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Kelly SE, Brooks SPJ, Benkhedda K, MacFarlane AJ, Greene-Finestone LS, Skidmore B, Clifford TJ, Wells GA. A scoping review shows that no single existing risk of bias assessment tool considers all sources of bias for cross-sectional studies. J Clin Epidemiol 2024; 172:111408. [PMID: 38844117 DOI: 10.1016/j.jclinepi.2024.111408] [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: 02/06/2024] [Revised: 05/27/2024] [Accepted: 05/28/2024] [Indexed: 07/09/2024]
Abstract
OBJECTIVES Different tools to assess the potential risk of bias (RoB) for cross-sectional studies have been developed, but it is unclear whether all pertinent bias concepts are addressed. We aimed to identify RoB concepts applicable to cross-sectional research validity and to explore coverage for each in existing appraisal tools. STUDY DESIGN AND SETTING This scoping review followed the Joanna Briggs Institute methodology. We included records of any study design describing or reporting methods, concepts or tools used to consider RoB in health research reported to be descriptive/prevalence survey or analytic/association (cross-sectional) study designs. Synthesis included quantitative and qualitative analysis. RESULTS Of the 4556 records screened, 90 were selected for inclusion; 67 (74%) described the development of, or validation process for, appraisal tools, 15 (17%) described methodological content or theory relevant to RoB for cross-sectional studies and 8 (9%) records of methodological systematic reviews. Review of methodological reports identified important RoB concepts for both descriptive/prevalence and analytic/association studies. Tools identified (n = 64 unique tools) were either intended to appraise quality or assess RoB in multiple study designs including cross-sectional studies (n = 21; 33%) or cross-sectional designs alone (n = 43; 67%). Several existing tools were modified (n = 17; 27%) for application to cross-sectional studies. The RoB items most frequently addressed in the RoB tools were validity and reliability of the exposure (53%) or outcome (65%) measurement and representativeness of the study population (59%). Most tools did not consider nonresponse or missingness appropriately or at all. CONCLUSION Assessing cross-sectional studies involve unique RoB considerations. We identified RoB tools designed for broad applicability across various study designs as well as those specifically tailored for cross-sectional studies. However, none of the identified tools comprehensively address all potential biases pertinent to cross-sectional studies. Our findings indicate a need for continued improvement of RoB tools and suggest that the development of context-specific or more precise tools for this study design may be necessary.
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Affiliation(s)
- Shannon E Kelly
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
| | | | - Karima Benkhedda
- Bureau of Nutritional Sciences, Health Canada, Ottawa, Ontario, Canada
| | - Amanda J MacFarlane
- Department of Biology, Carleton University, Ottawa, Ontario, Canada; Texas A&M Agriculture, Food, and Nutrition Evidence Center, Fort Worth, Texas, USA
| | | | | | - Tammy J Clifford
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - George A Wells
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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Foreman PK, Margulis AV, Alexander K, Shediac R, Calingaert B, Harding A, Pladevall-Vila M, Landis S. Birth prevalence of phenylalanine hydroxylase deficiency: a systematic literature review and meta-analysis. Orphanet J Rare Dis 2021; 16:253. [PMID: 34082800 PMCID: PMC8173927 DOI: 10.1186/s13023-021-01874-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 05/20/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Phenylalanine hydroxylase (PAH) deficiency is an autosomal recessive disorder that results in elevated concentrations of phenylalanine (Phe) in the blood. If left untreated, the accumulation of Phe can result in profound neurocognitive disability. The objective of this systematic literature review and meta-analysis was to estimate the global birth prevalence of PAH deficiency from newborn screening studies and to estimate regional differences, overall and for various clinically relevant Phe cutoff values used in confirmatory testing. METHODS The protocol for this literature review was registered with PROSPERO (International prospective register of systematic reviews). Pubmed and Embase database searches were used to identify studies that reported the birth prevalence of PAH deficiency. Only studies including numeric birth prevalence reports of confirmed PAH deficiency were included. RESULTS From the 85 publications included in the review, 238 birth prevalence estimates were extracted. After excluding prevalence estimates that did not meet quality assessment criteria or because of temporal and regional overlap, estimates from 45 publications were included in the meta-analysis. The global birth prevalence of PAH deficiency, estimated by weighting regional birth prevalences relative to their share of the population of all regions included in the study, was 0.64 (95% confidence interval [CI] 0.53-0.75) per 10,000 births and ranged from 0.03 (95% CI 0.02-0.05) per 10,000 births in Southeast Asia to 1.18 (95% CI 0.64-1.87) per 10,000 births in the Middle East/North Africa. Regionally weighted global birth prevalences per 10,000 births by confirmatory test Phe cutoff values were 0.96 (95% CI 0.50-1.42) for the Phe cutoff value of 360 ± 100 µmol/L; 0.50 (95% CI 0.37-0.64) for the Phe cutoff value of 600 ± 100 µmol/L; and 0.30 (95% CI 0.20-0.40) for the Phe cutoff value of 1200 ± 200 µmol/L. CONCLUSIONS Substantial regional variation in the birth prevalence of PAH deficiency was observed in this systematic literature review and meta-analysis of published evidence from newborn screening. The precision of the prevalence estimates is limited by relatively small sample sizes, despite widespread and longstanding newborn screening in much of the world.
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Affiliation(s)
- Pamela K Foreman
- BioMarin Pharmaceutical Inc, 770 Lindaro Street, San Rafael, CA, 94901, USA
| | - Andrea V Margulis
- RTI Health Solutions, Barcelona, Av. Diagonal 605, 9-4, 08028, Barcelona, Spain
| | - Kimberly Alexander
- BioMarin Pharmaceutical Inc, 770 Lindaro Street, San Rafael, CA, 94901, USA
| | - Renee Shediac
- BioMarin Pharmaceutical Inc, 770 Lindaro Street, San Rafael, CA, 94901, USA
| | - Brian Calingaert
- RTI Health Solutions, North Carolina, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709-2194, USA
| | - Abenah Harding
- RTI Health Solutions, North Carolina, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709-2194, USA
| | | | - Sarah Landis
- BioMarin (U.K.) Limited, 10 Bloomsbury Way, London, WC1A 2SL, UK.
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Abstract
Methodological flaws, limitations, and inadequate practices in research are well known and pose threats to the internal validity of any research study. However, there are ways of safeguarding research conduct to reduce the chance of research producing distorted results. Numerous tools now exist to assess the incorporation of such safeguards into primary research studies (also known as quality and/or risk-of-bias assessment). These tools typically include a variety of items that are then checked against those implemented in the study. Despite a lot of research in this area, no comprehensive generic classification of safeguards across study designs exist, although attempts have been made to clarify aspects of this. We review the developments in this area as well as use preliminary data from 100 methodological studies to illustrate our proposed approach. We conclude by proposing a new framework for identifying research studies at risk of being biased and the information in this article will promote a unification of the diverse approaches to facilitating bias assessment in clinical research.
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Development, content validation, and reliability of the Assessment of Real-World Observational Studies (ArRoWS) critical appraisal tool. Ann Epidemiol 2020; 55:57-63.e15. [PMID: 33011384 DOI: 10.1016/j.annepidem.2020.09.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 08/21/2020] [Accepted: 09/23/2020] [Indexed: 12/25/2022]
Abstract
PURPOSE The objective was to develop and test a pragmatic critical appraisal tool, the Assessment of Real-World Observational Studies (ArRoWS), to quickly and easily assess the quality of real-world evidence studies using electronic health records. METHODS The initial ArRoWS tool was developed by identifying items frequently found in existing validated assessment instruments and adapting these items to specifically assess real-world evidence studies. The tool was revised based on recommendations from an expert panel of 14 senior academic individuals specializing in epidemiology and content validity was measured. During March 2018-January 2019, 47 large, observational studies related to cardiometabolic medicine were identified through a search algorithm and assessed by three pairs of raters using the ArRoWS tool. RESULTS The final version of the ArRoWS had 16 items including nine core items and seven study design-specific items with item-specific content validity indexes ranging from 0.64 to 1.00. The scale-level content validity index of the ArRoWS appraisal tool was 0.91. When the ArRoWS tool was pilot tested, the observed agreement between assessor pairs on whether the study provided high-quality real-world evidence was 85.7%, 68.8%, and 58.8%. The prevalence adjusted bias-adjusted kappa for the assessor pairs was 0.71, 0.38, and 0.18. CONCLUSION The ArRoWS is a simple tool to standardize the assessment of real-world evidence studies.
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Migliavaca CB, Stein C, Colpani V, Munn Z, Falavigna M. Quality assessment of prevalence studies: a systematic review. J Clin Epidemiol 2020; 127:59-68. [PMID: 32679313 DOI: 10.1016/j.jclinepi.2020.06.039] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 05/19/2020] [Accepted: 06/30/2020] [Indexed: 01/25/2023]
Abstract
OBJECTIVES The objective of the study is to identify items and domains applicable for the quality assessment of prevalence studies. STUDY DESIGN AND SETTING We searched databases and the gray literature to identify tools or guides about the quality assessment of prevalence studies. After study selection, we abstracted questions applicable for prevalence studies and classified into at least one of the following domains: 'population and setting', 'condition measurement', 'statistics', and 'other'. PROSPERO registration:CRD42018088437. RESULTS We included 30 tools: eight (26.7%) specifically designed to appraise prevalence studies and 22 (73.3%) adaptable for this purpose. We identified 12 unique items in the domain "population and setting", 16 in the domain "condition measurement", and 14 in the domain "statistics". Of those, 25 (59.5%) were identified in the eight specific tools. Regarding the domain "other", we identified 77 unique items, mainly related to manuscript writing and reporting (n = 48, 62.3%); of those, 24 (31.2%) were identified in the eight specific tools and 53 (68.8%) in the additional 22 nonspecific tools. CONCLUSION We provide a comprehensive set of items classified by domains that can guide the appraisal of prevalence studies, conduction of primary prevalence studies, and update or development of tools to evaluate prevalence studies.
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Affiliation(s)
- Celina Borges Migliavaca
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, CEP 90035-003, Santa Cecília, Porto Alegre, Rio Grande do Sul, Brazil; Hospital Moinhos de Vento, Porto Alegre, Rua Ramiro Barcelos, 910, CEP 90035-001, Floresta, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Cinara Stein
- Hospital Moinhos de Vento, Porto Alegre, Rua Ramiro Barcelos, 910, CEP 90035-001, Floresta, Porto Alegre, Rio Grande do Sul, Brazil
| | - Verônica Colpani
- Hospital Moinhos de Vento, Porto Alegre, Rua Ramiro Barcelos, 910, CEP 90035-001, Floresta, Porto Alegre, Rio Grande do Sul, Brazil
| | - Zachary Munn
- Joanna Briggs Institute, Faculty of Health Sciences, University of Adelaide, Adelaide, Australia
| | - Maicon Falavigna
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, CEP 90035-003, Santa Cecília, Porto Alegre, Rio Grande do Sul, Brazil; Hospital Moinhos de Vento, Porto Alegre, Rua Ramiro Barcelos, 910, CEP 90035-001, Floresta, Porto Alegre, Rio Grande do Sul, Brazil
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Harder T, Takla A, Eckmanns T, Ellis S, Forland F, James R, Meerpohl JJ, Morgan A, Rehfuess E, Schünemann H, Zuiderent-Jerak T, de Carvalho Gomes H, Wichmann O. PRECEPT: an evidence assessment framework for infectious disease epidemiology, prevention and control. ACTA ACUST UNITED AC 2018; 22. [PMID: 29019317 PMCID: PMC5710124 DOI: 10.2807/1560-7917.es.2017.22.40.16-00620] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Decisions in public health should be based on the best available evidence, reviewed and appraised using a rigorous and transparent methodology. The Project on a Framework for Rating Evidence in Public Health (PRECEPT) defined a methodology for evaluating and grading evidence in infectious disease epidemiology, prevention and control that takes different domains and question types into consideration. The methodology rates evidence in four domains: disease burden, risk factors, diagnostics and intervention. The framework guiding it has four steps going from overarching questions to an evidence statement. In step 1, approaches for identifying relevant key areas and developing specific questions to guide systematic evidence searches are described. In step 2, methodological guidance for conducting systematic reviews is provided; 15 study quality appraisal tools are proposed and an algorithm is given for matching a given study design with a tool. In step 3, a standardised evidence-grading scheme using the Grading of Recommendations Assessment, Development and Evaluation Working Group (GRADE) methodology is provided, whereby findings are documented in evidence profiles. Step 4 consists of preparing a narrative evidence summary. Users of this framework should be able to evaluate and grade scientific evidence from the four domains in a transparent and reproducible way.
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Affiliation(s)
| | - Anja Takla
- Robert Koch Institute (RKI), Berlin, Germany
| | | | - Simon Ellis
- National Institute for Health and Care Excellence (NICE), London, United Kingdom
| | | | - Roberta James
- Scottish Intercollegiate Guidelines Network (SIGN), Edinburgh, United Kingdom
| | - Joerg J Meerpohl
- Cochrane Germany, Medical Center - University of Freiburg, Freiburg, Germany
| | - Antony Morgan
- Glasgow Caledonian University, Glasgow, United Kingdom
| | - Eva Rehfuess
- Institute of Medical Informatics, Biometry and Epidemiology, University of Munich, Munich, Germany
| | - Holger Schünemann
- Department of Health Research Methods, Evidence, and Impact, McMaster University Health Sciences Centre, Hamilton, Canada
| | - Teun Zuiderent-Jerak
- Department of Thematic Studies -Technology and Social Change, Linköping University, Linköping, Sweden
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Yang C, Pinart M, Kolsteren P, Van Camp J, De Cock N, Nimptsch K, Pischon T, Laird E, Perozzi G, Canali R, Hoge A, Stelmach-Mardas M, Dragsted LO, Palombi SM, Dobre I, Bouwman J, Clarys P, Minervini F, De Angelis M, Gobbetti M, Tafforeau J, Coltell O, Corella D, De Ruyck H, Walton J, Kehoe L, Matthys C, De Baets B, De Tré G, Bronselaer A, Rivellese A, Giacco R, Lombardo R, De Clercq S, Hulstaert N, Lachat C. Perspective: Essential Study Quality Descriptors for Data from Nutritional Epidemiologic Research. Adv Nutr 2017; 8:639-651. [PMID: 28916566 PMCID: PMC5593109 DOI: 10.3945/an.117.015651] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Pooled analysis of secondary data increases the power of research and enables scientific discovery in nutritional epidemiology. Information on study characteristics that determine data quality is needed to enable correct reuse and interpretation of data. This study aims to define essential quality characteristics for data from observational studies in nutrition. First, a literature review was performed to get an insight on existing instruments that assess the quality of cohort, case-control, and cross-sectional studies and dietary measurement. Second, 2 face-to-face workshops were organized to determine the study characteristics that affect data quality. Third, consensus on the data descriptors and controlled vocabulary was obtained. From 4884 papers retrieved, 26 relevant instruments, containing 164 characteristics for study design and 93 characteristics for measurements, were selected. The workshop and consensus process resulted in 10 descriptors allocated to "study design" and 22 to "measurement" domains. Data descriptors were organized as an ordinal scale of items to facilitate the identification, storage, and querying of nutrition data. Further integration of an Ontology for Nutrition Studies will facilitate interoperability of data repositories.
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Affiliation(s)
- Chen Yang
- Departments of Food Safety and Food Quality, Ghent University, Ghent, Belgium
| | - Mariona Pinart
- Molecular Epidemiology Research Group, Max Delbrück Centre for Molecular Medicine, Berlin, Germany
| | - Patrick Kolsteren
- Departments of Food Safety and Food Quality, Ghent University, Ghent, Belgium
| | - John Van Camp
- Departments of Food Safety and Food Quality, Ghent University, Ghent, Belgium
| | - Nathalie De Cock
- Departments of Food Safety and Food Quality, Ghent University, Ghent, Belgium
| | - Katharina Nimptsch
- Molecular Epidemiology Research Group, Max Delbrück Centre for Molecular Medicine, Berlin, Germany
| | - Tobias Pischon
- Molecular Epidemiology Research Group, Max Delbrück Centre for Molecular Medicine, Berlin, Germany
- Charité - Berlin University of Medicine, Berlin, Germany
- Max Delbrück Center for Molecular Medicine and Berlin Institute of Health, Berlin, Germany
- German Centre for Cardiovascular Research, partner site, Berlin, Germany
| | - Eamon Laird
- Vitamin Research Group, Trinity College Dublin, Dublin, Ireland
| | | | | | - Axelle Hoge
- Department of Public Health, University of Liège, Liège, Belgium
| | - Marta Stelmach-Mardas
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Lars Ove Dragsted
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Stéphanie Maria Palombi
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Irina Dobre
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Jildau Bouwman
- Netherlands Organisation for Applied Scientific Research, Zeist, Netherlands
| | | | - Fabio Minervini
- Department of Soil, Plant and Food Science, University of Bari Aldo Moro, Bari, Italy
| | - Maria De Angelis
- Department of Soil, Plant and Food Science, University of Bari Aldo Moro, Bari, Italy
| | - Marco Gobbetti
- Faculty of Science and Technology, Free University of Bozen-Bolzano, Bolzano, Italy
| | - Jean Tafforeau
- Department of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium
| | - Oscar Coltell
- Department of Computer Languages and Systems, University Jaume I, Castellón, Spain
- Department of Preventive Medicine and Public Health, University of Valencia, Valencia, Spain
| | - Dolores Corella
- Department of Preventive Medicine and Public Health, University of Valencia, Valencia, Spain
- Biomedical Research Centre in Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | - Hendrik De Ruyck
- Flanders research institute for agriculture, fisheries and food, Technology and Food Science Unit, Food Safety and Product Innovation, Melle, Belgium
| | - Janette Walton
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Laura Kehoe
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Christophe Matthys
- KU Leuven, Clinical and Experimental Endocrinology and University Hospitals Leuven/KU Leuven, Department of Endocrinology, Campus Gasthuisberg, Leuven, Belgium
| | - Bernard De Baets
- Mathematical Modelling, Statistics and Bioinformatic, Ghent University, Ghent, Belgium
| | - Guy De Tré
- Telecommunications and Information Processing, Ghent University, Ghent, Belgium
| | - Antoon Bronselaer
- Telecommunications and Information Processing, Ghent University, Ghent, Belgium
| | - Angela Rivellese
- Department of Clinical Medicine and Surgery, School of Medicine, University Federico II, Naples, Italy
| | - Rosalba Giacco
- Institute of Food Sciences of National Research Council, Avellino, Italy
| | - Rosario Lombardo
- The Microsoft Research, University of Trento Centre for Computational and Systems Biology, Trento, Italy
| | - Sofian De Clercq
- Department of Biochemistry, Ghent University, Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Niels Hulstaert
- Biochemistry, Ghent University, Ghent, Belgium
- VIB-UGent Center for Medical Biotechnology, VIB, Ghent, Belgium
| | - Carl Lachat
- Departments of Food Safety and Food Quality, Ghent University, Ghent, Belgium
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Lefebvre A, Manoha C, Bour JB, Abbas R, Fournel I, Tiv M, Pothier P, Astruc K, Aho-Glélé LS. Human metapneumovirus in patients hospitalized with acute respiratory infections: A meta-analysis. J Clin Virol 2016; 81:68-77. [PMID: 27337518 PMCID: PMC7106388 DOI: 10.1016/j.jcv.2016.05.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 05/26/2016] [Accepted: 05/30/2016] [Indexed: 12/31/2022]
Abstract
This meta-analysis aimed to estimate the prevalence of human metapneumovirus (hMPV) infections in patients hospitalized for acute respiratory infection (ARI) and to study factors associated with this prevalence. Medline and ScienceDirect databases were searched for prospective observational studies that screened hospitalized patients with ARI for hMPV by RT-PCR, with data available at December 27, 2014. The risk of bias was assessed regarding participation rate, definition of ARI, description of diagnostic technique, method of inclusion identical for all subjects, standardized and identical sampling method for all subjects, analysis performed according to the relevant subgroups, and presentation of data sources. Random-effect meta-analysis with arcsine transformation and meta-regressions was used. In the 75 articles included, the prevalence of hMPV among hospitalized ARI was 6.24% (95% CI 5.25-7.30). An effect of the duration of the inclusion period was observed (p=0.0114), with a higher prevalence of hMPV in studies conducted during periods of 7-11 months (10.56%, 95% CI 5.97-16.27) or complete years (7.55%, 95% CI 5.90-9.38) than in periods of 6 months or less (5.36%, 95% CI 4.29-6.54). A significant increase in the incidence with increasing distance from the equator was observed (p=0.0384). hMPV should be taken into account as a possible etiology in hospitalized ARI.
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Affiliation(s)
- Annick Lefebvre
- Epidemiology and infection control unit, Dijon University Hospital, France.
| | | | | | - Rachid Abbas
- Epidemiology and infection control unit, Dijon University Hospital, France
| | - Isabelle Fournel
- Epidemiology and infection control unit, Dijon University Hospital, France
| | - Michel Tiv
- Epidemiology and infection control unit, Dijon University Hospital, France
| | | | - Karine Astruc
- Epidemiology and infection control unit, Dijon University Hospital, France
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Devanarayana NM, Rajindrajith S, Pathmeswaran A, Abegunasekara C, Gunawardena NK, Benninga MA. Epidemiology of irritable bowel syndrome in children and adolescents in Asia. J Pediatr Gastroenterol Nutr 2015; 60:792-798. [PMID: 26000888 DOI: 10.1097/mpg.0000000000000714] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Several cross-sectional surveys have been conducted to study the prevalence of irritable bowel syndrome (IBS) in children. The aim of the present study was to conduct a systematic review and a meta-analysis of published literature to estimate the prevalence of IBS among Asian children. METHOD A computer-assisted search of MEDLINE, EMBASE, PsycINFO, and regional databases of Asia was carried out. Selected articles were reviewed in depth and data were extracted. Pooled prevalence, sex differences, and 95% confidence intervals were calculated. Heterogeneity of the studies was assessed using the I(2) test. RESULTS A total of 16 cross-sectional studies that reported prevalence of IBS (in children and adolescents) and qualified to be included were taken into the final analysis containing 38,076 patients. Selected studies are from China, Korea, Japan, Iran, Sri Lanka, and Saudi Arabia. Studies showed a marked heterogeneity with I(2) of 98.59 (P < 0.0001). Prevalence of IBS ranges from 2.8% to 25.7%, with a pooled prevalence of 12.41% (95% confidence interval 9.87-14.95). Prevalence risk ratio of girl:boy is 1.39. Prevalence of subtypes is diverse and varies between studies. CONCLUSIONS The published data indicate that IBS is a significant problem among Asian children and adolescents. Female sex predisposes children and adolescents to develop IBS.
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Affiliation(s)
- Niranga M Devanarayana
- *Department of Physiology †Department of Pediatrics ‡Department of Public Health §Department of Library ||Department of Parasitology, Faculty of Medicine, University of Kelaniya, Thalagolla Road, Ragama, Sri Lanka ¶Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Academic Medical Centre, Amsterdam, The Netherlands
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10
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Harder T, Takla A, Rehfuess E, Sánchez-Vivar A, Matysiak-Klose D, Eckmanns T, Krause G, de Carvalho Gomes H, Jansen A, Ellis S, Forland F, James R, Meerpohl JJ, Morgan A, Schünemann H, Zuiderent-Jerak T, Wichmann O. Evidence-based decision-making in infectious diseases epidemiology, prevention and control: matching research questions to study designs and quality appraisal tools. BMC Med Res Methodol 2014; 14:69. [PMID: 24886571 PMCID: PMC4063433 DOI: 10.1186/1471-2288-14-69] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 05/08/2014] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The Project on a Framework for Rating Evidence in Public Health (PRECEPT) was initiated and is being funded by the European Centre for Disease Prevention and Control (ECDC) to define a methodology for evaluating and grading evidence and strength of recommendations in the field of public health, with emphasis on infectious disease epidemiology, prevention and control. One of the first steps was to review existing quality appraisal tools (QATs) for individual research studies of various designs relevant to this area, using a question-based approach. METHODS Through team discussions and expert consultations, we identified 20 relevant types of public health questions, which were grouped into six domains, i.e. characteristics of the pathogen, burden of disease, diagnosis, risk factors, intervention, and implementation of intervention. Previously published systematic reviews were used and supplemented by expert consultation to identify suitable QATs. Finally, a matrix was constructed for matching questions to study designs suitable to address them and respective QATs. Key features of each of the included QATs were then analyzed, in particular in respect to its intended use, types of questions and answers, presence/absence of a quality score, and if a validation was performed. RESULTS In total we identified 21 QATs and 26 study designs, and matched them. Four QATs were suitable for experimental quantitative study designs, eleven for observational quantitative studies, two for qualitative studies, three for economic studies, one for diagnostic test accuracy studies, and one for animal studies. Included QATs consisted of six to 28 items. Six of the QATs had a summary quality score. Fourteen QATs had undergone at least one validation procedure. CONCLUSIONS The results of this methodological study can be used as an inventory of potentially relevant questions, appropriate study designs and QATs for researchers and authorities engaged with evidence-based decision-making in infectious disease epidemiology, prevention and control.
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Affiliation(s)
- Thomas Harder
- Robert Koch Institute, Berlin, Germany
- Immunization Unit, Department for Infectious Disease Epidemiology, Robert Koch Institute, Seestrasse 10, Berlin 13353, Germany
| | | | - Eva Rehfuess
- Institute of Medical Informatics, Biometry and Epidemiology, University of Munich, Munich, Germany
| | - Alex Sánchez-Vivar
- Health Protection Scotland (HPS) and the Scottish Health Protection Network (HPN), Glasgow, UK
| | | | | | - Gérard Krause
- Robert Koch Institute, Berlin, Germany
- Helmholtz Centre for Infection Research, Braunschweig, Germany
| | | | - Andreas Jansen
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Simon Ellis
- National Institute for Health and Care Excellence (NICE), London, UK
| | - Frode Forland
- Royal Tropical Institute, Amsterdam, The Netherlands
- Norwegian Institute of Public Health, Oslo, Norway
| | - Roberta James
- Scottish Intercollegiate Guidelines Network (SIGN), Edinburgh, UK
| | - Joerg J Meerpohl
- German Cochrane Center, University Medical Center Freiburg, Freiburg, Germany
| | - Antony Morgan
- National Institute for Health and Care Excellence (NICE), London, UK
| | - Holger Schünemann
- Departments of Clinical Epidemiology, Biostatistics & Medicine, McMaster University Health Sciences Centre, Hamilton, ON, Canada
| | - Teun Zuiderent-Jerak
- Department of Technology and Social Change, Linköping University, Linköping, Sweden
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Hemminki K, Li X, Sundquist K. Familial Risks for Diseases of Myoneural Junction and Muscle in Siblings Based on Hospitalizations and Deaths in Sweden. Twin Res Hum Genet 2012. [DOI: 10.1375/twin.9.4.573] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractDiseases of the myoneural junction and muscle are disabling and some are life-threatening. Recent successes in the identification of the underlying genetic mechanisms have had profound implication for their diagnostics, treatment and classification. We define familial risks for siblings who were hospitalized for or deceased from diseases of the myoneural junction and muscle. A nationwide database on diseases of the myoneural junction and muscle was constructed by linking the Multigeneration Register on 0- to 69-year-old siblings to the Hospital Discharge Register and the Causes of Death Register from years 1987 to 2001. Standardized risk ratios (SIRs) were calculated for affected sibling pairs by comparing to those whose siblings had no diseases of myoneural junction and muscle. Among a total of 2307 patients, myasthenia gravis, muscular dystrophy and myotonic disorders were commonest diagnoses. The sibling risks for these disease were 22, 190 and 198, respectively, when a sibling was diagnosed with any disease of the myoneural junction and muscle. The concordant SIRs, both siblings presenting the same disease, were 42 for myasthenia gravis, 737 for muscular dystrophy, 2000 for congenital myopathy, 1211 for myotonic disorder, 909 for periodic paralysis and 209 for unspecified myopathy. Only a few discordant sibling pairs were noted. The very high overall SIRs for the diseases of the myoneural junction and muscle imply that the sporadic forms of these diseases are relatively rare and these diseases are overwhelmingly heritable.
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Shamliyan TA, Kane RL, Ansari MT, Raman G, Berkman ND, Grant M, Janes G, Maglione M, Moher D, Nasser M, Robinson KA, Segal JB, Tsouros S. Development quality criteria to evaluate nontherapeutic studies of incidence, prevalence, or risk factors of chronic diseases: pilot study of new checklists. J Clin Epidemiol 2010; 64:637-57. [PMID: 21071174 DOI: 10.1016/j.jclinepi.2010.08.006] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Revised: 08/01/2010] [Accepted: 08/22/2010] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To develop two checklists for the quality of observational studies of incidence or risk factors of diseases. STUDY DESIGN AND SETTING Initial development of the checklists was based on a systematic literature review. The checklists were refined after pilot trials of validity and reliability were conducted by seven experts, who tested the checklists on 10 articles. RESULTS The checklist for studies of incidence or prevalence of chronic disease had six criteria for external validity and five for internal validity. The checklist for risk factor studies had six criteria for external validity, 13 criteria for internal validity, and two aspects of causality. A Microsoft Access database produced automated standardized reports about external and internal validities. Pilot testing demonstrated face and content validities and discrimination of reporting vs. methodological qualities. Interrater agreement was poor. The experts suggested future reliability testing of the checklists in systematic reviews with preplanned protocols, a priori consensus about research-specific quality criteria, and training of the reviewers. CONCLUSION We propose transparent and standardized quality assessment criteria of observational studies using the developed checklists. Future testing of the checklists in systematic reviews is necessary to develop reliable tools that can be used with confidence.
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Affiliation(s)
- Tatyana A Shamliyan
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA
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Shamliyan T, Kane RL, Dickinson S. A systematic review of tools used to assess the quality of observational studies that examine incidence or prevalence and risk factors for diseases. J Clin Epidemiol 2010; 63:1061-70. [DOI: 10.1016/j.jclinepi.2010.04.014] [Citation(s) in RCA: 152] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2009] [Revised: 03/30/2010] [Accepted: 04/04/2010] [Indexed: 12/01/2022]
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McGrath J, Saha S, Welham J, El Saadi O, MacCauley C, Chant D. A systematic review of the incidence of schizophrenia: the distribution of rates and the influence of sex, urbanicity, migrant status and methodology. BMC Med 2004; 2:13. [PMID: 15115547 PMCID: PMC421751 DOI: 10.1186/1741-7015-2-13] [Citation(s) in RCA: 579] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2003] [Accepted: 04/28/2004] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Understanding variations in the incidence of schizophrenia is a crucial step in unravelling the aetiology of this group of disorders. The aims of this review are to systematically identify studies related to the incidence of schizophrenia, to describe the key features of these studies, and to explore the distribution of rates derived from these studies. METHODS Studies with original data related to the incidence of schizophrenia (published 1965-2001) were identified via searching electronic databases, reviewing citations and writing to authors. These studies were divided into core studies, migrant studies, cohort studies and studies based on Other Special Groups. Between- and within-study filters were applied in order to identify discrete rates. Cumulative plots of these rates were made and these distributions were compared when the underlying rates were sorted according to sex, urbanicity, migrant status and various methodological features. RESULTS We identified 100 core studies, 24 migrant studies, 23 cohort studies and 14 studies based on Other Special Groups. These studies, which were drawn from 33 countries, generated a total of 1,458 rates. Based on discrete core data for persons (55 studies and 170 rates), the distribution of rates was asymmetric and had a median value (10%-90% quantile) of 15.2 (7.7-43.0) per 100,000. The distribution of rates was significantly higher in males compared to females; the male/female rate ratio median (10%-90% quantile) was 1.40 (0.9-2.4). Those studies conducted in urban versus mixed urban-rural catchment areas generated significantly higher rate distributions. The distribution of rates in migrants was significantly higher compared to native-born; the migrant/native-born rate ratio median (10%-90% quantile) was 4.6 (1.0-12.8). Apart from the finding that older studies reported higher rates, other study features were not associated with significantly different rate distributions (e.g. overall quality, methods related to case finding, diagnostic confirmation and criteria, the use of age-standardization and age range). CONCLUSIONS There is a wealth of data available on the incidence of schizophrenia. The width and skew of the rate distribution, and the significant impact of sex, urbanicity and migrant status on these distributions, indicate substantial variations in the incidence of schizophrenia.
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Affiliation(s)
- John McGrath
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Q4076, Australia
- Department of Psychiatry, University of Queensland, St Lucia, Q4072, Australia
| | - Sukanta Saha
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Q4076, Australia
| | - Joy Welham
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Q4076, Australia
| | - Ossama El Saadi
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Q4076, Australia
| | - Clare MacCauley
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Q4076, Australia
| | - David Chant
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Q4076, Australia
- Department of Psychiatry, University of Queensland, St Lucia, Q4072, Australia
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