Characteristics of randomized controlled trials of yoga: A bibliometric analysis

© 2014 Cramer et al.; licensee BioMed Central Ltd. Background: A growing number of randomized controlled trials (RCTs) have investigated the therapeutic value of yoga interventions. This bibliometric analysis aimed to provide a comprehensive review of the characteristics of the totality of available randomized yoga trials. Methods: All RCTs of yoga were eligible. Medline/PubMed, Scopus, the Cochrane Library, IndMED, and the tables of content of yoga specialty journals not listed in medical databases were screened through February 2014. Bibliometric data, data on participants, and intervention were extracted and analyzed descriptively. Results: Published between 1975 and 2014, a total of 366 papers were included, reporting 312 RCTs from 23 different countries with 22,548 participants. The median study sample size was 59 (range 8-410, interquartile range = 31, 93). Two hundred sixty-four RCTs (84.6%) were conducted with adults, 105 (33.7%) with older adults and 31 (9.9%) with children. Eighty-four RCTs (26.9%) were conducted with healthy participants. Other trials enrolled patients with one of 63 varied medical conditions; the most common being breast cancer (17 RCTs, 5.4%), depression (14 RCTs, 4.5%), asthma (14 RCTs, 4.5%) and type 2 diabetes mellitus (13 RCTs, 4.2%). Whilst 119 RCTs (38.1%) did not define the style of yoga used, 35 RCTs (11.2%) used Hatha yoga and 30 RCTs (9.6%) yoga breathing. The remaining 128 RCTs (41.0%) used 46 varied yoga styles, with a median intervention length of 9 weeks (range 1 day to 1 year; interquartile range = 5, 12). Two hundred and forty-four RCTs (78.2%) used yoga postures, 232 RCTs (74.4%) used breath control, 153 RCTs (49.0%) used meditation and 32 RCTs (10.3%) used philosophy lectures. One hundred and seventy-four RCTs (55.6%) compared yoga with no specific treatment; 21 varied control interventions were used in the remaining RCTs. Conclusions: This bibliometric analysis presents the most complete up-to-date overview on published randomized yoga trials. While the available research evidence is sparse for most conditions, there was a marked increase in published RCTs in recent years

GLADE: A galaxy catalogue for multimessenger searches in the advanced gravitational-wave detector era

We introduce a value-added full-sky catalogue of galaxies, named as Galaxy List for the Advanced Detector Era, or GLADE. The purpose of this catalogue is to (i) help identifications of host candidates for gravitational-wave events, (ii) support target selections for electromagnetic follow-up observations of gravitational-wave candidates, (iii) provide input data on the matter distribution of the local Universe for astrophysical or cosmological simulations, and (iv) help identifications of host candidates for poorly localized electromagnetic transients, such as gamma-ray bursts observed with the InterPlanetary Network. Both being potential hosts of astrophysical sources of gravitational waves, GLADE includes inactive and active galaxies as well. GLADE was constructed by cross-matching and combining data from five separate (but not independent) astronomical catalogues: GWGC, 2MPZ, 2MASS XSC, HyperLEDA, and SDSS-DR12Q. GLADE is complete up to dL=37+3−4Mpc in terms of the cumulative B-band luminosity of galaxies within luminosity distance dL, and contains all of the brightest galaxies giving half of the total B-band luminosity up to dL=91Mpc. As B-band luminosity is expected to be a tracer of binary neutron star mergers (currently the prime targets of joint GW+EM detections), our completeness measures can be used as estimations of completeness for containing all binary neutron star merger hosts in the local Universe

Searching for electromagnetic counterpart of LIGO gravitational waves in the Fermi GBM data with ADWO

The Fermi collaboration identified a possible electromagnetic counterpart of the gravitational wave event of September 14, 2015. Our goal is to provide an unsupervised data analysis algorithm to identify similar events in Fermi's Gamma-ray Burst Monitor CTTE data stream. We are looking for signals that are typically weak. Therefore, they can only be found by a careful analysis of count rates of all detectors and energy channels simultaneously. Our Automatized Detector Weight Optimization (ADWO) method consists of a search for the signal, and a test of its significance. We developed ADWO, a virtual detector analysis tool for multi-channel multi-detector signals, and performed successful searches for short transients in the data-streams. We have identified GRB150522B, as well as possible electromagnetic candidates of the transients GW150914 and LVT151012. ADWO is an independently developed, unsupervised data analysis tool that only relies on the raw data of the Fermi satellite. It can therefore provide a strong, independent test to any electromagnetic signal accompanying future gravitational wave observations.Comment: 4 pages and 4 figures, A&A Letters accepte

Associated factors and consequences of risk of bias in randomized controlled trials of yoga: A systematic review

© 2015 Cramer et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background: Bias in randomized controlled trials (RCTs) of complementary therapy interventions seems to be associated with specific factors and to potentially distort the studies' conclusions. This systematic review assessed associated factors of risk of bias and consequences for the studies' conclusions in RCTs of yoga as one of the most commonly used complementary therapies. Methods: Medline/PubMed, Scopus, IndMED and the Cochrane Library were searched through February 2014 for yoga RCTs. Risk of selection bias was assessed using the Cochrane tool and regressed to a) publication year; b) country of origin; c) journal type; and d) impact factor using multiple logistic regression analysis. Likewise, the authors' conclusions were regressed to risk of bias. Results: A total of 312 RCTs were included. Impact factor ranged from 0.0 to 39.2 (median = 1.3); 60 RCT (19.2%) had a low risk of selection bias, and 252 (80.8%) had a high or unclear risk of selection bias. Only publication year and impact factor significantly predicted low risk of bias; RCTs published after 2001 (adjusted odds ratio (OR) = 12.6; 95% confidence interval (CI) = 1.7, 94.0; p<0.001) and those published in journals with impact factor (adjusted OR = 2.6; 95%CI = 1.4, 4.9; p = 0.004) were more likely to have low risk of bias. The authors' conclusions were not associated with risk of bias. Conclusions: Risk of selection bias was generally high in RCTs of yoga; although the situation has improved since the publication of the revised CONSORT statement 2001. Pre-CONSORT RCTs and those published in journals without impact factor should be handled with increased care; although risk of bias is unlikely to distort the RCTs' conclusions

Mindfulness-based stress reduction for breast cancer- A systematic review and meta-analysis

Objective The aim of this systematic review and meta-analysis was to assess the effectiveness of mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) in patients with breast cancer. Methods The medline, Cochrane Library, embase, cambase, and PsycInfo databases were screened through November 2011. The search strategy combined keywords for MBSR and MBCT with keywords for breast cancer. Randomized controlled trials (RCTs) comparing MBSR or MBCT with control conditions in patients with breast cancer were included. Two authors independently used the Cochrane risk of bias tool to assess risk of bias in the selected studies. Study characteristics and outcomes were extracted by two authors independently. Primary outcome measures were health-related quality of life and psychological health. If at least two studies assessing an outcome were available, standardized mean differences (SMDS) and 95% confidence intervals (CIs) were calculated for that outcome. As a measure of heterogeneity, I 2 was calculated. Results Three RCTs with a total of 327 subjects were included. One RCT compared MBSR with usual care, one RCT compared MBSR with free-choice stress management, and a three-arm RCT compared MBSR with usual care and with nutrition education. Compared with usual care, MBSR was superior in decreasing depression (SMD: -0.37; 95% CI: -0.65 to -0.08; p = 0.01; I 2 = 0%) and anxiety (SMD: -0.51; 95% CI: -0.80 to -0.21; p = 0.0009; I 2 = 0%), but not in increasing spirituality (SMD: 0.27; 95% CI: -0.37 to 0.91; p = 0.41; I 2 = 79%). Conclusions There is some evidence for the effectiveness of MBSR in improving psychological health in breast cancer patients, but more RCTs are needed to underpin those results. © 2012 Multimed Inc

Integrative oncology: Best of both worlds - Theoretical, practical, and research issues

More and more cancer patients use complementary therapies. As the majority of patients do not disclose their use of complementary therapies to their oncologists, they expose themselves to possible detrimental effects from the therapies due to drug interactions. To meet the needs of patients and health care professionals on valid information on complementary therapies, the collaborative research project "Competence Network Complementary Medicine in Oncology - KOKON", an interdisciplinary network for complementary medicine research in oncology, was established. Moreover, Integrative Oncology, a combination of conventional and evidenced-based complementary therapies delivered using a comprehensive approach, is now increasingly used in the United States and Europe. A variety of different Integrative Oncology models have been established worldwide including an expert-based model at the Kliniken Essen-Mitte, Essen, Germany and a patient-centered, evidenced-based approach at The University of Texas MD Anderson Cancer Center. Both models are briefly reviewed. More research is needed and Comparative Effectiveness Research that places strong emphasis on the comparison of different treatment options in usual care settings by including more heterogeneous patients, using less standardized treatment protocols, and measuring patient-centered outcomes would provide useful information for decision-making. To improve the quality of care and research in Integrative Oncology, sustainable financial models for Integrative Oncology and more funding for research are needed. © 2013 Holger Cramer et al

A Systematic Review and Meta-Analysis Estimating the Expected Dropout Rates in Randomized Controlled Trials on Yoga Interventions

© 2016 Holger Cramer et al. A reasonable estimation of expected dropout rates is vital for adequate sample size calculations in randomized controlled trials (RCTs). Underestimating expected dropouts rates increases the risk of false negative results while overestimating rates results in overly large sample sizes, raising both ethical and economic issues. To estimate expected dropout rates in RCTs on yoga interventions, MEDLINE/PubMed, Scopus, IndMED, and the Cochrane Library were searched through February 2014; a total of 168 RCTs were meta-analyzed. Overall dropout rate was 11.42% (95% confidence interval [CI] = 10.11%, 12.73%) in the yoga groups; rates were comparable in usual care and psychological control groups and were slightly higher in exercise control groups (rate = 14.53%; 95% CI = 11.56%, 17.50%; odds ratio = 0.82; 95% CI = 0.68, 0.98; p = 0.03). For RCTs with durations above 12 weeks, dropout rates in yoga groups increased to 15.23% (95% CI = 11.79%, 18.68%). The upper border of 95% CIs for dropout rates commonly was below 20% regardless of study origin, health condition, gender, age groups, and intervention characteristics; however, it exceeded 40% for studies on HIV patients or heterogeneous age groups. In conclusion, dropout rates can be expected to be less than 15 to 20% for most RCTs on yoga interventions. Yet dropout rates beyond 40% are possible depending on the participants' sociodemographic and health condition

Yoga for posttraumatic stress disorder - a systematic review and meta-analysis

© 2018 The Author(s). Background: Yoga is increasingly used as a therapeutic treatment and seems to improve psychiatric conditions such as anxiety disorders and depression. The aim of this systematic review was to assess the evidence of yoga for reducing symptoms of posttraumatic stress disorder (PTSD). Methods: The Cochrane Library, Medline/PubMed, PsycINFO, Scopus, and IndMED were searched through July 2017 for randomized controlled trials (RCTs) assessing the effects of yoga on symptoms of PTSD. Mean differences (MD) and standardized mean differences (SMD) with 95% confidence intervals (CI) were computed. The quality of evidence and the strength of recommendation were graded according to the GRADE recommendations. Results: Seven RCTs (N = 284) were included. Meta-analysis revealed low quality evidence for clinically relevant effects of yoga on PTSD symptoms compared to no treatment (SMD = - 1.10, 95% CI [- 1.72, - 0.47], p < .001, I2 = 72%; MD = - 13.11, 95% CI [- 17.95, - 8.27]); and very low evidence for comparable effects of yoga and attention control interventions (SMD = - 0.31, 95%CI = [- 0.84, 0.22], p = .25; I2 = 43%). Very low evidence was found for comparable retention of patients in the trial for yoga and no treatment (OR = 0.68, 95%CI [0.06, 7.72]) or attention control interventions (OR = 0.66, 95%CI [0.10, 4.46]). No serious adverse events were reported. Limitations: Few RCTs with only limited sample size were available. Conclusions: Only a weak recommendation for yoga as an adjunctive intervention for PTSD can be made. More high quality research is needed to confirm or disconfirm these findings