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Jia Z, Greven J, Hildebrand F, Kobbe P, Eschweiler J. Conservative treatment versus surgical reconstruction for ACL rupture: A systemic review. J Orthop 2024; 57:8-16. [PMID: 38948499 PMCID: PMC11208802 DOI: 10.1016/j.jor.2024.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 05/30/2024] [Indexed: 07/02/2024] Open
Abstract
Background Anterior cruciate ligament (ACL) rupture is a prevalent sports injury with rising rates attributed to increased population participation in sports activities. ACL rupture can lead to severe knee complications including cartilage damage, torn meniscus, and osteoarthritis. Current treatment options include conservative measures and surgical interventions. However, debates persist regarding the optimal approach. Purpose This analysis intended to compare the function, knee stability, and incidence rate of secondary surgery between conservative and surgical treatments in ACL rupture patients. Methods A systematic search was performed via Embase, Ovid Medline, PubMed, Cochrane Library, Web of Science, and Google Scholar for reporting outcomes of conservative and surgical treatments after ACL rupture. The outcomes included patient-reported outcome measures (PROMs), knee stability, the need for secondary meniscal surgery, delayed ACL reconstruction surgery, and revision ACL reconstruction surgery. Outcomes were analyzed using mean differences or odd ratios (OR) with 95 % CIs. Results 11 studies were included with 1516 patients. For PROMs, our evidence indicated no differences in KOOS Pain, KOOS Symptoms, KOOS Sport/Rec, KOOS ADL, and KOOS QOL. (all p > 0.05). for knee stability, pivot shift (OR, 0.14; p < 0.001), Lachman test (OR, 0.06; p < 0.001), and tibia translation (p < 0.001) were evaluated, and the available evidence favored surgical treatment over conservative treatment. For the incidence rate of any secondary surgery after the first diagnosis, the surgical group showed a lower rate of meniscal surgery with statistical significance (OR, 0.37; p < 0.001). The average rate of revision ACL reconstruction is 5.80 %, while the rate of delayed ACL reconstruction after conservative treatment is 18.51 %. Conclusion Currently, there is insufficient empirical evidence to advocate a systematic surgical reconstruction for any patient who tore his ACL. This review found no differences in function outcomes between conservative and surgical treatments. Regarding knee stability and secondary meniscal surgery, the results prefer the surgical treatments. The occurrence rate of revision and delayed ACL reconstruction are non-negligible factors that must be fully understood by both surgeons and patients before choosing a suitable treatment.
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Affiliation(s)
- Zhongyu Jia
- Department for Orthopaedic, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Germany
| | - Johannes Greven
- Department for Thoracic Surgery, RWTH Aachen University Hospital, Germany
| | - Frank Hildebrand
- Department for Orthopaedic, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Germany
| | - Philipp Kobbe
- Department for Trauma and Reconstructive Surgery, BG Hospital Bergmannstrost Halle, Halle (Saale), Germany
- Department for Trauma and Reconstructive Surgery, University Hospital of the Martin Luther University Halle, Halle (Saale), Germany
| | - Jörg Eschweiler
- Department for Trauma and Reconstructive Surgery, BG Hospital Bergmannstrost Halle, Halle (Saale), Germany
- Department for Trauma and Reconstructive Surgery, University Hospital of the Martin Luther University Halle, Halle (Saale), Germany
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Farooq HZ, Whitton L, Mwendera C, Divall P, Spitters SJIM, Anderson J, Thornhill JP. Virtual care pathways for people living with HIV: A mixed-methods systematic review. HIV Med 2024. [PMID: 39289147 DOI: 10.1111/hiv.13701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 08/09/2024] [Indexed: 09/19/2024]
Abstract
BACKGROUND The COVID-19 pandemic prompted an unprecedented surge in virtual services, necessitating a rapid shift to digital healthcare approaches. This review focuses on evaluating the evidence of virtual care (VC) in delivering HIV care, considering the complex nature of HIV and the need for tailored-approaches, especially for marginalized populations. METHODS A mixed-methods systematic review was performed with searches on five databases, covering studies from January 1946 to May 2022. Inclusion criteria involved two-way virtual consultations between healthcare workers and people living with HIV (PLHIV), with detailed descriptions and outcomes. Qualitative and quantitative studies were included, and the risk of bias was assessed using the Newcastle-Ottawa score and Stenfors' framework. RESULTS Among 4143 identified records, 26 studies met the criteria, with various models of care described. The majority of studies were observational, and videoconferencing was the primary mode of virtual consultation employed. Quantitative analysis revealed PLHIV generally accept VC, with high attendance rates (87%). Mean acceptability and satisfaction rates were 80% and 85%, respectively, while 87% achieved HIV viral suppression. The setting and models of VC implementation varied, with some introduced in response to COVID-19 while others were as part of trials. CONCLUSIONS VC for PLHIV is deemed an acceptable and effective approach and is associated with good virological outcomes. Data on other health outcomes is lacking. The review underscores the importance of diverse models of care, patient choice and comprehensive training initiatives for both staff and patients. Establishing a 'gold standard' for VC models is crucial for ensuring appropriate and effective reviews of PLHIV in virtual settings.
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Affiliation(s)
- Hamzah Z Farooq
- SHARE Collaborative, Queen Mary University of London, London, UK
- Blizard Institute, Queen Mary University of London, London, UK
- Department of Infection and Immunity, Barts Health NHS Trust, London, UK
- Department of Infectious Diseases and Tropical Medicine, North Manchester General Hospital, Manchester University Foundation Trust, Manchester, UK
- Department of Virology, UK Health Security Agency Manchester, Manchester, UK
| | - Louise Whitton
- SHARE Collaborative, Queen Mary University of London, London, UK
- Blizard Institute, Queen Mary University of London, London, UK
- Department of Infection and Immunity, Barts Health NHS Trust, London, UK
| | - Chikondi Mwendera
- SHARE Collaborative, Queen Mary University of London, London, UK
- Blizard Institute, Queen Mary University of London, London, UK
- Department of Infection and Immunity, Barts Health NHS Trust, London, UK
| | - Pip Divall
- University Hospitals of Leicester Library, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Sophie J I M Spitters
- SHARE Collaborative, Queen Mary University of London, London, UK
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Jane Anderson
- SHARE Collaborative, Queen Mary University of London, London, UK
- Blizard Institute, Queen Mary University of London, London, UK
- Department of Infection and Immunity, Barts Health NHS Trust, London, UK
| | - John P Thornhill
- SHARE Collaborative, Queen Mary University of London, London, UK
- Blizard Institute, Queen Mary University of London, London, UK
- Department of Infection and Immunity, Barts Health NHS Trust, London, UK
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Bell Z, Nguyen G, Andreae G, Scott S, Sermin-Reed L, Lake AA, Heslehurst N. Associations between food insecurity in high-income countries and pregnancy outcomes: A systematic review and meta-analysis. PLoS Med 2024; 21:e1004450. [PMID: 39255262 PMCID: PMC11386426 DOI: 10.1371/journal.pmed.1004450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 07/24/2024] [Indexed: 09/12/2024] Open
Abstract
BACKGROUND Maternal nutrition is crucial for health in pregnancy and across the generations. Experiencing food insecurity during pregnancy is a driver of inequalities in maternal diet with potential maternal and infant health consequences. This systematic review explored associations between food insecurity in pregnancy and maternal and infant health outcomes. METHODS AND FINDINGS Searches included 8 databases (MEDLINE, Embase, Scopus, Web of Science, PsychInfo, ASSIA, SSPC in ProQuest, and CINAHL), grey literature, forwards and backwards citation chaining, and contacting authors. Studies in high-income countries (HICs) reporting data on food insecurity in pregnancy and maternal or infant health, from January 1, 2008 to November 21, 2023 were included. Screening, data extraction, and quality assessment were carried out independently in duplicate. Random effects meta-analysis was performed when data were suitable for pooling, otherwise narrative synthesis was conducted. The protocol was registered on PROSPERO (CRD42022311669), reported with PRISMA checklist (S1 File). Searches identified 24,223 results and 25 studies (n = 93,871 women) were included: 23 from North America and 2 from Europe. Meta-analysis showed that food insecurity was associated with high stress level (OR 4.07, 95% CI [1.22, 13.55], I2 96.40%), mood disorder (OR 2.53, 95% CI [1.46, 4.39], I2 55.62%), gestational diabetes (OR 1.64, 95% CI [1.37, 1.95], I2 0.00%), but not cesarean delivery (OR 1.42, 95% CI [0.78, 2.60], I2 56.35%), birth weight (MD -58.26 g, 95% CI [-128.02, 11.50], I2 38.41%), small-for-gestational-age (OR 1.20, 95%, CI [0.88, 1.63], I2 44.66%), large-for-gestational-age (OR 0.88, 95% CI [0.70, 1.12] I2 11.93%), preterm delivery (OR 1.18, 95% CI [0.98, 1.42], I2 0.00%), or neonatal intensive care (OR 2.01, 95% CI [0.85, 4.78], I2 70.48%). Narrative synthesis showed food insecurity was significantly associated with dental problems, depression, anxiety, and maternal serum concentration of perfluoro-octane sulfonate. There were no significant associations with other organohalogen chemicals, assisted delivery, postpartum haemorrhage, hospital admissions, length of stay, congenital anomalies, or neonatal morbidity. Mixed associations were reported for preeclampsia, hypertension, and community/resilience measures. CONCLUSIONS Maternal food insecurity is associated with some adverse pregnancy outcomes, particularly mental health and gestational diabetes. Most included studies were conducted in North America, primarily the United States of America, highlighting a research gap across other contexts. Further research in other HICs is needed to understand these associations within varied contexts, such as those without embedded interventions in place, to help inform policy and care requirements.
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Affiliation(s)
- Zoë Bell
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom
- Department of Nutritional Sciences, King’s College London, London, United Kingdom
| | - Giang Nguyen
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom
- Fuse, The Centre for Translational Research in Public Health, Newcastle Upon Tyne, United Kingdom
| | - Gemma Andreae
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Stephanie Scott
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom
- Fuse, The Centre for Translational Research in Public Health, Newcastle Upon Tyne, United Kingdom
| | - Letitia Sermin-Reed
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Amelia A. Lake
- Fuse, The Centre for Translational Research in Public Health, Newcastle Upon Tyne, United Kingdom
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Nicola Heslehurst
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom
- Fuse, The Centre for Translational Research in Public Health, Newcastle Upon Tyne, United Kingdom
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Donaldson LH, Vlok R, Sakurai K, Burrows M, McDonald G, Venkatesh K, Bagshaw SM, Bellomo R, Delaney A, Myburgh J, Hammond NE, Venkatesh B. Quantifying the Impact of Alternative Definitions of Sepsis-Associated Acute Kidney Injury on its Incidence and Outcomes: A Systematic Review and Meta-Analysis. Crit Care Med 2024; 52:1264-1274. [PMID: 38557802 DOI: 10.1097/ccm.0000000000006284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
OBJECTIVES To derive a pooled estimate of the incidence and outcomes of sepsis-associated acute kidney injury (SA-AKI) in ICU patients and to explore the impact of differing definitions of SA-AKI on these estimates. DATA SOURCES Medline, Medline Epub, EMBASE, and Cochrane CENTRAL between 1990 and 2023. STUDY SELECTION Randomized clinical trials and prospective cohort studies of adults admitted to the ICU with either sepsis and/or SA-AKI. DATA EXTRACTION Data were extracted in duplicate. Risk of bias was assessed using adapted standard tools. Data were pooled using a random-effects model. Heterogeneity was assessed by using a single covariate logistic regression model. The primary outcome was the proportion of participants in ICU with sepsis who developed AKI. DATA SYNTHESIS A total of 189 studies met inclusion criteria. One hundred fifty-four reported an incidence of SA-AKI, including 150,978 participants. The pooled proportion of patients who developed SA-AKI across all definitions was 0.40 (95% CI, 0.37-0.42) and 0.52 (95% CI, 0.48-0.56) when only the Risk Injury Failure Loss End-Stage, Acute Kidney Injury Network, and Improving Global Outcomes definitions were used to define SA-AKI. There was significant variation in the incidence of SA-AKI depending on the definition of AKI used and whether AKI defined by urine output criteria was included; the incidence was lowest when receipt of renal replacement therapy was used to define AKI (0.26; 95% CI, 0.24-0.28), and highest when the Acute Kidney Injury Network score was used (0.57; 95% CI, 0.45-0.69; p < 0.01). Sixty-seven studies including 29,455 participants reported at least one SA-AKI outcome. At final follow-up, the proportion of patients with SA-AKI who had died was 0.48 (95% CI, 0.43-0.53), and the proportion of surviving patients who remained on dialysis was 0.10 (95% CI, 0.04-0.17). CONCLUSIONS SA-AKI is common in ICU patients with sepsis and carries a high risk of death and persisting kidney impairment. The incidence and outcomes of SA-AKI vary significantly depending on the definition of AKI used.
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Affiliation(s)
- Lachlan H Donaldson
- Critical Care Program, The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Kensington, NSW, Australia
- Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Ruan Vlok
- Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Ken Sakurai
- Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Morgan Burrows
- Intensive Care Unit, North Shore Private Hospital, St Leonards, NSW, Australia
| | - Gabrielle McDonald
- Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Karthik Venkatesh
- Critical Care Program, The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Kensington, NSW, Australia
- Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Sean M Bagshaw
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, AB, Canada
| | - Rinaldo Bellomo
- Department of Intensive Care, Royal Melbourne Hospital, Melbourne, VIC, Australia
- Department of Epidemiology and Preventive Medicine, Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia
| | - Anthony Delaney
- Critical Care Program, The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Kensington, NSW, Australia
- Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - John Myburgh
- Critical Care Program, The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Kensington, NSW, Australia
- Department of Intensive Care Medicine, St George Hospital, Sydney, NSW, Australia
| | - Naomi E Hammond
- Critical Care Program, The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Kensington, NSW, Australia
- Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Balasubramanian Venkatesh
- Critical Care Program, The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Kensington, NSW, Australia
- Intensive Care Unit, Princess Alexandra and Wesley Hospitals, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
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Prentice S, Mullner H, Benson J, Kay M. Family medicine and general practitioner supervisor wellbeing: a literature review. BJGP Open 2024:BJGPO.2023.0230. [PMID: 38479758 DOI: 10.3399/bjgpo.2023.0230] [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: 11/20/2023] [Revised: 12/14/2023] [Accepted: 12/14/2023] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Research examining general practice supervisor wellbeing has often been conducted within the context of trainee wellbeing and educational outcomes. AIM To consolidate the current literature regarding the wellbeing of GP supervisors through a 'supervisor-wellbeing' lens. DESIGN & SETTING Literature review of original research studies on Embase, Ovid MEDLINE, and Ovid PsycINFO from inception to December 2022. METHOD The Embase, Ovid MEDLINE, and Ovid PsycINFO databases were systematically searched from inception to December 2022. Original research studies were eligible if they explored any aspect of wellbeing or burnout (that is, construct conceptualisations, risk and protective factors, implications, or interventions) among GPs involved in educating GP trainees. Reporting quality of included studies was assessed using the QualSyst tool. Results from included studies were narratively synthesised. RESULTS Data from 26 independent samples were reviewed. Burnout was generally conceptualised using the Leiter and Maslach model. Wellbeing was poorly defined in the literature, largely being conceptualised in personal psychological terms and, to a lesser extent, professional satisfaction. Risk and protective factors were identified and grouped as individual (for example, satisfaction with capacity to teach) and external (for example, autonomy, collegial relationships, resource availability) factors. GP supervisors' wellbeing appeared to affect their job performance and retention. This review identified only two studies evaluating interventions to support GP supervisors' wellbeing. CONCLUSION The present review highlights a lack of conceptual clarity and research examining interventions for GP supervisor wellbeing. It provides guidance for future research designed to maximise the wellbeing of GP supervisors and support the wellbeing of trainees.
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Affiliation(s)
- Shaun Prentice
- School of Psychology, The University of Adelaide, Adelaide, South Australia
- General Practice Training Research Department, Royal Australian College of General Practitioners, Adelaide, South Australia
| | - Helen Mullner
- General Practice Training, Royal Australian College of General Practitioners, Adelaide, South Australia
| | - Jill Benson
- General Practice Training, Royal Australian College of General Practitioners, Adelaide, South Australia
- School of Medicine, The University of Adelaide, Adelaide, Australia
| | - Margaret Kay
- General Practice Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, Queensland
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Nguyen G, Bell Z, Andreae G, Scott S, Sermin-Reed L, Lake AA, Heslehurst N. Food insecurity during pregnancy in high-income countries, and maternal weight and diet: A systematic review and meta-analysis. Obes Rev 2024; 25:e13753. [PMID: 38693587 DOI: 10.1111/obr.13753] [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: 03/17/2023] [Revised: 02/15/2024] [Accepted: 03/26/2024] [Indexed: 05/03/2024]
Abstract
Food insecurity is a well-established obesity driver. Less is known about food insecurity during pregnancy. This review (PROSPERO:CRD42022311669) aimed to explore associations between food insecurity, maternal obesity, gestational weight gain (GWG), and nutrition. Searches included seven databases, gray literature, references, citations, and contacting authors. Observational studies reporting data from January 1st, 2008 to 21 November 2023 in high-income countries were included. Duplicate screening, data extraction, and quality assessments were performed. Random effects meta-analysis estimated odds ratios (OR), mean difference (MD), and 95% confidence intervals (CI). Narrative synthesis was conducted when data could not be pooled. Database searches identified 22,272 results; 20 studies were included (n = 19 North America, n = 1 Europe; n = 32,803 women). Food insecurity significantly increased obesity (OR 1.53 95%CI 1.39, 1.66), but not underweight (OR 1.12 95%CI 0.89, 1.34) or overweight (OR 1.18 95%CI 0.90, 1.46). Food insecurity significantly reduced GWG (MD -0.42 kg 95%CI -0.62, -0.22) and increased inadequate GWG (OR 1.16 95%CI 1.05, 1.28), but not excessive GWG (OR 1.04 95%CI 0.96, 1.13). Diet outcomes were inconsistent, with some evidence of reduced vitamin E and diet quality and increased red/processed meat consumption. Further studies outside of North America are needed to inform practice and policy to support maternal health.
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Affiliation(s)
- Giang Nguyen
- Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Zoë Bell
- Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
- Department of Nutritional Sciences, King's College London, London, UK
| | - Gemma Andreae
- Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Stephanie Scott
- Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle Upon Tyne, UK
| | - Letitia Sermin-Reed
- Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Amelia A Lake
- Fuse, The Centre for Translational Research in Public Health, Newcastle Upon Tyne, UK
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Nicola Heslehurst
- Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle Upon Tyne, UK
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7
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Zhong W, Luo J, Zhang H. The therapeutic effectiveness of artificial intelligence-based chatbots in alleviation of depressive and anxiety symptoms in short-course treatments: A systematic review and meta-analysis. J Affect Disord 2024; 356:459-469. [PMID: 38631422 DOI: 10.1016/j.jad.2024.04.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 04/10/2024] [Accepted: 04/14/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND The emergence of artificial intelligence-based chatbot has revolutionized the field of clinical psychology and psychotherapy, granting individuals unprecedented access to professional assistance, overcoming time constraints and geographical limitations with cost-effective convenience. However, despite its potential, there has been a noticeable gap in the literature regarding their effectiveness in addressing common mental health issues like depression and anxiety. This meta-analysis aims to evaluate the efficacy of AI-based chatbots in treating these conditions. METHODS A systematic search was executed across multiple databases, including PubMed, Cochrane Library, Web of Science, PsycINFO, and Embase on April 4th, 2024. The effect size of treatment efficacy was calculated using the standardized mean difference (Hedge's g). Quality assessment measures were implemented to ensure trial's quality. RESULTS In our analysis of 18 randomized controlled trials involving 3477 participants, we observed noteworthy improvements in depression (g = -0.26, 95 % CI = -0.34, -0.17) and anxiety (g = -0.19, 95 % CI = -0.29, -0.09) symptoms. The most significant benefits were evident after 8 weeks of treatment. However, at the three-month follow-up, no substantial effects were detected for either condition. LIMITATIONS Several limitations should be considered. These include the lack of diversity in the study populations, variations in chatbot design, and the use of different psychotherapeutic approaches. These factors may limit the generalizability of our findings. CONCLUSION This meta-analysis highlights the promising role of AI-based chatbot interventions in alleviating depressive and anxiety symptoms among adults. Our results indicate that these interventions can yield substantial improvements over a relatively brief treatment period.
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Affiliation(s)
- Wenjun Zhong
- Center for Studies of Education and Psychology of Ethnic Minorities in Southwest China, Southwest University, Chongqing, China
| | - Jianghua Luo
- Center for Studies of Education and Psychology of Ethnic Minorities in Southwest China, Southwest University, Chongqing, China.
| | - Hong Zhang
- Center for Psychological Health Education, Xinjiang University of Finance & Economics, Urumqi, Xinjiang, China
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8
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Weerapol N, Leelakanok N. Communication between healthcare professionals and patients with hearing loss: A systematic review and meta-analysis. Am J Health Syst Pharm 2024; 81:521-530. [PMID: 38430534 DOI: 10.1093/ajhp/zxae045] [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: 02/16/2024] [Indexed: 03/04/2024] Open
Abstract
PURPOSE We aimed to systematically review and meta-analyze published evidence on modes of communication between healthcare professionals and patients with hearing loss. METHODS MEDLINE/PubMed, Scopus, CINAHL, ScienceDirect, and Thai Journals Online Complete databases were searched. A meta-analysis was performed using a random-effects model. Data on the prevalence and types of communication between healthcare professionals and patients with any extent of hearing loss were extracted. RESULTS Twenty studies were included. Using a hearing aid (pooled prevalence, 57.4%; 95% CI, 11.4%-103.4%, N = 3, I2 = 99.33) and gestures (pooled prevalence = 54.8%, 95%CI: 17.4% to 92.1%, N = 7, I2 = 99.68) were the most commonly reported modes of communication. Few healthcare professionals could use sign language, and limited access to qualified interpreters was common. CONCLUSION Communication barriers exist. Qualified sign language interpreters and assistive technology should be used to improve communication.
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Affiliation(s)
- Neeranun Weerapol
- Department of Pharmacy, Sawaengha Hospital, Ang Thong, Thailand
- Division of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, Chonburi, Thailand
| | - Nattawut Leelakanok
- Division of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, Chonburi, Thailand
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Guo Q, Jiang G, Zhao Q, Long Y, Feng K, Gu X, Xu Y, Li Z, Huang J, Du L. Rapid review: A review of methods and recommendations based on current evidence. J Evid Based Med 2024; 17:434-453. [PMID: 38512942 DOI: 10.1111/jebm.12594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 02/28/2024] [Indexed: 03/23/2024]
Abstract
Rapid review (RR) could accelerate the traditional systematic review (SR) process by simplifying or omitting steps using various shortcuts. With the increasing popularity of RR, numerous shortcuts had emerged, but there was no consensus on how to choose the most appropriate ones. This study conducted a literature search in PubMed from inception to December 21, 2023, using terms such as "rapid review" "rapid assessment" "rapid systematic review" and "rapid evaluation". We also scanned the reference lists and performed citation tracking of included impact studies to obtain more included studies. We conducted a narrative synthesis of all RR approaches, shortcuts and studies assessing their effectiveness at each stage of RRs. Based on the current evidence, we provided recommendations on utilizing certain shortcuts in RRs. Ultimately, we identified 185 studies focusing on summarizing RR approaches and shortcuts, or evaluating their impact. There was relatively sufficient evidence to support the use of the following shortcuts in RRs: limiting studies to those published in English-language; conducting abbreviated database searches (e.g., only searching PubMed/MEDLINE, Embase, and CENTRAL); omitting retrieval of grey literature; restricting the search timeframe to the recent 20 years for medical intervention and the recent 15 years for reviewing diagnostic test accuracy; conducting a single screening by an experienced screener. To some extent, the above shortcuts were also applicable to SRs. This study provided a reference for future RR researchers in selecting shortcuts, and it also presented a potential research topic for methodologists.
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Affiliation(s)
- Qiong Guo
- Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, Chengdu, P. R. China
- West China Medical Publishers, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Guiyu Jiang
- West China School of Public Health, Sichuan University, Chengdu, P. R. China
| | - Qingwen Zhao
- West China School of Public Health, Sichuan University, Chengdu, P. R. China
| | - Youlin Long
- Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, Chengdu, P. R. China
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Kun Feng
- Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, Chengdu, P. R. China
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Xianlin Gu
- Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, Chengdu, P. R. China
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Yihan Xu
- Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, Chengdu, P. R. China
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
- Center for education of medical humanities, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Zhengchi Li
- Center for education of medical humanities, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Jin Huang
- Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Liang Du
- Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, Chengdu, P. R. China
- West China Medical Publishers, West China Hospital, Sichuan University, Chengdu, P. R. China
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
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10
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Hannah K, Haddaway NR, Fuller RA, Amano T. Language inclusion in ecological systematic reviews and maps: Barriers and perspectives. Res Synth Methods 2024; 15:466-482. [PMID: 38286438 DOI: 10.1002/jrsm.1699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/19/2023] [Accepted: 11/29/2023] [Indexed: 01/31/2024]
Abstract
Systematic reviews and maps are considered a reliable form of research evidence, but often neglect non-English-language literature, which can be a source of important evidence. To understand the barriers that might limit authors' ability or intent to find and include non-English-language literature, we assessed factors that may predict the inclusion of non-English-language literature in ecological systematic reviews and maps, as well as the review authors' perspectives. We assessed systematic reviews and maps published in Environmental Evidence (n = 72). We also surveyed authors from each paper (n = 32 responses), gathering information on the barriers to the inclusion of non-English language literature. 44% of the reviewed papers (32/72) excluded non-English literature from their searches and inclusions. Commonly cited reasons included constraints related to resources and time. Regression analysis revealed that reviews with larger author teams, authors from diverse countries, especially those with non-English primary languages, and teams with multilingual capabilities searched in a significantly greater number of non-English languages. Our survey exposed limited language diversity within the review teams and inadequate funding as the principal barriers to incorporating non-English language literature. To improve language inclusion and reduce bias in systematic reviews and maps, our study suggests increasing language diversity within review teams. Combining machine translation with language skills can alleviate the financial and resource burdens of translation. Funding applications could also include translation costs. Additionally, establishing language exchange systems would enable access to information in more languages. Further studies investigating language inclusion in other journals would strengthen these conclusions.
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Affiliation(s)
- Kelsey Hannah
- School of the Environment, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Biodiversity and Conservation Science, The University of Queensland, Brisbane, Queensland, Australia
| | - Neal R Haddaway
- Leibniz-Centre for Agricultural Landscape Research (ZALF), Müncheberg, Germany
- Africa Centre for Evidence, University of Johannesburg, Johannesburg, South Africa
| | - Richard A Fuller
- School of the Environment, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Biodiversity and Conservation Science, The University of Queensland, Brisbane, Queensland, Australia
| | - Tatsuya Amano
- School of the Environment, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Biodiversity and Conservation Science, The University of Queensland, Brisbane, Queensland, Australia
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11
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Mheissen S, Spineli LM, Daraqel B, Alsafadi AS. Language bias in orthodontic systematic reviews: A meta-epidemiological study. PLoS One 2024; 19:e0300881. [PMID: 38557691 PMCID: PMC10984547 DOI: 10.1371/journal.pone.0300881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 03/06/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Orthodontic systematic reviews (SRs) include studies published mostly in English than non-English languages. Including only English studies in SRs may result in a language bias. This meta-epidemiological study aimed to evaluate the language bias impact on orthodontic SRs. DATA SOURCE SRs published in high-impact orthodontic journals between 2017 and 2021 were retrieved through an electronic search of PubMed in June 2022. Additionally, Cochrane oral health group was searched for orthodontic systematic reviews published in the same period. DATA COLLECTION AND ANALYSIS Study selection and data extraction were performed by two authors. Multivariable logistic regression was implemented to explore the association of including non-English studies with the SRs characteristics. For the meta-epidemiological analysis, one meta-analysis from each SRs with at least three trials, including one non-English trial was extracted. The average difference in SMD was obtained using a random-effects meta-analysis. RESULTS 174 SRs were included in this study. Almost one-quarter (n = 45/174, 26%) of these SRs included at least one non-English study. The association between SRs characteristics and including non-English studies was not statistically significant except for the restriction on language: the odds of including non-English studies reduced by 89% in SRs with a language restriction (OR: 0.11, 95%CI: 0.01 0.55, P< 0.01). Out of the sample, only fourteen meta-analyses were included in the meta-epidemiological analysis. The meta-epidemiological analysis revealed that non-English studies tended to overestimate the summary SMD by approximately 0.30, but this was not statistically significant when random-effects model was employed due to substantial statistical heterogeneity (ΔSMD = -0.29, 95%CI: -0.63 to 0.05, P = 0.37). As such, the overestimation of meta-analysis results by including non-English studies was statistically non-significant. CONCLUSION Language bias has non-negligible impact on the results of orthodontic SRs. Orthodontic systematic reviews should abstain from language restrictions and use sensitivity analysis to assess the impact of language on the conclusions, as non-English studies may have a lower quality.
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Affiliation(s)
- Samer Mheissen
- Specialist Orthodontist in Private Practice, Syria- Damascus, Syria
| | - Loukia M. Spineli
- Principal Investigator in Evidence Synthesis, Midwifery Research and Education Unit, Hannover Medical School, Hannover, Germany
| | - Baraa Daraqel
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Oral Health Research and Promotion Unit, Al-Quds University, Jerusalem, Palestine
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12
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Owjinezhad D, Abdoli A, Rahmanian V, Shaterian N, Bahadory S, Matin S, Taghipour A. Global Seroprevalence of Toxocara spp. in Children: A Systematic Review and Meta-analysis. Acta Parasitol 2024; 69:164-174. [PMID: 38195773 DOI: 10.1007/s11686-023-00772-0] [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: 09/10/2023] [Accepted: 11/30/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND In the present study, we performed a systematic review and meta-analysis to assess the global and regional seroprevalence of Toxocara spp. and associated risk factors among children. METHODS The present systematic review and meta-analysis was followed based on the Preferred Reporting. Items for Systematic Reviews and Meta-analyses (PRISMA) protocol. We searched the online databases (PubMed, Scopus, and Web of Science) and Google Scholar search engine for studies that measured seroprevalence of Toxocara spp. among children, published between 1 January 2000 and 15 January 2022. Accordingly, the pooled seroprevalence and 95% confidence intervals (CI) were estimated using a random-effects meta-analysis model. RESULTS A total of 65 articles from 22 countries met the inclusion criteria. The global seroprevalence of Toxocara spp. infection among children was estimated as 25% (95% CI 22-29). Meta-regression analysis showed that the type of population studied (p = 0.002) and year of publication (p = 0.044) it may be the source of heterogeneity. The highest and lowest pooled seroprevalence of Toxocara spp. infection were estimated in Thailand and Colombia as 58.2% (95% CI 50.9-65.5) and 7.04% (95% CI 3.05-11.3), respectively. Male gender was associated with a higher risk of Toxocara spp. compared to females, and this association was statistically significant (OR = 1.24; 95% CI 1.09-1.41, p = 0.001). However, residing in rural areas did not show a statistically significant increase in risk compared to living in urban areas (OR = 1.39; 95% CI 0.88-2.21, p = 0.143). CONCLUSION Toxocariasis is common among children, hence, prevention and control scheme of this helminth in children should be considered by health officials and health policymakers, especially in developing countries, where seroprevalence is highest.
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Affiliation(s)
- Dorna Owjinezhad
- Pediatric Department, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Amir Abdoli
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Vahid Rahmanian
- Department of Public Health, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran
| | - Negar Shaterian
- Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Saeed Bahadory
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Sara Matin
- Pediatric Department, Jahrom University of Medical Sciences, Jahrom, Iran.
| | - Ali Taghipour
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran.
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
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13
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Kolaski K, Logan LR, Ioannidis JPA. Guidance to best tools and practices for systematic reviews. Br J Pharmacol 2024; 181:180-210. [PMID: 37282770 DOI: 10.1111/bph.16100] [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: 04/26/2023] [Accepted: 04/26/2023] [Indexed: 06/08/2023] Open
Abstract
Data continue to accumulate indicating that many systematic reviews are methodologically flawed, biased, redundant, or uninformative. Some improvements have occurred in recent years based on empirical methods research and standardization of appraisal tools; however, many authors do not routinely or consistently apply these updated methods. In addition, guideline developers, peer reviewers, and journal editors often disregard current methodological standards. Although extensively acknowledged and explored in the methodological literature, most clinicians seem unaware of these issues and may automatically accept evidence syntheses (and clinical practice guidelines based on their conclusions) as trustworthy. A plethora of methods and tools are recommended for the development and evaluation of evidence syntheses. It is important to understand what these are intended to do (and cannot do) and how they can be utilized. Our objective is to distill this sprawling information into a format that is understandable and readily accessible to authors, peer reviewers, and editors. In doing so, we aim to promote appreciation and understanding of the demanding science of evidence synthesis among stakeholders. We focus on well-documented deficiencies in key components of evidence syntheses to elucidate the rationale for current standards. The constructs underlying the tools developed to assess reporting, risk of bias, and methodological quality of evidence syntheses are distinguished from those involved in determining overall certainty of a body of evidence. Another important distinction is made between those tools used by authors to develop their syntheses as opposed to those used to ultimately judge their work. Exemplar methods and research practices are described, complemented by novel pragmatic strategies to improve evidence syntheses. The latter include preferred terminology and a scheme to characterize types of research evidence. We organize best practice resources in a Concise Guide that can be widely adopted and adapted for routine implementation by authors and journals. Appropriate, informed use of these is encouraged, but we caution against their superficial application and emphasize their endorsement does not substitute for in-depth methodological training. By highlighting best practices with their rationale, we hope this guidance will inspire further evolution of methods and tools that can advance the field.
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Affiliation(s)
- Kat Kolaski
- Departments of Orthopaedic Surgery, Pediatrics, and Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Lynne Romeiser Logan
- Department of Physical Medicine and Rehabilitation, SUNY Upstate Medical University, Syracuse, New York, USA
| | - John P A Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University School of Medicine, Stanford, California, USA
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Li W, Wu C, Deng R, Li L, Wu Q, Zhang L, Yan T, Chen S. Comparison of Perioperative Safety of Carotid Artery Stenting and Endarterectomy in the Treatment of Carotid Artery Stenosis: A Meta-Analysis of Randomized Controlled Trials. World Neurosurg 2024; 181:e356-e375. [PMID: 37863425 DOI: 10.1016/j.wneu.2023.10.054] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/09/2023] [Accepted: 10/10/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Current management guidelines for the treatment of carotid stenosis are controversial. We performed this meta-analysis to evaluate the perioperative safety of carotid artery stenting (CAS) and endarterectomy. METHODS We systematically searched EMBASE, PubMed, Web of Science, and the Cochrane Library from inception to November 10, 2022, for randomized controlled trials that compared CAS with carotid endarterectomy (CEA) among patients with carotid stenosis. The analyzed outcomes mainly included stroke, death, myocardial infarction (MI), cranial nerve palsy, the cumulative incidence of mortality, stroke, or MI and the cumulative incidence of death or stroke in the perioperative periods. The risk ratio (RR) and 95% confidence interval (95% CI) were calculated and pooled. Subgroup analyses were based on whether patients were symptomatic or asymptomatic. We assessed the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation framework. RESULTS Seventeen randomized controlled trials with 12,277 participants (6514 and 5763 in the CAS and CEA groups, respectively) were included. Pooled analysis demonstrated that compared with CEA, CAS was associated with decreased risks of perioperative MI (RR = 0.47, 95% CI = 0.29∼0.77) and perioperative cranial nerve palsy (RR = 0.02, 95% CI = 0.01∼0.06) but higher risks of perioperative stroke (RR = 1.48, 95% CI = 1.18∼1.87) and cumulative incidence of death or stroke (RR = 1.52, 95% CI = 1.20∼1.93). CONCLUSIONS The perioperative safety was equivalent between CAS and CEA. However, CEA may be preferred when considering both procedural safety and long-term efficacy in preventing recurrent stroke.
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Affiliation(s)
- Wenkui Li
- Department of Neurology, Chongqing University Three Gorges Hospital, Chongqing, China; School of Medicine, Chongqing University, Chongqing, China
| | - Chuyue Wu
- Department of Neurology, Chongqing University Three Gorges Hospital, Chongqing, China; School of Medicine, Chongqing University, Chongqing, China; Chongqing Municipality Clinical Research Center for Geriatric Diseases, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Rong Deng
- Department of Neurology, Chongqing University Three Gorges Hospital, Chongqing, China; School of Medicine, Chongqing University, Chongqing, China
| | - Li Li
- Department of Neurology, Chongqing University Three Gorges Hospital, Chongqing, China; School of Medicine, Chongqing University, Chongqing, China
| | - Qingyuan Wu
- Department of Neurology, Chongqing University Three Gorges Hospital, Chongqing, China; School of Medicine, Chongqing University, Chongqing, China; Chongqing Municipality Clinical Research Center for Geriatric Diseases, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Lina Zhang
- Department of Neurology, Chongqing University Three Gorges Hospital, Chongqing, China; School of Medicine, Chongqing University, Chongqing, China; Chongqing Municipality Clinical Research Center for Geriatric Diseases, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Tao Yan
- Department of Clinical Laboratory, Tianjin Medical University General Hospital, Tianjin, China
| | - Shengli Chen
- Department of Neurology, Chongqing University Three Gorges Hospital, Chongqing, China.
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15
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Beccia C, Hunter B, Birkic V, White M, Manski-Nankervis JA. Have interventions aimed at assisting general practitioners in facilitating earlier diagnosis of type 1 diabetes in children been successful? A systematic review protocol. BMJ Open 2023; 13:e076459. [PMID: 38159949 PMCID: PMC10759093 DOI: 10.1136/bmjopen-2023-076459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 12/07/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Early diagnosis of type 1 diabetes in children is critical to prevent deterioration to diabetic ketoacidosis (DKA), a state where the body's insulin levels are critically low resulting in the use of fat for fuel and the accumulation of ketones. DKA is a life-threatening emergency where dehydration and cerebral oedema can quickly develop and lead to death. Despite treatment, DKA also has harmful impacts on cognition and brain development. Most children admitted to a hospital with DKA see their general practitioner in the week leading up to their admission. A delay in referral from general practice can result in delays in commencing lifesaving insulin therapy. Prior systematic reviews have explored publicity campaign interventions aimed at recognising type 1 diabetes earlier; however, no reviews have explored these interventions targeted at reducing the delay after presentation to the general practitioner. This systematic review aims to summarise interventions that target the diagnostic delay emerging from general practice and to evaluate their effectiveness in reducing DKA admissions. METHODS Six databases (Ovid (MEDLINE), Web of Science, EMBASE, CINAHL, Evidence-Based Medicine Reviews (EBMR) and Google Scholar) will be searched to identify studies exploring interventions to reduce diagnostic delay in children with type 1 diabetes, and hence DKA, in general practice. The primary outcome will be the number of DKA admissions to a hospital following a delay in general practice. The secondary outcome will be the behaviour of general practitioners with respect to urgent referral of children with type 1 diabetes. Title, abstract and full-text screening for exclusion and inclusion of publications will be completed by two independent reviewers. Any risks of bias within individual studies will be assessed by two independent reviewers, using the Risk Of Bias In Non-Randomized Studies of Interventions tool. Our confidence in the overall body of evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation. ETHICS AND DISSEMINATION The systematic review will be disseminated via publication and potentially in conference presentations. Ethics is not required for a systematic review of secondary data. PROSPERO REGISTRATION NUMBER CRD42023412504.
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Affiliation(s)
- Chiara Beccia
- Department of General Practice and Primary Care, The University of Melbourne, Melbourne, Victoria, Australia
| | - Barbara Hunter
- Department of General Practice and Primary Care, The University of Melbourne, Melbourne, Victoria, Australia
| | - Vesna Birkic
- MDHS Library, University of Melbourne Brownless Biomedical Library, Melbourne, Victoria, Australia
| | - Mary White
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Health Services Research Unit, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Jo-Anne Manski-Nankervis
- Department of General Practice and Primary Care, The University of Melbourne, Melbourne, Victoria, Australia
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16
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Jones A, Findlay A, Knight SR, Rees J, O'Reilly D, Jones RP, Pathak S. Follow up after surgery for colorectal liver metastases: A systematic review. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2023; 49:107103. [PMID: 37890234 DOI: 10.1016/j.ejso.2023.107103] [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: 04/21/2023] [Revised: 09/04/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023]
Abstract
INTRODUCTION Recurrence post hepatectomy for colorectal liver metastases (CRLM) occurs in 70 % of patients within two years. No established guidance on the method or intensity of follow-up currently exists. The aim of this systematic review was to summarise literature and determine whether it is possible to identify an optimal follow up regime. To this date there are no randomised prospective studies investigating this. METHODS A systematic review was performed according to PRISMA guidelines. Outcomes included general demographics, method, frequency and duration of follow up, survival and recurrence data. Quality assessment of the papers was performed. RESULTS Twenty-five articles published between 1994 and 2022 were included, including 9945 patients. CT was the most common imaging modality (n = 14) and CEA most common blood test (n = 11). Intensity of follow up was higher in the first two years post resection and only two papers continued follow up post 5 years resection. There was wide variation in outcome measures - Overall survival (OS) was most commonly reported. Nine papers reported OS ranging between 39 and 78.1 %. CONCLUSIONS There is wide variation in follow up methods and outcome reporting. There is no strong evidence to support intensive follow up, and the benefits of long term follow up are also unknown due to the lack of patient centred data. High quality, prospective studies should be the focus of future research as further retrospective data is unlikely to resolve uncertainties around optimal follow up.
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Affiliation(s)
- Annabel Jones
- University Hospitals Bristol and Weston NHS Foundation Trust, Marlborough St, Bristol, BS1 3NU, UK
| | - Alasdair Findlay
- Department of Abdominal Medicine and Surgery, St James's University Hospital, Beckett Street, Leeds, LS9 7TF, UK
| | - Stephen R Knight
- Centre for Medical Informatics, Usher Institute, Nine Edinburgh BioQuarter, 9 Little France Road, EH16 4UX, UK
| | - Jonathan Rees
- University Hospitals Bristol and Weston NHS Foundation Trust, Marlborough St, Bristol, BS1 3NU, UK
| | - David O'Reilly
- Cardiff Liver Unit, University Hospital of Wales, Cardiff, CF14 4XW, UK
| | - Robert P Jones
- Institute of Translational Medicine, University of Liverpool, Brownlow Hill, Liverpool, L69 3BX, UK
| | - Samir Pathak
- Department of Abdominal Medicine and Surgery, St James's University Hospital, Beckett Street, Leeds, LS9 7TF, UK.
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Sun J, Zhou T, Wang D. Effects of urbanisation on PM 2.5 concentrations: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 900:166493. [PMID: 37619722 DOI: 10.1016/j.scitotenv.2023.166493] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/19/2023] [Accepted: 08/20/2023] [Indexed: 08/26/2023]
Abstract
While urbanisation greatly improves a population's quality of life, it also has significant effects on urban air pollution. Previous studies have determined how urbanisation affects PM2.5 concentrations; the findings, however, have not been consistent. This study conducts a meta-analysis to systematically organise existing research and draw more conclusive and broadly applicable results regarding the impact of different factors of urbanisation on PM2.5 concentrations. The main research findings are as follows: (1) the Environmental Kuznets Curve (EKC) is proven to hold true in terms of the effect of population and land urbanisation on PM2.5 concentrations, while there is no consistent conclusion on the non-linear relationship between economic urbanisation and PM2.5 concentrations; (2) publication bias is evident in research on the economic and comprehensive urbanisation dimensions under linear assumptions; (3) there are notable heterogeneities in existing research in this field. The meta-regression model further indicates that model design, sample design, and publication characteristics might be responsible for these heterogeneities. This study innovatively applies a meta-analysis to investigate the effect of urbanisation on PM2.5 concentrations. The findings will contribute to scholars designing more rigorous research frameworks in this field.
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Affiliation(s)
- Jianing Sun
- School of Management Science and Real Estate, Chongqing University, Chongqing 400044, China.
| | - Tao Zhou
- School of Management Science and Real Estate, Chongqing University, Chongqing 400044, China; Research Center for Construction Economy and Management, Chongqing University, Chongqing 400044, China.
| | - Di Wang
- School of Geographical Sciences, Southwest University, Chongqing 400715, China.
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18
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Freiherr von Schoenhueb D, Boecking B, Mazurek B. Alexithymia in Patients with Somatization Difficulties and Tinnitus-Related Distress: A Systematic Review. J Clin Med 2023; 12:6828. [PMID: 37959295 PMCID: PMC10649228 DOI: 10.3390/jcm12216828] [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: 09/01/2023] [Revised: 09/29/2023] [Accepted: 09/30/2023] [Indexed: 11/15/2023] Open
Abstract
Chronic tinnitus, the perception of sound without an external source, can significantly affect individuals' well-being. As an often medically unexplained symptom, chronic tinnitus can present as a "somatoform" or "functional" difficulty. Some evidence has pointed to alexithymia as a transdiagnostically relevant risk factor for both symptom clusters. Using a two-part rapid review-searching within EBSCO, Embase by Ovid, PubMed, Web of Science-we summarize psychological studies regarding alexithymia, i.e., difficulties in recognizing and expressing emotions and (1) somatoform conditions and (2) chronic tinnitus. For the former (inclusion criteria: (1) adult human beings with different kinds of somatization, (2) longitudinal study designs, (3) publication between 2001 and 2021, (4) full-text in English or German) we identified eight studies that revealed significant links between alexithymia and somatoform conditions. Psychotherapy improved alexithymia in most studies. Additionally, alexithymia was associated with broader treatment outcomes such as improvements in pain intensity, gastrointestinal symptoms, and patient-therapist alliance. The 'Risk Of Bias In Non-randomized Studies-of Interventions' tool (ROBINS-I) and 'Revised Cochrane risk-of-bias tool for randomized trials' (RoB 2) were used for risk of bias assessment. Summarizing all available studies on alexithymia and chronic tinnitus, we identified three studies. Inclusion criteria were: (1) adult human beings with chronic tinnitus, (2) publication between 2001 and 2021, (3) full-text in English or German. Risk of bias was assessed by the 'JBI Critical Appraisal Checklist for Analytical Cross Sectional Studies'. The available studies suggested a high rate of alexithymia (65.7%) in patients with chronic tinnitus. Tinnitus-related distress was significantly associated with alexithymia in two studies, one of which, however, found no differences in alexithymia between patients with bothersome versus non-bothersome tinnitus. Conversely, one study reported high levels of alexithymia in patients with low levels of tinnitus-related distress. Overall, alexithymia may be a transdiagnostic psychological indicator of somatization phenomena, which might include some chronic tinnitus presentations. Psychotherapy likely improves alexithymia as well as somatoform symptom presentations.
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Affiliation(s)
| | | | - Birgit Mazurek
- Tinnitus Center, Charité—Universitatsmedizin Berlin, 10117 Berlin, Germany; (D.F.v.S.); (B.B.)
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Kolaski K, Logan LR, Ioannidis JPA. Guidance to best tools and practices for systematic reviews. Acta Anaesthesiol Scand 2023; 67:1148-1177. [PMID: 37288997 DOI: 10.1111/aas.14295] [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: 04/26/2023] [Accepted: 04/26/2023] [Indexed: 06/09/2023]
Abstract
Data continue to accumulate indicating that many systematic reviews are methodologically flawed, biased, redundant, or uninformative. Some improvements have occurred in recent years based on empirical methods research and standardization of appraisal tools; however, many authors do not routinely or consistently apply these updated methods. In addition, guideline developers, peer reviewers, and journal editors often disregard current methodological standards. Although extensively acknowledged and explored in the methodological literature, most clinicians seem unaware of these issues and may automatically accept evidence syntheses (and clinical practice guidelines based on their conclusions) as trustworthy. A plethora of methods and tools are recommended for the development and evaluation of evidence syntheses. It is important to understand what these are intended to do (and cannot do) and how they can be utilized. Our objective is to distill this sprawling information into a format that is understandable and readily accessible to authors, peer reviewers, and editors. In doing so, we aim to promote appreciation and understanding of the demanding science of evidence synthesis among stakeholders. We focus on well-documented deficiencies in key components of evidence syntheses to elucidate the rationale for current standards. The constructs underlying the tools developed to assess reporting, risk of bias, and methodological quality of evidence syntheses are distinguished from those involved in determining overall certainty of a body of evidence. Another important distinction is made between those tools used by authors to develop their syntheses as opposed to those used to ultimately judge their work. Exemplar methods and research practices are described, complemented by novel pragmatic strategies to improve evidence syntheses. The latter include preferred terminology and a scheme to characterize types of research evidence. We organize best practice resources in a Concise Guide that can be widely adopted and adapted for routine implementation by authors and journals. Appropriate, informed use of these is encouraged, but we caution against their superficial application and emphasize their endorsement does not substitute for in-depth methodological training. By highlighting best practices with their rationale, we hope this guidance will inspire further evolution of methods and tools that can advance the field.
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Affiliation(s)
- Kat Kolaski
- Departments of Orthopaedic Surgery, Pediatrics, and Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Lynne Romeiser Logan
- Department of Physical Medicine and Rehabilitation, SUNY Upstate Medical University, Syracuse, New York, USA
| | - John P A Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University School of Medicine, Stanford, California, USA
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Santos AT, Costa CM, Delgado-Márquez L, Banheiro RM. Analysing the Influence of WHO Initiatives on the Scientific Discourse of Noncommunicable Diseases through a Bibliometric Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6714. [PMID: 37754575 PMCID: PMC10530322 DOI: 10.3390/ijerph20186714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 09/28/2023]
Abstract
Noncommunicable diseases (NCDs) present a major public health challenge, prompting their inclusion in the United Nations' 2030 Agenda for Sustainable Development. In response, the World Health Organization (WHO) has implemented various initiatives, including a comprehensive monitoring framework with global targets and indicators. However, the extent to which these initiatives have shaped the scientific discourse remains unclear. This article addresses this knowledge gap through a two-fold approach. Firstly, a bibliometric analysis of 14,187 studies spanning over 60 years is conducted, identifying key contributors and trends. Secondly, the content analysis compares these trends to the goals established by the WHO. The findings indicate that the WHO initiatives have accelerated scientific research, and elevated global targets and indicators as central themes in scholarly discussions, since 2011. This study takes an innovative approach that contributes to the advancement of knowledge in this field, by providing valuable insights into the impact of WHO initiatives on the scientific debate surrounding NCDs, and offering guidance for policymakers, researchers, and stakeholders engaged in combating these diseases.
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Affiliation(s)
- Ana Teresa Santos
- Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health & Science, 2800 Almada, Portugal
| | - Cátia Miriam Costa
- Centro de Estudos Internacionais, Instituto Universitário de Lisboa (ISCTE-IUL), 1649-026 Lisbon, Portugal;
| | - Luisa Delgado-Márquez
- Department of Applied Economics, University of Granada, 18071 Granada, Spain;
- Business Research Unit (BRU-IUL), Instituto Universitário de Lisboa (ISCTE-IUL), 1649-026 Lisbon, Portugal
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21
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De Ketele A, Degreef I. Full-thickness skin grafting in preventing recurrence of Dupuytren's disease: A systematic review. HAND SURGERY & REHABILITATION 2023; 42:273-283. [PMID: 37336491 DOI: 10.1016/j.hansur.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/11/2023] [Accepted: 06/12/2023] [Indexed: 06/21/2023]
Abstract
Dupuytren's disease is a progressive hand disorder characterized by the formation of pathologic nodules and cords in the palm, often leading to progressive flexion contractures. Hand surgery is currently the only efficient treatment to restore hand function, however, reported recurrence rates vary widely. Currently, it remains unclear which type of fasciectomy is associated with the lowest recurrence rate. Therefore, a systematic review was conducted to compare recurrence rates after limited fasciectomy, open palm technique, or dermofasciectomy with a full-thickness skin graft. 79 studies were included, and results suggest that a dermofasciectomy with a full-thickness skin graft is associated with a lower recurrence rate. However, most studies were case series in which a wide range of definitions of recurrence was used. Moreover, all studies had a high risk of bias. Therefore, additional comparative clinical trials are recommended that use an unambiguous definition of recurrence. LEVEL OF EVIDENCE III: .
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Affiliation(s)
- Astrid De Ketele
- Department of Plastic Surgery, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
| | - Ilse Degreef
- Department of Orthopedic Surgery-Hand Unit, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
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22
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Abstract
Data continue to accumulate indicating that many systematic reviews are methodologically flawed, biased, redundant, or uninformative. Some improvements have occurred in recent years based on empirical methods research and standardization of appraisal tools; however, many authors do not routinely or consistently apply these updated methods. In addition, guideline developers, peer reviewers, and journal editors often disregard current methodological standards. Although extensively acknowledged and explored in the methodological literature, most clinicians seem unaware of these issues and may automatically accept evidence syntheses (and clinical practice guidelines based on their conclusions) as trustworthy. A plethora of methods and tools are recommended for the development and evaluation of evidence syntheses. It is important to understand what these are intended to do (and cannot do) and how they can be utilized. Our objective is to distill this sprawling information into a format that is understandable and readily accessible to authors, peer reviewers, and editors. In doing so, we aim to promote appreciation and understanding of the demanding science of evidence synthesis among stakeholders. We focus on well-documented deficiencies in key components of evidence syntheses to elucidate the rationale for current standards. The constructs underlying the tools developed to assess reporting, risk of bias, and methodological quality of evidence syntheses are distinguished from those involved in determining overall certainty of a body of evidence. Another important distinction is made between those tools used by authors to develop their syntheses as opposed to those used to ultimately judge their work. Exemplar methods and research practices are described, complemented by novel pragmatic strategies to improve evidence syntheses. The latter include preferred terminology and a scheme to characterize types of research evidence. We organize best practice resources in a Concise Guide that can be widely adopted and adapted for routine implementation by authors and journals. Appropriate, informed use of these is encouraged, but we caution against their superficial application and emphasize their endorsement does not substitute for in-depth methodological training. By highlighting best practices with their rationale, we hope this guidance will inspire further evolution of methods and tools that can advance the field.
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Affiliation(s)
- Kat Kolaski
- Departments of Orthopaedic Surgery, Pediatrics, and Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Lynne Romeiser Logan
- Department of Physical Medicine and Rehabilitation, SUNY Upstate Medical University, Syracuse, NY, USA
| | - John P.A. Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University School of Medicine, Stanford, CA, USA
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Frigerio G, Ferrari CM, Fustinoni S. Prenatal and childhood exposure to per-/polyfluoroalkyl substances (PFASs) and its associations with childhood overweight and/or obesity: a systematic review with meta-analyses. Environ Health 2023; 22:56. [PMID: 37580798 PMCID: PMC10424367 DOI: 10.1186/s12940-023-01006-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 07/23/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND Per-/polyfluoroalkyl substances (PFASs) are persistent organic pollutants and suspected endocrine disruptors. OBJECTIVE The aim of this work was to conduct a systematic review with meta-analysis to summarise the associations between prenatal or childhood exposure to PFASs and childhood overweight/obesity. METHODS The search was performed on the bibliographic databases PubMed and Embase with text strings containing terms related to prenatal, breastfeeding, childhood, overweight, obesity, and PFASs. Only papers describing a biomonitoring study in pregnant women or in children up to 18 years that assessed body mass index (BMI), waist circumference (WC), or fat mass in children were included. When the estimates of the association between a PFAS and an outcome were reported from at least 3 studies, a meta-analysis was conducted; moreover, to correctly compare the studies, we developed a method to convert the different effect estimates and made them comparable each other. Meta-analyses were performed also stratifying by sex and age, and sensitivity analyses were also performed. RESULTS In total, 484 and 779 articles were retrieved from PubMed and Embase, respectively, resulting in a total of 826 articles after merging duplicates. The papers included in this systematic review were 49: 26 evaluating prenatal exposure to PFASs, 17 childhood exposure, and 6 both. Considering a qualitative evaluation, results were conflicting, with positive, negative, and null associations. 30 papers were included in meta-analyses (19 prenatal, 7 children, and 4 both). Positive associations were evidenced between prenatal PFNA and BMI, between PFOA and BMI in children who were more than 3 years, and between prenatal PFNA and WC. Negative associations were found between prenatal PFOS and BMI in children who were 3 or less years, and between PFHxS and risk of overweight. Relatively more consistent negative associations were evidenced between childhood exposure to three PFASs (PFOA, PFOS, and PFNA) and BMI, in particular PFOS in boys. However, heterogeneity among studies was high. CONCLUSION Even though heterogeneous across studies, the pooled evidence suggests possible associations, mostly positive, between prenatal exposure to some PFASs and childhood BMI/WC; and relatively stronger evidence for negative associations between childhood exposure to PFASs and childhood BMI.
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Affiliation(s)
- Gianfranco Frigerio
- Environmental Cheminformatics, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Campus Belval | House of Biomedicine II, 6 Avenue du Swing, L-4367, Belvaux, Luxembourg.
- Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy.
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Chiara Matilde Ferrari
- Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy
| | - Silvia Fustinoni
- Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Chiu HHC, Lam PPY, Yiu CKY. The Impact of Minimal Intervention Dentistry on Patient-Reported and Observation-Based Outcomes in the Pediatric Population: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2023; 11:2241. [PMID: 37628440 PMCID: PMC10454713 DOI: 10.3390/healthcare11162241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
This review aimed to systematically investigate the effect of minimal intervention dentistry on patient-reported and observation-based outcomes of anxiety, pain and patient cooperation in the pediatric population. Microinvasive treatments (MITs) were compared to conventional treatments, home-based and professionally applied non-invasive treatments (NITs), and between MITs. Two reviewers independently screened studies from four electronic databases, extracted data, assessed the risk of bias and certainty of evidence with the GRADE approach. Ultimately, 26 studies were included for qualitative synthesis, with the data from 12 studies being incorporated into the meta-analysis. No statistically significantly differences in terms of anxiety were noted between MITs and conventional treatments, or between MITs from the meta-analyses. The treatment durations of MITs were not necessarily shorter than conventional treatments but varied with the use of local anesthesia, behavioral and clinical approach, and other confounding factors. The certainties of evidence were deemed low due to high risk of bias of the included studies. NITs evoked less anxiety and pain compared to MITs. Minimal intervention dentistry is an alternative treatment to manage dental caries among children and does not arouse different levels of dental anxiety and pain compared to other treatment modalities. However, further well-designed studies are required to draw an evidence-based conclusion.
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Affiliation(s)
| | | | - Cynthia Kar Yung Yiu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China; (H.H.C.C.); (P.P.Y.L.)
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Amir A, Alasnag M, Al-Raddadi R, Al-Bassam T, Saeed K, Yazıcıoğlu M, Shabana A. Patient journey for hypertension and dyslipidemia in Saudi Arabia: highlighting the evidence gaps. Arch Public Health 2023; 81:122. [PMID: 37400868 DOI: 10.1186/s13690-023-01121-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 05/30/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND In recent years, Saudi Arabia has witnessed staggering rates of hypertension and dyslipidemia-related cardiovascular (CV) deaths, overburdening the healthcare ecosystem of the country. Appropriate public health interventions can be devised through quantitative mapping of evidence. Identification of potential data gaps can prioritize future research needs and develop a 'best-fit' framework for patient-centric management of hypertension and dyslipidemia. METHODS This review quantified data gaps in the prevalence and key epidemiological touchpoints of the patient journey including awareness, screening, diagnosis, treatment, adherence, and control in patients with hypertension and dyslipidemia in Saudi Arabia. Studies published in English between January 2010 and December 2021 were identified through a structured search on MEDLINE, Embase, BIOSIS, and PubMed databases. An unstructured search on public and government websites, including Saudi Ministry of Health, without date limits was carried out to fill data gaps. After exclusion of studies based on predefined criteria, a total of 14 studies on hypertension and 12 studies and one anecdotal evidence for dyslipidemia were included in the final analyses. RESULTS The prevalence of hypertension was reported to be 14.0%-41.8% while that for dyslipidemia was 12.5%-62.0%. The screening rate for hypertension was 100.0% as revealed by the nationwide surveys. Among hypertensive patients, only 27.6%-61.1% patients were aware of their condition, 42.2% patients underwent diagnosis, 27.9%-78.9% patients received antihypertensive treatment, 22.5% patients adhered to treatment medication, while blood pressure (BP) control was achieved in 27.0%-45.0% patients. Likewise, among patients with dyslipidemia, 10.5%-47.3% patients were aware of their condition, 34.6% patients were screened, and 17.8% underwent diagnosis. Although high treatment rates ranging from 40.0%-94.0% were reported, medication adherence recorded was 45.0%-77.4% among the treated patients. The overall low control rates ranged from 28.0%-41.5%. CONCLUSIONS The study findings highlight evidence gaps along key touchpoints of patient journey. Reinforcing the efforts for high-quality evidence-based research at a national level may pave a path for better resource utilization and provide guidance to practice and amend health policies for patients, healthcare practitioners (HCPs), and healthcare policy makers for better patient outcomes in Saudi Arabia.
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Affiliation(s)
- Ashraf Amir
- Family Medicine Department, International Medical Center, Jeddah, Saudi Arabia
| | - Mirvat Alasnag
- Cardiac Center, King Fahd Armed Forces Hospital-Jeddah-Saudi Arabia, PO Box 9862, Jeddah, 21159, Saudi Arabia.
| | - Rajaa Al-Raddadi
- Faculty of Medicine, Department of Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Tawfik Al-Bassam
- Department of Internal Medicine, Medical Reference Center, Jeddah, Saudi Arabia
| | - Kanwal Saeed
- Research, Development and Medical, Pfizer Upjohn, Dubai, UAE
| | - Mehmet Yazıcıoğlu
- Emerging Markets Medical Portfolio Implementation Lead, Viatris, Istanbul, Turkey
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Truong M, Yeganeh L, Cartwright A, Ward E, Ibrahim J, Cuschieri D, Dawson M, Bugeja L. Domestic/Family Homicide: A Systematic Review of Empirical Evidence. TRAUMA, VIOLENCE & ABUSE 2023; 24:1908-1928. [PMID: 35549599 DOI: 10.1177/15248380221082084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Domestic/family homicide (D/FH) is a global social, economic and public health problem. To date, the research studies into risk factors associated with D/FH has largely focused on intimate partner homicide (IPH). A more contemporary approach recognizes that D/FH extends beyond the intimate partner relationship. This systematic review sought to identify and quantify the individual, relationship, community and societal factors in the empirical evidence literature on D/FH. METHODS Eight electronic databases were searched from January 1999 to December 2020. Published journal articles on studies of D/FH were included if the study included victims and/or perpetrator of D/FH, reported risk and/or protective factors associated with D/FH, reported primary data and was published in English. Factors were descriptively synthesized by the categories of the social ecological model and D/FH sub-type. RESULTS Three hundred and forty published articles met the inclusion criteria. From 1999 to 2020 the number of articles on D/FH increased globally from 10 to 40 respectively, declining to 23 in 2020. Almost half of the articles examined populations located in the Americas (160, 47.1%), predominately the United States and the majority of articles used quantitative designs (277, 81.5%). The forms of homicide more commonly studied were intimate partner (171, 50.3%), and filicide (98, 28.8%). Approximately 90% of articles reported individual victim and perpetrator factors, 64.7% examined relationship factors, 17.9% examined community factors and 15.6% examined societal factors. CONCLUSION To inform universal and targeted D/FH elimination and prevention strategies, more research across different regions and a greater emphasis on community and societal-level factors is needed.
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Affiliation(s)
- Mandy Truong
- Nursing and Midwifery, Monash University, Clayton, VIC, Australia
| | - Ladan Yeganeh
- Nursing and Midwifery, Monash University, Clayton, VIC, Australia
| | - Anna Cartwright
- Nursing and Midwifery, Monash University, Clayton, VIC, Australia
| | - Emma Ward
- Nursing and Midwifery, Monash University, Clayton, VIC, Australia
| | - Joseph Ibrahim
- Department of Forensic Medicine, Monash University, Southbank, VIC, Australia
| | | | - Myrna Dawson
- Department of Sociology and Anthropology, University of Guelph, Guelph, ON, Canada
| | - Lyndal Bugeja
- Department of Forensic Medicine, Monash University, Southbank, VIC, Australia
- Nursing and Midwifery, Monash University, Clayton VIC
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Ma T, Pei J, Shi F, Wang X, Li C, Ye B, Zhao J. Effectiveness of cognitive behavioral therapy for patients after total knee arthroplasty: a systematic review and meta-analysis. PSYCHOL HEALTH MED 2023; 28:2407-2418. [PMID: 36579927 DOI: 10.1080/13548506.2022.2162934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 12/13/2022] [Indexed: 12/30/2022]
Abstract
Total knee arthroplasty (TKA) is considered a common surgical option in patients with end-stage osteoarthritis of the knee. This systematic review and meta-analysis aimed to determine the effectiveness of cognitive behavioral therapy (CBT) for patients after TKA. PubMed, EMBASE, the Cochrane Library, Web of Science and CINAHL were searched for randomized controlled trials (RCTs) from inception to 20 August 2021. Included studies were evaluated with the Cochrane risk-of-bias tool. Six RCTs were included. Our study results demonstrated that a significant reduction in pain catastrophing was seen in patients receiving CBT at post-intervention (SMD -0.48, 95% CI = -0.72 to -0.23, I2 17.2%, p = 0.00) but not in 3-month or 12-month follow-up. There were no significant differences between CBT and usual-care patients regarding pain intensity or knee function at different time-points. This is the first time that meta-analysis has been conducted to determine the effectiveness of CBT for patients after TKA. It is necessary to conduct longer follow-ups, include larger samples and conduct rigorous RCTs to further explore this issue.
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Affiliation(s)
- Tong Ma
- Minimally invasive spinal surgery, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China
| | - Juhong Pei
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Fanfan Shi
- Clinical College of Traditional Chinese Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Xiangfu Wang
- Minimally invasive spinal surgery, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China
| | - Chenxu Li
- Minimally invasive spinal surgery, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China
| | - Bingli Ye
- Minimally invasive spinal surgery, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China
| | - Jirong Zhao
- Clinical College of Traditional Chinese Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
- The First Affiliated Hospital, Gansu University of Traditional Chinese Medicine, Lanzhou, Gansu, China
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Kolaski K, Logan LR, Ioannidis JPA. Guidance to best tools and practices for systematic reviews. Syst Rev 2023; 12:96. [PMID: 37291658 DOI: 10.1186/s13643-023-02255-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 02/19/2023] [Indexed: 06/10/2023] Open
Abstract
Data continue to accumulate indicating that many systematic reviews are methodologically flawed, biased, redundant, or uninformative. Some improvements have occurred in recent years based on empirical methods research and standardization of appraisal tools; however, many authors do not routinely or consistently apply these updated methods. In addition, guideline developers, peer reviewers, and journal editors often disregard current methodological standards. Although extensively acknowledged and explored in the methodological literature, most clinicians seem unaware of these issues and may automatically accept evidence syntheses (and clinical practice guidelines based on their conclusions) as trustworthy.A plethora of methods and tools are recommended for the development and evaluation of evidence syntheses. It is important to understand what these are intended to do (and cannot do) and how they can be utilized. Our objective is to distill this sprawling information into a format that is understandable and readily accessible to authors, peer reviewers, and editors. In doing so, we aim to promote appreciation and understanding of the demanding science of evidence synthesis among stakeholders. We focus on well-documented deficiencies in key components of evidence syntheses to elucidate the rationale for current standards. The constructs underlying the tools developed to assess reporting, risk of bias, and methodological quality of evidence syntheses are distinguished from those involved in determining overall certainty of a body of evidence. Another important distinction is made between those tools used by authors to develop their syntheses as opposed to those used to ultimately judge their work.Exemplar methods and research practices are described, complemented by novel pragmatic strategies to improve evidence syntheses. The latter include preferred terminology and a scheme to characterize types of research evidence. We organize best practice resources in a Concise Guide that can be widely adopted and adapted for routine implementation by authors and journals. Appropriate, informed use of these is encouraged, but we caution against their superficial application and emphasize their endorsement does not substitute for in-depth methodological training. By highlighting best practices with their rationale, we hope this guidance will inspire further evolution of methods and tools that can advance the field.
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Affiliation(s)
- Kat Kolaski
- Departments of Orthopaedic Surgery, Pediatrics, and Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - Lynne Romeiser Logan
- Department of Physical Medicine and Rehabilitation, SUNY Upstate Medical University, Syracuse, NY, USA
| | - John P A Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University School of Medicine, Stanford, CA, USA
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Kolaski K, Logan LR, Ioannidis JPA. Guidance to best tools and practices for systematic reviews. BMC Infect Dis 2023; 23:383. [PMID: 37286949 DOI: 10.1186/s12879-023-08304-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 05/03/2023] [Indexed: 06/09/2023] Open
Abstract
Data continue to accumulate indicating that many systematic reviews are methodologically flawed, biased, redundant, or uninformative. Some improvements have occurred in recent years based on empirical methods research and standardization of appraisal tools; however, many authors do not routinely or consistently apply these updated methods. In addition, guideline developers, peer reviewers, and journal editors often disregard current methodological standards. Although extensively acknowledged and explored in the methodological literature, most clinicians seem unaware of these issues and may automatically accept evidence syntheses (and clinical practice guidelines based on their conclusions) as trustworthy.A plethora of methods and tools are recommended for the development and evaluation of evidence syntheses. It is important to understand what these are intended to do (and cannot do) and how they can be utilized. Our objective is to distill this sprawling information into a format that is understandable and readily accessible to authors, peer reviewers, and editors. In doing so, we aim to promote appreciation and understanding of the demanding science of evidence synthesis among stakeholders. We focus on well-documented deficiencies in key components of evidence syntheses to elucidate the rationale for current standards. The constructs underlying the tools developed to assess reporting, risk of bias, and methodological quality of evidence syntheses are distinguished from those involved in determining overall certainty of a body of evidence. Another important distinction is made between those tools used by authors to develop their syntheses as opposed to those used to ultimately judge their work.Exemplar methods and research practices are described, complemented by novel pragmatic strategies to improve evidence syntheses. The latter include preferred terminology and a scheme to characterize types of research evidence. We organize best practice resources in a Concise Guide that can be widely adopted and adapted for routine implementation by authors and journals. Appropriate, informed use of these is encouraged, but we caution against their superficial application and emphasize their endorsement does not substitute for in-depth methodological training. By highlighting best practices with their rationale, we hope this guidance will inspire further evolution of methods and tools that can advance the field.
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Affiliation(s)
- Kat Kolaski
- Departments of Orthopaedic Surgery, Pediatrics, and Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - Lynne Romeiser Logan
- Department of Physical Medicine and Rehabilitation, SUNY Upstate Medical University, Syracuse, NY, USA
| | - John P A Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University School of Medicine, Stanford, CA, USA
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30
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Kolaski K, Logan LR, Ioannidis JPA. Guidance to Best Tools and Practices for Systematic Reviews. JBJS Rev 2023; 11:01874474-202306000-00009. [PMID: 37285444 DOI: 10.2106/jbjs.rvw.23.00077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
» Data continue to accumulate indicating that many systematic reviews are methodologically flawed, biased, redundant, or uninformative. Some improvements have occurred in recent years based on empirical methods research and standardization of appraisal tools; however, many authors do not routinely or consistently apply these updated methods. In addition, guideline developers, peer reviewers, and journal editors often disregard current methodological standards. Although extensively acknowledged and explored in the methodological literature, most clinicians seem unaware of these issues and may automatically accept evidence syntheses (and clinical practice guidelines based on their conclusions) as trustworthy.» A plethora of methods and tools are recommended for the development and evaluation of evidence syntheses. It is important to understand what these are intended to do (and cannot do) and how they can be utilized. Our objective is to distill this sprawling information into a format that is understandable and readily accessible to authors, peer reviewers, and editors. In doing so, we aim to promote appreciation and understanding of the demanding science of evidence synthesis among stakeholders. We focus on well-documented deficiencies in key components of evidence syntheses to elucidate the rationale for current standards. The constructs underlying the tools developed to assess reporting, risk of bias, and methodological quality of evidence syntheses are distinguished from those involved in determining overall certainty of a body of evidence. Another important distinction is made between those tools used by authors to develop their syntheses as opposed to those used to ultimately judge their work.» Exemplar methods and research practices are described, complemented by novel pragmatic strategies to improve evidence syntheses. The latter include preferred terminology and a scheme to characterize types of research evidence. We organize best practice resources in a Concise Guide that can be widely adopted and adapted for routine implementation by authors and journals. Appropriate, informed use of these is encouraged, but we caution against their superficial application and emphasize their endorsement does not substitute for in-depth methodological training. By highlighting best practices with their rationale, we hope this guidance will inspire further evolution of methods and tools that can advance the field.
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Affiliation(s)
- Kat Kolaski
- Departments of Orthopaedic Surgery, Pediatrics, and Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Lynne Romeiser Logan
- Department of Physical Medicine and Rehabilitation, SUNY Upstate Medical University, Syracuse, New York
| | - John P A Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University School of Medicine, Stanford, California
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Role of Patient-Reported Outcomes in Clinical Trials in Metastatic Colorectal Cancer: A Scoping Review. Cancers (Basel) 2023; 15:cancers15041135. [PMID: 36831478 PMCID: PMC9953919 DOI: 10.3390/cancers15041135] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/06/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023] Open
Abstract
PURPOSE To perform a scoping review on the use of Patient-Reported Outcome Measures (PROMs) in randomized trials on systemic therapy in patients with metastatic colorectal cancer (mCRC) between 2010 and 2021. METHODS First, a search on clinicaltrials.gov was performed, looking for randomized trials in mCRC. The use of PROMs was analyzed quantitatively. Subsequently, we assessed the completeness of PROM reporting based on the CONSORT PRO extension in publications related to the selected trials acquired using Embase and PubMed. RESULTS A total of 46/176 trials were registered on clinicaltrials.gov used PROMs. All these trials used validated PROM instruments. The EORTC QLQ-C30 was most frequently used (37 times), followed by the EQ-5D (21 times) and the EORTC QLQ-CR29 (six times). A total of 56/176 registered trials were published. In 35% (n = 20), the results of the PROMs were available. Overall, 7/20 (35%) trials documented all items of the CONSORT PRO extension and quality of reporting according to the CONSORT PRO extension was higher than in the period 2004-2012. In 3/20 (15%) of the published trials, the results of PROMs were not discussed nor included in the positioning of the new treatment compared to the reference treatment. CONCLUSION When PROMs are used, the quality of reporting on patient-reported outcomes is improving, but this must continue in order to optimize the translation of trial results to individual patient values.
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Friedman IS, Fernández-Gimenez AV. State of knowledge about biotechnological uses of digestive enzymes of marine fishery resources: A worldwide systematic review. AQUACULTURE AND FISHERIES 2023. [DOI: 10.1016/j.aaf.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
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Kolaski K, Romeiser Logan L, Ioannidis JPA. Guidance to best tools and practices for systematic reviews1. J Pediatr Rehabil Med 2023; 16:241-273. [PMID: 37302044 DOI: 10.3233/prm-230019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023] Open
Abstract
Data continue to accumulate indicating that many systematic reviews are methodologically flawed, biased, redundant, or uninformative. Some improvements have occurred in recent years based on empirical methods research and standardization of appraisal tools; however, many authors do not routinely or consistently apply these updated methods. In addition, guideline developers, peer reviewers, and journal editors often disregard current methodological standards. Although extensively acknowledged and explored in the methodological literature, most clinicians seem unaware of these issues and may automatically accept evidence syntheses (and clinical practice guidelines based on their conclusions) as trustworthy.A plethora of methods and tools are recommended for the development and evaluation of evidence syntheses. It is important to understand what these are intended to do (and cannot do) and how they can be utilized. Our objective is to distill this sprawling information into a format that is understandable and readily accessible to authors, peer reviewers, and editors. In doing so, we aim to promote appreciation and understanding of the demanding science of evidence synthesis among stakeholders. We focus on well-documented deficiencies in key components of evidence syntheses to elucidate the rationale for current standards. The constructs underlying the tools developed to assess reporting, risk of bias, and methodological quality of evidence syntheses are distinguished from those involved in determining overall certainty of a body of evidence. Another important distinction is made between those tools used by authors to develop their syntheses as opposed to those used to ultimately judge their work.Exemplar methods and research practices are described, complemented by novel pragmatic strategies to improve evidence syntheses. The latter include preferred terminology and a scheme to characterize types of research evidence. We organize best practice resources in a Concise Guide that can be widely adopted and adapted for routine implementation by authors and journals. Appropriate, informed use of these is encouraged, but we caution against their superficial application and emphasize their endorsement does not substitute for in-depth methodological training. By highlighting best practices with their rationale, we hope this guidance will inspire further evolution of methods and tools that can advance the field.
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Affiliation(s)
- Kat Kolaski
- Departments of Orthopaedic Surgery, Pediatrics, and Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Lynne Romeiser Logan
- Department of Physical Medicine and Rehabilitation, SUNY Upstate Medical University, Syracuse, NY, USA
| | - John P A Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University School of Medicine, Stanford, CA, USA
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Wright SR, Graham CD, Houghton R, Ghiglieri C, Berry E. Acceptance and commitment therapy (ACT) for caregivers of children with chronic conditions: A mixed methods systematic review (MMSR) of efficacy, process, and acceptance. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023. [DOI: 10.1016/j.jcbs.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Su YC, Lee YY, Su YC. Active-fluidics versus gravity-fluidics in lens extraction: A systematic review and meta-analysis of randomized controlled trials. Eur J Ophthalmol 2023; 33:247-256. [PMID: 35673714 DOI: 10.1177/11206721221107512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To investigate differences in outcomes between active-fluidics and gravity-fluidics phacoemulsification systems. METHODS We searched PubMed, Embase, and Cochrane Library databases for randomized controlled trials (RCTs) published no later than December 1, 2021. The Cochrane Collaboration risk of bias tool was used for quality assessment. We presented the outcomes as standardized mean differences (SMDs) with 95% confidence intervals (CI). Sensitivity analysis was performed by removing studies that included ≥2 types of phacoemulsification tips. RESULTS We analyzed six RCTs that totally enrolled 884 patients. Patients undergoing lens extraction with active-fluidics systems exhibited lower cumulative dissipated energy (CDE), total aspiration time (TAT), and estimated fluid usage (EFU) compared with patients who did not (SMD [95% CI]: CDE, - 0.818 [ - 1.054 to - 0.582]; TAT, - 0.664 [ - 0.850 to - 0.479]; EFU, - 0.655 [ - 0.932 to - 0.378]). A sensitivity analysis revealed similar results for CDE, TAT, and EFU. For endothelial cell density (ECD) 1 week after surgery, ECD 1 month after surgery, and central corneal thickness (CCT) 1 week after surgery, outcomes of both systems were comparable (ECD at 1 week, 0.074 [ - 0.177 to 0.325]; ECD at 1 month, 0.069 [ - 0.167 to 0.305]; CCT 1 week after surgery, 0.077 [ - 0.173 to 0.328]). No severe adverse events in patients treated with either system were reported in the studies. CONCLUSION Active-fluidics systems are superior to gravity-fluidics systems with respect to CDE, TAT, and EFU; no differences in postoperative ECD and CCT were observed. Future studies are required to determine the reasons for heterogeneity and to detect rare adverse events.
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Affiliation(s)
- Yu-Chen Su
- 63461National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Yen-Yin Lee
- 46615Taipei Veterans General Hospital, Taipei
| | - Yu-Chi Su
- 63461National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
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Reangsing C, Punsuwun S, Keller K. Effects of Mindfulness-Based Interventions on Depression in Patients With Breast Cancer: A Systematic Review and Meta-Analysis. Integr Cancer Ther 2023; 22:15347354231220617. [PMID: 38140816 DOI: 10.1177/15347354231220617] [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] [Indexed: 12/24/2023] Open
Abstract
OBJECTIVE We examined the effects of Mindfulness-based interventions (MBIs) on depressive symptoms in women with breast cancer and examined the moderating effects of participant characteristics, research methodologies, and features of interventions. METHODS We systematically searched 12 databases through November 2022 without date restrictions using the following search terms: (mindful* or meditation) AND (cancer OR neoplasm) AND (depress*). Studies included were primary studies evaluating MBIs in women with breast cancer who also had depression. Studies were included if they used a control group and were written in English. We used a random-effects model to compute effect sizes (ESs) using Hedges' g, forest plot, and Q and I2 statistics as measure of heterogeneity. We also requested moderator analyses. RESULTS We found 19 studies with 2139 participants (49.4 ± 8.3 years old) that met inclusion criteria for this meta-analysis and systematic review. Overall, women in MBI groups demonstrated significantly lower levels of depression (g = 0.48, 95% CI:0.159, 0.792, P < .001) compared to women in control groups. Regarding moderators, providing MBIs with a home assignment component showed a significantly greater effect on decreasing depressive symptoms (g = 1.75) compared to MBIs without a home assignment component (g = 0.20). When researchers used concealed allocation technique, the interventions demonstrated lower effects on depression than when concealed allocation (g = 0.11vs g = 1.33, P ≤ .001) was not reported. Additionally, when researchers reported high rates of sample attrition, they found a lower effect size on depression (β = -.019, Q = 3.97, P = .046) indicating that attrition moderates the effect. CONCLUSION MBIs are moderately effective interventions to reduce depressive symptoms among women with breast cancer. Clinicians might consider encouraging MBIs as adjunct/alternative treatments for women with breast cancer to manage symptoms of depression. Interventions that incorporat home assignments for practicing mindfulness are likely to have a greater effect on reducing depressive symptoms. Additionally, methods including concealed allocation and attrition rate were moderators of the effects of MBIs on depression in women with breast cancer.
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Affiliation(s)
- Chuntana Reangsing
- Mae Fah Luang University, Chiangrai, Thailand
- Nursing Innovation Research and Resource Unit, Mae Fah Luaung University, Thailand
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Puyat JH, Mohebbian M, Gupta A, Ellis U, Ranote H, Almeida A, Ridgway L, Vila-Rodriguez F, Kazanjian A. Home-based and community-based activities that can improve mental wellness: a protocol for an umbrella review. BMJ Open 2022; 12:e065564. [PMID: 36585148 PMCID: PMC9809256 DOI: 10.1136/bmjopen-2022-065564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Mental disorders affect about 13% of the world's population. While evidence-based mental health treatments are available, a significant number of persons with mental illnesses are untreated or do not receive adequate mental healthcare due to various reasons, including costs, stigma and the desire to self-manage symptoms. In the past few years, there has been an increase in the body of evidence regarding leisure activities and mental wellness. However, there is currently no published overview of the state of the evidence on these activities and their potential preventive and therapeutic effects on mental health. METHODS AND ANALYSIS Using Joanna Briggs Institute (JBI) review guidelines, an umbrella review will be undertaken to synthesise findings from systematic reviews and meta-analyses on the mental health benefits of home-based and community-based activities. MEDLINE, PsycInfo, Embase, CINAHL, Web of Science, Epistemonikos, Cochrane Database of Systematic Reviews, JBI Database of Systematic Reviews and Implementation Reports will be searched for potentially relevant systematic reviews and meta-analyses published from January 1991 to present. Title/abstract screening, full-text review, data extraction and assessment of methodological quality will each be performed independently by two reviewers. A third review author will be available to resolve discrepancies in any of the review tasks. To assess the quality of potentially eligible reviews, the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses will be used. Findings will be presented in table form and will be summarised by study population, type of home-based or community-based activity or intervention, and type of mental health outcomes. Overall assessment of the strength of existing evidence from eligible systematic reviews will be provided following the grading of recommendation, assessment, development and evaluation approach. ETHICS AND DISSEMINATION No ethical approval is required. Results of this umbrella review will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42021266989.
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Affiliation(s)
- Joseph H Puyat
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Mana Mohebbian
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Aanchel Gupta
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ursula Ellis
- Woodward Library, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Harmanpreet Ranote
- Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Alberto Almeida
- BC Mental Health and Substance Use Services, Vancouver, British Columbia, Canada
| | - Lisa Ridgway
- BC Support Unit, Vancouver, British Columbia, Canada
| | - Fidel Vila-Rodriguez
- Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
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Kim SY, Cho MK. The Effect of Nurse Support Programs on Job Satisfaction and Organizational Behaviors among Hospital Nurses: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:17061. [PMID: 36554942 PMCID: PMC9779627 DOI: 10.3390/ijerph192417061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
The purpose of this study was to calculate the combined effect size of nurse support programs on job satisfaction among hospital nurses. The PICO framework was used in this methodological study of systematic review and meta-analysis. Using nine electronic databases of four international and five Korean databases and applying the eligibility criteria, articles published from database inception through October 2022 were collected. A total of 24 Korean and international articles were selected following the PRISMA guidelines. The keywords of nurse, mentoring (preceptorship, internship, or residency) program, and job satisfaction were selected based on the PICO. The checklists for RCTs and quasi-experimental studies provided in the Joanna Briggs Institute of Critical Appraisal Tool were used for the quality assessment. The coded data were analyzed using MIX 2.0 statistical software. We analyzed the combined effect sizes, heterogeneity, funnel plot, Egger's regression test, Begg's test, subgroup analyses, and univariate meta-regression. The overall effects of the program on job satisfaction and organizational behavior such as organizational commitment, interpersonal relationships, self-efficacy, motivation, burnout, and turnover intention for hospital nurses were statistically significant. The results of this study may explain the effect of the nurse support program on job satisfaction and organizational behaviors for hospital nurses.
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Affiliation(s)
- Se Young Kim
- Department of Nursing, Changwon National University, Changwon 51140, Republic of Korea
| | - Mi-Kyoung Cho
- Department of Nursing Science, Chungbuk National University, Cheongju 28644, Republic of Korea
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Thomas T, Aggar C, Baker J, Massey D, Thomas M, D’Appio D, Brymer E. Social prescribing of nature therapy for adults with mental illness living in the community: A scoping review of peer-reviewed international evidence. Front Psychol 2022; 13:1041675. [PMID: 36562055 PMCID: PMC9765656 DOI: 10.3389/fpsyg.2022.1041675] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
Social prescribing of nature therapy "green social prescribing" facilitates access to local nature-based activities that improve biopsychosocial wellbeing outcomes, are affordable, accessible, and can be adapted to context. These are becoming increasingly popular and gray literature is emerging, however, peer-reviewed scientific evidence is exiguous. This scoping review aimed to identify and critique peer-reviewed evidence for green social prescribing interventions and develop recommendations for research and clinical practice. Included studies were published in peer-reviewed journals in English on/after 1 January 2000. Participants were community-living adults with mental illness; Intervention was any green social prescribing program; Comparator was not restricted/required; Outcomes were any biopsychosocial measures; and any/all Study Designs were included. Twelve databases were searched on 15 October 2022; these were Academic Search Premier, APA PsycArticles, APA PsycINFO, CINAHL, Cochrane Library, Google Scholar, JSTOR, ProQuest, PubMed, Science Direct, Scopus, and Web of Science. The Mixed Methods Appraisal Tool was used to assess quality. Seven publications describing 6 unique studies (5 UK, 1 Australia) were identified including 3 mixed-methods, 2 qualitative, and 1 RCT. Participants included 334 adults (45% female, aged 35-70 years); sample sizes ranged from 9 to 164. All studies showed improvements in biopsychosocial wellbeing, and participants from most studies (n = 5) reported increased connection to the earth and intention to further access nature. Participant demographics and diagnoses were poorly reported, and intervention activities and assessments varied considerably. However, MMAT scores were good overall suggesting these studies may reliably demonstrate intervention outcomes. We conclude that socially prescribed nature therapy can improve biopsychosocial wellbeing and is a potentially important intervention for mental illness. Recommendations for research and clinical practice are provided.
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Affiliation(s)
- Tamsin Thomas
- Faculty of Health, Southern Cross University, Bilinga, QLD, Australia
| | - Christina Aggar
- Faculty of Health, Southern Cross University, Bilinga, QLD, Australia
- Northern NSW Local Health District, Lismore, NSW, Australia
| | - James Baker
- Primary and Community Care Services, Thornleigh, NSW, Australia
| | - Debbie Massey
- Faculty of Health, Southern Cross University, Bilinga, QLD, Australia
| | - Megan Thomas
- Graduate School of Medicine, University of Wollongong, Keiraville, NSW, Australia
| | - Daniel D’Appio
- Primary and Community Care Services, Thornleigh, NSW, Australia
| | - Eric Brymer
- Faculty of Health, Southern Cross University, Bilinga, QLD, Australia
- Manna Institute, University of New England, Armidale, NSW, Australia
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Fox JW. How much does the typical ecological meta-analysis overestimate the true mean effect size? Ecol Evol 2022; 12:e9521. [PMID: 36407900 PMCID: PMC9666907 DOI: 10.1002/ece3.9521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/16/2022] [Accepted: 09/21/2022] [Indexed: 11/17/2022] Open
Abstract
Many primary research studies in ecology are underpowered, providing very imprecise estimates of effect size. Meta-analyses partially mitigate this imprecision by combining data from different studies. But meta-analytic estimates of mean effect size may still remain imprecise, particularly if the meta-analysis includes a small number of studies. Imprecise, large-magnitude estimates of mean effect size from small meta-analyses likely would shrink if additional studies were conducted (regression towards the mean). Here, I propose a way to estimate and correct this regression to the mean, using meta-meta-analysis (meta-analysis of meta-analyses). Hierarchical random effects meta-meta-analysis shrinks estimated mean effect sizes from different meta-analyses towards the grand mean, bringing those estimated means closer on average to their unknown true values. The intuition is that, if a meta-analysis reports a mean effect size much larger in magnitude than that reported by other meta-analyses, that large mean effect size likely is an overestimate. This intuition holds even if different meta-analyses of different topics have different true mean effect sizes. Drawing on a compilation of data from hundreds of ecological meta-analyses, I find that the typical (median) ecological meta-analysis overestimates the absolute magnitude of the true mean effect size by ~10%. Some small ecological meta-analyses overestimate the magnitude of the true mean effect size by >50%. Meta-meta-analysis is a promising tool for improving the accuracy of meta-analytic estimates of mean effect size, particularly estimates based on just a few studies.
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Affiliation(s)
- Jeremy W. Fox
- Department of Biological SciencesUniversity of CalgaryCalgaryAlbertaCanada
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Jiang C, Yan C, Duan J. Bone Mineral Density Is Inversely Associated With Mortality in Chronic Kidney Disease Patients: A Meta-Analysis. J Bone Miner Res 2022; 37:2094-2102. [PMID: 36055677 DOI: 10.1002/jbmr.4681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/09/2022] [Accepted: 08/14/2022] [Indexed: 11/09/2022]
Abstract
Low bone mineral density (BMD) is suggested to be associated with increased mortality in the general health population, but the relationship in chronic kidney disease (CKD) patients is still unclear. We performed a meta-analysis to investigate the association of BMD in different sites with risk of all-cause mortality in CKD patients. We searched PubMed, EMBASE, and Web of Science to identify eligible cohort studies that evaluated the association between BMD at different sites and risk of all-cause mortality in CKD patients. Twelve cohort studies were identified, which included 2828 CKD patients and 1052 deaths. Compared with normal/high level of total body BMD, lower total body BMD was associated with 25% higher risk of all-cause mortality. The pooled relative risk (RR) was 1.25 (95% confidence interval [CI] 1.09, 1.42) with little heterogeneity across studies. Regarding BMD measured at different sites, the risk of all-cause mortality was highest for lower BMD at hip/femoral neck (pooled RR = 1.69; 95% CI 1.20, 2.40). The pooled RRs were 1.26 (95% CI 1.04, 1.53) and 1.17 (95% CI 1.00, 1.37) for lower BMD at arm and spine, respectively. Similarly, the risk of death for per SD decrease in BMD was also higher at hip/femoral neck (pooled RR = 1.43, 95% CI 1.15, 1.77) compared with arm (pooled RR = 1.03, 95% CI 1.00, 1.06) and spine (pooled RR = 1.17, 95% CI 0.98, 1.39). In conclusion, lower BMD values at hip, arm, spine, as well as the whole body are associated with increased risk of all-cause mortality in CKD patients. The excess risk is highest for patients with lower BMD at hip/femoral neck, suggesting BMD measured at hip region may be the best indicator of mortality risk in CKD patients. © 2022 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Chao Jiang
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chongnan Yan
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jingzhu Duan
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
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TURNBULL D. On the sizes and distances of the sun and the moon. Minerva Anestesiol 2022; 88:979-981. [DOI: 10.23736/s0375-9393.22.16966-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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Chu JTW, McCormack J, Marsh S, Wells A, Wilson H, Bullen C. Impact of prenatal alcohol exposure on neurodevelopmental outcomes: a systematic review. Health Psychol Behav Med 2022; 10:973-1002. [PMID: 36238426 PMCID: PMC9553152 DOI: 10.1080/21642850.2022.2129653] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/20/2022] [Indexed: 11/04/2022] Open
Abstract
Background Prenatal exposure to alcohol (PAE) represents a significant public health concern. Previous research linking PAE to neurodevelopmental outcomes has been mixed and often has limited focus on residual confounding or moderating factors. Methods A systematic review of prospective cohort studies (n = >1000) assessing the impact of PAE on neurodevelopmental outcomes was undertaken (neurophysiology, motor skills, cognition, language, academic achievement, memory, attention, executive function, affect regulation, and adaptive behaviour, social skills, or communication). Electronic searches of EMBASE, Medline, CINAHL, and Psychinfo were conducted in May 2021. A quality assessment was conducted using an adapted version of the Newcastle-Ottawa Scale (NOS). Results Thirty longitudinal cohort studies met the inclusion criteria. Evidence of the impact of PAE was mixed across domains. We found no evidence that PAE affects executive function, but there were impacts on motor skills, cognition, language, academic achievement, attention, affect regulation, and adaptive behaviour. The most consistent adverse effect was on affect regulation (nine out of thirteen studies, six of which found an association between heavy alcohol consumption or binge drinking during pregnancy). We found no protective factors. Few studies controlled for variables in the postnatal environment. Discussion This review was unable to conclude a safe level of alcohol consumption during pregnancy. Methodological improvements are needed to improve the quality and consistency in which PAE is studied. Further research into residual confounding variables is vital, including a greater focus on the postpartum environment.
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Affiliation(s)
- Joanna Ting Wai Chu
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Jessica McCormack
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Samantha Marsh
- Social and Community Health, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Alesha Wells
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Holly Wilson
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Chris Bullen
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
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Edessa D, Assefa N, Dessie Y, Asefa F, Dinsa G, Oljira L. Non-prescribed antibiotic use for children at community levels in low- and middle-income countries: a systematic review and meta-analysis. J Pharm Policy Pract 2022; 15:57. [PMID: 36180895 PMCID: PMC9524137 DOI: 10.1186/s40545-022-00454-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 09/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-prescribed antibiotic use is an emerging risky practice around the globe. An inappropriate use involving nonprescription access is one cause of the rapid increase in antibiotic resistance. Children commonly encounter many self-limiting illnesses for which they frequently use antibiotics without prescription. However, no specific and conclusive evidence exists to inform actions against this unsafe practice. We thus aimed to estimate the pooled proportion of non-prescribed antibiotic use for children at community levels in low- and middle-income countries. METHODS A systematic search of records was conducted from PubMed/Medline, Embase, Scopus, CINAHL, and Google scholar. Eligible English-language publications were original articles which reported on community-based non-prescribed antibiotic use for children and conducted in low- and middle-income countries. Study features and the number of antibiotics used without prescriptions were extracted and pooled for effect sizes employing a random-effects model. The pooled proportion of non-prescribed antibiotic use was estimated as a percentage. RESULTS In this analysis, we included a total of 39 articles consisting of 40,450 participants. Of these, 16,315 participants used non-prescribed antibiotics. The pooled percentage for this use of non-prescribed antibiotics was 45% (95% CI: 40-50%). The estimate was considerably higher in studies involving simulated patient methods (56%; 95% CI: 49-62%) than those studies with community surveys (40%; 95% CI: 34-46%) (P = 0.001). It was also varied by the recall period of antibiotics use-56% (95% CI: 50-62%) for instantly observed practice, 36% (95% CI: 22-50%) for within two week recall, 35% (95% CI: 26-45%) for 1-6 months recall, and 46% (95% CI: 37-54%) for more than six months recall (P = 0.001). Primary access points for the non-prescribed antibiotic uses were retail drug outlets. CONCLUSIONS We found that nearly half of the antibiotics used for children in community settings were without prescriptions. For these unsafe practices, caregivers accessed antibiotics mainly from drug outlets. Hence, context-specific educational and regulatory interventions at these outlets and the community levels are the first steps to improving antibiotic usage for children in low- and middle-income countries. TRIAL REGISTRATION NUMBER CRD42021288971 (PROSPERO). https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021288971 .
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Affiliation(s)
- Dumessa Edessa
- School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
| | - Nega Assefa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Fekede Asefa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Center for Biomedical Informatics, Department of Pediatrics, College of Medicine, University of Tennessee Health Science Center-Oak Ridge National Laboratory (UTHSC-ORNL, Memphis, TN, USA
| | - Girmaye Dinsa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Lemessa Oljira
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Lam PPY, Zhou N, Yiu CKY, Wong HM. Impact of Antiretroviral Therapy on Oral Health among Children Living with HIV: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191911943. [PMID: 36231240 PMCID: PMC9565507 DOI: 10.3390/ijerph191911943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 05/11/2023]
Abstract
Oral health is an integral component of general health and well-being but might be undermined among children living with HIV (CLWH) due to the condition itself or the antiretroviral therapy (ART) received. This review summarises the current evidence and compares the oral health status of the CLWH who were treatment-naïve with those undergoing different ART medications. Fourteen studies were included in the final qualitative and quantitative analyses. This review identified no significant difference in the prevalence of caries, periodontal conditions, and tooth development between both groups. Orofacial opportunistic infections were more prevalent in the CLWH without ART. Children undergoing ART with a duration longer than 3 years had a significantly lower prevalence of oral candidiasis and CD4+ T-cell counts. However, due to the insufficient number of well-administered case-control studies with adequate sample size, the quality of the evidence in all outcomes was of very low certainty.
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Affiliation(s)
- Phoebe Pui Ying Lam
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
| | - Ni Zhou
- School of Stomatology, Kunming Medical University, Kunming 650032, China
| | - Cynthia Kar Yung Yiu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
| | - Hai Ming Wong
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
- Correspondence: ; Tel.: +852-2859-0261
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Helbach J, Pieper D, Mathes T, Rombey T, Zeeb H, Allers K, Hoffmann F. Restrictions and their reporting in systematic reviews of effectiveness: an observational study. BMC Med Res Methodol 2022; 22:230. [PMID: 35987985 PMCID: PMC9392276 DOI: 10.1186/s12874-022-01710-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 08/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Restrictions in systematic reviews (SRs) can lead to bias and may affect conclusions. Therefore, it is important to report whether and which restrictions were used. This study aims to examine the use of restrictions regarding language, publication period, and study type, as well as the transparency of reporting in SRs of effectiveness. METHODS A retrospective observational study was conducted with a random sample of 535 SRs of effectiveness indexed in PubMed between 2000 and 2019. The use of restrictions and their reporting were analysed using descriptive statistics. RESULTS Of the total 535 SRs included, four out of every ten (41.3%) lacked information on at least one of the three restrictions considered (language, publication period, or study type). Overall, 14.6% of SRs did not provide information on restrictions regarding publication period, 19.1% regarding study type, and 18.3% regarding language. Of all included SRs, language was restricted in 46.4%, and in more than half of the SRs with restricted language (130/248), it was unclear whether the restriction was applied during either the search or the screening process, or both. The restrictions were justified for publication period in 22.2% of the respective SRs (33/149), study type in 6.5% (28/433), and language in 3.2% (8/248). Differences in reporting were found between countries as well as between Cochrane and non-Cochrane reviews. CONCLUSIONS This study suggests that there is a lack of transparency in reporting on restrictions in SRs. Authors as well as editors and reviewers should be encouraged to improve the reporting and justification of restrictions to increase the transparency of SRs.
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Affiliation(s)
- Jasmin Helbach
- Department of Health Services Research, School of Medicine and Health Sciences, Carl Von Ossietzky University Oldenburg, Oldenburg, Germany.
| | - Dawid Pieper
- Institute for Research in Operative Medicine, Faculty of Health, School of Medicine, Witten/Herdecke University, Cologne, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Institute for Health Services and Health System Research, Rüdersdorf, Germany
- Center for Health Services Research, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany
| | - Tim Mathes
- Institute for Research in Operative Medicine, Faculty of Health, School of Medicine, Witten/Herdecke University, Cologne, Germany
- Institute for Medical Statistics, University Medical Centre Göttingen, Göttingen, Germany
| | - Tanja Rombey
- Institute for Research in Operative Medicine, Faculty of Health, School of Medicine, Witten/Herdecke University, Cologne, Germany
- Department of Health Care Management, Technische Universität Berlin, Berlin, Germany
| | - Hajo Zeeb
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Katharina Allers
- Department of Health Services Research, School of Medicine and Health Sciences, Carl Von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Falk Hoffmann
- Department of Health Services Research, School of Medicine and Health Sciences, Carl Von Ossietzky University Oldenburg, Oldenburg, Germany
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Donaldson L, Edington A, Vlok R, Astono I, Iredale T, Flower O, Ma A, Davidson K, Delaney A. The incidence of cerebral arterial vasospasm following aneurysmal subarachnoid haemorrhage: a systematic review and meta-analysis. Neuroradiology 2022; 64:2381-2389. [PMID: 35794390 PMCID: PMC9643195 DOI: 10.1007/s00234-022-03004-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 06/26/2022] [Indexed: 11/24/2022]
Abstract
Purpose
To describe a pooled estimated incidence of cerebral arterial vasospasm (aVSP) following aneurysmal subarachnoid haemorrhage (aSAH) and to describe sources of variation in the reported incidence. Methods We performed a systematic review and meta-analysis of randomised clinical trials (RCTs) and cohort studies. The primary outcome was the proportion of study participants diagnosed with aVSP. We assessed for heterogeneity based on mode of imaging, indication for imaging, study design and clinical characteristics at a study level. Results We identified 120 studies, including 19,171 participants. More than 40 different criteria were used to diagnose aVSP. The pooled estimate of the proportion of patients diagnosed with aVSP was 0.42 (95% CI 0.39 to 0.46, I2 = 96.5%). There was no evidence that the incidence aVSP was different, nor that heterogeneity was reduced, when the estimate was assessed by study type, imaging modalities, the proportion of participants with high grade CT scores or poor grade clinical scores. The pooled estimate of the proportion of study participants diagnosed with aVSP was higher in studies with routine imaging (0.47, 95% CI 0.43 to 0.52, I2 = 96.5%) compared to those when imaging was performed when indicated (0.30, 95% CI 0.25 to 0.36, I2 = 94.0%, p for between-group difference < 0.0005). Conclusion The incidence of cerebral arterial vasospasm following aSAH varies widely from 9 to 93% of study participants. Heterogeneity in the reported incidence may be due to variation in the criteria used to diagnose aVSP. A standard set of diagnostic criteria is necessary to resolve the role that aVSP plays in delayed neurological deterioration following aSAH. PROSPERO registration CRD42020191895 Supplementary Information The online version contains supplementary material available at 10.1007/s00234-022-03004-w.
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Affiliation(s)
- Lachlan Donaldson
- Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Reserve Rd, St. Leonards, Sydney, NSW, 2065, Australia. .,Division of Critical Care, The George Institute for Global Health, Faculty of Medicine UNSW, Sydney, Australia.
| | - Ashleigh Edington
- Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Ruan Vlok
- Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Reserve Rd, St. Leonards, Sydney, NSW, 2065, Australia.,Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Inez Astono
- Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Reserve Rd, St. Leonards, Sydney, NSW, 2065, Australia
| | - Tom Iredale
- Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Reserve Rd, St. Leonards, Sydney, NSW, 2065, Australia
| | - Oliver Flower
- Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Reserve Rd, St. Leonards, Sydney, NSW, 2065, Australia.,Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Alice Ma
- Department of Neurosurgery, Royal North Shore Hospital, Sydney, Australia
| | - Keryn Davidson
- Department of Neurosurgery, Royal North Shore Hospital, Sydney, Australia
| | - Anthony Delaney
- Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Reserve Rd, St. Leonards, Sydney, NSW, 2065, Australia.,Division of Critical Care, The George Institute for Global Health, Faculty of Medicine UNSW, Sydney, Australia.,Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia
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48
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Maccabe TA, Robertson HF, Skipworth J, Rees J, Roberts K, Pathak S. A systematic review of post-pancreatectomy haemorrhage management stratified according to ISGPS grading. HPB (Oxford) 2022; 24:1110-1118. [PMID: 35101359 DOI: 10.1016/j.hpb.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 11/15/2021] [Accepted: 12/08/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Morbidity and mortality from post-pancreatectomy haemorrhage (PPH) remains high. The International Study Group of Pancreatic Surgery (ISGPS) published guidelines to standardise definitions of PPH severity, management and reporting. This study aimed to i) identify the number of studies reporting PPH using ISGPS guidelines (Grade A, B or C) and ii) describe treatment modality success by grade. METHODS A systematic literature review was performed, identifying studies reporting PPH by ISGPS Grade and their subsequent management. RESULTS Of 62 studies reporting on PPH management, 17 (27.4%) stratified by ISGPS guidelines and included 608 incidences of PPH: 48 Grade A, 274 Grade B (62 early, 166 late, 46 unspecified) and 286 Grade C. 96% of Grade A PPH were treated conservatively. Of 62 early Grade B, 54.8% were managed conservatively and 37.1% surgically. Late Grade B were managed non-operatively in 25.3% (42/166), with successful endoscopy in 90.9% (10/11) and angiography in 90.3% (28/31). In Grade C, endoscopic treatment was successful in 64.4% (29/45) and angiography in 90.8% (108/119). Surgical intervention was required in 43.5% early Grade B, 7.8% late Grade B and 33.2% Grade C. CONCLUSION PPH grading is underreported and despite guidelines, inconsistencies remain when using definitions and reporting of outcomes.
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Affiliation(s)
- Thomas A Maccabe
- Department of Hepatopancreatobiliary Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol UK.
| | - Harry F Robertson
- Department of Hepatopancreatobiliary Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol UK
| | - James Skipworth
- Department of Hepatopancreatobiliary Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol UK
| | - Jonathan Rees
- Department of Hepatopancreatobiliary Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol UK
| | - Keith Roberts
- Department of Hepatopancreatobiliary Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol UK; Department of Pancreatic Surgery, University Hospitals Birmingham, UK
| | - Samir Pathak
- Department of Hepatopancreatobiliary Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol UK
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Xie Q, Pei J, Gou L, Zhang Y, Zhong J, Su Y, Wang X, Ma L, Dou X. Risk factors for fear of falling in stroke patients: a systematic review and meta-analysis. BMJ Open 2022; 12:e056340. [PMID: 35772831 PMCID: PMC9247667 DOI: 10.1136/bmjopen-2021-056340] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Even though 32%-83% for fear of falling (FoF) in patients with stroke, very little is known about the predictors of the problems. Therefore, we systematically reviewed the literature on risk factors for FoF in patients with stroke. DESIGN A systematic review and meta-analysis DATA SOURCES: PubMed, Embase, Cochrane Library database, Web of Science, CINAHL, PsycINFO, Grey literature and other relevant databases for related publications were searched (from inception to 17 July 2021). RESULTS Eight studies involving 1597 participants were selected to analyse risk factors for patients with stroke with FoF. The quality of all included studies was assessed and categorised as medium or high quality. Review Manager V.5.3 merged the OR value and 95% CI of the potential risk factors. Meta-regression and Egger's test were performed by Stata V.15.1. The risk factors for FoF in patients with stroke were women (OR=2.13, 95% CI 1.47 to 3.09), impaired balance ability (OR=5.54; 95% CI 3.48 to 8.81), lower mobility (OR=1.12; 95% CI 1.05 to 1.19), history of falls (OR=2.33; 95% CI 1.54 to 3.53) and walking aid (OR=1.98; 95% CI 1.37 to 2.88), anxiety (OR=2.29; 95% CI 1.43 to 3.67), depression (OR=1.80; 95% CI 1.22 to 2.67), poor lower limb motor function (OR=1.14; 95% CI 1.00 to 1.29) and physically inactiveness (OR=2.04; 95% CI 1.01 to 4.12). Measurement of heterogeneity between studies was high for all outcomes (I2 =0%-93%), indicating that the substantial interstudy heterogeneity in estimated proportions was not attributed to the sampling error. Sensitivity analysis (leave-one-out method) showed that the pooled estimate was stable. CONCLUSION This meta-analysis indicated that female population, impaired balance ability, lower mobility, history of falls and walking aid in patients with stroke might be at greater risk for FoF. Future studies are recommended to determine other risk factors specific to patients with stroke.
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Affiliation(s)
- Qi Xie
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Juhong Pei
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Ling Gou
- Department of Nursing, Qinghai Provincial People's Hospital, Xining, Qinghai, China
| | - Yabin Zhang
- Neurological Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Juanping Zhong
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
- Medical Department of Neurology, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Yujie Su
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Xinglei Wang
- Department of Liver Diseases Branch, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Li Ma
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Xinman Dou
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
- Department of Nursing, Lanzhou University Second Hospital, Lanzhou, Gansu, China
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Wiedemann A, Oussalah A, Lamireau N, Théron M, Julien M, Mergnac JP, Augay B, Deniaud P, Alix T, Frayssinoux M, Feillet F, Guéant JL. Clinical, phenotypic and genetic landscape of case reports with genetically proven inherited disorders of vitamin B 12 metabolism: A meta-analysis. Cell Rep Med 2022; 3:100670. [PMID: 35764087 PMCID: PMC9381384 DOI: 10.1016/j.xcrm.2022.100670] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 11/22/2021] [Accepted: 06/02/2022] [Indexed: 10/31/2022]
Abstract
Inherited disorders of B12 metabolism produce a broad spectrum of manifestations, with limited knowledge of the influence of age and the function of related genes. We report a meta-analysis on 824 patients with a genetically proven diagnosis of an inherited disorder of vitamin B12 metabolism. Gene clusters and age categories are associated with patients' manifestations. The "cytoplasmic transport" cluster is associated with neurological and ophthalmological manifestations, the "mitochondrion" cluster with hypotonia, acute metabolic decompensation, and death, and the "B12 availability" and "remethylation" clusters with anemia and cytopenia. Hypotonia, EEG abnormalities, nystagmus, and strabismus are predominant in the younger patients, while neurological manifestations, such as walking difficulties, peripheral neuropathy, pyramidal syndrome, cerebral atrophy, psychiatric disorders, and thromboembolic manifestations, are predominant in the older patients. These results should prompt systematic checking of markers of vitamin B12 status, including homocysteine and methylmalonic acid, when usual causes of these manifestations are discarded in adult patients.
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Affiliation(s)
- Arnaud Wiedemann
- Nutrition, Genetics, and Environmental Risk Exposure (NGERE), Faculty of Medicine of Nancy, University of Lorraine, INSERM UMR_S 1256, 54000 Nancy, France; Department of Pediatrics, University Hospital of Nancy, 54000 Nancy, France; Reference Center for Inborn Errors of Metabolism (ORPHA67872), University Hospital of Nancy, 54000 Nancy, France
| | - Abderrahim Oussalah
- Nutrition, Genetics, and Environmental Risk Exposure (NGERE), Faculty of Medicine of Nancy, University of Lorraine, INSERM UMR_S 1256, 54000 Nancy, France; Reference Center for Inborn Errors of Metabolism (ORPHA67872), University Hospital of Nancy, 54000 Nancy, France; Department of Molecular Medicine, Division of Biochemistry, Molecular Biology, Nutrition, and Metabolism, University Hospital of Nancy, 54000 Nancy, France
| | - Nathalie Lamireau
- Department of Pediatrics, University Hospital of Nancy, 54000 Nancy, France
| | - Maurane Théron
- Department of Pediatrics, University Hospital of Nancy, 54000 Nancy, France
| | - Melissa Julien
- Department of Molecular Medicine, Division of Biochemistry, Molecular Biology, Nutrition, and Metabolism, University Hospital of Nancy, 54000 Nancy, France
| | | | - Baptiste Augay
- Department of Pediatrics, University Hospital of Nancy, 54000 Nancy, France
| | - Pauline Deniaud
- Department of Pediatrics, University Hospital of Nancy, 54000 Nancy, France
| | - Tom Alix
- Department of Molecular Medicine, Division of Biochemistry, Molecular Biology, Nutrition, and Metabolism, University Hospital of Nancy, 54000 Nancy, France
| | - Marine Frayssinoux
- Department of Molecular Medicine, Division of Biochemistry, Molecular Biology, Nutrition, and Metabolism, University Hospital of Nancy, 54000 Nancy, France
| | - François Feillet
- Nutrition, Genetics, and Environmental Risk Exposure (NGERE), Faculty of Medicine of Nancy, University of Lorraine, INSERM UMR_S 1256, 54000 Nancy, France; Department of Pediatrics, University Hospital of Nancy, 54000 Nancy, France; Reference Center for Inborn Errors of Metabolism (ORPHA67872), University Hospital of Nancy, 54000 Nancy, France
| | - Jean-Louis Guéant
- Nutrition, Genetics, and Environmental Risk Exposure (NGERE), Faculty of Medicine of Nancy, University of Lorraine, INSERM UMR_S 1256, 54000 Nancy, France; Reference Center for Inborn Errors of Metabolism (ORPHA67872), University Hospital of Nancy, 54000 Nancy, France; Department of Molecular Medicine, Division of Biochemistry, Molecular Biology, Nutrition, and Metabolism, University Hospital of Nancy, 54000 Nancy, France.
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