@phdthesis{Held2024, author = {Held, Helena}, title = {The effectiveness of non-occlusal therapies in relation to the chronicity of temporomandibular disorders: a systematic review with meta-analysis}, doi = {10.25972/OPUS-34799}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-347990}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {Background: That a differentiated treatment of subjects with low and high levels of disabling pain might be necessarily has only been suspected but not sufficiently confirmed so far. Furthermore, the effectiveness of extraoral therapy methods for TMD is still controversial in the literature. The present work could make an important contribution to this. Objectives: Five systematic reviews with meta-analysis were conducted to investigate the efficacy of extraoral therapies (acupuncture, laser, medication, psychosocial interventions, and physiotherapy) in the treatment of TMD in relation to the degree of chronicity of pain. Literature sources: With this objective, the databases Pubmed/MEDLINE, EMBASE, Cochrane Library, Livivo, OpenGrey, drks.de, Clinicaltrials.gov. were searched. Criteria for the selection of suitable studies: Adults suffering from painful TMD and treated with either acupuncture, laser, medication, psychosocial interventions, or physiotherapy. The studies were then examined for evidence in the subjects' characteristics suggesting that they were suffering from chronic TMD in terms of pain dysfunction. These included a high score on the GCPS, resistance to undergone treatments, multilocular pain, depression, and regular use of pain medication. The effectiveness of the five interventions was then differentiated according to the suspected degree of chronicity. Effectiveness was assessed by the following outcomes: patient- related current pain intensity, MMO, pain on palpation, temporomandibular joint sounds, depression, and somatization. Study evaluation: After the assessment of the studies, the quality assessment (Risk of Bias Tool of the Cochrane Institute) and the extraction of the data were conducted. After that five meta-analyses were carried out for each of the five interventions using the Review Manager of the Cochrane Institute (RevMan 5.3) Results: Acupuncture and dry needling were statistically significantly more effective in providing short-term pain relief compared to the control group in patients with low disability pain (p=0.04) and (p=0.02), respectively. Acupuncture or dry needling did not show a significant result in the improvement of MMO in the short-term period. Laser therapy is more effective in relieving pain (p<0.0001) and functional outcomes (p=0.03) in the short term compared to placebo for low disability pain. Botulinum toxin (p=0.003) and NSAIDs (p=0.03) showed significantly better short-term improvement in pain intensity for high disability pain. Low disability pain is significantly better treated by psychosocial interventions than by other treatments in terms of long-term pain relief (more than 12 months) (p=0.02). Patients with high disability pain had significantly lower depression scores after psychosocial interventions than after other treatments (p=0.008). Physiotherapy showed a statistically significant short-term analgesic effect in patients with high disability pain compared to placebo (p=0.04). Manual Therapy (MT) showed a statistically significant short-term analgesic effect in high disability pain compared to the control group (p=0.01). Patients with low disability pain showed a statistically significant short-term pain-relieving effect with the single intervention of MT in combination with exercise compared to the control groups (p=0.003). A statistically significant result in the improvement of MMO was found in the short-term period in low disability pain for the single interventions of physiotherapy (p=0.008) and physiotherapy in combination with another treatment compared to other treatments (p=0.03), MT compared to the control group (p=0.03) and physiotherapy compared to splint therapy (p=0.03). Clinical conclusion: Individual interventions of the five extraoral therapies confirm the hypothesis that painful TMDs respond differently to established therapies depending on the degree of chronic pain-related disability and that the prognosis of therapy is significantly influenced by the degree of chronic pain- related disability of the condition, according to the GCPS. Registration number of the review at PROSPERO: CRD42020202558 Keywords: meta-analysis, systematic review, temporomandibular disorders, extra oral therapy, acupuncture, laser, medication, psychosocial interventions, physiotherapy, low disability, high disability, pain, chronification}, subject = {Metaanalyse}, language = {en} } @phdthesis{Marker2020, author = {Marker, Caroline}, title = {On a meta-level: Contributions of meta-analytic summaries in media psychological research}, doi = {10.25972/OPUS-20917}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-209173}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2020}, abstract = {The rising use of new media has given rise to public discussions about their possible negative consequences. The social sciences have answered these concerns, providing many studies investigating different media types (e.g., social media, video games) and different related variables (e.g., psychological well-being, academic achievement). Within this big body of research, some research results have confirmed negative associations with frequent media use; other studies have found no or even positive relationships. With heterogeneous results, it is difficult to obtain a clear picture of the relationships and causalities of new media. The method of meta-analysis allows a synthesis of all existing data, providing an overall effect size as well as moderator and mediator analyses which might explain the heterogeneity. Three manuscripts present meta-analytic evidence related to a) the relationship between social media use and academic achievement, b) the relationship between video gaming and overweight, and c) the relationship between social media and psychological correlates. Manuscript \#1 found small relationships which depend on the usage pattern of social media. The relationship is positive, as long as social media use is related to school. Manuscript \#2 showed that children's and adolescents' video gaming is independent from their body mass, while adults who play more have a higher body mass. Manuscript \#3 summarized existing meta-analytic evidence that links social media with psychological wellbeing, academic achievement, and narcissism with small to moderate effect sizes. All three manuscripts underscore the potential of meta-analyses to synthesize previous research and to identify moderators. Although meta-analyses are not necessarily superior to other approaches because of their limitations (e.g. limited information or quality of primary studies) they are very promising for media psychology. Meta-analyses can reduce complexity and might be helpful for the communication of research results to the general public.}, subject = {Medienkonsum}, language = {en} } @phdthesis{Schnabel2011, author = {Schnabel, Eva}, title = {Alcohol and driving-related performance - A comprehensive meta-analysis focusing the significance of the non-significant}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-69959}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2011}, abstract = {The present work reviews the experimental literature on the acute effects of alcohol on human behaviour related to driving performance. A meta-analysis was conducted which includes studies published between 1954 and 2007 in order to provide a comprehensive knowledge of the substance alcohol. 450 studies reporting 5,300 findings were selected from over 12,000 references after applying certain in- and exclusion criteria. Thus, the present meta-analysis comprises far more studies than reviews on alcohol up to now. In the selected studies, different performance tests were conducted which were relevant for driving. The classification system used in this work assigns these tests to eight categories. The main categories consist of several sub categories classifying the tasks more precisely. The main categories were: (1) visual functions, (2) attention (including vigilance), (3) divided attention, (4) en-/decoding (including information processing and memory), (5) reaction time (including simple reaction time and choice reaction time), (6) psychomotor skills, (7) tracking and (8) driving. In addition to the performance aspect, the classification system takes into account mood and social behaviour variables related to driving safety like tiredness or aggression. Following the evaluation method of vote-counting, the number of significant findings and the number of non-significant findings were summarised per blood alcohol concentration (BAC) group. Thereby, a quantitative estimation of the effects of alcohol depending on the BAC was established, the so-called impairment function, which shows the percentage of significantly impaired findings. In order to provide a general overview of alcohol effects on driving-related performance, a global impairment function was established by aggregating all performance findings. The function is nearly linear with about 30\% significant findings at a BAC of 0.05\% and 50\% significant findings at a BAC of 0.08\%. In addition, more specific impairment functions considering only the findings of the single behavioural categories were calculated. The results revealed that impairment depends not only on the BAC, but also clearly differs between most of the performance categories. Tracking and driving performance were most affected by alcohol with impairment beginning at very low BACs of 0.02\%. Also psychomotor skills were considerably affected by rather low BACs. Impairment of visual functions and information processing occurred at BACs of 0.04\% and increased substantially with higher BACs. Impairment in memory tests could be found with very low BACs of 0.02\%, but varied depending on the kind of memory. Performance decrements in divided attention tests could also be found with very low BACs in some studies. Attention started to be impaired at 0.04\% BAC, but - as in vigilance tasks - considerable impairment only occurred at higher BACs. Choice reaction time was affected at lower BACs than simple reaction time, which was - together with the critical flicker fusion frequency - the least sensitive parameter to the effects of alcohol. To conclude, most skills which are relevant for the safe operation of a vehicle are clearly impaired by BACs of 0.05\%, with motor functions being more affected than cognitive functions and complex tasks more than simple tasks. Generally, the results provided no evidence of a threshold effect for alcohol. There was no driving-related performance category for which a sudden transition from unimpaired to impaired occurred at a particular BAC level. In addition, a comparison was made between the present meta-analysis and two reviews of Moskowitz (Moskowitz \& Fiorentino, 2000; Moskowitz \& Robinson, 1988). Moskowitz reported much lower BACs at which performance was impaired. The reasons for this discrepancy lies in a different way to review scientific findings. On the one hand, Moskowitz focused on significant findings when selecting studies and findings for his reviews. On the other hand, the evaluation method used by Moskowitz ignored non-significant findings and counted each study once at the lowest BAC for which impairment was found. Those non-significant findings are as important as the significant ones in order to determine thresholds of impairment. Therefore, in contrast to Moskowitz, the present work describes the effects of alcohol with functions considering also the non-significant findings. The significance of the non-significant is emphasized with respect to the selection procedure as well as to the evaluation method.}, subject = {Trunkenheit im Verkehr}, language = {en} }