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Lunny C, Kanji S, Thabet P, Haidich AB, Bougioukas KI, Pieper D. Assessing the methodological quality and risk of bias of systematic reviews: primer for authors of overviews of systematic reviews. BMJ MEDICINE 2024; 3:e000604. [PMID: 38826514 PMCID: PMC11141200 DOI: 10.1136/bmjmed-2023-000604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 05/03/2024] [Indexed: 06/04/2024]
Affiliation(s)
- Carole Lunny
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
- Cochrane Hyptertension Review Group, Cochrane Canada, Vancouver, BC, Canada
| | - Salmaan Kanji
- Ottawa Hospital, Ottawa, ON, Canada
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Pierre Thabet
- School of Pharmaceutical Sciences University of Ottawa, Hôpital Montfort, Ottawa, ON, Canada
| | - Anna-Bettina Haidich
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, Aristotle University of Thessaloniki Faculty of Health Sciences, Thessaloniki, Central Macedonia, Greece
| | - Konstantinos I Bougioukas
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, Aristotle University of Thessaloniki Faculty of Health Sciences, Thessaloniki, Central Macedonia, Greece
| | - Dawid Pieper
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane Ruppin Clinics, Neuruppin, Brandenburg, Germany
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2
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Liang J, Yang Y, He P, Mandizadza OO, Zhang W, Lin S, Ji C. Treatment of multiple myeloma based on autologous stem cell transplant: An overview of systematic reviews. Medicine (Baltimore) 2023; 102:e35456. [PMID: 37800752 PMCID: PMC10553094 DOI: 10.1097/md.0000000000035456] [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: 07/04/2023] [Accepted: 09/11/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Multiple myeloma (MM) is a malignant plasma cell disease. In recent years, several systematic reviews, and meta-analyses have been published on treatment protocols, including autologous stem cell transplantation for MM. METHODS Web of Science, PubMed, Embase, and Cochrane Library were searched to systematically summarize the quality of the methodology and evidence of meta-analyses regarding treatment of MM including autologous stem cell transplantation. RESULTS Total 11 meta-analyses were included. The preferred reporting items for systematic reviews and meta-analyses evaluation revealed that the quality of included reviews was affected by possible unevaluated bias between studies and the lack of protocol and registration. The AMSTAR2 scale indicated that the quality of the methodology of included reviews ranged from very low to moderate. The grading, assessment, development, and evaluation of recommendations evaluation showed that among the included outcome indicators, most of them are of low quality. CONCLUSION This overview suggested that the combination of drugs has improved patient survival rates, efficacy and safety compared with the standard regimen. However, the strength of the evidence is uneven and due to methodological errors, the results should be interpreted with caution in order to provide a reference for further improvement of the study design. The methodological quality of the relevant meta-analysis needs to be further improved.
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Affiliation(s)
- Juan Liang
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, P.R. China
| | - Ying Yang
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, P.R. China
| | - Peijie He
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, P.R. China
| | | | - Wanjun Zhang
- The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, P.R. China
| | - Shengyun Lin
- The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, P.R. China
| | - Conghua Ji
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, P.R. China
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3
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Bracchiglione J, Meza N, Pérez-Carrasco I, Vergara-Merino L, Madrid E, Urrútia G, Bonfill Cosp X. A methodological review finds mismatch between overall and pairwise overlap analysis in a sample of overviews. J Clin Epidemiol 2023; 159:31-39. [PMID: 37164290 DOI: 10.1016/j.jclinepi.2023.05.006] [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: 02/18/2023] [Revised: 04/30/2023] [Accepted: 05/01/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVES Overlap of primary studies is a key methodological challenge for overviews. There are limited reports of methods used to address overlap, and there is no detailed assessment of the corrected covered area (CCA) of a representative sample of overviews. To describe the approaches used to address overlap, and to estimate the overall and pairwise CCA. METHODS We searched PubMed for overviews published in 2018. Two authors conducted the screening process. We described the strategy used for assessing overlap, and calculated overall and pairwise CCA for each overview. RESULTS We analyzed a random sample of 30 out of 89 eligible articles. Eleven did not address the overlap. Of the remainder, most frequent strategies were visual assessment and discussion of overlap as a limitation. Median overall CCA among the included overviews was 6.7%. The pairwise analysis showed that 52.8% of SR pairs had slight overlap, while 28.3% had very high overlap. CONCLUSION Reported strategies for addressing overlap vary considerably among overview authors. The pairwise approach for assessing the CCA revealed highly overlapped pairs of SRs in overviews with overall slight overlap and vice versa. We encourage authors to complement the overall CCA assessment with a pairwise approach.
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Affiliation(s)
- Javier Bracchiglione
- Iberoamerican Cochrane Centre, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain; Interdisciplinary Centre for Health Studies (CIESAL), Universidad de Valparaíso, Viña del Mar, Chile; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Nicolás Meza
- Interdisciplinary Centre for Health Studies (CIESAL), Universidad de Valparaíso, Viña del Mar, Chile
| | | | - Laura Vergara-Merino
- Interdisciplinary Centre for Health Studies (CIESAL), Universidad de Valparaíso, Viña del Mar, Chile
| | - Eva Madrid
- Interdisciplinary Centre for Health Studies (CIESAL), Universidad de Valparaíso, Viña del Mar, Chile
| | - Gerard Urrútia
- Iberoamerican Cochrane Centre, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Xavier Bonfill Cosp
- Iberoamerican Cochrane Centre, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Universitat Autònoma de Barcelona, Barcelona, Spain
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4
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Maier CB, Winkelmann J, Pfirter L, Williams GA. Skill-Mix Changes Targeting Health Promotion and Prevention Interventions and Effects on Outcomes in all Settings (Except Hospitals): Overview of Reviews. Int J Public Health 2023; 68:1605448. [PMID: 37228895 PMCID: PMC10203245 DOI: 10.3389/ijph.2023.1605448] [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: 10/01/2022] [Accepted: 04/14/2023] [Indexed: 05/27/2023] Open
Abstract
Objectives: Skill-mix changes to step up health promotion and prevention are increasing, but there is limited evidence on their effects. Methods: Overview of reviews, based on a protocol. The search was carried out in six databases, screening was performed ensuring high interrater reliability. All countries, health professions and lay workers in all settings (except hospitals) were included, quality appraisals performed. Results: A total of 31 systematic reviews were included. Expanded roles performing outreach (e.g., home visits) had mostly positive effects on access and health outcomes, primarily for hard-to-reach groups. Task-shifting in colorectal or skin cancer screenings (performed by advanced practice nurses) were suggested effective; supporting roles (by community health workers) increased uptake in screenings, but based on limited evidence. Expanded roles of various professions focusing on lifestyle modification showed promising effects in most reviews, including weight, diet, smoking cessation and physical activity. Reviews on cost-effectiveness were based on limited evidence. Conclusion: Promising skill-mix changes included expanded roles providing lifestyle modifying interventions, task-shifting, and outreach roles for hard-to-reach groups, whereas evidence on costs was limited.
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Affiliation(s)
- Claudia Bettina Maier
- Department of Health Care Management, Faculty of Economics and Management, Technical University Berlin, Berlin, Germany
| | | | - Laura Pfirter
- Department of Health Care Management, Faculty of Economics and Management, Technical University Berlin, Berlin, Germany
| | - Gemma A. Williams
- European Observatory on Health Systems and Policies, London School of Economics and Political Science, London, United Kingdom
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5
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D'Souza P, Phagdol T, D'Souza SRB, D S A, Nayak BS, Velayudhan B, Bailey JV, Stephenson J, Oliver S. Interventions to support contraceptive choice and use: a global systematic map of systematic reviews. EUR J CONTRACEP REPR 2023; 28:83-91. [PMID: 36802955 DOI: 10.1080/13625187.2022.2162337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
BACKGROUND To review the highest level of available evidence, a systematic map identified systematic reviews that evaluated the effectiveness of interventions to improve contraception choice and increase contraception use. METHODS Systematic reviews published since 2000 were identified from searches of nine databases. Data were extracted using a coding tool developed for this systematic map. Methodological quality of included reviews was assessed using AMSTAR 2 criteria. FINDINGS AND CONCLUSION Fifty systematic reviews reported evaluations of interventions for contraception choice and use addressing three domains (individual, couples, community); Meta-analyses in 11 of the reviews mostly addressed interventions for individuals. We identified 26 reviews covering High Income Countries, 12 reviews covering Low Middle-Income Countries and the rest a mix of both. Most reviews (15) focussed on psychosocial interventions, followed by incentives (6) and m-health interventions (6). The strongest evidence from meta-analyses is for the effectiveness of motivational interviewing, contraceptive counselling, psychosocial interventions, school-based education, and interventions promoting contraceptive access, demand-generation interventions (community and facility based, financial mechanisms and mass media), and mobile phone message interventions. Even in resource constrained settings, community-based interventions can increase contraceptive use. There are gaps in the evidence on interventions for contraception choice and use, and limitations in study designs and lack of representativeness. Most approaches focus on individual women rather than couples or wider socio-cultural influences on contraception and fertility. This review identifies interventions which work to increase contraception choice and use, and these could be implemented in school, healthcare or community settings.
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Affiliation(s)
- Preethy D'Souza
- UCL Social Research Institute, University College London, London, UK
| | - Tenzin Phagdol
- Department of Pediatric Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - Sonia R B D'Souza
- Department of Obstetrics and Gynaecological Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - Anupama D S
- Department of Obstetrics and Gynaecological Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - Baby S Nayak
- Department of Pediatric Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - Binil Velayudhan
- Department of Mental Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - Julia V Bailey
- Research Department of Primary Care and Population Health, University College London, Royal Free Hospital, London, UK
| | | | - Sandy Oliver
- UCL Social Research Institute, University College London, London, UK.,Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
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6
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Witzke T, Stojanov A, Ristau J, Berger-Höger B, Lindhardt CL, Balzer K, Rahn AC. Specialised nursing tasks in cancer care and their effects. Pflege 2023; 36:20-30. [PMID: 36602257 DOI: 10.1024/1012-5302/a000927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background: Several reviews are available on the effects of specific nursing tasks in oncology care. However, a synthesis across cancer entities and stages is lacking. Aim: To synthesise the results of reviews assessing the scope and effectiveness of tasks of nurses specifically qualified in cancer care. Methods: We conducted an Umbrella Review based on systematic searches in six databases and a search for grey literature following a priori-defined inclusion criteria. Further steps: standardised data extraction and quality assessment, determination of the degree of overlap, and structured narrative summary on outcome measures of health-related quality of life, symptom burden, utilisation of care services/resources, and patient satisfaction. All reviews were categorised according to the EONS Cancer Nursing Education Framework and the Omaha System Intervention Scheme. Results: After screening 2,657 references, 11 reviews (10 high quality) for a total of 148 studies were included. Specially qualified nurses and advanced practice nurses take on a variety of tasks in the disease process, especially related to education, counselling, and case management. Effects on outcome measures are mixed, with increased indications of reduced symptom burden. Conclusion: Specially qualified nurses with expanded roles have the potential to contribute to improved oncology care. This emphasises the importance of appropriate task profiles and qualification programs. More well-reported studies based on theoretical framework models are needed.
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Affiliation(s)
- Teresa Witzke
- Nursing Research Unit, Institute of Social Medicine and Epidemiology, University of Lübeck, Germany
| | - Adele Stojanov
- Nursing Research Unit, Institute of Social Medicine and Epidemiology, University of Lübeck, Germany
| | - Johanna Ristau
- Nursing Research Unit, Institute of Social Medicine and Epidemiology, University of Lübeck, Germany
| | - Birte Berger-Höger
- Department Evaluation and Implementation Research in Nursing Science, Institute for Public Health and Nursing Research, University of Bremen, Germany
| | - Christina Louise Lindhardt
- Center for Patient Communication, Odense University Hospital, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Katrin Balzer
- Nursing Research Unit, Institute of Social Medicine and Epidemiology, University of Lübeck, Germany
| | - Anne Christin Rahn
- Nursing Research Unit, Institute of Social Medicine and Epidemiology, University of Lübeck, Germany
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7
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Straudi S, Baluardo L, Arienti C, Bozzolan M, Lazzarini SG, Agostini M, Aprile I, Paci M, Casanova E, Marino D, La Rosa G, Bressi F, Sterzi S, Giansanti D, Perrero L, Battistini A, Miccinilli S, Filoni S, Sicari M, Petrozzino S, Solaro CM, Gargano S, Benanti P, Boldrini P, Bonaiuti D, Castelli E, Draicchio F, Falabella V, Galeri S, Gimigliano F, Grigioni M, Mazzoleni S, Mazzon S, Molteni F, Petrarca M, Picelli A, Posteraro F, Senatore M, Turchetti G, Morone G. Effectiveness of robot-assisted arm therapy in stroke rehabilitation: An overview of systematic reviews. NeuroRehabilitation 2022; 51:559-576. [PMID: 36530097 DOI: 10.3233/nre-220027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Robot-assisted arm therapy (RAT) has been used mainly in stroke rehabilitation in the last 20 years with rising expectations and growing evidence summarized in systematic reviews (SRs). OBJECTIVE The aim of this study is to provide an overview of SRs about the effectiveness, within the ICF domains, and safety of RAT in the rehabilitation of adult with stroke compared to other treatments. METHODS The search strategy was conducted using search strings adapted explicitly for each database. A screening base on title and abstract was realized to find all the potentially relevant studies. The methodological quality of the included SRs was assessed using AMSTAR-2. A pre-determined standardized form was used to realize the data extraction. RESULTS 18 SRs were included in this overview. Generally, positive effects from the RAT were found for motor function and muscle strength, whereas there is no agreement for muscle tone effects. No effect was found for pain, and only a SR reported the positive impact of RAT in daily living activity. CONCLUSION RAT can be considered a valuable option to increase motor function and muscle strength after stroke. However, the poor quality of most of the included SRs could limit the certainty around the results.
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Affiliation(s)
- Sofia Straudi
- Department of Neuroscience and Rehabilitation, Ferrara University, Ferrara, Italy
| | - Ludovica Baluardo
- Department of Neuroscience and Rehabilitation, Ferrara University, Ferrara, Italy
| | | | - Michela Bozzolan
- Interdepartmental Educational Service, Azienda Ospedaliero Universitaria S. Anna Ferrara, Ferrara, Italy
| | | | | | - Irene Aprile
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Matteo Paci
- AUSL (Unique Sanitary Local Company) District of Central Tuscany, Florence, Italy
| | - Emanuela Casanova
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Dario Marino
- IRCCS Neurolysis Center "Bonino Pulejo", Messina, Italy
| | | | - Federica Bressi
- Campus Bio-Medico University Hospital Foundation, Rome, Italy
| | - Silvia Sterzi
- Campus Bio-Medico University Hospital Foundation, Rome, Italy
| | - Daniele Giansanti
- National Center for Innovative Technologies in Public Health, Italian National Institute of Health, Rome, Italy
| | - Luca Perrero
- Neurorehabilitation Unit, Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | | | - Serena Filoni
- Padre Pio Onlus Rehabilitation Centers Foundation, San Giovanni Rotondo, Italy
| | - Monica Sicari
- A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | | | | | | | | | - Paolo Boldrini
- Società Italiana di Medicina Fisica e Riabilitativa (SIMFER), Rome, Italy
| | | | - Enrico Castelli
- Department of Paediatric Neurorehabilitation, IRCCS Bambino Gesù Children's Hospital,, Rome, Italy
| | - Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Rome, Italy
| | - Vincenzo Falabella
- Italian Federation of Persons with Spinal Cord Injuries (Faip Onlus), Rome, Italy
| | | | - Francesca Gimigliano
- Department of Mental, Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mauro Grigioni
- National Center for Innovative Technologies in Public Health, Italian National Institute of Health, Rome, Italy
| | - Stefano Mazzoleni
- Department of Electrical and Information Engineering, Politecnico di Bari, Bari, Italy
| | - Stefano Mazzon
- AULSS6 (Unique Sanitary Local Company), Euganea Padova - Distretto 4 "Alta Padovana", Padua, Italy
| | - Franco Molteni
- Department of Rehabilitation Medicine, Villa Beretta Rehabilitation Center, Valduce Hospital, Lecco, Italy
| | - Maurizio Petrarca
- Movement Analysis and Robotics Laboratory (MARlab), IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Alessandro Picelli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Federico Posteraro
- Department of Rehabilitation, Versilia Hospital - AUSL12, Viareggio, Italy
| | - Michele Senatore
- Associazione Italiana dei Terapisti Occupazionali (AITO), Rome, Italy
| | | | - Giovanni Morone
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
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8
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Sardana D, Manchanda S, Ekambaram M, Yang Y, McGrath CP, Yiu CKY. Prevention of demineralization during multi-bracketed fixed orthodontic treatment: An overview of systematic reviews. Int J Paediatr Dent 2022; 32:473-502. [PMID: 34562331 DOI: 10.1111/ipd.12927] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/30/2021] [Accepted: 08/12/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND Demineralization during multi-bracketed fixed orthodontic treatment is a well-known problem. AIM To systematically evaluate the evidence for the prevention of enamel demineralization during multi-bracketed fixed orthodontic treatment. DESIGN Systematic reviews (with or without meta-analysis) that have appraised the primary studies on the prevention of demineralization during multi-bracketed fixed orthodontic treatment were searched systematically and included as per pre-defined eligibility criteria. The risk of bias of the included reviews was assessed by two authors using the ROBIS tool and AMSTAR-2 tool. RESULTS Twenty-nine reviews conducted on 128 exclusive primary studies were included for the present overview; 23 of these reviews were assessed to be of a high risk of overall bias, 5 were of low risk, and 1 review was of unclear risk of bias. CONCLUSIONS Predominantly, the published reviews have focused on fluorides, whereas some reviews have also studied the role of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), reminder therapy, lasers, and sealants. Professional fluorides, sealants, reminder therapy, and lasers might be valuable interventions to prevent demineralization during orthodontic treatment based on the conclusions of reviews with high quality; however, further studies are required to elucidate the role of CPP-ACP, chlorhexidine varnish, and powered toothbrushes.
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Affiliation(s)
- Divesh Sardana
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R., China.,T.H. Chan School of Public Health, Harvard University, Massachusetts, USA
| | - Sheetal Manchanda
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R., China
| | - Manikandan Ekambaram
- Paediatric Dentistry, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Yanqi Yang
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R., China
| | - Colman P McGrath
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R., China
| | - Cynthia K Y Yiu
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R., China
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9
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Zhou Q, Chen J, Yu W, Yang K, Guo T, Niu P, Ye Y, Liu A. The Effectiveness of Duloxetine for Knee Osteoarthritis: An Overview of Systematic Reviews. Front Physiol 2022; 13:906597. [PMID: 35860654 PMCID: PMC9292134 DOI: 10.3389/fphys.2022.906597] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Knee osteoarthritis (KOA) has become a public health problem. Several systematic reviews (SRs) have reported that duloxetine may be an effective treatment for improving pain and depressive symptoms in patients with KOA. Aim: To evaluate the available results and provide scientific evidence for the efficacy and safety of duloxetine for KOA. Methods: A comprehensive search strategy was conducted across eight databases from inception to 31 December 2021. Two researchers independently selected eligible studies, collected data and evaluated those included SRs’ quality. For assessing methodological quality, the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR 2) was employed. Risk of Bias in Systematic Reviews (ROBIS) was used to assess the risk of bias. Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) was utilized for assessing reporting quality. In addition, the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to determine primary outcome indicators’ evidence quality. Results: Totally 6 SRs were contained in this overview. After assessment based on AMSTAR 2, ROBIS, and PRISMA, unsatisfactory results in terms of methodological quality, risk of bias as well as reporting quality, were obtained. Limitations included a search of grey literature, the reasons for selecting the study type, an excluded study list and the specific reasons, reporting bias assessment, and reporting of potential sources of conflict of interest. According to the GRADE results, the evidence quality was high in 0, moderate in 5, low in 19, and very low in 36. Limitations were the most commonly downgraded factor, followed by publication bias and inconsistency. Conclusion: Duloxetine may be an effective treatment for improving pain and depressive symptoms in KOA patients with acceptable adverse events. However, due to the low quality of the available evidence, the original study design and the quality of evidence from SRs should be further improved, so as to provide strong scientific evidence for definitive conclusions. Systematic Review Registration: PROSPERO; (http://www.crd.york.ac.uk/PROSPERO/), identifier (CRD42021289823).
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Affiliation(s)
- Qinxin Zhou
- Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Jixin Chen
- Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Weijie Yu
- Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Kun Yang
- Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Tianci Guo
- Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Puyu Niu
- Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Yuntian Ye
- Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Aifeng Liu
- Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- *Correspondence: Aifeng Liu,
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10
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Aderoba AK, Nasir N, Quigley M, Impey L, Rivero-Arias O, Kurinczuk JJ. Late pregnancy ultrasound parameters identifying fetuses at risk of adverse perinatal outcomes: a protocol for a systematic review of systematic reviews. BMJ Open 2022; 12:e058293. [PMID: 35321896 PMCID: PMC8943771 DOI: 10.1136/bmjopen-2021-058293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Stillbirths and neonatal deaths are leading contributors to the global burden of disease and pregnancy ultrasound has the potential to help decrease this burden. In the absence of high-Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence on universal obstetric ultrasound screening at or close to term, many different screening strategies have been proposed. Systematic reviews have rapidly increased over the past decade owing to the diverse nature of ultrasound parameters and the wide range of possible adverse perinatal outcomes. This systematic review will summarise the evidence on key ultrasound parameters in the published literature to help develop an obstetric ultrasound protocol that identifies pregnancies at risk of adverse perinatal outcomes at or close to term. METHODS This study will follow the recent Cochrane guidelines for a systematic review of systematic reviews. A comprehensive literature search will be conducted using Embase (OvidSP), Medline (OvidSP), CDSR, CINAHL (EBSCOhost) and Scopus. Systematic reviews evaluating at least one ultrasound parameter in late pregnancy to detect pregnancies at risk of adverse perinatal outcomes will be included. Two independent reviewers will screen, assess the quality including the risk of bias using the ROBIS tool, and extract data from eligible systematic reviews that meet the study inclusion criteria. Overlapping data will be assessed and managed with decision rules, and study evidence including the GRADE assessment of the certainty of results will be presented as a narrative synthesis as described in the Cochrane guidelines for an overview of reviews. ETHICS AND DISSEMINATION This research uses publicly available published data; thus, an ethics committee review is not required. The findings will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42021266108.
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Affiliation(s)
- Adeniyi Kolade Aderoba
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, Oxfordshire, UK
- Centre for Population Health and Interdisciplinary Research, HealthMATE 360, Ondo, Nigeria
| | - Naima Nasir
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Univerity of Oxford, Oxford, UK
| | - Maria Quigley
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, Oxfordshire, UK
| | - Lawrence Impey
- Department of Fetal Medicine, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Oliver Rivero-Arias
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, Oxfordshire, UK
| | - Jennifer J Kurinczuk
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, Oxfordshire, UK
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11
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Pérez-Bracchiglione J, Meza N, Bangdiwala SI, Niño de Guzmán E, Urrútia G, Bonfill X, Madrid E. Graphical Representation of Overlap for OVErviews: GROOVE tool. Res Synth Methods 2022; 13:381-388. [PMID: 35278030 DOI: 10.1002/jrsm.1557] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 02/03/2022] [Accepted: 02/26/2022] [Indexed: 11/11/2022]
Abstract
Overlap of primary studies among systematic reviews (SRs) are one of the main methodological challenges when conducting overviews. If not assessed properly, overlapped primary studies may mislead findings, since they may have a major influence either in qualitative analyses or in statistical weight. Moreover, overlapping SRs may represent the existence of duplicated efforts. Matrices of evidence and the calculation of the overall corrected covered area (CCA) are appropriate methods to address this issue, but they seem to be not comprehensive enough. In this article we present GROOVE (Graphical Representation of Overlap for OVErviews), an easy-to-use tool for overview authors. Starting from a matrix of evidence, GROOVE provides the number of included primary studies and SRs included in the matrix; the absolute number of overlapped and non-overlapped primary studies; and an overall CCA assessment. The tool also provides a detailed CCA assessment for each possible pair of SRs (or "nodes"), with a graphical and easy-to-read representation of these results. Additionally, it includes an advanced optional usage, incorporating structural missingness in the matrix. In this article, we show the details about how to use GROOVE, what results it achieves and how the tool obtains these results. GROOVE is intended to improve the overlap assessment by making it easier, faster, and more friendly for both authors and readers. The tool is freely available at http://doi.org/10.17605/OSF.IO/U2MS4 and https://es.cochrane.org/es/groovetool This article is protected by copyright. All rights reserved.
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Affiliation(s)
- J Pérez-Bracchiglione
- Interdisciplinary Centre for Health Studies (CIESAL), Universidad de Valparaíso, Chile.,Iberoamerican Cochrane Centre, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - N Meza
- Interdisciplinary Centre for Health Studies (CIESAL), Universidad de Valparaíso, Chile
| | - S I Bangdiwala
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - E Niño de Guzmán
- Iberoamerican Cochrane Centre, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Spain
| | - G Urrútia
- Iberoamerican Cochrane Centre, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - X Bonfill
- Iberoamerican Cochrane Centre, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - E Madrid
- Interdisciplinary Centre for Health Studies (CIESAL), Universidad de Valparaíso, Chile
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Kim TH, Tian ZY, Liao X, Robinson N. Essential elements required for conducting and structuring an overview of systematic reviews in the field of traditional and complementary medicine. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2021.101605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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13
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Budde H, Williams GA, Winkelmann J, Pfirter L, Maier CB. The role of patient navigators in ambulatory care: overview of systematic reviews. BMC Health Serv Res 2021; 21:1166. [PMID: 34706733 PMCID: PMC8555047 DOI: 10.1186/s12913-021-07140-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 10/06/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Patient navigators have been introduced across various countries to enable timely access to healthcare services and to ensure completion of diagnosis and follow-up of care. There is an increasing evidence on the the role of patient navigation for patients and healthcare systems. The aim of this study was to analyse the evidence on patient navigation interventions in ambulatory care and to evaluate their effects on individuals and health system outcomes. METHODS An overview of reviews was conducted, following a prespecified protocol. All patients in ambulatory care or transitional care setting were included in this review as long as it was related to the role of patient navigators. The study analysed patient navigators covering a wide range of health professionals such as physicians, nurses, pharmacists, social workers and lay health workers or community-based workers with no or very limited training. Studies including patient-related measures and health system-related outcomes were eligible for inclusion. A rigorous search was performed in multiple data bases. After reaching a high inter-rater agreement of 0.86, title and abstract screening was independently performed. Of an initial 14,248 search results and an additional 62 articles identified through the snowballing approach, a total of 7159 hits were eligible for title/abstract screening. 679 articles were included for full-text screening. RESULTS Eleven systematic reviews were included covering various patient navigation intervention in cancer care, disease screening, transitional care and for various chronic conditions and multimorbidity. Nine systematic reviews primarily tailored services to ethnic minorities or other disadvantaged groups. Patient navigators performed tasks such as providing education and counselling, translations, home visits, outreach, scheduling of appointments and follow-up. Eight reviews identified positive outcomes in expanding access to care, in particular for vulnerable patient groups. Two reviews on patient navigation in transitional care reported improved patient outcomes, hospital readmission rates and mixed evidence on quality of life and emergency department visits. Two reviews demonstrated improved patient outcomes for persons with various chronic conditions and multimorbidity. CONCLUSIONS Patient navigators were shown to expand access to screenings and health services for vulnerable patients or population groups with chronic conditions who tend to underuse health services.
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Affiliation(s)
- Hannah Budde
- London School of Economics and Political Science, Houghton St, London, WC2A 2AE, UK.
| | - Gemma A Williams
- European Observatory on Health Systems and Policies, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
| | - Juliane Winkelmann
- Department of Healthcare Management, Technische Universität Berlin, Straße des 17. Juni 135, 10623, Berlin, Germany
| | - Laura Pfirter
- Maecenata Institut für Philanthropie und Zivilgesellschaft in Berlin, Rungestr. 17, D-10179, Berlin, Germany
| | - Claudia B Maier
- Department of Healthcare Management, Technische Universität Berlin, Straße des 17. Juni 135, 10623, Berlin, Germany.
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14
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Salvador-Oliván JA, Marco-Cuenca G, Arquero-Avilés R. Development of an efficient search filter to retrieve systematic reviews from PubMed. J Med Libr Assoc 2021; 109:561-574. [PMID: 34858085 PMCID: PMC8608217 DOI: 10.5195/jmla.2021.1223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Objective: Locating systematic reviews is essential for clinicians and researchers when creating or updating reviews and for decision-making in health care. This study aimed to develop a search filter for retrieving systematic reviews that improves upon the performance of the PubMed systematic review search filter. Methods: Search terms were identified from abstracts of reviews published in Cochrane Database of Systematic Reviews and the titles of articles indexed as systematic reviews in PubMed. Both the precision of the candidate terms and the number of systematic reviews retrieved from PubMed were evaluated after excluding the subset of articles retrieved by the PubMed systematic review filter. Terms that achieved a precision greater than 70% and relevant publication types indexed with MeSH terms were included in the filter search strategy. Results: The search strategy used in our filter added specific terms not included in PubMed's systematic review filter and achieved a 61.3% increase in the number of retrieved articles that are potential systematic reviews. Moreover, it achieved an average precision that is likely greater than 80%. Conclusions: The developed search filter will enable users to identify more systematic reviews from PubMed than the PubMed systematic review filter with high precision.
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Affiliation(s)
| | - Gonzalo Marco-Cuenca
- , Professor, School of Medicine, Department of Library and Information Science, University of Zaragoza, Spain
| | - Rosario Arquero-Avilés
- , Professor, Department of Library and Information Science, Complutense University of Madrid, Madrid, Spain
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15
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Lunny C, Pieper D, Thabet P, Kanji S. Managing overlap of primary study results across systematic reviews: practical considerations for authors of overviews of reviews. BMC Med Res Methodol 2021; 21:140. [PMID: 34233615 PMCID: PMC8265144 DOI: 10.1186/s12874-021-01269-y] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/05/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Overviews often identify and synthesise a large number of systematic reviews on the same topic, which is likely to lead to overlap (i.e. duplication) in primary studies across the reviews. Using a primary study result multiple times in the same analysis overstates its sample size and number of events, falsely leading to greater precision in the analysis. This paper aims to: (a) describe types of overlapping data that arise from the same primary studies reported across multiple reviews, (b) describe methods to identify and explain overlap of primary study data, and (c) present six case studies illustrating different approaches to manage overlap. METHODS We first updated the search in PubMed for methods from the MOoR framework relating to overlap of primary studies. One author screened the studies titles and abstracts, and any full-text articles retrieved, extracted methods data relating to overlap of primary studies and mapped it to the overlap methods from the MOoR framework. We also describe six case studies as examples of overviews that use specific overlap methods across the steps in the conduct of an overview. For each case study, we discuss potential methodological implications in terms of limitations, efficiency, usability, and resource use. RESULTS Nine methods studies were found and mapped to the methods identified by the MOoR framework to address overlap. Overlap methods were mapped across four steps in the conduct of an overview - the eligibility criteria step, the data extraction step, the assessment of risk of bias step, and the synthesis step. Our overview case studies used multiple methods to reduce overlap at different steps in the conduct of an overview. CONCLUSIONS Our study underlines that there is currently no standard methodological approach to deal with overlap in primary studies across reviews. The level of complexity when dealing with overlap can vary depending on the yield, trends and patterns of the included literature and the scope of the overview question. Choosing a method might be dependent on the number of included reviews and their primary studies. Gaps in evaluation of methods to address overlap were found and further investigation in this area is needed.
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Affiliation(s)
- Carole Lunny
- Cochrane Hypertension Group and the Therapeutics Initiative, Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, Canada
| | - Dawid Pieper
- Institute for Research in Operative Medicine, Witten/Herdecke University, Cologne, Germany
| | | | - Salmaan Kanji
- The Ottawa Hospital and Ottawa Hospital Research Institute, Ottawa, Canada
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16
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Mathioudakis AG, Miligkos M, Boccabella C, Alimani GS, Custovic A, Deschildre A, Ducharme FM, Kalayci O, Murray C, Garcia AN, Phipatanakul W, Price D, Sheikh A, Agache IO, Bacharier L, Beloukas A, Bentley A, Bonini M, Castro-Rodriguez JA, De Carlo G, Craig T, Diamant Z, Feleszko W, Felton T, Gern JE, Grigg J, Hedlin G, Hossny EM, Ierodiakonou D, Jartti T, Kaplan A, Lemanske RF, Le Souëf PN, Mäkelä MJ, Mathioudakis GA, Matricardi P, Mitrogiorgou M, Morais-Almeida M, Nagaraju K, Papageorgiou E, Pité H, Pitrez PMC, Pohunek P, Roberts G, Tsiligianni I, Turner S, Vijverberg S, Winders TA, Wong GW, Xepapadaki P, Zar HJ, Papadopoulos NG. Management of asthma in childhood: study protocol of a systematic evidence update by the Paediatric Asthma in Real Life (PeARL) Think Tank. BMJ Open 2021; 11:e048338. [PMID: 34215609 PMCID: PMC8256789 DOI: 10.1136/bmjopen-2020-048338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Clinical recommendations for childhood asthma are often based on data extrapolated from studies conducted in adults, despite significant differences in mechanisms and response to treatments. The Paediatric Asthma in Real Life (PeARL) Think Tank aspires to develop recommendations based on the best available evidence from studies in children. An overview of systematic reviews (SRs) on paediatric asthma maintenance management and an SR of treatments for acute asthma attacks in children, requiring an emergency presentation with/without hospital admission will be conducted. METHODS AND ANALYSIS Standard methodology recommended by Cochrane will be followed. Maintenance pharmacotherapy of childhood asthma will be evaluated in an overview of SRs published after 2005 and including clinical trials or real-life studies. For evaluating pharmacotherapy of acute asthma attacks leading to an emergency presentation with/without hospital admission, we opted to conduct de novo synthesis in the absence of adequate up-to-date published SRs. For the SR of acute asthma pharmacotherapy, we will consider eligible SRs, clinical trials or real-life studies without time restrictions. Our evidence updates will be based on broad searches of Pubmed/Medline and the Cochrane Library. We will use A MeaSurement Tool to Assess systematic Reviews, V.2, Cochrane risk of bias 2 and REal Life EVidence AssessmeNt Tool to evaluate the methodological quality of SRs, controlled clinical trials and real-life studies, respectively.Next, we will further assess interventions for acute severe asthma attacks with positive clinical results in meta-analyses. We will include both controlled clinical trials and observational studies and will assess their quality using the previously mentioned tools. We will employ random effect models for conducting meta-analyses, and Grading of Recommendations Assessment, Development and Evaluation methodology to assess certainty in the body of evidence. ETHICS AND DISSEMINATION Ethics approval is not required for SRs. Our findings will be published in peer reviewed journals and will inform clinical recommendations being developed by the PeARL Think Tank. PROSPERO REGISTRATION NUMBERS CRD42020132990, CRD42020171624.
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Affiliation(s)
- Alexander G Mathioudakis
- Division of Infection, Immunity and Respiratory Medicine, The University of Manchester, Manchester, UK
- North West Lung Centre, Manchester University NHS Foundation Trust, Manchester, UK
- Athens Breath Centre, Athens, Greece
| | - Michael Miligkos
- First Department of Pediatrics, "Aghia Sofia" Children's Hospital, University of Athens, Athens, Attica, Greece
| | - Cristina Boccabella
- Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Milano, Lombardia, Italy
| | - Gioulinta S Alimani
- Athens Breath Centre, Athens, Greece
- Department of Biomedical Sciences, University of West Attica, Egaleo, Attica, Greece
| | - Adnan Custovic
- Department of Paediatrics, Imperial College London, London, UK
| | - A Deschildre
- Unité de Pneumologie et Allergologie Pédiatriques, Hôpital Jeanne de Flandre, CHU Lille, Lille, Hauts-de-France, France
| | | | - Omer Kalayci
- Pediatric Allergy and Asthma Unit, Hacettepe Universitesi, Ankara, Turkey
| | - Clare Murray
- Division of Infection, Immunity and Respiratory Medicine, The University of Manchester, Manchester, UK
- North West Lung Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Antonio Nieto Garcia
- Pulmonology and Allergy Unity, La Fe University and Polytechnic Hospital, Valencia, Comunidad Valenciana, Spain
| | - Wanda Phipatanakul
- Pediatric Allergy and Immunology, Children's Hospital Boston, Boston, Massachusetts, USA
| | - David Price
- Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK
- Observational and Pragmatic Research Institute, Singapore
| | - Aziz Sheikh
- Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | | | - Leonard Bacharier
- Department of Allergy, Immunology, and Pulmonary Medicine, University of Washington, Seattle, Washington, USA
| | - Apostolos Beloukas
- Department of Biomedical Sciences, University of West Attica, Egaleo, Attica, Greece
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | - Andrew Bentley
- North West Lung Centre, Manchester University NHS Foundation Trust, Manchester, UK
- Acute Intensive Care Unit, University Hospital of South Manchester NHS Foundation Trust, Manchester, Greater Manchester, UK
| | - Matteo Bonini
- Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Milano, Lombardia, Italy
- National Heart and Lung Institute (NHLI), Imperial College London, London, UK
| | | | - Giuseppe De Carlo
- Allergy and Airway Diseases Patient's Associations, European Federation of Pharmaceutical Industries and Associations, Brussels, Belgium
| | - Timothy Craig
- Allergy, Asthma and Immunology, Penn State University, Hershey, Pennsylvania, USA
| | - Zuzana Diamant
- Department of Respiratory Medicine and Allergology, Institute for Clinical Science, Skane University Hospital Lund Hematological Clinic, Lund, Skåne, Sweden
- Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic
- Department of Clinical Pharmacy & Pharmacology, University of Groningen, University Medical Center of Groningen and QPS-NL, Groningen, Netherlands
| | - Wojciech Feleszko
- Department of Pediatric Pulmonology and Allergy, Medical University of Warsaw, Warszawa, Poland
| | - Tim Felton
- Division of Infection, Immunity and Respiratory Medicine, The University of Manchester, Manchester, UK
- North West Lung Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - James E Gern
- Department of Pediatrics and Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Jonathan Grigg
- Centre for Genomics and Child Health, Blizard Institute, Queen Mary University of London, London, UK
| | - Gunilla Hedlin
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Stockholm, Sweden
| | - Elham M Hossny
- Pediatric Allergy and Immunology Unit, Ain Shams University, Cairo, Egypt
| | - Despo Ierodiakonou
- Department of Social Medicine, Faculty of Medicine, University of Crete, Rethimno, Greece
| | - Tuomas Jartti
- Department of Paediatrics, University of Turku, Turku, Finland
| | - Alan Kaplan
- Family Physician, Airways Group of Canada, University of Toronto, Toronto, Ontario, Canada
| | - Robert F Lemanske
- Department of Pediatrics and Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Peter N Le Souëf
- School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia
| | - Mika J Mäkelä
- Department of Allergy, University of Helsinki, Helsinki, Uusimaa, Finland
| | | | - Paolo Matricardi
- Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine, Charité - University Medicine, Berlin, Germany
| | - Marina Mitrogiorgou
- Third Department of Paediatrics, National and Kapodistrian University of Athens School of Health Sciences, Athens, Greece
| | | | | | - Effie Papageorgiou
- Department of Biomedical Sciences, University of West Attica, Egaleo, Attica, Greece
| | - Helena Pité
- Allergy Center, Hospital CUF Descobertas, Lisboa, Portugal
- Allergy Center, CUF Infante Santo Hospital, Lisbon, Portugal
- Chronic Diseases Research Center (CEDOC), NOVA Medical School / Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Paulo M C Pitrez
- Laboratory of Respiratory Physiology, Infant Center, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Petr Pohunek
- Paediatric Department, Motol University Hospital, Praha, Czech Republic
| | - Graham Roberts
- The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Newport Isle of Wight, UK
- Faculty of Medicine, Clinical and Experimental Sciences and Human Development in Health Academic Units, University of Southampton, Southampton, UK
- NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Ioanna Tsiligianni
- Department of Social Medicine, Faculty of Medicine, University of Crete, Rethimno, Greece
| | - Stephen Turner
- Department of Child Health, University of Aberdeen, Aberdeen, Aberdeen, UK
| | - Susanne Vijverberg
- Department of Respiratory Medicine and Department of Pediatric Pulmonology, University of Amsterdam, Amsterdam, Netherlands
| | - Tonya A Winders
- Allergy & Asthma, Global Patient Platform, Virginia, Virginia, USA
| | - Gary Wk Wong
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Paraskevi Xepapadaki
- Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Attica, Greece
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Rondebosch, Western Cape, South Africa
- Unit on Child and Adolescent Health, Medical Reaserch Council, Cape Town, South Africa
| | - Nikolaos G Papadopoulos
- Division of Infection, Immunity and Respiratory Medicine, The University of Manchester, Manchester, UK
- Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Attica, Greece
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Acupuncture for diabetic peripheral neuropathy: An overview of systematic reviews. Complement Ther Clin Pract 2021; 43:101375. [PMID: 33819833 DOI: 10.1016/j.ctcp.2021.101375] [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: 05/16/2020] [Revised: 02/19/2021] [Accepted: 03/24/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Acupuncture has been widely used to treat diabetic peripheral neuropathy (DPN) in China as a complementary and alternative therapy. This study aims to summarize the characteristics and evaluate the methodology quality of the systematic reviews (SRs) regarding acupuncture for DPN. METHODS A comprehensive literature search was performed from inception to February 2020. We assessed the methodological quality of the included SRs with the Assessment of Multiple Systematic Reviews 2 (AMSTAR 2) tool, adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist to evaluate the reporting characteristics of included SRs, and utilized the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach to evaluate the quality of evidence for outcomes including total effective rate, sensory nerve conduction velocity, motor nerve conduction velocity and adverse events. One-way analysis of variance and multiple linear regression were conducted to evaluate the associations between characteristics and two index scores (PRISMA and AMSTAR 2). RESULTS Eighteen SRs were included in this overview. The methodology quality of the included SRs ranged from very low to high. Only protocol registration and funding source reported were associated with the AMSTAR 2 index scores, while no variable showed significant difference in the PRISMA scores. The overall quality of evidence in included SRs ranged from "very low" to "moderate". CONCLUSION This overview suggested beneficial effects of acupuncture on DPN, whereas the results should be interpreted with cautious owing to methodology flaws, providing reference for further improvement of the study design.
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Bougioukas KI, Vounzoulaki E, Mantsiou CD, Papanastasiou GD, Savvides ED, Ntzani EE, Haidich AB. Global mapping of overviews of systematic reviews in healthcare published between 2000 and 2020: a bibliometric analysis. J Clin Epidemiol 2021; 137:58-72. [PMID: 33775811 DOI: 10.1016/j.jclinepi.2021.03.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/24/2021] [Accepted: 03/18/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To conduct a bibliometric analysis using a large sample of overviews of systematic reviews (OoSRs) and reveal research trends and areas of interest about these studies. STUDY DESIGN AND SETTING We searched MEDLINE, Scopus and Cochrane Database of Systematic Reviews from 1/1/2000 to 15/10/2020. We used Scopus meta-data and two authors recorded supplementary information independently. We summarized the data using frequencies with percentages. RESULTS A total of 1558 studies were considered eligible for analysis. We found that the publications have been increasing yearly and their nomenclature was not uniform (the most frequent label in the title was "overview of systematic reviews"). The largest number of papers and the most cited ones were published by corresponding authors from the UK. The publications were distributed across 737 scholarly journals and many of them were published in the field of complementary/alternative medicine, psychiatry/psychology, nutrition/dietetics, and pediatrics. The co-authorship analysis revealed collaborations among countries. The most common clinical conditions were depression, diabetes, cancer, dementia, pain, cardiovascular disease, stroke, obesity, and schizophrenia. CONCLUSION OoSRs have recently become a popular approach of evidence synthesis. International collaborations between overview authors from countries with increased research productivity and countries with less research activity should be encouraged.
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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, LE5 4PW, UK; National Institute for Health Research Applied Research Collaboration-East Midlands, Leicester Diabetes Centre, Leicester LE5 4PW, UK
| | - Chrysanthi D Mantsiou
- Department of Hygiene, Social-Preventive Medicine & Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | | | - Eliophotos D Savvides
- 2nd Surgical Department, School of medicine, G. Gennimatas General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evangelia E 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; Institute of Biosciences, University Research Center of loannina, University of Ioannina, Ioannina, Greece
| | - 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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19
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Shi J, Zhao L, Gao Y, Niu M, Yan M, Chen Y, Song Z, Ma X, Wang P, Tian J. Associating the risk of three urinary cancers with obesity and overweight: an overview with evidence mapping of systematic reviews. Syst Rev 2021; 10:58. [PMID: 33597037 PMCID: PMC7888186 DOI: 10.1186/s13643-021-01606-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 01/31/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The relationship between cancer with overweight and obesity has been extensively reported. However, the association between urinary cancers with these risk factors remains unclear, with existing reports showing conflicting findings. The current review, therefore, sought to clarify the latter association by assessing the methodological and reporting quality of existing systematic reviews on the subject. METHODS We first screened PubMed, EMBASE, and Cochrane Library databases for relevant literature and subjected the resulting articles to meta-analysis. We adopted the AMSTAR-2 and PRISMA checklists for assessing methodological and reporting quality, respectively, then performed meta-analyses to determine the relationship between incidence and mortality of three types of urinary cancers with obesity and overweight. Indirect comparisons were also done across subgroups. RESULTS All systematic reviews (SRs) were of critically low methodological quality. Seventeen SRs had minimal reporting flaws, and 11 SRs had minor reporting flaws. We found an association between obesity with an incidence of kidney (RR = 1.68, 95% CI 1.47-1.92), bladder (RR = 1.1, 95% CI 1.07-1.13), and prostate (RR = 1.02, 95% CI 0.91, 1.13) cancers. Similarly, overweight was associated with the incidence of the three types of cancer, recording RR values of 1.37 (95% CI 1.26-1.48), 1.07 (95% CI 1.03-1.1), and 1 (95% CI 0.93, 1.07) for kidney, bladder, and prostate cancers, respectively. With regard to the dose analysis, the RR of BMI (per 5 kg/m2 increase) was associated with kidney (RR = 1.24, 95% CI 1.2-1.28), bladder (RR = 1.03, 95% CI 1.02-1.05), and prostate (RR = 1.02, 95% CI 1.01, 1.03) cancers. CONCLUSIONS This comprehensive quantitative analysis provides an affirmation that overweight and obesity are strong risk factors for kidney cancer, owing to a strong association between them. Conversely, a weak association between overweight and obesity with bladder and prostate cancers confirms their status as mild risk factors for the 2 types of cancer. But due to the low quality of included SRs, the results need to be interpreted with caution. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019119459.
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Affiliation(s)
- Jiyuan Shi
- Evidence-Based Nursing Centre, School of Nursing, Lanzhou University, Lanzhou City, 730000, China
- Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou City, 730000, China
- School of Nursing and Health, Zhengzhou University, Zhengzhou city, 450001, China
| | - Liang Zhao
- Evidence-Based Nursing Centre, School of Nursing, Lanzhou University, Lanzhou City, 730000, China
| | - Ya Gao
- Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou City, 730000, China
| | - Mingming Niu
- Evidence-Based Nursing Centre, School of Nursing, Lanzhou University, Lanzhou City, 730000, China
| | - Meili Yan
- Evidence-Based Nursing Centre, School of Nursing, Lanzhou University, Lanzhou City, 730000, China
| | - Yamin Chen
- Evidence-Based Nursing Centre, School of Nursing, Lanzhou University, Lanzhou City, 730000, China
| | - Ziwei Song
- Evidence-Based Nursing Centre, School of Nursing, Lanzhou University, Lanzhou City, 730000, China
| | - Xueni Ma
- The Second Clinical Medical College of Lanzhou University, Lanzhou University, Lanzhou City, 730000, China
| | - Peng Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou city, 450001, China.
| | - Jinhui Tian
- Evidence-Based Nursing Centre, School of Nursing, Lanzhou University, Lanzhou City, 730000, China.
- Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou City, 730000, China.
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20
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Hasan B, Nayfeh T, Alzuabi M, Wang Z, Kuchkuntla AR, Prokop LJ, Newman CB, Murad MH, Rajjo TI. Weight Loss and Serum Lipids in Overweight and Obese Adults: A Systematic Review and Meta-Analysis. J Clin Endocrinol Metab 2020; 105:5909285. [PMID: 32954416 DOI: 10.1210/clinem/dgaa673] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 09/16/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Excess adipose tissue is associated with an abnormal lipid profile that may improve with weight reduction. In this meta-analysis, we aimed to estimate the magnitude of change in lipid parameters associated with weight loss in adults who are overweight or obese. METHODS We searched MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and Scopus from 2013 to September, 2018. We included randomized controlled trials (RCTs) that evaluated interventions to treat adult obesity (lifestyle, pharmacologic and surgical) with follow-up of 6 months or more. RESULTS We included 73 RCTs with moderate-to-low risk of bias, enrolling 32 496 patients (mean age, 48.1 years; weight, 101.6 kg; and body mass index [BMI], 36.3 kg/m2). Lifestyle interventions (diet, exercise, or both), pharmacotherapy, and bariatric surgery were associated with reduced triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) concentrations and increased high-density lipoprotein cholesterol (HDL-C) at 6 and 12 months. The following data are for changes in lipid parameters after 12 months of the intervention with 95% CI. Following lifestyle interventions, per 1 kg of weight lost, TGs were reduced by -4.0 mg/dL (95% CI, -5.24 to -2.77 mg/dL), LDL-C was reduced by -1.28 mg/dL (95% CI, -2.19 to -0.37 mg/dL), and HDL-C increased by 0.46 mg/dL (95% CI, 0.20 to 0.71 mg/dL). Following pharmacologic interventions, per 1 kg of weight lost, TGs were reduced by -1.25 mg/dL (95% CI, -2.94 to 0.43 mg/dL), LDL-C was reduced by -1.67 mg/dL (95% CI, -2.28 to -1.06 mg/dL), and HDL-C increased by 0.37 mg/dL (95% CI, 0.23 to 0.52 mg/dL). Following bariatric surgery, per 1 kg of weight lost, TGs were reduced by -2.47 mg/dL (95% CI, -3.14 to -1.80 mg/dL), LDL-C was reduced by -0.33 mg/dL (95% CI, -0.77 to 0.10 mg/dL), and HDL-C increased by 0.42 mg/dL (95% CI, 0.37 to 0.47 mg/dL). Low-carbohydrate diets resulted in reductions in TGs and increases in HDL-C, whereas low-fat diets resulted in reductions in TGs and LDL-C and increases in HDL-C. Results were consistent across malabsorptive and restrictive surgery. CONCLUSIONS Weight loss in adults is associated with statistically significant changes in serum lipids. The reported magnitude of improvement can help in setting expectations, inform shared decision making, and facilitate counseling.
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Affiliation(s)
- Bashar Hasan
- Evidence-Based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Tarek Nayfeh
- Evidence-Based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Muayad Alzuabi
- Evidence-Based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Zhen Wang
- Evidence-Based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Aravind Reddy Kuchkuntla
- Evidence-Based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Larry J Prokop
- Library Public Services, Mayo Clinic, Rochester, Minnesota
| | - Connie B Newman
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, NYU School of Medicine, New York, New York
| | - Mohammad Hassan Murad
- Evidence-Based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Tamim I Rajjo
- Evidence-Based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
- Department of Family Medicine, Mayo Clinic, Rochester, Minnesota
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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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Cunningham N. Understanding the training and education needs of homecare workers supporting people with dementia and cancer: A systematic review of reviews. DEMENTIA 2020; 19:2780-2803. [PMID: 31271044 PMCID: PMC7925442 DOI: 10.1177/1471301219859781] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Many people with dementia, supported by family carers, prefer to live at home and may rely on homecare support services. People with dementia are also often living with multimorbidities, including cancer. The main risk factor for both cancer and dementia is age and the number of people living with dementia and cancer likely to rise. Upskilling the social care workforce to facilitate more complex care is central to national workforce strategies and challenges. Training and education development must also respond to the key requirements of a homecare workforce experiencing financial, recruitment and retention difficulties. This systematic review of reviews provides an overview of dementia and cancer training and education accessible to the homecare workforce. Findings reveal there is a diverse range of training and education available, with mixed evidence of effectiveness. Key barriers and facilitators to effective training and education are identified in order to inform future training, education and learning development for the homecare workforce supporting people with dementia and cancer.
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Lorenc T, Lester S, Sutcliffe K, Stansfield C, Thomas J. Interventions to support people exposed to adverse childhood experiences: systematic review of systematic reviews. BMC Public Health 2020; 20:657. [PMID: 32397975 PMCID: PMC7216383 DOI: 10.1186/s12889-020-08789-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 04/27/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) such as abuse, neglect or household adversity may have a range of serious negative impacts. There is a need to understand what interventions are effective to improve outcomes for people who have experienced ACEs. METHODS Systematic review of systematic reviews. We searched 18 database sources from 2007 to 2018 for systematic reviews of effectiveness data on people who experienced ACEs aged 3-18, on any intervention and any outcome except incidence of ACEs. We included reviews with a summary quality score (AMSTAR) of 5.5 or above. RESULTS Twenty-five reviews were included. Most reviews focus on psychological interventions and mental health outcomes. The strongest evidence is for cognitive-behavioural therapy for people exposed to abuse. For other interventions - including psychological therapies, parent training, and broader support interventions - the findings overall are inconclusive, although there are some positive results. CONCLUSIONS There are significant gaps in the evidence on interventions for ACEs. Most approaches focus on mitigating individual psychological harms, and do not address the social pathways which may mediate the negative impacts of ACEs. Many negative impacts of ACEs (e.g. on health behaviours, social relationships and life circumstances) have also not been widely addressed by intervention studies.
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Affiliation(s)
- Theo Lorenc
- Centre for Reviews & Dissemination, University of York, York, YO10 5DD, UK.
| | - Sarah Lester
- EPPI-Centre, Social Science Research Unit, Institute of Education, University College London, 18 Woburn Square, London, WC1H 0NR, UK
| | - Katy Sutcliffe
- EPPI-Centre, Social Science Research Unit, Institute of Education, University College London, 18 Woburn Square, London, WC1H 0NR, UK
| | - Claire Stansfield
- EPPI-Centre, Social Science Research Unit, Institute of Education, University College London, 18 Woburn Square, London, WC1H 0NR, UK
| | - James Thomas
- EPPI-Centre, Social Science Research Unit, Institute of Education, University College London, 18 Woburn Square, London, WC1H 0NR, UK
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Hennessy EA, Johnson BT, Acabchuk RL, McCloskey K, Stewart-James J. Self-regulation mechanisms in health behavior change: a systematic meta-review of meta-analyses, 2006-2017. Health Psychol Rev 2020; 14:6-42. [PMID: 31662031 PMCID: PMC7571594 DOI: 10.1080/17437199.2019.1679654] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 10/09/2019] [Indexed: 12/28/2022]
Abstract
Self-regulation is one primary mechanism in interventions for health behavior change and has been examined in numerous recent meta-analyses. This pre-registered meta-review (PROSPERO CRD42017074018) examined Mmeta-analyses of any intervention and health behavior/outcome were eligible if they quantitatively assessed self-regulation and appeared between January 2006 and August 2017. In total, 66 meta-analyses were ultimately eligible; 27% reported a protocol, 11% used GRADE; 58% focused on RCTs. Reviews satisfied only a moderate number of items on the AMSTAR 2 (M = 45.45%, SD = 29.57%). Only 6% of meta-analyses directly examined whether changes in self-regulation predicted the behavior change (i.e., self-efficacy and physical activity, l = 2; frequency of self-monitoring and goal attainment, l = 1; cognitive bias modification and addiction, l = 1). Meta-analyses more routinely assessed self-regulation by comparing the efficacy of intervention components (97%), such as those from behavior change taxonomies. Meta-analyses that focused on intervention components identified several as successful, including personalized feedback, goal setting, and self-monitoring; however, none were consistently successful in that each worked only for some health behaviors and with particular populations. Some components had inconclusive evidence, given that they were only examined in low- quality reviews. Future reviewers should utilize advanced methods to assess mechanisms, and study authors should report hypothesized mechanisms to facilitate synthesis.
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Affiliation(s)
- Emily A Hennessy
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, USA
| | - Blair T Johnson
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, USA
| | - Rebecca L Acabchuk
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, USA
| | - Kiran McCloskey
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, USA
| | - Jania Stewart-James
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, USA
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Gadalla MA, Norman RJ, Tay CT, Hiam DS, Melder A, Pundir J, Thangaratinam S, Teede HJ, Mol BWJ, Moran LJ. Medical and Surgical Treatment of Reproductive Outcomes in Polycystic Ovary Syndrome: An Overview of Systematic Reviews. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2020; 13:257-270. [PMID: 31710185 PMCID: PMC6875858 DOI: 10.22074/ijfs.2020.5608] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 03/10/2019] [Indexed: 12/28/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a common, complex condition that affects up to 18% of reproductiveaged women, causing reproductive, metabolic and psychological dysfunctions. We performed an overview and appraisal of methodological quality of systematic reviews that assessed medical and surgical treatments for reproductive outcomes in women with PCOS. Databases (MEDLINE, EMBASE, CINAHL PLUS and PROSPERO) were searched on the 15th of September 2017. We included any systematic review that assessed the effect of medical or surgical management of PCOS on reproductive, pregnancy and neonatal outcomes. Eligibility assessment, data extraction and quality assessment by the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) tool were performed in duplicate. We identified 53 reviews comprising 44 reviews included in this overview; the majority were moderate to high quality. In unselected women with PCOS, letrozole was associated with a higher live birth rate than clomiphene citrate (CC), while CC was better than metformin or placebo. In women with CC-resistant PCOS, gonadotrophins were associated with a higher live birth rate than CC plus metformin, which was better than laparoscopic ovarian drilling (LOD). LOD was associated with lower multiple pregnancy rates than other medical treatments. In women with PCOS undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI), the addition of metformin to gonadotrophins resulted in less ovarian hyperstimulation syndrome (OHSS), and higher pregnancy and live birth rates than gonadotrophins alone. Gonadotrophin releasing hormone (GnRH) antagonist was associated with less OHSS, gonadotrophin units and shorter stimulation length than GnRH agonist. Letrozole appears to be a good first line treatment and gonadotrophins, as a second line treatment, for anovulatory women with PCOS. LOD results in lower multiple pregnancy rates. However, due to the heterogeneous nature of the included populations of women with PCOS, further larger scale trials are needed with more precise assessment of treatments according to heterogeneous variants of PCOS.
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Affiliation(s)
- Moustafa A Gadalla
- Women's Health Hospital, Department of Obstetrics and Gynaecology, Assiut University, Assiut, Egypt.Elevtronic Address:
- Robinson Research Institute, Discipline of Obstetrics and Gynaecology, University of Adelaide, Adelaide, Australia
| | - Robert J Norman
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Victoria, Melbourne, Australia
- Monash Diabetes and Endocrinology Units, Monash Health, Victoria, Melbourne, Australia
| | | | - Danielle S Hiam
- Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Australia
| | - Angela Melder
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Victoria, Melbourne, Australia
| | - Jyotsna Pundir
- Centre of Reproductive Medicine, St Bartholomew's Hospital, London, United Kingdom
| | - Shakila Thangaratinam
- Women's Health Research Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University London, London, United Kingdom
| | - Helena J Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Victoria, Melbourne, Australia
- Monash Diabetes and Endocrinology Units, Monash Health, Victoria, Melbourne, Australia
| | - Ben W J Mol
- Robinson Research Institute, Discipline of Obstetrics and Gynaecology, University of Adelaide, Adelaide, Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Melbourne, Australia
| | - Lisa J Moran
- Robinson Research Institute, Discipline of Obstetrics and Gynaecology, University of Adelaide, Adelaide, Australia
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Victoria, Melbourne, Australia
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Suls J, Mogavero JN, Falzon L, Pescatello LS, Hennessy EA, Davidson KW. Health behaviour change in cardiovascular disease prevention and management: meta-review of behaviour change techniques to affect self-regulation. Health Psychol Rev 2019; 14:43-65. [PMID: 31707938 DOI: 10.1080/17437199.2019.1691622] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Self-regulation processes assume a major role in health behaviour theory and are postulated as important mechanisms of action in behavioural interventions to improve health prevention and management. The need to better understand mechanisms of behaviour change interventions for cardiovascular diseases (CVD) called for conducting a meta-review of meta-analyses for interventions targeting self-regulation processes. The protocol, preregistered on Open Science Framework (OSF), found 15 eligible meta-analyses, published between 2006 and August 2019, which quantitatively assessed the role of self-regulatory mechanisms and behaviour change techniques (BCTs). Quality of the meta-analyses varied widely according to AMSTAR-2 criteria. Several BCTs, assumed to engage self-regulatory mechanisms, were unevenly represented in CVD meta-analytic reviews. Self-monitoring, the most frequently studied self-regulatory BCT, seemed to improve health behaviour change and health outcomes but these results merit cautious interpretation. Findings for other self-regulatory BCTs were less promising. No studies in the CVD domain directly tested engagement of self-regulation processes. A general challenge for this area stems from reliance on post-hoc tests of the effects of BCTs in multiple-component interventions. Recent advances in BCT taxonomies and the experimental medicine approach to engaging self-regulation mechanisms, however, provide opportunities to improve CVD prevention and management behavioural interventions.
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Affiliation(s)
- Jerry Suls
- Center for Personalized Health, Feinstein Institute for Medical Research, Northwell Health, New York, NY, USA
| | - Jazmin N Mogavero
- Center for Personalized Health, Feinstein Institute for Medical Research, Northwell Health, New York, NY, USA
| | - Louise Falzon
- Center for Personalized Health, Feinstein Institute for Medical Research, Northwell Health, New York, NY, USA
| | | | - Emily A Hennessy
- The Sharp Research Lab, University of Connecticut, Storrs, CT, USA
| | - Karina W Davidson
- Center for Personalized Health, Feinstein Institute for Medical Research, Northwell Health, New York, NY, USA
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Cunningham NA, Cunningham TR, Roberston JM. Understanding and Measuring the Wellbeing of Carers of People With Dementia. THE GERONTOLOGIST 2019; 59:e552-e564. [PMID: 29566167 PMCID: PMC6857741 DOI: 10.1093/geront/gny018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To determine how the wellbeing of carers of people with dementia is understood and measured in contemporary health research. RESEARCH DESIGN AND METHODS A systematic review of reviews was designed, registered with PROSPERO, and then conducted. This focused on systematic reviews of research literature published from 2010 onwards; with the wellbeing of carers of people with dementia being a primary focus. N = 19 studies met the inclusion criteria. Quality appraisal was conducted using the AMSTAR tool (2015). A narrative synthesis was conducted to explore how wellbeing is currently being understood and measured. RESULTS Contemporary health research most frequently conceptualizes wellbeing in the context of a loss-deficit model. Current healthcare research has not kept pace with wider discussions surrounding wellbeing which have become both more complex and more sophisticated. Relying on the loss-deficit model limits current research in understanding and measuring the lived experience of carers of people with dementia. There remains need for a clear and consistent measurement of wellbeing. DISCUSSION AND IMPLICATIONS Without clear consensus, health professionals must be careful when using the term "wellbeing". To help inform healthcare policy and practice, we offer a starting point for a richer concept of wellbeing in the context of dementia that is multi-faceted to include positive dimensions of caregiving in addition to recognized aspects of burden. Standardized and robust measurements are needed to enhance research and there may be benefit from developing a more mixed, blended approach to measurement.
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Affiliation(s)
| | | | - Jane M Roberston
- Faculty of Social Sciences, University of Stirling, Stirling, Scotland, UK
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Pollock A, van Wijck F. Cochrane overviews: how can we optimize their impact on evidence-based rehabilitation? Eur J Phys Rehabil Med 2019; 55:395-410. [PMID: 30938138 DOI: 10.23736/s1973-9087.19.05780-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Overviews (i.e. reviews of multiple systematic reviews) comprise a relatively novel methodology to systematically synthesize research findings. Overviews aim for a beneficial impact on clinical practice, but their methods and pathways to impact have so far not been mapped. The aim of this paper was to inform recommendations for optimizing impact on rehabilitation practice and research by mapping methods and pathways to impact in Cochrane overviews relevant to rehabilitation. EVIDENCE ACQUISITION We systematically searched and identified published Cochrane overviews (to June 2018) relevant to rehabilitation. We extracted data and compared overviews on key characteristics, methods of evidence synthesis, statements about impact, and access metrics. We explored one overview in detail regarding beneficiaries, activities and outputs, mapped potential pathways to impact, and, using an iterative process, refined this into a generic map. Through exploration of all synthesized data, we propose further recommendations for planning, conducting and reporting of future overviews in order to optimize impact on rehabilitation. EVIDENCE SYNTHESIS We identified seven Cochrane overviews relevant to rehabilitation. Their focus and methods varied, but they were broadly related to rehabilitation interventions for populations of people with diverse long-term conditions. Overviews also varied regarding their intended impact; only 4 overviews identified specific beneficiaries. All overviews included multiple tables and figures, but only one synthesized key findings into a single figure. For five overviews, the Altmetric Attention Score (a weighted count of attention that an output receives based on a range of online sources) was in the top 5% of all research outputs scored by Altmetric. The overview within our worked example had four key impact goals, each with different beneficiaries and required actions; this example led to a generic map of potential pathways to impact for other overviews. CONCLUSIONS Cochrane overviews have the potential to play a key role in knowledge translation and therefore to be useful in supporting evidence-based rehabilitation practice. However, current overviews relating to rehabilitation differ in methods, approaches and intended impact, and sometimes fall short of promoting easy access to key information for beneficiaries. Future Cochrane overviews should address topics of importance to key beneficiaries and clearly outline potential pathways to impact in order to have a potential beneficial impact on evidence-based rehabilitation and to improve rehabilitation outcomes.
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Affiliation(s)
- Alex Pollock
- Nursing Midwifery and Allied Health Professions (NMAHP) Research Unit, Glasgow Caledonian University, Glasgow, UK -
| | - Frederike van Wijck
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
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Stead M, Angus K, Langley T, Katikireddi SV, Hinds K, Hilton S, Lewis S, Thomas J, Campbell M, Young B, Bauld L. Mass media to communicate public health messages in six health topic areas: a systematic review and other reviews of the evidence. PUBLIC HEALTH RESEARCH 2019. [DOI: 10.3310/phr07080] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BackgroundMass media campaigns can be used to communicate public health messages at the population level. Although previous research has shown that they can influence health behaviours in some contexts, there have been few attempts to synthesise evidence across multiple health behaviours.ObjectivesTo (1) review evidence on the effective use of mass media in six health topic areas (alcohol, diet, illicit drugs, physical activity, sexual and reproductive health and tobacco), (2) examine whether or not effectiveness varies with different target populations, (3) identify characteristics of mass media campaigns associated with effectiveness and (4) identify key research gaps.DesignThe study comprised (1) a systematic review of reviews, (2) a review of primary studies examining alcohol mass media campaigns, (3) a review of cost-effectiveness evidence and (4) a review of recent primary studies of mass media campaigns conducted in the UK. A logic model was developed to inform the reviews. Public engagement activities were conducted with policy, practitioner and academic stakeholders and with young people.ResultsThe amount and strength of evidence varies across the six topics, and there was little evidence regarding diet campaigns. There was moderate evidence that mass media campaigns can reduce sedentary behaviour and influence sexual health-related behaviours and treatment-seeking behaviours (e.g. use of smoking quitlines and sexual health services). The impact on tobacco use and physical activity was mixed, there was limited evidence of impact on alcohol use and there was no impact on illicit drug behaviours. Mass media campaigns were found to increase knowledge and awareness across several topics, and to influence intentions regarding physical activity and smoking. Tobacco and illicit drug campaigns appeared to be more effective for young people and children but there was no or inconsistent evidence regarding effectiveness by sex, ethnicity or socioeconomic status. There was moderate evidence that tobacco mass media campaigns are cost-effective, but there was weak or limited evidence in other topic areas. Although there was limited evidence on characteristics associated with effectiveness, longer or greater intensity campaigns were found to be more effective, and messages were important, with positive and negative messages and social norms messages affecting smoking behaviour. The evidence suggested that targeting messages to target audiences can be effective. There was little evidence regarding the role that theory or media channels may play in campaign effectiveness, and also limited evidence on new media.LimitationsStatistical synthesis was not possible owing to considerable heterogeneity across reviews and studies. The focus on review-level evidence limited our ability to examine intervention characteristics in detail.ConclusionsOverall, the evidence is mixed but suggests that (1) campaigns can reduce sedentary behaviour, improve sexual health and contribute to smoking cessation, (2) tobacco control campaigns can be cost-effective, (3) longer and more intensive campaigns are likely to be more effective and (4) message design and targeting campaigns to particular population groups can be effective.Future workFuture work could fill evidence gaps regarding diet mass media campaigns and new-media campaigns, examine cost-effectiveness in areas other than tobacco and explore the specific contribution of mass media campaigns to multicomponent interventions and how local, regional and national campaigns can work together.Study registrationThis study is registered as PROSPERO CRD42015029205 and PROSPERO CRD42017054999.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- Martine Stead
- Institute for Social Marketing, University of Stirling, Stirling, UK
- UK Centre for Tobacco and Alcohol Studies, UK
| | - Kathryn Angus
- Institute for Social Marketing, University of Stirling, Stirling, UK
- UK Centre for Tobacco and Alcohol Studies, UK
| | - Tessa Langley
- UK Centre for Tobacco and Alcohol Studies, UK
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Srinivasa Vittal Katikireddi
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Kate Hinds
- Institute of Education, University College London, London, UK
| | - Shona Hilton
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Sarah Lewis
- UK Centre for Tobacco and Alcohol Studies, UK
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - James Thomas
- Institute of Education, University College London, London, UK
| | - Mhairi Campbell
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Ben Young
- UK Centre for Tobacco and Alcohol Studies, UK
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Linda Bauld
- UK Centre for Tobacco and Alcohol Studies, UK
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
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Jin XC, Zhang L, Wang Y, Cai HB, Bao XJ, Jin YY, Zheng GQ. An Overview of Systematic Reviews of Chinese Herbal Medicine for Parkinson's Disease. Front Pharmacol 2019; 10:155. [PMID: 30890935 PMCID: PMC6413625 DOI: 10.3389/fphar.2019.00155] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 02/08/2019] [Indexed: 01/05/2023] Open
Abstract
Parkinson's disease (PD) is a high prevalence neurodegenerative disorder without a disease-modifying therapy. Up to now, a number of systematic reviews have been conducted to evaluate efficacy and safety of Chinese herbal Medicine (CHM) for PD patients. Here, we aimed to assess the methodological quality and reporting quality of systematic reviews using an overview, and then synthesize and evaluate the available evidence level of CHM for PD. Six databases were searched from inception to September 2018. The literatures were selected and data were extracted according to prespecified criteria. A Measurement Tool to Assess Systematic Reviews (AMSTAR) was used to evaluate the quality of methodology, and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to determine the evidence quality of the primary outcome measures. A total of 11 systematic reviews with 230 RCTs of CHM for PD were included. AMSTAR scores of the included reviews were range from 4 to 9. Compared with conventional western medicine (WCM), CHM paratherapy showed significant effect in improving UPDRS score, Webster scale score, PDQ-39, NMSQuest, CHM Syndrome Integral Scale, and PDSS. However, CHM monotherapy showed no difference relative to WCM according to various outcome measures. Adverse events were reported in 9 systematic reviews. The side effect in CHM paratherapy group was generally less than or lighter than that in WCM group. The quality of the evidence of primary outcomes was moderate (42%) to high (54%) according to the GRADE profiler. The present finding supported the use of CHM paratherapy for PD patients but we should treat the evidence cautiously because of the methodological flaws, whereas there is insufficient evidence of CHM monotherapy for PD.
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Affiliation(s)
- Xin-Chun Jin
- Department of Neurology, The First People's Hospital of Wenling, The Affiliated Wenling Hospital of Wenzhou Medical University, Wenling, China.,Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Li Zhang
- Department of Neurology, The First People's Hospital of Wenling, The Affiliated Wenling Hospital of Wenzhou Medical University, Wenling, China
| | - Yong Wang
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hai-Bo Cai
- Department of Neurology, The First People's Hospital of Wenling, The Affiliated Wenling Hospital of Wenzhou Medical University, Wenling, China
| | - Xian-Jun Bao
- Department of Neurology, The First People's Hospital of Wenling, The Affiliated Wenling Hospital of Wenzhou Medical University, Wenling, China
| | - You-Yu Jin
- Department of Neurology, The First People's Hospital of Wenling, The Affiliated Wenling Hospital of Wenzhou Medical University, Wenling, China
| | - Guo-Qing Zheng
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
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Tuominen L, Stolt M, Meretoja R, Leino-Kilpi H. Effectiveness of nursing interventions among patients with cancer: An overview of systematic reviews. J Clin Nurs 2019; 28:2401-2419. [PMID: 30585667 DOI: 10.1111/jocn.14762] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 12/03/2018] [Accepted: 12/18/2018] [Indexed: 12/25/2022]
Abstract
AIMS AND OBJECTIVES To explore nursing interventions used among patients with cancer and summarise the results of their effectiveness. The ultimate goal was to improve the quality of care and provide best evidence for clinicians to refer to while developing effective nursing interventions. BACKGROUND Nursing interventions refer to actions that nurses take with the aim of improving the well-being of people with cancer-related health and care needs. A plethora of systematic reviews has been conducted in this research area, although with scattered results. We conducted a comprehensive review to identify and summarise the existing evidence. METHODS This overview of systematic reviews adheres to the PRISMA guidelines. The PubMed, CINAHL, MEDLINE and Scopus databases were searched. Nine reviews reporting findings from 112 original studies published 2007-2017 met the selection criteria. The results of intervention effectiveness were analysed using descriptive quantification and a narrative summary of the quantitative data. RESULTS The effectiveness of educational nursing interventions was inconsistent on quality of life (QoL), attitudes, anxiety and distress, but positive on level of knowledge, symptom severity, sleep and uncertainty. Psychosocial nursing interventions had a significant effect on spiritual well-being, meaning of life, fatigue and sleep. Psychological nursing interventions reduced cancer-related fatigue. Nursing interventions supporting patients' coping had a significant impact on anxiety, distress, fatigue, sleep, dyspnoea and functional ability. Activity-based interventions may prevent cancer-related fatigue. CONCLUSIONS Nursing interventions achieved significant physical and psychological effects on the lives of patients with cancer. Multidimensional nature of interventions by combining different elements reinforces the effect. Priorities for future research include identifying the most beneficial components of these interventions. RELEVANCE TO CLINICAL PRACTICE Implementation of these nursing interventions into clinical practice is important to improve patients' knowledge and QoL as well as reducing various symptoms and side effects related to cancer and its treatment.
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Affiliation(s)
- Leena Tuominen
- Department of Nursing Science, University of Turku, Turku, Finland.,Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland
| | - Minna Stolt
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Riitta Meretoja
- Department of Nursing Science, University of Turku, Turku, Finland.,Corporate Headquarters, Helsinki University Hospital, Helsinki, Finland
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
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Abstract
OBJECTIVES To systematically examine the evidence of harms and benefits relating to time spent on screens for children and young people's (CYP) health and well-being, to inform policy. METHODS Systematic review of reviews undertaken to answer the question 'What is the evidence for health and well-being effects of screentime in children and adolescents (CYP)?' Electronic databases were searched for systematic reviews in February 2018. Eligible reviews reported associations between time on screens (screentime; any type) and any health/well-being outcome in CYP. Quality of reviews was assessed and strength of evidence across reviews evaluated. RESULTS 13 reviews were identified (1 high quality, 9 medium and 3 low quality). 6 addressed body composition; 3 diet/energy intake; 7 mental health; 4 cardiovascular risk; 4 for fitness; 3 for sleep; 1 pain; 1 asthma. We found moderately strong evidence for associations between screentime and greater obesity/adiposity and higher depressive symptoms; moderate evidence for an association between screentime and higher energy intake, less healthy diet quality and poorer quality of life. There was weak evidence for associations of screentime with behaviour problems, anxiety, hyperactivity and inattention, poorer self-esteem, poorer well-being and poorer psychosocial health, metabolic syndrome, poorer cardiorespiratory fitness, poorer cognitive development and lower educational attainments and poor sleep outcomes. There was no or insufficient evidence for an association of screentime with eating disorders or suicidal ideation, individual cardiovascular risk factors, asthma prevalence or pain. Evidence for threshold effects was weak. We found weak evidence that small amounts of daily screen use is not harmful and may have some benefits. CONCLUSIONS There is evidence that higher levels of screentime is associated with a variety of health harms for CYP, with evidence strongest for adiposity, unhealthy diet, depressive symptoms and quality of life. Evidence to guide policy on safe CYP screentime exposure is limited. PROSPERO REGISTRATION NUMBER CRD42018089483.
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Affiliation(s)
- Neza Stiglic
- Population, policy and practice research programme, UCL Institute of Child Health, London, UK
| | - Russell M Viner
- Population, policy and practice research programme, UCL Institute of Child Health, London, UK
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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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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: 76] [Impact Index Per Article: 12.7] [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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Ribeiro ELA, de Mendonça Lima T, Vieira MEB, Storpirtis S, Aguiar PM. Efficacy and safety of aripiprazole for the treatment of schizophrenia: an overview of systematic reviews. Eur J Clin Pharmacol 2018; 74:1215-1233. [PMID: 29905899 DOI: 10.1007/s00228-018-2498-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 05/31/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE To conduct an overview to summarize the efficacy and safety of aripiprazole for the treatment of schizophrenia. METHODS A literature search was performed in PubMed, the Cochrane Library, LILACS, and the Centre for Reviews and Dissemination, for articles published until March 31, 2017. We included systematic reviews with meta-analyses of randomized controlled trials assessing the efficacy, and/or the safety of aripiprazole, for patients with schizophrenia. Two authors independently performed the study selection, data extraction, and quality assessment. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach and the Risk of Bias in Systematic Review (ROBIS) tool were used to appraise the quality of evidence and the risk of bias in the reviews, respectively. RESULTS Fourteen studies fulfilled the inclusion criteria. Aripiprazole showed efficacy similar to that of both typical and atypical antipsychotic drugs (except olanzapine and amisulpride). Aripiprazole caused significantly lower weight gain and alterations in glucose and cholesterol levels, as compared to clozapine, risperidone, and olanzapine. In addition, aripiprazole caused significantly fewer general extrapyramidal side effects, less use of antiparkinsonian drugs, and akathisia, compared with typical antipsychotic drugs and risperidone. The overall quality of evidence in the reviews ranged from "very low" to "moderate," principally because of the risk of bias of original trials, inconsistency, and imprecision in the outcomes. According to the ROBIS tool, there are four reviews with "high" risk of bias and five with "unclear" risk of bias. CONCLUSIONS Aripiprazole exhibited efficacy similar to that of other antipsychotic drugs and a better safety profile than that of typical (i.e., less some extrapyramidal side effects) and atypical (i.e., less metabolic changes) antipsychotic drugs.
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Affiliation(s)
- Esther Letícia Amorim Ribeiro
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of Sao Paulo, Av. Prof. Lineu Prestes, 580 - Conj. das Químicas - Bloco 13 - Cidade Universitária Butantã, Sao Paulo, Brazil
| | - Tácio de Mendonça Lima
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of Sao Paulo, Av. Prof. Lineu Prestes, 580 - Conj. das Químicas - Bloco 13 - Cidade Universitária Butantã, Sao Paulo, Brazil
| | | | - Sílvia Storpirtis
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of Sao Paulo, Av. Prof. Lineu Prestes, 580 - Conj. das Químicas - Bloco 13 - Cidade Universitária Butantã, Sao Paulo, Brazil
| | - Patricia Melo Aguiar
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of Sao Paulo, Av. Prof. Lineu Prestes, 580 - Conj. das Químicas - Bloco 13 - Cidade Universitária Butantã, Sao Paulo, Brazil.
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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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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: 91] [Impact Index Per Article: 13.0] [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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Prousali E, Mataftsi A, Ziakas N, Fontalis A, Brazitikos P, Haidich AB. Interventions to control myopia progression in children: protocol for an overview of systematic reviews and meta-analyses. Syst Rev 2017; 6:188. [PMID: 28893307 PMCID: PMC5594593 DOI: 10.1186/s13643-017-0580-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 09/04/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Myopia is a common visual disorder with increasing prevalence among developed countries of the world. Myopia constitutes a substantial risk factor for several ocular conditions that can lead to blindness. The purpose of this study is to conduct an overview of systematic reviews and meta-analyses in order to identify and appraise robust research evidence regarding the management of myopia progression in children and adolescents. METHODS A literature search will be conducted in MEDLINE, EMBASE, The Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effects (DARE), and Health Technology Assessment (HTA) Database via Centre for Reviews and Dissemination (CRD). We will search for systematic reviews or meta-analyses that examine optical or pharmaceutical modalities for myopia control. Two independent overview authors will screen the titles and abstracts against the eligibility criteria. Individual study's methodological quality and quality of evidence for each outcome of interest will be assessed by two independent authors using the ROBIS tool and GRADE rating, respectively. In cases of disagreement, consensus will be reached with the help of a third author. Our primary outcomes will be the mean change in refractive error, mean axial length change, and adverse events. A citation matrix will be generated, and the corrected covered area (CCA) will be estimated, in order to identify overlapping primary studies. Possible meta-biases and measures of heterogeneity will be described, and cases of dual co-authorship will be identified and discussed. If any recently published randomized controlled trials (RCTs) are detected, these will be appraised and their findings will be presented. An overall summary of outcomes will be provided using descriptive statistics and will be supplemented by narrative synthesis. DISCUSSION This overview will examine the high level of existing evidence for treatment of myopia progression. Efficient interventions will be identified, and side effects will be reported. The expected benefit is that all robust recent research evidence will be compiled in a single study. The results may inform future research in this area, which should provide insight into the appropriate regimes for the administration of these modalities and contribute to future guideline development. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017068204.
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Affiliation(s)
| | - Asimina Mataftsi
- IInd Department of Ophthalmology, Aristotle University of Thessaloniki, 56403, Thessaloniki, Greece
| | - Nikolaos Ziakas
- Ist Department of Ophthalmology, Aristotle University of Thessaloniki, 54621, Thessaloniki, Greece
| | | | - Periklis Brazitikos
- IInd Department of Ophthalmology, Aristotle University of Thessaloniki, 56403, Thessaloniki, Greece
| | - Anna-Bettina Haidich
- Department of Hygiene and Epidemiology, Aristotle University of Thessaloniki, 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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Zubala A, MacGillivray S, Frost H, Kroll T, Skelton DA, Gavine A, Gray NM, Toma M, Morris J. Promotion of physical activity interventions for community dwelling older adults: A systematic review of reviews. PLoS One 2017; 12:e0180902. [PMID: 28700754 PMCID: PMC5507305 DOI: 10.1371/journal.pone.0180902] [Citation(s) in RCA: 190] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 06/22/2017] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES While there is strong evidence that regular participation in physical activity (PA) brings numerous health benefits to older adults, and interventions to effectively promote PA are being developed and tested, the characteristics and components of the most effective interventions remain unclear. This systematically conducted review of systematic reviews evaluated the effects and characteristics of PA promotion interventions aimed at community dwelling people over 50 years old. METHODS Major databases were searched for reviews from January 1990 to May 2015. TIDieR guidelines aided data extraction and the ROBIS tool was used to assess the risk of bias. Primary outcomes were objective and self-reported levels of PA. Indicators of psychological wellbeing and participation rates were secondary outcomes. RESULTS Of 1284 records identified, 19 reviews met inclusion criteria and eight included meta-analyses. Interventions typically incorporated behaviour change techniques (BCTs) and were delivered as face-to-face, remote, group, individual or as combined interventions. Despite their heterogeneity, interventions often resulted in sustained improvements in PA over the study period, typically at 12 months, and led to improvements in general wellbeing. However, ways to ensure effective maintenance beyond one year are unclear. Certain intervention components were more clearly associated with positive effects (e.g. tailoring promotion strategy with combination of cognitive and behavioural elements, low to moderate intensity activity recommended). We found no evidence that certain other intervention characteristics were superior in achieving positive outcomes (e.g. mode of delivery, setting, professional background of the intervention provider, type of PA recommended). CONCLUSION The evidence suggests that interventions to promote PA among older adults are generally effective but there is uncertainty around the most beneficial intervention components. There are indications that purely cognitive strategies and BCTs might be less suitable for older adults than motivators more meaningful to them, including social and environmental support, and enjoyment coming from being physically active. A whole system-oriented approach is required that is tailored to meet the needs of older adults and aligned with social, individual and environmental factors.
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Affiliation(s)
- Ania Zubala
- Scottish Improvement Science Collaborating Centre, School of Nursing and Health Sciences, University of Dundee, Dundee, Scotland, United Kingdom
| | - Stephen MacGillivray
- Evidence Synthesis Training and Research Group (STAR Group), School of Nursing and Health Sciences, University of Dundee, Dundee, Scotland, United Kingdom
| | - Helen Frost
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland, United Kingdom
| | - Thilo Kroll
- School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
| | - Dawn A. Skelton
- Institute for Applied Health Research, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom
| | - Anna Gavine
- Evidence Synthesis Training and Research Group (STAR Group), School of Nursing and Health Sciences, University of Dundee, Dundee, Scotland, United Kingdom
| | - Nicola M. Gray
- Scottish Improvement Science Collaborating Centre, School of Nursing and Health Sciences, University of Dundee, Dundee, Scotland, United Kingdom
| | - Madalina Toma
- Scottish Improvement Science Collaborating Centre, School of Nursing and Health Sciences, University of Dundee, Dundee, Scotland, United Kingdom
| | - Jacqui Morris
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom
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Pharmacist-led medication review in community settings: An overview of systematic reviews. Res Social Adm Pharm 2017; 13:661-685. [DOI: 10.1016/j.sapharm.2016.08.005] [Citation(s) in RCA: 135] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 08/07/2016] [Accepted: 08/19/2016] [Indexed: 02/08/2023]
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Labarca G, Ortega F, Arenas A, Reyes T, Rada G, Jorquera J. Extrapulmonary effects of continuous airway pressure on patients with obstructive sleep apnoea: protocol for an overview of systematic reviews. BMJ Open 2017; 7:e015315. [PMID: 28667213 PMCID: PMC5734478 DOI: 10.1136/bmjopen-2016-015315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Obstructive sleep apnoea (OSA) is associated with both pulmonary and extrapulmonary consequences. Continuous positive airway pressure (CPAP) is an effective treatment for pulmonary symptoms. However, it is not clear if CPAP modifies extrapulmonary symptoms, especially in the long term. To date, several studies addressing this issue have been performed, but the evidence is scattered across different reviews that address each outcome separately. Therefore, we will conduct an overview to assess and summarise all systematic reviews on the extrapulmonary effects of this intervention in patients with OSA. METHODS This is a protocol for a systematic overview of reviews that will follow the guidelines from the Cochrane Handbook of Systematic Reviews of Interventions and PRISMA-P. We will conduct comprehensive literature searches using MEDLINE, EMBASE, Cochrane, CINAHL, DARE and Epistemonikos. We will consider systematic reviews and meta-analyses of randomised controlled trials evaluating the extrapulmonary effects of CPAP on OSA. Two reviewers will independently screen articles for inclusion using criteria that are determined a priori, assessing the quality of included reviews and extracting relevant information. We will create matrices of evidence in the Epistemonikos database, including all systematic reviews addressing a similar question and all studies addressing the question in those reviews. We will try to explain why studies are not included in individual reviews using the inclusion criteria, and we will estimate the overlap between different reviews in the same matrix of evidence. ETHICS AND DISSEMINATION This review will be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER CRD42014013036.
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Affiliation(s)
- Gonzalo Labarca
- Facultad de Medicina, Universidad San Sebastian, Concepcion, Chile
- Complejo Asistencial Dr. Victor Rios Ruiz, Los Angeles, Chile
- Faculty of Medicine, Evidence Based Health Care Program, Pontificia Universidad Católica de Chile, Santiago, Chile
- Epistemonikos Foundation, Santiago, Chile
| | - Francisco Ortega
- Department of Internal Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alex Arenas
- Department of Internal Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Tomas Reyes
- Department of Internal Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Gabriel Rada
- Faculty of Medicine, Evidence Based Health Care Program, Pontificia Universidad Católica de Chile, Santiago, Chile
- Epistemonikos Foundation, Santiago, Chile
| | - Jorge Jorquera
- Sleep Center and Respiratory Diseases, Clinica Las Condes, Santiago, Chile
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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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Rajjo T, Mohammed K, Alsawas M, Ahmed AT, Farah W, Asi N, Almasri J, Prokop LJ, Murad MH. Treatment of Pediatric Obesity: An Umbrella Systematic Review. J Clin Endocrinol Metab 2017; 102:763-775. [PMID: 28359101 DOI: 10.1210/jc.2016-2574] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 10/14/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Multiple interventions are available to reduce excess body weight in children. We appraised the quality of evidence supporting each intervention and assessed the effectiveness on different obesity-related outcomes. METHODS We conducted a systematic search for systematic reviews of randomized controlled trials evaluating pediatric obesity interventions applied for ≥6 months. We assessed the quality of evidence for each intervention using GRADE (Grading of Recommendation, Assessment, Development, and Evaluation) approach. RESULTS From 16 systematic reviews, we identified 133 eligible randomized controlled trials. Physical activity interventions reduced systolic blood pressure and fasting glucose (low to moderate quality of evidence). Dietary interventions with low-carbohydrate diets had a similar effect to low-fat diets in terms of body mass index (BMI) reduction (moderate quality of evidence). Educational interventions reduced waist circumference, BMI, and diastolic blood pressure (low quality of evidence). Pharmacological interventions reduced BMI (metformin, sibutramine, orlistat) and waist circumference (sibutramine, orlistat) and increased high-density lipoprotein cholesterol (sibutramine) but also raised systolic and diastolic blood pressure (sibutramine). Surgical interventions (laparoscopic adjustable gastric banding, Roux-en-Y gastric bypass, sleeve gastrectomy) resulted in the largest BMI reduction (moderate quality of evidence). Combined interventions consisting of dietary modification, physical activity, behavioral therapy, and education significantly reduced systolic and diastolic blood pressure, BMI, and triglycerides. Combined parent-child interventions and parent-only interventions had similar effects on BMI (low quality of evidence). CONCLUSIONS Several childhood obesity interventions are effective in improving metabolic and anthropometric measures. A comprehensive multicomponent intervention, however, appears to have the best overall outcomes.
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Affiliation(s)
- Tamim Rajjo
- Evidence-Based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery
- Department of Family Medicine
| | - Khaled Mohammed
- Evidence-Based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery
- Division of Preventive, Occupational and Aerospace Medicine, and
| | - Mouaz Alsawas
- Evidence-Based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery
- Division of Preventive, Occupational and Aerospace Medicine, and
| | - Ahmed T Ahmed
- Evidence-Based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery
| | - Wigdan Farah
- Evidence-Based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery
- Division of Preventive, Occupational and Aerospace Medicine, and
| | - Noor Asi
- Evidence-Based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery
- Division of Preventive, Occupational and Aerospace Medicine, and
| | - Jehad Almasri
- Evidence-Based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery
- Division of Preventive, Occupational and Aerospace Medicine, and
| | - Larry J Prokop
- Library Public Services, Mayo Clinic, Rochester, Minnesota 55905
| | - Mohammad Hassan Murad
- Evidence-Based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery
- Division of Preventive, Occupational and Aerospace Medicine, and
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Prevention of alcohol and drug misuse in adolescents: An overview of systematic reviews. NORDIC STUDIES ON ALCOHOL AND DRUGS 2017. [DOI: 10.1515/nsad-2015-0019] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background – Systematic reviews have evaluated a wide variety of programmes aiming to prevent, reduce or delay substance use in adolescents. This paper presents an overview of recent systematic reviews, summarising the evidence on the effectiveness of prevention strategies which target adolescents misusing alcohol and/or drugs. Methods – We performed a comprehensive search in major electronic databases, consulted websites and checked reference lists of relevant articles. Studies that met our inclusion criteria were critically appraised using the AMSTAR instrument. The findings from the included systematic reviews were synthesised using a vote counting procedure. Results – Twenty-one systematic reviews were identified. Ten of these were rated as of high quality. There was little overlap between reviews in terms of the target group, intervention, setting and outcome measures. The components or mechanisms of the prevention programmes were poorly described. Ten reviews evaluated school-based prevention. The effects of these prevention programmes are promising, while effects of community-based, family-based and multi-faceted programmes were less convincing. Conclusion – Based on the current evidence, there is a small but consistent positive effect of school-based prevention programmes, but it is less clear what the “active ingredient” is. For example, which group should one target, in which setting and in which circumstances? A set of standardised process and outcome measures would allow us to better compare and statistically pool the results of original studies and reviews. This overview of reviews, like similar other overviews, should encourage researchers to increase uniformity and consistency between studies. This would improve the comparability of evidence, which is needed to formulate valid recommendations for practice.
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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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Wu X, Tian W, Kubilay NZ, Ren J, Li J. Is It Necessary To Place Prophylactically an Abdominal Drain To Prevent Surgical Site Infection in Abdominal Operations? A Systematic Meta-Review. Surg Infect (Larchmt) 2016; 17:730-738. [PMID: 27513842 DOI: 10.1089/sur.2016.082] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Xiuwen Wu
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Weiliang Tian
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Nejla Zeynep Kubilay
- Infection Prevention and Control Unit, Department of Service Delivery & Safety, World Health Organization, Geneva, Switzerland
| | - Jianan Ren
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jieshou Li
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
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Karmali KN, Lloyd-Jones DM, Berendsen M, Goff DC, Sanghavi DM, Brown N, Korenovska L, Huffman MD. Drugs for Primary Prevention of Atherosclerotic Cardiovascular Disease: An Overview of Systematic Reviews. JAMA Cardiol 2016; 1:341-9. [PMID: 27438118 PMCID: PMC5053397 DOI: 10.1001/jamacardio.2016.0218] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
IMPORTANCE The Million Hearts initiative emphasizes ABCS (aspirin for high-risk patients, blood pressure [BP] control, cholesterol level management, and smoking cessation). Evidence of the effects of drugs used to achieve ABCS has not been synthesized comprehensively in the prevention of primary atherosclerotic cardiovascular disease (ASCVD). OBJECTIVE To compare the efficacy and safety of aspirin, BP-lowering therapy, statins, and tobacco cessation drugs for fatal and nonfatal ASCVD outcomes in primary ASCVD prevention. EVIDENCE REVIEW Structured search of the Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment Database (HTA), MEDLINE, EMBASE, and PROSPERO International Prospective Systematic Review Trial Register to identify systematic reviews published from January 1, 2005, to June 17, 2015, that reported the effect of aspirin, BP-lowering therapy, statin, or tobacco cessation drugs on ASCVD events in individuals without prevalent ASCVD. Additional studies were identified by searching the reference lists of included systematic reviews, meta-analyses, and health technology assessment reports. Reviews were selected according to predefined criteria and appraised for methodologic quality using the Assessment of Multiple Systematic Reviews (AMSTAR) tool (range, 0-11). Studies were independently reviewed for key participant and intervention characteristics. Outcomes that were meta-analyzed in each included review were extracted. Qualitative synthesis was performed, and data were analyzed from July 2 to August 13, 2015. FINDINGS From a total of 1967 reports, 35 systematic reviews of randomized clinical trials were identified, including 15 reviews of aspirin, 4 reviews of BP-lowering therapy, 12 reviews of statins, and 4 reviews of tobacco cessation drugs. Methodologic quality varied, but 30 reviews had AMSTAR ratings of 5 or higher. Compared with placebo, aspirin (relative risk [RR], 0.90; 95% CI, 0.85-0.96) and statins (RR, 0.75; 95% CI, 0.70-0.81) reduced the risk for ASCVD. Compared with placebo, BP-lowering therapy reduced the risk for coronary heart disease (RR, 0.84; 95% CI, 0.79-0.90) and stroke (RR, 0.64; 95% CI, 0.56-0.73). Tobacco cessation drugs increased the odds of continued abstinence at 6 months (odds ratio range, 1.82 [95% CI, 1.60-2.06] to 2.88 [95% CI, 2.40-3.47]), but the direct effects on ASCVD were poorly reported. Aspirin increased the risk for major bleeding (RR, 1.54; 95% CI, 1.30-1.82), and statins did not increase overall risk for adverse effects (RR, 1.00; 95% CI, 0.97-1.03). Adverse effects of BP-lowering therapy and tobacco cessation drugs were poorly reported. CONCLUSIONS AND RELEVANCE This overview demonstrates high-quality evidence to support aspirin, BP-lowering therapy, and statins for primary ASCVD prevention and tobacco cessation drugs for smoking cessation. Treatment effects of each drug can be used to enrich discussions between health care professionals and patients in primary ASCVD prevention.
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Affiliation(s)
- Kunal N. Karmali
- Departments of Preventive Medicine and Medicine-Cardiology, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Donald M. Lloyd-Jones
- Departments of Preventive Medicine and Medicine-Cardiology, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Mark Berendsen
- Galter Health Sciences Library, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - David C. Goff
- Colorado School of Public Health, University of Colorado Anschutz Medical Center, Colorado, USA
| | | | - Nina Brown
- Center for Medicare and Medicaid Services, Baltimore, Maryland
| | | | - Mark D. Huffman
- Departments of Preventive Medicine and Medicine-Cardiology, Northwestern University Feinberg School of Medicine, Chicago, USA
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Shackleton N, Jamal F, Viner R, Dickson K, Hinds K, Patton G, Bonell C. Systematic review of reviews of observational studies of school-level effects on sexual health, violence and substance use. Health Place 2016; 39:168-76. [PMID: 27126364 DOI: 10.1016/j.healthplace.2016.04.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 03/24/2016] [Accepted: 04/05/2016] [Indexed: 01/08/2023]
Abstract
For three decades there have been reports that the quality of schools affects student health. The literature is diverse and reviews have addressed different aspects of how the school environment may affect health. This paper is the first to synthesise this evidence using a review of reviews focusing on substance-use, violence and sexual-health. Twelve databases were searched. Eleven included reviews were quality-assessed and synthesised narratively. There is strong evidence that schools' success in engaging students is associated with reduced substance use. There is little evidence that tobacco-control policies and school sexual-health clinics on their own are associated with better outcomes.
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Affiliation(s)
- Nichola Shackleton
- University College London Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
| | - Farah Jamal
- University College London Institute of Education, 20 Bedford Way, London WC1H 0AL, UK.
| | - Russell Viner
- University College London Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
| | - Kelly Dickson
- University College London Institute of Education, 20 Bedford Way, London WC1H 0AL, UK.
| | - Kate Hinds
- University College London Institute of Education, 20 Bedford Way, London WC1H 0AL, UK.
| | - George Patton
- School Of Paediatrics, Royal Children's Hospital, University of Melbourne, Level 5, 161 Barry Street, Parkville, 3010 VIC, Australia.
| | - Chris Bonell
- University College London Institute of Education, 20 Bedford Way, London WC1H 0AL, UK.
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