Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Apr 2007
ReviewPsychological interventions to improve adherence to oral hygiene instructions in adults with periodontal diseases.
Adherence to oral hygiene is an important aspect of the treatment of periodontal disease. Traditional educational interventions have been shown to be of little value in achieving long term behaviour change. ⋯ There is tentative evidence from low quality studies that psychological approaches to behaviour management can improve oral hygiene related behaviours. However, the overall quality of the included trials was low. Furthermore, the design of the interventions was weak and limited, ignoring key aspects of the theories. Thus, there is a need for greater methodological rigour in the design of trials in this area.
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Prolotherapy involves repeated injections of irritant solutions to strengthen lumbosacral ligaments and reduce some types of chronic low-back pain; spinal manipulation and exercises are often used to enhance its effectiveness. ⋯ There is conflicting evidence regarding the efficacy of prolotherapy injections for patients with chronic low-back pain. When used alone, prolotherapy is not an effective treatment for chronic low-back pain. When combined with spinal manipulation, exercise, and other co-interventions, prolotherapy may improve chronic low-back pain and disability. Conclusions are confounded by clinical heterogeneity amongst studies and by the presence of co-interventions.
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Esophageal cancer is the seventh leading cause of cancer death worldwide. Traditional Chinese medicinal herbs are sometimes used as an adjunct to radiotherapy or chemotherapy for this type of cancer. ⋯ The included studies were of low quality. The results suggest Zhenxiang capsules or Huachansu injection may not improve short-term therapy effects or one-year survival rate when used as adjunct treatment to chemo- or radiotherapy in the treatment of esophageal cancer. The quality of life may be improved by Huachansu injection. The results suggest that more high-quality trials on Huachansu injection and other Chinese herbal medicines are needed in the future.
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It has been suggested that a time-lag bias exists whereby research studies with striking results are more likely to be stopped earlier than originally planned, published quicker, or both. If time-lag bias exists, new interventions might be mistakenly assumed to be effective. ⋯ Our review shows that trials with positive results are published sooner than other trials. This has important implications for the timing of the initiation and updating of a review, especially if there is an association between the inclusion of a trial in a review and its publication status. It is of particular concern when one considers reviews containing only a small number of studies.
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Cochrane Db Syst Rev · Apr 2007
ReviewGrey literature in meta-analyses of randomized trials of health care interventions.
The inclusion of grey literature (i.e. literature that has not been formally published) in systematic reviews may help to overcome some of the problems of publication bias, which can arise due to the selective availability of data. ⋯ This review shows that published trials tend to be larger and show an overall greater treatment effect than grey trials. This has important implications for reviewers who need to ensure they identify grey trials, in order to minimise the risk of introducing bias into their review.