ArticleInternational urology and nephrology2026
Music as a non-pharmacological intervention for anxiety during extracorporeal shock wave lithotripsy: a systematic review, meta-analysis, and trial sequential analysis of randomized controlled trials.
Article in International urology and nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionExtracorporeal shock wave lithotripsy (ESWL) is a widely used non-invasive treatment for urinary stones. Nevertheless, procedural noise, discomfort, uncertainty, and repeated shock-wave delivery may cause clinically relevant anxiety. Music has been proposed as an accessible non-pharmacological strategy to improve the patient experience, but previous reviews have reported heterogeneous results and have frequently combined anxiety with pain or audiovisual interventions. We evaluated the association between music exposure and anxiety during ESWL.
methodsMEDLINE/PubMed, Embase, Scopus, the Cochrane Central Register of Controlled Trials, and Google Scholar were searched from inception to March 2026. Randomized controlled trials comparing music with standard care or no music in adults undergoing ESWL were eligible. Anxiety measured using a Visual Analog Scale (VAS) and the State-Trait Anxiety Inventory (STAI) was analyzed separately. Random-effects meta-analyses were performed using mean differences (MDs) with 95% confidence intervals (CIs). Risk of bias was evaluated using Cochrane RoB 2. Leave-one-out sensitivity analyses, Baujat plots, funnel plots, and trial sequential analysis (TSA) were also performed.
resultsTwelve randomized controlled trials were included in the systematic review. Ten contributed to the VAS analysis and eight to the STAI analysis. Music was associated with lower anxiety measured using VAS (MD -1.01; 95% CI -1.63 to -0.39; I
conclusionMusic was associated with modest reductions in anxiety scores during ESWL and may be considered a feasible non-pharmacological adjunct. Nevertheless, substantial heterogeneity, methodological limitations, variation in music and analgesia protocols, and very low certainty of evidence limit confidence in the magnitude and clinical relevance of the pooled effects. Additional well-designed trials using standardized interventions and clinically meaningful anxiety outcomes remain warranted.
Indexed as
Identifiers
42481774What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.