Heterogeneity Factor Analysis of Studies Evaluating the Effect of Tai Chi on Improving the Overall Quality of Life in Patients with Breast Cancer

Yuanqing Pan; Yanxu Yang; Yi Dong; Nan Li; Haiqian Liang; Qi Cui

doi:doi:10.11648/j.cmr.20180703.12

| Peer-Reviewed

Heterogeneity Factor Analysis of Studies Evaluating the Effect of Tai Chi on Improving the Overall Quality of Life in Patients with Breast Cancer

Yuanqing Pan, Yanxu Yang, Yi Dong, Nan Li, Haiqian Liang, Qi Cui

Published in Clinical Medicine Research (Volume 7, Issue 3)

Received: 12 May 2018 Accepted: 4 June 2018 Published: 15 June 2018

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Background: In the case of large heterogeneity, the data combination of randomized controlled trials will lead to the decrease of the reliability of systematic review and meta analysis, so we conducted the present study. Objectives: To explore sources of heterogeneity in studies on Tai Chi Chuan (TCC) as a complementary and alternative method for managing the overall quality of life of postoperative breast cancer patients. Methods: Randomized controlled trials were searched for in PubMed, EMBASE, Web of Science and the Cochrane Library through August 2017. The Cochrane Handbook 5.2 standards and Stata software version 10.0 were adopted for evaluating the quality of the included studies and the data was analyzed on overall quality of life of TCC. A separate univariate meta-regression analysis was performed on the study duration, sample size, cancer staging, prior breast cancer treatment, different types of TCC intervention group, different types of control group, intervention duration, mean age, and ethnicity to detect important factors leading to heterogeneity. Results: Significant heterogeneity was present in the included studies that used TCC to improve the overall quality of life of postoperative breast cancer patients from the retrieved literature (P < 0.05). The univariate meta-regression analysis indicated that the source of heterogeneity was not apparent in the analyzed factors within or between studies. Conclusions: A normative approach in studies evaluating the use of TCC for improving the overall quality of life of postoperative breast cancer patients was not sufficiently explored in the existing randomized controlled trials (RCTs). An insufficient number of RCTs in this field may be the reason that the effect size had unclear clinical significance. The existing evidence provided limited judgment on sources of heterogeneity between studies evaluating the use of TCC for improving overall quality of life in postoperative breast cancer patients.

Published in	Clinical Medicine Research (Volume 7, Issue 3)
DOI	10.11648/j.cmr.20180703.12
Page(s)	57-66
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Breast Neoplasms, Heterogeneity, Quality of Life, Tai Chi Chuan

References

[1]	Rojas K, Stuckey A. Breast Cancer Epidemiology and Risk Factors. Clin Obstet Gynecol. Vol. 59, No. 4, 2016, pp. 651-672.
[2]	Subramani R, Lakshmanaswamy R. Complementary and Alternative Medicine and Breast Cancer. Prog Mol Biol Transl Sci. Vol. 151, 2017, pp. 231-274.
[3]	Ernst E. Assessments of complementary and alternative medicine: the clinical guidelines from NICE. International Journal of Clinical practice. Vol. 64, No. 10, 2010, pp. 1350-1358.
[4]	Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0. Online document at: The Cochrane Collaboration http://www.07November2011.cochrane-handbook.org. Accessed 2011.
[5]	Stata software (computer program) (version 10.0). Stata Corp., College Station, TX, USA. 2010.
[6]	Mustian KM, Katula JA, Gill DL, Roscoe JA, Lang D, Murphy K. Tai Chi Chuan, health-related quality of life and self-esteem: a randomized trial with breast cancer survivors. Support Care Cancer. Vol. 12, No. 12, 2004, pp. 871-876.
[7]	Robins JL, McCain NL, Elswick RK Jr, Walter JM, Gray DP, Tuck I. Psychoneuroimmunology-based stress management during adjuvant chemotherapy for early breast cancer. Evidence Based Complementary Alternative Medicine. 2013; 2013: 372908.
[8]	Mustian KM, Palesh OG, Flecksteiner SA. Tai Chi Chuan for breast cancer survivors. Medical Sport Science. Vol. 52, 2008, pp. 209-217.
[9]	Sprod LK, Janelsins MC, Palesh OG, et al. Health-related quality of life and biomarkers in breast cancer survivors participating in Tai Chi Chuan. Journal of Cancer Survivorship. Vol. 6, 2012, pp. 146-54.
[10]	Campo RA, O'Connor K, Light KC, et al. Feasibility and acceptability of a Tai Chi Chih randomized controlled trial in senior female cancer survivors. Integrative Cancer Therapies. Vol. 12, No. 6, 2013, pp. 464-474.
[11]	Rausch SM. Evaluating psychosocial effects of two intervention, Tai Chi and spiritual growth groups, in women with breast cancer. Dissertation, June 2007 Virginia Commonwealth University.
[12]	Choi SW, Lam DM. Heterogeneity in meta-analyses. Comparing apples and oranges? Anaesthesia. Vol. 72, No. 4, 2017, pp, 532-534.
[13]	Hicks A, Fairhurst C, Torgerson DJ. A simple technique investigating baseline heterogeneity helped to eliminate potential bias in meta-analyses. J Clin Epidemiol. Vol. 95, 2018, pp. 55-62.
[14]	Garcia-Alamino JM, Bankhead C, Heneghan C, Pidduck N, Perera R. Impact of heterogeneity and effect size on the estimation of the optimal information size: analysis of recently published meta-analyses. BMJ Open. Vol. 7, No. 11, 2017, pp.e015888.
[15]	Doleman B, Sutton AJ, Sherwin M, Lund JN, Williams JP. Baseline Morphine Consumption May Explain Between-Study Heterogeneity in Meta-analyses of Adjuvant Analgesics and Improve Precision and Accuracy of Effect Estimates. Anesth Analg. Vol. 126 No. 2, 2018, pp. 648-660.
[16]	Yan JH, Pan L, Zhang XM, Sun CX, Cui GH. Lack of efficacy of Tai Chi in improving quality of life in breast cancer survivors: a systematic review and meta-analysis. Asian Pacific Journal of Cancer Prevention Apjcp. Vol. 15, No. 8, 2014, pp. 3715-3720.
[17]	Lee MS, Choi TY, Ernst E. Tai chi for breast cancer patients: a systematic review. Breast Cancer Research & Treatment. Vol. 120, No. 2, 2010, pp. 309-316.
[18]	Lee MS, Pittler MH, Ernst E. Is Tai Chi an effective adjunct in cancer care? A systematic review of controlled clinical trials. Support Care Cancer. Vol. 15, No. 6, 2007, pp. 597-601.
[19]	Probst P, Grummich K, Heger P, Zaschke S, Knebel P, Ulrich A, Büchler MW, Diener MK. Blinding in randomized controlled trials in general and abdominal surgery: protocol for a systematic review and empirical study. Syst Rev. 2016, 24; 5: 48.
[20]	Liu L, Petrich S, McLaren B, Kelly L, Baxter GD.An integrative Tai Chi program for patients with breast cancer undergoing cancer therapy: study protocol for a randomized controlled feasibility study. J Integr Med. Vol. 16, No. 2, 2018, pp. 99-105.
[21]	Pan Y, Yang K, Shi X, Liang H, Zhang F, Lv Q. Tai chi chuan exercise for patients with breast cancer: a systematic review and meta-analysis. Evid Based Complement Alternat Med. 2015, 2015: 535237.
[22]	Créquit P, Trinquart L, Yavchitz A, Ravaud P. Wasted research when systematic reviews fail to provide a complete and up-to-date evidence synthesis: the example of lung cancer.BMC Med. 2016 Jan 20; 14: 8.
[23]	Yan JH, Pan L, Zhang XM, Sun CX, Cui GH. Lack of efficacy of Tai Chi in improving quality of life in breast cancer survivors: a systematic review and meta-analysis. Asian Pac J Cancer Prev. Vol. 15, No. 8, 2014, pp. 3715-20.
[24]	Zeng Y, Luo T, Xie H, Huang M, Cheng AS. Health benefits of qigong or tai chi for cancer patients: a systematic review and meta-analyses. Complement Ther Med. Vol. 22, No. 1, 2014, pp. 173-86.

Cite This Article

Plain Text BibTeX RIS

APA Style

Yuanqing Pan, Yanxu Yang, Yi Dong, Nan Li, Haiqian Liang, et al. (2018). Heterogeneity Factor Analysis of Studies Evaluating the Effect of Tai Chi on Improving the Overall Quality of Life in Patients with Breast Cancer. Clinical Medicine Research, 7(3), 57-66. https://doi.org/10.11648/j.cmr.20180703.12

Copy | Download

ACS Style

Yuanqing Pan; Yanxu Yang; Yi Dong; Nan Li; Haiqian Liang, et al. Heterogeneity Factor Analysis of Studies Evaluating the Effect of Tai Chi on Improving the Overall Quality of Life in Patients with Breast Cancer. Clin. Med. Res. 2018, 7(3), 57-66. doi: 10.11648/j.cmr.20180703.12

Copy | Download

AMA Style

Yuanqing Pan, Yanxu Yang, Yi Dong, Nan Li, Haiqian Liang, et al. Heterogeneity Factor Analysis of Studies Evaluating the Effect of Tai Chi on Improving the Overall Quality of Life in Patients with Breast Cancer. Clin Med Res. 2018;7(3):57-66. doi: 10.11648/j.cmr.20180703.12

Copy | Download

@article{10.11648/j.cmr.20180703.12,
  author = {Yuanqing Pan and Yanxu Yang and Yi Dong and Nan Li and Haiqian Liang and Qi Cui},
  title = {Heterogeneity Factor Analysis of Studies Evaluating the Effect of Tai Chi on Improving the Overall Quality of Life in Patients with Breast Cancer},
  journal = {Clinical Medicine Research},
  volume = {7},
  number = {3},
  pages = {57-66},
  doi = {10.11648/j.cmr.20180703.12},
  url = {https://doi.org/10.11648/j.cmr.20180703.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20180703.12},
  abstract = {Background: In the case of large heterogeneity, the data combination of randomized controlled trials will lead to the decrease of the reliability of systematic review and meta analysis, so we conducted the present study. Objectives: To explore sources of heterogeneity in studies on Tai Chi Chuan (TCC) as a complementary and alternative method for managing the overall quality of life of postoperative breast cancer patients. Methods: Randomized controlled trials were searched for in PubMed, EMBASE, Web of Science and the Cochrane Library through August 2017. The Cochrane Handbook 5.2 standards and Stata software version 10.0 were adopted for evaluating the quality of the included studies and the data was analyzed on overall quality of life of TCC. A separate univariate meta-regression analysis was performed on the study duration, sample size, cancer staging, prior breast cancer treatment, different types of TCC intervention group, different types of control group, intervention duration, mean age, and ethnicity to detect important factors leading to heterogeneity. Results: Significant heterogeneity was present in the included studies that used TCC to improve the overall quality of life of postoperative breast cancer patients from the retrieved literature (P < 0.05). The univariate meta-regression analysis indicated that the source of heterogeneity was not apparent in the analyzed factors within or between studies. Conclusions: A normative approach in studies evaluating the use of TCC for improving the overall quality of life of postoperative breast cancer patients was not sufficiently explored in the existing randomized controlled trials (RCTs). An insufficient number of RCTs in this field may be the reason that the effect size had unclear clinical significance. The existing evidence provided limited judgment on sources of heterogeneity between studies evaluating the use of TCC for improving overall quality of life in postoperative breast cancer patients.},
 year = {2018}
}

Copy | Download

TY  - JOUR
T1  - Heterogeneity Factor Analysis of Studies Evaluating the Effect of Tai Chi on Improving the Overall Quality of Life in Patients with Breast Cancer
AU  - Yuanqing Pan
AU  - Yanxu Yang
AU  - Yi Dong
AU  - Nan Li
AU  - Haiqian Liang
AU  - Qi Cui
Y1  - 2018/06/15
PY  - 2018
N1  - https://doi.org/10.11648/j.cmr.20180703.12
DO  - 10.11648/j.cmr.20180703.12
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 57
EP  - 66
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20180703.12
AB  - Background: In the case of large heterogeneity, the data combination of randomized controlled trials will lead to the decrease of the reliability of systematic review and meta analysis, so we conducted the present study. Objectives: To explore sources of heterogeneity in studies on Tai Chi Chuan (TCC) as a complementary and alternative method for managing the overall quality of life of postoperative breast cancer patients. Methods: Randomized controlled trials were searched for in PubMed, EMBASE, Web of Science and the Cochrane Library through August 2017. The Cochrane Handbook 5.2 standards and Stata software version 10.0 were adopted for evaluating the quality of the included studies and the data was analyzed on overall quality of life of TCC. A separate univariate meta-regression analysis was performed on the study duration, sample size, cancer staging, prior breast cancer treatment, different types of TCC intervention group, different types of control group, intervention duration, mean age, and ethnicity to detect important factors leading to heterogeneity. Results: Significant heterogeneity was present in the included studies that used TCC to improve the overall quality of life of postoperative breast cancer patients from the retrieved literature (P < 0.05). The univariate meta-regression analysis indicated that the source of heterogeneity was not apparent in the analyzed factors within or between studies. Conclusions: A normative approach in studies evaluating the use of TCC for improving the overall quality of life of postoperative breast cancer patients was not sufficiently explored in the existing randomized controlled trials (RCTs). An insufficient number of RCTs in this field may be the reason that the effect size had unclear clinical significance. The existing evidence provided limited judgment on sources of heterogeneity between studies evaluating the use of TCC for improving overall quality of life in postoperative breast cancer patients.
VL  - 7
IS  - 3
ER  -

Copy | Download

Author Information

Yuanqing Pan

Department of Medical Psychology, Department of Public Course, Tianjin Medical College, Tianjin, China
Yanxu Yang

Department of Public Health, Tianjin Medical College, Tianjin, China
Yi Dong

Department of Pharmacy, Tianjin Medical College, Tianjin, China
Nan Li

Nursing Department of Neurosurgery, Tianjin Pingjin Hospital, Tianjin, China
Haiqian Liang

Department of Neurosurgery, Tianjin Pingjin Hospital, Tianjin, China
Qi Cui

The Department of Clinical Pathway and Quality Control the Frist Affiliated Hospital of Lanzhou University, Lanzhou, China

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Yuanqing Pan, Yanxu Yang, Yi Dong, Nan Li, Haiqian Liang, et al. (2018). Heterogeneity Factor Analysis of Studies Evaluating the Effect of Tai Chi on Improving the Overall Quality of Life in Patients with Breast Cancer. Clinical Medicine Research, 7(3), 57-66. https://doi.org/10.11648/j.cmr.20180703.12

Copy | Download

ACS Style

Yuanqing Pan; Yanxu Yang; Yi Dong; Nan Li; Haiqian Liang, et al. Heterogeneity Factor Analysis of Studies Evaluating the Effect of Tai Chi on Improving the Overall Quality of Life in Patients with Breast Cancer. Clin. Med. Res. 2018, 7(3), 57-66. doi: 10.11648/j.cmr.20180703.12

Copy | Download

AMA Style

Yuanqing Pan, Yanxu Yang, Yi Dong, Nan Li, Haiqian Liang, et al. Heterogeneity Factor Analysis of Studies Evaluating the Effect of Tai Chi on Improving the Overall Quality of Life in Patients with Breast Cancer. Clin Med Res. 2018;7(3):57-66. doi: 10.11648/j.cmr.20180703.12

Copy | Download

@article{10.11648/j.cmr.20180703.12,
  author = {Yuanqing Pan and Yanxu Yang and Yi Dong and Nan Li and Haiqian Liang and Qi Cui},
  title = {Heterogeneity Factor Analysis of Studies Evaluating the Effect of Tai Chi on Improving the Overall Quality of Life in Patients with Breast Cancer},
  journal = {Clinical Medicine Research},
  volume = {7},
  number = {3},
  pages = {57-66},
  doi = {10.11648/j.cmr.20180703.12},
  url = {https://doi.org/10.11648/j.cmr.20180703.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20180703.12},
  abstract = {Background: In the case of large heterogeneity, the data combination of randomized controlled trials will lead to the decrease of the reliability of systematic review and meta analysis, so we conducted the present study. Objectives: To explore sources of heterogeneity in studies on Tai Chi Chuan (TCC) as a complementary and alternative method for managing the overall quality of life of postoperative breast cancer patients. Methods: Randomized controlled trials were searched for in PubMed, EMBASE, Web of Science and the Cochrane Library through August 2017. The Cochrane Handbook 5.2 standards and Stata software version 10.0 were adopted for evaluating the quality of the included studies and the data was analyzed on overall quality of life of TCC. A separate univariate meta-regression analysis was performed on the study duration, sample size, cancer staging, prior breast cancer treatment, different types of TCC intervention group, different types of control group, intervention duration, mean age, and ethnicity to detect important factors leading to heterogeneity. Results: Significant heterogeneity was present in the included studies that used TCC to improve the overall quality of life of postoperative breast cancer patients from the retrieved literature (P < 0.05). The univariate meta-regression analysis indicated that the source of heterogeneity was not apparent in the analyzed factors within or between studies. Conclusions: A normative approach in studies evaluating the use of TCC for improving the overall quality of life of postoperative breast cancer patients was not sufficiently explored in the existing randomized controlled trials (RCTs). An insufficient number of RCTs in this field may be the reason that the effect size had unclear clinical significance. The existing evidence provided limited judgment on sources of heterogeneity between studies evaluating the use of TCC for improving overall quality of life in postoperative breast cancer patients.},
 year = {2018}
}

Copy | Download

TY  - JOUR
T1  - Heterogeneity Factor Analysis of Studies Evaluating the Effect of Tai Chi on Improving the Overall Quality of Life in Patients with Breast Cancer
AU  - Yuanqing Pan
AU  - Yanxu Yang
AU  - Yi Dong
AU  - Nan Li
AU  - Haiqian Liang
AU  - Qi Cui
Y1  - 2018/06/15
PY  - 2018
N1  - https://doi.org/10.11648/j.cmr.20180703.12
DO  - 10.11648/j.cmr.20180703.12
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 57
EP  - 66
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20180703.12
AB  - Background: In the case of large heterogeneity, the data combination of randomized controlled trials will lead to the decrease of the reliability of systematic review and meta analysis, so we conducted the present study. Objectives: To explore sources of heterogeneity in studies on Tai Chi Chuan (TCC) as a complementary and alternative method for managing the overall quality of life of postoperative breast cancer patients. Methods: Randomized controlled trials were searched for in PubMed, EMBASE, Web of Science and the Cochrane Library through August 2017. The Cochrane Handbook 5.2 standards and Stata software version 10.0 were adopted for evaluating the quality of the included studies and the data was analyzed on overall quality of life of TCC. A separate univariate meta-regression analysis was performed on the study duration, sample size, cancer staging, prior breast cancer treatment, different types of TCC intervention group, different types of control group, intervention duration, mean age, and ethnicity to detect important factors leading to heterogeneity. Results: Significant heterogeneity was present in the included studies that used TCC to improve the overall quality of life of postoperative breast cancer patients from the retrieved literature (P < 0.05). The univariate meta-regression analysis indicated that the source of heterogeneity was not apparent in the analyzed factors within or between studies. Conclusions: A normative approach in studies evaluating the use of TCC for improving the overall quality of life of postoperative breast cancer patients was not sufficiently explored in the existing randomized controlled trials (RCTs). An insufficient number of RCTs in this field may be the reason that the effect size had unclear clinical significance. The existing evidence provided limited judgment on sources of heterogeneity between studies evaluating the use of TCC for improving overall quality of life in postoperative breast cancer patients.
VL  - 7
IS  - 3
ER  -

Copy | Download