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Funnel plot of comparison: 1 music versus standard care, outcome: 1.2 Anxiety (all measures) ‐ patient type.

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Figure 1

Funnel plot of comparison: 1 music versus standard care, outcome: 1.2 Anxiety (all measures) ‐ patient type.

Funnel plot of comparison: 1 music versus standard care, outcome: 1.11 Heart rate‐patient type.

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Figure 2

Funnel plot of comparison: 1 music versus standard care, outcome: 1.11 Heart rate‐patient type.

Funnel plot of comparison: 1 music versus standard care, outcome: 1.15 Systolic blood pressure.

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Figure 3

Funnel plot of comparison: 1 music versus standard care, outcome: 1.15 Systolic blood pressure.

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

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Figure 4

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

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Figure 5

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

Comparison 1: Music versus standard care, Outcome 1: Psychological distress

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Analysis 1.1

Comparison 1: Music versus standard care, Outcome 1: Psychological distress

Comparison 1: Music versus standard care, Outcome 2: Anxiety (all measures) ‐ patient type

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Analysis 1.2

Comparison 1: Music versus standard care, Outcome 2: Anxiety (all measures) ‐ patient type

Comparison 1: Music versus standard care, Outcome 3: Anxiety (all measures) ‐ music preference

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Analysis 1.3

Comparison 1: Music versus standard care, Outcome 3: Anxiety (all measures) ‐ music preference

Comparison 1: Music versus standard care, Outcome 4: State anxiety (STAI) ‐ patient type

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Analysis 1.4

Comparison 1: Music versus standard care, Outcome 4: State anxiety (STAI) ‐ patient type

Comparison 1: Music versus standard care, Outcome 5: State Anxiety (STAI) ‐ music preference

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Analysis 1.5

Comparison 1: Music versus standard care, Outcome 5: State Anxiety (STAI) ‐ music preference

Comparison 1: Music versus standard care, Outcome 6: State Anxiety (STAI) ‐ music preference MI only

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Analysis 1.6

Comparison 1: Music versus standard care, Outcome 6: State Anxiety (STAI) ‐ music preference MI only

Comparison 1: Music versus standard care, Outcome 7: Anxiety (non‐STAI)‐patient type

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Analysis 1.7

Comparison 1: Music versus standard care, Outcome 7: Anxiety (non‐STAI)‐patient type

Comparison 1: Music versus standard care, Outcome 8: Anxiety (non‐STAI) ‐ music preference

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Analysis 1.8

Comparison 1: Music versus standard care, Outcome 8: Anxiety (non‐STAI) ‐ music preference

Comparison 1: Music versus standard care, Outcome 9: Depression

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Analysis 1.9

Comparison 1: Music versus standard care, Outcome 9: Depression

Comparison 1: Music versus standard care, Outcome 10: Mood

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Analysis 1.10

Comparison 1: Music versus standard care, Outcome 10: Mood

Comparison 1: Music versus standard care, Outcome 11: Heart rate‐patient type

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Analysis 1.11

Comparison 1: Music versus standard care, Outcome 11: Heart rate‐patient type

Comparison 1: Music versus standard care, Outcome 12: Heart rate ‐ music preference

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Analysis 1.12

Comparison 1: Music versus standard care, Outcome 12: Heart rate ‐ music preference

Comparison 1: Music versus standard care, Outcome 13: Heart rate variability

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Analysis 1.13

Comparison 1: Music versus standard care, Outcome 13: Heart rate variability

Comparison 1: Music versus standard care, Outcome 14: Respiratory rate ‐ music preference

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Analysis 1.14

Comparison 1: Music versus standard care, Outcome 14: Respiratory rate ‐ music preference

Comparison 1: Music versus standard care, Outcome 15: Systolic blood pressure

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Analysis 1.15

Comparison 1: Music versus standard care, Outcome 15: Systolic blood pressure

Comparison 1: Music versus standard care, Outcome 16: Diastolic blood pressure

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Analysis 1.16

Comparison 1: Music versus standard care, Outcome 16: Diastolic blood pressure

Comparison 1: Music versus standard care, Outcome 17: Mean A rterial Pressure

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Analysis 1.17

Comparison 1: Music versus standard care, Outcome 17: Mean A rterial Pressure

Comparison 1: Music versus standard care, Outcome 18: Oxygen Saturation

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Analysis 1.18

Comparison 1: Music versus standard care, Outcome 18: Oxygen Saturation

Comparison 1: Music versus standard care, Outcome 19: Pain

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Analysis 1.19

Comparison 1: Music versus standard care, Outcome 19: Pain

Comparison 1: Music versus standard care, Outcome 20: Length of hospital stay

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Analysis 1.20

Comparison 1: Music versus standard care, Outcome 20: Length of hospital stay

Comparison 1: Music versus standard care, Outcome 21: Opioid intake

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Analysis 1.21

Comparison 1: Music versus standard care, Outcome 21: Opioid intake

Comparison 1: Music versus standard care, Outcome 22: Quality of sleep

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Analysis 1.22

Comparison 1: Music versus standard care, Outcome 22: Quality of sleep

Summary of findings 1. Music versus standard care for coronary heart disease

Music versus standard care for coronary heart disease

Patient or population: people with coronary heart disease
Settings:
Intervention: music versus standard care

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Control

Music versus standard care

Psychological Distress
POMS

The mean psychological distress in the intervention groups was
1.26 lower
(2.30 to 0.22 lower)

228
(5 studies)

⊕⊕⊝⊝
low1

Anxiety (all measures)
NRS, VAS, HADS, STAI

The mean anxiety (all measures) in the intervention groups was
0.70 standard deviations lower
(1.17 to 0.22 lower)

353
(10 studies)

⊕⊝⊝⊝
very low1,2,3

State anxiety (MI patients)
STAI

The mean state anxiety (MI patients) in the intervention groups was
5.87 lower
(7.99 to 3.75 lower)

243
(6 studies)

⊕⊕⊝⊝
low1

Heart rate
bpm

The mean heart rate in the intervention groups was
3.62 lower
(6.28 to 0.95 lower)

828
(13 studies)

⊕⊝⊝⊝
very low1,2,3

Respiratory rate
breaths per minute

The mean respiratory rate in the intervention groups was
2.50 lower
(3.61 to 1.39 lower)

442
(7 studies)

⊕⊝⊝⊝
very low1,4

Systolic blood pressure

The mean systolic blood pressure in the intervention groups was
5.52 lower
(7.43 to 3.60 lower)

775
(11 studies)

⊕⊕⊝⊝
low1

Pain
VAS, NRS

The mean pain in the intervention groups was
0.43 standard deviations lower
(0.80 to 0.05 lower)

562
(8 studies)

⊕⊝⊝⊝
very low1,3,5

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval;

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1The majority of the trials were assessed as being at high risk of bias
2Results were inconsistent across studies as evidenced by I² = 77%.
3Wide confidence interval
4Results were inconsistent across studies as evidenced by I² = 79%.
5Results were inconsistent across studies as evidenced by I² = 81%.

Figuras y tablas -
Summary of findings 1. Music versus standard care for coronary heart disease
Comparison 1. Music versus standard care

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1.1 Psychological distress Show forest plot

5

228

Mean Difference (IV, Fixed, 95% CI)

‐1.26 [‐2.30, ‐0.22]

1.2 Anxiety (all measures) ‐ patient type Show forest plot

10

353

Std. Mean Difference (IV, Random, 95% CI)

‐0.70 [‐1.17, ‐0.22]

1.2.1 anxiety (all measures) (MI)

4

143

Std. Mean Difference (IV, Random, 95% CI)

‐0.94 [‐1.95, 0.06]

1.2.2 anxiety (all measures)(surgical/procedural)

4

171

Std. Mean Difference (IV, Random, 95% CI)

‐0.63 [‐1.25, ‐0.01]

1.2.3 anxiety (all measures)(rehabilitation)

2

39

Std. Mean Difference (IV, Random, 95% CI)

‐0.38 [‐1.60, 0.83]

1.3 Anxiety (all measures) ‐ music preference Show forest plot

9

323

Std. Mean Difference (IV, Random, 95% CI)

‐0.79 [‐1.29, ‐0.29]

1.3.1 Anxiety (all measures) ‐ partcipant‐selected

4

144

Std. Mean Difference (IV, Random, 95% CI)

‐0.89 [‐1.42, ‐0.36]

1.3.2 Anxiety (all measures) ‐ researcher‐selected

5

179

Std. Mean Difference (IV, Random, 95% CI)

‐0.74 [‐1.55, 0.08]

1.4 State anxiety (STAI) ‐ patient type Show forest plot

7

310

Mean Difference (IV, Random, 95% CI)

‐4.58 [‐7.78, ‐1.39]

1.4.1 State anxiety (STAI) ‐ MI

6

243

Mean Difference (IV, Random, 95% CI)

‐5.87 [‐7.99, ‐3.75]

1.4.2 State anxiety (STAI) ‐ surgical/procedural

1

67

Mean Difference (IV, Random, 95% CI)

0.40 [‐1.33, 2.13]

1.5 State Anxiety (STAI) ‐ music preference Show forest plot

7

310

Mean Difference (IV, Random, 95% CI)

‐4.58 [‐7.78, ‐1.39]

1.5.1 State Anxiety (STAI) ‐ participant‐preferred

3

167

Mean Difference (IV, Random, 95% CI)

‐4.71 [‐10.76, 1.33]

1.5.2 State Anxiety (STAI) ‐ researcher‐selected

4

143

Mean Difference (IV, Random, 95% CI)

‐4.68 [‐8.27, ‐1.10]

1.6 State Anxiety (STAI) ‐ music preference MI only Show forest plot

6

243

Mean Difference (IV, Random, 95% CI)

‐5.87 [‐7.99, ‐3.75]

1.6.1 State Anxiety (STAI) ‐ participant‐preferred

2

100

Mean Difference (IV, Random, 95% CI)

‐7.36 [‐9.45, ‐5.27]

1.6.2 State Anxiety (STAI) ‐ researcher‐selected

4

143

Mean Difference (IV, Random, 95% CI)

‐4.68 [‐8.27, ‐1.10]

1.7 Anxiety (non‐STAI)‐patient type Show forest plot

7

248

Std. Mean Difference (IV, Random, 95% CI)

‐0.43 [‐0.93, 0.06]

1.7.1 Anxiety (surgical/procedural)

4

171

Std. Mean Difference (IV, Random, 95% CI)

‐0.63 [‐1.25, ‐0.01]

1.7.2 Anxiety (MI and rehabilitation)

3

77

Std. Mean Difference (IV, Random, 95% CI)

‐0.03 [‐0.61, 0.56]

1.8 Anxiety (non‐STAI) ‐ music preference Show forest plot

7

248

Std. Mean Difference (IV, Random, 95% CI)

‐0.43 [‐0.93, 0.06]

1.8.1 Anxiety (non‐STAI) ‐ participant‐preferred

4

144

Std. Mean Difference (IV, Random, 95% CI)

‐0.89 [‐1.42, ‐0.36]

1.8.2 Anxiety (non‐STAI) ‐ researcher‐selected

3

104

Std. Mean Difference (IV, Random, 95% CI)

0.11 [‐0.28, 0.49]

1.9 Depression Show forest plot

6

217

Std. Mean Difference (IV, Fixed, 95% CI)

‐0.11 [‐0.38, 0.16]

1.10 Mood Show forest plot

2

97

Std. Mean Difference (IV, Random, 95% CI)

1.08 [‐0.02, 2.17]

1.11 Heart rate‐patient type Show forest plot

13

828

Mean Difference (IV, Random, 95% CI)

‐3.40 [‐6.12, ‐0.69]

1.11.1 heart rate (surg ical/procedural)

7

604

Mean Difference (IV, Random, 95% CI)

‐2.61 [‐5.62, 0.39]

1.11.2 Heart rate (MI)

5

194

Mean Difference (IV, Random, 95% CI)

‐4.75 [‐9.26, ‐0.25]

1.11.3 Heart rate (rehab)

1

30

Mean Difference (IV, Random, 95% CI)

4.50 [‐9.68, 18.68]

1.12 Heart rate ‐ music preference Show forest plot

13

828

Mean Difference (IV, Random, 95% CI)

‐3.62 [‐6.28, ‐0.95]

1.12.1 Heart rate ‐ participant‐selected music

7

430

Mean Difference (IV, Random, 95% CI)

‐4.69 [‐9.40, 0.02]

1.12.2 Heart rate ‐ researcher‐selected music

6

398

Mean Difference (IV, Random, 95% CI)

‐2.67 [‐4.27, ‐1.07]

1.13 Heart rate variability Show forest plot

2

90

Std. Mean Difference (IV, Fixed, 95% CI)

0.07 [‐0.34, 0.48]

1.14 Respiratory rate ‐ music preference Show forest plot

7

442

Mean Difference (IV, Random, 95% CI)

‐2.50 [‐3.61, ‐1.39]

1.14.1 Respiratory Rate ‐ participant‐selected

3

186

Mean Difference (IV, Random, 95% CI)

‐4.42 [‐7.37, ‐1.46]

1.14.2 Respiratory Rate ‐ researcher‐selected

4

256

Mean Difference (IV, Random, 95% CI)

‐1.66 [‐2.20, ‐1.12]

1.15 Systolic blood pressure Show forest plot

11

775

Mean Difference (IV, Fixed, 95% CI)

‐5.52 [‐7.43, ‐3.60]

1.16 Diastolic blood pressure Show forest plot

9

685

Mean Difference (IV, Fixed, 95% CI)

‐1.12 [‐2.57, 0.34]

1.17 Mean A rterial Pressure Show forest plot

3

158

Mean Difference (IV, Fixed, 95% CI)

‐0.91 [‐4.08, 2.26]

1.18 Oxygen Saturation Show forest plot

3

184

Mean Difference (IV, Random, 95% CI)

‐0.02 [‐1.65, 1.61]

1.19 Pain Show forest plot

8

630

Std. Mean Difference (IV, Random, 95% CI)

‐0.43 [‐0.80, ‐0.05]

1.19.1 One music session

5

420

Std. Mean Difference (IV, Random, 95% CI)

‐0.55 [‐1.16, 0.07]

1.19.2 Two or more music sessions

3

210

Std. Mean Difference (IV, Random, 95% CI)

‐0.27 [‐0.55, ‐0.00]

1.20 Length of hospital stay Show forest plot

2

82

Mean Difference (IV, Fixed, 95% CI)

‐0.06 [‐1.03, 0.92]

1.21 Opioid intake Show forest plot

2

90

Std. Mean Difference (IV, Fixed, 95% CI)

‐0.25 [‐0.67, 0.16]

1.22 Quality of sleep Show forest plot

2

122

Std. Mean Difference (IV, Random, 95% CI)

0.91 [0.03, 1.79]

Figuras y tablas -
Comparison 1. Music versus standard care