan Patwardhan
- Journal of Ayurveda & Integrative Medicine, Ramkumar Rathi Patanjali Yoga Chair, School of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
| | - L. Susan Wieland
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- Department of Family & Community Medicine, School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Obijiofor Aginam
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- United Nations University International Institute for Global Health, Kuala Lumpur, Malaysia
| | - Anchalee Chuthaputti
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- Institute of Thai Traditional Medicine, Nonthaburi, Thailand
| | - Ricardo Ghelman
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- Department of Medicine & Primary Care, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Roshanak Ghods
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- Department of Persian Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Goh Cheng Soon
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- Traditional & Complementary Medicine Division, Ministry of Health, Kuala Lumpur, Malaysia
| | - Motlalepula G. Matsabisa
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- Department of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Georg Seifert
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- Department of Pediatrics, Division of Oncology & Hematology, Charité - Universitätsmedizin Berlin, Berlin
| | - Sione Tu’itahi
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- Health Promotion Forum, Auckland, New Zealand
| | - Kim Sung Chol
- TCI Unit, World Health Organization, Geneva, Switzerland
| | | | - Kathi Kemper
- Journal Editors Endorsing Editorial, University of Maryland, Baltimore, MD, USA
- Complementary Therapies in Medicine, Ohio State University College of Medicine, Columbus, OH, USA
| | - Holger Cramer
- Journal Editors Endorsing Editorial, University of Maryland, Baltimore, MD, USA
- Journal of Complementary & Integrative Medicine, University of Duisburg-Essen Chair of Complementary & Integrative Medicine, Essen, Germany
| | - H. R. Nagendra
- Indian Journal of Traditional Knowledge, S-VYASA Yoga University, Bengaluru, Karnataka, India
- Journal Editors Endorsing Editorial, University of Maryland, Baltimore, MD, USA
| | - Anup Thakar
- AYU Journal, Institute of Teaching & Research in Ayurveda, Jamnagar, Gujarat, India
- Journal Editors Endorsing Editorial, University of Maryland, Baltimore, MD, USA
| | - Tanuja Nesari
- International Journal of Ayurveda Research, All India Institute of Ayurveda, New Delhi, India
- Journal Editors Endorsing Editorial, University of Maryland, Baltimore, MD, USA
| | - Sanjeev Sharma
- Journal of Ayurveda, National Institute of Ayurveda, Jaipur, Rajasthan, India
- Journal Editors Endorsing Editorial, University of Maryland, Baltimore, MD, USA
| | - Narayanam Srikanth
- Journal of Research in Ayurvedic Sciences, Central Council for Research in Ayurvedic Sciences, New Delhi, India
- Journal Editors Endorsing Editorial, University of Maryland, Baltimore, MD, USA
| | - Rabinarayan Acharya
- Journal of Drug Research in Ayurvedic Sciences, Central Council for Research in Ayurvedic Sciences, New Delhi, India
- Journal Editors Endorsing Editorial, University of Maryland, Baltimore, MD, USA
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19
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Patwardhan B, Wieland LS, Aginam O, Chuthaputti A, Ghelman R, Ghods R, Soon GC, Matsabisa MG, Seifert G, Tu'itahi S, Chol KS, Kuruvilla S, Kemper K, Cramer H, Nagendra HR, Thakar A, Nesari T, Sharma S, Srikanth N, Acharya R. Evidence-based traditional medicine for transforming global health and well-being. J Ayurveda Integr Med 2023; 14:100790. [PMID: 37562183 PMCID: PMC10432791 DOI: 10.1016/j.jaim.2023.100790] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023] Open
Affiliation(s)
- Bhushan Patwardhan
- Journal of Ayurveda and Integrative Medicine, Ramkumar Rathi Patanjali Yoga Chair at School of Health Sciences, Savitribai Phule Pune University, Pune, India; External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland.
| | - L Susan Wieland
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland; Department of Family & Community Medicine, School of Medicine, University of Maryland, Baltimore, MD, United States of America
| | - Obijiofor Aginam
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland; United Nations University International Institute for Global Health, Kuala Lumpur, Malaysia
| | - Anchalee Chuthaputti
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland; Department of Thai Traditional and Alternative Medicine, Nonthaburi, Thailand
| | - Ricardo Ghelman
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland; Department of Medicine to Primary Care, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Roshanak Ghods
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland; Department of Traditional Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Goh Cheng Soon
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland; Traditional and Complementary Medicine Division, Ministry of Health, Kuala Lumpur, Malaysia
| | - Motlalepula G Matsabisa
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland; African Medicines Innovations and Technologies Development, Department of Pharmacology, School of Clinical Medicine, Faculty of Health Sciences, University of Free State, Bloemfontein, South Africa
| | - Georg Seifert
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland; Department of Pediatrics, Division of Oncology and Hematology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Sione Tu'itahi
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland; Health Promotion Forum, Auckland, New Zealand
| | - Kim Sung Chol
- TCI Unit, World Health Organization, Geneva, Switzerland
| | | | - Kathi Kemper
- Journal Editors Endorsing Editorial; Complementary Therapies in Medicine, Ohio State University College of Medicine, Columbus, OH, United States of America
| | - Holger Cramer
- Journal Editors Endorsing Editorial; Journal of Integrative and Complementary Medicine; Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany; Robert Bosch Center for Integrative Medicine and Health, Bosch Health Campus, Stuttgart, Germany
| | - H R Nagendra
- Journal Editors Endorsing Editorial; Indian Journal of Traditional Knowledge, S-VYASA Yoga University, Bengaluru, India
| | - Anup Thakar
- Journal Editors Endorsing Editorial; AYU Journal, Institute of Teaching and Research in Ayurveda, Jamnagar, India
| | - Tanuja Nesari
- Journal Editors Endorsing Editorial; International Journal of Ayurveda Research, All India Institute of Ayurveda, New Delhi, India
| | - Sanjeev Sharma
- Journal Editors Endorsing Editorial; Journal of Ayurveda, National Institute of Ayurveda, Jaipur, India
| | - Narayanam Srikanth
- Journal Editors Endorsing Editorial; Journal of Research in Ayurvedic Sciences, Central Council for Research in Ayurvedic Sciences, New Delhi, India
| | - Rabinarayan Acharya
- Journal Editors Endorsing Editorial; Journal of Drug Research in Ayurvedic Sciences, Central Council for Research in Ayurvedic Sciences, New Delhi, India
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20
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Wieland LS. Synopses of Cochrane Reviews from Cochrane Library Issue 10 2022 Through Issue 1 2023. J Integr Complement Med 2023; 29:276-278. [PMID: 37010376 PMCID: PMC10494900 DOI: 10.1089/jicm.2023.0063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Affiliation(s)
- L. Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
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21
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Lee B, Kim TH, Birch S, Alraek T, Lee HW, Nielsen A, Wieland LS, Lee MS. Comparative effectiveness of acupuncture in sham-controlled trials for knee osteoarthritis: A systematic review and network meta-analysis. Front Med (Lausanne) 2023; 9:1061878. [PMID: 36698820 PMCID: PMC9868382 DOI: 10.3389/fmed.2022.1061878] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/05/2022] [Indexed: 01/11/2023] Open
Abstract
Objectives Although many trials have assessed the effect of acupuncture on knee osteoarthritis (KOA), its efficacy remains controversial. Sham acupuncture techniques are regarded as representative control interventions in acupuncture trials and sometimes incorporate the use of sham devices (base units) to support a non-penetrating needle. To achieve successful blinding, these trials also use acupuncture base units in the verum acupuncture group. Base units are not used in real-world clinical settings. We aimed to assess the effect sizes of verum and sham acupuncture for KOA in sham-controlled trials with or without base units. Methods A total of 10 electronic databases for randomized controlled trials (RCTs) comparing the efficacy of verum manual acupuncture and sham acupuncture for the treatment of KOA were searched for articles published before April 12, 2022. The primary outcome was pain intensity, and the secondary outcomes included physical function. The first assessment after the end of treatment was chosen for analysis. Effect sizes are reported as standardized mean differences (SMDs) with 95% confidence intervals (95% CIs). The risk of bias was assessed using the Cochrane risk of bias tool, and publication bias was evaluated using a funnel plot and Egger's test. The quality of evidence for estimates was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Results Fifteen RCTs were included. There was generally a low risk of bias except for the difficulty in blinding acupuncture therapists (performance bias). Compared to verum acupuncture in sham-controlled trials using base units, verum acupuncture in sham-controlled trials without base units was more effective for improving pain (SMD -0.56, 95% CI -1.09 to -0.03) and function (SMD -0.73, 95% CI -1.36 to -0.10) in KOA. The quality of evidence for network estimates was moderate to low due to the risk of bias and imprecision. Conclusion These findings suggest that verum acupuncture in different types of sham-controlled trials has different effect sizes for KOA. Because base units are not used in clinical settings, the results of verum acupuncture in sham-controlled trials with base units need to be interpreted carefully. Systematic review registration https://www.researchregistry.com/browse-the-registry#registryofsystematicreviewsmeta-analyses/registryofsystematicreviewsmeta-analysesdetails/6269f962606c5e001fd8790c/, identifier reviewregistry1351.
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Affiliation(s)
- Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Tae-Hun Kim
- Korean Medicine Clinical Trial Center, Korean Medicine Hospital, Kyung Hee University, Seoul, Republic of Korea
| | - Stephen Birch
- School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Terje Alraek
- School of Health Sciences, Kristiania University College, Oslo, Norway
- Department of Community Medicine, Faculty of Health Sciences, National Research Center in Complementary and Alternative Medicine, Tromsø, Norway
| | - Hye Won Lee
- KM Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Arya Nielsen
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - L. Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Myeong Soo Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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22
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Wieland LS. Synopses of Cochrane Reviews from Cochrane Library Issue 6 2022 Through Issue 9 2022. J Integr Complement Med 2023; 29:4-5. [PMID: 36454197 PMCID: PMC9917287 DOI: 10.1089/jicm.2022.0774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- L. Susan Wieland
- Department of Family and Community Medicine, Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.,Address correspondence to: L. Susan Wieland, MPH, PhD, Department of Family and Community Medicine, Center for Integrative Medicine, University of Maryland School of Medicine, 520 W. Lombard Street, Baltimore, MD 21201, USA
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23
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Hayden JA, Hayden JA, Ogilvie R, Singh S, Kashif S, Hartvigsen J, Maher CG, Furlan AD, Lasserson T, Tugwell P, van Tulder M, Qaseem A, Ferreira ML, Buchbinder R, Wieland LS, Jesus-Moraleida FR, Saragiotto BT, Yamato TP, de Zoete A, Bülow K, Almeida de Oliveira L, Bejarano G, Cancelliere C. Commentary: collaborative systematic review may produce and share high-quality, comparative evidence more efficiently. J Clin Epidemiol 2022; 152:288-294. [PMID: 36182007 DOI: 10.1016/j.jclinepi.2022.09.013] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/20/2022] [Accepted: 09/22/2022] [Indexed: 01/25/2023]
Abstract
Systematic reviews are necessary to synthesize available evidence and inform clinical practice and health policy decisions. There has been an explosion of evidence available in many fields; this makes it challenging to keep evidence syntheses up to date and useful. Comparative effectiveness systematic reviews are informative; however, producing these often-large reviews bring intense time and resource demands. This commentary describes the implementation of a systematic review using a collaborative model of evidence synthesis. We are implementing the collaborative review model to update a large Cochrane review investigating the efficacy and comparative effectiveness of the design, delivery, and type of exercise treatment for people with chronic low-back pain. Three key benefits of the collaborative review model for evidence synthesis are (1) team coordination and collaboration, (2) quality control measures, and (3) advanced comparative and other analyses. This new collaborative review model is developed and implemented to produce and share high-quality, comparative evidence more efficiently while building capacity and community within a research field.
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Affiliation(s)
- Jill A Hayden
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, Canada.
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- Department of Community Health & Epidemiology, Dalhousie University, Halifax, Canada
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24
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Pilkington K, Wieland LS, Teng L, Jin XY, Storey D, Liu JP. Coriolus (Trametes) versicolor mushroom to reduce adverse effects from chemotherapy or radiotherapy in people with colorectal cancer. Cochrane Database Syst Rev 2022; 11:CD012053. [PMID: 36445793 PMCID: PMC9707730 DOI: 10.1002/14651858.cd012053.pub2] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Radiotherapy and chemotherapy are used to improve survival in colorectal cancer but adverse effects can be a problem. Severe adverse effects may result in dose reduction or cessation of treatment, which have an impact on survival. Coriolus versicolor (Trametes versicolor or 'Turkey Tail') mushroom and its extracts have been used by cancer patients to help with adverse effects. OBJECTIVES To assess the effects of adjunctive Coriolus versicolor (Trametes versicolor) and its extracts on adverse effects and on survival during colorectal cancer treatment (chemotherapy and radiotherapy) compared with no adjunctive treatment. SEARCH METHODS We searched databases including CENTRAL, MEDLINE, Embase, AMED and CINAHL, Chinese and Japanese databases, and trials registers to 12th April 2022 without restriction of language or publication status. We screened reference lists and attempted to contact researchers in the field to identify additional studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) investigating the efficacy and safety of Coriolus versicolor and its extracts in adult participants with a confirmed diagnosis of colorectal cancer, in addition to conventional treatment. Interventions included any preparation of Coriolus versicolor (raw, decoction, capsule, tablet, tincture, extract, injection), any part of the fungus (cap, stem, mycelium or whole), in any dose or regimen. Outcomes included adverse events rates, survival, disease progression and recurrence, response rates and quality of life. DATA COLLECTION AND ANALYSIS Two review authors independently screened and selected studies, extracted outcome data, and assessed risk of bias. We evaluated the overall certainty of evidence using the GRADE approach. MAIN RESULTS We included seven parallel RCTs (1569 participants). Six studies (1516 participants) were conducted in Japan and one study (53 participants) in China. Studies included both male and female participants with colorectal cancer (five studies), colon cancer (one study) or rectal cancer (one study). Participants were diagnosed with cancer ranging from stage II to stage IV. Coriolus was used in the form of an extract in all seven studies and was generally used after curative resection, although in one study it was used preoperatively. Duration of treatment with the extract varied between four weeks and three years. Chemotherapeutic regimens in six studies consisted of an oral fluoropyrimidine which was preceded by weekly intravenous 5-Fluorouracil (5-FU) in one study, by mitomycin C in two studies, and which was combined with folinic acid (Leucovorin) in two studies and with radiotherapy preoperatively in one study. XELOX (oxaliplatin intravenous infusion and capecitabine) was used in the remaining study. We found very low-certainty evidence of little to no effect of adjunctive treatment with Coriolus (in the form of an extract, polysaccharide-Krestin, PSK) on withdrawal from treatment due to adverse events (risk ratio (RR) 1.03, 95% confidence interval (CI) 0.45 to 2.34; 703 participants; 3 studies;). We are uncertain whether adjunctive Coriolus versicolor and its extracts compared to usual care alone resulted in a difference in adverse events including neutropenia (RR 0.41, 95% CI 0.24 to 0.71; 133 participants; 3 studies; very low certainty), oral cavity disorders such as oral dryness and mucositis (RR 0.37, 95% CI 0.13 to 1.03; 1022 participants; 5 studies; very low certainty), nausea (RR 0.73, 95% CI 0.44 to 1.22; 969 participants; 4 studies; very low certainty), diarrhoea (RR 0.77, 95% CI 0.32 to 1.86; 1022 participants; 5 studies; very low certainty), and fatigue (RR 0.76; 95% CI 0.33 to 1.78; 133 participants; 3 studies; very low certainty). We found low-certainty evidence of a small effect of adjunctive Coriolus on improved survival at five years compared with no adjunctive care (RR 1.08, 95% CI 1.01 to 1.15; 1094 participants; 3 studies; number needed to benefit (NNTB) = 16 (95% Cl 9 to 70). The effect at earlier time points was unclear. AUTHORS' CONCLUSIONS Due to the very low certainty of evidence, we were uncertain about the effect of adjunctive Coriolus (in the form of an extract PSK) on adverse events resulting from conventional chemotherapy for colorectal cancer. This includes effects on withdrawal of treatment due to adverse events and on specific adverse outcomes such as neutropenia and nausea. The uncertainty in the evidence also means that it was unclear whether any adverse events were due to the chemotherapy or to the extract itself. While there was low-certainty evidence of a small effect on overall survival at five years, the influence of reduced adverse effects on this could not be determined. In addition, chemotherapy regimens used in assessing this outcome do not reflect current preferred practice.
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Affiliation(s)
- Karen Pilkington
- School of Health and Care Professions, University of Portsmouth, Portsmouth, UK
| | - L Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Lida Teng
- Department of Health Economics and Outcomes Research, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
| | - Xin Yan Jin
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Dawn Storey
- Beatson West of Scotland Cancer Centre, Gartnavel General Hospital, Glasgow, UK
| | - Jian Ping Liu
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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Abstract
BACKGROUND Non-specific low back pain is a common, potentially disabling condition usually treated with self-care and non-prescription medication. For chronic low back pain, current guidelines recommend exercise therapy. Yoga is a mind-body exercise sometimes used for non-specific low back pain. OBJECTIVES To evaluate the benefits and harms of yoga for treating chronic non-specific low back pain in adults compared to sham yoga, no specific treatment, a minimal intervention (e.g. education), or another active treatment, focusing on pain, function, quality of life, and adverse events. SEARCH METHODS We used standard, extensive Cochrane search methods. The latest search date was 31 August 2021 without language or publication status restrictions. SELECTION CRITERIA We included randomized controlled trials of yoga compared to sham yoga, no intervention, any other intervention and yoga added to other therapies. DATA COLLECTION AND ANALYSIS We followed standard Cochrane methods. Our major outcomes were 1. back-specific function, 2. pain, 3. clinical improvement, 4. mental and physical quality of life, 5. depression, and 6. ADVERSE EVENTS Our minor outcome was 1. work disability. We used GRADE to assess certainty of evidence for the major outcomes. MAIN RESULTS We included 21 trials (2223 participants) from the USA, India, the UK, Croatia, Germany, Sweden, and Turkey. Participants were recruited from both clinical and community settings. Most were women in their 40s or 50s. Most trials used iyengar, hatha, or viniyoga yoga. Trials compared yoga to a non-exercise control including waiting list, usual care, or education (10 trials); back-focused exercise such as physical therapy (five trials); both exercise and non-exercise controls (four trials); both non-exercise and another mind-body exercise (qigong) (one trial); and yoga plus exercise to exercise alone (one trial). One trial comparing yoga to exercise was an intensive residential one-week program, and we analyzed this trial separately. All trials were at high risk of performance and detection bias because participants and providers were not blinded to treatment, and outcomes were self-assessed. We found no trials comparing yoga to sham yoga. Low-certainty evidence from 11 trials showed that there may be a small clinically unimportant improvement in back-specific function with yoga (mean difference [MD] -1.69, 95% confidence interval [CI] -2.73 to -0.65 on the 0- to 24-point Roland-Morris Disability Questionnaire [RMDQ], lower = better, minimal clinically important difference [MCID] 5 points; 1155 participants) and moderate-certainty evidence from nine trials showed a clinically unimportant improvement in pain (MD -4.53, 95% CI -6.61 to -2.46 on a 0 to 100 scale, 0 no pain, MCID 15 points; 946 participants) compared to no exercise at three months. Low-certainty evidence from four trials showed that there may be a clinical improvement with yoga (risk ratio [RR] 2.33, 95% CI 1.46 to 3.71; assessed as participant rating that back pain was improved or resolved; 353 participants). Moderate-certainty evidence from six trials showed that there is probably a small improvement in physical and mental quality of life (physical: MD 1.80, 95% CI 0.27 to 3.33 on the 36-item Short Form [SF-36] physical health scale, higher = better; mental: MD 2.38, 95% CI 0.60 to 4.17 on the SF-36 mental health scale, higher = better; both 686 participants). Low-certainty evidence from three trials showed little to no improvement in depression (MD -1.25, 95% CI -2.90 to 0.46 on the Beck Depression Inventory, lower = better; 241 participants). There was low-certainty evidence from eight trials that yoga increased the risk of adverse events, primarily increased back pain, at six to 12 months (RR 4.76, 95% CI 2.08 to 10.89; 43/1000 with yoga and 9/1000 with no exercise; 1037 participants). For yoga compared to back-focused exercise controls (8 trials, 912 participants) at three months, we found moderate-certainty evidence from four trials for little or no difference in back-specific function (MD -0.38, 95% CI -1.33 to 0.62 on the RMDQ, lower = better; 575 participants) and very low-certainty evidence from two trials for little or no difference in pain (MD 2.68, 95% CI -2.01 to 7.36 on a 0 to 100 scale, lower = better; 326 participants). We found very low-certainty evidence from three trials for no difference in clinical improvement assessed as participant rating that back pain was improved or resolved (RR 0.97, 95% CI 0.72 to 1.31; 433 participants) and very low-certainty evidence from one trial for little or no difference in physical and mental quality of life (physical: MD 1.30, 95% CI -0.95 to 3.55 on the SF-36 physical health scale, higher = better; mental: MD 1.90, 95% CI -1.17 to 4.97 on the SF-36 mental health scale, higher = better; both 237 participants). No studies reported depression. Low-certainty evidence from five trials showed that there was little or no difference between yoga and exercise in the risk of adverse events at six to 12 months (RR 0.93, 95% CI 0.56 to 1.53; 84/1000 with yoga and 91/1000 with non-yoga exercise; 640 participants). AUTHORS' CONCLUSIONS There is low- to moderate-certainty evidence that yoga compared to no exercise results in small and clinically unimportant improvements in back-related function and pain. There is probably little or no difference between yoga and other back-related exercise for back-related function at three months, although it remains uncertain whether there is any difference between yoga and other exercise for pain and quality of life. Yoga is associated with more adverse events than no exercise, but may have the same risk of adverse events as other exercise. In light of these results, decisions to use yoga instead of no exercise or another exercise may depend on availability, cost, and participant or provider preference. Since all studies were unblinded and at high risk of performance and detection bias, it is unlikely that blinded comparisons would find a clinically important benefit.
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Affiliation(s)
- L Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Nicole Skoetz
- Cochrane Cancer, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Karen Pilkington
- School of Health and Care Professions, University of Portsmouth, Portsmouth, UK
| | | | | | - Brian M Berman
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
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26
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Wieland LS. Synopses of Cochrane Reviews from Cochrane Library Issue 2 2022 Through Issue 5 2022. J Integr Complement Med 2022; 28:699-701. [PMID: 35917552 PMCID: PMC9917319 DOI: 10.1089/jicm.2022.0649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- L. Susan Wieland
- Department of Family and Community Medicine, Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
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27
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Ng JY, Dhawan T, Dogadova E, Taghi-Zada Z, Vacca A, Fajardo RG, Masood HA, Patel R, Sunderji S, Wieland LS, Moher D. A comprehensive search string informed by an operational definition of complementary, alternative, and integrative medicine for systematic bibliographic database search strategies. BMC Complement Med Ther 2022; 22:200. [PMID: 35897034 PMCID: PMC9327196 DOI: 10.1186/s12906-022-03683-1] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 07/20/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Determining which therapies fall under the umbrella of complementary, alternative, and/or integrative medicine (CAIM) is difficult for several reasons. An operational definition is dynamic, and changes depending on both historical time period and geographical location, with many countries integrating or considering their traditional system(s) of medicine as conventional care. We have previously reported the first operational definition of CAIM informed by a systematic search. In the present study, we have developed a comprehensive search string informed by an operational definition of CAIM for systematic bibliographic database search strategies. METHODS We developed a single search string for the most common bibliographic databases, including those searchable on the OVID platform (e.g., MEDLINE, EMBASE, PsycINFO, AMED), the EBSCO platform (e.g., ERIC, CINAHL), Scopus, and Web of Science, using the finalised operational definition of CAIM's 604 therapies. We searched the Therapeutic Research Center's "Natural Medicines" database for all 604 therapies, and each item's scientific name and/or synonym was included as a keyword or phrase in the search string. RESULTS This developed search string provides a standardised list of CAIM terms (i.e., keywords and phrases) that may be searched on bibliographic databases including those found on the OVID platform (e.g., MEDLINE, EMBASE, PsycINFO, AMED), the EBSCO platform (e.g., ERIC, CINAHL), Scopus, and Web of Science. CONCLUSION Researchers can select relevant terms for their CAIM study and insert the keywords/phrases into these databases to receive all accessible data. This search technique can simply be copied and pasted into the search bar of each database to identify research by keywords, which is the most inclusive, or by words in the article title, which is more selective. Given its versatility across multiple commonly used academic platforms/databases, it is expected that this search string will be of great value to those conducting research on CAIM topics involving systematic search strategies.
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Affiliation(s)
- Jeremy Y. Ng
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario Canada ,grid.412687.e0000 0000 9606 5108Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Tushar Dhawan
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario Canada
| | - Ekaterina Dogadova
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario Canada
| | - Zhala Taghi-Zada
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario Canada
| | - Alexandra Vacca
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario Canada
| | - Renee-Gabrielle Fajardo
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario Canada
| | - Hooriya A. Masood
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario Canada
| | - Riva Patel
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario Canada
| | - Samira Sunderji
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario Canada
| | - L. Susan Wieland
- grid.411024.20000 0001 2175 4264Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD USA
| | - David Moher
- grid.412687.e0000 0000 9606 5108Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada ,grid.28046.380000 0001 2182 2255School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
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28
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Patwardhan B, Wieland LS, Aginam O, Chuthaputti A, Ghelman R, Ghods R, Soon GC, Matsabisa MG, Seifert G, Tu’itahi S, Chol KS, Kuruvilla S, Kemper K, Cramer H, Nagendra H, Thakar A, Nesari T, Sharma S, Srikanth N, Acharya R. Evidence-based traditional medicine for transforming global health and well-being. Ayu 2022; 43:71-74. [PMID: 38075187 PMCID: PMC10710233 DOI: 10.4103/ayu.ayu_218_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/05/2023] [Accepted: 09/05/2023] [Indexed: 02/12/2024] Open
Affiliation(s)
- Bhushan Patwardhan
- Journal of Ayurveda and Integrative Medicine, Ramkumar Rathi Patanjali Yoga Chair at School of Health Sciences, Savitribai Phule Pune University, Pune, India
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
| | - L. Susan Wieland
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- Department of Family & Community Medicine, School of Medicine, University of Maryland, Baltimore, MD, United States of America
| | - Obijiofor Aginam
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- United Nations University International Institute for Global Health, Kuala Lumpur, Malaysia
| | - Anchalee Chuthaputti
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- Institute of Thai Traditional Medicine, Nonthaburi, Thailand
| | - Ricardo Ghelman
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- Department of Medicine and Primary Care, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Roshanak Ghods
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- Department of Persian Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Goh Cheng Soon
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- Traditional and Complementary Medicine Division, Ministry of Health, Kuala Lumpur, Malaysia
| | - Motlalepula G. Matsabisa
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- Department of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Georg Seifert
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- Department of Pediatrics, Division of Oncology and Hematology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Sione Tu’itahi
- External Advisory Group for the WHO Traditional Medicine Global Summit, World Health Organization, Geneva, Switzerland
- Health Promotion Forum, Auckland, New Zealand
| | - Kim Sung Chol
- TCI Unit, World Health Organization, Geneva, Switzerland
| | | | - Kathi Kemper
- Journal Editors Endorsing Editorial, University of Maryland, Baltimore, MD, United States of America
- Complementary Therapies in Medicine, Ohio State University College of Medicine, Columbus, OH, United States of America
| | - Holger Cramer
- Journal Editors Endorsing Editorial, University of Maryland, Baltimore, MD, United States of America
- Journal of Complementary and Integrative Medicine, University of Duisburg-Essen Chair of Complementary and Integrative Medicine, Essen, Germany
| | - H.R. Nagendra
- Journal Editors Endorsing Editorial, University of Maryland, Baltimore, MD, United States of America
- Indian Journal of Traditional Knowledge, S-VYASA Yoga University, Bengaluru, India
| | - Anup Thakar
- Journal Editors Endorsing Editorial, University of Maryland, Baltimore, MD, United States of America
- AYU Journal, Institute of Teaching and Research in Ayurveda, Jamnagar, India
| | - Tanuja Nesari
- Journal Editors Endorsing Editorial, University of Maryland, Baltimore, MD, United States of America
- International Journal of Ayurveda Research, All India Institute of Ayurveda, New Delhi, India
| | - Sanjeev Sharma
- Journal Editors Endorsing Editorial, University of Maryland, Baltimore, MD, United States of America
- Journal of Ayurveda, National Institute of Ayurveda, Jaipur, India
| | - Narayanam Srikanth
- Journal Editors Endorsing Editorial, University of Maryland, Baltimore, MD, United States of America
- Journal of Research in Ayurvedic Sciences, Central Council for Research in Ayurvedic Sciences, New Delhi, India
| | - Rabinarayan Acharya
- Journal Editors Endorsing Editorial, University of Maryland, Baltimore, MD, United States of America
- Journal of Drug Research in Ayurvedic Sciences, Central Council for Research in Ayurvedic Sciences, New Delhi, India
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Wieland LS. Synopses of Cochrane Reviews from Cochrane Library Issue 11 2021 Through Issue 1 2022. J Integr Complement Med 2022; 28:375-376. [PMID: 35363047 PMCID: PMC10027336 DOI: 10.1089/jicm.2022.0535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Affiliation(s)
- L. Susan Wieland
- Department of Family & Community Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- Address correspondence to: L. Susan Wieland, MPH, PhD, Department of Family & Community Medicine University of Maryland School of Medicine, 520 W. Lombard Street, Baltimore, MD 21201, USA
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Ng JY, Dhawan T, Dogadova E, Taghi-Zada Z, Vacca A, Wieland LS, Moher D. Operational definition of complementary, alternative, and integrative medicine derived from a systematic search. BMC Complement Med Ther 2022; 22:104. [PMID: 35413882 PMCID: PMC9006507 DOI: 10.1186/s12906-022-03556-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 03/07/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Identifying what therapies constitute complementary, alternative, and/or integrative medicine (CAIM) is complex for a multitude of reasons. An operational definition is dynamic, and changes based on both historical time period and geographical location whereby many jurisdictions may integrate or consider their traditional system(s) of medicine as conventional care. To date, only one operational definition of "complementary and alternative medicine" has been proposed, by Cochrane researchers in 2011. This definition is not only over a decade old but also did not use systematic methods to compile the therapies. Furthermore, it did not capture the concept "integrative medicine", which is an increasingly popular aspect of the use of complementary therapies in practice. An updated operational definition reflective of CAIM is warranted given the rapidly increasing body of CAIM research literature published each year. METHODS Four peer-reviewed or otherwise quality-assessed information resource types were used to inform the development of the operational definition: peer-reviewed articles resulting from searches across seven academic databases (MEDLINE, EMBASE, AMED, PsycINFO, CINAHL, Scopus and Web of Science); the "aims and scope" webpages of peer-reviewed CAIM journals; CAIM entries found in online encyclopedias, and highly-ranked websites identified through searches of CAIM-related terms on HONcode. Screening of eligible resources, and data extraction of CAIM therapies across them, were each conducted independently and in duplicate. CAIM therapies across eligible sources were deduplicated. RESULTS A total of 101 eligible resources were identified: peer-reviewed articles (n = 19), journal "aims and scope" webpages (n = 22), encyclopedia entries (n = 11), and HONcode-searched websites (n = 49). Six hundred four unique CAIM terms were included in this operational definition. CONCLUSIONS This updated operational definition is the first to be informed by systematic methods, and could support the harmonization of CAIM-related research through the provision of a standard of classification, as well as support improved collaboration between different research groups.
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Affiliation(s)
- Jeremy Y. Ng
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON Canada ,grid.412687.e0000 0000 9606 5108Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Tushar Dhawan
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON Canada
| | - Ekaterina Dogadova
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON Canada
| | - Zhala Taghi-Zada
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON Canada
| | - Alexandra Vacca
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON Canada
| | - L. Susan Wieland
- grid.411024.20000 0001 2175 4264Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD USA
| | - David Moher
- grid.412687.e0000 0000 9606 5108Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada ,grid.28046.380000 0001 2182 2255School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
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Dai Z, Liao X, Wieland LS, Hu J, Wang Y, Kim TH, Liu JP, Zhan S, Robinson N. Cochrane systematic reviews on traditional Chinese medicine: What matters-the quantity or quality of evidence? Phytomedicine 2022; 98:153921. [PMID: 35104758 PMCID: PMC9741948 DOI: 10.1016/j.phymed.2021.153921] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/22/2021] [Accepted: 12/30/2021] [Indexed: 05/07/2023]
Abstract
BACKGROUND Systematic reviews on traditional Chinese medicine (TCM) are constantly increasing. However, if these reviews are to be of practical value, the evidence needs to be relevant, valid, and adequately reported. Cochrane Systematic Reviews (CSRs) are considered as high-quality systematic reviews that can inform health care decision making. Our aim was to provide an overview of the scope, findings, quality and impact of CSRs on the benefits and harms associated with TCM interventions for the treatment and prevention of disease to provide new information for clinical practice and future research. METHODS The Cochrane Database of Systematic Reviews was searched up to May 2021, and descriptive characteristics were extracted. The correspondence between the questions asked in the CSRs and the available evidence, conclusions and certainty of findings (according to GRADE assessment), methodological quality (AMSTAR 2), and impact (Altmetric Attention Score [AAS], total citations by guideline, and total citations in Web of Science [WoS]) of CSRs were extracted. Tabular and graphical summaries of these descriptive characteristics were constructed. RESULTS Of 104 CSRs on TCM identified, 70 diseases belonged to 16 disease systems and contained 1642 primary studies with 157,943 participants. Interventions included Chinese herbal medicine (n = 70), acupuncture (n = 28), TCM exercises (n = 4), and moxibustion (n = 2). Among 1642 primary studies, 662 studies included an intervention group treated with at least one TCM therapy and 980 studies included a combination of therapies. Promising outcomes from the 104 CSRs were divided into endpoint outcomes (34 diseases), doctor- or patient-reported outcomes (27 diseases), and surrogate outcomes (37 diseases). Despite the presence of promising outcomes, only 5/104 CSRs drew overall positive conclusions, 42 CSRs concluded the evidence was insufficient, and 54 failed to draw firm conclusions. GRADE assessments were reported in 41.3% of the CSRs, and the ratings were mostly low or very low. Comparing the questions asked and results obtained, there was frequently a lack of information about specific outcomes. Only 16 CSRs obtained results for all outcomes listed in the methods section. According to AMSTAR 2, 51 CSRs (49.0%) were of low quality. The total number of citations in the WoS was 2135 (mean ± SD: 20.8 ± 21.2), and 38.5% of the CSRs had been cited in guidelines 95 times. CONCLUSION Although TCM is commonly used, evidence of its effectiveness remains largely inconclusive. Rigorous high-quality trials are needed to support the performance of high-quality reviews and to increase the evidence base. It is critical to emphasize quality over quantity in future TCM research.
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Affiliation(s)
- Zeqi Dai
- Center for Evidence Based Chinese Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China; China Center for Evidence Based Traditional Chinese Medicine, Beijing 100700, China
| | - Xing Liao
- Center for Evidence Based Chinese Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - L Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore MD 21201, USA
| | - Jing Hu
- Evidence-based Medicine Center, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine, Beijing 100010, China
| | - Yongyan Wang
- Center for Evidence Based Chinese Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Tae-Hun Kim
- Korean Medicine Clinical Trial Center, Korean Medicine Hospital, Kyung Hee University, #23 Kyungheedae-ro, Dondaemun-gu, Seoul 02447, South Korea
| | - Jian-Ping Liu
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing 100029, China.
| | - Siyan Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.5 Yiheyuan Road, Haidian District, Beijing 100191, China.
| | - Nicola Robinson
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing 100029, China; Institute of Health and Social Care, London South Bank University, 103 Borough Road, London SE1 0AA, UK.
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Wieland LS. Synopses of Cochrane Reviews from Cochrane Library Issue 7 2021 Through Issue 10 2021. J Integr Complement Med 2022; 28:3-5. [PMID: 35085019 DOI: 10.1089/jicm.2021.0407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- L Susan Wieland
- Center for Integrative Medicine, Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
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Wieland LS, Pilkington K, Lauche R, Cramer H, Verstappen A, Parker E. Characteristics of systematic reviews of yoga: a bibliometric analysis of the research. Eur J Integr Med 2021. [DOI: 10.1016/j.eujim.2021.101957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Wieland LS, Moonaz S, Shipper AG, Cogo E, Bingham III C. Yoga for osteoarthritis of the hip or knee. Hippokratia 2021. [DOI: 10.1002/14651858.cd014563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- L Susan Wieland
- Center for Integrative Medicine; University of Maryland School of Medicine; Baltimore Maryland USA
| | - Steffany Moonaz
- Research; Maryland University of Integrative Health; Laurel Maryland USA
| | - Andrea G Shipper
- University of Maryland Health Sciences and Human Services Library; Baltimore Maryland USA
| | - Elise Cogo
- Cochrane Response; Cochrane; Toronto Canada
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Wieland LS, Hamel C, Konstantinidis M, Nourouzpour S, Shipper AG, Lipski E. Zinc for prevention and treatment of the common cold. Hippokratia 2021. [DOI: 10.1002/14651858.cd014914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- L Susan Wieland
- Center for Integrative Medicine; University of Maryland School of Medicine; Baltimore Maryland USA
| | | | - Menelaos Konstantinidis
- Division of Biostatistics, Dalla Lana School of Public Health; University of Toronto; Toronto Canada
- Child Health Evaluative Sciences; The Hospital for Sick Children; Toronto Canada
| | | | - Andrea G Shipper
- Health Sciences and Human Services Library; University of Maryland, Baltimore; Baltimore MD USA
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Wieland LS. Synopses of Cochrane Reviews from Cochrane Library Issue 4 2021 Through Issue 6 2021. J Altern Complement Med 2021; 27:627-629. [PMID: 34406080 DOI: 10.1089/acm.2021.0249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- L Susan Wieland
- Department of Family and Community Medicine, Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
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Wieland LS, Cramer H, Lauche R, Verstappen A, Parker EA, Pilkington K. Evidence on yoga for health: A bibliometric analysis of systematic reviews. Complement Ther Med 2021; 60:102746. [PMID: 34091028 PMCID: PMC8350934 DOI: 10.1016/j.ctim.2021.102746] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To support the research agenda in yoga for health by comprehensively identifying systematic reviews of yoga for health outcomes and conducting a bibliometric analysis to describe their publication characteristics and topic coverage. METHODS We searched 7 databases (MEDLINE/PubMed, Embase, PsycINFO, CINAHL, AMED, the Cochrane Database of Systematic Reviews, and PROSPERO) from their inception to November 2019 and 1 database (INDMED) from inception to January 2017. Two authors independently screened each record for inclusion and one author extracted publication characteristics and topics of included reviews. RESULTS We retrieved 2710 records and included 322 systematic reviews. 157 reviews were exclusively on yoga, and 165 were on yoga as one of a larger class of interventions (e.g., exercise). Most reviews were published in 2012 or later (260/322; 81 %). First/corresponding authors were from 32 different countries; three-quarters were from the USA, Germany, China, Australia, the UK or Canada (240/322; 75 %). Reviews were most frequently published in speciality journals (161/322; 50 %) complementary medicine journals (66/322; 20 %) or systematic review journals (59/322; 18 %). Almost all were present in MEDLINE (296/322; 92 %). Reviews were most often funded by government or non-profits (134/322; 42 %), unfunded (74/322; 23 %), or not explicit about funding (111/322; 34 %). Common health topics were psychiatric/cognitive (n = 56), cancer (n = 39) and musculoskeletal conditions (n = 36). Multiple reviews covered similar topics, particularly depression/anxiety (n = 18), breast cancer (n = 21), and low back pain (n = 16). CONCLUSIONS Further research should explore the overall quality of reporting and conduct of systematic reviews of yoga, the direction and certainty of specific conclusions, and duplication or gaps in review coverage of topics.
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Affiliation(s)
- L S Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - H Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Germany; National Centre for Naturopathic Medicine, Southern Cross University, Lismore, Australia
| | - R Lauche
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, Australia
| | - A Verstappen
- Global Alliance for Rheumatic and Congenital Hearts, Philadelphia, PA, USA
| | - E A Parker
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD, USA
| | - K Pilkington
- School of Health and Care Professions, University of Portsmouth, UK
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Wieland LS. Synopses of Cochrane Reviews from Cochrane Library Issue 12 2020 Through Issue 3 2021. J Altern Complement Med 2021; 27:287-289. [PMID: 33872060 DOI: 10.1089/acm.2021.0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- L Susan Wieland
- Center for Integrative Medicine, Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
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Cramer H, Wieland LS. Taking a Closer Look at Methodological Quality: JACM Partners with Cochrane Complementary Medicine. J Altern Complement Med 2021; 27:285-286. [PMID: 33872059 DOI: 10.1089/acm.2021.29092.hcr] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - L Susan Wieland
- Cochrane Complementary Medicine, Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
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40
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Wieland LS, Moffet I, Shade S, Emadi A, Knott C, Gorman EF, D'Adamo C. Risks and benefits of antioxidant dietary supplement use during cancer treatment: protocol for a scoping review. BMJ Open 2021; 11:e047200. [PMID: 33849858 PMCID: PMC8051392 DOI: 10.1136/bmjopen-2020-047200] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 02/15/2021] [Accepted: 03/24/2021] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Antioxidant dietary supplements are used by many patients with cancer to reduce the side effects of chemotherapy and improve prognosis. While some research indicates oral antioxidant supplementation reduces side effects and improves patient survival, other studies suggest the use of antioxidant dietary supplements may interfere with chemotherapy and reduce its curative effects. There is a need to clarify the evidence base on the impact of dietary antioxidant supplementation during chemotherapy on both side effect and treatment efficacy outcomes. We will use a scoping review approach to identify what systematic review evidence exists regarding beneficial and harmful effects of dietary antioxidant supplements when used during cancer treatment. METHODS AND ANALYSIS We will use Arksey & O'Malley and Joanna Briggs Institute methods for scoping reviews. We will systematically search PubMed, Embase, CINAHL, Scopus, Dissertations & Theses Global and the Cochrane Library from inception to October 2020. Systematic reviews of randomised controlled trials of oral dietary antioxidant supplements used by participants receiving curative chemotherapy, radiotherapy or other biological therapy for cancer will be eligible. Two reviewers will screen citations and full texts for inclusion and chart data on research questions from included reviews. Two reviewers will assess the overall confidence in systematic review results using A Measurement Tool to Assess Systematic Reviews-2 (AMSTAR-2), and summarised evidence will focus on reviews rated at high or moderate overall confidence. Tables will be used to map existing evidence and identify evidence gaps for safety and effectiveness outcomes. ETHICS AND DISSEMINATION This scoping review does not require ethical approval as it is a secondary assessment of available literature. The results will be presented at conferences and submitted for publication in a peer-reviewed journal. We will also disseminate results to community and clinical stakeholders and involve them in developing subsequent research to address critical existing gaps in the evidence as identified by the scoping review.
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Affiliation(s)
- L Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Ilana Moffet
- University of Michigan College of Literature, Science, and the Arts, Ann Arbor, Michigan, USA
| | - Sydney Shade
- Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA
| | - Ashkan Emadi
- School of Medicine, University of Maryland Baltimore, Baltimore, Maryland, USA
- University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Cheryl Knott
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, Maryland, USA
- Office of Community Outreach and Engagement, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Emily F Gorman
- Health Sciences and Human Services Library, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Christopher D'Adamo
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Wieland LS, Piechotta V, Feinberg T, Ludeman E, Hutton B, Kanji S, Seely D, Garritty C. Elderberry for prevention and treatment of viral respiratory illnesses: a systematic review. BMC Complement Med Ther 2021; 21:112. [PMID: 33827515 PMCID: PMC8026097 DOI: 10.1186/s12906-021-03283-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 03/21/2021] [Indexed: 01/12/2023] Open
Abstract
Background Elderberry has traditionally been used to prevent and treat respiratory problems. During the COVID-19 pandemic, there has been interest in elderberry supplements to treat or prevent illness, but also concern that elderberry might overstimulate the immune system and increase the risk of ‘cytokine storm’. We aimed to determine benefits and harms of elderberry for the prevention and treatment of viral respiratory infections, and to assess the relationship between elderberry supplements and negative health impacts associated with overproduction of pro-inflammatory cytokines. Methods We conducted a systematic review and searched six databases, four research registers, and two preprint sites for studies. Two reviewers independently assessed studies for inclusion, extracted data from studies, assessed risk of bias using Cochrane tools, and evaluated certainty of estimates using GRADE. Outcomes included new illnesses and the severity and duration of illness. Results We screened 1187 records and included five randomized trials on elderberry for the treatment or prevention of viral respiratory illness. We did not find any studies linking elderberry to clinical inflammatory outcomes. However, we found three studies measuring production of cytokines ex vivo after ingestion of elderberry. Elderberry may not reduce the risk of developing the common cold; it may reduce the duration and severity of colds, but the evidence is uncertain. Elderberry may reduce the duration of influenza but the evidence is uncertain. Compared to oseltamivir, an elderberry-containing product may be associated with a lower risk of influenza complications and adverse events. We did not find evidence on elderberry and clinical outcomes related to inflammation. However, we found evidence that elderberry has some effect on inflammatory markers, although this effect may decline with ongoing supplementation. One small study compared elderberry to diclofenac (a nonsteroidal anti-inflammatory drug) and provided some evidence that elderberry is as effective or less effective than diclofenac in cytokine reduction over time. Conclusions Elderberry may be a safe option for treating viral respiratory illness, and there is no evidence that it overstimulates the immune system. However, the evidence on both benefits and harms is uncertain and information from recent and ongoing studies is necessary to make firm conclusions. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-021-03283-5.
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Affiliation(s)
- L Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Vanessa Piechotta
- Evidence-based Oncology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Termeh Feinberg
- Kelly Government Solutions, Rockville, MD, USA.,Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, CT, USA.,Yale Center for Medical Informatics, Yale University School of Medicine, New Haven, CT, USA
| | - Emilie Ludeman
- University of Maryland, Health Sciences and Human Services Library, Baltimore, MD, USA
| | - Brian Hutton
- The Ottawa Hospital Research Institute (OHRI), Ottawa, Ontario, Canada.,University of Ottawa, School of Epidemiology and Public Health, Ottawa, Ontario, Canada
| | - Salmaan Kanji
- The Ottawa Hospital Research Institute (OHRI), Ottawa, Ontario, Canada.,The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Dugald Seely
- The Ottawa Hospital, Ottawa, Ontario, Canada.,The Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada.,The Centre for Health Innovation, The Canadian College of Naturopathic Medicine, Ottawa, Ontario, Canada
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Kwak J, Susan Wieland L. Physical interventions to interrupt or reduce the spread of respiratory viruses: Summary of a Cochrane review. Explore (NY) 2021; 17:277-278. [PMID: 33726953 DOI: 10.1016/j.explore.2021.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Affiliation(s)
- L Susan Wieland
- Center for Integrative Medicine; University of Maryland School of Medicine; Baltimore Maryland USA
| | | | | | - Nikhil K Prasad
- Epidemiology; University of Maryland School of Medicine; Baltimore Maryland USA
| | - Hakima Amri
- Department of Biochemistry, Cellular and Molecular Biology; Georgetown University Medical Center; Washington District of Columbia USA
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Pratt M, Stevens A, Thuku M, Butler C, Skidmore B, Wieland LS, Clemons M, Kanji S, Hutton B. Benefits and harms of medical cannabis: a scoping review of systematic reviews. Syst Rev 2019; 8:320. [PMID: 31823819 PMCID: PMC6905063 DOI: 10.1186/s13643-019-1243-x] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 11/24/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND There has been increased interest in the role of cannabis for treating medical conditions. The availability of different cannabis-based products can make the side effects of exposure unpredictable. We sought to conduct a scoping review of systematic reviews assessing benefits and harms of cannabis-based medicines for any condition. METHODS A protocol was followed throughout the conduct of this scoping review. A protocol-guided scoping review conduct. Searches of bibliographic databases (e.g., MEDLINE®, Embase, PsycINFO, the Cochrane Library) and gray literature were performed. Two people selected and charted data from systematic reviews. Categorizations emerged during data synthesis. The reporting of results from systematic reviews was performed at a high level appropriate for a scoping review. RESULTS After screening 1975 citations, 72 systematic reviews were included. The reviews covered many conditions, the most common being pain management. Several reviews focused on management of pain as a symptom of conditions such as multiple sclerosis (MS), injury, and cancer. After pain, the most common symptoms treated were spasticity in MS, movement disturbances, nausea/vomiting, and mental health symptoms. An assessment of review findings lends to the understanding that, although in a small number of reviews results showed a benefit for reducing pain, the analysis approach and reporting in other reviews was sub-optimal, making it difficult to know how consistent findings are when considering pain in general. Adverse effects were reported in most reviews comparing cannabis with placebo (49/59, 83%) and in 20/24 (83%) of the reviews comparing cannabis to active drugs. Minor adverse effects (e.g., drowsiness, dizziness) were common and reported in over half of the reviews. Serious harms were not as common, but were reported in 21/59 (36%) reviews that reported on adverse effects. Overall, safety data was generally reported study-by-study, with few reviews synthesizing data. Only one review was rated as high quality, while the remaining were rated of moderate (n = 36) or low/critically low (n = 35) quality. CONCLUSIONS Results from the included reviews were mixed, with most reporting an inability to draw conclusions due to inconsistent findings and a lack of rigorous evidence. Mild harms were frequently reported, and it is possible the harms of cannabis-based medicines may outweigh benefits. SYSTEMATIC REVIEW REGISTRATION The protocol for this scoping review was posted in the Open Access (https://ruor.uottawa.ca/handle/10393/37247).
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Affiliation(s)
- Misty Pratt
- Knowledge Synthesis Group, Ottawa Methods Centre, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, 501 Smyth Road, Ottawa, Ontario K1H 8 L6 Canada
| | - Adrienne Stevens
- Knowledge Synthesis Group, Ottawa Methods Centre, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, 501 Smyth Road, Ottawa, Ontario K1H 8 L6 Canada
- TRIBE Graduate Program, University of Split School of Medicine, Split, Croatia
| | - Micere Thuku
- Knowledge Synthesis Group, Ottawa Methods Centre, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, 501 Smyth Road, Ottawa, Ontario K1H 8 L6 Canada
| | - Claire Butler
- Knowledge Synthesis Group, Ottawa Methods Centre, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, 501 Smyth Road, Ottawa, Ontario K1H 8 L6 Canada
- Department of Pharmacology and Therapeutics, McGill University, Montreal, Quebec H3A 2B4 Canada
| | | | - L. Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD USA
| | - Mark Clemons
- School of Epidemiology and Public Health, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8 M5 Canada
- Division of Medical Oncology and Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Salmaan Kanji
- School of Epidemiology and Public Health, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8 M5 Canada
- Department of Pharmacy, The Ottawa Hospital, Ottawa, Canada
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Brian Hutton
- Knowledge Synthesis Group, Ottawa Methods Centre, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, 501 Smyth Road, Ottawa, Ontario K1H 8 L6 Canada
- School of Epidemiology and Public Health, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8 M5 Canada
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Wieland LS, Brassington R, Macdonald G. Barriers to the registration and conduct of Cochrane systematic reviews of traditional East Asian medicine therapies. Eur J Integr Med 2019; 32:101008. [PMID: 31933695 PMCID: PMC6957081 DOI: 10.1016/j.eujim.2019.101008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Traditional East Asian medicine (TEAM) is widely used in Asia and increasingly in the West. Systematic reviews (SRs) are the best summaries of the potential benefits or harms of interventions, and Cochrane is a leading international SR organization. Cochrane perspectives on the barriers to the initiation and completion of Cochrane SRs of TEAM therapies were solicited. METHODS Cochrane Review Groups (CRGs) were identified from the online listing of CRGs at cochrane.org and a link to an online survey was e-mailed to the primary contact for each CRG. RESULTS Forty-eight responses were received on behalf of 49/53 (92%) CRGs. Most CRGs had experience producing TEAM reviews, primarily in acupuncture or herbal medicine. The main barriers to taking on a new TEAM review were difficulty in understanding and assessing the intervention, and the low priority of TEAM topics. Problems with the quality and accessibility of randomized trials in TEAM were cited as a major concern. CRGs suggested that the quality and accessibility of randomized trials should be improved, that the methodological and language expertise of authors should be enhanced, and that further peer review expertise should be made available to CRGs. CONCLUSIONS TEAM topics are covered in Cochrane reviews but are often considered low-priority. This survey highlights Cochrane concerns about the quality of the underlying evidence base and the training of the author teams as barriers to successful SR completion. Specific approaches are proposed to increase the number of TEAM reviews and address the limitations of TEAM research processes within Cochrane.
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Affiliation(s)
- L Susan Wieland
- Cochrane Complementary Medicine, Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore MD, USA
| | - Ruth Brassington
- Cochrane Neuromuscular, Queen Square Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery and UCL Institute of Neurology, London, UK
| | - Geraldine Macdonald
- Cochrane Developmental, Psychosocial and Learning Problems, School of Policy Studies, University of Bristol, Bristol, UK
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Wieland LS, Owens N, Santesso N. A summary of a Cochrane review: Vitamin D supplementation during pregnancy. Eur J Integr Med 2019. [DOI: 10.1016/j.eujim.2019.100985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lee MS, Nielsen A, Kim TH, Ha IH, Harbin S, Wieland LS. Acupuncture for chronic neck pain. Hippokratia 2019. [DOI: 10.1002/14651858.cd013477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Myeong Soo Lee
- Korea Institute of Oriental Medicine; Clinical Medicine Division; 461-24 Jeonmin-dong, Yuseong-gu Daejeon Korea, South 34054
| | - Arya Nielsen
- Icahn School of Medicine at Mount Sinai; Department of Family Medicine and Community Health; 1923 Glasco Tnpk Woodstock New York USA 12498
| | - Tae-Hun Kim
- College of Korean Medicine, Kyung Hee University; Korean Medicine Clinical Trial Center; #23 Kyungheedae-ro Dongdaemun-gu Seoul Korea, South 130-872
| | - In-Hyuk Ha
- Jaseng Medical Foundation; Jaseng Spine and Joint Research Institute; 858 Eonju-ro, Gangnam-gu Seoul Korea, South
| | - Shireen Harbin
- Institute for Work & Health; Cochrane Back and Neck Review Group; 481 University Avenue Suite 800 Toronto ON Canada M5G 2E9
| | - L Susan Wieland
- University of Maryland School of Medicine; Center for Integrative Medicine; 520 W. Lombard Street Baltimore Maryland USA 21201
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Abstract
Cochrane is an international non-profit organization established in 1993 to produce and disseminate high quality and unbiased systematic reviews of evidence on health care interventions. At the forefront of systematic review methodology, Cochrane is generally accepted to be among the most carefully prepared and rigorous sources of systematic review evidence. There are numerous Cochrane reviews on nonpharmacologic interventions for pain and multiple Cochrane reviews evaluating acupuncture therapy in pain conditions. But how complete and up to date are those reviews relative to other rigorous systematic reviews with meta-analyses of acupuncture therapy for pain published in the literature? In this 'snapshot' overview, we found 22 relevant Cochrane reviews, some concluding that acupuncture therapy is probably useful for treating specific pain conditions. However, many of the conditions for which acupuncture is most commonly used are either not represented in Cochrane reviews or the existing Cochrane reviews are seriously outdated and do not reflect current evidence. This creates confusion with the risks of adverse effects and addiction liability associated with pain medications, the prevalence of chronic pain, the ongoing opioid epidemic and the need for evidence-based options for pain as part of comprehensive pain care. Clinicians and patients want clarification on safe and effective options to treat pain. Issues involving reviewed trials' inadequate use of sham comparators, of acupuncture as a complex intervention with interactive components and a shift in research focus from efficacy trials to real-world pragmatic trials are discussed in relation to updating Cochrane reviews of acupuncture therapy for pain.
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Affiliation(s)
- Arya Nielsen
- Icahn School of Medicine at Mount Sinai, Department of Family Medicine & Community Health, United States.
| | - L Susan Wieland
- University of Maryland School of Medicine, Center for Integrative Medicine, United States
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Susan Wieland L, Santesso N. A summary of a Cochrane review: Omega-3 fatty acid addition during pregnancy. Eur J Integr Med 2019. [DOI: 10.1016/j.eujim.2019.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Wieland LS, Pilkington K, Messin LJ. Announcing the affiliation between BMC Complementary and Alternative Medicine and Cochrane Complementary Medicine. Altern Ther Health Med 2019; 19:69. [PMID: 30922270 PMCID: PMC6440073 DOI: 10.1186/s12906-019-2480-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 03/11/2019] [Indexed: 11/10/2022]
Affiliation(s)
- L Susan Wieland
- Cochrane Complementary Medicine, Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, USA
| | - Karen Pilkington
- School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK
| | - Liam J Messin
- BMC Complementary and Alternative Medicine, London, UK.
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