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López-Valverde N, Rueda JAB. Effect of Periodontal Treatment in Patients with Periodontitis and Diabetes: Review of Systematic Reviews with Meta-Analyses in the Last Five Years. Healthcare (Basel) 2024; 12:1844. [PMID: 39337185 PMCID: PMC11431200 DOI: 10.3390/healthcare12181844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 09/08/2024] [Accepted: 09/12/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Periodontitis is a chronic infectious-inflammatory pathology, with a high prevalence, which destroys the dental support and, if left untreated, leads to tooth loss. It is associated with other pathologies, particularly diabetes mellitus. OBJECTIVES Our objective was to conduct a review of systematic reviews with meta-analyses to determine the evidence for periodontal treatment on periodontitis and diabetes. Second, we assessed the risk of bias and methodological quality using the AMSTAR-2 and ROBIS tools. METHODS We performed bibliographic searches in PubMed/Medline, Embase, Cochrane Central, Dentistry & Oral Sciences Source databases and in the Web of Science (WOS) scientific information service to identify systematic reviews with meta-analyses from the last five years. RESULTS Eighteen studies that met the inclusion criteria and evaluated 16,247 subjects were included. The most studied parameters were probing pocket depth, clinical attachment level, bleeding on probing and the glycated hemoglobin. Most of the included meta-analyses evaluated adult patients with periodontitis and type 2 diabetes mellitus (T2DM). Most of the meta-analyses considered and assessed by AMSTAR-2 showed significant methodological errors. The risk of bias was the domain with the worst assessment with the ROBIS tool. CONCLUSIONS Despite the weaknesses of the included meta-analyses in terms of methodological quality and the risk of bias, periodontal treatment and DM treatment appear to contribute to improved clinical outcomes in a bidirectional manner between periodontitis and DM.
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Affiliation(s)
- Nansi López-Valverde
- Department of Surgery, University of Salamanca, 37008 Salamanca, Spain;
- Biomedical Research Institute of Salamanca (IBSAL), 37007 Salamanca, Spain
| | - José Antonio Blanco Rueda
- Department of Surgery, University of Salamanca, 37008 Salamanca, Spain;
- Biomedical Research Institute of Salamanca (IBSAL), 37007 Salamanca, Spain
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Donato H, Donato M. [Review of Reviews (Umbrella Reviews): Step-by-Step Guide]. ACTA MEDICA PORT 2024; 37:547-555. [PMID: 38950608 DOI: 10.20344/amp.21796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 05/13/2024] [Indexed: 07/03/2024]
Abstract
In recent years, as a result of the dramatic increase in the number of systematic reviews, a new type of systematic review, the 'systematic reviews of systematic reviews', also known as umbrella reviews, reviews of reviews, meta-reviews or synthesis of review, was developed. The aim of this article is to provide recommendations on how this type of systematic review should be conducted and reported to ensure its quality and usefulness. These reviews are designed to compile evidence from multiple systematic reviews of interventions into an accessible and usable document and are one of the highest levels of evidence synthesis.
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Affiliation(s)
- Helena Donato
- Serviço de Documentação e Informação Científica. Hospitais da Universidade de Coimbra. Unidade Local de Saúde de Coimbra. Coimbra; Faculdade de Medicina. Universidade de Coimbra. Coimbra. Portugal
| | - Mariana Donato
- Serviço de Otorrinolaringologia. Unidade Local de Saúde Lisboa Ocidental. Lisboa; NOVA Medical School. Lisboa. Portugal
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Gallego H, Arango S, Combalia A, Fuster S, Jaramillo C, Herrera AM. Treatment Options for Failed Back Surgery Syndrome: An Umbrella Systematic Review of Systematic Reviews on the Effectiveness of Therapeutic Interventions. Spine Surg Relat Res 2024; 8:143-154. [PMID: 38618223 PMCID: PMC11007241 DOI: 10.22603/ssrr.2023-0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/30/2023] [Indexed: 04/16/2024] Open
Abstract
Background Failed back surgery syndrome (FBSS) is a common and incapacitating condition affecting patients with previous spine surgery in whom treatment approach can be challenging. This study aimed to summarize existing secondary studies and up-to-date randomized clinical trials (RCTs) that assess the effectiveness of available treatment options for FBSS. Methods Systematic searches were carried out in five databases (PubMed, Cochrane, Scielo, Epistemonikos, and Google scholar) for all systematic reviews on the effectiveness of treatment options for FBSS published after 2012. Outcomes of interest were pain levels measured through visual analog scale or numeric rating scale, Oswestry Disability Index, and quality of life. Methodological and risk of bias assessments were performed with the AMSTAR-2 tool for systematic reviews and the Joanna Briggs Institute checklist for RCT. Prospective PROSPERO registration: CRD42022307609. Results Fifteen studies, seven systematic reviews, and eight RCTs met the inclusion criteria and fulfilled the methodological quality assessment. Of the 15 included studies, 8 were on neurostimulation, 4 on adhesiolysis, 4 on epidural or intrathecal injections, and 3 on other treatment modalities. The risk of bias was low in seven studies, moderate in five, and high in three. Conclusions Based on this systematic overview and the considerable heterogeneity among studies, the FBSS therapeutic approach must be individualized. FBSS treatment should start with conservative management, considering the implementation of neurostimulation, a technique with the most robust evidence of effective results, in cases of refractory axial or neuropathic pain. As the last resource, in light of the evidence found, more invasive procedures or new surgical interventions are indicated.
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Affiliation(s)
- Hernán Gallego
- Department of Spine Surgery, Clinica del Campestre and Hospital Pablo Tobón Uribe, Medellín, Colombia
- Fellowship in Spine Surgery, Faculty of Medicine and Health Sciences, Universidad de Barcelona (UB), Barcelona, España
| | - Sergio Arango
- Department of Spine Surgery, Clinica del Campestre and Hospital Pablo Tobón Uribe, Medellín, Colombia
| | - Andrés Combalia
- Department of Surgery and Medical-surgical Specialties, Faculty of Medicine and Health Sciences, Universidad de Barcelona (UB), Barcelona, España
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España
| | - Salvador Fuster
- Department of Surgery and Medical-surgical Specialties, Faculty of Medicine and Health Sciences, Universidad de Barcelona (UB), Barcelona, España
- Department of Spine Surgery, Hospital Clinic de Barcelona, Barcelona, España
| | | | - Ana Milena Herrera
- Department of Epidemiology and Clinical Research, Clinica del Campestre, Medellín, Colombia
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An H, Chen J, Li S, Chen A. Pantoprazole and Vonoprazan Performed Well in Preventing Peptic Ulcer Recurrence in Low-Dose Aspirin Users. Dig Dis Sci 2024; 69:670-682. [PMID: 38252210 DOI: 10.1007/s10620-023-08233-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/07/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND Low-dose aspirin (LDA) administration is associated with an elevated risk of recurring peptic ulcer (PU) and gastrointestinal (GI) hemorrhage. AIMS This systematic review and Bayesian network meta-analysis aimed to comprehensively assess the effectiveness of diverse medications in preventing the recurrence of PU and GI hemorrhage in patients with a history of PU receiving long-term LDA therapy. METHODS This systematic review and network meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was registered on PROSPERO (CRD42023406550). We searched relevant studies in main databases from inception to March 2023. All statistical analyses were performed using R (version 4.1.3), with the "Gemtc" (version 1.0-1) package. The pooled risk ratio (RR), corresponding 95% credible interval (95% CrI), and the surface under the cumulative ranking curve (SUCRA) were calculated. RESULTS 11 Randomized clinical trials (RCTs) were included. The analysis underscored pantoprazole was the most efficacious for reducing the risk of PU recurrence (RR [95% CrI] = 0.02 [0, 0.28]; SUCRA: 90.76%), followed by vonoprazan (RR [95% CrI] = 0.03 [0, 0.19]; SUCRA: 86.47%), comparing with the placebo group. Pantoprazole also performed well in preventing GI hemorrhage (RR [95% CrI] = 0.01[0, 0.42]; SUCRA: 87.12%) compared with Teprenone. CONCLUSIONS For patients with a history of PU receiving LDA, pantoprazole and vonoprazan might be the optimal choices to prevent PU recurrence and GI hemorrhage.
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Affiliation(s)
- Haoyu An
- School of Medicine, The Chinese University of Hong Kong, Shatin, NT, 999077, Hong Kong.
- Prince of Wales Hospital, 30 Yincheng Street, Shatin, Hong Kong.
| | - Jing Chen
- Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Shicong Li
- School of Life Science, Central South University, Changsha, 410008, Hunan, China
| | - Anni Chen
- NYU School of Global Public Health, New York University, New York, NY, 10003, USA
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Borges MHR, Miranda LFB, Dini C, Marañón-Vásquez GA, Magno MB, Maia LC, Barão VAR. Clinical performance of and patient satisfaction with conventional complete dentures with different occlusal schemes: A systematic review of systematic reviews. J Prosthet Dent 2023; 130:341-350. [PMID: 34991859 DOI: 10.1016/j.prosdent.2021.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/19/2021] [Accepted: 10/19/2021] [Indexed: 10/19/2022]
Abstract
STATEMENT OF PROBLEM The complete denture occlusal scheme may influence clinical performance and patient satisfaction. However, a consensus on which occlusal scheme should be used for complete denture users is lacking. As a result, many dentists choose the scheme based on their preferences and clinical experience. PURPOSE The purpose of this review was to assess the methodological quality and summarize the scientific evidence from secondary studies about the influence of occlusal schemes on the clinical performance of and patient satisfaction with complete dentures. MATERIAL AND METHODS Ten sources were surveyed according to the patient, intervention, comparison, outcome (PICO) strategy. Systematic reviews that evaluated the clinical performance and patient satisfaction (O) of rehabilitated edentulous patients with conventional complete dentures (P) under different occlusal schemes (I/C) were included. Methodological quality was assessed by using A MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2 tool by 2 authors independently. The effect of each occlusal scheme in comparison with others was summarized and classified as positive, neutral, negative, or inconclusive based on the conclusions of the systematic review concerning clinical performance and patient satisfaction outcomes. RESULTS The search led to the inclusion of 10 systematic reviews. Seven were classified as of critically low, 2 as low, and 1 as moderate methodological quality. The following occlusal designs were included and analyzed: bilateral balanced occlusion, lingualized occlusion, canine guidance, group function, and monoplane occlusion. Bilateral balanced occlusion and canine guidance obtained satisfactory results for both outcomes. Lingualized occlusion showed a trend toward better results than other occlusal schemes for normal and resorbed ridges. Group function presented mainly inconclusive results, and monoplane occlusion did not deliver satisfactory outcomes. CONCLUSIONS The present overview concluded that occlusal schemes might interfere with the clinical performance of and patient satisfaction with complete dentures. Lingualized, bilateral balanced, and canine guidance are preferred compared with monoplane occlusion, but lingualized occlusion tends to show better results in some reviews. However, the results should be carefully considered because of the low quality of the systematic reviews included.
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Affiliation(s)
- Maria Helena Rossy Borges
- Masters' degree student, Piracicaba Dental School, University of Campinas (UNICAMP) Piracicaba, São Paulo, Brazil
| | | | - Caroline Dini
- PhD Candidate, Piracicaba Dental School, University of Campinas (UNICAMP) Piracicaba, São Paulo, Brazil
| | | | - Marcela Baraúna Magno
- Postdoctoral Fellow, School of Dentistry, Federal University of Rio de Janeiro (UFRJ) Rio de Janeiro, Brazil
| | - Lucianne Cople Maia
- Professor, School of Dentistry, Federal University of Rio de Janeiro (UFRJ) Rio de Janeiro, Brazil
| | - Valentim A R Barão
- Associate Professor, Piracicaba Dental School, University of Campinas (UNICAMP) Piracicaba, São Paulo, Brazil.
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Déry J, Ouellet B, de Guise É, Bussières ÈL, Lamontagne ME. Prognostic factors for persistent symptoms in adults with mild traumatic brain injury: an overview of systematic reviews. Syst Rev 2023; 12:127. [PMID: 37468999 PMCID: PMC10357711 DOI: 10.1186/s13643-023-02284-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 06/26/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Mild traumatic brain injury (mTBI) is an increasing public health problem, because of its persistent symptoms and several functional consequences. Understanding the prognosis of a condition is an important component of clinical decision-making and can help to guide the prevention of persistent symptoms following mTBI. The prognosis of mTBI has stimulated several empirical primary research papers and many systematic reviews leading to the identification of a wide range of factors. We aim to synthesize these factors to get a better understanding of their breadth and scope. METHODS We conducted an overview of systematic reviews. We searched in databases systematic reviews synthesizing evidence about the prognosis of persistent symptoms after mTBI in the adult population. Two reviewers independently screened all references and selected eligible reviews based on eligibility criteria. They extracted relevant information using an extraction grid. They also rated independently the risk of bias using the ROBIS tool. We synthesized evidence into a comprehensive conceptual map to facilitate the understanding of prognostic factors that have an impact on persistent post-concussion symptoms. RESULTS From the 3857 references retrieved in a database search, we included 25 systematic reviews integrating the results of 312 primary articles published between 1957 and 2019. We examined 35 prognostic factors from the systematics reviews. No single prognostic factor demonstrated convincing and conclusive results. However, age, sex, and multiple concussions showed an affirmatory association with persistent post-concussion outcomes in systematic reviews. CONCLUSION We highlighted the need for a comprehensive picture of prognostic factors related to persistent post-concussion symptoms. We believe that these prognostic factors would guide clinical decisions and research related to prevention and intervention regarding persistent post-concussion symptoms. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020176676.
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Affiliation(s)
- Julien Déry
- School of Rehabilitation Sciences, Université Laval, Pavillon Ferdinand-Vandry, local 2475, 1050, avenue de la Médecine, Québec, QC, G1V 0A6, Canada
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale (Cirris), 525, boul. Wilfrid-Hamel, Québec, QC, G1M 2S8, Canada
| | - Béatrice Ouellet
- School of Rehabilitation Sciences, Université Laval, Pavillon Ferdinand-Vandry, local 2475, 1050, avenue de la Médecine, Québec, QC, G1V 0A6, Canada
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale (Cirris), 525, boul. Wilfrid-Hamel, Québec, QC, G1M 2S8, Canada
| | - Élaine de Guise
- Department of Psychology, Université de Montréal, Montréal, Canada
- Research Institute of the McGill University Health Centre (RI-MUHC), Montréal, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montréal, Canada
| | - Ève-Line Bussières
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale (Cirris), 525, boul. Wilfrid-Hamel, Québec, QC, G1M 2S8, Canada
- Department of Psychology, Université du Québec à Trois-Rivières, 3007 Michel-Sarrazin, 3600 rue Sainte-Marguerite, Trois-Rivières, QC, G9A 5H7, Canada
| | - Marie-Eve Lamontagne
- School of Rehabilitation Sciences, Université Laval, Pavillon Ferdinand-Vandry, local 2475, 1050, avenue de la Médecine, Québec, QC, G1V 0A6, Canada.
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale (Cirris), 525, boul. Wilfrid-Hamel, Québec, QC, G1M 2S8, Canada.
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Pamporis K, Bougioukas KI, Karakasis P, Papageorgiou D, Zarifis I, Haidich AB. Overviews of reviews in the cardiovascular field underreported critical methodological and transparency characteristics: a methodological study based on the Preferred Reporting Items for Overviews of Reviews (PRIOR) statement. J Clin Epidemiol 2023; 159:139-150. [PMID: 37245702 DOI: 10.1016/j.jclinepi.2023.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVES This study aimed to evaluate the epidemiology, reporting characteristics, and adherence to the Preferred Reporting Items for Overviews of Reviews (PRIOR) statement of overviews of reviews (overviews) of interventions in the cardiovascular field. STUDY DESIGN AND SETTING MEDLINE, Scopus, and the Cochrane Database of Systematic Reviews were searched from January 1, 2000, to October 15, 2020. An updated search was performed in MEDLINE, Epistemonikos, and Google Scholar up to August 25, 2022. Overviews of interventions published in English and primarily considering populations, interventions, and outcomes pertinent to the cardiovascular field were eligible. Study selection, data extraction, and PRIOR adherence assessment were performed by two authors independently. RESULTS We analyzed 96 overviews. Almost half (43/96 [45%]) were published between 2020 and 2022 and contained a median of 15 systematic reviews (SRs) (interquartile range, 9-28). The commonest title terminology was "overview of (systematic) reviews" (38/96 [40%]). Methods for handling SR overlap were reported in 24/96 (25%), methods for assessing primary study overlap in 18/96 (19%), handling of discrepant data in 11/96 (11%), and methods for methodological quality or risk of bias assessment of the primary studies within SRs in 23/96 (24%). Authors included data sharing statements in 28/96 (29%), complete funding disclosure in 43/96 (45%), protocol registration in 43/96 (45%), and conflict of interest statement in 82/96 (85%) overviews. CONCLUSION Insufficient reporting was identified in methodological characteristics unique in overviews' conduct and most transparency markers. Adoption of PRIOR from the research community could ameliorate overviews' reporting.
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Affiliation(s)
- Konstantinos Pamporis
- Department of Hygiene, Social-Preventive Medicine & Medical Statistics, Medical School, Aristotle University of Thessaloniki, University Campus, Thessaloniki 54124, Greece
| | - Konstantinos I Bougioukas
- Department of Hygiene, Social-Preventive Medicine & Medical Statistics, Medical School, Aristotle University of Thessaloniki, University Campus, Thessaloniki 54124, Greece
| | - Paschalis Karakasis
- Department of Hygiene, Social-Preventive Medicine & Medical Statistics, Medical School, Aristotle University of Thessaloniki, University Campus, Thessaloniki 54124, Greece
| | - Dimitrios Papageorgiou
- Department of Hygiene, Social-Preventive Medicine & Medical Statistics, Medical School, Aristotle University of Thessaloniki, University Campus, Thessaloniki 54124, Greece
| | - Ippokratis Zarifis
- Department of Hygiene, Social-Preventive Medicine & Medical Statistics, Medical School, Aristotle University of Thessaloniki, University Campus, Thessaloniki 54124, Greece
| | - Anna-Bettina Haidich
- Department of Hygiene, Social-Preventive Medicine & Medical Statistics, Medical School, Aristotle University of Thessaloniki, University Campus, Thessaloniki 54124, Greece.
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Zhong J, Lu J, Zhang G, Mao S, Chen H, Yin Q, Hu Y, Xing Y, Ding D, Ge X, Zhang H, Yao W. An overview of meta-analyses on radiomics: more evidence is needed to support clinical translation. Insights Imaging 2023; 14:111. [PMID: 37336830 DOI: 10.1186/s13244-023-01437-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/14/2023] [Indexed: 06/21/2023] Open
Abstract
OBJECTIVE To conduct an overview of meta-analyses of radiomics studies assessing their study quality and evidence level. METHODS A systematical search was updated via peer-reviewed electronic databases, preprint servers, and systematic review protocol registers until 15 November 2022. Systematic reviews with meta-analysis of primary radiomics studies were included. Their reporting transparency, methodological quality, and risk of bias were assessed by PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) 2020 checklist, AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews, version 2) tool, and ROBIS (Risk Of Bias In Systematic reviews) tool, respectively. The evidence level supporting the radiomics for clinical use was rated. RESULTS We identified 44 systematic reviews with meta-analyses on radiomics research. The mean ± standard deviation of PRISMA adherence rate was 65 ± 9%. The AMSTAR-2 tool rated 5 and 39 systematic reviews as low and critically low confidence, respectively. The ROBIS assessment resulted low, unclear and high risk in 5, 11, and 28 systematic reviews, respectively. We reperformed 53 meta-analyses in 38 included systematic reviews. There were 3, 7, and 43 meta-analyses rated as convincing, highly suggestive, and weak levels of evidence, respectively. The convincing level of evidence was rated in (1) T2-FLAIR radiomics for IDH-mutant vs IDH-wide type differentiation in low-grade glioma, (2) CT radiomics for COVID-19 vs other viral pneumonia differentiation, and (3) MRI radiomics for high-grade glioma vs brain metastasis differentiation. CONCLUSIONS The systematic reviews on radiomics were with suboptimal quality. A limited number of radiomics approaches were supported by convincing level of evidence. CLINICAL RELEVANCE STATEMENT The evidence supporting the clinical application of radiomics are insufficient, calling for researches translating radiomics from an academic tool to a practicable adjunct towards clinical deployment.
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Affiliation(s)
- Jingyu Zhong
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Junjie Lu
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Guangcheng Zhang
- Department of Orthopedics, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
| | - Shiqi Mao
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China
| | - Haoda Chen
- Department of General Surgery, Pancreatic Disease Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Qian Yin
- Department of Pathology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
| | - Yangfan Hu
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Yue Xing
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Defang Ding
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Xiang Ge
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Huan Zhang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Weiwu Yao
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China.
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Karakasis P, Pamporis K, Stachteas P, Patoulias D, Bougioukas KI, Fragakis N. Efficacy and safety of sodium-glucose cotransporter-2 inhibitors in heart failure with mildly reduced or preserved ejection fraction: an overview of 36 systematic reviews. Heart Fail Rev 2023:10.1007/s10741-023-10324-3. [PMID: 37284930 DOI: 10.1007/s10741-023-10324-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/28/2023] [Indexed: 06/08/2023]
Abstract
The recently published randomized trials (RCTs) evaluating the effect of Sodium-glucose cotransporter-2 inhibitors (SGLT2i) in heart failure with mildly reduced (HFmrEF) or preserved ejection fraction (HFpEF) led researchers to perform a plethora of systematic reviews (SRs), often providing contradictory conclusions. This overview of reviews was aimed at summarizing the evidence of these SRs, quantifying the overlap, re-analyzing the evidence in case new studies that were identified, and mapping knowledge gaps. Literature search was conducted through Medline, Scopus, and Cochrane until March 22, 2023. Overall, 36 SRs synthesizing results from 18 RCTs were identified. A substantial overlap was identified among the SRs synthesizing large heart failure or cardiovascular outcome trials (CVOTs). Regarding the composite outcome of cardiovascular (CV) mortality or hospitalization for heart failure (HHF), all authors reported a significant favorable effect. A beneficial effect was also noted for CV and all-cause mortality, albeit not significant. Our meta-analysis demonstrated a significant improvement in health-related quality-of-life (HRQoL) as assessed by the Kansas City Cardiomyopathy Questionnaire Overall Summary Score (KCCQ-OSS, MD = 1.97, p < 0.001), Total Symptom Score (KCCQ-TSS, MD = 2.29, p < 0.001), Clinical Summary Score (KCCQ-CSS, MD = 1.59, p < 0.001), and the 6-min walking distance (MD = 10.78 m, p = 0.032). Regarding safety, SGLT2i were associated with a significantly lower risk of serious adverse events compared to placebo (RR = 0.94, p = 0.002). The use of SGLT2i in HFpEF is both efficient and safe. Further research is required to clarify the impact of SGTL2i on different subphenotypes of HFpEF and the cardiorespiratory capacity of these patients.
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Affiliation(s)
- Paschalis Karakasis
- Second Cardiology Department, Medical School, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
- Department of Hygiene, Social-Preventive Medicine & Medical Statistics, Medical School, Aristotle University of Thessaloniki, University Campus, 54124, Thessaloniki, Greece.
| | - Konstantinos Pamporis
- Department of Hygiene, Social-Preventive Medicine & Medical Statistics, Medical School, Aristotle University of Thessaloniki, University Campus, 54124, Thessaloniki, Greece
| | - Panagiotis Stachteas
- Second Cardiology Department, Medical School, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Patoulias
- Second Cardiology Department, Medical School, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Second Department of Internal Medicine, European Interbalkan Medical Center, 57001, Thessaloniki, Greece
- Outpatient Department of Cardiometabolic Medicine, Second Department of Cardiology, General Hospital Hippokration, Aristotle University of Thessaloniki, 54642, Thessaloniki, Greece
| | - Konstantinos I Bougioukas
- Department of Hygiene, Social-Preventive Medicine & Medical Statistics, Medical School, Aristotle University of Thessaloniki, University Campus, 54124, Thessaloniki, Greece
| | - Nikolaos Fragakis
- Second Cardiology Department, Medical School, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Bougioukas KI, Pamporis K, Vounzoulaki E, Karagiannis T, Haidich AB. Types and associated methodologies of overviews of reviews in health care: a methodological study with published examples. J Clin Epidemiol 2023; 153:13-25. [PMID: 36351511 DOI: 10.1016/j.jclinepi.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 10/16/2022] [Accepted: 11/02/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To provide a descriptive insight into the different types of research questions/objectives and associated methodologies of overviews of reviews, supplemented by representative examples from the health care literature. STUDY DESIGN AND SETTING We searched in methodological articles for information on types and methodologies used in overviews and we explored the typology of reviews to identify similar types in literature of overviews. We categorized the types of overviews based on the research question/objective and the methodological approach used. Indicative examples for each category were selected from a sample of 2,121 overviews that were retrieved between 2000 and 2022 from MEDLINE, Scopus, and Cochrane Database of Systematic Reviews. RESULTS Based on type of research question, overviews were classified as overviews of reviews of interventions, associations, prediction, diagnostic accuracy, prevalence/incidence, experiences/views, economic evaluation, and measurement properties. Based on the methodological approach, we identified a variety of methods (systematic, living, rapid, scoping, evidence mapping, framework, and methodological) used in overviews. CONCLUSION The proposed classification and examples provide an essential starting point for future theory-building research on typologies and study designs of overviews of reviews. It is important for methodologists to make vigorous effort to create consensus-based methodological and reporting guidelines to cover these diverse types and key methodological challenges.
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Affiliation(s)
- Konstantinos I Bougioukas
- Department of Hygiene, Social-Preventive Medicine & Medical Statistics, Medical School, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - Konstantinos Pamporis
- Department of Hygiene, Social-Preventive Medicine & Medical Statistics, Medical School, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - Elpida Vounzoulaki
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester LE5 4PW, UK
| | - Thomas Karagiannis
- Clinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University of Thessaloniki, Thessaloniki, Greece; Diabetes Centre, Second Medical Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anna-Bettina Haidich
- Department of Hygiene, Social-Preventive Medicine & Medical Statistics, Medical School, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece.
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11
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Wang Y, Chen N, Guo K, Li Y, E F, Yang C, Shang X, Li X, Yang K. Reporting and methodological quality of acupuncture network meta-analyses could be improved: an evidence mapping. J Clin Epidemiol 2023; 153:1-12. [PMID: 36351510 DOI: 10.1016/j.jclinepi.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 10/11/2022] [Accepted: 11/02/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVES To evaluate and map the reporting and methodological quality of network meta-analysis (NMA) on acupuncture. METHODS Published acupuncture NMAs were searched through eight databases from inception to February 2022. The reporting and methodological quality of included studies was assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Network Meta-Analysis (PRISMA-NMA) statement and the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) checklist. RESULTS A total of 113 NMAs were identified. Most (99, 87.61%) studies were performed in China. Most studies focused on multiple acupuncture techniques (82.30%), and the main studied ailments were pain and poststroke sequelae (20.24%). The median (interquartile range (IQR)) score of the reporting quality was 26.5 (25-28.5). However, poor reporting rates in the protocol and registration (33.63%) and geometry of the network (35.40%), especially for China-based studies, were identified. The methodological quality of only 2 (1.77%) English studies was high. The reporting rate of Chinese studies was below 15% on each of items 4, 7, 10, and 12. CONCLUSION The reporting quality of the NMAs was moderate, but the methodological quality was very low. The reporting and methodological quality of future NMAs, especially for Chinese studies, need further improvement.
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Affiliation(s)
- Yan Wang
- Evidence-Based Social Science Research Center & Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Nan Chen
- Research and Education Department, Shaanxi Provincial Rehabilitation Hospital, Xi'an, China
| | - Kangle Guo
- Gansu Provincial Hospital, Lanzhou, China
| | - Yanfei Li
- Evidence-Based Social Science Research Center & Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Fenfen E
- Evidence-Based Social Science Research Center & Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Chaoqun Yang
- Evidence-Based Social Science Research Center & Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Xue Shang
- Evidence-Based Social Science Research Center & Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Xiuxia Li
- Evidence-Based Social Science Research Center & Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.
| | - Kehu Yang
- Evidence-Based Social Science Research Center & Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.
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12
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Kim JSM, Pollock M, Kaunelis D, Weeks L. Guidance on review type selection for health technology assessments: key factors and considerations for deciding when to conduct a de novo systematic review, an update of a systematic review, or an overview of systematic reviews. Syst Rev 2022; 11:206. [PMID: 36167611 PMCID: PMC9513959 DOI: 10.1186/s13643-022-02071-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/11/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND A systematic review (SR) helps us make sense of a body of research while minimizing bias and is routinely conducted to evaluate intervention effects in a health technology assessment (HTA). In addition to the traditional de novo SR, which combines the results of multiple primary studies, there are alternative review types that use systematic methods and leverage existing SRs, namely updates of SRs and overviews of SRs. This paper shares guidance that can be used to select the most appropriate review type to conduct when evaluating intervention effects in an HTA, with a goal to leverage existing SRs and reduce research waste where possible. PROCESS We identified key factors and considerations that can inform the process of deciding to conduct one review type over the others to answer a research question and organized them into guidance comprising a summary and a corresponding flowchart. This work consisted of three steps. First, a guidance document was drafted by methodologists from two Canadian HTA agencies based on their experience. Next, the draft guidance was supplemented with a literature review. Lastly, broader feedback from HTA researchers across Canada was sought and incorporated into the final guidance. INSIGHTS Nine key factors and six considerations were identified to help reviewers select the most appropriate review type to conduct. These fell into one of two categories: the evidentiary needs of the planned review (i.e., to understand the scope, objective, and analytic approach required for the review) and the state of the existing literature (i.e., to know the available literature in terms of its relevance, quality, comprehensiveness, currency, and findings). The accompanying flowchart, which can be used as a decision tool, demonstrates the interdependency between many of the key factors and considerations and aims to balance the potential benefits and challenges of leveraging existing SRs instead of primary study reports. CONCLUSIONS Selecting the most appropriate review type to conduct when evaluating intervention effects in an HTA requires a myriad of factors to be considered. We hope this guidance adds clarity to the many competing considerations when deciding which review type to conduct and facilitates that decision-making process.
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Affiliation(s)
- Joanne S M Kim
- Canadian Agency for Drugs and Technologies in Health, Ottawa, ON, Canada.
| | | | - David Kaunelis
- Canadian Agency for Drugs and Technologies in Health, Ottawa, ON, Canada
| | - Laura Weeks
- Canadian Agency for Drugs and Technologies in Health, Ottawa, ON, Canada
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13
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Adadi A, Lahmer M, Nasiri S. Artificial Intelligence and COVID-19: A Systematic umbrella review and roads ahead. JOURNAL OF KING SAUD UNIVERSITY. COMPUTER AND INFORMATION SCIENCES 2022; 34:5898-5920. [PMID: 37520766 PMCID: PMC8831917 DOI: 10.1016/j.jksuci.2021.07.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/21/2021] [Accepted: 07/11/2021] [Indexed: 12/15/2022]
Abstract
Artificial Intelligence (AI) has played a substantial role in the response to the challenges posed by the current pandemic. The growing interest in using AI to handle Covid-19 issues has accelerated the pace of AI research and resulted in an exponential increase in articles and review studies within a very short period of time. Hence, it is becoming challenging to explore the large corpus of academic publications dedicated to the global health crisis. Even with the presence of systematic review studies, given their number and diversity, identifying trends and research avenues beyond the pandemic should be an arduous task. We conclude therefore that after the one-year mark of the declaration of Covid-19 as a pandemic, the accumulated scientific contribution lacks two fundamental aspects: Knowledge synthesis and Future projections. In contribution to fill this void, this paper is a (i) synthesis study and (ii) foresight exercise. The synthesis study aims to provide the scholars a consolidation of findings and a knowledge synthesis through a systematic review of the reviews (umbrella review) studying AI applications against Covid-19. Following the PRISMA guidelines, we systematically searched PubMed, Scopus, and other preprint sources from 1st December 2019 to 1st June 2021 for eligible reviews. The literature search and screening process resulted in 45 included reviews. Our findings reveal patterns, relationships, and trends in the AI research community response to the pandemic. We found that in the space of few months, the research objectives of the literature have developed rapidly from identifying potential AI applications to evaluating current uses of intelligent systems. Only few reviews have adopted the meta-analysis as a study design. Moreover, a clear dominance of the medical theme and the DNN methods has been observed in the reported AI applications. Based on its constructive systematic umbrella review, this work conducts a foresight exercise that tries to envision the post-Covid-19 research landscape of the AI field. We see seven key themes of research that may be an outcome of the present crisis and which advocate a more sustainable and responsible form of intelligent systems. We set accordingly a post-pandemic research agenda articulated around these seven drivers. The results of this study can be useful for the AI research community to obtain a holistic view of the current literature and to help prioritize research needs as we are heading toward the new normal.
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Affiliation(s)
- Amina Adadi
- ISIC Research Team of High School of Technology, LMMI Laboratory, Moulay Ismail University, Meknes, Morocco
| | - Mohammed Lahmer
- ISIC Research Team of High School of Technology, LMMI Laboratory, Moulay Ismail University, Meknes, Morocco
| | - Samia Nasiri
- ISIC Research Team of High School of Technology, LMMI Laboratory, Moulay Ismail University, Meknes, Morocco
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14
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Chuachamsai S, Acharya A, Fischer K, Nibali L, Ho D, Pelekos G. The effectiveness of adjunctive measures in managing peri-implant mucositis: an umbrella review. Int J Implant Dent 2022; 8:26. [PMID: 35674882 PMCID: PMC9177933 DOI: 10.1186/s40729-022-00426-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 05/30/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES The purpose of this umbrella review was to gather and summarize the data from published systematic reviews (SRs) that compared non-surgical mechanical debridement (NSMD) with and without the use of adjunctive treatments on the management of peri-implant mucositis (PIM). MATERIALS AND METHODS A protocol was developed and registered in PROSPERO (CRD42021254350) before the systematic search for the SRs. Seven electronic databases, including Cochrane Library, Embase (via Ovid), MEDLINE (via Pubmed), Proquest, Prospero, Scopus and Web of Science, were searched for published reviews. The search for unpublished and informally published reviews was further attempted in the last four databases. The methodological quality of the included reviews was assessed using AMSTAR 2. RESULTS Twelve included SRs assessed clinical studies published between 2014 and 2020, including a total of seventeen primary clinical trials. All SRs summarized data from individual studies and provided a narrative conclusion regarding the effectiveness of the adjunctive treatments. Only six SRs performed a meta-analysis (MA) of additional benefits of the adjunctive therapy for PIM, with results indicating no significant difference between the different treatment modalities. The overall confidence was adjudged ranging from critically low to low using AMSTAR 2 and significant additional benefits of any adjunctive treatments in comparison with NSMD were not apparent. CONCLUSION Overall, the reviewed evidence did not support the use of adjunctive treatments for improvement of clinical outcomes in PM management as compared to NSMD alone.
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Affiliation(s)
- Sompol Chuachamsai
- Division of Periodontology and Implant Dentistry Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Aneesha Acharya
- Dr D. Y. Patil Dental College and Hospital, Dr D. Y. Patil Vidyapeeth, Pune, India
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Kai Fischer
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, University of Zurich, Zurich, Switzerland
| | - Luigi Nibali
- Periodontology Unit, Faculty of Dentistry, Oral and Craniofacial Sciences, Centre for Host-Microbiome Interactions, King's College London, London, UK
| | - Dominic Ho
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Georgios Pelekos
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China.
- Department of Periodontology, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong, 999077, SAR, China.
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15
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Jorgenson A, Adalberto Luz R, Fábrega Juskevicius L, Clara Padoveze M, Price L. The Consolidated Framework for Implementation Research: a reflection on researchers' experiences of its benefits and challenges and the lessons learnt from using it. Nurse Res 2022; 30:31-38. [PMID: 35238188 DOI: 10.7748/nr.2022.e1827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND In healthcare implementation research, there is little discussion of researchers' experiences of using frameworks, including the Consolidated Framework for Implementation Research (CFIR). AIM To identify and discuss the benefits and challenges encountered and the lessons learnt from researchers' experiences of using the CFIR in different contexts and phases of research. DISCUSSION This article synthesises the reflections of nursing and public health researchers on their experiences of using the CFIR across four separate healthcare-associated infection prevention and control implementation studies. The CFIR's benefits and challenges, the resolutions to these challenges and the lessons learnt from the application of the framework were discussed. CONCLUSIONS Identified benefits included the framework's adaptability and flexibility, and its provision of structure and shared language for research. Translation to another language and differentiating between domains and constructs were challenges. IMPLICATIONS FOR PRACTICE Nurse researchers may find this article useful when considering use of the CFIR, or to anticipate and prepare to overcome the challenges highlighted when using the framework.
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Affiliation(s)
| | | | | | | | - Lesley Price
- Glasgow Caledonian University, Glasgow, Scotland
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16
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Grussu P, Vicini B, Quatraro RM. Sexuality in the perinatal period: A systematic review of reviews and recommendations for practice. SEXUAL & REPRODUCTIVE HEALTHCARE 2021; 30:100668. [PMID: 34563859 DOI: 10.1016/j.srhc.2021.100668] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 06/23/2021] [Accepted: 09/07/2021] [Indexed: 11/26/2022]
Abstract
In the time of transition to parenthood, many physical, psychological and social changes may affect the multidimensional theme of sexuality. This area plays a significant role in the overall well-being of the individual, the couple and the family. The aim of this systematic review is to consider current and emerging trends in the study of sexual function during pregnancy and after childbirth, evaluating the available evidence in the literature reported in specific reviews, and pulling together the suggestions that various authors have brought forward as being useful for daily clinical practice. A total of 4 databases were searched on EBSCOhost: MEDLINE, Cochrane reviews, CINAHAL, and PsychInfo. A systematic search strategy was formulated using the key terms Sexuality, Sexual, Pregnancy, Postpartum, Puerperium, Perinatal, and Review. Eleven articles were included. The results revealed a gradual decline in the frequency of sexual behaviour throughout pregnancy, sharper in the third trimester. Sexual activity started to be resumed around 6-8 weeks after childbirth, to fully recover only after 6 months. A simultaneous change in sexual function was also found, such as less orgasm, sexual desire and satisfaction, more dyspareunia. Many aspects are related to these changes: physical, psychological and social factors, fears about negative consequences of sexual intercourse, inadequate or absent professional counselling about sexuality, method of delivery and breastfeeding. Healthcare professionals need to adequately inform couples about the common fluctuations in sexual activity, interest, desire, and responsiveness over the course of the pregnancy and following childbirth. Joint counselling, if possible, is preferred.
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Affiliation(s)
- Pietro Grussu
- Consultorio Familiare, Azienda ULSS 6 Euganea, Veneto Region, National Health Service, Italy.
| | - Benedetta Vicini
- Consultorio Familiare, Azienda ULSS 6 Euganea, Veneto Region, National Health Service, Italy
| | - Rosa Maria Quatraro
- Hospital Psychology Unit, Obstetrics and Gynaecology Section, Azienda ULSS 8 Berica, National Health Service, Italy; Maternità in Difficoltà®, Padova and Vicenza, Italy
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17
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Déry J, De Guise É, Bussières ÈL, Lamontagne ME. Prognostic factors for persistent symptoms in adults with mild traumatic brain injury: protocol for an overview of systematic reviews. Syst Rev 2021; 10:254. [PMID: 34556172 PMCID: PMC8461939 DOI: 10.1186/s13643-021-01810-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 09/05/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Mild traumatic brain injury (mTBI) is an increasing public health problem that can lead to persistent symptoms that have several functional consequences. Understanding the prognosis of a condition is an important component of clinical decision-making and can help guide the prevention of long-term disabilities of patients with mTBI. Several studies and systematic reviews have been conducted in order to understand prognosis of chronic symptoms following mTBI. We aim to synthesize evidence from systematic reviews on factors that affect the risk of persistent symptoms in mTBI-affected adults. METHODS We will conduct an overview of systematic reviews following steps described in the Cochrane Handbook. We will search in Cochrane, Medline, CINAHL, Embase, PsycINFO, and Epistemonikos for systematic reviews about the prognosis of persistent symptoms following mTBI in the adult population. Two reviewers will independently screen all references and then select eligible reviews based on eligibility criteria. A data extraction grid will be used to extract relevant information. The risk of bias in the included reviews will be assessed using the ROBIS tool. Data will be synthesized into a comprehensive conceptual model in order to have a better understanding of the predictive factors of post-concussion symptoms following mTBI. DISCUSSION Results will help multiple stakeholders, such as clinicians and rehabilitation program managers, to understand the prognosis of long-term consequences following mTBI. It could guide stakeholders to recognize their patients' prognostic factors and to invest their time and resources in patients who need it the most. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020176676 .
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Affiliation(s)
- Julien Déry
- Department of Rehabilitation, Université Laval, Pavillon Ferdinand-Vandry, Local 2475, 1050, Avenue de la Médecine, Québec, G1V 0A6, Canada.,Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, 525, boul. Wilfrid-Hamel, Québec, G1M 2S8, Canada
| | - Élaine De Guise
- Department of Psychology, Université de Montréal, Montréal, Canada.,Research Institute of the McGill University Health Centre (RI-MUHC), Montréal, Canada.,Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montréal, Canada
| | - Ève-Line Bussières
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, 525, boul. Wilfrid-Hamel, Québec, G1M 2S8, Canada.,Department of Psychology, Université du Québec à Trois-Rivières, 3007 Michel-Sarrazin, 3600 rue Sainte-Marguerite, Trois-Rivières, Québec, G9A 5H7, Canada
| | - Marie-Eve Lamontagne
- Department of Rehabilitation, Université Laval, Pavillon Ferdinand-Vandry, Local 2475, 1050, Avenue de la Médecine, Québec, G1V 0A6, Canada. .,Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, 525, boul. Wilfrid-Hamel, Québec, G1M 2S8, Canada.
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18
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Brunner S, Mayer H, Qin H, Breidert M, Dietrich M, Müller Staub M. Interventions to optimise nutrition in older people in hospitals and long-term care: Umbrella review. Scand J Caring Sci 2021; 36:579-598. [PMID: 34212419 PMCID: PMC9545538 DOI: 10.1111/scs.13015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 05/13/2021] [Accepted: 06/05/2021] [Indexed: 12/01/2022]
Abstract
Background Inpatients have a high need for protein‐energy intake because of increased physical stress metabolism due to illnesses. Protein‐energy undernutrition in older patients increases the risk of complications such as falls, pressure ulcers and even death. An overview of effective interventions addressing this complex issue of malnutrition in older people is missing. Aims To give an overview of effective interventions to optimise nutrition in older people in hospitals and long‐term care. Design An umbrella review, according to the Joanna Briggs Institute and PRISMA statement, was conducted in April 2020. Methods A systematic search of publications from 2010 until 2020 was conducted in CINAHL, PubMed and Cochrane Database. Included were studies reporting nutrition interventions that involved nurses or the interprofessional team in optimising older hospitalised people's nutrition. Excluded were studies investigating the effects of parenteral nutrition, certain food supplements or tube feeding and research from intensive, community or palliative care. Components of interventions were classified according to the intervention Nutrition management: Patients’ assistance, patients’ instruction, foodservice, environment for meals and nutrient‐dense snacks. Findings Included were 13 reviews from 19 countries of the continents Asia, Australia, Europe and North America from hospitals and long‐term care settings. An interprofessional food promoting culture, including staff training as part of a multi‐component measure, has shown to be a successful element in implementing activities of Nutrition Management. Conclusion Several studies synthesised that optimising nutrition in older people in hospitals and long‐term care is achievable. Interventions were effective if—on a meta‐level—staff training was addressed as part of a multi‐component measure to reach an interprofessional food promoting culture. Implications for practice Interventions to optimise older people's nutrition have to consider an interprofessional food promoting culture, including staff training about the importance of nutrition, patients’ assistance and an appropriate environment for meals.
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Affiliation(s)
- Silvia Brunner
- City Hospital Waid and Triemli, Tièchestrasse, Zürich, Switzerland.,University Vienna, A, Alser Strasse, Vienna, Austria.,TU Munich, Munich, Germany
| | - Hanna Mayer
- University Vienna, A, Alser Strasse, Vienna, Austria
| | - Hong Qin
- University Vienna, A, Alser Strasse, Vienna, Austria
| | - Matthias Breidert
- City Hospital Waid and Triemli, Tièchestrasse, Zürich, Switzerland.,TU Munich, Munich, Germany
| | - Michael Dietrich
- City Hospital Waid and Triemli, Tièchestrasse, Zürich, Switzerland.,University Zurich, Zürich, Switzerland
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19
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Bougioukas KI, Vounzoulaki E, Mantsiou CD, Savvides ED, Karakosta C, Diakonidis T, Tsapas A, Haidich AB. Methods for depicting overlap in overviews of systematic reviews: An introduction to static tabular and graphical displays. J Clin Epidemiol 2020; 132:34-45. [PMID: 33309886 DOI: 10.1016/j.jclinepi.2020.12.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 11/21/2020] [Accepted: 12/02/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVE To introduce potential static tabular and graphical techniques for visually presenting overlap between systematic reviews (SRs) included in overviews of systematic reviews (OoSRs). METHODS The graphical approaches described include Venn and Euler diagrams, as well as matrix-based, node-link, and aggregation-based techniques. We used fundamental concepts of mathematics from set and network theory to develop our novel graphical approaches. The graphical displays were created using R. RESULTS Overview authors have the flexibility to choose from a variety of visualizations, depending on the characteristics of their study. If the OoSRs include few SRs, a Venn or an Euler diagram can be used. In case of OoSRs with more SRs, Upset plots, heatmaps, and node-link graphs are more appropriate for visualizing overlapping SRs. Stacked bar plots constitute an aggregation-based technique of illustrating overlap. Strengths and limitations of each graphical approach are presented. CONCLUSION The degree of overlap should be explored for the entire study and for specific outcomes of interest. The proposed graphical techniques may assist methodologists and authors in identifying overlap, which in turn may improve validity and transparency in OoSRs. More research is needed to understand which technique would be most useful and easiest to understand.
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Affiliation(s)
- Konstantinos I Bougioukas
- Department of Hygiene, Social-Preventive Medicine & Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - Elpida Vounzoulaki
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK; National Institute for Health Research Applied Research Collaboration-East Midlands, Leicester Diabetes Centre, Leicester LE5 4PW, UK
| | - Chrysanthi D Mantsiou
- Second Medical Department, Clinical Research and Evidence-Based Medicine Unit, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eliophotos D Savvides
- 1st Department of Urology, Medical School, G. Gennimatas General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christina Karakosta
- Department of Hygiene, Social-Preventive Medicine & Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - Theodoros Diakonidis
- Department of Hygiene, Social-Preventive Medicine & Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - Apostolos Tsapas
- Second Medical Department, Clinical Research and Evidence-Based Medicine Unit, Aristotle University of Thessaloniki, Thessaloniki, Greece; Second Medical Department, Diabetes Centre, Aristotle University of Thessaloniki, Thessaloniki, Greece; Harris Manchester College, University of Oxford, Oxford, UK
| | - Anna-Bettina Haidich
- Department of Hygiene, Social-Preventive Medicine & Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece.
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20
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Moorthy D, Merrill R, Namaste S, Iannotti L. The Impact of Nutrition-Specific and Nutrition-Sensitive Interventions on Hemoglobin Concentrations and Anemia: A Meta-review of Systematic Reviews. Adv Nutr 2020; 11:1631-1645. [PMID: 32845972 PMCID: PMC7666908 DOI: 10.1093/advances/nmaa070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 02/12/2020] [Accepted: 05/21/2020] [Indexed: 11/14/2022] Open
Abstract
Anemia is a multifactorial condition arising from inadequate nutrition, infection, chronic disease, and genetic-related etiologies. Our aim was to assess the impact of nutrition-sensitive and nutrition-specific interventions on hemoglobin (Hb) concentrations and anemia to inform the prioritization and scale-up of interventions to address the multiple causes of anemia. We performed a meta-review synthesis of information by searching multiple databases for reviews published between 1990 and 2017 and used standard methods for conducting a meta-review of reviews, including double independent screening, extraction, and quality assessment. Quantitative pooling and narrative syntheses were used to summarize information. Hb concentration and anemia outcomes were pooled in specific population groups (children aged <5 y, school-age children, and pregnant women). Methodological quality of the systematic reviews was assessed using Assessing the Methodological Quality of Systematic Reviews (AMSTAR) criteria. Of the 15,444 records screened, we identified 118 systematic reviews that met inclusion criteria. Reviews focused on nutrition-specific interventions (96%). Daily and intermittent iron supplementation, micronutrient powders, malaria treatment, use of insecticide-treated nets (ITNs), and delayed cord clamping were associated with increased Hb concentration in children aged <5 y. Among children older than 5 y, daily and intermittent iron supplementation and deworming, and in pregnant women, daily iron-folic acid supplementation, use of ITNs, and delayed cord clamping, were associated with increased Hb concentration. Similar results were obtained for the reduced risk of anemia outcome. This meta-review suggests the importance of nutrition-specific interventions for anemia and highlights the lack of evidence to understand the influence of nutrition-sensitive and multifaceted interventions on the condition.
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Affiliation(s)
- Denish Moorthy
- USAID Advancing Nutrition (USAID AN), Arlington, VA, USA
| | - Rebecca Merrill
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sorrel Namaste
- The Demographic and Health Survey Program, ICF, Rockville, MD, USA
| | - Lora Iannotti
- Brown School, Institute for Public Health, Washington University in St Louis, MO, USA
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Bressan V, Mio M, Palese A. Nursing handovers and patient safety: Findings from an umbrella review. J Adv Nurs 2019; 76:927-938. [DOI: 10.1111/jan.14288] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 11/16/2019] [Accepted: 12/03/2019] [Indexed: 01/18/2023]
Affiliation(s)
| | - Moreno Mio
- School of Nursing Department of Medical Sciences University of Udine Udine Italy
| | - Alvisa Palese
- Department of Medical Sciences University of Udine Udine Italy
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Händel MN, Cardoso I, Rasmussen KM, Rohde JF, Jacobsen R, Nielsen SM, Christensen R, Heitmann BL. Processed meat intake and chronic disease morbidity and mortality: An overview of systematic reviews and meta-analyses. PLoS One 2019; 14:e0223883. [PMID: 31622423 PMCID: PMC6797176 DOI: 10.1371/journal.pone.0223883] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 10/01/2019] [Indexed: 01/03/2023] Open
Abstract
Despite the nutritional value of meat, a large volume of reviews and meta-analyses suggests that processed meat intake is associated with an increased risk of chronic diseases. However, assessments of the quality of these published reviews internal validity are generally lacking. We systematically reviewed and assessed the quality alongside summarizing the results of previously published systematic reviews and meta-analyses that examined the association between processed meat intake and cancers, type II diabetes (T2D), and cardiovascular diseases (CVD). Reviews and meta-analyses published until May 2018 were identified through a systematic literature search in the databases MEDLINE and EMBASE, and reference lists of included reviews. The quality of the systematic reviews and meta-analyses was assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR). All eligible reviews had to comply with two quality requirements: providing sufficient information on quality assessment of the primary studies and a comprehensive search. The results were summarized for T2D, CVD, and each of the different cancer types. The certainty in the estimates of the individual outcomes was rated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) method. In total, 22 systematic reviews were eligible and thus included in this review. More than 100 reviews were excluded because quality assessment of the primary studies had not been performed. The AMSTAR score of the included reviews ranged from 5 to 8 indicating moderate quality. Overall, the quality assessments of primary studies of the reviews are generally lacking; the scientific quality of the systematic reviews reporting positive associations between processed meat intake and risk of various cancers, T2D and CVD is moderate, and the results from case-control studies suggest more often a positive association than the results from cohort studies. The overall certainty in the evidence was very low across all individual outcomes, due to serious risk of bias and imprecision.
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Affiliation(s)
- Mina Nicole Händel
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- * E-mail:
| | - Isabel Cardoso
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Katrine Marie Rasmussen
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jeanett Friis Rohde
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Ramune Jacobsen
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark
| | - Sabrina Mai Nielsen
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Odense, Denmark
| | - Robin Christensen
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Odense, Denmark
| | - Berit Lilienthal Heitmann
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, University of Sydney, Sydney, Australia
- Department of Public Health, Section for General Practice, University of Copenhagen, Copenhagen, Denmark
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23
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Hosking J, Macmillan A, Jones R, Ameratunga S, Woodward A. Searching for health equity: validation of a search filter for ethnic and socioeconomic inequalities in transport. Syst Rev 2019; 8:94. [PMID: 30971313 PMCID: PMC6458782 DOI: 10.1186/s13643-019-1009-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 03/26/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Efforts to improve health equity should be informed by the best available evidence. However, equity-related research is inconsistently indexed, and uses a variety of terms to describe key concepts, making it difficult to reliably identify all relevant studies. We report the development and validation of a search strategy for studies investigating whether the effects of interventions differ by ethnicity or socio-economic status, using the field of transport and health as an example. METHODS Adapting previously described methods, we followed four steps: generation of a test set of eligible studies, search strategy development, search strategy validation, and documentation. RESULTS Drawing from 12 systematic reviews, supplemented by additional studies identified by experts and colleagues, we identified a test set of 11 studies that met our eligibility criteria. We assigned five studies to a development set, which we used to develop and refine our search strategy. We assigned the remaining six studies to a validation set, against which we tested our final search strategy. The final search strategy identified all studies in both validation and development sets. CONCLUSIONS The validated search strategy derived in this study facilitates the conduct of systematic reviews and other literature searches investigating whether the effects of interventions differ by ethnicity or socio-economic status and may be further developed in future for other equity-focused searches and reviews.
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Affiliation(s)
- Jamie Hosking
- Section of Epidemiology and Biostatistics, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
| | - Alexandra Macmillan
- Department of Preventive and Social Medicine, University of Otago, Box 56, Dunedin, PO 9054 New Zealand
| | - Rhys Jones
- Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
| | - Shanthi Ameratunga
- Section of Epidemiology and Biostatistics, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
| | - Alistair Woodward
- Section of Epidemiology and Biostatistics, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
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Garritty C, Stevens A, Hamel C, Golfam M, Hutton B, Wolfe D. Knowledge Synthesis in Evidence-Based Medicine. Semin Nucl Med 2019; 49:136-144. [PMID: 30819393 DOI: 10.1053/j.semnuclmed.2018.11.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Systematic reviews are the most common form of knowledge synthesis and remain a cornerstone of the practice of evidence-based medicine. They offer enhanced rigor and validity relative to traditional narrative review articles by reducing bias and increasing objectivity. In answering focused research questions, systematic reviews are directly applicable to clinical practice as well as the development of clinical guidelines and the identification of knowledge gaps, which may drive future primary research directions. Typically, such a rigorous process necessarily requires substantive time to carefully and systematically identify, screen, and synthesize all relevant available primary research on a topic. Further, other knowledge synthesis methods have emerged to address the varying needs of decision makers with respect to condensed timelines and more diverse research questions, as well as to allow incorporation of already synthesized evidence into reviews. These alternative methods include rapid reviews, scoping reviews, and overviews of systematic reviews, which are being used with increasing frequency by clinicians, decision-makers, and researchers. We encourage clinicians and researchers in nuclear medicine and other imaging sciences to acquire a greater familiarity with these methods and to consider them in clinical decision making, the development of clinical guidelines, and the planning of future research activities.
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Affiliation(s)
- C Garritty
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa Methods Centre, Ottawa, Canada
| | - A Stevens
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa Methods Centre, Ottawa, Canada
| | - C Hamel
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa Methods Centre, Ottawa, Canada
| | - M Golfam
- Edmundston Regional Hospital, Vitalite Health Network, New Brunswick, Canada
| | - B Hutton
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa Methods Centre, Ottawa, Canada; Ottawa University School of Epidemiology, Public Health and Preventive Medicine, Ottawa, Canada
| | - D Wolfe
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa Methods Centre, Ottawa, Canada.
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25
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Hersi M, Traversy G, Thombs BD, Beck A, Skidmore B, Groulx S, Lang E, Reynolds DL, Wilson B, Bernstein SL, Selby P, Johnson-Obaseki S, Manuel D, Pakhale S, Presseau J, Courage S, Hutton B, Shea BJ, Welch V, Morrow M, Little J, Stevens A. Effectiveness of stop smoking interventions among adults: protocol for an overview of systematic reviews and an updated systematic review. Syst Rev 2019; 8:28. [PMID: 30660199 PMCID: PMC6339342 DOI: 10.1186/s13643-018-0928-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 12/20/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Tobacco smoking is the leading cause of cancer, preventable death, and disability. Smoking cessation can increase life expectancy by nearly a decade if achieved in the third or fourth decades of life. Various stop smoking interventions are available including pharmacotherapies, electronic cigarettes, behavioural support, and alternative therapies. This protocol outlines an evidence review which will evaluate the benefits and harms of stop smoking interventions in adults. METHODS The evidence review will consist of two stages. First, an overview of systematic reviews evaluating the benefits and harms of various stop smoking interventions delivered in or referred from the primary care setting will be conducted. The second stage will involve updating a systematic review on electronic cigarettes identified in the overview; randomized controlled trials will be considered for outcomes relating to benefits while randomized controlled trials, non-randomized controlled trials, and comparative observational studies will be considered for evaluating harms. Search strategies will be developed and peer-reviewed by medical information specialists. The search strategy for the updated review on e-cigarettes will be developed using that of the candidate systematic review. The MEDLINE®, PsycINFO, Embase, and the Cochrane Library electronic databases will be searched as of 2008 for the overview of reviews and from the last search date of the selected review for the updated review. Organizational websites and trial registries will be searched for unpublished or ongoing reviews/studies. Two reviewers will independently screen the title and abstracts of citations using the liberal accelerated method. Full-text screening will be performed independently by two reviewers. Extracted data will be verified by a second reviewer. Disagreements regarding full-text screening and data extraction will be resolved by consensus or third-party adjudication. The methodological quality of systematic reviews, risk of bias of randomized and non-randomized trials, and methodological quality of cohort studies will be evaluated using AMSTAR 2, the Cochrane risk of bias tool, and a modified version of the Scottish Intercollegiate Guidelines Network critical appraisal tool, respectively. The GRADE framework will be used to assess the quality of the evidence for outcomes. DISCUSSION The evidence review will evaluate the benefits and harms of various stop smoking interventions for adults. Findings will be used to inform a national tobacco cessation guideline by the Canadian Task Force on Preventive Health Care. SYSTEMATIC REVIEW REGISTRATION PROSPERO (CRD42018099691, CRD42018099692).
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Affiliation(s)
- Mona Hersi
- Knowledge Synthesis Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Centre for Practice-Changing Research, 501 Smyth Road, Box 201, Ottawa, Ontario K1H 8L6 Canada
| | | | - Brett D. Thombs
- Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec Canada
- Department of Psychiatry, McGill University, Montreal, Quebec Canada
| | - Andrew Beck
- Knowledge Synthesis Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Centre for Practice-Changing Research, 501 Smyth Road, Box 201, Ottawa, Ontario K1H 8L6 Canada
| | - Becky Skidmore
- Knowledge Synthesis Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Centre for Practice-Changing Research, 501 Smyth Road, Box 201, Ottawa, Ontario K1H 8L6 Canada
| | - Stéphane Groulx
- Department of Community Health Sciences, University of Sherbrooke, Sherbrooke, Quebec Canada
- Centre de recherche Charles-Le Moyne – Saguenay–Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, Quebec, Quebec Canada
| | - Eddy Lang
- University of Calgary Cumming School of Medicine, Calgary, Alberta Canada
- Alberta Health Services, Calgary, Alberta Canada
| | - Donna L. Reynolds
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada
| | - Brenda Wilson
- Division of Community Health and Humanities, Memorial University of Newfoundland, St. John’s, Newfoundland Canada
| | - Steven L. Bernstein
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT USA
| | - Peter Selby
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario Canada
| | - Stephanie Johnson-Obaseki
- Department of Otolaryngology, University of Ottawa, Ottawa, Ontario Canada
- The Ottawa Hospital, Ottawa, Ontario Canada
| | - Douglas Manuel
- The Ottawa Hospital, Ottawa, Ontario Canada
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario Canada
- Bruyere Research Institute, Ottawa, Ontario Canada
| | - Smita Pakhale
- The Ottawa Hospital, Ottawa, Ontario Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario Canada
| | - Justin Presseau
- Ottawa Hospital Research Institute, Ottawa, Ontario Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario Canada
- School of Psychology, University of Ottawa, Ottawa, Ontario Canada
| | - Susan Courage
- Public Health Agency of Canada, Ottawa, Ontario Canada
| | - Brian Hutton
- Knowledge Synthesis Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Centre for Practice-Changing Research, 501 Smyth Road, Box 201, Ottawa, Ontario K1H 8L6 Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario Canada
| | - Beverley J. Shea
- Knowledge Synthesis Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Centre for Practice-Changing Research, 501 Smyth Road, Box 201, Ottawa, Ontario K1H 8L6 Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario Canada
| | - Vivian Welch
- Ottawa Hospital Research Institute, Ottawa, Ontario Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario Canada
- Bruyere Research Institute, Ottawa, Ontario Canada
| | - Matt Morrow
- Patient representative, Vancouver, British Columbia Canada
| | - Julian Little
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario Canada
| | - Adrienne Stevens
- Knowledge Synthesis Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Centre for Practice-Changing Research, 501 Smyth Road, Box 201, Ottawa, Ontario K1H 8L6 Canada
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Broderick J, Vancampfort D, Mockler D, Bennett K, Waugh A, McDonough C, Cramer H, Walshe M. Yoga for schizophrenia. Hippokratia 2018. [DOI: 10.1002/14651858.cd013213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Julie Broderick
- Trinity Centre for Health Sciences; Discipline of Physiotherapy; St James's Hospital Dublin Ireland
| | - Davy Vancampfort
- Katholieke Universiteit Leuven; Department of Rehabilitation Sciences; Tervuursevest 101 Leuven Belgium 3001
| | - David Mockler
- Trinity Centre for Health Sciences, St James Hospital; John Stearne Library; Dublin Ireland
| | - Kathleen Bennett
- School of Medicine, Trinity College Dublin; Department of Pharmacology and Therapeutics; St James's Hospital Dublin Ireland
| | - Alice Waugh
- St James Hospital; Department of Physiotherapy; James Street Dublin Ireland
| | - Catherine McDonough
- Health Services Executive; Louth Meath Rehabilitation Service; Louth Ireland
| | - Holger Cramer
- University of Duisburg-Essen; Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine; Am Deimelsberg 34a Essen Germany 45276
| | - Margaret Walshe
- Trinity College Dublin; Clinical Speech and Language Studies; 7-9 South Leinster Street Dublin Ireland
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Hegland PA, Aasprang A, Hjelle Øygard S, Nordberg S, Kolotkin R, Moltu C, Tell GS, Andersen JR. A review of systematic reviews on the effects of patient-reported outcome monitoring with clinical feedback systems on health-related quality of life-implications for a novel technology in obesity treatment. Clin Obes 2018; 8:452-464. [PMID: 30208266 DOI: 10.1111/cob.12277] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 06/14/2018] [Accepted: 07/13/2018] [Indexed: 01/10/2023]
Abstract
Patient-reported outcome monitoring with clinical feedback systems (PRO/CFS) has been employed in many disease states to measure and improve health-related quality of life (HRQOL). Exploring the role of PRO/CFS in treatment for obesity may prove valuable. Systematic reviews were summarized to determine the effectiveness of PRO/CFS on HRQOL in any disease area. Primary studies evaluating the effect of PRO/CFS on HRQOL in treatment for obesity were also considered for inclusion. Systematic searches were performed in The Cochrane Library, PROSPERO, Epistemonikos, HTA, DARE, CINAHL, Medline, Embase, PsycINFO, BMJ Clinical Evidence, PDQ-Evidence and PubPsych. Two reviewers independently screened references until final inclusion and critically appraised included reviews using PRISMA checklist. Five systematic reviews and no primary studies met inclusion criteria. Although results were inconsistent, effectiveness of PRO/CFS on HRQOL was demonstrated in some diseases/treatments (e.g. psychiatric treatment; symptom burden in cancer treatment). No trials using PRO/CFS in treatment for obesity were identified. In some trials, PRO/CFS was not fully integrated into consultations, thereby PRO/CFS was not extensively studied. General effectiveness of PRO/CFS on HRQOL is inconclusive due to heterogeneous and statistically insignificant findings, and lack of stringency in conceptualization and execution of PRO/CFS. There are no data relevant to treatment for obesity. Future studies should use rigorous methodology to examine the effectiveness of PRO/CFS in treatment for obesity.
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Affiliation(s)
- P A Hegland
- Departement of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - A Aasprang
- Departement of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway
| | - S Hjelle Øygard
- Departement of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway
| | - S Nordberg
- Department of Population Medicine, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway
| | - R Kolotkin
- Departement of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway
- Department of Community and Family Medicine, Duke University School of Medicine, Durham, NC, USA
| | - C Moltu
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway
| | - G S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - J R Andersen
- Departement of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway
- Centre of Health Research, District General Hospital of Førde, Førde, Norway
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Lunny C, Brennan SE, McDonald S, McKenzie JE. Toward a comprehensive evidence map of overview of systematic review methods: paper 2-risk of bias assessment; synthesis, presentation and summary of the findings; and assessment of the certainty of the evidence. Syst Rev 2018; 7:159. [PMID: 30314530 PMCID: PMC6186052 DOI: 10.1186/s13643-018-0784-8] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 07/19/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Overviews of systematic reviews (SRs) attempt to systematically retrieve and summarise the results of multiple systematic reviews. This is the second of two papers from a study aiming to develop a comprehensive evidence map of the methods used in overviews. Our objectives were to (a) develop a framework of methods for conducting, interpreting and reporting overviews (stage I)-the Methods for Overviews of Reviews (MOoR) framework-and (b) to create an evidence map by mapping studies that have evaluated overview methods to the framework (stage II). In the first paper, we reported findings for the four initial steps of an overview (specification of purpose, objectives and scope; eligibility criteria; search methods; data extraction). In this paper, we report the remaining steps: assessing risk of bias; synthesis, presentation and summary of the findings; and assessing certainty of the evidence arising from the overview. METHODS In stage I, we identified cross-sectional studies, guidance documents and commentaries that described methods proposed for, or used in, overviews. Based on these studies, we developed a framework of possible methods for overviews, categorised by the steps in conducting an overview. Multiple iterations of the framework were discussed and refined by all authors. In stage II, we identified studies evaluating methods and mapped these evaluations to the framework. RESULTS Forty-two stage I studies described methods relevant to one or more of the latter steps of an overview. Six studies evaluating methods were included in stage II. These mapped to steps involving (i) the assessment of risk of bias (RoB) in SRs (two SRs and three primary studies, all reporting evaluation of RoB tools) and (ii) the synthesis, presentation and summary of the findings (one primary study evaluating methods for measuring overlap). CONCLUSION Many methods have been described for use in the latter steps in conducting an overview; however, evaluation and guidance for applying these methods is sparse. The exception is RoB assessment, for which a multitude of tools exist-several with sufficient evaluation and guidance to recommend their use. Evaluation of other methods is required to provide a comprehensive evidence map.
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Affiliation(s)
- Carole Lunny
- Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Sue E. Brennan
- Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Steve McDonald
- Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Joanne E. McKenzie
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC 3004 Australia
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Tonin FS, Borba HH, Leonart LP, Mendes AM, Steimbach LM, Pontarolo R, Fernandez-Llimos F. Methodological quality assessment of network meta-analysis of drug interventions: implications from a systematic review. Int J Epidemiol 2018; 48:620-632. [DOI: 10.1093/ije/dyy197] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/20/2018] [Accepted: 08/24/2018] [Indexed: 01/08/2023] Open
Affiliation(s)
| | - Helena H Borba
- Department of Pharmacy, Universidade Federal do Paraná, Curitiba, Brazil
| | | | | | | | - Roberto Pontarolo
- Department of Pharmacy, Universidade Federal do Paraná, Curitiba, Brazil
| | - Fernando Fernandez-Llimos
- Department of Social Pharmacy, Research Institute for Medicines (iMed.ULisboa), Universidade de Lisboa, Lisbon, Portugal
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Behdinan A, Gunn E, Baral P, Sritharan L, Fafard P, Hoffman SJ. An Overview of Systematic Reviews to Inform the Institutional Design of Scientific Advisory Committees. GLOBAL CHALLENGES (HOBOKEN, NJ) 2018; 2:1800019. [PMID: 30333927 PMCID: PMC6174971 DOI: 10.1002/gch2.201800019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 05/31/2018] [Indexed: 06/08/2023]
Abstract
The current lack of synthesized evidence for informing the design of scientific advisory committees (SACs) is surprising in light of the widespread use of SACs throughout decision-making processes. While existing research points to the importance of quality, relevance, and legitimacy for SACs' effectiveness, those planning SACs would benefit from efforts to systematically pinpoint optimal designs of these committees for maximal effectiveness. Search strategies are developed for seven electronic databases. Of the 1895 systematic reviews identified, six reviews meet the inclusion criteria: they report the results of systematic reviews that followed a clearly identified systematic methodology, examine factors related to the design of SACs, and involve processes in the natural or social sciences. These reviews collectively summarize 444 primary studies. Three of the six reviews look at the impacts of SAC size, two evaluate the influence of the committee's diversity, and half mention the importance of properly on-boarding new members. The goal is to identify recurring themes to understand the specific institutional features that optimize the usefulness of SACs. In turn, this overview of systematic reviews aims to contribute to a growing body of literature on how SACs should be designed to maximize their effectiveness and helpfulness for decision-making.
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Affiliation(s)
- Asha Behdinan
- Global Strategy LabYork University/University of OttawaCanada
- Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
| | - Elliot Gunn
- Global Strategy LabYork University/University of OttawaCanada
| | - Prativa Baral
- Global Strategy LabYork University/University of OttawaCanada
- Dahdaleh Institute for Global Health ResearchFaculty of Health and Osgoode Hall Law SchoolYork UniversityTorontoOntarioCanada
| | | | - Patrick Fafard
- Global Strategy LabYork University/University of OttawaCanada
- Graduate School of Public and International AffairsUniversity of OttawaOttawaOntarioCanada
| | - Steven J. Hoffman
- Global Strategy LabYork University/University of OttawaCanada
- Dahdaleh Institute for Global Health ResearchFaculty of Health and Osgoode Hall Law SchoolYork UniversityTorontoOntarioCanada
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Pagano E, Romano B, Izzo AA, Borrelli F. The clinical efficacy of curcumin-containing nutraceuticals: An overview of systematic reviews. Pharmacol Res 2018; 134:79-91. [DOI: 10.1016/j.phrs.2018.06.007] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 05/29/2018] [Accepted: 06/07/2018] [Indexed: 12/21/2022]
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Puthussery S, Chutiyami M, Tseng PC, Kilby L, Kapadia J. Effectiveness of early intervention programs for parents of preterm infants: a meta-review of systematic reviews. BMC Pediatr 2018; 18:223. [PMID: 29986683 PMCID: PMC6038283 DOI: 10.1186/s12887-018-1205-9] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 07/02/2018] [Indexed: 01/17/2023] Open
Abstract
Background Various intervention programs exist for parents of preterm babies and some systematic reviews (SRs) have synthesised the evidence of their effectiveness. These reviews are, however, limited to specific interventions, components, or outcomes, and a comprehensive evidence base is lacking. The aim of this meta-review was to appraise and meta-synthesise the evidence from existing SRs to provide a comprehensive evidence base on the effectiveness of interventions for parents of preterm infants on parental and infant outcomes. Methods We conducted a comprehensive search of the following databases to identify relevant SRs: Cochrane library, Web of science, EMBASE, CINAHL, British Nursing Index, PsycINFO, Medline, ScienceDirect, Scopus, IBSS, DOAJ, ERIC, EPPI-Centre, PROSPERO, WHO Library. Additional searches were conducted using authors’ institutional libraries, Google Scholar, and the reference lists of identified reviews. Identified articles were screened in two stages against an inclusion criteria with titles and abstracts screened first followed by full-text screening. Selected SRs were appraised using the AMSTAR tool. Extracted data using a predesigned tool were synthesised narratively examining the direction of impact on outcomes. Results We found 11 SRs eligible for inclusion that synthesised a total of 343 quantitative primary studies. The average quality of the SRs was ‘medium’. Thirty four interventions were reported across the SRs with considerable heterogeneity in the structural framework and the targeted outcomes that included maternal-infant dyadic, maternal/parental, and infant outcomes. Among all interventions, Kangaroo Care (KC) showed the most frequent positive impact across outcomes (n = 19) followed by Mother Infant Transaction Program (MITP) (n = 14). Other interventions with most consistent positive impact on infant outcomes were Modified-Mother Infant Transaction Program (M-MITP) (n = 6), Infant Health and Development Program (IHDP) (n = 5) and Creating Opportunities for Parent Empowerment (COPE) (n = 5). Overall, interventions with both home and facility based components showed the most frequent positive impact across outcomes. Conclusions Neonatal care policy and planning for preterm babies should consider the implementation of interventions with most positive impact on outcomes. The heterogeneity in interventions and outcomes calls for the development and implementation of an integrated program for parents of preterm infants with a clearly defined global set of parental and infant outcomes.
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Affiliation(s)
- Shuby Puthussery
- Maternal and Child Health Research Centre, Institute for Health Research, University of Bedfordshire, Putteridge Bury, Hitchin Road, Luton, Bedfordshire, LU2 8LE, UK.
| | - Muhammad Chutiyami
- Maternal and Child Health Research Centre, Institute for Health Research, University of Bedfordshire, Putteridge Bury, Hitchin Road, Luton, Bedfordshire, LU2 8LE, UK
| | - Pei-Ching Tseng
- Maternal and Child Health Research Centre, Institute for Health Research, University of Bedfordshire, Putteridge Bury, Hitchin Road, Luton, Bedfordshire, LU2 8LE, UK
| | - Lesley Kilby
- Neonatal Unit, Luton and Dunstable Hospital, Lewsey Rd, Luton, LU4 0DZ, UK
| | - Jogesh Kapadia
- Neonatal Unit, Luton and Dunstable Hospital, Lewsey Rd, Luton, LU4 0DZ, UK
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Driot D, Bismuth M, Maurel A, Soulie-Albouy J, Birebent J, Oustric S, Dupouy J. Management of first depression or generalized anxiety disorder episode in adults in primary care: A systematic metareview. Presse Med 2017; 46:1124-1138. [DOI: 10.1016/j.lpm.2017.10.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 09/28/2017] [Accepted: 10/04/2017] [Indexed: 01/09/2023] Open
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Schultz A, Goertzen L, Rothney J, Wener P, Enns J, Halas G, Katz A. A scoping approach to systematically review published reviews: Adaptations and recommendations. Res Synth Methods 2017; 9:116-123. [PMID: 29032590 DOI: 10.1002/jrsm.1272] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 09/09/2017] [Accepted: 09/29/2017] [Indexed: 11/06/2022]
Abstract
Knowledge translation is a central focus of the health research community, which includes strategies to synthesize published research to support uptake within health care practice and policy arenas. Within the literature concerning review methodologies, a new discussion has emerged concerning methods that review and synthesize published review articles. In this paper, our multidisciplinary team from family medicine, nursing, dental hygiene, kinesiology, occupational therapy, physiology, population health, clinical psychology, and library sciences contributes to this discussion by sharing our experiences in conducting 3 scoping reviews of published review studies. A brief discussion of Cochrane Collaboration overview reviews and Joanna Briggs Institute umbrella reviews foreshadows a discussion of insights from our experiences of conducting the 3 scoping reviews of published reviews. We address 6 adaptations along with our recommendations for each, which may guide other researchers with designing scoping review approaches to synthesize published reviews. The ability of researchers to publish research findings is growing, and our ability to effectively transfer findings into useful evidence for health care practice and policy is imperative to our work.
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Affiliation(s)
- Annette Schultz
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Leah Goertzen
- Faculty of Kinesiology and Recreation Management and Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Janet Rothney
- Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, MB, Canada
| | - Pamela Wener
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Jennifer Enns
- Manitoba Centre for Health Policy, Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Gayle Halas
- Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Alan Katz
- Manitoba Centre for Health Policy, Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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Lunny C, Brennan SE, McDonald S, McKenzie JE. Toward a comprehensive evidence map of overview of systematic review methods: paper 1-purpose, eligibility, search and data extraction. Syst Rev 2017; 6:231. [PMID: 29162130 PMCID: PMC5698938 DOI: 10.1186/s13643-017-0617-1] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 10/20/2017] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Overviews of systematic reviews attempt to systematically retrieve and summarise the results of multiple systematic reviews. Methods for conducting, interpreting and reporting overviews are in their infancy. To date, there has been no evidence map of the methods used in overviews, thus making it difficult to determine the gaps and priorities for methods research. Our objectives were to develop and populate a comprehensive framework of methods for conducting, interpreting and reporting overviews (stage I) and to create an evidence map by mapping studies that have evaluated overview methods to the framework (stage II). METHODS We searched methods collections (e.g. Cochrane Methodology Register, Meth4ReSyn library, AHRQ Effective Health Care Program) to identify eligible studies for both stages of this research. In stage I, cross-sectional studies, guidance documents and commentaries that described methods proposed for, or used in, overviews were used to develop and populate the framework of methods. Drafts and multiple iterations of the framework were discussed and refined by all authors. In stage II, we identified and described studies evaluating overview methods and mapped these evaluations to the framework. RESULTS In this paper, we present results for the four initial steps of conducting an overview: (a) specification of the purpose, objectives and scope, (b) specification of the eligibility criteria, (c) search methods and (d) data extraction. Twenty-nine studies mentioned or described methods relevant to one or more of these steps. In the developed framework, identified methods and approaches were grouped according to the steps an overview author would need to undertake. Fifteen studies evaluated identified methods, all of which mapped to the search methods step. These studies either reported the development and evaluation of a new search filter to retrieve systematic reviews or compared the performance of multiple filters. CONCLUSION Gaps in the evaluation of methods were found for the majority of steps in the framework. More empirical studies are needed to evaluate the methods outlined and provide a comprehensive evidence map. The framework is useful for planning these evaluations and for planning methods required to deal with challenges that arise when conducting an overview.
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Affiliation(s)
- Carole Lunny
- Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Sue E Brennan
- Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Steve McDonald
- Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Joanne E McKenzie
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
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Bougioukas KI, Liakos A, Tsapas A, Ntzani E, Haidich AB. Preferred reporting items for overviews of systematic reviews including harms checklist: a pilot tool to be used for balanced reporting of benefits and harms. J Clin Epidemiol 2017; 93:9-24. [PMID: 29037888 DOI: 10.1016/j.jclinepi.2017.10.002] [Citation(s) in RCA: 156] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 09/18/2017] [Accepted: 10/06/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVES An overview of systematic reviews (OoSRs) is a study designed to synthesize multiple evidence from existing systematic reviews on a specific domain. The aim of this paper was to offer a pilot version checklist with Preferred Reporting Items for OoSRs (PRIO-harms) to promote a more balanced reporting of benefits and harms in OoSRs of health care interventions. STUDY DESIGN AND SETTING The included items were developed by combining key features from health care OoSRs designs with recommendations from statements of other relevant checklists and pertinent methodological review articles. Two raters independently used the PRIO-harms checklist to assess a sample of 20 OoSRs. RESULTS The PRIO-harms tool consists of a 27-item (56 (sub-)items in total) checklist and is accompanied by a five-stage process flow diagram (identification, screening, eligibility, inclusion, and separation of relevant studies). The mean interrater reliability (Gwet's AC1 statistic) between reviewers was 0.90 (95% confidence interval: 0.88, 0.92) indicating a very good agreement. CONCLUSION The PRIO-harms tool can be used in every OoSRs that addresses health care interventions. This instrument will assist overview authors to improve completeness and transparency of research reporting with emphasis on harms. However, it might benefit from critical review and further validation from experts and research teams that produce OoSRs.
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Affiliation(s)
- Konstantinos I Bougioukas
- Department of Hygiene and Epidemiology, Medical School, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - Aris Liakos
- Second Medical Department, Clinical Research and Evidence-Based Medicine Unit, Aristotle University of Thessaloniki, Konstantinoupoleos 49, 54642 Thessaloniki, Greece
| | - Apostolos Tsapas
- Second Medical Department, Clinical Research and Evidence-Based Medicine Unit, Aristotle University of Thessaloniki, Konstantinoupoleos 49, 54642 Thessaloniki, Greece; Harris Manchester College, University of Oxford, Mansfield Rd, Oxford, OX1 3TD, UK
| | - Evangelia Ntzani
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, University Campus, Stavros Niarchos Av., Ioannina, Greece; Center for Evidence Synthesis in Health, Department of Health Services, Policy and Practice, School of Public Health, Brown University, 121 South Main Street, Providence, RI 02903, USA
| | - Anna-Bettina Haidich
- Department of Hygiene and Epidemiology, Medical School, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece.
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Abu-Omar K, Rütten A, Burlacu I, Schätzlein V, Messing S, Suhrcke M. The cost-effectiveness of physical activity interventions: A systematic review of reviews. Prev Med Rep 2017; 8:72-78. [PMID: 28856084 PMCID: PMC5573782 DOI: 10.1016/j.pmedr.2017.08.006] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 07/11/2017] [Accepted: 08/15/2017] [Indexed: 11/24/2022] Open
Abstract
Background Despite growing recognition of the need to promote physical activity, the existing evidence base on the cost-effectiveness of relevant interventions appears scant and scattered. This systematic review of reviews set out to take stock of the evidence on the cost-effectiveness of physical activity interventions. Methods Ten literature databases were systematically searched for available reviews on the cost-effectiveness of physical activity interventions, complemented by a hand search. Out of the 515 articles identified, 18 reviews met the inclusion criteria. A quality appraisal of the 18 reviews was undertaken. Results Of the 18 reviews, 4 contained information on the target group of children and adolescents, 12 on adults, 3 on older adults, and 6 on the general population. Across the reviews some intervention strategies were identified as being particularly cost-effective, including certain school-based interventions (children and adolescents), interventions using pedometers (adults), fall prevention programs (older people), mass media campaigns and environmental approaches (general population). However, for some of these approaches (e.g. mass media campaigns), the underlying evidence of being able to change physical activity behavior remains inconsistent. Conclusion Available evidence for the cost-effectiveness of physical activity interventions is scattered, but points towards the cost-effectiveness of certain interventions. Until this moment, cost-effectiveness has more often been studied for individual-level interventions. This is potentially due to some methodological challenges in assessing the cost-effectiveness of population-based interventions. The review of review indicates cost-effectiveness of physical activity interventions Brief interventions in the health care setting, are cost-effective Pedometer based interventions are cost-effective Environmental approaches are cost-effective There remain some methodological challenges in evaluating cost-effectiveness
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Faillie JL, Ferrer P, Gouverneur A, Driot D, Berkemeyer S, Vidal X, Martínez-Zapata MJ, Huerta C, Castells X, Rottenkolber M, Schmiedl S, Sabaté M, Ballarín E, Ibáñez L. A new risk of bias checklist applicable to randomized trials, observational studies, and systematic reviews was developed and validated to be used for systematic reviews focusing on drug adverse events. J Clin Epidemiol 2017; 86:168-175. [PMID: 28487158 DOI: 10.1016/j.jclinepi.2017.04.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 03/30/2017] [Accepted: 04/25/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The objective of the study was to develop and validate an adequate tool to evaluate the risk of bias of randomized controlled trials, observational studies, and systematic reviews assessing drug adverse events. STUDY DESIGN AND SETTING We developed a structured risk of bias checklist applicable to randomized trials, cohort, case-control and nested case-control studies, and systematic reviews focusing on drug safety. Face and content validity was judged by three experienced reviewers. Interrater and intrarater reliability were determined using 20 randomly selected studies, assessed by three other independent reviewers including one performing a 3-week retest. RESULTS The developed checklist examines eight domains: study design and objectives, selection bias, attrition, adverse events information bias, other information bias, statistical methods to control confounding, other statistical methods, and conflicts of interest. The total number of questions varied from 10 to 32 depending on the study design. Interrater and intrarater agreements were fair with Kendall's W of 0.70 and 0.74, respectively. Median time to complete the checklist was 8.5 minutes. CONCLUSION The developed checklist showed face and content validity and acceptable reliability to assess the risk of bias for studies analyzing drug adverse events. Hence, it might be considered as a novel useful tool for systematic reviews and meta-analyses focusing on drug safety.
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Affiliation(s)
- Jean-Luc Faillie
- Laboratory of Biostatistics, Epidemiology and Public Health (EA2415), Faculty of Medicine, Institut Universitaire de Recherche Clinique, University of Montpellier, 641 Avenue du Doyen Gaston Giraud, Montpellier 34093, France; Department of Medical Pharmacology and Toxicology, CHU Montpellier University Hospital, 371 Avenue du Doyen Gaston Giraud, Montpellier 34295, France
| | - Pili Ferrer
- Catalan Institute of Pharmacology Foundation (FICF), Department of Pharmacology Therapeutics and Toxicology, Autonomous University of Barcelona, Clinical Pharmacology Unit, Vall d'Hebron University Hospital, Pg. Vall d'Hebron 119-129, Barcelona 08035, Spain
| | - Amandine Gouverneur
- Univ. Bordeaux, Inserm UMR 1219, CHU de Bordeaux, Pôle de Santé Publique, Service de l'Information Médicale, 146 Rue Léo Saignat, Bordeaux 33076, France
| | - Damien Driot
- Department of Clinical and Medical Pharmacology, CHU Toulouse University Hospital, University of Toulouse, 37 Allées Jules-Guesde, Toulouse 31000, France
| | - Shoma Berkemeyer
- Department of Community Health, Hochschule fuer Gesundheit, Gesundheitscampus 6-8, North Rhine-Westphalia, Bochum 44801, Germany
| | - Xavier Vidal
- Catalan Institute of Pharmacology Foundation (FICF), Department of Pharmacology Therapeutics and Toxicology, Autonomous University of Barcelona, Clinical Pharmacology Unit, Vall d'Hebron University Hospital, Pg. Vall d'Hebron 119-129, Barcelona 08035, Spain
| | - Maria José Martínez-Zapata
- Iberoamerican Cochrane Centre, Institute of Biomedical Research (IIB Sant Pau), Barcelona, CIBER de Epidemiología y Salud Pública (CIBERESP), Sant Antoni Maria Claret 167, Barcelona 08025, Spain
| | - Consuelo Huerta
- Pharmacoepidemiology and Pharmacovigilance Division, Medicines for Human Use Department, Spanish Agency of Medicinal Products and Medical Devices (AEMPS), Calle Campezo 1, Madrid E28022, Spain
| | - Xavier Castells
- TransLab Research Group, Department of Medical Sciences, University of Girona, Girona, Spain
| | - Marietta Rottenkolber
- Diabetes Research Group, Medizinische Klinik und Poliklinik IV, Klinikum der Universitaet, Pettenkoferstrasse 8A, Munich 81377, Germany
| | - Sven Schmiedl
- Department of Clinical Pharmacology, School of Medicine, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Strasse 50, Witten D-58448, Germany; Philipp Klee-Institute for Clinical Pharmacology, HELIOS Clinic Wuppertal, Heusnerstrasse 40, Wuppertal D-42283, Germany
| | - Mònica Sabaté
- Catalan Institute of Pharmacology Foundation (FICF), Department of Pharmacology Therapeutics and Toxicology, Autonomous University of Barcelona, Clinical Pharmacology Unit, Vall d'Hebron University Hospital, Pg. Vall d'Hebron 119-129, Barcelona 08035, Spain
| | - Elena Ballarín
- Catalan Institute of Pharmacology Foundation (FICF), Department of Pharmacology Therapeutics and Toxicology, Autonomous University of Barcelona, Clinical Pharmacology Unit, Vall d'Hebron University Hospital, Pg. Vall d'Hebron 119-129, Barcelona 08035, Spain
| | - Luisa Ibáñez
- Catalan Institute of Pharmacology Foundation (FICF), Department of Pharmacology Therapeutics and Toxicology, Autonomous University of Barcelona, Clinical Pharmacology Unit, Vall d'Hebron University Hospital, Pg. Vall d'Hebron 119-129, Barcelona 08035, Spain.
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Choi J, Lee M, Lee JK, Kang D, Choi JY. Correlates associated with participation in physical activity among adults: a systematic review of reviews and update. BMC Public Health 2017; 17:356. [PMID: 28438146 PMCID: PMC5404309 DOI: 10.1186/s12889-017-4255-2] [Citation(s) in RCA: 163] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Accepted: 04/11/2017] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Understanding which factors influence participation in physical activity is important to improve the public health. The aim of the present review of reviews was to summarize and present updated evidence on personal and environmental factors associated with physical activity. METHODS MEDLINE and EMBASE were searched for reviews published up to 31 Jan. 2017 reporting on potential factors of physical activity in adults aged over 18 years. The quality of each review was appraised with the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) checklist. The corrected covered area (CCA) was calculated as a measure of overlap for the primary publications in each review. RESULTS Twenty-five articles met the inclusion criteria which reviewed 90 personal and 27 environmental factors. The average quality of the studies was moderate, and the CCA ranged from 0 to 4.3%. For personal factors, self-efficacy was shown as the strongest factor for participation in physical activity (7 out of 9). Intention to exercise, outcome expectation, perceived behavioral control and perceived fitness were positively associated with physical activity in more than 3 reviews, while age and bad status of health or fitness were negatively associated with participation in physical activity in more than 3 reviews. For environmental factors, accessibility to facilities, presence of sidewalks, and aesthetics were positively associated with participation in physical activity. CONCLUSIONS The findings of this review of reviews suggest that some personal and environmental factors were related with participation in physical activity. However, an association of various factors with physical activity could not be established because of the lack of primary studies to build up the organized evidence. More studies with a prospective design should be conducted to understand the potential causes for physical activity.
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Affiliation(s)
- Jaesung Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Miyoung Lee
- College of Physical Education and Sport Science, Kookmin University, 77 Jeongneung-ro, Seongbuk-gu, Seoul, 02707, Korea
| | - Jong-Koo Lee
- JW Lee Center for Global Medicine, Seoul National University College of Medicine, 71 Ihwhajang-gil, Jongno-gu, Seoul, 03087, Korea.,Department of Family Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Daehee Kang
- Department of Biomedical Sciences, Seoul National University Graduate School, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.,Institute of Environmental Medicine, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.,Department of Preventive Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.,Cancer Research Institute, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Ji-Yeob Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Korea. .,Department of Preventive Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Korea. .,Cancer Research Institute, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
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Fernandes RM, Cary M, Duarte G, Jesus G, Alarcão J, Torre C, Costa S, Costa J, Carneiro AV. Effectiveness of needle and syringe Programmes in people who inject drugs - An overview of systematic reviews. BMC Public Health 2017; 17:309. [PMID: 28399843 PMCID: PMC5387338 DOI: 10.1186/s12889-017-4210-2] [Citation(s) in RCA: 144] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 03/31/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Needle and syringe programmes (NSP) are a critical component of harm reduction interventions among people who inject drugs (PWID). Our primary objective was to summarize the evidence on the effectiveness of NSP for PWID in reducing blood-borne infection transmission and injecting risk behaviours (IRB). METHODS We conducted an overview of systematic reviews that included PWID (excluding prisons and consumption rooms), addressed community-based NSP, and provided estimates of the effect regarding incidence/prevalence of Human Immunodeficiency Virus (HIV), Hepatitis C virus (HCV), Hepatitis B virus (HBV) and bacteremia/sepsis, and/or measures of IRB. Systematic literature searches were undertaken on relevant databases, including EMBASE, MEDLINE, and PsychINFO (up to May 2015). For each review we identified relevant studies and extracted data on methods, and findings, including risk of bias and quality of evidence assessed by review authors. We evaluated the risk of bias of each systematic review using the ROBIS tool. We categorized reviews by reported outcomes and use of meta-analysis; no additional statistical analysis was performed. RESULTS We included thirteen systematic reviews with 133 relevant unique studies published between 1989 and 2012. Reported outcomes related to HIV (n = 9), HCV (n = 8) and IRB (n = 6). Methods used varied at all levels of design and conduct, with four reviews performing meta-analysis. Only two reviews were considered to have low risk of bias using the ROBIS tool, and most included studies were evaluated as having low methodological quality by review authors. We found that NSP was effective in reducing HIV transmission and IRB among PWID, while there were mixed results regarding a reduction of HCV infection. Full harm reduction interventions provided at structural level and in multi-component programmes, as well as high level of coverage, were more beneficial. CONCLUSIONS The heterogeneity and the overall low quality of evidence highlights the need for future community-level studies of adequate design to support these results. TRIAL REGISTRATION The protocol of this systematic review was registered in Prospective Register of Systematic Reviews (PROSPERO 2015: CRD42015026145 ).
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Affiliation(s)
- Ricardo M Fernandes
- Center for Evidence-Based Medicine, Faculty of Medicine, University of Lisbonl, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal
- Portuguese Collaborating Centre of the IberoAmerican Cochrane Network-Cochrane Portugal Faculty of Medicine, University of Lisbon, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal
| | - Maria Cary
- Centre for Health Evaluation & Research (CEFAR), National Association of Pharmacies, Rua Marechal Saldanha, n°1, 1249-069 Lisbon, Portugal
| | - Gonçalo Duarte
- Center for Evidence-Based Medicine, Faculty of Medicine, University of Lisbonl, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal
| | - Gonçalo Jesus
- Center for Evidence-Based Medicine, Faculty of Medicine, University of Lisbonl, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal
| | - Joana Alarcão
- Center for Evidence-Based Medicine, Faculty of Medicine, University of Lisbonl, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal
| | - Carla Torre
- Centre for Health Evaluation & Research (CEFAR), National Association of Pharmacies, Rua Marechal Saldanha, n°1, 1249-069 Lisbon, Portugal
| | - Suzete Costa
- Centre for Health Evaluation & Research (CEFAR), National Association of Pharmacies, Rua Marechal Saldanha, n°1, 1249-069 Lisbon, Portugal
| | - João Costa
- Center for Evidence-Based Medicine, Faculty of Medicine, University of Lisbonl, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal
- Portuguese Collaborating Centre of the IberoAmerican Cochrane Network-Cochrane Portugal Faculty of Medicine, University of Lisbon, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal
| | - António Vaz Carneiro
- Center for Evidence-Based Medicine, Faculty of Medicine, University of Lisbonl, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal
- Portuguese Collaborating Centre of the IberoAmerican Cochrane Network-Cochrane Portugal Faculty of Medicine, University of Lisbon, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal
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Nielsen SM, Tarp S, Christensen R, Bliddal H, Klokker L, Henriksen M. The risk associated with spinal manipulation: an overview of reviews. Syst Rev 2017; 6:64. [PMID: 28340595 PMCID: PMC5366149 DOI: 10.1186/s13643-017-0458-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 03/15/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Spinal manipulative therapy (SMT) is a widely used manual treatment, but many reviews exist with conflicting conclusions about the safety of SMT. We performed an overview of reviews to elucidate and quantify the risk of serious adverse events (SAEs) associated with SMT. METHODS We searched five electronic databases from inception to December 8, 2015. We included reviews on any type of studies, patients, and SMT technique. Our primary outcome was SAEs. Quality of the included reviews was assessed using a measurement tool to assess systematic reviews (AMSTAR). Since there were insufficient data for calculating incidence rates of SAEs, we used an alternative approach; the conclusions regarding safety of SMT were extracted for each review, and the communicated opinion were judged by two reviewers independently as safe, harmful, or neutral/unclear. Risk ratios (RRs) of a review communicating that SMT is safe and meeting the requirements for each AMSTAR item, were calculated. RESULTS We identified 283 eligible reviews, but only 118 provided data for synthesis. The most frequently described adverse events (AEs) were stroke, headache, and vertebral artery dissection. Fifty-four reviews (46%) expressed that SMT is safe, 15 (13%) expressed that SMT is harmful, and 49 reviews (42%) were neutral or unclear. Thirteen reviews reported incidence estimates for SAEs, roughly ranging from 1 in 20,000 to 1 in 250,000,000 manipulations. Low methodological quality was present, with a median of 4 of 11 AMSTAR items met (interquartile range, 3 to 6). Reviews meeting the requirements for each of the AMSTAR items (i.e. good internal validity) had a higher chance of expressing that SMT is safe. CONCLUSIONS It is currently not possible to provide an overall conclusion about the safety of SMT; however, the types of SAEs reported can indeed be significant, sustaining that some risk is present. High quality research and consistent reporting of AEs and SAEs are needed. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42015030068 .
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Affiliation(s)
- Sabrina Mai Nielsen
- The Parker Institute, Copenhagen University Hospital, Frederiksberg & Bispebjerg, Frederiksberg, 2000, Denmark
| | - Simon Tarp
- The Parker Institute, Copenhagen University Hospital, Frederiksberg & Bispebjerg, Frederiksberg, 2000, Denmark
| | - Robin Christensen
- The Parker Institute, Copenhagen University Hospital, Frederiksberg & Bispebjerg, Frederiksberg, 2000, Denmark
| | - Henning Bliddal
- Clinical Research Unit, The Parker Institute, Copenhagen University Hospital, Frederiksberg & Bispebjerg, Frederiksberg, 2000, Denmark
| | - Louise Klokker
- The Parker Institute, Copenhagen University Hospital, Frederiksberg & Bispebjerg, Frederiksberg, 2000, Denmark
| | - Marius Henriksen
- Physiotherapy and Biomechanics Research Unit, The Parker Institute, Copenhagen University Hospital, Frederiksberg & Bispebjerg, Frederiksberg, 2000, Denmark.
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Ballard M, Montgomery P. Risk of bias in overviews of reviews: a scoping review of methodological guidance and four-item checklist. Res Synth Methods 2017; 8:92-108. [PMID: 28074553 DOI: 10.1002/jrsm.1229] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 08/16/2016] [Accepted: 09/27/2016] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To assess the conditions under which employing an overview of systematic reviews is likely to lead to a high risk of bias. STUDY DESIGN To synthesise existing guidance concerning overview practice, a scoping review was conducted. Four electronic databases were searched with a pre-specified strategy (PROSPERO 2015:CRD42015027592) ending October 2015. Included studies needed to describe or develop overview methodology. Data were narratively synthesised to delineate areas highlighted as outstanding challenges or where methodological recommendations conflict. RESULTS Twenty-four papers met the inclusion criteria. There is emerging debate regarding overlapping systematic reviews; systematic review scope; quality of included research; updating; and synthesizing and reporting results. While three functions for overviews have been proposed-identify gaps, explore heterogeneity, summarize evidence-overviews cannot perform the first; are unlikely to achieve the second and third simultaneously; and can only perform the third under specific circumstances. Namely, when identified systematic reviews meet the following four conditions: (1) include primary trials that do not substantially overlap, (2) match overview scope, (3) are of high methodological quality, and (4) are up-to-date. CONCLUSION Considering the intended function of proposed overviews with the corresponding methodological conditions may improve the quality of this burgeoning publication type. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Madeleine Ballard
- Centre for Evidence-Based Intervention, University of Oxford, Oxford, UK
| | - Paul Montgomery
- Centre for Evidence-Based Intervention, University of Oxford, Oxford, UK
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Abstract
Purpose
A significant proportion of the world’s adult population is insufficiently active. One approach used to overcome barriers and facilitate participation in physical activity is social marketing. The purpose of this paper are twofold: first, this review seeks to provide a contemporary review of social marketing’s effectiveness in changing physical activity for the better; and second, it seeks to ascertain the extent that Andreasen’s (2002) six social marketing benchmark criteria have been applied in social marketing interventions targeting physical activity.
Design/methodology/approach
In total, 94 articles covering 26 social marketing interventions were identified following systematic literature review procedures.
Findings
None of the interventions gave evidence that they addressed all six social marketing benchmark criteria, and only four interventions addressed five criteria. The results indicate that three of the benchmark criteria, namely, behavioural objectives, formative research, and marketing mix are well utilised in social marketing interventions. Inclusion of market segmentation, exchange and competition offers potential to extend further on social marketing’s effectiveness in increasing physical activity.
Originality/value
The results of the current study indicate that increasing the number of benchmark criteria used in an intervention to at least four increases the chances of achieving positive behavioural outcomes.
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An evaluation of harvest plots to display results of meta-analyses in overviews of reviews: a cross-sectional study. BMC Med Res Methodol 2015; 15:91. [PMID: 26502717 PMCID: PMC4623293 DOI: 10.1186/s12874-015-0084-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Accepted: 10/15/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Harvest plots are used to graphically display evidence from complex and diverse studies or results. Overviews of reviews bring together evidence from two or more systematic reviews. Our objective was to determine the feasibility of using harvest plots to depict complex results of overviews of reviews. METHODS We conducted a survey of 279 members of Cochrane Child Health to determine their preferences for graphical display of data, and their understanding of data presented in the form of harvest plots. Preferences were rated on a scale of 0-100 (100 most preferred) and tabulated using descriptive statistics. Knowledge and accuracy were assessed by tabulating the number of correctly answered questions for harvest plots and traditional data summary tables; t-tests were used to compare responses between formats. RESULTS 53 individuals from 7 countries completed the survey (19%): 60% were females; the majority had an MD (38%), PhD (47%), or equivalent. Respondents had published a median of 3 systematic reviews (inter-quartile range 1 to 8). There were few differences between harvest plots and tables in terms of being: well-suited to summarize and display results from meta-analysis (52 vs. 56); easy to understand (53 vs. 51); and, intuitive (49 vs. 44). Harvest plots were considered more aesthetically pleasing (56 vs. 44, p = 0.03). 40% felt the harvest plots could be used in conjunction with tables to display results from meta-analyses; additionally, 45% felt the harvest plots could be used with some improvement. There was no statistically significant difference in percentage of knowledge questions answered correctly for harvest plots compared with tables. When considering both types of data display, 21% of knowledge questions were answered incorrectly. CONCLUSIONS Neither harvest plots nor standard summary tables were ranked highly in terms of being easy to understand or intuitive, reflecting that neither format is ideal to summarize the results of meta-analyses in overviews of reviews. Responses to knowledge questions showed some misinterpretation of results of meta-analyses. Reviewers should ensure that messages are clearly articulated and summarized in the text to avoid misinterpretation.
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Howard-Wilsher S, Irvine L, Fan H, Shakespeare T, Suhrcke M, Horton S, Poland F, Hooper L, Song F. Systematic overview of economic evaluations of health-related rehabilitation. Disabil Health J 2015; 9:11-25. [PMID: 26440556 DOI: 10.1016/j.dhjo.2015.08.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 07/08/2015] [Accepted: 08/14/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND Health related rehabilitation is instrumental in improving functioning and promoting participation by people with disabilities. To make clinical and policy decisions about health-related rehabilitation, resource allocation and cost issues need to be considered. OBJECTIVES To provide an overview of systematic reviews (SRs) on economic evaluations of health-related rehabilitation. METHODS We searched multiple databases to identify relevant SRs of economic evaluations of health-related rehabilitation. Review quality was assessed by AMSTAR checklist. RESULTS We included 64 SRs, most of which included economic evaluations alongside randomized controlled trials (RCTs). The review quality was low to moderate (AMSTAR score 5-8) in 35, and high (score 9-11) in 29 of the included SRs. The included SRs addressed various health conditions, including spinal or other pain conditions (n = 14), age-related problems (11), stroke (7), musculoskeletal disorders (6), heart diseases (4), pulmonary (3), mental health problems (3), and injury (3). Physiotherapy was the most commonly evaluated rehabilitation intervention in the included SRs (n = 24). Other commonly evaluated interventions included multidisciplinary programmes (14); behavioral, educational or psychological interventions (11); home-based interventions (11); complementary therapy (6); self-management (6); and occupational therapy (4). CONCLUSIONS Although the available evidence is often described as limited, inconsistent or inconclusive, some rehabilitation interventions were cost-effective or showed cost-saving in a variety of disability conditions. Available evidence comes predominantly from high income countries, therefore economic evaluations of health-related rehabilitation are urgently required in less resourced settings.
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Affiliation(s)
| | - Lisa Irvine
- Faculty of Medicine and Health Science, University of East Anglia, Norwich, UK
| | - Hong Fan
- School of Public Health, Nanjing Medical University, Nanjing, PR China
| | - Tom Shakespeare
- Faculty of Medicine and Health Science, University of East Anglia, Norwich, UK
| | - Marc Suhrcke
- Faculty of Medicine and Health Science, University of East Anglia, Norwich, UK; Centre for Health Economics, University of York, York, UK
| | - Simon Horton
- Faculty of Medicine and Health Science, University of East Anglia, Norwich, UK
| | - Fiona Poland
- Faculty of Medicine and Health Science, University of East Anglia, Norwich, UK
| | - Lee Hooper
- Faculty of Medicine and Health Science, University of East Anglia, Norwich, UK
| | - Fujian Song
- Faculty of Medicine and Health Science, University of East Anglia, Norwich, UK.
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State of the Art on the Evidence Base in Cardiac Regenerative Therapy: Overview of 41 Systematic Reviews. BIOMED RESEARCH INTERNATIONAL 2015; 2015:613782. [PMID: 26176013 PMCID: PMC4484838 DOI: 10.1155/2015/613782] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 03/16/2015] [Indexed: 02/05/2023]
Abstract
Objectives. To provide a comprehensive appraisal of the evidence from secondary research on cardiac regenerative therapy. Study Design and Setting. Overview of systematic reviews of controlled clinical trials concerning stem cell administration or mobilization in patients with cardiovascular disease. Results. After a systematic database search, we short-listed 41 reviews (660 patients). Twenty-two (54%) reviews focused on acute myocardial infarction (AMI), 19 (46%) on chronic ischemic heart disease (IHD) or heart failure (HF), 29 (71%) on bone marrow-derived stem-cells (BMSC), and 36 (88%) to randomized trials only. Substantial variability among reviews was found for validity (AMSTAR score: median 9 [minimum 3]; 1st quartile 9; 3rd quartile 10; maximum 11), effect estimates (change in ejection fraction from baseline to follow-up: 3.47% [0.02%; 2.90%; 4.22%; 6.11%]), and citations (Web of Science yearly citations: 4.1 [0; 2.2; 6.5; 68.9]). No significant association was found between these three features. However, reviews focusing on BMSC therapy had higher validity scores (P = 0.008) and showed more pronounced effect estimates (P = 0.002). Higher citations were associated with journal impact factor (P = 0.007), corresponding author from North America/Europe (P = 0.022), and inclusion of nonrandomized trials (P = 0.046). Conclusions. Substantial heterogeneity is apparent among these reviews in terms of quality and effect estimates.
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Robinson J, Thomson D. Connecting with our readers--a look at what is most often downloaded. EVIDENCE-BASED CHILD HEALTH : A COCHRANE REVIEW JOURNAL 2014; 9:299-300. [PMID: 25404603 DOI: 10.1002/ebch.1969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Joan Robinson
- Department of Pediatrics, University of Alberta and Stollery Children's Hospital, Edmonton, Alberta, Canada
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