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Intervenciones con música para mejorar los resultados psicológicos y físicos en pacientes con cáncer

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Appendices

Appendix 1. CENTRAL search strategy

#1 MeSH descriptor Neoplasms explode all trees
#2 malignan* or neoplasm* or cancer or carcinoma* or tumo*
#3 (#1 OR #2)
#4 MeSH descriptor Music explode all trees
#5 MeSH descriptor Music Therapy explode all trees
#6 music* or melod*
#7 sing or sings or singing or song* or compose or composing or improvis*
#8 (#4 OR #5 OR #6 OR #7)
#9 (#3 AND #8)

Appendix 2. MEDLINE search strategy (OvidSp)

1 exp neoplasms/
2 (malignan* or neoplas* or cancer* or carcinoma* or tumo*).mp.
3 1 or 2
4 music/ or music therapy/
5 (sing or sings or singing or song* or improvis*).mp.
6 (music* or melod*).mp.
7 4 or 5 or 6
8 3 and 7
9 randomized controlled trial.pt.
10 controlled clinical trial.pt.
11 randomized.ab.
12 placebo.ab.
13 clinical trials as topic.sh.
14 randomly.ab.
15 trial.ti.
16 9 or 10 or 11 or 12 or 13 or 14 or 15
17 8 and 16

key: mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept, rare disease supplementary concept, unique identifier; pt=publication type; ab=abstract; ti=title

Appendix 3. Embase search strategy (OvidSp)

1 exp neoplasm/
2 (malignan* or neoplasm* or cancer* or carcinom* or tumo*).mp.
3 1 or 2
4 music therapy/ or music/
5 (sing or sings or singing or song* or improvis*).mp.
6 (music* or melod*).mp.
7 4 or 5 or 6
8 3 and 7
9 crossover procedure/
10 double‐blind procedure/
11 randomized controlled trial/
12 single‐blind procedure/
13 random*.mp.
14 factorial*.mp.
15 (crossover* or cross over* or cross‐over*).mp.
16 placebo*.mp.
17 (double* adj blind*).mp.
18 (singl* adj blind*).mp.
19 assign*.mp.
20 allocat*.mp.
21 volunteer*.mp.
22 9 or 10 or 11 or 12 or 13 or 14 or 15 or 16 or 17 or 18 or 19 or 20 or 21
23 8 and 22

key: [mp=title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword]                                                              

Appendix 4. CINAHL search strategy (EbscoHost)

S22 S21 and S7 and S4
S21 S20 or S19 or S18 or S17 or S16 or S15 or S14 or S13 or S12 or S11 or S10 or S9 or S8
S20 TI ( (singl* or doubl* or treb* or tripl*) ) and TI ( (blind* or mask*) )
S19 AB ( (singl* or doubl* or treb* or tripl*) ) and AB ( (blind* or mask*) )
S18 Randomized controlled trials/
S17 evaluation studies/
S16 comparative study/
S15 prospective studies/
S14 clinical trial/
S13 study design/
S12 AB ( (control$ or prospectiv$ or volunteer$) ) or TI ( (control$ or prospectiv$ or volunteer$) )
S11 AB random$ or TI random$
S10 AB placebo$ or TI placebo$
S9 placebos/
S8 AB (clin$ N25 trial$) or TI (clin$ N25 trial$)
S7 S5 OR S6
S6 TX (malignan$ or neoplasm$ or cancer or carcinoma$ or tumo$)
S5 neoplasms/
S4 S3 OR S2 OR S1
S3 TX (music$ OR melod$ OR sing OR singing OR sings OR song$ OR improvis$)
S2 music therapy/
S1 music/

Appendix 5. PsycInfo search strategy (OvidSp)

1 exp Neoplasms/
2 (malignan$ or neoplasm$ or cancer or carcinoma$ or tumo$).tw.
3 1 or 2
4 music/ or music therapy/
5 (music$ or melod$).tw.
6 (sing or sings or singing or song$ or improvis$).tw.
7 or/4‐6
8 3 and 7
9 empirical study.md.
10 followup study.md.
11 longitudinal study.md.
12 prospective study.md.
13 quantitative study.md.
14 "2000".md.
15 treatment effectiveness evaluation/
16 exp hypothesis testing/
17 repeated measures/
18 exp experimental design/
19 placebo$.ti,ab.
20 random$.ti,ab.
21 (clin$ adj25 trial$).ti,ab.
22 ((singl$ or doubl$ or trebl$ or tripl$) adj (blind$ or mask$)).ti,ab.
23 or/9‐22
24 8 and 23
25 limit 24 to human

Appendix 6. LILACS search strategy (Virtual Health Library)

((music$)) and ((((malignan$ or neoplasm$ or cancer or carcinoma$ or tumo$)) or (("cancer"))))

Appendix 7. Social Science Citation Index search strategy (ISI)

#1 Topic=(music*)
#2 TopiC= (music therapy)
#3 Topic=(singing or sings or song* or improvis* or melod*)
#4 #1 OR #2 OR #3
#5 Topic=(neoplasm*)
#6 Topic=(malignan* or neoplasm* or cancer or carcinoma* or tumo*)
#7 #5 OR #6
#8 Topic=(random allocation)
#9 Topic=(controlled clinical trial*)
#10 Topic=(randomized controlled trial*)
#11Topic=(double blind method*)
#12 Topic=(single blind method*)
#13 Topic=(clinical trial*)
#14 Topic=(placebo*)
#15 Topic=(random*)
#16 #8 OR #9 OR #10 OR #11 OR #12 OR #13 OR #14 OR #15
#17 #4 AND #7 AND # 16

Appendix 8. CancerLit search strategy

music OR (music therapy)

Appendix 9. CAIRSS search strategy

Cancer OR neoplasm OR neoplasms
Malignant OR carcinoma OR carcinomas
Tumor OR tumour

Appendix 10. Proquest Digital Dissertations search strategy (Proquest)

Music and (cancer or tumor or malignant or neoplasm)

Appendix 11. clinicaltrials.gov search strategy

music OR "music therapy"

Appendix 12. Current Controlled Trials search strategy

music OR "music therapy"

Appendix 13. National Research Register search strategy

music

Appendix 14. RILM Abstracts of Music Literature search strategy (EbscoHost)

Cancer or tumor or malignant or neoplasm

Appendix 15. Study Selection, Quality Assessment & Data Extraction Form

Review: Music interventions for improving psychological and physical outcomes in cancer patients

Name Coder:        

Date:                                                           

Paper Code:    

First author

Title

Journal/Conference Proceedings etc

Year

Language

 

 

 

 

 

Other references to trial

If there are further references to this trial, link the papers now & list below. All references to a trial should be linked under one Study ID in RevMan (main paper should be [number]A; other publications related  to the same trial should be [same number]B)

Code each paper

Author(s)

Journal/Conference Proceedings etc

Year

Language

 

 

 

 

 

 

 

 

 

 

 Study eligibility

1. Level of Randomization

2. Cancer Patients?

3. Intervention:

Music vs standard care alone

Music vs. standard care + other treatment

4. Outcome:

Psychological/physical/or social outcomes?

RCT

Systematic method

Unclear

Yes/ No / Unclear

Yes / No / Unclear

Yes / No / Unclear

 

Do not proceed if  the answers to 2), 3), or 4) are No.  If study to be included in Excluded studies section of the review, record below the information to be inserted into Table of excluded studies (give specific reason for exclusion).

EXCLUDED BECAUSE (circle) 

1. Not RCT  (list study design:____________________________________________)

                                                               2. Not population of interest    

                                                                3. Not music/music therapy intervention vs standard care or vs standard care + other treatment

                                                                4. Not outcome of interest

                                                                5. Other:_____________________________________________________

AWAIT FURTHER ASSESSMENT TO MAKE DECISION

 

Study Design (circle): 2‐arm parallel group               3‐arm parallel group                         cross‐over trial

Describe experimental and control group/condition interventions:

Experimental group:

 

Control group:

 

Participants and trial characteristics

Participant characteristics

Age (mean, median, range)

Experimental:                             Control:                                    Total:                    Range:

Sex of participants (numbers / %)

Experimental:           F            M         Control:       F           M               Total:       F         M

Ethnicity (%)

 

Diagnosis/Disease status (if available)

 

Setting (please circle)

Inpatient

Outpatient

Other:

 

Methodological quality

Method of randomization

Was the trial reported as randomized?

Yes

No

Random sequence generation

Low risk

Unclear risk

High risk

State here randomization method used and reasons for grading (circle):

1. Computer‐generated number list

2. Table of random numbers

3. Draw of lots

4. Flip coin

5. Systematic, please specify:

6. Other:

 

Concealment of allocation

Concealment of allocation

Low risk

Unclear risk

High risk

State here the method used to conceal allocation and reasons for grading

1. Opaque sealed envelopes

2. Central randomization

3. Alteration method

4. Other___________________________________________

Low risk: (1) central randomization, (2) serially numbered opaque envelopes, (3) other descriptions with convincing concealment

High risk: (1) alternation methods, (2) other manners in which allocation was not adequately concealed

Unclear risk: authors did not adequately report on method of concealment used

Blinding

Blinding of study participants and music therapist/music provider

Low risk

Unclear risk

High risk

Blinding of outcome assessor(s) for objective outcomes

Low risk

Unclear risk

High risk

Blinding of outcome assessor(s) for subjective outcomes

Low risk

Unclear risk

High risk

Intention‐to‐treat

  • Low risk: if fewer than 20% of patients were lost to follow‐up and reasons for loss to follow‐up were similar in both treatment arms

  • Unclear risk: if loss to follow‐up was not reported

  • High risk: if more than 20% of patients were lost to follow‐up or reasons for loss to follow‐up differed between treatment arms

Number of withdrawals:

Were withdrawals described?      Yes                 No ?           Not clear  ?  

Please add reasons for withdrawal + N or %  here:

Low risk

Unclear risk

High risk

Selective reporting

  • Low risk: reports of the study were free of suggestion of selective outcome reporting

  • High risk: reports of the study suggest selective outcome reporting

Low risk

Unclear risk

High risk

Other sources of bias

Are studies free of other problems that could have put them at high risk of bias (e.g. financial conflict of interest)?

Please list other sources of bias:

Low risk

Unclear risk

High risk

Data reporting

Is data reporting sufficient for inclusion in review (are means and SD for each outcome variable reported for experimental group/condition and for control group/condition)?

If no, please detail what type of data is available:

 

Yes  /  No

Data extraction

Outcomes relevant to your review

 

 

 

Reported in paper (circle)

 

Reported in paper (circle)

Psychological outcomes (depression, anxiety, etc)

Yes / No

Communication

Yes / No

Physical outcomes (pain, nausea)

Yes / No

Disease‐free survival

Yes / No

Physiological outcomes (HR, RR, AP, SBP, DBP)

Yes / No

Social/Spiritual outcomes

Yes / No

Quality of life

Yes / No

 

 

 

For continuous data

 

Code of paper

 

 

Outcomes

 

 

Unit of measurement or scale used

Intervention group

Control group

If mean (SD) are not reported, report either:

‐ t‐value and/or P value associated with t‐test

‐ SE of means calculated from within group

‐ confidence interval of means from within group

‐ description of results in text

N

Mean (SD)

N

Mean (SD)

 

Depression

 

 

 

 

 

 

 

Anxiety

 

 

 

 

 

 

 

Anger

 

 

 

 

 

 

 

Hopelessness

 

 

 

 

 

 

 

 

Helplessness

 

 

 

 

 

 

 

 

Other psychological:

 

 

 

 

 

 

 

 

 

Other psychological:

 

 

 

 

 

 

 

 

 

Quality of life

 

 

 

 

 

 

 

 

Fatigue

 

 

 

 

 

 

 

 

Nausea

 

 

 

 

 

 

 

 

Pain

 

 

 

 

 

 

 

 

Heart rate

 

 

 

 

 

 

 

 

Respiratory rate

 

 

 

 

 

 

 

 

Arterial pressure

 

 

 

 

 

 

 

 

Systolic blood pressure

 

 

 

 

 

 

 

 

Diastolic blood pressure

 

 

 

 

 

 

 

 

Cortisol levels

 

 

 

 

 

 

 

 

IgA levels

 

 

 

 

 

 

 

 

Other hormone levels: _________

 

 

 

 

 

 

 

 

Other hormone levels:

_________

 

 

 

 

 

 

 

 

Social support. Specify:

 

 

 

 

 

 

 

 

 

Communication. Specify:

 

 

 

 

 

 

 

 

 

Disease free survival

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other information which you feel is relevant to the results

Indicate if: any data were obtained from the primary author; if results were estimated from graphs etc; or calculated by you using a formula (this should be stated and the formula given). In general if results not reported in paper(s) are obtained this should be made clear here to be cited in review.

 

 

 

 

Music Intervention

 

Music Medicine

 Yes   /   No

Type:

  

 Patient‐Preferred?   Yes  /   No

 

Music Therapy

Yes   /   No

Intervention used (mark):

Music Listening

Music used:

  

Patient‐Preferred?   Yes  /   No /  Unknown

Active Music Making

     Type: ________________________________

 

Music‐guided Imagery

       Music used:

  

       Patient‐Preferred?  Yes / No / Unknown

 

Intensity

 

Number of sessions: 

 

Duration of each session:

Time period (State weeks / months, etc, if cross‐over trial give length of time in each arm):

 

 

Appendix 1

Trial characteristics

 

Further details

Single centre / multicentre

 

Country / countries

 

How was participant eligibility defined?

 

 

How many people were randomizedrandomized?

 

Number of participants in each intervention group (circle groups that are used for this review if 3‐arm parallel group)

Exp.group 1:        Exp group 2:  Control:

Number of participants who received intended treatment

Exp.group 1: Exp group 2:  Control:

Number of participants who were analyzed

Exp.group 1:        Exp group 2:  Control:

Time‐points when measurements were taken during the study

 

Time‐points reported in the study

 

 

Time‐points you are using in RevMan

 

 

Other

 

 

 

 

Appendix 16. Original search strategies

MEDLINE search strategy (OvidSp)

1 exp Neoplasms/
2 (malignan$ or neoplasm$ or cancer or carcinoma$ or tumo$).tw.
3 1 or 2
4 music/ or music therapy/
5 (sing or sings or singing or song$ or improvis$).tw.
6 (music$ or melod$).tw.
7 or/4‐6
8 Randomized Controlled Trials/
9 random allocation/
10 Controlled Clinical Trials/
11 control groups/
12 clinical trials/
13 double‐blind method/
14 single‐blind method/
15 Placebos/
16 placebo effect/
17 cross‐over studies/
18 Multicenter Studies/
19 Therapies, Investigational/
20 Research Design/
21 Program Evaluation/
22 evaluation studies/
23 randomized controlled trial.pt.
24 controlled clinical trial.pt.
25 clinical trial.pt.
26 multicenter study.pt.
27 evaluation studies.pt.
28 random$.tw.
29 (controlled adj5 (trial$ or stud$)).tw.
30 (clinical$ adj5 trial$).tw.
31 ((control or treatment or experiment$ or intervention) adj5 (group$ or subject$ or patient$)).tw.
32 (quasi‐random$ or quasi random$ or pseudo‐random$ or pseudo random$).tw.
33 ((multicenter or multicentre or therapeutic) adj5 (trial$ or stud$)).tw.
34 ((control or experiment$ or conservative) adj5 (treatment or therapy or procedure or manage$)).tw.
35 ((singl$ or doubl$ or tripl$ or trebl$) adj5 (blind$ or mask$)).tw.
36 (coin adj5 (flip or flipped or toss$)).tw.
37 latin square.tw.
38 (cross‐over or cross over or crossover).tw.
39 placebo$.tw.
40 sham.tw.
41 (assign$ or alternate or allocat$ or counterbalance$ or multiple baseline).tw.
42 controls.tw.
43 (treatment$ adj6 order).tw.
44 or/8‐43
45 3 and 7 and 44
46 limit 45 to humans

Embase search strategy (OvidSp)

1 exp Neoplasm/
2 (malignan* or neoplasm* or cancer or carcinom* or tumo*).mp. [mp = title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer name]
3 1 or 2
4 exp music therapy/ or exp music/
5 (music* or melod*).mp. [mp = title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer name]
6 (sing or sings or singing or song* or compose or composing or improvis*).mp. [mp = title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer name]
7 6 or 4 or 5
8 Randomized Controlled Trial/
9 Randomization/
10 exp Controlled Clinical Trial/
11 Control Group/
12 Clinical Trial/
13 Double Blind Procedure/
14 Single Blind Procedure/
15 Placebo/
16 Crossover Procedure/
17 Multicenter Study/
18 Experimental Therapy/
19 Methodology/
20 exp Health Care Quality/
21 exp Evaluation/
22 random*.mp. [mp = title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer name]
23 (controlled adj5 (trial* or stud*)).mp. [mp = title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer name]
24 (clinical* adj5 trial*).mp. [mp = title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer name]
25 ((control or treatment or experiment* or intervention) adj5 (group* or subject* or patient*)).mp. [mp = title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer name]
26 (quasi‐random* or quasi random* or pseudo‐random* or pseudo random*).mp. [mp = title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer name]
27 ((multicenter or multicentre or therapeutic) adj5 (trial* or stud*)).mp. [mp = title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer name]
28 ((control or experiment* or conservative) adj5 (treatment or therapy or procedure or manage*)).mp. [mp = title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer name]
29 ((single* or double* or tripl* or trebl*) adj5 (blind* or mask*)).mp. [mp = title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer name]
30 (coin adj5 (flip or flipped or toss*)).mp. [mp = title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer name]
31 latin square.mp. [mp = title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer name]
32 (cross‐over or cross over or crossover).mp. [mp = title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer name]
33 placebo*.mp. [mp = title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer name]
34 sham.mp. [mp = title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer name]
35 (assign* or alternate or allocat* or counterbalance* or multiple baseline).mp. [mp = title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer name]
36 controls.mp. [mp = title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer name]
37 (treatment* adj6 order).mp. [mp = title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer name]
38 35 or 33 or 32 or 11 or 21 or 26 or 17 or 22 or 18 or 30 or 23 or 16 or 13 or 29 or 27 or 25 or 28 or 36 or 9 or 12 or 14 or 15 or 20 or 8 or 34 or 37 or 24 or 10 or 19 or 31
39 38 and 3 and 7
40 39

CancerLit Search Strategy (CancerLit was searched in the original review but is no longer available)

music OR (music therapy)

Musictherapyworld.de (was searched in the original review but is no longer functional)

The site's research register, dissertation archive, and bibliography were searched in 2008 for the following terms:
cancer or tumor or tumour or malignant or neoplasm or neoplasms or carcinoma or carcinomas

Study flow diagram.
Figuras y tablas -
Figure 1

Study flow diagram.

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Figuras y tablas -
Figure 2

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.
Figuras y tablas -
Figure 3

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

Funnel plot of comparison: 1 Music intervention plus standard care versus standard care alone, outcome: 1.1 Anxiety (STAI).
Figuras y tablas -
Figure 4

Funnel plot of comparison: 1 Music intervention plus standard care versus standard care alone, outcome: 1.1 Anxiety (STAI).

Funnel plot of comparison: 1 Music intervention plus standard care versus standard care alone, outcome: 1.6 Depression.
Figuras y tablas -
Figure 5

Funnel plot of comparison: 1 Music intervention plus standard care versus standard care alone, outcome: 1.6 Depression.

Funnel plot of comparison: 1 Music intervention plus standard care versus standard care alone, outcome: 1.11 Pain.
Figuras y tablas -
Figure 6

Funnel plot of comparison: 1 Music intervention plus standard care versus standard care alone, outcome: 1.11 Pain.

Funnel plot of comparison: 1 Music intervention plus standard care versus standard care alone, outcome: 1.15 Heart rate.
Figuras y tablas -
Figure 7

Funnel plot of comparison: 1 Music intervention plus standard care versus standard care alone, outcome: 1.15 Heart rate.

Funnel plot of comparison: 1 Music intervention plus standard care versus standard care alone, outcome: 1.13 Fatigue.
Figuras y tablas -
Figure 8

Funnel plot of comparison: 1 Music intervention plus standard care versus standard care alone, outcome: 1.13 Fatigue.

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 1 Anxiety (STAI).
Figuras y tablas -
Analysis 1.1

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 1 Anxiety (STAI).

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 2 Anxiety (non‐STAI (full version) measures).
Figuras y tablas -
Analysis 1.2

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 2 Anxiety (non‐STAI (full version) measures).

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 3 Anxiety (intervention subgroup).
Figuras y tablas -
Analysis 1.3

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 3 Anxiety (intervention subgroup).

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 4 Anxiety (music preference).
Figuras y tablas -
Analysis 1.4

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 4 Anxiety (music preference).

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 5 Anxiety (music‐guided relaxation).
Figuras y tablas -
Analysis 1.5

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 5 Anxiety (music‐guided relaxation).

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 6 Depression.
Figuras y tablas -
Analysis 1.6

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 6 Depression.

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 7 Depression (intervention subgroup).
Figuras y tablas -
Analysis 1.7

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 7 Depression (intervention subgroup).

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 8 Depression (music preference).
Figuras y tablas -
Analysis 1.8

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 8 Depression (music preference).

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 9 Mood.
Figuras y tablas -
Analysis 1.9

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 9 Mood.

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 10 Mood (intervention subgroup).
Figuras y tablas -
Analysis 1.10

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 10 Mood (intervention subgroup).

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 11 Pain.
Figuras y tablas -
Analysis 1.11

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 11 Pain.

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 12 Pain (music preference).
Figuras y tablas -
Analysis 1.12

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 12 Pain (music preference).

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 13 Fatigue.
Figuras y tablas -
Analysis 1.13

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 13 Fatigue.

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 14 Physical functioning.
Figuras y tablas -
Analysis 1.14

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 14 Physical functioning.

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 15 Heart rate.
Figuras y tablas -
Analysis 1.15

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 15 Heart rate.

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 16 Heart rate (music preference).
Figuras y tablas -
Analysis 1.16

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 16 Heart rate (music preference).

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 17 Respiratory rate.
Figuras y tablas -
Analysis 1.17

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 17 Respiratory rate.

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 18 Systolic blood pressure.
Figuras y tablas -
Analysis 1.18

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 18 Systolic blood pressure.

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 19 Systolic blood pressure (music preference).
Figuras y tablas -
Analysis 1.19

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 19 Systolic blood pressure (music preference).

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 20 Diastolic blood pressure.
Figuras y tablas -
Analysis 1.20

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 20 Diastolic blood pressure.

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 21 Diastolic blood pressure (music preference).
Figuras y tablas -
Analysis 1.21

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 21 Diastolic blood pressure (music preference).

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 22 Oxygen Saturation.
Figuras y tablas -
Analysis 1.22

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 22 Oxygen Saturation.

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 23 Quality of Life.
Figuras y tablas -
Analysis 1.23

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 23 Quality of Life.

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 24 Quality of life (intervention subgroup).
Figuras y tablas -
Analysis 1.24

Comparison 1 Music intervention plus standard care versus standard care alone, Outcome 24 Quality of life (intervention subgroup).

Comparison 2 Music therapy plus standard care versus music medicine plus standard care, Outcome 1 Anxiety.
Figuras y tablas -
Analysis 2.1

Comparison 2 Music therapy plus standard care versus music medicine plus standard care, Outcome 1 Anxiety.

Comparison 3 Music interventions plus standard care versus standard care plus placebo control, Outcome 1 Distress.
Figuras y tablas -
Analysis 3.1

Comparison 3 Music interventions plus standard care versus standard care plus placebo control, Outcome 1 Distress.

Comparison 3 Music interventions plus standard care versus standard care plus placebo control, Outcome 2 Spiritual well‐being.
Figuras y tablas -
Analysis 3.2

Comparison 3 Music interventions plus standard care versus standard care plus placebo control, Outcome 2 Spiritual well‐being.

Summary of findings for the main comparison. Music interventions compared to standard care for psychological and physical outcomes in cancer patients

Music interventions versus standard care for psychological and physical outcomes in cancer patients

Patient or population: cancer patients
Setting: inpatient and outpatient cancer care
Intervention: music interventions
Comparison: standard care

Outcomes

Relative effect (95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Anxiety
assessed with: Spielberger State Anxiety Index
Scale from: 0 to 40

The mean anxiety in the music intervention group was 8.54 units less (12.04 less to 5.05 less) than in the standard care group

1028
(13 RCTs)

⊕⊕⊝⊝
Lowa,b

Depression

The mean depression in the music intervention group was 0.40 standard deviations less (0.74 less to 0.06 less) than in the standard care group

723
(7 RCTs)

⊕⊝⊝⊝
Very lowa,c

An SMD of 0.40 is considered a low to moderate effect size

Mood

The mean mood in the music intervention group was 0.47 standard deviations better (0.02 worse to 0.97 better) than in the standard care group

236
(5 RCTs)

⊕⊕⊝⊝
Lowa,d

An SMD of 0.47 is considered a moderate effect size

Pain

The mean pain in the intervention group was 0.91 standard deviations less (1.46 less to 0.36 less) than in the standard care group

528
(7 RCTs)

⊕⊕⊝⊝
Lowa,e

An SMD of 0.91 is considered a large effect size

Fatigue

The mean fatigue in the music intervention group was 0.38 standard deviations less (0.72 less to 0.04 less) than in the standard care group

253
(6 RCTs)

⊕⊕⊝⊝
Lowa

An SMD of 0.38 is considered a small to moderate effect size

Quality of life

The mean quality of life in the music intervention group was 0.98 standard deviations more (0.36 less to 2.33 more) than in the standard care group

545
(6 RCTs)

⊕⊕⊝⊝
Lowa,f

An SMD of 0.98 is considered a large effect size

*The risk in the intervention group (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; SMD: standardized mean difference.

GRADE Working Group grades of evidence
High quality: We are very confident that the true effect lies close to that of the estimate of the effect
Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect

a The majority of the trials were at high risk of bias.
b Results were inconsistent across studies as evidenced by I2 = 93%, but all treatment effects were in the desired direction.
c Results were inconsistent across studies as evidenced by I2 = 77%, but all treatment effects were in the desired direction.
d Results were inconsistent across studies as evidenced by I2 = 70%, but all treatment effects were in the desired direction.
e Results were inconsistent across studies as evidenced by I2 = 88%, but all treatment effects were in the desired direction.
f Results were inconsistent across studies as evidenced by I2 = 98% ,but all treatment effects were in desired direction and large heterogeneity was mostly due to outlying values of one study.

Figuras y tablas -
Summary of findings for the main comparison. Music interventions compared to standard care for psychological and physical outcomes in cancer patients
Comparison 1. Music intervention plus standard care versus standard care alone

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Anxiety (STAI) Show forest plot

13

Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 All studies

13

1028

Mean Difference (IV, Random, 95% CI)

‐8.54 [‐12.04, ‐5.05]

1.2 Sensitivity analysis

11

929

Mean Difference (IV, Random, 95% CI)

‐8.64 [‐12.50, ‐4.79]

2 Anxiety (non‐STAI (full version) measures) Show forest plot

6

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

Subtotals only

2.1 All studies

6

449

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

‐0.71 [‐0.98, ‐0.43]

2.2 Sensitivity analysis

3

157

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

‐0.80 [‐1.44, ‐0.16]

3 Anxiety (intervention subgroup) Show forest plot

18

1457

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

‐0.94 [‐1.34, ‐0.55]

3.1 Music therapy studies

3

111

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

‐0.62 [‐1.01, ‐0.24]

3.2 Music medicine studies

15

1346

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

‐1.00 [‐1.45, ‐0.55]

4 Anxiety (music preference) Show forest plot

13

1142

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

‐0.88 [‐1.28, ‐0.47]

4.1 Patient‐preferred music

10

860

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

‐0.86 [‐1.38, ‐0.34]

4.2 Researcher‐selected music

3

282

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

‐0.89 [‐1.43, ‐0.35]

5 Anxiety (music‐guided relaxation) Show forest plot

14

1306

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

‐0.98 [‐1.44, ‐0.51]

5.1 Music‐guided relaxation studies

4

476

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

‐1.61 [‐2.56, ‐0.65]

5.2 Listening to music only

10

830

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

‐0.71 [‐1.16, ‐0.26]

6 Depression Show forest plot

7

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

Subtotals only

6.1 All studies

7

723

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

‐0.40 [‐0.74, ‐0.06]

6.2 Sensitivity analysis

6

541

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

‐0.37 [‐0.79, 0.05]

7 Depression (intervention subgroup) Show forest plot

7

723

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

‐0.40 [‐0.74, ‐0.06]

7.1 Music therapy studies

3

130

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

‐0.11 [‐0.46, 0.24]

7.2 Music medicine studies

4

593

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

‐0.57 [‐1.03, ‐0.10]

8 Depression (music preference) Show forest plot

4

505

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

‐0.60 [‐1.04, ‐0.16]

8.1 Patient‐preferred music

2

275

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

‐0.88 [‐1.67, ‐0.09]

8.2 Researcher‐selected music

2

230

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

‐0.32 [‐0.84, 0.19]

9 Mood Show forest plot

5

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

Subtotals only

9.1 All studies

5

236

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

0.47 [‐0.02, 0.97]

9.2 Sensitivity analysis

4

192

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

0.57 [‐0.03, 1.18]

10 Mood (intervention subgroup) Show forest plot

5

236

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

0.47 [‐0.02, 0.97]

10.1 Music therapy studies

2

104

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

0.37 [‐0.13, 0.87]

10.2 Music medicine studies

3

132

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

0.55 [‐0.37, 1.47]

11 Pain Show forest plot

7

528

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

‐0.91 [‐1.46, ‐0.36]

12 Pain (music preference) Show forest plot

6

496

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

‐0.92 [‐1.53, ‐0.30]

12.1 Patient‐preferred music

4

320

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

‐1.06 [‐1.93, ‐0.20]

12.2 Researcher‐selected music

2

176

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

‐0.59 [‐1.34, 0.15]

13 Fatigue Show forest plot

6

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

Subtotals only

13.1 All studies

6

253

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

‐0.38 [‐0.72, ‐0.04]

13.2 Sensitivity analysis

5

203

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

‐0.20 [‐0.48, 0.08]

14 Physical functioning Show forest plot

4

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

Subtotals only

14.1 All studies

4

493

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

0.78 [‐0.74, 2.31]

14.2 Sensitivity analysis

3

233

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

0.08 [‐0.18, 0.34]

15 Heart rate Show forest plot

8

Mean Difference (IV, Random, 95% CI)

Subtotals only

15.1 All studies

8

589

Mean Difference (IV, Random, 95% CI)

‐3.32 [‐6.21, ‐0.44]

15.2 Sensitivity analysis

6

339

Mean Difference (IV, Random, 95% CI)

‐4.63 [‐8.18, ‐1.09]

16 Heart rate (music preference) Show forest plot

7

539

Mean Difference (IV, Random, 95% CI)

‐3.77 [‐6.97, ‐0.58]

16.1 Patient‐preferred music

5

479

Mean Difference (IV, Random, 95% CI)

‐3.13 [‐6.54, 0.27]

16.2 Researcher‐selected music

2

60

Mean Difference (IV, Random, 95% CI)

‐7.94 [‐15.10, ‐0.78]

17 Respiratory rate Show forest plot

4

Mean Difference (IV, Random, 95% CI)

Subtotals only

17.1 All studies

4

437

Mean Difference (IV, Random, 95% CI)

‐1.24 [‐2.54, 0.06]

17.2 Sensitivity analysis

3

237

Mean Difference (IV, Random, 95% CI)

‐1.83 [‐3.36, ‐0.30]

18 Systolic blood pressure Show forest plot

7

Mean Difference (IV, Random, 95% CI)

Subtotals only

18.1 All studies

7

559

Mean Difference (IV, Random, 95% CI)

‐5.40 [‐8.32, ‐2.49]

18.2 Sensitivity analysis

5

309

Mean Difference (IV, Random, 95% CI)

‐7.63 [‐10.75, ‐4.52]

19 Systolic blood pressure (music preference) Show forest plot

6

509

Mean Difference (IV, Random, 95% CI)

‐6.29 [‐8.86, ‐3.72]

19.1 Patient‐preferred music

4

449

Mean Difference (IV, Random, 95% CI)

‐6.65 [‐10.07, ‐3.23]

19.2 Researcher‐selected music

2

60

Mean Difference (IV, Random, 95% CI)

‐4.72 [‐10.80, 1.37]

20 Diastolic blood pressure Show forest plot

7

Mean Difference (IV, Random, 95% CI)

Subtotals only

20.1 All studies

7

559

Mean Difference (IV, Random, 95% CI)

‐2.35 [‐5.88, 1.18]

20.2 Sensitivity analysis

5

309

Mean Difference (IV, Random, 95% CI)

‐4.94 [‐7.78, ‐2.09]

21 Diastolic blood pressure (music preference) Show forest plot

6

509

Mean Difference (IV, Random, 95% CI)

‐3.74 [‐7.53, 0.05]

21.1 Patient‐preferred music

4

449

Mean Difference (IV, Random, 95% CI)

‐4.10 [‐8.78, 0.59]

21.2 Researcher‐selected music

2

60

Mean Difference (IV, Random, 95% CI)

‐2.01 [‐6.26, 2.25]

22 Oxygen Saturation Show forest plot

3

292

Mean Difference (IV, Random, 95% CI)

0.50 [‐0.18, 1.18]

23 Quality of Life Show forest plot

6

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

Subtotals only

23.1 All studies

6

545

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

0.98 [‐0.36, 2.33]

23.2 Sensitivity analysis

4

241

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

0.52 [0.01, 1.02]

24 Quality of life (intervention subgroup) Show forest plot

5

568

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

0.99 [‐0.34, 2.31]

24.1 Music therapy studies

3

132

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

0.42 [0.06, 0.78]

24.2 Music medicine studies

2

436

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

1.33 [‐0.96, 3.63]

Figuras y tablas -
Comparison 1. Music intervention plus standard care versus standard care alone
Comparison 2. Music therapy plus standard care versus music medicine plus standard care

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Anxiety Show forest plot

2

166

Mean Difference (IV, Fixed, 95% CI)

‐3.67 [‐11.68, 4.35]

Figuras y tablas -
Comparison 2. Music therapy plus standard care versus music medicine plus standard care
Comparison 3. Music interventions plus standard care versus standard care plus placebo control

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Distress Show forest plot

2

Mean Difference (Random, 95% CI)

‐0.07 [‐0.39, 0.26]

2 Spiritual well‐being Show forest plot

2

Std. Mean Difference (Fixed, 95% CI)

0.31 [‐0.11, 0.73]

Figuras y tablas -
Comparison 3. Music interventions plus standard care versus standard care plus placebo control