Korean Journal of Family Medicine

"systematic review"

Original Articles

Effect of saffron on premenstrual syndrome and dysmenorrhea: a systematic review and meta-analysis: Mohammad Mehdi Mohammadi, Zohreh Karimi; Received October 7, 2024 Accepted January 2, 2025 Published online October 28, 2025; DOI: https://doi.org/10.4082/kjfm.24.0259 [Epub ahead of print]

Abstract
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Background
Premenstrual syndrome (PMS) and dysmenorrhea are common symptoms in women. In this study, we investigated the effects of saffron on PMS and dysmenorrhea in women.
Methods
In this systematic review and meta-analysis, we comprehensively screened a range of databases, including PubMed, Web of Science, and Science Direct. We included randomized clinical trials investigating the effects of saffron on PMS or dysmenorrhea. Quality assessment of the identified studies was conducted using the Cochrane risk-of-bias assessment tool. Meta-analysis was performed using Comprehensive Meta-Analysis software ver. 2 based on the random effects model.
Results
Meta-analysis revealed that saffron had a significant positive effect on the symptoms of PMS in women (standardized mean difference [SMD], –0.64; 95% confidence interval [CI], –0.84 to –0.44). Furthermore, saffron was effective in reducing dysmenorrhea (SMD, –0.51; 95% CI, –1.01 to –0.01).
Conclusion
The findings of our meta-analysis indicate that saffron exerts beneficial effects on the symptoms of both PMS and dysmenorrhea in women.

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Effect of Curcumin on Dysmenorrhea and Symptoms of Premenstrual Syndrome: A Systematic Review and Meta-Analysis: Foruzan Sharifipour, Shahla Faal Siahkal, Kowsar Qaderi, Zeynab Mohaghegh, Maryam Zahedian, Faeze Azizi; Korean J Fam Med 2024;45(2):96-104. Published online January 24, 2024; DOI: https://doi.org/10.4082/kjfm.23.0184; Retraction in: Korean J Fam Med 2025;46(2):124

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Review Articles

Global Mapping of Potentially Inappropriate Prescribing for Older Adults in Community Settings: An Umbrella Review: Nafiseh Ghassab-Abdollahi, Haidar Nadrian, Fatemeh Saadati, Fariba ashazadeh, Elnaz Shaseb, Mina Hashemiparast, Hamid Allahverdipour; Korean J Fam Med 2023;44(4):189-204. Published online July 18, 2023; DOI: https://doi.org/10.4082/kjfm.23.0032

Potentially inappropriate prescribing (PIP) is a major public health concern with several undesirable health consequences for older adults. In this overview, we aimed to map and gather information from existing literature to provide a better insight into the prevalence of PIP among community dwellers. Electronic databases were searched from their inception to April 2022. The quality of the included systematic reviews (SRs) was assessed using the assessment of multiple systematic reviews checklist. The degree of overlap within the SRs was also evaluated (2% overlap). All SRs on the prevalence of PIP in older individuals in community settings were included, and a narrative approach was used to synthesize data. Nineteen SRs comprising 548 primary studies met the inclusion criteria, and the average quality of the included SRs was moderate. More than half (50.5%) of the primary studies were conducted in Europe, followed by the United States (22.8%), and Asia (18.9%). Thirty different criteria were used in the primary studies to estimate the prevalence of PIP. The most widely used criteria were those presented in Beers (41.8%) and STOPP (Screening Tool of Older Persons’ Prescriptions)/START (Screening Tool to Alert to Right Treatment) (21.8%) criteria. Benzodiazepines, nonsteroidal anti-inflammatory drugs, and antidepressants were the most frequently reported PIPs. A considerable variation in the prevalence of PIP ranging from 0% to 98% was reported by SRs. However, there is a high degree of uncertainty regarding the extent of PIP in community settings. To identify knowledge-to-action gaps, SR authors should consider the differences in prevalence of PIP according to settings, applied tools, data sources, geographical areas, and specific pathologies. There is also a need for primary and SR studies from low- and middle-income countries regarding the prevalence of PIP.

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A Prospective Study on Potentially Inappropriate Drug Use and All‐Cause Mortality in Community‐Dwelling Older Adults
Liat Orenstein, Angela Chetrit, Keren Laufer, Rachel Dankner
Journal of the American Geriatrics Society.2025; 73(9): 2828. CrossRef

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RoBANS 2: A Revised Risk of Bias Assessment Tool for Nonrandomized Studies of Interventions: Hyun-Ju Seo, Soo Young Kim, Yoon Jae Lee, Ji-Eun Park; Korean J Fam Med 2023;44(5):249-260. Published online July 7, 2023; DOI: https://doi.org/10.4082/kjfm.23.0034

Abstract
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Assessment of the risk of bias is an essential component of any systematic review. This is true for both nonrandomized studies and randomized trials, which are the main study designs of systematic reviews. The Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS) was developed in 2013 and has gained wide usage as a risk-of-bias assessment tool for nonrandomized studies. Four risk-of-bias assessment experts revised it by reviewing existing assessment tools and user surveys. The main modifications included additional domains of selection and detection bias susceptible to nonrandomized studies of interventions, a more detailed consideration of the comparability of participants, and more reliable and valid outcome measurements. A psychometric assessment of the revised RoBANS (RoBANS 2) revealed acceptable inter-rater reliability (weighted kappa, 0.25 to 0.49) and construct validity in which intervention effects of studies with an unclear or high risk of bias were overestimated. The RoBANS 2 has acceptable feasibility, fair-to-moderate reliability, and construct validity. It provides a comprehensive framework for allowing authors to assess and understand the plausible risk of bias in nonrandomized studies of interventions.

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Original Articles

Association between Family Functionality and Depression: A Systematic Review and Meta-Analysis: Daniel Guerrero-Muñoz, Diana Salazar, Victoria Constain, Alvaro Perez, Carlos Andrés Pineda-Cañar, Herney Andrés García-Perdomo; Korean J Fam Med 2021;42(2):172-180. Published online June 10, 2020; DOI: https://doi.org/10.4082/kjfm.19.0166

Abstract
PDF

Background
Different scales have attempted to assess various aspects of family dynamics and structures. Good family function seems to allow for better prognoses for basic diseases and appears to be a predictor of depression. The aim of this study was to determine the association between family functionality and depression.
Methods
This is a systematic review and meta-analysis including cross-sectional, cohort, and case-control studies using validated instruments such as the Family APGAR (Adaptability, Partnership, Growth, Affection, and Resolve) and Family Adaptability and Cohesion Evaluation Scale III. A search strategy was designed for the MEDLINE, Embase, Central, and LILACS databases along with data saturation through a search of unpublished literature from the onset of the databases to the present. The categorical variables are expressed in terms of odds ratios (OR), and the statistical analysis was carried out using Review Manager ver. 5.31 (The Cochrane Collaboration, Oxford, UK) using forest plots with corresponding 95% confidence intervals (CI). A fixed-effect model was used according to the expected heterogeneity, expressed in terms of I² . The risk of bias was evaluated using the MINORS (methodological index for non-randomized studies) tool.
Results
A total of 1,519 studies were found, of which 10 were selected for the qualitative synthesis and four were chosen for the meta-analysis. The result for the association between family dysfunction and depression yielded an OR (95% CI) of 3.72 (2.70 to 5.12) and I² of 24%.
Conclusion
Family dysfunction and depression are strongly associated.

Citations

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Effects of Having Usual Source of Care on Preventive Services and Chronic Disease Control: A Systematic Review: Min Young Kim, Ju Heon Kim, Il-Kwon Choi, In Hong Hwang, Soo Young Kim; Korean J Fam Med 2012;33(6):336-345. Published online November 27, 2012; DOI: https://doi.org/10.4082/kjfm.2012.33.6.336

Abstract
PDF

Background

Having usual source of care has been associated with improved receipt of preventive services and control of chronic diseases (such as hypertension, diabetes, and hypercholesterolemia). The objective of this study was to examine whether having usual source of care is associated with improved receipt of preventive services and control of chronic diseases.

Methods

We searched MEDLINE, EMBASE, Cochrane, CINAHL, KMbase, KoreaMed, RiSS4U, National Assembly Library, and KISS for studies released through May 31st 2011. Two authors independently extracted the data. We manually searched the references and twenty recent related articles on PubMed. To assess the risk of bias RoBANS tool was used.

Results

We identified 10 studies. Most having usual source of care were associated with improved receipt of preventive services (cervical cancer screening, clinical breast exam, mammogram, prostate cancer screening, and flu shot) compared with no usual source of care. However, gastric cancer and colon cancer screening were difficult to conclude and blood pressure checkup showed mixed results. Overall there was no association between having usual source of care and smoking behaviors and the effect on chronic disease control was difficult to conclude.

Conclusion

Having usual source of care was associated with improved receipt of preventive services and overall the results were consistent. So, the results suggested that having usual source of care may help to receive preventive services. Hereafter, cohort studies are needed to evaluate casual relationships and more studies are needed in various countries and systems.

Citations

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Present Status of Papers on the Primary Care Quality Assessment in Korea.: Jae Wook Jeong, Nak Jin Sung; Korean J Fam Med 2009;30(7):525-532. Published online July 20, 2009; DOI: https://doi.org/10.4082/kjfm.2009.30.7.525

Abstract
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Background
The analysis of the papers on the primary care quality assessment in Korea was performed to summarize existing papers, estimate the level of primary care quality, and suggest the directions and areas of the future research. Methods: Primary care quality-related papers were selected via internet web search engines which were Korean Journal of Family Medicine homepage, KMbase, and KoreaMed. Further papers were added after consultation to primary care quality assessment specialists in Korea. Results: The number of related papers was 29. Data collection was done mostly via mail or telephone questionnaire to suppliers, primary care physicians. Papers on resource capacity area were 11, on services delivery 4, on outcome by service 2, and on clinical performance 12. The total primary care score was low. The themes of clinical performance studies were common diseases in Korea. Conclusion: Research volume on primary care quality assessment was poor, especially on outcome area. Data collection methods and quality indicators are needed to diverse. Future researches using OECD health care quality indicators are needed to make international comparison possible, which fi nally contributes to primary care quality improvement in Korea.

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Patients' Perceived Quality of Family Physicians' Primary Care with or without 'Family Medicine' in the Clinic Name
Ka Young Kim, Kangjin Lim, Eal Whan Park, Eun Young Choi, Yoo Seock Cheong
Korean Journal of Family Medicine.2016; 37(5): 303. CrossRef
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Journal of the Korean Medical Association.2013; 56(10): 899. CrossRef

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Evaluation of School-based Obesity Prevention and Management Program in Korean Children.: Kyung Hee Park, Sun Mi Yoo; J Korean Acad Fam Med 2006;27(6):471-480. Published online June 10, 2006

Abstract
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Background
: Childhood and adolescent obesity are major health concern impacting on short and long-term health. Prevention programs for obesity through school channel are essential. With the increasing prevalence of obesity and overweight among children and adolescence since 1990's, obesity prevention and management have been pursued in Korea. Schools, where students spend much of their daytime, are in a unique position to play a pivotal role in performing obesity prevention and management programs. The objective of this study was to assess the effectiveness of school-based interventions designed to prevent or manage obesity among elementary, middle, and high school students in Korea.

Methods : Electronic database were searched using the following key words; obesity, obesity prevention, obesity prevention program, child, adolescence, and effectiveness. In this systematic review, school-based programs were evaluated with the assessment items.

Results : Thirteen studies were included in the study. Most programs include at least one of the following components: dietary changes, physical activity, behavioral modifications, and parental participation. Studies that involved multidisciplinary measures including dietary education, increased physical activity, parental involvement and behavioral modification and studies focused on increased physical activity among subjects showed positive results. But the majority of studies were short-term and secondary prevention among children, not adolescents, not randomized, and without control. Few studies used validated questionnaires and process evaluation.

Conclusion : The development and application of evidence-based and feasible strategies in support of communities and families to the school-centered obesity prevention program are needed in the near future.