Efficacy and safety of Ayurveda interventions for Sinusitis: A systematic review and meta-analysis
Bibliographic record
Abstract
ABSTRACT Objectives To provide a broad evaluation of the efficacy and safety of Ayurveda interventions (procedural and non-procedural) for the management of sinusitis, and also of the relative efficacy and safety of different Ayurveda therapies for Sinusitis. Methods Five electronic databases for published research articles, three databases for the unpublished doctoral thesis, clinical trial registries, and hand searches were done till August 2020. All comparative clinical trials recruiting sinusitis patients of any age group, receiving Ayurveda intervention, regardless of forms, dosages, and ingredients, for not less than one week were included. The data extraction and the risk of bias(RoB) assessment were done by two reviewers independently. Results A total of 2824 records were identified, of which 09 randomized parallel arms trials met inclusion criteria. No studies were found comparing Ayurveda versus placebo or non-Ayurveda interventions. Combined Ayurveda therapy (CT) was statistically more beneficial compared with either procedural or non-procedural Ayurveda therapy alone in reducing symptoms nasal discharge (standardized MD −0.71, 95% CI −1.16 to −0.26, I 2 58%, 210 participants) and headache (standardized MD −0.44, 95% CI −0.86 to −0.02, I 2 56%, 218 participants), however, no significant difference was found in reducing symptoms nasal obstruction and loss of smell. No numerical data related to the safety of Ayurveda intervention was found in included trials. Because, included trials(09) were having ‘high’ to ‘unclear’ overall bias, sub-standard methodology, and heterogeneity in results, the overall findings need to be interpreted cautiously. Conclusions Although individual studies appeared to produce positive results, very low certainty of total effect(downgraded twice for RoB, once for inconsistency, indirectness, and imprecision each) hindered to arrive at any conclusion regarding efficacy or safety of Ayurveda interventions for sinusitis. There is a need for well-designed-executed-reported clinical studies on clinically relevant outcomes. PROSPERO registration number RD42018103995 ARTICLE SUMMARY Strength and limitations of this study This is the first systematic review to provide the status of available evidence on the efficacy and safety of Ayurveda interventions for sinusitis. The search strategy was comprehensive, all the relevant sources were searched for published as well as unpublished research works. This systematic review has a broad review question, which compromises its eternal validity. The certainty of the overall effect is ‘very low’ due to ‘unclear’ to ‘high’ overall risk of bias, lack of validated outcome measures, inconsistency in results with wide CIs, small sample sizes, incomplete reporting, etc.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.017 | 0.032 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.024 | 0.038 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".