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We included three RCTs (four reports) of 246 children aged under 16 years undergoing tonsillectomy. Children were given weight-appropriate doses of the study medication, either PRN or ATC, by a parent or carer at home for up to four days following surgery. We did not identify any studies assessing the management of pos... | In July 2014, we found three studies (randomised controlled trials) of 246 children under the age of 16 years. All studies compared the two ways of giving medicine for pain relief after tonsillectomy (an operation to remove the tonsils). The studies were small, and generally of low quality. One study showed that the ch... |
Eleven RCTs, all at high risk of bias, and four economic evaluations were included. Apart from one study, the times to fracture healing were comparable between the BMP and control groups. There was some evidence for increased healing rates, without requiring a secondary procedure, of BMP compared with usual care contro... | The review included 11 trials. All were flawed which means that their results may be biased. Four trials involved people with acute fractures of the tibia (shin bone). Evidence from these trials showed that BMP may enhance healing of these fractures, and that people with these fractures when treated with BMP required f... |
We included two RCTs (116 adult participants). One compared large-volume (150 ml) hypertonic (2%) saline irrigation with usual treatment over a six-month period; the other compared 5 ml nebulised saline twice a day with intranasal corticosteroids, treating participants for three months and evaluating them on completion... | We included two randomised controlled trials with a total of 116 adult participants in this review. One compared large-volume (150 ml) hypertonic saline irrigation with usual treatment over a six-month period. The other compared 5 ml of nebulised saline twice a day with intranasal corticosteroids, treating participants... |
Sixty-two trials with 10,187 randomised participants have been included in the review. Maximum duration of intervention was 18 months. Most included trials had poor study quality. The pooled weighted mean difference (WMD) for percentage weight change showed a benefit of supplementation of 2.2% (95% confidence interval ... | A total of 10,187 randomised participants from the 62 trials has been included. Maximum duration of intervention was 18 months. The reviewers suggest that supplementation appears to produce a small but consistent weight gain. There was no evidence in this updated review of a beneficial effect on mortality overall, but ... |
We identified 25 RCTs from 27 papers (with 8453 participants) studying the effect of PPIs versus placebo, H2RAs or prokinetics for improvement of global symptoms of dyspepsia and quality of life in people with FD. Low-dose PPIs had similar efficacy as standard-dose PPIs, therefore we combined these subgroups for the an... | We included 25 studies (with 8453 participants). There were six studies (2304 participants) comparing low-dose PPIs versus standard-dose PPIs (the dose used in clinical practice); 18 studies (6172 participants) comparing PPIs with placebo (pretend treatment); two studies (740 participants) comparing PPIs with H2RAs; fi... |
No new RCTs of biopsy or resection for LGG were identified. No additional ineligible non-randomized studies (NRS) were included in this updated review. Twenty other ineligible studies were previously retrieved for further analysis despite not meeting the pre-specified criteria. Ten studies were retrospective or were li... | Conclusions: There are no randomized clinical trials on this topic; some institutional, non-clinical trials studies have suggested improved overall survival and seizure control with higher extent of resection. However, physicians should approach each case individually and weigh the risks and benefits of biopsy versus s... |
Four studies, including 83 participants, are included in this review. Two studies used mantra meditation while the other two used yoga compared with drugs, relaxation training, non-specific exercises and standard treatment control. Design limitations caused high risk of bias across the studies. Only one out of four stu... | The objective of this review was to assess the efficacy of this treatment. As a result of the small number of studies that we were able to include in this review and the limitations of those studies, we were unable to draw any conclusions regarding the effectiveness of meditation therapy for ADHD. No adverse effects of... |
We included 11 studies (four CTPA, five lung scintigraphy, two both) with a total of 695 CTPA and 665 lung scintigraphy results. Lung scintigraphy was applied by different techniques. No MRA studies matched our inclusion criteria. Overall, risk of bias and concerns regarding applicability were high in all studies as ju... | We found 11 studies (current until July 2015) that described 695 computed tomography pulmonary angiography results, 665 lung scintigraphy results and no magnetic resonance angiography results. Studies on lung scintigraphy used varying techniques. Overall, these studies were of poor quality; therefore, we could not anal... |
We included one unpublished RCT, randomising 180 children aged three years at study commencement. The setting was nursery schools in an area with high prevalence of dental caries and a low level of fluoride in drinking water. Data from 166 participants were available for analysis. The study carried a high risk of bias.... | Authors from Cochrane Oral Health reviewed existing studies to find all available evidence up to November 2014. We searched scientific databases for clinical trials testing the effects of fluoridated milk compared with non-fluoridated milk. Treatment had to be used and monitored for a minimum of two years. We found one... |
Two studies met the inclusion criteria, enrolling 157 participants (37 participants in one study and 120 in the other study), of whom 114 were included in the analyses. The studies compared oral dexamethasone to placebo, followed by an open-label phase in one study. One study lasted seven days, and the duration of the ... | We searched the literature in January 2018. We found two studies, enrolling 157 participants in total, that tested the effect of systemic corticosteroids on breathlessness in adults with cancer, compared to a dummy medicine (placebo). One study lasted seven days, and the other study lasted 15 days. Both studies compare... |
Seven randomised controlled trials were identified that satisfied the inclusion criteria. In patients with moderate to severe ulcerative colitis whose disease was refractory to conventional treatment using corticosteroids and/or immunosuppressive agents, infliximab (three intravenous infusions at 0, 2, and 6 weeks) was... | This review shows that intravenous infusions of infliximab, a TNF-α blocking agent is effective in inducing clinical remission, promoting mucosal healing, and reducing the need for colectomy in patients with active ulcerative colitis whose disease has not responded to conventional treatment. |
Six RCTs (n = 2324 patients) met the inclusion criteria. A low risk of bias was assigned to all studies. The two briakinumab trials were not pooled due to differences in doses and time points for analysis. In both studies there was no statistically significant difference in remission rates. One study (n = 79) compared ... | The researchers identified six studies that included a total of 2324 participants. Two studies compared briakinumab to placebo (a fake medicine) and four studies compared ustekinumab to placebo. All of the studies were high quality. There was no difference in the proportion of briakinumab and placebo participants who a... |
We found five reports of two single-centre, placebo-controlled, double-blinded studies (130 participants). Participants in both studies were a mix of adults with either intermittent or persistent allergic rhinitis. Both studies had a low risk of bias. One study, with 12 weeks’ follow-up, used a single percutaneous appl... | We included two well-designed studies with a total of 130 adult participants, each study using a different species of gastrointestinal helminth (human hookworm in one study and pig whipworm in the other) as the intervention. Both studies found no significant efficacy from helminths, although one helminth species (Trich... |
We included four randomised controlled trials (all conducted in Italy) reporting on 567 women who were less than 11 weeks' to 24 weeks' pregnant at the start of the trials. The trials had small sample sizes and one trial only reported an interim analysis. Two trials were open-label. The overall risk of bias was unclear... | We searched for studies on 2 November 2015 and included four small randomised controlled trials involving a total of 567 women who were less than 11 weeks' to 24 weeks' pregnant at the start of the trials. The quality of the evidence was assessed as low or very low and the overall risk of bias was unclear. Myo-inositol... |
We included nine reviews with 152 included studies and 13,524 participants, but because some studies appeared in more than one review the number of unique studies and participants was smaller than this. Most participants had moderate or severe pain associated with a range of different types of cancer. Studies in the re... | In this overview of Cochrane Reviews we examined all the evidence on how well morphine-like drugs worked, mostly when taken by mouth or through a skin patch, how many people had side effects, and how severe or troublesome those side effects were — for example, whether they caused participants to stop taking their medic... |
We included three trials, all in women with type 1 diabetes (223 women and babies). All three trials were at high risk of bias due to lack of blinding, unclear methods of randomisation and selective reporting of outcomes. Two trials compared very tight (3.33 to 5.0 mmol/L fasting blood glucose (FBG)) with tight-moderat... | We found three small trials (in total 223 pregnant women with type 1 diabetes) looking at different blood glucose targets: very tight, tight, moderate, and loose. The quality of the studies and therefore the strength of the evidence was very low or low, so future research may change the results. There were very few dif... |
We included three randomised controlled trials (351 participants) investigating immediate versus delayed chemotherapy in people diagnosed with asymptomatic, metastatic, incurable colorectal cancer. Giving immediate versus delayed chemotherapy may make little or no difference to overall survival (hazard ratio (HR) 1.17,... | We included three randomised clinical trials. In these trials, people with metastatic and incurable colorectal cancer, without symptoms, received chemotherapy straight away (standard group) or their chemotherapy was delayed (intervention group). There were a total of 176 participants In the standard groups and 175 in t... |
Of 2029 screened records, we included seven studies in the review and six in the meta-analysis. Risk of bias varied: the randomisation and allocation process was often not clearly described, five of seven studies were double-blind and there was almost no missing data. The quality of the evidence for mortality was high.... | The number and size of the trials investigating adjunctive corticosteroids for HIV-infected patients co-infected with PCP is small (the six trials included in the meta-analysis comprised 242 individuals in the intervention groups and 247 individuals in the control groups; the trial on infants comprised 47 individuals i... |
The searches identified 104 trial reports which represented 51 trials, of which three cross-over trials (providing data on 77 participants) met our inclusion criteria. We present three comparisons: inhalation before versus during airway clearance techniques; inhalation before versus after airway clearance techniques; a... | The review included three studies with 77 people with cystic fibrosis aged between 18 and 64 years of age. The studies looked at the impact of the timing of hypertonic saline inhalation in relation to airway clearance techniques. The studies reported immediate outcomes after inhalation of hypertonic saline before, duri... |
We included seven trials with a total of 435 participants. Three trials focused on Physalia (Bluebottle) jellyfish, one trial on Carukia jellyfish and three on Carybdea alata (Hawaiian box) jellyfish. Two ongoing trials were identified. Six of the seven trials were judged as having high risk of bias. Blinding was not f... | This review identified seven trials on the treatment of jellyfish stings primarily involving two jellyfish species—Physalia (Bluebottle) and Carybdea alata (Hawaiian box) jellyfish—as well as two trials that are in progress. Many different types of treatments were tested in these trials. Large variation was observed be... |
We included 51 RCTs with 2793 participants; of these 45 RCTs (2491 participants: peripheral nerve block = 1288; comparators = 1203) were included in meta-analyses. There are 11 ongoing studies and three awaiting classification. Compared to systemic analgesia alone, peripheral nerve blocks reduced: pain at rest on arriv... | We included 51 studies (2793 participants) in the review and analysed results from 45 studies (2491 participants). There are 11 ongoing studies and three awaiting classification. Funding sources included governments, charities, institutions, industry (in part, n = 1); over half were unspecified (n = 29). Compared to sy... |
We included 10 trials (six randomised and four quasi-randomised) involving a total of 527 children (531 fractures). All trials were at some risk of bias, including performance bias as care provider blinding was not practical, but to a differing extent. Just one trial was at low risk of selection bias. Reflecting both t... | We searched for studies in the medical literature until August 2013. The review includes 10 randomised or quasi-randomised controlled trials that recruited 527 children. Four trials compared different surgical versus non-surgical treatments; three compared different methods of non-surgical treatment and three compared ... |
We included 17 RCTs with a total of 1496 participants. Apart from two trials, the trial participants were women identified as 'poor responders' to standard IVF protocols. The included trials compared either testosterone or DHEA treatment with placebo or no treatment. When DHEA was compared with placebo or no treatment,... | This Cochrane review included 17 randomised controlled trials which compared treatment with the androgens DHEA or T with placebo or no treatment in a total of 1496 women, almost all of whom had been identified as 'poor responders' to standard assisted reproduction protocols. The main outcomes were live birth (defined a... |
We included four trials involving 543 women and their babies (but only data from 521 women and their babies is included in our analyses). Three of the four included studies had moderate to high risk of bias and one study was at low to moderate risk of bias. Babies born to women receiving management for borderline GDM (... | This review found dietary advice or counselling and blood glucose level monitoring for women with borderline GDM helped reduce the number of macrosomic and LGA babies. A single trial found that the interventions led to more inductions of labour. The interventions did not increase the risk of caesarean sections, operati... |
We included nine studies with 994 participants in this update. Occupational therapy targeted towards activities of daily living after stroke increased performance scores (standardised mean difference (SMD) 0.17, 95% confidence interval (CI) 0.03 to 0.31, P = 0.02; 7 studies; 749 participants; low-quality evidence) and ... | We found nine studies up to January 2017, involving 994 participants, that looked at the benefits of occupational therapy interventions for adults with stroke who had problems with activities of daily living. This is an update of the Cochrane review first published in 2006. We found that occupational therapy for people... |
Thirty-six trials involving 1718 people met the inclusion criteria. Study quality was mixed. Compared with control, CPAP showed significant improvements in certain objective and subjective sleepiness, measures of quality of life and cognitive function (parallel-group studies: Epworth sleepiness scale (ESS) -3.83 units,... | We searched and reviewed all randomised controlled trials that had been undertaken to evaluate the benefit of CPAP in adult patients with sleep apnoea. Some of the trials had methodological flaws, although more recent studies have begun to use appropriate forms of control. The overall results demonstrate that in people... |
Five trials randomised 201 participants (110 participants to subcutaneous rapid-acting insulin analogues and 91 to intravenous regular insulin). The criteria for DKA were consistent with the American Diabetes Association criteria for mild or moderate DKA. The underlying cause of DKA was mostly poor compliance with diab... | We found five randomised controlled trials (clinical studies where people are randomly put into one of two or more treatment groups) with a total of 201 participants. Most trials did not report on type of diabetes. Younger diabetic participants and children were underrepresented in our included trials (one trial only).... |
Eleven studies with a total of 404 participants (337 pemphigus vulgaris, 27 pemphigus foliaceus and 40 not specified ) were identified. The quality of included studies was not high, the majority of studies did not report allocation concealment, and power was limited by very small sample sizes. Interventions assessed in... | This review included data from 11 clinical trials involving 404 participants. The studies had very small numbers of participants, so can provide only limited information. Ten different active treatments were studied, including prednisolone, pulsed oral dexamethasone, azathioprine, cyclophosphamide, cyclosporine, dapson... |
Fourteen eligible trials, which recruited patients between 1974 and 2005, were identified, eight of which compared 'more' with 'less' chemotherapy. Results from these eight trials, including 1519 patients, showed that treatment consisting of 'more' chemotherapy was associated with longer overall survival (OS) (hazard r... | Using more chemotherapy drugs in combination seems to help women with advanced or recurrent endometrial cancer to live for longer and to delay the cancer from spreading or getting worse. However, giving these extra drugs may cause more serious short-term side effects. We do not know what effect using more drugs has on ... |
Five trials involving 213 women were included. Behavioural intervention vs control: One trial of pain management training reported reduction in pain and symptoms compared to a control. Three trials of relaxation compared to control reported varied results, two trials showed no difference in symptom severity scores ho... | This review found that progressive muscle relaxation with or without imagery and relaxation may help with spasmodic (acute, cramping pain) symptoms of period pain. Also that pain management training and relaxation plus biofeedback may help with period pain in general. The results are not conclusive due to the small num... |
Five trials were included in this review, representing 924 randomised children with epilepsy, all under 16 years of age at randomisation, with a median follow-up of 5.6 years. No eligible trial evaluated adults or assessed mortality or status epilepticus as outcomes. The pooled risk ratio for seizure relapse after AED ... | We searched electronic databases in June 2014, adding to the research done in a previous version of this review. The same five trials were included in our analysis, comprising 924 epileptic children (all below 16 years old) who were randomly assigned to either early removal of AEDs (before completing two years without ... |
Our search did not yield any trial investigating treatment of VVC in HIV positive women. Two trials dealing with prophylaxis were eligible for inclusion.One trial (n= 323) favoured the use of weekly Fluconazole as compared to placebo (RR 0.68; 95% CI 0.47 to 0.97). The second trial with three arms of comparison; Clotri... | The search yielded two studies dealing with the preventive aspect of the condition. The first trial found weekly fluconazole significantly effective in preventing clinical episodes from occurring as compared to placebo. However,this regimen lead to emergence of species resistant to azoles. The second trial with three a... |
We included 15 studies with a total of 1326 women. All included studies compared a vasodilator versus placebo or no treatment. We judged most of these studies as having unclear risk of bias. Overall, the quality of evidence was low to moderate for most outcomes. The main limitations were imprecision due to low numbers ... | We found 15 randomised controlled trials (a type of experiment in which people are randomly allocated to one or more treatment groups) that compared the use of vasodilators versus placebo or no treatment in a total of 1326 women undergoing fertility treatment. The evidence is current to October 2017. Only three of the ... |
We found three RCTs involving 1815 men. Adjuvant RT following prostatectomy did not affect overall survival at 5 years (RD (risk difference) 0.00; 95% CI -0.03 to 0.03), but improved survival at 10 years (RD -0.11; 95% CI -0.20 to -0.02). Adjuvant RT did not improve prostate cancer-specific mortality at 5 years (RD -0.... | One trial with longer follow up (more than 10 years) showed improved survival with adjuvant radiotherapy but this improvement did not exist at 5 years follow up. Radiotherapy reduced the number of men whose cancer spread to other parts of the body (metastases). We found that radiotherapy improved local control in the p... |
We included 43 studies with 6617 participants that evaluated the impact of an eHealth intervention in people with CKD. Included studies were heterogeneous in terms of eHealth modalities employed, type of intervention, CKD population studied and outcomes assessed. The majority of studies (39 studies) were conducted in a... | We found 43 studies involving 6617 people who had CKD that examined if eHealth interventions improve patient care and health outcomes. eHealth interventions used different modes of technology, such as Telehealth, electronic monitors, mobile or tablet applications, text message or emails, websites, and DVDs or videos. I... |
We identified 11 trials investigating a total of 742 children in treatment arms relevant to our study question. Risks of bias in the studies were mainly low or unclear, but two studies had aspects of their methodology that had a high risk of bias. Overall, the quality of the evidence from pooled studies was low or had ... | The evidence is current to December 2012. We identified a total of 11 controlled studies, including a total of 742 children, where clonidine was compared to another medication or to a dummy treatment (placebo). We found evidence that when clonidine is given at an adequate dose (4 µg/kg) it is effective in reducing the ... |
Two trials of moderate quality in children (n = 134) with no evidence of airflow restriction did not find any benefits from oral beta2-agonists. Five trials in adults (n = 418) had mixed results but overall summary statistics did not reveal any significant benefits from oral (three trials) nor from inhaled (two trials)... | Our searches are current to May 2015. We found no new trials. In previous searches, we found seven randomised controlled trials that used beta2-agonist drugs for people with acute bronchitis. Two trials studied children aged one to 10 years (134 participants) and five were conducted in adults (418 participants). None o... |
We included seven studies (662 participants). Five were planned as RCTs and two as prospective controlled trials. One RCT failed completely, another was continued as an observational study, reporting also the results of the participants that had been randomized. There was very low quality evidence from one small RCT (1... | This review included seven studies, with a total of 662 adolescents of both genders. AIS from 15° to more than 45° curves were considered. Elastic, rigid (polyethylene), and very rigid (polycarbonate) braces were studied. The evidence is current to October 2013. Funding sources were not reported or external governmenta... |
We included eight RCTs (n = 1243 children) that were at relatively high risk of bias. We found high levels of clinical heterogeneity in the participants, interventions and outcome measures across studies. Nevertheless, in order to quantify pooled effects of supplementary feeding, we decided to combine studies according... | We included eight studies where the participants were randomly assigned to two groups: one group received the extra food and the other group was a control, either receiving no food or food with very low nutritional content. Although the impact of supplementary feeding on child growth appeared to be negligible, it is no... |
We included 28 studies. We found no clear-cut evidence of effect of the well-researched practice of reviewer and/or author concealment on the outcome of the quality assessment process (9 studies). Checklists and other standardisation media have some evidence to support their use (2 studies). There is no evidence that r... | Editorial peer review is used world-wide as a tool to assess and improve the quality of submissions to paper and electronic biomedical journals. As the information revolution gathers pace, an empirically proven method of quality assurance is of paramount importance. The increasing availability of empirical research on ... |
An initial search yielded 2808 citations. After excluding studies failing to meet the inclusion criteria, 19 were deemed eligible for inclusion. Of these studies, two presented duplicate data and were removed. The remaining 17 studies were included in the qualitative synthesis and 8 studies were meta-analyzed. Twelve ... | A systematic review of the literature and a quantitative assessment found that VCT is an effective strategy for reducing some HIV-related risk behaviors, including decreasing the number of sexual partners of participants. Condom use was also significantly increased among participants who tested HIV-positive during VCT.... |
We pooled mortality data from eight studies and found a non-significant reduction in mortality at 12 months (OR 0.72, 95% CI 0.45 to, 1.15). We pooled four studies that assessed disease-specific heath-related quality of life (HRQL) and found a statistically significant improvement in HRQL (mean difference -2.61, 95% CI... | However, this review of nine randomised controlled trial found that home care resulted in an improvement in people's quality of life, but has an unpredictable effect on the risk of being admitted to hospital. We could only find information on the cost of care from one study, but this indicated that home care was an exp... |
Seven trials were identified. Two of them were at low risk of bias (the HALT-C and EPIC3 trials) and included 1676 patients. Both of these trials addressed the role of long-term low-dose pegylated interferon therapy in patients with severe fibrosis (demonstrated on liver biopsy) and were designed to assess the clinical... | However, there is no direct evidence that has proven that these outcomes are valid because there have been no long-term trials that have shown that an improvement in these tests translates into reduced mortality or morbidity. Patients who fail to have sustained viral responses after an initial course of therapy do beco... |
We included six studies that compared early oropharyngeal colostrum versus water, saline, placebo, or donor, or versus no intervention, enrolling 335 preterm infants with gestational ages ranging from 25 to 32 weeks' gestation and birth weights of 410 to 2500 grams. Researchers found no significant differences between ... | We searched for both published and unpublished studies comparing oropharyngeal colostrum versus a control such as water, placebo, or no oral priming. We included only clinical trials reporting outcomes in preterm babies (< 37 weeks' gestation). The evidence is up-to-date as of August 2017. We did not limit the review t... |
This review includes a total of 1897 children and 729 adults in 39 trials. Thirty-three trials were conducted in the emergency room and equivalent community settings, and six trials were on inpatients with acute asthma (207 children and 28 adults). The method of delivery of beta₂-agonist did not show a significant diff... | We found 39 clinical trials involving 1897 children and 729 adults. Thirty-three of the trials were conducted in an emergency room (or emergency department) and community settings (such as a GP's surgery), and six trials were on inpatients (people in hospital) with acute asthma (207 children and 28 adults). Overall we ... |
We identified eight RCTs with a total of 1183 participants. The duration of the interventions ranged from 12 to 26 weeks; in five trials, the duration of intervention was 12 or 13 weeks. The included studies had moderate risk of bias, and the overall quality of evidence was low or very low for all outcomes. We compared... | We found eight trials with a total of 1183 participants to include in the review. Five trials provided CCT for three months, two for four months, and one for six months. We compared CCT with other activities, such as watching educational videos, and with no activity. We looked for effects on overall cognitive function ... |
We included 50 studies with a total of 3704 participants. Forty studies (81%) were at high risk of bias, nine (18%) were at unclear risk of bias, with just one assessed as at low risk of bias. There were 34 different sedatives used with or without inhalational nitrous oxide. Dosages, mode of administration and time of ... | Authors from Cochrane Oral Health carried out this review and the evidence is up to date to 22 February 2018. A total of 50 randomised controlled trials were included with a total of 3704 participants. Within these studies 34 different sedatives were used, often with inhalational nitrous oxide as well. Dosages and deli... |
We included 66 RCTs of oral phlebotonics, but only 53 trials provided quantifiable data (involving 6013 participants; mean age 50 years) for the efficacy analysis: 28 for rutosides, 10 hidrosmine and diosmine, nine calcium dobesilate, two Centella asiatica, two aminaftone, two french maritime pine bark extract and one ... | In total, 66 studies (53 with quantifiable data, including 6013 participants; mean age 50 years) met the eligibility criteria for this review (current until August 2015). Moderate-quality evidence from 13 studies (involving 1245 people) suggests that phlebotonics reduce puffiness (oedema) compared with placebo. Low qua... |
We identified 1549 records; 85 items from electronic databases, 45 from study registries, and 1419 from congress proceedings. The revised search strategy did not identify any additional RCTs. In the previous version of the review, we identified one RCT comparing HDCT followed by autologous HSCT versus standard-dose che... | The evidence is current to 6 September 2016. We found one RCT that compared 38 people in the high-dose chemotherapy and transplantation group versus 45 people in the chemotherapy-only group and was judged to have mainly a low risk of bias (as it was well designed). The participants were 18 to 65 years old, had various ... |
We found no trials comparing one type of support versus another. We included seven RCTs (including one cluster-RCT) involving 831 women. The number of women in each trial ranged from 36 to 226. The trials were conducted in high-income countries: USA (5 trials); Denmark (1 trial) and Australia (1 trial), between 2006 an... | We searched for evidence (January 2019) and identified seven randomised controlled trials (RCTs), involving 831 women (range 36 to 226 women), conducted in high-income countries (USA, Denmark, Australia) between 2006 and 2015. Three trials only included women who were obese prior to pregnancy and four trials included w... |
We included two trials involving 189 participants. One study, with 35 participants, compared methadone with levo-alpha-acetylmethadol (LAAM) for maintenance treatment lasting 16 weeks, after which patients were detoxified. The other study, with 154 participants, compared maintenance treatment with buprenorphine-naloxon... | The review authors searched the literature and identified two controlled trials from the USA that involved 187 heroin addicts, aged 14 to 21 years; the participants were treated as outpatients. One study of 37 participants compared methadone with levo-alpha-acetylmethadol (LAAM) for maintenance treatment. After 16 week... |
At this update six trials and a new comparison (Mechanical bowel preparation versus enema) were added. Altogether eighteen trials were analysed, with 5805 participants; 2906 allocated to MBP (Group A), and 2899 to no preparation (Group B), before elective colorectal surgery. For the comparison Mechanical Bowel Preparat... | This review has identified all known trials that compared any kind of mechanical bowel preparation with no preparation (Comparison 1) and mechanical bowel preparation with rectal enema (Comparison 2) in patients submitted to elective colorectal surgery. Five new trials have been included in this third update of the re... |
We included six RCTs that involved a total of 9484 participants. Mean follow-up was 3.7 years (range 1.0 to 4.7 years). All RCTs provided individual participant data. We found no change in total mortality (risk ratio (RR) 1.06, 95% confidence interval (CI) 0.91 to 1.23) or cardiovascular mortality (RR 1.03, 95% CI 0.82... | For this updated review, we included six trials with 9484 participants who were followed-up from one year to 4.7 years. We analyzed data to detect differences between lower and standard blood pressure goals in terms of numbers of deaths and numbers of serious adverse events (leading to hospital admission). We found no ... |
No trials were included in the review. There are no published or ongoing randomised controlled clinical trials relevant to this review question. Therefore, in the absence of any high level evidence, clinicians should base their decisions on clinical experience and in conjunction with preferences of the individual where... | Unfortunately, we did not find any good quality trials to include in the review. This does not mean that carnitine is ineffective or should not be used in treating inborn errors of metabolism; however, individuals receiving carnitine should be carefully observed and monitored. Therefore, we recommend that clinicians ba... |
Six studies were added to this update resulting in a total of 29 included studies (n = 10,390). The quality of the studies was downgraded as there was a risk of bias in some individual studies relating to risk of attrition and reporting bias; in addition several studies did not adequately report on the randomisation me... | This review included 29 randomised controlled trials involving 10,390 participants (current to September 2016), which compared LMWH or UFH for treating people with blood clots. Pooling the results of these trials showed that fewer participants treated with LMWH formed further blood clots and that fewer cases of bleedin... |
Ten studies were identified of which 4 met the inclusion criteria. The included studies either differed in the type of TNF-a blocking agent used or in the way outcomes were assessed to such an extent that we considered it inappropriate to combine the data statistically. There is evidence from one randomised controlled ... | This review shows that a single intravenous infusion of infliximab (5 mg/kg) may be an effective treatment for patients with active Crohn's disease who no longer respond to corticosteroids or immunosuppressive drugs. There is also some evidence that CDP571, another TNF alpha blocking drug may be effective. There is no ... |
Thirty-four RCTs (enrolling 13,787 participants) fulfilled the eligibility criteria. Available evidence enabled us to address multiple clinical issues regarding the survival effects of second-line systemic therapy of people with metastatic CRC. 1. Chemotherapy (irinotecan) was more effective than best supportive care (... | The evidence is current to May 2016. In this updated review, we identified 34 clinical trials that compared second-line therapy with either no chemotherapy (best supportive care) or an alternative second-line therapy, so addressing the issue of second-line therapy performance in people with metastatic colorectal cancer... |
In this updated review, one new eligible study was identified and included, yielding a total of two eligible studies (including a combined total of 401 participants). Of those 401 participants, 170 received 'high'-dose partial liquid ventilation (i.e. a mean dose of at least 20 mL/kg), 99 received 'low-dose' partial li... | To provide the best possible answer to this question, this review was conducted in a special preplanned way with the intention of putting together the results of all selected studies to produce an overall measure of the value of partial liquid ventilation. Two eligible studies (including a total of 401 participants) we... |
We detected four eligible trials. Two trials compared lower versus higher rates of glucose infusion in the early postnatal period. These trials were too small to assess effects on mortality or major morbidities. Two trials, one a moderately large multicentre trial (NIRTURE, Beardsall 2008), compared insulin infusion wi... | Trials which compared lower with higher amounts of sugar delivered by vein were too small to determine effects on the health outcomes of the babies. Insulin was found to reduce the number of babies who developed high blood sugar levels, but the health outcomes of the babies were not improved. In fact, insulin infusion ... |
Nine randomized placebo-controlled trials involving 499 individuals with HIV infection and AIDS met the inclusion criteria. Methodological quality of trials was assessed as adequate in five full publications and unclear in other trials. Eight different herbal medicines were tested. A compound of Chinese herbs (IGM-1) s... | Although many trials of these therapies exist, very few meet the scientific standards necessary to support the claims of beneficial effects in the therapies studied. This review identified nine randomized clinical trials, which tested eight different herbal medicines, compared with placebo, in HIV-infected individuals ... |
Four trials (2300 women) are included. The interventions ranged from brief advice through to education on health and lifestyle over several sessions. For most outcomes, data were only available from individual studies. Only one study followed up through pregnancy and there was no strong evidence of a difference between... | The review looks at randomised controlled trials examining routine health promotion before pregnancy to see whether it changes behaviour and leads to improved health for mothers and babies. Four trials with 2300 women provided information for the review. The health promotion offered to women in these studies ranged fro... |
We found two completed studies involving a total of 1136 participants that ultimately met our inclusion criteria. We also found one ongoing study and one planned study. We noted significant heterogeneity in the characteristics of interventions and outcomes measured or reported across these studies, thus we could not po... | This review searched for high-quality research studies that considered whether mobilizing community first responders could improve survival or neurological outcome, or both, following out-of-hospital cardiac arrest in adults and children. We last searched available databases in January 2019. We found two eligible resea... |
We found six trials of five different interventions eligible for inclusion in this review. The trials were conducted in hospitals in Canada, China, Germany, Japan and the UK, and included 151 participants in total. All trials randomised participants aged 16 years and older (mean or median age in the trials ranged from ... | Cochrane Review authors collected and analysed all relevant randomised controlled trials (RCTs) to answer the review question. In RCTs people are allocated to treatment groups at random, which reduces bias. We found six eligible RCTs testing five different treatments in a total of 151 participants. We were uncertain ab... |
We included two studies (212 participants) comparing antibiotics versus no treatment, and identified three on-going studies. Overall, incidence of symptomatic UTI varied between 19% and 31% in the groups not treated for asymptomatic bacteriuria. Antibiotic treatment had uncertain effects on preventing symptomatic UTI (... | The bacterial infection of the urine often persisted, whether antibiotics were given or not. It was uncertain whether antibiotics prevented symptomatic urinary infection or increased the risk of selecting bacteria resistant to antibiotics, because there were too few data and several limitations in the included studies.... |
The search identified three RCTs with 138 participants. All three trials included only children with viral encephalitis, one of these included only children with Japanese encephalitis, a specific form of viral encephalitis. Only the trial of Japanese encephalitis (22 children) contributed to the primary outcome of this... | We searched medical databases for studies in which neither participants nor researchers were told which treatment was given (called a randomised double-blind trial). The effectiveness and safety of IVIG were considered in terms of the occurrence of significant disability at six months after hospital discharge and the p... |
We included eight RCTs that evaluated the effects of chlorhexidine varnishes (1%, 10% or 40% concentration) and chlorhexidine gel (0.12%) on the primary or permanent teeth, or both, of children from birth to 15 years of age at the start of the study. The studies randomised a total of 2876 participants, of whom 2276 (79... | The evidence in this review, carried out through the Cochrane Oral Health Group, is up-to-date at 25 February 2015. We found eight studies that were suitable to include in this review. The studies involved a total of 2876 children from birth to 15 years of age who were at moderate to high risk of tooth decay. Six of th... |
We added nine studies to this review to bring the total number of included studies to 32 comparing an intervention tailored to address identified determinants of practice to no intervention or an intervention(s) not tailored to the determinants. The outcome was implementation of recommended practice, e.g. clinical prac... | In a previous review, we included 26 studies and we concluded that tailoring can change professional practice. However, more studies of tailoring have been published and therefore we have incorporated the new studies into an update of the review. We have included 32 studies in the new review. The findings continue to i... |
The updated search resulted in the identification of one ongoing trial comparing surgery versus conservative treatment. Four trials, involving a total of 237 participants, were included. All four trials were methodologically flawed and potentially biased. Three trials tested conservative treatment interventions. One tr... | Four trials, involving a total of 237 participants, were included in the review. These trials had methodological weaknesses that could have resulted in serious bias. One trial compared 'short arm' (splintage stopping below the elbow) pre-fabricated functional braces with 'long arm' (splintage includes the elbow) plaste... |
The search retrieved 1585 records; from those five studies were eligible, including 351 women (intervention = 166; control = 185). All studies were judged to be at high risk of bias. All reported per-woman rather than per-cycle data. When use of low-dose hCG to replace FSH was compared with conventional COH for the out... | Follicle-stimulating hormone (FSH) - a relatively expensive drug - is commonly used for several days to stimulate the ovaries of women undergoing assisted reproduction. Initial studies have shown that after a few days of using FSH to stimulate the ovaries, it can be replaced by human chorionic gonadotropin (hCG), which... |
There are 77 studies included in this updated review. We retained 12 studies from the original review and identified 65 new studies. Evidence from 21 countries is provided in this update, an increase of eight countries from the original review. The nature of the intervention precludes randomized controlled trials. Thir... | We searched for studies that investigated the effect of introducing a ban on any measures of health, or on smoking behaviour (up to February 2015). Since the previous version of this review had shown clear evidence that introducing legislation to ban smoking in public places does reduce exposure to secondhand smoke (SH... |
We included a total of 18 studies involving 2366 participants (976 participants with common bile duct stones and 1390 participants without common bile duct stones). Eleven studies evaluated EUS alone, and five studies evaluated MRCP alone. Two studies evaluated both tests. Most studies included patients who were suspec... | We performed a thorough search for studies that reported the accuracy of EUS or MRCP in the diagnosis of CBD stones. We included a total of 18 studies involving 2532 participants. Eleven studies evaluated EUS alone, five studies evaluated MRCP alone, and two studies evaluated both tests. A total of 1537 participants we... |
We found five relevant trials (total n=537), but no usable data on service outcomes, general functioning, behaviour, engagement with services, satisfaction with treatment or economic outcomes. Overall, reporting of data was poor. Those data we were able to use suggested that equal proportions of people allocated lamotr... | We searched major medical databases for studies that have examined the use of lamotrigine for people with schizophrenia. We identified five relevant studies that were conducted according to existing standards of research. A total of 537 people with schizophrenia participated in these five studies. The participants were... |
Primary outcomes Stenting may slightly reduce the number of unplanned return visits (16 trials with 1970 participants; very low CoE), but we are very uncertain of this finding. Pain on the day of surgery as measured on a visual analogue scale (scale 0 to 10; higher values reflect more pain) is probably similar (mean di... | We included 23 trials with 2656 people who either had a stent or not. Whether they received a stent or not was decided by chance. A stent may make people come back to the hospital for problems less often, but we are very uncertain of this finding. Pain on the day of surgery and on days one to three after surgery may be... |
Four trials compared the short-term effects of ipratropium bromide versus a beta2-agonist. Short-term changes in FEV1 (up to 90 minutes) showed no significant difference between beta2-agonist and ipratropium bromide treated patients. The differences were similar among the studies and when combined: Weighted Mean Differ... | Trials comparing ipratropium bromide versus beta-agonists showed no significant difference in short-term or long-term effects (24 hours) on ease of breathing. Side effects of these drugs were reported by only a minority of patients and include dry mouth and tremor, and a 'strange feeling' after drug administration. |
Forty-five trials, studying 69 exercise interventions, were eligible for this review, including 2250 people with MS. The prescribed exercise interventions were categorised as endurance training (23 interventions), muscle power training (nine interventions), task-oriented training (five interventions), mixed training (1... | We searched scientific databases for clinical trials comparing exercise to no exercise or other treatments in adults with MS. The evidence is current to October 2014. We found 45 trials, involving 2250 people with MS, assessing the effect of exercise therapy using self reported fatigue. We used 36 studies, involving 16... |
The search identified a total of 824 citations; one study was identified for inclusion and two studies are awaiting classification. The 214 participants involved in the included study were adults with AECOPD, receiving treatment by paramedics en route to hospital. The mean age of participants was 68 years. A reduction ... | To investigate this question we looked for randomised controlled trials (RCTs), these are studies in which people involved have an equal chance of receiving the treatment or comparator. We were interested in trials that compared different flow rates (concentrations) of oxygen delivered in an ambulance to people being t... |
We included 14 trials involving 1014 women. The trials were small and not of high methodologic quality. Of the nine trials reporting on physical fitness, six reported significant improvement in physical fitness in the exercise group, although inconsistencies in summary statistics and measures used to assess fitness pre... | Aerobic exercise is physical activity that stimulates a person's breathing and blood circulation. The review of 14 trials, involving 1014 pregnant women, found that pregnant women who engage in vigorous exercise at least two to three times per week improve (or maintain) their physical fitness, and there is some evidenc... |
For this updated review, we added 24 new studies meeting the eligibility criteria to the 11 studies from prior updates. We have therefore included 35 studies, randomising 925,171 participants. Seven studies including 11,204 individuals compared adherence rates of those in an intensification of a patient care interventi... | The people included in the studies were adults over 18 years of age in outpatient settings, for whom lipid-lowering therapy was recommended. We now include 35 studies covering 925,171 participants in this review. Of the 35 included studies, 16 compared interventions categorised as 'intensified patient care' versus usua... |
There are sixteen included trials, all of which included participants with mild-moderate dementia or cognitive decline. All trials assessed the cognitive effects of ALC and in addition most considered severity of dementia, functional ability and clinical global impression. When considering clinical global impression (... | Early studies suggested a beneficial effect of ALC on cognition and behaviour in aging subjects. However, later, larger studies have not supported these findings. The early and later studies differ widely in methodology and assessment tools used, and are therefore difficult to compare. There is no evidence of benefit o... |
High-standard 14-day course versus standard 14-day course Two RCTs compared the high-standard 14-day regimen with the standard 14-day regimen. People with G6PD deficiency and pregnant or lactating women were excluded. We do not know if there is any difference in P vivax recurrences at 6 months with 0.5 mg/kg/day primaq... | We summarized trials that compared the World Health Organization (WHO)-recommended primaquine regimen of 15 to 30 mg per day for 14 days with the same or higher doses of primaquine given over different lengths of time to determine whether alternative regimens were as successful as the recommended courses at preventing ... |
Two studies met the inclusion criteria. 1. Randomised comparison between operative hysteroscopy versus control for unexplained subfertility associated with suspected major uterine cavity abnormalities. In women with otherwise unexplained subfertility and submucous fibroids, we were uncertain whether hysteroscopic myome... | We found two studies. The first study compared the removal of fibroids versus no removal in 94 women wishing to become pregnant spontaneously from January 1998 to April 2005. The second study compared the removal of polyps versus simple hysteroscopy only in 204 women before insemination with husband's sperm from Januar... |
Three trials with 146 participants met the inclusion criteria of this review. Two parallel group trials with 100 participants provided information on one or more outcomes. The remaining trial was a cross-over trial, with no usable data for analysis. All the trials were at high risk of bias. Overall, all the evidence wa... | We identified three trials. Two trials with 100 participants provided information on one or more outcomes (measures of how well the treatments worked). The trials compared phlebotomy (removal of blood or 'blood letting') versus erythrocytapheresis (removal of blood, separation of red cells (which carry oxygen in the bl... |
We identified no RCTs or quasi-RCTs that fulfilled the inclusion criteria. Our searches retrieved eight potentially relevant studies, but after assessment of the full-text reports we excluded all of them due to the absence of randomisation or because the patients did not have Frey's syndrome. We excluded one randomised... | We carried out a comprehensive search for randomised controlled trials (RCTs) in participants diagnosed with Frey's syndrome. We planned to include trials in which participants received any intervention compared to no treatment (observation) or an alternative intervention, with or without a second active treatment. Des... |
We included seven new studies with 663 participants in the 2017 update; five RCTs and two CCTs. These were added to the nine previously included studies (six RCTs and three CCTs with a total of 373 participants) for a total of 16 included studies and 1036 participants in this updated review. The mean age and range data... | We examined a total of 16 controlled clinical studies using aromatherapy for PONV with a total of 1036 participants (seven new studies from the March 2017 searches were added to nine studies from the original review). The participants were adults except for two studies in children. The studies applied aromatherapy at t... |
Nine studies involving 1359 participants met the inclusion criteria. Six studies compared individual education to usual care and three compared individual education to group education (361 participants). There were no long-term studies and overall the quality of the studies was not high. In the six studies comparing in... | Nine studies involving 1359 participants met the inclusion criteria. Six studies compared individual education to usual care and three compared individual education to group education (361 participants). There were no long-term studies and overall the quality of the studies was not high. Individual face-to-face patient... |
Ten trials including 657 patients compared different methods of vascular occlusion. All trials were of high risk of bias. Only one or two trials were included under each comparison. There was no statistically significant differences in mortality, liver failure, or other morbidity between any of the comparisons. Hepatic... | Ten trials including 657 patients were included in this review. All were of high risk of bias (systematic error) and play of chance (random error). Only one or two trials were included under each comparison. There was no difference in mortality, liver failure, or post-operative complications between any of the comparis... |
A total of 50 trials were potentially eligible for inclusion, of which 42 trials were excluded. We included eight RCTs with a total of 233 extraction sites in 184 participants. One trial was judged to be at unclear risk of bias and the remaining trials were at high risk of bias. From two trials comparing xenograft with... | Authors from Cochrane Oral Health carried out this review and the evidence is up to date from 22 July 2014. Eight trials were included with a total of 233 extraction sites (teeth taken out) in 184 participants. Participants were adults aged 18 years or older, in good general health, needing one or more permanent teeth ... |
We did not include any new trials in this update. One randomised controlled trial of 32 patients is included. Concerning risk of bias, generation of the allocation sequence was at low risk; however, allocation concealment, blinding and selective reporting were at high risk. Treatment response, defined as 20% improvemen... | In people with central nervous system lupus: - We are uncertain whether cyclophosphamide improves signs and symptoms or disease activity compared to methylprednisolone. - No differences between the two groups were found in tissue or organ damage, or in the number of monthly seizures, but this may have happened by chanc... |
We included two trials enrolling 624 women in the review. It is uncertain whether breast surgery improves overall survival as the quality of the evidence has been assessed as very low (HR 0.83, 95% CI 0.53 to 1.31; 2 studies; 624 women). The two studies did not report quality of life. Breast surgery may improve local p... | The evidence is current to February 2016. We included only randomised clinical trials, as they are considered to be the best type of scientific study to answer questions about treatment, that compared the survival of women undergoing breast surgery combined with medical treatment versus medical treatment alone. We iden... |
We included eight trials, involving 952 participants, of which 64% were women. Included trials were generally of adequate quality, with six trials at low risk of bias, and two trials at high risk of bias. Three trials with 518 participants compared five different drugs with placebo; all reported the primary outcome as ... | The evidence is current to August 2014. We included eight clinical trials of 952 participants. The trials assessed many different medicines at different doses, but only three trials included a placebo group (dummy medication). Six of these trials were of high quality, with low risk of error (i.e. bias, where the true e... |
Two randomized controlled trials were included, with a total of 115 participants. One study compared clonazepam to carbamazepine as monotherapy for participants with newly diagnosed psychomotor epilepsy (a condition corresponding to what is now termed mesial temporal lobe epilepsy). One study (published as abstract) co... | We identified only two small trials comparing clonazepam with a different drug in two different epileptic syndromes, mesial temporal lobe epilepsy (the most common and well-defined focal epilepsy with seizures originating in the internal part of the temporal lobe of the brain) and absence seizures (generalized seizures... |
Four small randomised controlled trials involving 728 allocated/224 analysed participants met our inclusion criteria. These trials had a high risk of bias. Drug companies sponsored two of the trials. We were unable to pool the data due to the heterogeneity in outcome definitions and the different antibiotics used. The ... | We identified only four studies that compared different antibiotic regimens. They included a limited number of people. Each trial investigated different types and doses of antibiotics. These studies were published between 1998 and 2006 and were conducted in the USA, Spain and Finland. The evidence is up to date as of 3... |
We included 14 trials (n = 565), 13 (n = 525) of which compared intravenous administration of amino acids to a control (usually saline solution or Ringer's lactate). The remaining trial (n = 40) compared intravenous administration of fructose versus a control. We noted much variation in these trials, which used differe... | We looked for evidence up to November 2015. We included 14 randomized studies (involving 565 participants). Thirteen studies compared people who received normal care with additional intravenous amino acids against people who received normal care but no amino acids (the control group). One study compared people who rece... |
Ten studies (786 patients) were included. Mupirocin ointment reduced the risk of catheter-related bacteraemia (RR 0.17, 95%CI 0.07 to 0.43) and had a significant effect on catheter-related infections caused by S. aureus. The risk of catheter-related bacteraemia was reduced by polysporin (RR 0.40, 95%CI 0.19 to 0.86) an... | The review of 10 studies (786 patients) found that mupirocin ointment reduced the risk of patients developing catheter-related bacteraemia (bacteria in the blood). However, monitoring of mupirocin resistance needs to be considered in future studies. There was not enough evidence to determine which ointment (povidone-io... |
We identified one RCT which met our inclusion criteria and was included in this review. Sixty-three participants with primary involutional lower eyelid entropion were randomised to everting sutures alone or everting sutures with a lateral tarsal strip. Eight participants were lost to follow-up. The trial indicates that... | The review authors searched the medical literature and found a single trial that met the inclusion criteria of the review. Sixty-three participants with lower eyelid entropion were enrolled and randomised to either everting sutures alone or everting sutures and a lateral tarsal strip. Eight participants were lost to fo... |
No randomised controlled trials or controlled trials were found that examined the efficacy of non-pharmacological swallowing therapy for the treatment of dysphagia in Parkinson's disease. However there is one large RCT currently recruiting patients that will compare 'chin down' posture with thickened liquids in the tre... | Only randomised controlled trials (RCT) were eligible for this review. In RCTs the patients are assigned to each of the groups in a random fashion so as to reduce the potential for bias. Either one group of patients had swallowing therapy, the other had a sham treatment or no treatment, or two forms of swallowing thera... |
The four trials examining tracheostomy-free survival included a total of 974 riluzole-treated patients and 503 placebo-treated patients. No new randomized controlled trials were found when we updated the searches for this update in 2011. The methodological quality was acceptable and three trials were easily comparable,... | In this review, we examine the evidence from four randomized clinical trials involving 1477 people with ALS. The methodological quality of the trials was acceptable and three of the trials were easily comparable (although one of them included older patients with more advanced ALS). The searches for this review were las... |
We included 15 trials involving 622 women who received G-CSF and 631 women who received placebo or no additional treatment during IVF. The main limitations in the quality of the evidence were inadequate reporting of study methods and high risk of performance bias due to lack of blinding. We assessed only two of the 15 ... | We found 15 trials (1253 women) comparing G-CSF with placebo or no treatment. Eleven trials evaluated the role of G-CSF in women undergoing IVF, with a majority of trials including those women with two or more failed attempts. The remaining four trials investigated the role of G-CSF in women with thin endometrium under... |
We included four studies with 166 participants. No studies compared the effects of home-based upper limb therapy programmes with placebo or no intervention. Three studies compared the effects of home-based upper limb therapy programmes with usual care. Primary outcomes: we found no statistically significant result for ... | This review of four studies with 166 relevant participants, looked at whether participating in home-based therapy programmes, targeted at the upper limb, could improve performance in activities of daily living (ADL), functional movement of the upper limb, performance in extended ADL and arm motor impairment. In compari... |
We identified four cluster-RCTs and one cohort study (n = 12,742) of influenza vaccination for HCWs caring for individuals ≥ 60 years in LTCIs. Four cluster RCTs (5896 residents) provided outcome data that addressed the objectives of our review. The studies were comparable in their study populations, intervention and o... | Our evidence is current to October 2015. Overall five studies were included in our review but we used data from three trials with 5896 residents . In one trial the average age was 77 and 71% were female, in another this was 82 years and 70% were female, and in the last this was 86 years and 77% were female. One study w... |
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