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Cockroach and other inhalant insect allergens
Published in Richard F. Lockey, Dennis K. Ledford, Allergens and Allergen Immunotherapy, 2020
Given the high efficacy of properly implemented bait treatments, it is important to note several inadequacies in how they are treated in some reviews, meta-analyses, and even policy decisions [114,117]. First, pest control interventions that target different pests are often grouped as “multicomponent interventions,” with the tacit expectation of equivalent outcomes with all pests. In fact, acaricides targeting house dust mites are not nearly as effective as baits targeting cockroaches, and it is nearly impossible to eradicate mite populations with pesticides alone. It is not surprising therefore that acaricide-based interventions have contributed little to allergen reductions and clinical outcomes. Second, the requirements in randomized controlled trials of blinding participants and study personnel, and of placebo controls, severely limit the number of studies included in reviews and meta-analyses. The requirement for randomized controlled trials, in itself, disqualifies many excellent entomological interventions on the effectiveness of innovative tactics for cockroach control. Blinding participants is clearly required when they are the target of the intervention. But the target of cockroach interventions is the pest population, not participants, and blinding, while useful, is neither practical nor useful if unbiased assessment tools (e.g., sticky traps) are used to quantify effectiveness. Finally, placebo treatments with baits lacking insecticide are ill-advised, because they supplement the home environment with highly palatable cockroach food that can unintentionally increase the pest population.
Rate Ratios and Differences
Published in Peter Cummings, Analysis of Incidence Rates, 2019
Randomized controlled trials have the advantage that randomization, will, on average, create groups of subjects who are similar regarding not only measured confounding variables, but also similar regarding variables that we cannot measure or have not even considered. Thus, any comparison should, on average, be free of confounding bias. In any particular trial, of course, especially a small trial, confounding bias could be present. Selection bias can arise due to dropouts. Measurement error can also bias a randomized trial. For example, the outcome might be a pain score reported by trial subjects. If some patients deduce which arm of the trial they are in (treatment versus placebo), this might influence their reports of pain.
Quantitative approaches in sport-related concussion research
Published in Gordon A. Bloom, Jeffrey G. Caron, Psychological Aspects of Sport-Related Concussions, 2019
Meredith Rocchi, Camille Guertin, Scott Rathwell
Randomized controlled trials are preferred because, through randomization, they minimize the risk that confounding variables impact the conclusions of the study. The use of a control condition ensures that variations due to extraneous factors are accounted for within the study design. The prospective design also minimizes recall error and selection bias for participants, thus improving the fidelity of the results. Finally, the best advantage is that the study design allows for causal inferences. For instance, Swartz and colleagues (2015) conducted a randomized controlled trial in a concussion prevention setting to test a helmetless-tackling behavior intervention for collegiate football players. A sample of 50 players were randomized to either the intervention (25 players) or control (25 players) group. The intervention group participated in a five-minute tackling drill without their helmets or shoulder pads twice a week during the preseason and once per week throughout the season. During the same period, the control group performed noncontact football skills. Their frequency of head impacts was recorded with an impact sensor in all games. Differences between the two groups were examined, and the results supported that a helmetless-tackling training intervention reduced head impacts in collegiate football players within one football season.
Fibromyalgia and Nutrition: An Updated Review
Published in Journal of the American College of Nutrition, 2021
Laura Tomaino, Lluís Serra-Majem, Stefania Martini, Maria Rosaria Ingenito, Paola Rossi, Carlo La Vecchia, Fabrizia Bamonti, Luisella Vigna
However, little evidence suggests that nutrition and/or nutritional intervention play a significant role on FM severity or that these measures can exert a beneficial effect in ameliorating patients’ symptoms. Randomized controlled trials provide the best evidence of the efficacy of a treatment. Nevertheless, in the present review, the RCTs performed are weak, as the risk of bias is elevated. In fact, each trial investigated the effects of different interventions on FM symptoms (i.e. probiotic treatment (32), physiotherapy combined with lacto-vegetarian diet (34), antioxidant supplementation (38), gluten-free diet (40), or other nutritional supplementation (42)). There were also between-studies differences in the outcomes evaluated (i.e. cognition, emotional symptoms and functional status (32), low-back pain relief and body composition (34), FM symptoms (38), gluten-sensitivity symptoms (40), or physical fitness (42)).
Transitioning children from tube to oral feeding: a systematic review of current treatment approaches
Published in Speech, Language and Hearing, 2021
Sarah Ann Taylor, Javier Virues-Ortega, Rachel Anderson
In addition, prior reviews have focused on single-subject design studies only (Sharp, Jaquess, et al., 2010), or group design studies only (Lukens & Silverman, 2014; Sharp, Volkert, et al., 2016). Single-subject experimental designs typically involve small numbers of participants, with each participant serving as their own control (Kazdin, 2011). Visually displayed data from each participant are then compared across experimental phases in order to identify clinically important effects (see for example Smith, 2012). By contrast, group designs typically involve a relatively larger n and the use of statistics to evaluate changes in performance after treatment. The randomized controlled trial is the gold standard of group designs, and compares the performance of participants receiving the intervention with a control group that has not received the intervention. As the literature base for tube dependency has grown, it is important to survey both single-subject and group design studies, to obtain a broader view of available treatments. For example, behavioural interventions are often reported in single-subject experimental design studies (Sharp, Jaquess, et al., 2010). In comparison, approaches that include the reduction of tube feeds to stimulate hunger (Hunger Provocation) are more often reported in group-design studies (Lukens & Silverman, 2014).
Lack of Efficacy of the Neutropenic Diet in Decreasing Infections among Cancer Patients: A Systematic Review
Published in Nutrition and Cancer, 2020
Venkataraghavan Ramamoorthy, Muni Rubens, Sandeep Appunni, Anshul Saxena, Peter McGranaghan, Emir Veledar, Ana Viamonte-Ros, Nancy Shehadeh, Adeel Kaiser, Rupesh Kotecha
Studies that had outcome variable such as infection rates (e.g., bacteremia, pneumonia, or fungemia), infection-related mortality and mortality of any cause were included for the review. Two major types of studies that looked for the effectiveness of the neutropenic diet with above mentioned outcomes included: 1) meta-analyses (n = 3) which rigorously verify and ascertain the quality and methodology of individual studies; and 2) individual quantitative studies including randomized controlled trials (n = 5) and cohort studies (n = 3), such as prospective and retrospective studies. Randomized controlled trials generate superior evidences of efficacy, whereas observational studies need further investigation because they are correlational and do not establish the causal relationship. We have summarized the study characteristics such as source, year, design, settings, outcomes, results, and study rating following the directions by the Oxford Center for Evidence Based Medicine (22) in Table 1. Heterogeneity of study methods (meta-analysis, randomized controlled trials, and observational studies) and populations (adult and pediatric cancer patients) and differences in definitions of the neutropenic diet limited us from conducting a meta-analysis to calculate pooled estimates. Hence, we conducted a systematic review of different studies on the neutropenic diet.