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Hussain S, Swystun AG, Caputo M, Angelini GD, Vohra HA. A review and meta-analysis of conventional sternotomy versus minimally invasive mitral valve surgery for degenerative mitral valve disease focused on the last decade of evidence. Perfusion 2024; 39:988-997. [PMID: 37145960 DOI: 10.1177/02676591231174579] [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] [Indexed: 05/07/2023]
Abstract
OBJECTIVES Early meta-analyses comparing minimally invasive mitral valve surgery (MIMVS) with conventional sternotomy (CS) have determined the safety of MIMVS. We performed this review and meta-analysis based on studies from 2014 onwards to examine the differences in outcomes between MIMVS and CS. Specifically, some outcomes of interest included renal failure, new onset atrial fibrillation, mortality, stroke, reoperation for bleeding, blood transfusion and pulmonary infection. METHODS A systematic search was performed in six databases for studies comparing MIMVS with CS. Although the initial search identified 821 papers in total, nine studies were suitable for the final analysis. All studies included compared CS with MIMVS. The Mantel - Haenszel statistical method was chosen due the use of inverse variance and random effects. A meta-analysis was performed on the data. RESULTS MIMVS had significantly lower odds of renal failure (OR: 0.52; 95% CI 0.37 to 0.73, p < 0.001), new onset atrial fibrillation (OR: 0.78; 95% CI 0.67 to 0.90, p < 0.001), reduced prolonged intubation (OR: 0.50; 95% CI 0.29 to 0.87, p = 0.01) and reduced mortality (OR: 0.58; 95% CI 0.38 to 0.87, p < 0.01). MIMVS had shorter ICU stay (WMD: -0.42; 95% CI -0.59 to -0.24, p < 0.001) and shorter time to discharge (WMD: -2.79; 95% CI -3.86 to -1.71, p < 0.001). CONCLUSION In the modern era, MIMVS for degenerative disease is associated with improved short-term outcomes when compared to the CS.
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Affiliation(s)
| | | | - Massimo Caputo
- Department of Cardiac Surgery, Bristol Heart Institute, Bristol, UK
| | | | - Hunaid A Vohra
- Department of Cardiac Surgery, Bristol Heart Institute, Bristol, UK
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Shen L, Liu J, Zhao X, Wang A, Hu X. Association between insulin receptor substrate 1 gene polymorphism rs1801278 and gestational diabetes mellitus: an updated meta- analysis. Diabetol Metab Syndr 2024; 16:62. [PMID: 38448958 PMCID: PMC10919047 DOI: 10.1186/s13098-024-01289-w] [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: 12/15/2023] [Accepted: 02/12/2024] [Indexed: 03/08/2024] Open
Abstract
OBJECTIVES we performed this meta- analysis to investigate the impact of insulin receptor substrate 1 (IRS1) gene rs1801278 on susceptibility to gestational diabetes mellitus (GDM). METHODS The pooled odds ratio (OR) and 95% confidence interval (95% CI) were calculated, and p value is used to determine statistical significance. Sensitivity analysis was performed under three models (dominant, recessive and allele model), and the pooled ORs and 95%CI were calculated. Funnel plots and Begger's regression test were employed to test the publication bias. RESULTS The meta-analysis included 4777 participants (2116 cases and 2661 controls). The IRS1 rs1801278 (C/T) were not significant associated with GDM risk under the dominant and allele models, OR (95%CI) = 1.22 (0.88-1.70) and 1.24 (0.91-1.68), respectively (both p values were more than 0.05). But we also found the IRS1 rs1801278 (C/T) were significant associated with GDM risk under the recessive model, OR (95%CI) = 0.37 (0.16-0.86), p = 0.030. Our results showed that none of the studies affected the quality of the pooled OR. We also found no significant publication bias existed in this meta study for three genetic models, PTT + CT vs. CC = 0.445; PCC+CT vs. TT= 0.095; PC vs. T = 0.697. CONCLUSION this meta-analysis indicated that IRS1 rs1801278 (C/T) was associated with the GDM risk under the recessive model but was not associated with the GDM risk under dominant and allele models.
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Affiliation(s)
- Lili Shen
- Department of Obstetrics and Gynecology, Heping Hospital Affiliated to Changzhi Medical College, 110 South Yan'an Road, 046000, Changzhi, Shanxi Province, China.
| | - Junli Liu
- Department of Obstetrics and Gynecology, Heping Hospital Affiliated to Changzhi Medical College, 110 South Yan'an Road, 046000, Changzhi, Shanxi Province, China
| | - Xiaolei Zhao
- Department of Obstetrics and Gynecology, Heping Hospital Affiliated to Changzhi Medical College, 110 South Yan'an Road, 046000, Changzhi, Shanxi Province, China
| | - Aiqin Wang
- Department of Obstetrics and Gynecology, Heping Hospital Affiliated to Changzhi Medical College, 110 South Yan'an Road, 046000, Changzhi, Shanxi Province, China
| | - Xiaomei Hu
- Department of Obstetrics and Gynecology, Heping Hospital Affiliated to Changzhi Medical College, 110 South Yan'an Road, 046000, Changzhi, Shanxi Province, China
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Hocagil TA, Hwang H, Jacobson JL, Jacobson SW, Ryan LM. Meta-analysis on studies with heterogeneous and partially observed covariates. JBI Evid Synth 2024; 22:413-433. [PMID: 38475899 PMCID: PMC11200172 DOI: 10.11124/jbies-23-00078] [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] [Indexed: 03/14/2024]
Abstract
Individual participant data meta-analysis is a commonly used alternative to the traditional aggregate data meta-analysis. It is popular because it avoids relying on published results and enables direct adjustment for relevant covariates. However, a practical challenge is that the studies being combined often vary in terms of the potential confounders that were measured. Furthermore, it will inevitably be the case that some individuals have missing values for some of those covariates. In this paper, we demonstrate how these challenges can be resolved using a propensity score approach, combined with multiple imputation, as a strategy to adjust for covariates in the context of individual participant data meta-analysis. To illustrate, we analyze data from the Bill and Melinda Gates Foundation-funded Healthy Birth, Growth, and Development Knowledge Integration project to investigate the relationship between physical growth rate in the first year of life and cognition measured later during childhood. We found that the overall effect of average growth velocity on cognitive outcome is slightly, but significantly, positive with an estimated effect size of 0.36 (95% CI 0.18, 0.55).
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Affiliation(s)
- Tugba Akkaya Hocagil
- Department of Statistics and Actuarial Science, University of Waterloo, Ontario, Canada
- Department of Biostatistics, Ankara University School of Medicine, Ankara, Turkiye
| | - Hon Hwang
- School of Mathematical and Physical Sciences, University of Technology Sydney, Ultimo, NSW, Australia
| | - Joseph L. Jacobson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Sandra W. Jacobson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Louise M. Ryan
- School of Mathematical and Physical Sciences, University of Technology Sydney, Ultimo, NSW, Australia
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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4
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Korevaar E, Turner SL, Forbes AB, Karahalios A, Taljaard M, McKenzie JE. Comparison of statistical methods used to meta-analyse results from interrupted time series studies: an empirical study. BMC Med Res Methodol 2024; 24:31. [PMID: 38341540 PMCID: PMC10858609 DOI: 10.1186/s12874-024-02147-z] [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: 12/20/2022] [Accepted: 01/10/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND The Interrupted Time Series (ITS) is a robust design for evaluating public health and policy interventions or exposures when randomisation may be infeasible. Several statistical methods are available for the analysis and meta-analysis of ITS studies. We sought to empirically compare available methods when applied to real-world ITS data. METHODS We sourced ITS data from published meta-analyses to create an online data repository. Each dataset was re-analysed using two ITS estimation methods. The level- and slope-change effect estimates (and standard errors) were calculated and combined using fixed-effect and four random-effects meta-analysis methods. We examined differences in meta-analytic level- and slope-change estimates, their 95% confidence intervals, p-values, and estimates of heterogeneity across the statistical methods. RESULTS Of 40 eligible meta-analyses, data from 17 meta-analyses including 282 ITS studies were obtained (predominantly investigating the effects of public health interruptions (88%)) and analysed. We found that on average, the meta-analytic effect estimates, their standard errors and between-study variances were not sensitive to meta-analysis method choice, irrespective of the ITS analysis method. However, across ITS analysis methods, for any given meta-analysis, there could be small to moderate differences in meta-analytic effect estimates, and important differences in the meta-analytic standard errors. Furthermore, the confidence interval widths and p-values for the meta-analytic effect estimates varied depending on the choice of confidence interval method and ITS analysis method. CONCLUSIONS Our empirical study showed that meta-analysis effect estimates, their standard errors, confidence interval widths and p-values can be affected by statistical method choice. These differences may importantly impact interpretations and conclusions of a meta-analysis and suggest that the statistical methods are not interchangeable in practice.
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Affiliation(s)
- Elizabeth Korevaar
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Simon L Turner
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Andrew B Forbes
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Amalia Karahalios
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Monica Taljaard
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, K1Y 4E9, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, K1N 6N5, Canada
| | - Joanne E McKenzie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
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Wang S, Wang J, Kang H, Zeng L, Liu G, Qiu Y, Wei M. Assessment of the prevalence and related factors of financial toxicity in cancer patients based on the COST scale: A systematic review and meta-analysis. Eur J Oncol Nurs 2024; 68:102489. [PMID: 38118267 DOI: 10.1016/j.ejon.2023.102489] [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: 08/02/2023] [Revised: 12/01/2023] [Accepted: 12/08/2023] [Indexed: 12/22/2023]
Abstract
PURPOSE The high cost of cancer treatment exposes patients to financial toxicity during treatment; however, no study has comprehensively analyzed the incidence of financial toxicity using a validated assessment tool. In this study, the objective was to ascertain the incidence of financial toxicity in cancer patients and the factors influencing it. METHODS Nine electronic databases were retrieved to collect cross-sectional studies reporting financial toxicity in cancer patients. A random effects meta-analysis was applied to yield the overall prevalence of financial toxicity. Subgroup analyses were conducted depending on the factors affecting financial toxicity. RESULTS In total, 30 studies met our inclusion criteria. The pooled prevalence of financial toxicity in cancer patients was 48% (95%CI:38%-58%, I2 = 99.4%, p < 0.001). In the subgroup analysis, a higher prevalence of financial toxicity in patients aged <67 years (47%, 95%CI: 28%-66%, I2 = 97.5%, p < 0.001), female (46%, 95%CI:39%-53%, I2 = 94.9%,p < 0.001), lung cancer(57%, 95%CI:38%-75%, I2 = 96.9%, p < 0.001), developing countries (64%, 95%CI:55%-72%, I2 = 98.1%, p < 0.001), time of investigation following COVID-19 (53%, 95%CI:37%-69%, I2 = 99.4%, p < 0.001). CONCLUSION Financial toxicity is prevalent in cancer patients and is increasingly evident after COVID-19. Furthermore, the odds of financial toxicity are higher in patients who are female, younger, whose cancer type is lung cancer, and from developing countries. These findings emphasize the significance of evaluating financial toxicity in cancer patients after COVID-19, especially in developing countries. This may play a pivotal role in helping patients cope with financial toxicity.
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Affiliation(s)
- Shuping Wang
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan province, 611137, China.
| | - Jialin Wang
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan province, 611137, China.
| | - Hua Kang
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan province, 611137, China.
| | - Li Zeng
- Sichuan Nursing Vocational College, Chengdu City, Sichuan province, China.
| | - Guiling Liu
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan province, 611137, China.
| | - Yinong Qiu
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan province, 611137, China.
| | - Meng Wei
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan province, 611137, China.
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Liang P, Li J, Li Z, Wei J, Li J, Zhang S, Xu S, Liu Z, Wang J. Effect of low-frequency noise exposure on cognitive function: a systematic review and meta-analysis. BMC Public Health 2024; 24:125. [PMID: 38195479 PMCID: PMC10775542 DOI: 10.1186/s12889-023-17593-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 12/27/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Low-frequency noise may cause changes in cognitive function. However, there is no established consensus on the effect of low-frequency noise on cognitive function. Therefore, this systematic review and meta-analysis aimed to explore the relationship between low-frequency noise exposure and cognitive function. METHODS We conducted a systematic review and identified original studies written in English on low-frequency noise and cognition published before December 2022 using the PsycINFO, PubMed, Medline, and Web of Science databases. The risk of bias was evaluated according to established guidelines. A random-effects meta-analysis was performed where appropriate. To explore the association between low-frequency noise exposure and cognitive function, we reviewed eight relevant studies. These studies covered cognitive functions grouped into four domains: attention, executive function, memory, and higher-order cognitive functions. The data extraction process was followed by a random-effects meta-analysis for each domain, which allowed us to quantify the overall effect. RESULTS Our analysis of the selected studies suggested that interventions involving low-frequency noise only had a negative impact on higher-order cognitive functions (Z = 2.42, p = 0.02), with a standardized mean difference of -0.37 (95% confidence interval: -0.67, -0.07). A moderate level of heterogeneity was observed among studies (p = 0.24, I2 = 29%, Tau2 = 0.03). CONCLUSIONS Our study findings suggest that low-frequency noise can negatively impact higher-order cognitive functions, such as logical reasoning, mathematical calculation, and data processing. Therefore, it becomes important to consider the potential negative consequences of low-frequency noise in everyday situations, and proactive measures should be taken to address this issue and mitigate the associated potential adverse outcomes.
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Affiliation(s)
- Peng Liang
- Department of Rehabilitative Physioltherapy, The Second Affiliated Hospital of Air Force Medical University, Xi'an, 710038, China
- Hospital of No. 95007 Unit of PLA, Guangzhou, 510410, China
| | - Jiangjing Li
- Department of Anesthesiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, 710038, China
| | - Zenglei Li
- Department of Rehabilitative Physioltherapy, The Second Affiliated Hospital of Air Force Medical University, Xi'an, 710038, China
| | - Jing Wei
- Department of Radiation Medical Protection, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Military Preventive Medicine, Fourth Military Medical University, Xi'an, 710068, China
| | - Jing Li
- Department of Radiation Medical Protection, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Military Preventive Medicine, Fourth Military Medical University, Xi'an, 710068, China
| | - Shenghao Zhang
- Department of Neurosurgery, the 940th Hospital of PLA Joint Logistics Support Force, Lanzhou, 730050, China
| | - Shenglong Xu
- Department of Radiation Medical Protection, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Military Preventive Medicine, Fourth Military Medical University, Xi'an, 710068, China
| | - Zhaohui Liu
- Department of Orthopaedics, The Second Affiliated Hospital of Air Force Medical University, Xi'an, 710038, China.
| | - Jin Wang
- Department of Radiation Medical Protection, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Military Preventive Medicine, Fourth Military Medical University, Xi'an, 710068, China.
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Azzani M, Atroosh WM, Anbazhagan D, Kumarasamy V, Abdalla MMI. Describing financial toxicity among cancer patients in different income countries: a systematic review and meta-analysis. Front Public Health 2024; 11:1266533. [PMID: 38229668 PMCID: PMC10789858 DOI: 10.3389/fpubh.2023.1266533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/17/2023] [Indexed: 01/18/2024] Open
Abstract
Background There is limited evidence of financial toxicity (FT) among cancer patients from countries of various income levels. Hence, this study aimed to determine the prevalence of objective and subjective FT and their measurements in relation to cancer treatment. Methods PubMed, Science Direct, Scopus, and CINAHL databases were searched to find studies that examined FT. There was no limit on the design or setting of the study. Random-effects meta-analysis was utilized to obtain the pooled prevalence of objective FT. Results Out of 244 identified studies during the initial screening, only 64 studies were included in this review. The catastrophic health expenditure (CHE) method was often used in the included studies to determine the objective FT. The pooled prevalence of CHE was 47% (95% CI: 24.0-70.0) in middle- and high-income countries, and the highest percentage was noted in low-income countries (74.4%). A total of 30 studies focused on subjective FT, of which 9 used the Comprehensive Score for FT (COST) tool and reported median scores ranging between 17.0 and 31.9. Conclusion This study shows that cancer patients from various income-group countries experienced a significant financial burden during their treatment. It is imperative to conduct further studies on interventions and policies that can lower FT caused by cancer treatment.
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Affiliation(s)
- Meram Azzani
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
- Centre of Occupational Safety, Health and Wellbeing, Universiti Teknologi MARA, Puncak Alam, Selangor, Malaysia
| | - Wahib Mohammed Atroosh
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Microbiology and Parasitology, Faculty of Medicine and Health Sciences, University of Aden, Aden, Yemen
| | - Deepa Anbazhagan
- Department of Microbiology, International Medical School (IMS), Management & Science University (MSU), Shah Alam, Selangor, Malaysia
| | - Vinoth Kumarasamy
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Kuala Lumpur, Malaysia
| | - Mona Mohamed Ibrahim Abdalla
- Physiology Department, Human Biology Division, School of Medicine, International Medical University (IMU), Kuala Lumpur, Malaysia
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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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Cumpston MS, McKenzie JE, Ryan R, Thomas J, Brennan SE. Critical elements of synthesis questions are incompletely reported: survey of systematic reviews of intervention effects. J Clin Epidemiol 2023; 163:79-91. [PMID: 37778736 DOI: 10.1016/j.jclinepi.2023.09.013] [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: 07/04/2023] [Revised: 09/21/2023] [Accepted: 09/26/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVES To examine the characteristics of population, intervention and outcome groups and the extent to which they were completely reported for each synthesis in a sample of systematic reviews (SRs) of interventions. STUDY DESIGN AND SETTING We coded groups that were intended (or used) for comparisons in 100 randomly sampled SRs of public health and health systems interventions published in 2018 from the Health Evidence and Health Systems Evidence databases. RESULTS Authors commonly used population, intervention and outcome groups to structure comparisons, but these groups were often incompletely reported. For example, of 41 SRs that identified and/or used intervention groups for comparisons, 29 (71%) identified the groups in their methods description before reporting of the results (e.g., in the Background or Methods), 12 (29%) defined the groups in enough detail to replicate decisions about which included studies were eligible for each synthesis, 6 (15%) provided a rationale, and 24 (59%) stated that the groups would be used for comparisons. Sixteen (39%) SRs used intervention groups in their synthesis without any mention in the methods. Reporting for population, outcome and methodological groups was similarly incomplete. CONCLUSION Complete reporting of the groups used for synthesis would improve transparency and replicability of reviews, and help ensure that the synthesis is not driven by what is reported in the included studies. Although concerted effort is needed to improve reporting, this should lead to more focused and useful reviews for decision-makers.
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Affiliation(s)
- Miranda S Cumpston
- Methods in Evidence Synthesis Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
| | - Joanne E McKenzie
- Methods in Evidence Synthesis Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
| | - Rebecca Ryan
- Centre for Health Communication & Participation, La Trobe University, Melbourne, Victoria 3086, Australia
| | - James Thomas
- EPPI-Centre, UCL Social Research Institute, University College London, Gower St, London, WC1E 6BT, UK
| | - Sue E Brennan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia.
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Korevaar E, Turner SL, Forbes AB, Karahalios A, Taljaard M, McKenzie JE. Evaluation of statistical methods used to meta-analyse results from interrupted time series studies: A simulation study. Res Synth Methods 2023; 14:882-902. [PMID: 37731166 PMCID: PMC10946504 DOI: 10.1002/jrsm.1669] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 08/11/2023] [Accepted: 08/29/2023] [Indexed: 09/22/2023]
Abstract
Interrupted time series (ITS) are often meta-analysed to inform public health and policy decisions but examination of the statistical methods for ITS analysis and meta-analysis in this context is limited. We simulated meta-analyses of ITS studies with continuous outcome data, analysed the studies using segmented linear regression with two estimation methods [ordinary least squares (OLS) and restricted maximum likelihood (REML)], and meta-analysed the immediate level- and slope-change effect estimates using fixed-effect and (multiple) random-effects meta-analysis methods. Simulation design parameters included varying series length; magnitude of lag-1 autocorrelation; magnitude of level- and slope-changes; number of included studies; and, effect size heterogeneity. All meta-analysis methods yielded unbiased estimates of the interruption effects. All random effects meta-analysis methods yielded coverage close to the nominal level, irrespective of the ITS analysis method used and other design parameters. However, heterogeneity was frequently overestimated in scenarios where the ITS study standard errors were underestimated, which occurred for short series or when the ITS analysis method did not appropriately account for autocorrelation. The performance of meta-analysis methods depends on the design and analysis of the included ITS studies. Although all random effects methods performed well in terms of coverage, irrespective of the ITS analysis method, we recommend the use of effect estimates calculated from ITS methods that adjust for autocorrelation when possible. Doing so will likely to lead to more accurate estimates of the heterogeneity variance.
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Affiliation(s)
- Elizabeth Korevaar
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Simon L. Turner
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Andrew B. Forbes
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Amalia Karahalios
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global HealthUniversity of MelbourneMelbourneVictoriaAustralia
| | - Monica Taljaard
- Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaOntarioCanada
- School of Epidemiology and Public HealthUniversity of OttawaOttawaOntarioCanada
| | - Joanne E. McKenzie
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
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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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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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Turner SL, Korevaar E, Cumpston MS, Kanukula R, Forbes AB, McKenzie JE. Effect estimates can be accurately calculated with data digitally extracted from interrupted time series graphs. Res Synth Methods 2023; 14:622-638. [PMID: 37293884 PMCID: PMC10946754 DOI: 10.1002/jrsm.1646] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 03/12/2023] [Accepted: 05/10/2023] [Indexed: 06/10/2023]
Abstract
Interrupted time series (ITS) studies are frequently used to examine the impact of population-level interventions or exposures. Systematic reviews with meta-analyses including ITS designs may inform public health and policy decision-making. Re-analysis of ITS may be required for inclusion in meta-analysis. While publications of ITS rarely provide raw data for re-analysis, graphs are often included, from which time series data can be digitally extracted. However, the accuracy of effect estimates calculated from data digitally extracted from ITS graphs is currently unknown. Forty-three ITS with available datasets and time series graphs were included. Time series data from each graph was extracted by four researchers using digital data extraction software. Data extraction errors were analysed. Segmented linear regression models were fitted to the extracted and provided datasets, from which estimates of immediate level and slope change (and associated statistics) were calculated and compared across the datasets. Although there were some data extraction errors of time points, primarily due to complications in the original graphs, they did not translate into important differences in estimates of interruption effects (and associated statistics). Using digital data extraction to obtain data from ITS graphs should be considered in reviews including ITS. Including these studies in meta-analyses, even with slight inaccuracy, is likely to outweigh the loss of information from non-inclusion.
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Affiliation(s)
- Simon Lee Turner
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - Elizabeth Korevaar
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - Miranda S. Cumpston
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - Raju Kanukula
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - Andrew B. Forbes
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - Joanne E. McKenzie
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
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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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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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Su P, Gao C, Zhang X, Zhang D, Liu X, Xiang T, Luo Y, Chu K, Zhang G, Bu N, Li Z. Microplastics stimulated nitrous oxide emissions primarily through denitrification: A meta-analysis. JOURNAL OF HAZARDOUS MATERIALS 2023; 445:130500. [PMID: 36469991 DOI: 10.1016/j.jhazmat.2022.130500] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 05/16/2023]
Abstract
Microplastics can profoundly alter nitrogen cycling. However, it remains poorly understood how microplastics impact soil nitrogen processes and generate N2O. A meta-analysis was conducted for this investigation based on 60 published studies to elucidate the effects of microplastics on soil nitrogen cycling, from genes to processes. Under microplastic exposure, the emissions of soil N2O was significantly increased (140.6%), while the nitrate reductase activities increased by 4.8%. The denitrification rate and number of denitrifier genes were increased by 17.8% and 10.6%, respectively. Meanwhile, the nitrification rate and nitrifier genes were not significantly altered, so did the nitrogen immobilization and mineralization rates. The additional emission of soil N2O might primarily from stimulated denitrification. Soil N2O emission and denitrification genes were always increased, regardless of the concentrations of microplastic or experiment duration. As a result, the nitrite was increased by 38.8% and nitrate was decreased by 22.4%, respectively. Interestingly, the N2O emission increments and copy number of denitrifiers genes diminished over time. This study revealed divergent changes in soil nitrogen processes and highlighted N2O emissions with a greater denitrification rate under microplastic exposure. The negative impacts of microplastics on soil health were revealed from the perspective of soil nitrogen availability and N2O emissions.
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Affiliation(s)
- Pinjie Su
- School of Environmental Science, Liaoning University, Shenyang 110036, China; Key Laboratory of Low-carbon Green Agriculture, Ministry of Agriculture and Rural Affairs, Interdisciplinary Research Center for Agriculture Green Development in Yangtze River Basin, College of Resources and Environment, and Academy of Agricultural Sciences, Southwest University, Chongqing 400715, China
| | - Changyuan Gao
- School of Environmental Science, Liaoning University, Shenyang 110036, China
| | - Xiaojing Zhang
- School of Environmental Science, Liaoning University, Shenyang 110036, China
| | - Dan Zhang
- School of Environmental Science, Liaoning University, Shenyang 110036, China
| | - Xingyu Liu
- School of Environmental Science, Liaoning University, Shenyang 110036, China
| | - Tingting Xiang
- School of Environmental Science, Liaoning University, Shenyang 110036, China
| | - Yifu Luo
- School of Environmental Science, Liaoning University, Shenyang 110036, China
| | - Kuo Chu
- School of Environmental Science, Liaoning University, Shenyang 110036, China
| | - Guohui Zhang
- School of Environmental Science, Liaoning University, Shenyang 110036, China
| | - Naishun Bu
- School of Environmental Science, Liaoning University, Shenyang 110036, China; Institute for Carbon Neutrality, Liaoning University, Shenyang 110036, China; Collaborative Innovation Center of Ecological Environment Protection and Livelihood Security, Water Source Protection Area of Liaoning Province, Shenyang 110036, China.
| | - Zhaolei Li
- Key Laboratory of Low-carbon Green Agriculture, Ministry of Agriculture and Rural Affairs, Interdisciplinary Research Center for Agriculture Green Development in Yangtze River Basin, College of Resources and Environment, and Academy of Agricultural Sciences, Southwest University, Chongqing 400715, China.
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Obande D, Young I, Gao JL, Pearl DL, Papadopoulos A. Systematic review and meta-regression of food safety knowledge and behaviour of primary food preparers for young children in the home setting. Food Control 2023. [DOI: 10.1016/j.foodcont.2022.109455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Beverly A, Ong G, Kimber C, Sandercock J, Dorée C, Welton NJ, Wicks P, Estcourt LJ. Drugs to reduce bleeding and transfusion in major open vascular or endovascular surgery: a systematic review and network meta-analysis. Cochrane Database Syst Rev 2023; 2:CD013649. [PMID: 36800489 PMCID: PMC9936832 DOI: 10.1002/14651858.cd013649.pub2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
BACKGROUND Vascular surgery may be followed by internal bleeding due to inadequate surgical haemostasis, abnormal clotting, or surgical complications. Bleeding ranges from minor, with no transfusion requirement, to massive, requiring multiple blood product transfusions. There are a number of drugs, given systemically or applied locally, which may reduce the need for blood transfusion. OBJECTIVES To assess the effectiveness and safety of anti-fibrinolytic and haemostatic drugs and agents in reducing bleeding and the need for blood transfusion in people undergoing major vascular surgery or vascular procedures with a risk of moderate or severe (> 500 mL) blood loss. SEARCH METHODS We searched: Cochrane Central Register of Controlled Trials; MEDLINE; Embase; CINAHL, and Transfusion Evidence Library. We also searched the WHO ICTRP and ClinicalTrials.gov trial registries for ongoing and unpublished trials. Searches used a combination of MeSH and free text terms from database inception to 31 March 2022, without restriction on language or publication status. SELECTION CRITERIA We included randomised controlled trials (RCTs) in adults of drug treatments to reduce bleeding due to major vascular surgery or vascular procedures with a risk of moderate or severe blood loss, which used placebo, usual care or another drug regimen as control. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcomes were units of red cells transfused and all-cause mortality. Our secondary outcomes included risk of receiving an allogeneic blood product, risk of reoperation or repeat procedure due to bleeding, risk of a thromboembolic event, risk of a serious adverse event and length of hospital stay. We used GRADE to assess certainty of evidence. MAIN RESULTS We included 22 RCTs with 3393 participants analysed, of which one RCT with 69 participants was reported only in abstract form, with no usable data. Seven RCTs evaluated systemic drug treatments (three aprotinin, two desmopressin, two tranexamic acid) and 15 RCTs evaluated topical drug treatments (drug-containing bioabsorbable dressings or glues), including fibrin, thrombin, collagen, gelatin, synthetic sealants and one investigational new agent. Most trials were conducted in high-income countries and the majority of the trials only included participants undergoing elective surgery. We also identified two ongoing RCTs. We were unable to perform the planned network meta-analysis due to the sparse reporting of outcomes relevant to this review. Systemic drug treatments We identified seven trials of three systemic drugs: aprotinin, desmopressin and tranexamic acid, all with placebo controls. The trials of aprotinin and desmopressin were small with very low-certainty evidence for all of our outcomes. Tranexamic acid versus placebo was the systemic drug comparison with the largest number of participants (2 trials; 1460 participants), both at low risk of bias. The largest of these included a total of 9535 individuals undergoing a number of different higher risk surgeries and reported limited information on the vascular subgroup (1399 participants). Neither trial reported the number of units of red cells transfused per participant up to 30 days. Three outcomes were associated with very low-certainty evidence due to the very wide confidence intervals (CIs) resulting from small study sizes and low number of events. These were: all-cause mortality up to 30 days; number of participants requiring an allogeneic blood transfusion up to 30 days; and risk of requiring a repeat procedure or operation due to bleeding. Tranexamic acid may have no effect on the risk of thromboembolic events up to 30 days (risk ratio (RR) 1.10, 95% CI 0.88 to 1.36; 1 trial, 1360 participants; low-certainty evidence due to imprecision). There is one large ongoing trial (8320 participants) comparing tranexamic acid versus placebo in people undergoing non-cardiac surgery who are at high risk of requiring a red cell transfusion. This aims to complete recruitment in April 2023. This trial has primary outcomes of proportion of participants transfused with red blood cells and incidence of venous thromboembolism (DVT or PE). Topical drug treatments Most trials of topical drug treatments were at high risk of bias due to their open-label design (compared with usual care, or liquids were compared with sponges). All of the trials were small, most were very small, and few reported clinically relevant outcomes in the postoperative period. Fibrin sealant versus usual care was the topical drug comparison with the largest number of participants (5 trials, 784 participants). The five trials that compared fibrin sealant with usual care were all at high risk of bias, due to the open-label trial design with no measures put in place to minimise reporting bias. All of the trials were funded by pharmaceutical companies. None of the five trials reported the number of red cells transfused per participant up to 30 days or the number of participants requiring an allogeneic blood transfusion up to 30 days. The other three outcomes were associated with very low-certainty evidence with wide confidence intervals due to small sample sizes and the low number of events, these were: all-cause mortality up to 30 days; risk of requiring a repeat procedure due to bleeding; and risk of thromboembolic disease up to 30 days. We identified one large trial (500 participants) comparing fibrin sealant versus usual care in participants undergoing abdominal aortic aneurysm repair, which has not yet started recruitment. This trial lists death due to arterial disease and reintervention rates as primary outcomes. AUTHORS' CONCLUSIONS Because of a lack of data, we are uncertain whether any systemic or topical treatments used to reduce bleeding due to major vascular surgery have an effect on: all-cause mortality up to 30 days; risk of requiring a repeat procedure or operation due to bleeding; number of red cells transfused per participant up to 30 days or the number of participants requiring an allogeneic blood transfusion up to 30 days. There may be no effect of tranexamic acid on the risk of thromboembolic events up to 30 days, this is important as there has been concern that this risk may be increased. Trials with sample size targets of thousands of participants and clinically relevant outcomes are needed, and we look forward to seeing the results of the ongoing trials in the future.
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Affiliation(s)
- Anair Beverly
- Systematic Review Initiative, NHS Blood and Transplant, Oxford, UK
| | - Giok Ong
- Systematic Review Initiative, NHS Blood and Transplant, Oxford, UK
| | - Catherine Kimber
- Systematic Review Initiative, NHS Blood and Transplant, Oxford, UK
| | - Josie Sandercock
- Systematic Review Initiative, NHS Blood and Transplant, Oxford, UK
| | - Carolyn Dorée
- Systematic Review Initiative, NHS Blood and Transplant, Oxford, UK
| | - Nicky J Welton
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Peter Wicks
- Cardiac Anaesthesia and Intensive Care, University Hospital Southampton, Southampton, UK
| | - Lise J Estcourt
- Haematology/Transfusion Medicine, NHS Blood and Transplant, Oxford, UK
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Cumpston MS, Brennan SE, Ryan R, McKenzie JE. Synthesis methods other than meta-analysis were commonly used but seldom specified: survey of systematic reviews. J Clin Epidemiol 2023; 156:42-52. [PMID: 36758885 DOI: 10.1016/j.jclinepi.2023.02.003] [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: 10/27/2022] [Revised: 01/27/2023] [Accepted: 02/01/2023] [Indexed: 02/11/2023]
Abstract
OBJECTIVES To examine the specification and use of summary and statistical synthesis methods, focusing on synthesis methods other than meta-analysis. STUDY DESIGN AND SETTING We coded the specification and use of summary and synthesis methods in 100 randomly sampled systematic reviews (SRs) of public health and health systems interventions published in 2018 from the Health Evidence and Health Systems Evidence databases. RESULTS Sixty of the 100 SRs used other synthesis methods for some (27/100) or all syntheses (33/100). Of these, 54/60 used vote counting: three based on direction of effect, 36 on statistical significance, and 15 were unclear. Eight SRs summarized effect estimates (for example, using medians). Seventeen SRs used the term 'narrative synthesis' (or equivalent) without describing methods; in practice 15 of these used vote counting. 58/100 SRs used meta-analysis. In SRs providing a rationale for not proceeding with meta-analysis, the most common reason was due to diversity in study characteristics (33/39). CONCLUSION Statistical synthesis methods other than meta-analysis are commonly used, but few SRs describe the methods. Improved description of methods is required to allow users to appropriately interpret findings, critique methods used and verify the results. Greater awareness of the serious limitations of vote counting based on statistical significance is required.
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Affiliation(s)
- Miranda S Cumpston
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
| | - Sue E Brennan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
| | - Rebecca Ryan
- Centre for Health Communication and Participation, La Trobe University, Melbourne, Victoria, 3086, Australia
| | - Joanne E McKenzie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia.
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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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22
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Qiu Q, Yang L, He M, Gao W, Mar H, Li J, Wang G. The Effects of Forest Therapy on the Blood Pressure and Salivary Cortisol Levels of Urban Residents: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:458. [PMID: 36612777 PMCID: PMC9819785 DOI: 10.3390/ijerph20010458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Urban residents have a higher risk of hypertension and psychological stress than rural residents. Aside from medical interventions, understanding how to control hypertension and alleviate the stress of urban populations has become a public concern. As an alternative medical measure, forest therapy has shown the effects of normalizing blood pressure (BP) and reducing stress increasingly in recent literature, but this is still inconclusive. In order to systematically verify forest therapy’s effects on the BP and mental stress of urban residents, we conducted meta-analyses to assess the changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and salivary cortisol concentration (SCC; a stress biomarker) between the forest therapy group and urban control group. We searched 4 online databases, and 21 studies on BP involving 2270 participants and 13 studies on SCC involving 1786 participants were included. Through the meta-analysis, the mean difference and confidence interval (CI) estimates indicated that forest therapy significantly reduced participants’ SBP −3.44 (95% CI −5.74, −1.14), DBP −3.07 (95% CI −5.59, −0.54), and SCC −0.07 (95% CI −0.10, −0.04), as compared with urban control. Yet, there was substantial heterogeneity (I2 = 72.87−88.59%) among these studies. We also found that each prediction interval (PI) for SBP (95% PI −13.30, 6.42), DBP (95% PI −15.54, 9.41), and SCC (95% PI −0.18, 0.05) were all much wider than the CIs and contained values above 0. This means that forest therapy may reduce SBP, DBP, and SCC on average, but may not exclude adverse results. Meta-regression analyses showed that participants’ age and baseline SBP levels determined the heterogeneity among SBP studies. After forest therapy, older participants and those with higher baseline SBP levels had greater SBP-lowering effects. Among DBP studies, the primary source of heterogeneity was participants’ baseline DBP levels; participants with higher baseline DBP levels had greater DBP reduction. In subgroup analyses, we discovered that longer-term forest therapy programs (≥20 min) resulted in a greater reduction in BP and SCC than shorter-term forest therapy programs (<20 min). Additionally, seated viewing, walking, or multi-session programs in forests were observed to have similar effects on reducing BP and SCC. Despite extensive analyses, the study did not identify any sources of heterogeneity among forest therapy programs for lowering SCC levels. Overall, we conclude that forest therapy programs have beneficial therapeutic effects on urban residents’ physio-psychological health through lowering BP and relieving stress (reducing SCC). This finding provides solid evidence of the contribution of forest therapy to urban residents’ health and wellbeing.
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Affiliation(s)
- Quan Qiu
- Guangdong Key Laboratory for Innovative Development and Utilization of Forest Plant Germplasm, College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou 510642, China
- Faculty of Forestry, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Ling Yang
- Guangdong Key Laboratory for Innovative Development and Utilization of Forest Plant Germplasm, College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou 510642, China
| | - Mei He
- Faculty of Forestry, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Jiangxi Academy of Forestry, Nanchang 330013, China
| | - Wen Gao
- Faculty of Forestry, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Co-Innovation Center for Sustainable Forestry in Southern China, Nanjing Forestry University, Nanjing 210037, China
| | - Harrison Mar
- Faculty of Forestry, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Jiyue Li
- Guangdong Key Laboratory for Innovative Development and Utilization of Forest Plant Germplasm, College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou 510642, China
| | - Guangyu Wang
- Faculty of Forestry, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
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Donkor A, Atuwo-Ampoh VD, Yakanu F, Torgbenu E, Ameyaw EK, Kitson-Mills D, Vanderpuye V, Kyei KA, Anim-Sampong S, Khader O, Khader J. Financial toxicity of cancer care in low- and middle-income countries: a systematic review and meta-analysis. Support Care Cancer 2022; 30:7159-7190. [PMID: 35467118 PMCID: PMC9385791 DOI: 10.1007/s00520-022-07044-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/05/2022] [Indexed: 12/29/2022]
Abstract
INTRODUCTION The costs associated with cancer diagnosis, treatment and care present enormous financial toxicity. However, evidence of financial toxicity associated with cancer in low- and middle-income countries (LMICs) is scarce. AIM To determine the prevalence, determinants and how financial toxicity has been measured among cancer patients in LMICs. METHODS Four electronic databases were searched to identify studies of any design that reported financial toxicity among cancer patients in LMICs. Random-effects meta-analysis was used to derive the pooled prevalence of financial toxicity. Sub-group analyses were performed according to costs and determinants of financial toxicity. RESULTS A total of 31 studies were included in this systematic review and meta-analysis. The pooled prevalence of objective financial toxicity was 56.96% (95% CI, 30.51, 106.32). In sub-group meta-analyses, the objective financial toxicity was higher among cancer patients with household size of more than four (1.17% [95% CI, 1.03, 1.32]; p = 0.02; I2 = 0%), multiple cycles of chemotherapy (1.94% [95% CI, 1.00, 3.75]; p = 0.05; I2 = 43%) and private health facilities (2.87% [95% CI, 1.89, 4.35]; p < 0.00001; I2 = 26%). Included studies hardly focused primarily on subjective measures of financial toxicity, such as material, behavioural and psychosocial. One study reported that 35.4% (n = 152 of 429) of cancer patients experienced high subjective financial toxicity. CONCLUSIONS This study indicates that cancer diagnosis, treatment and care impose high financial toxicity on cancer patients in LMICs. Further rigorous research on cancer-related financial toxicity is needed.
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Affiliation(s)
- Andrew Donkor
- Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, New South Wales, Sydney, Australia.
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Vivian Della Atuwo-Ampoh
- Department of Medical Imaging, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Frederick Yakanu
- National Centre for Radiotherapy, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Eric Torgbenu
- Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, New South Wales, Sydney, Australia
- Department of Physiotherapy and Rehabilitation Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Edward Kwabena Ameyaw
- The Australian Centre for Public and Population Health Research (ACPPHR), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | | | - Verna Vanderpuye
- National Centre for Radiotherapy, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Kofi Adesi Kyei
- Department of Radiography, University of Ghana, Accra, Ghana
| | | | - Omar Khader
- Faculty of Medicine, University of Jordan, Amman, Jordan
| | - Jamal Khader
- Radiation Oncology Department, King Hussein Cancer Centre, Amman, Jordan
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Yan Z, MuRong Z, Huo B, Zhong H, Yi C, Liu M, Liu M. Acupuncture as a Complementary Therapy for Cancer-Induced Bone Pain: A Systematic Review and Meta-Analysis. FRONTIERS IN PAIN RESEARCH 2022; 3:925013. [PMID: 35978992 PMCID: PMC9377524 DOI: 10.3389/fpain.2022.925013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/16/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundCancer-induced bone pain (CIBP) is a special type of cancer pain and lacks safe and effective treatments. Acupuncture is a potentially valuable treatment for CIBP, studies evaluating the effect of acupuncture on CIBP have increased significantly, but the safety and efficacy of acupuncture to control CIBP remains controversial.ObjectiveTo provide the first meta-analysis to evaluate the safety and efficacy of acupuncture in CIBP management.Data SourcesCNKI, CBM, Wanfang, VIP Database, PubMed, Embase, and Cochrane Library were searched from their inception until 1 June 2022.Study SelectionRCTs with primary bone tumor patients or other types of primary cancer companied by bone metastases as the research subjects and to evaluate the efficacy of acupuncture treatment alone or combined with the control treatment were included. Meanwhile, RCTs should choose the pain score as the primary outcome and pain relief rate, frequency of breakthrough pain, analgesic onset time, analgesia duration, quality of life, and adverse events as reference outcomes.Data Collection and AnalysisWe designed a data-extraction form that was used to extract key information from the articles. Data extraction study evaluation was conducted independently by two reviewers, and a third reviewer would resolve any disagreements. The risk of bias was assessed by the Cochrane Collaboration's tool for assessing the risk bias. The quality of the evidence for main outcomes was evaluated by the GRADE system. Mean differences (MD), relative risk (RR), and 95% confidence intervals (CIs) were calculated. The forest plots were performed using the Review Manager Software (5.3 version). Subgroup analysis was used to investigate the possible sources of potential heterogeneity. Descriptive analysis was performed in case of unacceptable clinical heterogeneity.ResultsThirteen RCTs (with 1,069 patients) were included, and all studies were at high risk of bias owing to lack of blinding or other bias. Eleven studies evaluated the effectiveness of acupuncture as a complementary therapy, and showed that acupuncture plus control treatment (compared with control treatment) was connected with reduced pain intensity (MD = −1.34, 95% CI −1.74 to −0.94; Q < 0.1; I2 = 98%, P < 0.01). Subgroup analyses based on acupoints type partly explain the potential heterogeneity. The results also showed that acupuncture plus control treatment (compared with control treatment) was connected with relieving pain intensity, increasing the pain relief rate, reducing the frequency of breakthrough pain, shortening analgesic onset time, extending the analgesic duration, and improving the quality of life. We have no sufficient evidence to prove the effectiveness of acupuncture alone. Four RCTs reported only adverse events related to opioids' side effects. Evidence was qualified as “very low” because of low methodological quality, considerable heterogeneity, or a low number of included studies.ConclusionAcupuncture has a certain effect as a complementary therapy on pain management of CIBP, which not only mitigates the pain intensity but also improves the quality of life and reduces the incidence of opioids' side effects, although the evidence level was very low. In future, a larger sample size and rigorously designed RCTs are needed to provide sufficient evidence to identify the efficacy and safety of acupuncture as a treatment for CIBP.
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Affiliation(s)
- Zhaobo Yan
- College of Acupuncture and Moxibustion, Hunan University of Chinese Medicine, Hunan, China
| | - Zhimiao MuRong
- College of Acupuncture and Moxibustion, Hunan University of Chinese Medicine, Hunan, China
| | - Bixiu Huo
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Huan Zhong
- College of Acupuncture and Moxibustion, Hunan University of Chinese Medicine, Hunan, China
| | - Chun Yi
- Department of Pathology, Hunan University of Chinese Medicine, Hunan, China
| | - Mailan Liu
- College of Acupuncture and Moxibustion, Hunan University of Chinese Medicine, Hunan, China
- *Correspondence: Mi Liu
| | - Mi Liu
- College of Acupuncture and Moxibustion, Hunan University of Chinese Medicine, Hunan, China
- Mailan Liu
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25
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Yang J, Kang Y, Zhao W, Jiang J, Jiang Y, Zhao B, Jiao M, Yuan B, Zhao J, Ma B. Evaluation of patches for rotator cuff repair: A systematic review and meta-analysis based on animal studies. Bioact Mater 2022; 10:474-491. [PMID: 34901561 PMCID: PMC8633530 DOI: 10.1016/j.bioactmat.2021.08.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/12/2021] [Accepted: 08/12/2021] [Indexed: 02/06/2023] Open
Abstract
Based on the published animal studies, we systematically evaluated the outcomes of various materials for rotator cuff repair in animal models and the potentials of their clinical translation. 74 animal studies were finally included, of which naturally derived biomaterials were applied the most widely (50.0%), rats were the most commonly used animal model (47.0%), and autologous tissue demonstrated the best outcomes in all animal models. The biomechanical properties of naturally derived biomaterials (maximum failure load: WMD 18.68 [95%CI 7.71-29.66]; P = 0.001, and stiffness: WMD 1.30 [95%CI 0.01-2.60]; P = 0.048) was statistically significant in the rabbit model. The rabbit model showed better outcomes even though the injury was severer compared with the rat model.
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Affiliation(s)
- Jinwei Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
- Reproductive Medicine Center, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, 730050, China
| | - Yuhao Kang
- Department of Sports Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Wanlu Zhao
- College of Biomedical Engineering, Sichuan University, Chengdu, 610064, China
- National Engineering Research Center for Biomaterials, Chengdu, 610064, China
| | - Jia Jiang
- Department of Sports Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Yanbiao Jiang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
| | - Bing Zhao
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
| | - Mingyue Jiao
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
| | - Bo Yuan
- College of Biomedical Engineering, Sichuan University, Chengdu, 610064, China
- National Engineering Research Center for Biomaterials, Chengdu, 610064, China
| | - Jinzhong Zhao
- Department of Sports Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Bin Ma
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
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26
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Korevaar E, Karahalios A, Turner SL, Forbes AB, Taljaard M, Cheng AC, Grimshaw JM, Bero L, McKenzie JE. Methodological systematic review recommends improvements to conduct and reporting when meta-analysing interrupted time series studies. J Clin Epidemiol 2022; 145:55-69. [PMID: 35045318 DOI: 10.1016/j.jclinepi.2022.01.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/21/2021] [Accepted: 01/13/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Interrupted Time Series (ITS) are a type of non-randomised design commonly used to evaluate public health policy interventions, and the impact of exposures, at the population level. Meta-analysis may be used to combine results from ITS across studies (in the context of systematic reviews) or across sites within the same study. We aimed to examine the statistical approaches, methods, and completeness of reporting in reviews that meta-analyse results from ITS. STUDY DESIGN AND SETTINGS Eight electronic databases were searched to identify reviews (published 2000-2019) that meta-analysed at least two ITS. Characteristics of the included reviews, the statistical methods used to analyse the ITS and meta-analyse their results, effect measures, and risk of bias assessment tools were extracted. RESULTS Of the 4213 identified records, 54 reviews were included. Nearly all reviews (94%) used two-stage meta-analysis, most commonly fitting a random effects model (69%). Among the 41 reviews that re-analysed the ITS, linear regression (39%) and ARIMA (20%) were most commonly used; 38% adjusted for autocorrelation. The most common effect measure meta-analysed was an immediate level-change (46/54). Reporting of the statistical methods and ITS characteristics was often incomplete. CONCLUSION Improvement is needed in the conduct and reporting of reviews that meta-analyse results from ITS.
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Affiliation(s)
- Elizabeth Korevaar
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Victoria, Australia
| | - Amalia Karahalios
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, 3010, Victoria Australia
| | - Simon L Turner
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Victoria, Australia
| | - Andrew B Forbes
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Victoria, Australia
| | - Monica Taljaard
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, K1Y 4E9, Canada; School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, K1N 6N5, Canada
| | - Allen C Cheng
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Victoria, Australia; Infection Prevention and Healthcare Epidemiology Unit, Alfred Health, Melbourne, 3004, Victoria, Australia
| | - Jeremy M Grimshaw
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, K1Y 4E9, Canada; School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, K1N 6N5, Canada; Department of Medicine, University of Ottawa, Ottawa, Ontario, K1H 8M5, Canada
| | - Lisa Bero
- School of Medicine and Colorado School of Public Health, Center for Bioethics and Humanities, University of Colorado Anschutz Medical Campus, 13080 E. 19th Ave, Aurora, CO 80045
- Mail Stop B137, Denver, Colorado
| | - Joanne E McKenzie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Victoria, Australia.
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Wang N, Jin S. Meta-Analysis for Epigenome-Wide Association Studies. Methods Mol Biol 2022; 2432:101-111. [PMID: 35505210 DOI: 10.1007/978-1-0716-1994-0_8] [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: 06/14/2023]
Abstract
With the rapid development of methylation profiling technology, many datasets are generated to quantify genome-wide methylation patterns. Given the heavy burden of multiple testing of hundreds of thousands of DNA methylation markers, individual studies often have limited sample sizes and power. The EWAS meta-analysis is an approach that combines results from multiple studies on the same scientific question. It helps to improve statistical power by combining information from individual studies and reduce the chances of false positives. This chapter introduces commonly used meta-analysis methods and analytical tools with application to EWAS data.
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Affiliation(s)
- Nan Wang
- School of Mathematics, Harbin Institute of Technology, Harbin, Heilongjiang, China.
| | - Shuilin Jin
- School of Mathematics, Harbin Institute of Technology, Harbin, Heilongjiang, China.
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28
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Hu X, Cui C, Sun T, Wang W. Associations between ADIPOQ rs2241766 SNP and breast cancer risk: a systematic review and a meta-analysis. Genes Environ 2021; 43:48. [PMID: 34742352 PMCID: PMC8572453 DOI: 10.1186/s41021-021-00221-2] [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: 01/19/2021] [Accepted: 10/13/2021] [Indexed: 11/12/2022] Open
Abstract
Purpose We aimed to conduct a meta-analysis to accurately evaluate the potential association between ADIPOQ rs2241766 gene SNP and breast cancer risk. Methods A systematic literature search on Cochrane Library, PubMed, Embase, Web of Science and China National Knowledge Infrastructure (CNKI) identified 8 articles with 1692 cases and 1890 controls. Strength of association was evaluated by pooled odds ratio (OR), 95 % confidence interval (CI) and p value. Funnel plots and Begger’s regression test were applied for testing the publication bias. Statistical analysis of all data was performed by Stata 12.0. Results The meta-analysis results indicated that the ADIPOQ rs2241766 gene polymorphism did not significantly associated with the risk of breast cancer for these genetic models (TT vs. TG + GG: OR = 1.20, 95 % CI = 0.77–1.89, p=0.417; TT + TG vs. GG: OR = 1.05, 95 % CI = 0.71–1.56, p=0.805; T vs. G: OR =1.17, 95 % CI = 0.79–1.74, p=0.437). Conclusions This study indicated that no significant relationship between the ADIPOQ rs2241766 SNP and breast cancer. Further large-scale and well-designed studies will be indispensable to confirm our result.
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Affiliation(s)
- Xue Hu
- Department of Breast Surgery, China-Japan Union Hospital of Jilin University, 126 Xiantai Blvd, 130033, Changchun, China
| | - Chunguo Cui
- Department of Breast Surgery, China-Japan Union Hospital of Jilin University, 126 Xiantai Blvd, 130033, Changchun, China
| | - Tong Sun
- Department of Breast Surgery, China-Japan Union Hospital of Jilin University, 126 Xiantai Blvd, 130033, Changchun, China
| | - Wan Wang
- Department of Breast Surgery, China-Japan Union Hospital of Jilin University, 126 Xiantai Blvd, 130033, Changchun, China.
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29
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Wang F, Zhang R, Zhang J, Li D, Wang Y, Yang YH, Wei Q. Effects of mirror therapy on phantom limb sensation and phantom limb pain in amputees: A systematic review and meta-analysis of randomized controlled trials. Clin Rehabil 2021; 35:1710-1721. [PMID: 34308686 DOI: 10.1177/02692155211027332] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to evaluate the effects of mirror therapy on phantom limb sensation and phantom limb pain in amputees. DATA SOURCES Nine electronic databases (PubMed, EMBASE, MEDLINE, Web of Science, the Cochrane Library, CINAHL, PsycInfo, PreQuest, PEDro) were searched from their inception to May 10th, 2021. METHODS Two authors independently selected relevant studies and extracted the data. The effect sizes were calculated under a random-effects model meta-analysis, and heterogeneity was assessed using the I2 test. The risk of bias was evaluated by the Cochrane risk of bias tool, and the methodological quality was appraised by the PEDro scale. The GRADE approach was applied to assess the confidence of the effect. RESULTS A total of 11 RCTs involving 491 participants were included in this review and nine RCTs involving 372 participants were included in meta-analysis. The quality of these studies was from poor to good with scores ranging from 2 to 8 points according to PEDro scale. The pooled SMD showed that mirror therapy reduced the pain with a large effect size (-0.81; 95% CI = -1.36 to -0.25; P = 0.005; I2 = 82%; n = 372) compared with other methods (four covered mirror, one phantom exercise, three mental visualization, one sensorimotor exercise, one transcutaneous electrical nerve stimulation, one tactile stimuli). The quality of evidence for the outcome pain intensity was determined to be fair according to GRADE approach. CONCLUSION There is fair-quality evidence that MT is beneficial for reducing phantom limb pain.
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Affiliation(s)
- Fengyi Wang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.,Key Laboratory of Rehabilitation Medicine of Sichuan Province, Chengdu, Sichuan Province, China
| | - Rengang Zhang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.,Key Laboratory of Rehabilitation Medicine of Sichuan Province, Chengdu, Sichuan Province, China
| | - Jiaqi Zhang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Dinggen Li
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.,Key Laboratory of Rehabilitation Medicine of Sichuan Province, Chengdu, Sichuan Province, China
| | - Yu Wang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Yong-Hong Yang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.,Key Laboratory of Rehabilitation Medicine of Sichuan Province, Chengdu, Sichuan Province, China
| | - Quan Wei
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.,Key Laboratory of Rehabilitation Medicine of Sichuan Province, Chengdu, Sichuan Province, China
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30
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Jiang HL, Du H, Deng YJ, Liang X. Effect of KCNQ1 rs2237892 polymorphism on the predisposition to type 2 diabetes mellitus: An updated meta-analysis. Diabetol Metab Syndr 2021; 13:75. [PMID: 34238370 PMCID: PMC8264960 DOI: 10.1186/s13098-021-00683-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/02/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Previous studies have analyzed the potential effect of KCNQ1 rs2237892 polymorphism on the predisposition to type 2 diabetes mellitus, but the findings are inconclusive and the subject of debate. The purpose of our study was to provide further insight into the potential association between KCNQ1 rs2237892 polymorphism and the risk of type 2 diabetes mellitus. METHODS In total, 50 articles (60 studies) with 77,276 cases and 76,054 controls were utilized in our analysis. The pooled odds ratio (OR), 95% confidence interval (95% CI), and p value were used to evaluate the significance of our findings. Funnel plots and Beggar's regression tests were utilized to determine the presence of publication bias. RESULTS Our meta-analysis results indicated that KCNQ1 rs2237892 polymorphism could be correlated with the risk of type 2 diabetes mellitus under the C allelic, recessive, and dominant genetic models (OR = 1.25, 95% 1.19-1.32, p < 0.001; OR = 1.50, 95% CI 1.34-1.68, p < 0.001; OR = 1.26, 95% CI 1.14-1.40, p < 0.001, respectively). Additionally, ethnicity analysis revealed that the source of control, case size, and Hardy-Weinberg Equilibrium status were correlated to the polymorphism in the three genetic models. CONCLUSIONS Our meta-analysis demonstrated significant evidence to support the association between KCNQ1 rs2237892 polymorphism and predisposition to type 2 diabetes mellitus.
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Affiliation(s)
- Hong-Liang Jiang
- Department of Anorectal Medicine, Gaozhou Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Gaozhou, 525025, Guangdong, China
| | - Han Du
- Dermatology Department of Gaozhou Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, No. 32 Maoming Avenue, Gaozhou, 525025, Guangdong, China.
| | - Ying-Jun Deng
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong, China
| | - Xue Liang
- Department of Science and Education, Gaozhou Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Gaozhou, 525025, Guangdong, China
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Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, McKenzie JE. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ 2021; 372:n160. [PMID: 33781993 PMCID: PMC8005925 DOI: 10.1136/bmj.n160+10.1136/bmj.n160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2023]
Abstract
The methods and results of systematic reviews should be reported in sufficient detail to allow users to assess the trustworthiness and applicability of the review findings. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement was developed to facilitate transparent and complete reporting of systematic reviews and has been updated (to PRISMA 2020) to reflect recent advances in systematic review methodology and terminology. Here, we present the explanation and elaboration paper for PRISMA 2020, where we explain why reporting of each item is recommended, present bullet points that detail the reporting recommendations, and present examples from published reviews. We hope that changes to the content and structure of PRISMA 2020 will facilitate uptake of the guideline and lead to more transparent, complete, and accurate reporting of systematic reviews.
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Affiliation(s)
- Matthew J Page
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Patrick M Bossuyt
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, Netherlands
| | - Isabelle Boutron
- Université de Paris, Centre of Epidemiology and Statistics (CRESS), Inserm, F 75004 Paris, France
| | - Tammy C Hoffmann
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Cynthia D Mulrow
- University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States; Annals of Internal Medicine
| | - Larissa Shamseer
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Toronto, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | | | - Elie A Akl
- Clinical Research Institute, American University of Beirut, Beirut, Lebanon; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sue E Brennan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Roger Chou
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, United States
| | - Julie Glanville
- York Health Economics Consortium (YHEC Ltd), University of York, York, UK
| | - Jeremy M Grimshaw
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada; Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Asbjørn Hróbjartsson
- Centre for Evidence-Based Medicine Odense, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Manoj M Lalu
- Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, Canada; Clinical Epidemiology Program, Blueprint Translational Research Group, Ottawa Hospital Research Institute, Ottawa, Canada; Regenerative Medicine Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Tianjing Li
- Department of Ophthalmology, School of Medicine, University of Colorado Denver, Denver, Colorado, United States; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - Elizabeth W Loder
- Division of Headache, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States; Head of Research, The BMJ, London, UK
| | - Evan Mayo-Wilson
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, United States
| | - Steve McDonald
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Luke A McGuinness
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Lesley A Stewart
- Centre for Reviews and Dissemination, University of York, York, UK
| | - James Thomas
- EPPI-Centre, UCL Social Research Institute, University College London, London, UK
| | - Andrea C Tricco
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, Toronto, Canada; Epidemiology Division of the Dalla Lana School of Public Health and the Institute of Health Management, Policy, and Evaluation, University of Toronto, Toronto, Canada; Queen's Collaboration for Health Care Quality Joanna Briggs Institute Centre of Excellence, Queen's University, Kingston, Canada
| | - Vivian A Welch
- Methods Centre, Bruyère Research Institute, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Penny Whiting
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Joanne E McKenzie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, McKenzie JE. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ : BRITISH MEDICAL JOURNAL 2021. [DOI: 10.1136/bmj.n160 10.1136/bmj.n160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, McKenzie JE. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ 2021; 372:n160. [PMID: 33781993 PMCID: PMC8005925 DOI: 10.1136/bmj.n160] [Citation(s) in RCA: 3381] [Impact Index Per Article: 1127.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/04/2021] [Indexed: 12/16/2022]
Affiliation(s)
- Matthew J Page
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Patrick M Bossuyt
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, Netherlands
| | - Isabelle Boutron
- Université de Paris, Centre of Epidemiology and Statistics (CRESS), Inserm, F 75004 Paris, France
| | - Tammy C Hoffmann
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Cynthia D Mulrow
- University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States; Annals of Internal Medicine
| | - Larissa Shamseer
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Toronto, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | | | - Elie A Akl
- Clinical Research Institute, American University of Beirut, Beirut, Lebanon; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sue E Brennan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Roger Chou
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, United States
| | - Julie Glanville
- York Health Economics Consortium (YHEC Ltd), University of York, York, UK
| | - Jeremy M Grimshaw
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada; Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Asbjørn Hróbjartsson
- Centre for Evidence-Based Medicine Odense, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Manoj M Lalu
- Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, Canada; Clinical Epidemiology Program, Blueprint Translational Research Group, Ottawa Hospital Research Institute, Ottawa, Canada; Regenerative Medicine Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Tianjing Li
- Department of Ophthalmology, School of Medicine, University of Colorado Denver, Denver, Colorado, United States; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - Elizabeth W Loder
- Division of Headache, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States; Head of Research, The BMJ, London, UK
| | - Evan Mayo-Wilson
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, United States
| | - Steve McDonald
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Luke A McGuinness
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Lesley A Stewart
- Centre for Reviews and Dissemination, University of York, York, UK
| | - James Thomas
- EPPI-Centre, UCL Social Research Institute, University College London, London, UK
| | - Andrea C Tricco
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, Toronto, Canada; Epidemiology Division of the Dalla Lana School of Public Health and the Institute of Health Management, Policy, and Evaluation, University of Toronto, Toronto, Canada; Queen's Collaboration for Health Care Quality Joanna Briggs Institute Centre of Excellence, Queen's University, Kingston, Canada
| | - Vivian A Welch
- Methods Centre, Bruyère Research Institute, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Penny Whiting
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Joanne E McKenzie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Cumpston MS, McKenzie JE, Thomas J, Brennan SE. The use of 'PICO for synthesis' and methods for synthesis without meta-analysis: protocol for a survey of current practice in systematic reviews of health interventions. F1000Res 2021; 9:678. [PMID: 33728041 PMCID: PMC7919603 DOI: 10.12688/f1000research.24469.2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/20/2021] [Indexed: 01/08/2023] Open
Abstract
Introduction: Systematic reviews involve synthesis of research to inform decision making by clinicians, consumers, policy makers and researchers. While guidance for synthesis often focuses on meta-analysis, synthesis begins with specifying the ’PICO for each synthesis’ (i.e. the criteria for deciding which populations, interventions, comparators and outcomes are eligible for each analysis). Synthesis may also involve the use of statistical methods other than meta-analysis (e.g. vote counting based on the direction of effect, presenting the range of effects, combining P values) augmented by visual display, tables and text-based summaries. This study examines these two aspects of synthesis. Objectives: To identify and describe current practice in systematic reviews of health interventions in relation to: (i) approaches to grouping and definition of PICO characteristics for synthesis; and (ii) methods of summary and synthesis when meta-analysis is not used. Methods: We will randomly sample 100 systematic reviews of the quantitative effects of public health and health systems interventions published in 2018 and indexed in the
Health Evidence and Health Systems Evidence databases. Two authors will independently screen citations for eligibility. Two authors will confirm eligibility based on full text, then extract data for 20% of reviews on the specification and use of PICO for synthesis, and the presentation and synthesis methods used (e.g. statistical synthesis methods, tabulation, visual displays, structured summary). The remaining reviews will be confirmed as eligible and data extracted by a single author. We will use descriptive statistics to summarise the specification of methods and their use in practice. We will compare how clearly the PICO for synthesis is specified in reviews that primarily use meta-analysis and those that do not. Conclusion: This study will provide an understanding of current practice in two important aspects of the synthesis process, enabling future research to test the feasibility and impact of different approaches.
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Affiliation(s)
- Miranda S Cumpston
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Joanne E McKenzie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - James Thomas
- EPPI-Centre, UCL Social Research Institute, University College London, London, WC1H 0NR, UK
| | - Sue E Brennan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
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Wang Q, Zhang S, Wang Y, Jing Z, Zhou Y, Qi K, Wang X, Zhou C. Prevalence and risk factors of posttraumatic stress disorder among Chinese shidu parents: A systemic review and meta-analysis. J Affect Disord 2021; 282:1180-1186. [PMID: 33601693 DOI: 10.1016/j.jad.2021.01.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 01/05/2021] [Accepted: 01/07/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Losing the only child is an extremely distressful life event for parents. Previous studies indicated that shidu parents were more vulnerable to develop posttraumatic stress disorder (PTSD). This study aims to calculate the pooled prevalence of PTSD and identify its risk factors. METHOD We conducted a systematic literature search in PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Wanfang databases, Vip databases. We performed a meta-analysis using random effects models to calculate the pooled PTSD in shidu parents. Associated factors for PTSD was evaluated by determining standardized mean difference (SMD) with 95% CIs. All analyses were performed using the Stata 16.0. RESULTS Eight articles (covering 2,722 shidu parents) were included in this study. The pooled prevalence of PTSD was 46.8% (95%CI: 33.2%-60.3%) among Chinese shidu parents. Female (SMD[95%CI]: 0.41[0.20, 0.62]), higher education level (SMD[95%CI]: 0.15[0.03, 0.28]), lower income (SMD[95%CI]: 0.33[0.13, 0.53]), losing a daughter (SMD[95%CI]: 0.16[0.03, 0.28]) and shorter time since loss (SMD[95%CI]: 0.24[0.07, 0.40]) were significantly associated with a higher PTSD prevalence. Registered residence, cause of death, age of the child, and having a grandchild were not associated with PTSD. LIMITATIONS Some variables included in this meta-analysis were only measured twice, which limited the conclusions to some extent. CONCLUSION This meta-analysis indicated that nearly half of shidu parents experienced PTSD and provided evidence of risk factors for PTSD in shidu parents. Further research is suggested to determine how these factors interact. Effective interventions should be conducted to shidu parents with PTSD.
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Affiliation(s)
- Qiong Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
| | - Shimin Zhang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
| | - Yi Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
| | - Zhengyue Jing
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
| | - Yanxin Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
| | - Kaili Qi
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
| | - Xiyuan Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan 250012, China.
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Jiang J, Zhang J, Li R, Zhao Z, Ye X. Research Trends of Systematic Review/Meta-Analysis on Acupuncture Therapy: A Bibliometric Analysis. J Pain Res 2021; 14:561-573. [PMID: 33679140 PMCID: PMC7926265 DOI: 10.2147/jpr.s290516] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 01/16/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE We aimed to explore the hotspots and frontiers of systematic review/meta-analysis on acupuncture therapy according to bibliometric methods. METHODS Systematic review/meta-analysis articles on acupuncture therapy were retrieved from the Web of Science Core Collection. We used CiteSpace 5.6.R5 to analyze annual publication, categories, countries, institutions, journals, authors, cited references, and keywords through visual maps to explore the research hotspots and trends. RESULTS An analysis of 1189 articles in English showed that the total number of publications continually increased in the last 12 years. General medicine was the most used category, and the country and institution ranking highest in this field were China and Beijing University of Chinese Medicine, respectively. The Journal of Alternative and Complementary Medicine was the most prolific journal, and Cochrane Database of Systematic Reviews was the most cited journal. Myeong Soo Lee was the most productive author, and J.P.T. Higgins ranked first in frequency among the cited authors. In the cited references, the top two were Cochrane Handbook for Systematic Reviews of Interventions and the Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA). As for keywords, there were 6 main frontiers including interventions, disease, patient, comparisons, study types, and outcomes. The first disease was pain, while the intervention was electroacupuncture (EA). CONCLUSION The present study examined the research trends in systematic reviews and meta-analysis on acupuncture therapy through bibliometric methods and revealed potential future hotspots of research in this field.
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Affiliation(s)
- Jinlan Jiang
- The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, People’s Republic of China
| | - Jiaxin Zhang
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, People’s Republic of China
| | - Rongrong Li
- The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, People’s Republic of China
| | - Zhengqi Zhao
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, People’s Republic of China
| | - Xiaolin Ye
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, People’s Republic of China
- The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, People’s Republic of China
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Yang X, Zhao H, Li Z, Zhu A, Ren M, Geng M, Li Y, Qin Y, Feng L, Peng Z, An Z, Zheng J, Li Z, Feng Z. Influenza Vaccine Effectiveness in Mainland China: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2021; 9:vaccines9020079. [PMID: 33498688 PMCID: PMC7912587 DOI: 10.3390/vaccines9020079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/20/2021] [Accepted: 01/20/2021] [Indexed: 12/03/2022] Open
Abstract
Influenza endangers human health but can be prevented in part by vaccination. Assessing influenza vaccine effectiveness (VE) provides scientific evidence for developing influenza vaccination policy. We conducted a systematic review and meta-analysis of studies that evaluated influenza VE in mainland China. We searched six relevant databases as of 30 August 2019 to identify studies and used Review Manager 5.3 software to analyze the included studies. The Newcastle–Ottawa scale was used to assess the risk of publication bias. We identified 1408 publications, and after removing duplicates and screening full texts, we included 21 studies in the analyses. Studies were conducted in Beijing, Guangzhou, Suzhou, and Zhejiang province from the 2010/11 influenza season through the 2017/18 influenza season. Overall influenza VE for laboratory confirmed influenza was 36% (95% CI: 25–46%). In the subgroup analysis, VE was 45% (95% CI: 18–64%) for children 6–35 months who received one dose of influenza vaccine, and 57% (95% CI: 50–64%) who received two doses. VE was 47% (95% CI: 39–54%) for children 6 months to 8 years, and 18% (95% CI: 0–33%) for adults ≥60 years. For inpatients, VE was 21% (95% CI: −11–44%). We conclude that influenza vaccines that were used in mainland China had a moderate effectiveness, with VE being higher among children than the elderly. Influenza VE should be continuously monitored in mainland China to provide evidence for policy making and improving uptake of the influenza vaccine.
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Affiliation(s)
- Xiaokun Yang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.Y.); (H.Z.); (Z.L.); (M.R.); (M.G.); (Y.L.); (Y.Q.); (Z.P.)
| | - Hongting Zhao
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.Y.); (H.Z.); (Z.L.); (M.R.); (M.G.); (Y.L.); (Y.Q.); (Z.P.)
| | - Zhili Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.Y.); (H.Z.); (Z.L.); (M.R.); (M.G.); (Y.L.); (Y.Q.); (Z.P.)
| | - Aiqin Zhu
- Division of Infectious Disease Prevention and Disinfection Management, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai 200136, China;
| | - Minrui Ren
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.Y.); (H.Z.); (Z.L.); (M.R.); (M.G.); (Y.L.); (Y.Q.); (Z.P.)
| | - Mengjie Geng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.Y.); (H.Z.); (Z.L.); (M.R.); (M.G.); (Y.L.); (Y.Q.); (Z.P.)
| | - Yu Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.Y.); (H.Z.); (Z.L.); (M.R.); (M.G.); (Y.L.); (Y.Q.); (Z.P.)
| | - Ying Qin
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.Y.); (H.Z.); (Z.L.); (M.R.); (M.G.); (Y.L.); (Y.Q.); (Z.P.)
| | - Luzhao Feng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China;
| | - Zhibin Peng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.Y.); (H.Z.); (Z.L.); (M.R.); (M.G.); (Y.L.); (Y.Q.); (Z.P.)
| | - Zhijie An
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 102206, China;
| | - Jiandong Zheng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.Y.); (H.Z.); (Z.L.); (M.R.); (M.G.); (Y.L.); (Y.Q.); (Z.P.)
- Correspondence: (J.Z.); (Z.L.); (Z.F.); Tel.: +86-010-5890-0541 (J.Z.); +86-010-5890-0543 (Z.L.); +86-010-5890-0309 (Z.F.)
| | - Zhongjie Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.Y.); (H.Z.); (Z.L.); (M.R.); (M.G.); (Y.L.); (Y.Q.); (Z.P.)
- Correspondence: (J.Z.); (Z.L.); (Z.F.); Tel.: +86-010-5890-0541 (J.Z.); +86-010-5890-0543 (Z.L.); +86-010-5890-0309 (Z.F.)
| | - Zijian Feng
- Chinese Center for Disease Control and Prevention, Beijing 102206, China
- Correspondence: (J.Z.); (Z.L.); (Z.F.); Tel.: +86-010-5890-0541 (J.Z.); +86-010-5890-0543 (Z.L.); +86-010-5890-0309 (Z.F.)
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Liu W, Zhang J, Liu H, Guo X, Zhang X, Yao X, Cao Z, Zhang T. A review of the removal of microplastics in global wastewater treatment plants: Characteristics and mechanisms. ENVIRONMENT INTERNATIONAL 2021; 146:106277. [PMID: 33227584 DOI: 10.1016/j.envint.2020.106277] [Citation(s) in RCA: 170] [Impact Index Per Article: 56.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/06/2020] [Accepted: 11/07/2020] [Indexed: 05/12/2023]
Abstract
Wastewater treatment plants (WWTPs) are considered to be the main sources of microplastic contaminants in the aquatic environment, and an in-depth understanding of the behavior of microplastics among the critical treatment technologies in WWTPs is urgently needed. In this paper, the characteristics and removal of microplastics in 38 WWTPs in 11 countries worldwide were reviewed. The abundance of microplastics in the influent, effluent, and sludge was compared. Then, based on existing data, the removal efficiency of microplastics in critical treatment technologies were compared by quantitative analysis. Particularly, detailed mechanisms of critical treatment technologies including primary settling treatment with flocculation, bioreactor system, advanced oxidation and membrane filtration were discussed. Thereafter, the abundance load and ecological hazard of the microplastics discharged from WWTPs into the aquatic and soil environments were summarized. The abundance of microplastics in the influent ranged from 0.28 particles L-1 to 3.14 × 104 particles L-1, while that in the effluent ranged from 0.01 particles L-1 to 2.97 × 102 particles L-1. The microplastic abundance in the sludge within the range of 4.40 × 103-2.40 × 105 particles kg-1. In addition, there are still 5.00 × 105-1.39 × 1010 microplastic particles discharged into the aquatic environment each day Moreover, among the critical treatment technologies, the quantitative analysis revealed that filter-based treatment technologies exhibited the best microplastics removal efficiency. Fibers and microplastics with large particle sizes (0.5-5 mm) were easily separated by primary settling. Polyethene and small-particle size microplastics (<0.5 mm) were easily trapped by bacteria in the activated sludge of bioreactor system. The negative impact of microplastics from wastewater treatment plant was worthy of attention. Moreover, unknown transformation products of microplastics and their corresponding toxicity need in-depth research.
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Affiliation(s)
- Weiyi Liu
- Department of Environmental Science and Engineering, Research Centre for Resource and Environment, Beijing University of Chemical Technology, Beijing 100029, People's Republic of China
| | - Jinlan Zhang
- Department of Environmental Science and Engineering, Research Centre for Resource and Environment, Beijing University of Chemical Technology, Beijing 100029, People's Republic of China
| | - Hang Liu
- Department of Environmental Science and Engineering, Research Centre for Resource and Environment, Beijing University of Chemical Technology, Beijing 100029, People's Republic of China
| | - Xiaonan Guo
- Department of Environmental Science and Engineering, Research Centre for Resource and Environment, Beijing University of Chemical Technology, Beijing 100029, People's Republic of China
| | - Xiyue Zhang
- Department of Environmental Science and Engineering, Research Centre for Resource and Environment, Beijing University of Chemical Technology, Beijing 100029, People's Republic of China
| | - Xiaolong Yao
- Department of Environmental Science and Engineering, Beijing Technology and Business University, Beijing 100048, People's Republic of China
| | - Zhiguo Cao
- School of Environment, Henan Normal University, Xinxiang 453007, People's Republic of China
| | - Tingting Zhang
- Department of Environmental Science and Engineering, Research Centre for Resource and Environment, Beijing University of Chemical Technology, Beijing 100029, People's Republic of China.
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Korevaar E, Karahalios A, Forbes AB, Turner SL, McDonald S, Taljaard M, Grimshaw JM, Cheng AC, Bero L, McKenzie JE. Methods used to meta-analyse results from interrupted time series studies: A methodological systematic review protocol. F1000Res 2020; 9:110. [PMID: 33163155 PMCID: PMC7607479 DOI: 10.12688/f1000research.22226.3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/09/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Systematic reviews are used to inform healthcare decision making. In reviews that aim to examine the effects of organisational, policy change or public health interventions, or exposures, evidence from interrupted time series (ITS) studies may be included. A core component of many systematic reviews is meta-analysis, which is the statistical synthesis of results across studies. There is currently a lack of guidance informing the choice of meta-analysis methods for combining results from ITS studies, and there have been no studies examining the meta-analysis methods used in practice. This study therefore aims to describe current meta-analysis methods used in a cohort of reviews of ITS studies. Methods: We will identify the 100 most recent reviews (published between 1 January 2000 and 11 October 2019) that include meta-analyses of ITS studies from a search of eight electronic databases covering several disciplines (public health, psychology, education, economics). Study selection will be undertaken independently by two authors. Data extraction will be undertaken by one author, and for a random sample of the reviews, two authors. From eligible reviews we will extract details at the review level including discipline, type of interruption and any tools used to assess the risk of bias / methodological quality of included ITS studies; at the meta-analytic level we will extract type of outcome, effect measure(s), meta-analytic methods, and any methods used to re-analyse the individual ITS studies. Descriptive statistics will be used to summarise the data. Conclusions: This review will describe the methods used to meta-analyse results from ITS studies. Results from this review will inform future methods research examining how different meta-analysis methods perform, and ultimately, the development of guidance.
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Affiliation(s)
- Elizabeth Korevaar
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
| | - Amalia Karahalios
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
| | - Andrew B Forbes
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
| | - Simon L Turner
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
| | - Steve McDonald
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
| | - Monica Taljaard
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, K1Y 4E9, Canada.,School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, K1N 6N5, Canada
| | - Jeremy M Grimshaw
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, K1Y 4E9, Canada.,School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, K1N 6N5, Canada.,Department of Medicine, University of Ottawa, Ottawa, Ontario, K1H 8M5, Canada
| | - Allen C Cheng
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia.,Infection Prevention and Healthcare Epidemiology Unit, Alfred Health, Melbourne, Victoria, 3004, Australia
| | - Lisa Bero
- Faculty of Medicine and Health and Charles Perkins Centre, University of Sydney, Sydney, New South Wales, 2006, Australia
| | - Joanne E McKenzie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
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Breast Implants for Mammaplasty: An Umbrella Review of Meta-analyses of Multiple Complications. Aesthetic Plast Surg 2020; 44:1988-1996. [PMID: 32696163 DOI: 10.1007/s00266-020-01866-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 06/30/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND The association of breast implants and complications after mammaplasty has been extensively researched. The aim of this study is to summarize all available results in meta-analysis investigating the association between implants and the incidence of various complications. METHODS An umbrella review for breast implants and associated complications was performed by searching related reviews from electronic databases including Pubmed, Ovid and CINAHL. We collected and reviewed evidence across meta-analyses of observational and interventional studies of implants and any health outcome. The quality of the reviews was assessed using the AMSTAR tool (A measurement tool to assess systematic reviews). RESULTS The research included 92 meta-analyses of 609 studies concerning various areas. Capsular contracture was the most investigated outcome. Radiotherapy, human acellular dermal matrix application, direct-to-implant reconstruction, smooth implant, silicone-filled implant and periareolar incision were significantly associated with higher rates of some of the complications. CONCLUSIONS This umbrella review provides surgeons with summarized evidence of the association between the complications and implant-related factors in mammaplasty surgery to help surgeons make informed choices in the future. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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41
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Guo S, Deng W, Wang H, Liu J, Liu X, Yang X, He C, Zhang Q, Liu B, Dong X, Yang Z, Li Z, Li X. The efficacy of internet‐based cognitive behavioural therapy for social anxiety disorder: A systematic review and meta‐analysis. Clin Psychol Psychother 2020; 28:656-668. [DOI: 10.1002/cpp.2528] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 10/22/2020] [Accepted: 10/23/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Shangyu Guo
- Department of Medical Psychology, Chaohu Clinical Medical College Anhui Medical University Hefei China
- Department of Pediatrics, Second Clinical Medical College Anhui Medical University Hefei China
| | - Wenrui Deng
- Department of Medical Psychology, Chaohu Clinical Medical College Anhui Medical University Hefei China
| | - Hongtao Wang
- Department of Pediatrics, Second Clinical Medical College Anhui Medical University Hefei China
| | - Jiayuan Liu
- Department of Medical Anesthesia, First Clinical Medical College Anhui Medical University Hefei China
| | - Xiaoyu Liu
- Department of Medical Psychology, Chaohu Clinical Medical College Anhui Medical University Hefei China
| | - Xinxin Yang
- Department of Medical Psychology, Chaohu Clinical Medical College Anhui Medical University Hefei China
| | - Cengceng He
- Department of Medical Psychology, Chaohu Clinical Medical College Anhui Medical University Hefei China
| | - Qiqi Zhang
- Department of Clinical Medical, First Clinical Medical College Anhui Medical University Hefei China
| | - Boya Liu
- Department of Clinical Medical, First Clinical Medical College Anhui Medical University Hefei China
| | - Xinghua Dong
- Department of Clinical Medical, First Clinical Medical College Anhui Medical University Hefei China
| | - Zifan Yang
- Department of Clinical Medical, First Clinical Medical College Anhui Medical University Hefei China
| | - Ziqi Li
- Department of Clinical Medical, First Clinical Medical College Anhui Medical University Hefei China
| | - Xiaoming Li
- Department of Medical Psychology, Chaohu Clinical Medical College Anhui Medical University Hefei China
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Charlesworth E, Alderson AJ, de Juan V, Elliott DB. When is refraction stable following routine cataract surgery? A systematic review and meta-analysis. Ophthalmic Physiol Opt 2020; 40:531-539. [PMID: 32696501 DOI: 10.1111/opo.12719] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 01/07/2023]
Abstract
PURPOSE We systematically reviewed the literature to investigate when refraction is stable following routine cataract surgery implanting monofocal intraocular lenses. Current advice recommends obtaining new spectacles 4-6 weeks following surgery. Due to advancements in surgical techniques, we hypothesised that refractive stability would be achieved earlier, which could have major short-term improvements in quality of life for patients. METHODS Medline, CINAHL, AMED, Embase, Web of Science and the Cochrane Library were searched with key words chosen to find articles, which assessed refraction following uncomplicated cataract surgery. Citation chains and the reference lists of all included papers were searched. Unpublished literature was identified using OpenGrey (www.opengrey.eu). The review considered studies that measured refraction at regular intervals following surgery until stability was achieved. RESULTS The search identified 6,680 papers. Two reviewers independently screened the abstracts and nine papers were found to fit the criteria, of which five were included in the meta-analysis. The quality of the papers was evaluated using the Methodological Index for Non-Randomised Studies (MINORS) instrument. Meta-analysis of 301 patients' data of spherical, cylindrical and spherical equivalent correction were performed using Review Manager 5 (RevMan 5.3) (https://revman.cochrane.org/). Refraction at 1-week versus the gold standard of 4-weeks showed no significant difference for sphere data (effect size and 95% confidence interval of; ES = 0.00, 95% CI: -0.17, 0.17; p = 1.00), cylindrical data (ES = +0.06; 95% CI: -0.05, 0.17; p = 0.31), and spherical equivalent (ES = -0.01; 95% CI: -0.12, 0.10; p = 0.90). Heterogeneity was non-significant (I2 < 25%) for all refractive elements. Data were similar for 2- versus 4-weeks post-surgery. Acquired data from one study highlighted a small number of patients with very unstable cylindrical corrections at 1-week post-operatively. CONCLUSIONS No statistical difference was found when comparing sphere, cylindrical and spherical equivalent values at 1- and 4-weeks post cataract surgery. This suggests that new glasses could be provided 1-week after surgery. However, from a clinical perspective, a small number of patients (~7%) from an acquired dataset (N = 72) showed very unstable cylindrical corrections at 1-week. Further work is needed to determine why this is the case and how these patients can be detected.
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Affiliation(s)
- Emily Charlesworth
- Bradford School of Optometry and Vision Science, University of Bradford, Bradford, UK
| | - Alison J Alderson
- Bradford School of Optometry and Vision Science, University of Bradford, Bradford, UK
| | - Victoria de Juan
- Ophthalmology Service, University Hospital Ramón y Cajal, School of Medicine and Health Science, University of Alcalá (IRYCIS), Madrid, Spain
| | - David B Elliott
- Bradford School of Optometry and Vision Science, University of Bradford, Bradford, UK
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Cumpston MS, McKenzie JE, Thomas J, Brennan SE. The use of 'PICO for synthesis' and methods for synthesis without meta-analysis: protocol for a survey of current practice in systematic reviews of health interventions. F1000Res 2020; 9:678. [PMID: 33728041 PMCID: PMC7919603 DOI: 10.12688/f1000research.24469.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/20/2021] [Indexed: 06/30/2024] Open
Abstract
Introduction: Systematic reviews involve synthesis of research to inform decision making by clinicians, consumers, policy makers and researchers. While guidance for synthesis often focuses on meta-analysis, synthesis begins with specifying the 'PICO for each synthesis' (i.e. the criteria for deciding which populations, interventions, comparators and outcomes are eligible for each analysis). Synthesis may also involve the use of statistical methods other than meta-analysis (e.g. vote counting based on the direction of effect, presenting the range of effects, combining P values) augmented by visual display, tables and text-based summaries. This study examines these two aspects of synthesis. Objectives: To identify and describe current practice in systematic reviews of health interventions in relation to: (i) approaches to grouping and definition of PICO characteristics for synthesis; and (ii) methods of summary and synthesis when meta-analysis is not used. Methods: We will randomly sample 100 systematic reviews of the quantitative effects of public health and health systems interventions published in 2018 and indexed in the Health Evidence and Health Systems Evidence databases. Two authors will independently screen citations for eligibility. Two authors will confirm eligibility based on full text, then extract data for 20% of reviews on the specification and use of PICO for synthesis, and the presentation and synthesis methods used (e.g. statistical synthesis methods, tabulation, visual displays, structured summary). The remaining reviews will be confirmed as eligible and data extracted by a single author. We will use descriptive statistics to summarise the specification of methods and their use in practice. We will compare how clearly the PICO for synthesis is specified in reviews that primarily use meta-analysis and those that do not. Conclusion: This study will provide an understanding of current practice in two important aspects of the synthesis process, enabling future research to test the feasibility and impact of different approaches.
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Affiliation(s)
- Miranda S. Cumpston
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Joanne E. McKenzie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - James Thomas
- EPPI-Centre, UCL Social Research Institute, University College London, London, WC1H 0NR, UK
| | - Sue E. Brennan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
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44
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Beverly A, Ong G, Doree C, Welton NJ, Estcourt LJ. Drugs to reduce bleeding and transfusion in major open vascular or endovascular surgery: a systematic review and network meta-analysis. Hippokratia 2020. [DOI: 10.1002/14651858.cd013649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Anair Beverly
- Systematic Review Initiative; NHS Blood and Transplant; Oxford UK
| | - Giok Ong
- Systematic Review Initiative; NHS Blood and Transplant; Oxford UK
| | - Carolyn Doree
- Systematic Review Initiative; NHS Blood and Transplant; Oxford UK
| | - Nicky J Welton
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
| | - Lise J Estcourt
- Haematology/Transfusion Medicine; NHS Blood and Transplant; Oxford UK
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45
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Shi H, Sheng R, Hu Y, Liu X, Jiang L, Wang Z, Cui D. Risk Factors for the Relapse of Graves' Disease Treated With Antithyroid Drugs: A Systematic Review and Meta-analysis. Clin Ther 2020; 42:662-675.e4. [PMID: 32139177 DOI: 10.1016/j.clinthera.2020.01.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 01/28/2020] [Accepted: 01/30/2020] [Indexed: 01/11/2023]
Abstract
PURPOSE Antithyroid drugs (ATDs) are the first-line treatment for Graves' disease (GD). A common problem with ATD treatment is the high relapse rate after drug withdrawal. The goal of this study was to analyze the influencing factors for the relapse of GD patients treated with ATD by using a systematic review and meta-analysis, provide some predictive indexes for the susceptibility of GD recurrence, and then further explore some useful methods to decrease the GD relapse rate after ATD treatment. METHODS Articles published in PubMed, EMBASE, The Cochrane Library, China National Knowledge Infrastructure, Wan Fang, and Chinese Biomedical Literature databases before January 2019 were collected. Patients newly diagnosed with GD, who were aged >16 years, were treated with ATD. Follow-up was then conducted for at least 12 months after ATD withdrawal. Only prospective or retrospective studies were eligible. The primary end point was the recurrence of GD during follow-up. All the data from the trials were analyzed via meta-analysis and meta-regression. p values < 0.05 were considered statistically significant, and statistical heterogeneity was assessed by using I2 statistics. FINDINGS A total of 20 studies and 3242 patients were involved in this meta-analysis, with 1681 patients relapsed (incidence rate, 51.9%) during the follow-up time. Analysis of risk factors suggested that younger age (weighted raw mean difference [RMD], -3.51; 95% CI, -5.74 to -1.29), larger thyroid volume (RMD, 4.38; 95% CI, 1.68 to 7.08), bigger goiter size (1.94% risk; 95% CI, 0.43 to 3.46), higher free triiodothyronine level (RMD, 5.09; 95% CI, 4.42 to 5.77), and higher free thyroxine level (RMD, 4.21; 95% CI, 0.54 to 7.89) were associated with the higher relapse rate of GD. The block-replace ATD regimen (a fixed high dose of an ATD with levothyroxine supplementation to maintain euthyroidism) (risk ratio, 0.64; 95% CI, 0.52 to 0.78) exhibits a lower relapse rate than the titration regimen (an ATD used alone and dose adjusted according to thyroid function tests). IMPLICATIONS This analysis revealed that certain risk factors were associated with GD relapses such as younger age, larger goiter size or thyroid volume, and the higher free triiodothyronine or free thyroxine level in the diagnosing phase of GD. For patients with these clinical characteristics, early definitive treatment with radioactive iodine or surgery should be offered to those who are unlikely to achieve remission with ATDs only. In addition, more prospective cohort studies with different ATD regimens would help to determine the optimum ATD treatment for patients with GD. PROSPERO identifier: CRD 42019146825.
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Affiliation(s)
- He Shi
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Rongrong Sheng
- Department of Information Technology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yifang Hu
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaoyun Liu
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Lin Jiang
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zhongmin Wang
- Department of Information Technology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - Dai Cui
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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Wang N, Zhang J, Xu L, Qi J, Liu B, Tang Y, Jiang Y, Cheng L, Jiang Q, Yin X, Jin S. A novel estimator of between-study variance in random-effects models. BMC Genomics 2020; 21:149. [PMID: 32046631 PMCID: PMC7014785 DOI: 10.1186/s12864-020-6500-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 01/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With the rapid development of high-throughput sequencing technologies, many datasets on the same biological subject are generated. A meta-analysis is an approach that combines results from different studies on the same topic. The random-effects model in a meta-analysis enables the modeling of differences between studies by incorporating the between-study variance. RESULTS This paper proposes a moments estimator of the between-study variance that represents the across-study variation. A new random-effects method (DSLD2), which involves two-step estimation starting with the DSL estimate and the [Formula: see text] in the second step, is presented. The DSLD2 method is compared with 6 other meta-analysis methods based on effect sizes across 8 aspects under three hypothesis settings. The results show that DSLD2 is a suitable method for identifying differentially expressed genes under the first hypothesis. The DSLD2 method is also applied to Alzheimer's microarray datasets. The differentially expressed genes detected by the DSLD2 method are significantly enriched in neurological diseases. CONCLUSIONS The results from both simulationes and an application show that DSLD2 is a suitable method for detecting differentially expressed genes under the first hypothesis.
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Affiliation(s)
- Nan Wang
- School of Mathematics, Harbin Institute of Technology, Harbin, Heilongjiang, China
| | - Jun Zhang
- Rehabilitation department, Heilongjiang Province Land Reclamation Headquarters General Hospital, Harbin, Heilongjiang, China
| | - Li Xu
- College of Computer Science and Technology, Harbin Engineering University, Harbin, Heilongjiang, China
| | - Jing Qi
- School of Mathematics, Harbin Institute of Technology, Harbin, Heilongjiang, China
| | - Beibei Liu
- School of Mathematics, Harbin Institute of Technology, Harbin, Heilongjiang, China
| | - Yiyang Tang
- School of Mathematics, Heilongjiang University, Harbin, Heilongjiang, China
| | - Yinan Jiang
- Heilongjiang Province Hospital of Chinese Medicine, Harbin, Heilongjiang, China
| | - Liang Cheng
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Qinghua Jiang
- School of Life Science and Technology, Harbin Institute of Technology, Harbin, Heilongjiang, China
| | - Xunbo Yin
- School of Mathematics, Harbin Institute of Technology, Harbin, Heilongjiang, China
| | - Shuilin Jin
- School of Mathematics, Harbin Institute of Technology, Harbin, Heilongjiang, China
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Lin S, Zhu B, Huang G, Wang C, Zeng Q, Zhang S. Short-Term Effect of Kinesiotaping on Chronic Nonspecific Low Back Pain and Disability: A Meta-Analysis of Randomized Controlled Trials. Phys Ther 2020; 100:238-254. [PMID: 31696916 DOI: 10.1093/ptj/pzz163] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 06/26/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Low back pain (LBP) is a very common and disabling disorder in modern society. The intervention strategies for LBP include drug therapy, surgery, and physical interventions. Recently, kinesiotaping, as a simple and noninvasive treatment, has been used to treat chronic nonspecific LBP, but its effectiveness and true merit remains unclear. PURPOSE The purpose of this study was to summarize the results of randomized controlled trials (RCTs) on the effectiveness of kinesiotaping (KT) for chronic nonspecific low back pain (CNLBP) and disability. DATA SOURCES Medline, Cochrane Library, Google Scholar, Web of Science, and EmBase were searched from inception to September 1, 2018. STUDY SELECTION Studies were included in the review if they met the following criteria: RCTs published in English; patients (>18 years old) diagnosed with CNLBP (pain duration of > 12 weeks), with or without leg pain; KT as a single treatment or as a part of other forms of physical therapy; outcomes measured included pain intensity and disability. DATA EXTRACTION Three independent investigators completed data extraction. Methodological quality was appraised using the Cochrane tool for assessing the risk of bias. The GRADE (Grading of Recommendations Assessment, Development, and Evaluation) guidelines were applied to assess the confidence of the effect estimates. DATA SYNTHESIS Eleven RCT studies involving 785 patients were retained for the meta-analysis.Standardized mean differences (SMDs) with 95% CIs were calculated using a random-effects model. Compared with the control group, the pooled SMD of pain intensity was significantly reduced (SMD = -0.73; 95% CI = -1.12 to -0.35; GRADE: low) and disability was improved (SMD = -0.51; 95% CI = -0.85 to -0.17; GRADE: low) in the KT group. Subgroup analyses showed that, compared with the control, the I strip of KT significantly reduced pain (SMD = -0.48; GRADE: low) but not disability (SMD = -0.26; GRADE: low). Compared with sham/placebo tape, KT provided significant pain reduction (SMD = -0.84; GRADE: low) and disability improvement (SMD = -0.56; GRADE: low). Moreover, compared with the no-tape group, the KT group also showed pain reduction (SMD = -0.74; GRADE: low) and disability improvement (SMD = -0.65; GRADE: low). LIMITATIONS Limitations of the review included a lack of homogeneity, different methodologies and treatment duration of KT application, and relatively small sample sizes. CONCLUSIONS There is low-quality evidence that KT has a beneficial role in pain reduction and disability improvement for patients with CNLBP. More high-quality studies are required to confirm the effects of KT on CNLBP.
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Affiliation(s)
- Shanshan Lin
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University
| | - Bo Zhu
- Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, China
| | - Guozhi Huang
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Chuhuai Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qing Zeng
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University
| | - Shanshan Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Meta-analysis: diagnostic accuracy of the citrullinated peptides derived from fibrinogen and vimentin in rheumatoid arthritis. Clin Rheumatol 2019; 39:1111-1120. [DOI: 10.1007/s10067-019-04845-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 08/15/2019] [Accepted: 11/04/2019] [Indexed: 12/19/2022]
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Global variation in prevalence and incidence of amyotrophic lateral sclerosis: a systematic review and meta-analysis. J Neurol 2019; 267:944-953. [PMID: 31797084 DOI: 10.1007/s00415-019-09652-y] [Citation(s) in RCA: 143] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 11/22/2019] [Accepted: 11/23/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) is a global disease, which adversely affects the life quality of patients and significantly increases the burden of families and society. We aimed to assess the changing incidence, prevalence of ALS around the world. METHODS We searched Medline, Embase, Web of Science, and Cochrane library to identify articles published until September 9, 2018. Each included study was independently reviewed for methodological quality by two reviewers. We used a random-effects model to summarize individual studies and assessed heterogeneity (I2) with the χ2 test on Cochrane's Q statistic. RESULTS We identified 124 studies that were eligible for final inclusion, including 110 studies of incidence and 58 studies of prevalence. The overall crude worldwide ALS prevalence and incidence were 4.42 (95% CI 3.92-4.96) per 1,00,000 population and 1.59 (95% CI 1.39-1.81) per 1,00,000 person-years, respectively. ALS prevalence and incidence increased by age until the age of 70-79. Since 1957, incidence has been significantly rising year by year, and this upward trend was weakened after standardization. The longest survival time were in Asia (ranging from 3.74 years in South Asia to 9.23 years in West Asia). CONCLUSIONS With the aggravation of population aging and the rapid growth of economy, developing regions following the development pattern of the developed regions may suffer rising ALS prevalence and incidence which may increase their disease burden as well. These data highlight the need for research into underlying mechanism and innovations in health-care systems.
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50
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Beverly A, Ong G, Wilkinson KL, Doree C, Welton NJ, Estcourt LJ. Drugs to reduce bleeding and transfusion in adults undergoing cardiac surgery: a systematic review and network meta-analysis. Hippokratia 2019. [DOI: 10.1002/14651858.cd013427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Anair Beverly
- NHS Blood and Transplant; Systematic Review Initiative; Oxford UK
| | - Giok Ong
- NHS Blood and Transplant; Systematic Review Initiative; Oxford UK
| | - Kirstin L Wilkinson
- Southampton University NHS Hospital; Paediatric and Adult Cardiothoracic Anaesthesia; Tremona Road Southampton UK SO16 6YD
| | - Carolyn Doree
- NHS Blood and Transplant; Systematic Review Initiative; Oxford UK
| | - Nicky J Welton
- University of Bristol; Population Health Sciences, Bristol Medical School; Bristol UK
| | - Lise J Estcourt
- NHS Blood and Transplant; Haematology/Transfusion Medicine; Level 2, John Radcliffe Hospital Headington Oxford UK OX3 9BQ
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