Defining the process to literature searching in systematic reviews: a literature review of guidance and supporting studies

The Complex Pattern Mismatch Negativity as a Potential Indicator of Psychosis Across all Phases of Illness: A Meta-Analysis

Over the past decade, there has been extensive research on the mismatch negativity (MMN) and its promise as a biomarker of illness in people with schizophrenia (SZ). Nevertheless, when attempting to assess the early stages of illness progression, the utility of MMN has been inconsistent. Recently, researchers have been investigating a more advanced MMN paradigm (the complex MMN [cMMN]) which is believed to index higher-order cognitive processing and has been suggested to be a more effective indicator of the early phases of SZ. The cMMN is defined as a paradigm that relies on alterations within a pre-established pattern of stimuli. In this meta-analysis, we investigated cMMN deficits in individuals with SZ, including an analysis involving those in the first 5 years of illness. Our search also included individuals with bipolar disorder who experience psychosis; however, no related papers were found and thus, no findings are reported. Our findings indicate a small/moderate effect (d = 0.47), suggesting that individuals with SZ exhibit reduced cMMN amplitudes compared to individuals without SZ. Interestingly, this effect seems to be more pronounced in individuals within the first 5 years of their illness (d = 0.58), suggesting that cMMN might be a more sensitive biomarker in the early phases of SZ compared to traditional paradigms.

Effects of resistance training on cardiovascular risk factors in patients with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials

AIMS

Type 2 diabetes mellitus (T2DM) is prevalent worldwide, often manageable through lifestyle changes like physical activity. This meta-analysis aimed to determine the effect of resistance training (RT) on cardiovascular risk factors in adults with T2DM.

METHODS

Four databases were searched up to March 2024. The mean difference (MD) was calculated by a random effect model with 95% confidence interval (CI).

RESULTS

Forty-eight articles were included in the review. There was a significant pooled effect size for the meta-analysis comparing RT vs. control on hemoglobin A1C (MD = -0.49, 95% CI: -0.66, -0.33; P < 0.00001), fasting blood sugar (MD = -11.58, 95% CI: -18.61, -4.55; P = 0.001), insulin (ES = -1.65, 95% CI: -2.87, -0.42; P = 0.008), HOMA-IR (MD = -1.20, 95% CI: -1.85, -0.55; P = 0.0003), triglyceride (MD = -18.14, 95% CI: -30.32, -5.96; P = 0.004), and high-density lipoprotein (MD = 2.71, 95% CI: 0.78, 4.64; P = 0.006). Moreover, RT was effective for reducing body weight (MD = -0.81, 95% CI: -1.50, -0.13; P = 0.02), fat percentage (MD = -0.92, 95% CI: -1.62, -0.22; P = 0.010), and waist circumference (MD = -2.14, 95% CI: -3.00, -1.28; P < 0.00001).

CONCLUSION

RT effectively improves cardiovascular risk factors in T2DM adults, suggesting potential as treatment or prevention. Future studies can consider investigating the optimal RT regimen to achieve effective T2DM management in adults.

Response of infrared thermography related parameters to (non-)sport specific exercise and relationship with internal load parameters in individual and team sport athletes-a systematic review

Introduction

Monitoring internal load is crucial for athletes but often requires invasive methods for muscle-related parameters, limiting practicality. Infrared thermography (IRT) related parameters might overcome this limitation. This systematic review aimed to examine the available literature on the response of IRT related parameters to (non-)sport specific exercise and reveal relationships with internal load parameters in athletic populations.

Methods

Four scientific databases were systematically searched (February 2024) with keywords related to IRT, load, and sports disciplines. Risk of bias was evaluated using QUADAS-2. Main inclusion criteria for studies were i) reporting of IRT related parameters and other internal load parameters prior/post (non-)sport specific exercise ii) inclusion of least Tier 2 athletes ≥ 18 years. After identifying n = 10,538 studies, 13 articles (n = 231 participants) were included.

Results

Following (non-)sport specific exercise in athletic populations, the majority of relevant studies showed a decrease in IRT related parameters within 15 min, while studies showed an increase in IRT related parameters following 30 min, 24 h, 48 h, and 72 h after exercise cessation. Relationships between alterations in IRT related parameters and other internal load parameters are inconsistent across the literature.

Conclusion

While the majority of studies show an increase in IRT related parameters following (non-)sport specific exercise, relationships with other internal load parameters and underlying physiological mechanisms evoking IRT related alterations are not conclusively revealed in athletic populations. Future research needs to assess the relationship of IRT related parameters especially with inflammatory parameters in athletic populations following (non-)sport specific exercise. Practitioners might assess IRT related parameters in conjunction with other load parameters.

Participation among tribal youths of India in vocational training measures: A systematic review of literature

PURPOSE

Vocational Training is integral to Skill India Mission 2015, which targets to mitigate youth unemployment. However, evidence reveals a significant number of unenrolled youths. Existing studies pinpoint the reasons for this decline in varied nations including India, but rarely they are specific to indigenous communities. Therefore, the aim is to delve into the diverse aspects of participation in vocational training, focusing on tribal communities in India.

METHOD

This systematic literature review uses the SPICE tool for question formulation, PRISMA guidelines for article selection, Mendeley for duplication elimination, and SQUIRE 2.0 for evaluating research quality.

FINDINGS

There are few studies on tribal population participation in vocational training in India. An interpretation of synthesis based on 37 included studies highlights the low participation of tribes despite government emphasis. The analysis reveals that social stigma still hinders access to vocational training, undermining the potential benefits. Hence, inadequate progress in this area has compromised the fulfilment of its true purpose.

ORIGINALITY

This study offers a unique approach by extracting literature and employing scientific review tools to find new insights. Notably, the review findings can shape the understanding of vocational training by stimulating global discussions.

Effectiveness of psychosocial interventions for improving asthma symptoms and parental stress in families of school-age children with asthma: A systematic review and meta-analysis

BACKGROUND

Asthma is a prevalent chronic disease affecting school-age children, with substantial psychosocial implications for children and their parents.

OBJECTIVES

This review aimed to synthesise current evidence on the effects of psychosocial interventions for families of school-age children with asthma and investigate the optimal features of effective interventions.

METHODS

Embase, MEDLINE, PsycINFO, CINAHL, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, Google Scholar, CNKI, and Wanfang Data were searched from inception to November 2023. Randomised controlled trials (RCTs) examining psychosocial interventions in children aged six to twelve with asthma on asthma symptoms and parental stress were included. Emergency department visits, hospitalisations, lung function, psychological symptoms and health-related quality of life in both children and parents were secondary outcomes. Data were pooled for short-term (≤ three months), medium-term (> three months and ≤ six months), and long-term (> six months) follow-ups. Risk of bias was appraised using version 2 of the Cochrane risk of bias tool for randomised trials. Meta-analysis was performed using RevMan 5.4.1.

RESULTS

Seven RCTs with 884 parent-child dyads from two countries were included. Meta-analyses found that psychosocial interventions improved asthma control (k = 2, n = 301, standardised mean difference [SMD] 0.35, 95 % confidence interval [CI] 0.12 to 0.58, P = 0.003), sleep problem (k = 2, n = 149, SMD -0.47, 95 % CI -0.79 to -0.14, P = 0.005), cough (k = 2, n = 149, SMD -0.97, 95 % CI -1.59 to -0.35, P = 0.002), wheezing (k = 2, n = 149, SMD -0.76, 95 % CI -1.09 to -0.42, P < 0.0001), and parental stress (k = 6, n = 813, SMD -0.32, 95 % CI -0.61 to -0.02, P = 0.03), compared to controls in the short term. Subgroup analysis revealed significant effects of psychoeducation, family empowerment interventions, and acceptance and commitment therapy-based interventions on reducing parental stress. No significant intervention effects were observed on parental symptoms of depression at any follow-up. Narrative synthesis indicated that psychosocial interventions may provide benefits in children's health-related quality of life in the short term, parental symptoms of anxiety in the medium term, and activity limitation, cough, and wheezing in the long term. The intervention effects for other reviewed outcomes were inconsistent.

CONCLUSIONS

Psychosocial interventions demonstrate possible benefits for families of school-aged children with asthma in asthma symptoms, parental stress, and children's health-related quality of life within three months post-intervention and parental symptoms of anxiety at six months post-intervention. Future research with rigorous design should investigate the optimal duration, frequency, and intervention approaches of psychosocial interventions.

TWEETABLE ABSTRACT

Psychosocial interventions improve asthma symptoms and parental stress within three months post-intervention for families of school-age children with asthma @ConnieChong1.

How is process tracing applied in health research? A systematic scoping review

Complex health system questions often have a case study (such as a country) as the unit of analysis. Process tracing, a method from policy studies, is a flexible approach for causal analysis within case studies, increasingly used in applied health research. The aim of this study was to identify the ways in which process tracing methods have been used in health research, and provide insights for best practice. We conducted a systematic scoping review of applied studies purporting to use process tracing methods in health research contexts. We examined the range of studies and how they conducted and reported process tracing. We found 84 studies published from 2011 to 2023. Studies were categorised into two groups: those with greater methodological description (n = 19 studies) and those with less methodological description (n = 65 studies). A majority of studies were focused on public health and health policy with around half of studies focused on low and middle income countries. Of those 19 studies that provided greater methodological description eight studies featured four areas of good practice: (1) reporting the development of a mechanistic theory and making it explicit; (2) linking empirical material collected to the mechanistic theory; (3) clearly presenting the causal mechanism tracing; and (4) reporting how consideration of counterfactuals or evidence of alternatives within the study were analysed in practice. The review demonstrates the rapid take-up of process tracing to generate theory and evidence to support a better understanding of causal mechanisms in complex health research. To support future studies in conducting and reporting process tracing, we provide emergent recommendations.

Evaluating the adoption of handsearching, citation chasing, and screening tools in education research: a survey study

Introduction

The rapid development of software tools to assist systematic reviewers has led to varying degrees of adoption and selection among researchers. However, the actual usage patterns of these tools, their preferred features, and the criteria for selecting the most suitable tools remain unclear.

Methods

To understand these aspects, we collected 175 responses from researchers across different continents.

Results

In terms of handsearching, despite new tools developed, our findings reveal that manual handsearching remains prevalent among more than half of the participants. Databases are the most popular tools for citation searching, followed by citation management tools and spreadsheets. This reliance on citation management tools and spreadsheets is concerning as they are not specifically designed for systematic reviews. The primary factors influencing tool selection are the research environment and ease of use. Barriers stopping researchers from adopting alternative tools include limited awareness, challenges in learning new tools, and the financial costs associated with acquiring licenses. Moreover, researchers located in Europe show greater familiarity with a wider range of tools compared to their North American counterparts.

Discussion

This preregistered study contributes valuable insights into the tool usage patterns of education researchers, emphasizing the importance of promoting awareness and facilitating the broader adoption of existing tools.

Precision and Sensitivity: A Surrogate for Quality of Literature Search in Systematic Reviews

The adequacy of the literature search is one of the critical domains that affect the quality of the systematic review. The aim of a literature search in the systematic review should be to obtain thorough, comprehensive, transparent, and reproducible results. Precision (also called "positive predictive value") and sensitivity (also called "recall") have been postulated as 2 markers for rating the quality of literature search in systematic reviews. The reporting of such measures shall help in improving the relevance, transparency, reproducibility, and comprehensibility of the search. A search strategy that maximizes sensitivity with reasonable precision shall improve the quality of the review.

Psychological well-being of travellers on long-distance shipping voyages: A systematic review protocol

The psychosocial well-being of every individual is as important as the well-being of long-distance voyages, especially that they have to spend longer hours and days travelling to their destinations with all the experiences of adventure and adversities characterizing the journey. The aim of this systematic review is to explore the psychosocial well-being of long-distance seafarers on board shipping vessels to gain an understanding of their psychological and social well-being with the objective of ameliorating the adversities associated with these travels. A systematic review will be conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (2020) statement. The databases to be searched for the data will be limited to Scopus, Web of Science, and Advanced Google Scholar using keywords selected by the reviewers. Meta-analysis, narrative synthesis, or both will be used depending on the extent of heterogeneity across eligible observational studies included in the review. Some specific countries will be selected for data extraction, and only data published in English will be included. It is expected that the findings from this review will bring to bear if these categories of seafarers are prone to risks that affect their psychosocial wellbeing and if so discovered. This protocol was registered with the PROSPERO. PROSPERO registration number: CRD42024517277(08/03/2024).

Global trends in the clinical utilization of exosomes in dermatology: a bibliometric analysis

The arena of exosomal research presents substantial emerging prospects for clinical dermatology applications. This investigation conducts a thorough analysis of the contemporary global research landscape regarding exosomes and their implications for dermatological applications over the preceding decade. Employing bibliometric methodologies, this study meticulously dissects the knowledge framework and identifies dynamic trends within this specialized field. Contemporary scholarly literature spanning the last decade was sourced from the Web of Science Core Collection (WoSCC) database. Subsequent to retrieval, both quantitative and visual analyses of the pertinent publications were performed utilizing the analytical software tools VOSviewer and Citespace. A comprehensive retrieval yielded 545 scholarly articles dated from January 1, 2014, to December 31, 2023. Leading the research forefront are institutions such as Shanghai Jiao Tong University, The Fourth Military Medical University, and Sun Yat-sen University. The most prolific contributors on a national scale are China, the United States, and South Korea. Among the authors, Zhang Bin, Zhang Wei, and Zhang Yan emerge as the most published, with Zhang Bin also achieving the distinction of being the most cited. The International Journal of Molecular Sciences leads in article publications, whereas Stem Cell Research & Therapy holds the pinnacle in citation rankings. Theranostics boasts the highest impact factor among the periodicals. Current research hotspots in this area include Adipose mesenchymal stem cell-derived exosomes(ADSC-Exos), diabetic skin wounds, cutaneous angiogenesis, and the combination of biomaterials and exosomes. This manuscript constitutes the inaugural comprehensive bibliometric analysis that delineates the prevailing research trends and advancements in the clinical application of exosomes in dermatology. These analyses illuminate the contemporary research focal points and trajectories, providing invaluable insights that will inform further exploration within this domain.

Searching for studies: A guide to information retrieval for Campbell systematic reviews

This guide outlines general issues in searching for studies; describes the main sources of potential studies; and discusses how to plan the search process, design, and carry out search strategies, manage references found during the search process and document and report the search process.

Loneliness prevalence of community-dwelling older adults and the impact of the mode of measurement, data collection, and country: A systematic review and meta-analysis

OBJECTIVES

The aim of this systematic review and meta-analysis is to assess the prevalence of loneliness in many countries worldwide which have different ways of assessing it.

DESIGN

Systematic review and meta-analysis.

SETTING

We searched seven electronic databases for English peer-reviewed studies published between 1992 and 2021.

PARTICIPANTS

We selected English-language peer-reviewed articles, with data from non-clinical populations of community-dwelling older adults (>60 years), and with "loneliness" or "lonely" in the title.

MEASUREMENTS

A multilevel random-effects meta-analysis was used to estimate the prevalence of loneliness across studies and to pool prevalence rates for different measurement instruments, data collection methods, and countries.

RESULTS

Our initial search identified 2,021 studies of which 45 (k = 101 prevalence rates) were included in the final meta-analysis. The estimated pooled prevalence rate was 31.6% (n = 168,473). Measurement instrument was a statistically significant moderator of the overall prevalence of loneliness. Loneliness prevalence was lowest for single-item questions and highest for the 20-item University of California-Los Angeles Loneliness Scale. Also, differences between modes of data collection were significant: the loneliness prevalence was significantly the highest for face-to-face data collection and the lowest for telephone and CATI data collection. Our moderator analysis to look at the country effect indicated that four of the six dimensions of Hofstede also caused a significant increase (Power Distance Index, Uncertainty Avoidance Index, Indulgence) or decrease (Individualism) in loneliness prevalence.

CONCLUSIONS

This study suggests that there is high variability in loneliness prevalence rates among community-dwelling older adults, influenced by measurement instrument used, mode of data collection, and country.

Appraising the clinical, operational, and economic impacts of automated medication dispensing cabinets in perioperative and surgical settings: A systematic literature review

BACKGROUND

Initiation of pharmacy automation and automated dispensing cabinets (ADCs) in hospitals has been shown to improve clinical, operational, and economical outcomes. Implementation of ADCs in surgical areas has lagged behind that of traditional inpatient hospitals settings.

OBJECTIVES

To assess the documented impact of ADCs in ambulatory surgery centers (ASCs), perioperative, and surgical care areas.

METHODS

A systematic literature review (SLR) was conducted in PubMed and Google Scholar in November 2022. The SLR was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Original research studies were included if they reported empirical data on ADCs in ASCs, perioperative areas, and surgical settings. The search criteria consisted of site locations in North America or Europe, with articles written in English and published since 1992. Outcomes of the studies were categorized as medication errors, controlled substance discrepancies, inventory management, user experience, and cost effectiveness.

RESULTS

A total of nine studies met the inclusion criteria. Six assessed ADC impact on controlled-substance inventory management, with all finding reductions in controlled-substance discrepancies ranging from 16% to 62.5%. Two studies showed a reduction in medication errors from 23% in 1 study and to up to 100% after ADC implementation in the other. Three studies revealed a positive impact on user experience, with a range of 81% to 100% of health care providers across these settings being satisfied with ADC usage. Only 1 study showed post-ADC implementation labor cost savings due to reduction in labor hours, but was based on data from 3 decades ago.

CONCLUSIONS

ADC implementation in surgical settings was found to decrease medication errors, reduce controlled-substance discrepancies, improve inventory management, enhance user experience, and reduce labor hours although the evidence consisted of smaller-scale studies. Larger-scale studies are needed to support these findings, thereby fostering a more comprehensive view of the multifactorial impact of ADCs in these settings.

The global psychological and physical effects of domestic abuse and violence on South Asian women: a qualitative systematic review

Introduction

The purpose of this review is to systematically extract and analyse global academic literature to determine the physical and psychological effects of domestic abuse and violence on South Asian women.

Design

This review employs a qualitative systematic approach and thematic analysis to synthesize the narratives of affected women found in the literature. Given that domestic violence is often concealed and downplayed by various social factors, statistical reports and prevalence data offer only a limited view of the issue due to underreporting. Therefore, qualitative literature is deemed more dependable in this subjective domain as it captures and interprets the experiences and meanings within this under-studied group.

Data sources

Embase, PsycINFO, Google Scholar, Web Of Science, MEDLINE, and ASSIA were searched.

Review methods

All included studies were critically appraised using the CASP tool for qualitative research. Thematic analysis was conducted to develop six themes. Studies excluded did not address the research question, although intersecting population issues could be valuable topics for further research.

Results

The literature indicates severe mental and physical health consequences of domestic violence and abuse, with some traits persisting long-term. The analysis underscores the significant role of resilience, suggesting that individuals can overcome traumatic social experiences without enduring lifelong labels or a deficit model.

Conclusion

The findings provide support for future interventions aimed at recognizing signs of abuse and preventing severe psychological and physical consequences, particularly among South Asian women. Further research is needed to understand the impact on children and other family members affected by the victim's abuse, which falls beyond the scope of this review.

A systematic review for the evidence of recommendations and guidelines in hybrid nuclear cardiovascular imaging

OBJECTIVES

This study aimed to evaluate the level of evidence of expert recommendations and guidelines for clinical indications and procedurals in hybrid nuclear cardiovascular imaging.

METHODS

From inception to August 2023, a PubMed literature analysis of the latest version of guidelines for clinical hybrid cardiovascular imaging techniques including SPECT(/CT), PET(/CT), and PET(/MRI) was performed in two categories: (1) for clinical indications for all-in primary diagnosis; subgroup in prognosis and therapy evaluation; and for (2) imaging procedurals. We surveyed to what degree these followed a standard methodology to collect the data and provide levels of evidence, and for which topic systematic review evidence was executed.

RESULTS

A total of 76 guidelines, published between 2013 and 2023, were included. The evidence of guidelines was based on systematic reviews in 7.9% of cases, non-systematic reviews in 47.4% of cases, a mix of systematic and non-systematic reviews in 19.7%, and 25% of guidelines did not report any evidence. Search strategy was reported in 36.8% of cases. Strengths of recommendation were clearly reported in 25% of guidelines. The notion of external review was explicitly reported in 23.7% of cases. Finally, the support of a methodologist was reported in 11.8% of the included guidelines.

CONCLUSION

The use of evidence procedures for developing for evidence-based cardiovascular hybrid imaging recommendations and guidelines is currently suboptimal, highlighting the need for more standardized methodological procedures.

Nurse-led physical activity interventions for people with dementia in nursing homes: A systematic review on intervention characteristics and implementation facilitators/barriers

BACKGROUND

Physical activities are important to maintain and promote physical functioning and activities of daily living in people with dementia. Nurses are in a key position to deliver physical activity interventions in nursing homes. However, synthesized strategies for sustainable implementation of physical activity interventions in nursing homes for people with dementia are lacking.

OBJECTIVE

We aimed at synthesizing the evidence on nurse-led physical activity interventions and at identifying facilitators and barriers to sustainable implementation of physical activity interventions for people with dementia.

DESIGN

Systematic review.

REVIEW METHODS

We performed a comprehensive literature search combining database searches (MEDLINE, CINAHL, CENTRAL, Web of Science Core Collection; last search: September 27, 2023) and supplementary search methods (citation tracking, web searching, clinical guideline database searching). We considered studies on nurse-led physical activity interventions for people with dementia living in nursing homes for eligibility; published as journal articles and related material in English, French, German language, without restrictions on primary study design and publication year. Independently and in duplicate, we assessed the references' eligibility and the quality of the included studies. We used the Mixed Methods Appraisal Tool to appraise quality of included studies. We piloted and double-checked data extractions, and summarized the results narratively and graphically (harvest plot). We prospectively registered our review (PROSPERO CRD42021271833).

RESULTS

We identified 24 studies (of which eleven were randomized trials) assessing various interventions that we categorized into physical exercise (n = 8), care-integrated physical activity (n = 6), outdoor or walking activity (n = 5), technology-supported physical exercise (n = 3), and dancing (n = 2). Types of outcomes and length of follow-up varied widely. Effects were inconclusive, except for outdoor or walking activities showing an overall positive impact on physical outcomes. For eight interventions, we identified evidence on implementation barriers (b) and facilitators (f), including staff shortage (b), staff time resources (b), or ease of implementation for staff (f) and adaptability of interventions (f) or refusal to participate of people with dementia (b).

CONCLUSIONS

The results of our review provide a comprehensive overview on types, characteristics and effects of nurse-led physical activity interventions for people with dementia in nursing homes. Based on evidence from a range of study designs and sources, we came to the conclusion that all stakeholders involved considered physical activity interventions for people with dementia as useful and relevant. Outcome measures varied widely and a clear conclusion on effectiveness remains open.

Worldwide trend in research on Candida albicans and cancer correlations: a comprehensive bibliometric analysis

Objective

Candida albicans (C. albicans), an opportunistic pathogen, is implicated in the carcinogenesis of various cancers, thereby significantly impacting human health. This study conducts an in-depth analysis of the prevailing research dynamics concerning the relationship between C. albicans and cancer over the past decade, offering a comprehensive overview of the knowledge structure and emerging focal points in this field through bibliometric scrutiny.

Methods

A methodical quantitative and visual scrutiny of pertinent literature from the Web of Science Core Collection (WoSCC) spanning the previous decade was carried out employing VOS Viewer and CiteSpace software.

Results

From January 1, 2014, to January 1, 2024, a comprehensive corpus of 1,259 articles was delineated. Prominent research institutions included the Egyptian Knowledge Bank, Cairo University, and King Saud University. The top three prolific countries were the United States, China, and India. Among the authors, Mohamed, Gehad G., Mahmoud, Walaa H., and Netea, Mihai G., emerged as the most prolific, with Pfaller, Ma being distinguished as the most frequently cited author. The journal Molecules published the highest number of articles, while PLoS One had the highest citation count. Nature had the highest impact factor. The research focal points in this field encompassed the interactions between C. albicans and cancer, the correlation with oral cancer, the underlying mechanisms of C. albicans carcinogenic potential, as well as antifungal and anticancer therapies.

Conclusion

This investigation constitutes a pioneering bibliometric analysis elucidating the trends and advancements in research regarding the correlation between C. albicans and cancer. Said analyses uncover the prevailing research focal points and trends, offering insightful guidance for subsequent inquiry in this domain.

Systematic review registration

https://www.webofscience.com/wos/woscc/summary/df33afba-f843-41e8-b932-cb3678eb8243-e92e7316/relevance/1.

Rapid reviews methods series: guidance on rapid qualitative evidence synthesis

This paper forms part of a series of methodological guidance from the Cochrane Rapid Reviews Methods Group and addresses rapid qualitative evidence syntheses (QESs), which use modified systematic, transparent and reproducible methodsu to accelerate the synthesis of qualitative evidence when faced with resource constraints. This guidance covers the review process as it relates to synthesis of qualitative research. 'Rapid' or 'resource-constrained' QES require use of templates and targeted knowledge user involvement. Clear definition of perspectives and decisions on indirect evidence, sampling and use of existing QES help in targeting eligibility criteria. Involvement of an information specialist, especially in prioritising databases, targeting grey literature and planning supplemental searches, can prove invaluable. Use of templates and frameworks in study selection and data extraction can be accompanied by quality assurance procedures targeting areas of likely weakness. Current Cochrane guidance informs selection of tools for quality assessment and of synthesis method. Thematic and framework synthesis facilitate efficient synthesis of large numbers of studies or plentiful data. Finally, judicious use of Grading of Recommendations Assessment, Development and Evaluation approach for assessing the Confidence of Evidence from Reviews of Qualitative research assessments and of software as appropriate help to achieve a timely and useful review product.

Global trends in Cryptococcus and its interactions with the host immune system: a bibliometric analysis

Objectives

This manuscript undertakes a systematic examination of the research landscape concerning global Cryptococcus species and their dynamism with the host immune system spanning the past decade. It furnishes a detailed survey of leading knowledge institutions and critical focal points in this area, utilizing bibliometric analysis.

Methods

VOSviewer and CiteSpace software platforms were employed to systematically analyze and graphically depict the relevant literature indexed in the WoSCC database over the preceding ten years.

Results

In the interval between October 1, 2013, and October 1, 2023, a corpus of 795 publications was amassed. The primary research institutions involved in this study include Duke University, the University of Minnesota, and the University of Sydney. The leading trio of nations, in terms of publication volume, comprises the United States, China, and Brazil. Among the most prolific authors are Casadevall, Arturo; Wormley, Floyd L., Jr.; and Olszewski, Michal A., with the most highly cited author being Perfect, Jr. The most esteemed journal is Mbio, while Infection and Immunity commands the highest citation frequency, and the Journal of Clinical Microbiology boasts the most significant impact factor. Present research foci encompass the intricate interactions between Cryptococcus pathogenesis and host immunity, alongside immune mechanisms, complications, and immunotherapies.

Conclusion

This represents the first exhaustive scholarly review and bibliometric scrutiny of the evolving landscapes in Cryptococcus research and its interactions with the host immune system. The analyses delineated herein provide insights into prevailing research foci and trajectories, thus furnishing critical directions for subsequent inquiries in this domain.

CyPVICS: A framework to prevent or minimise cybersickness in immersive virtual clinical simulation

Cybersickness is a global issue affecting users of immersive virtual reality. However, there is no agreement on the exact cause of cybersickness. Taking into consideration how it can differ greatly from one person to another, it makes it even more difficult to determine the exact cause or find a solution. Because cybersickness excludes so many prospective users, including healthcare professionals, from using immersive virtual reality as a learning tool, this research sought to find solutions in existing literature and construct a framework that can be used to prevent or minimise cybersickness during immersive virtual clinical simulation (CyPVICS). The Bestfit Framework by Carrol and authors were used to construct the CyPVICS framework. The process started by conducting two separate literature searchers using the BeHEMoTh (for models, theories, and frameworks) and SPIDER (for primary research articles) search techniques. Once the literature searches were completed the models, theories and framework were used to construct a priori framework. The models' theories and frameworks were analysed to determine aspects relevant to causes, reducing, eliminating, and detecting cybersickness. The priori framework was expanded by, first coding the findings of the primary research study into the existing aspects of the priori framework. Once coded the aspects that could not be coded were added in the relevant category, for example causes. After reviewing 1567 abstracts and titles as part of the BeHEMoTh search string,19 full text articles, a total of 15 papers containing models, theories, and frameworks, were used to construct the initial CyPVICS framework. Once the initial CyPVICS was created, a total 904 primary research studies (SPIDER) were evaluated, based on their titles and abstracts, of which 100 were reviewed in full text. In total, 67 articles were accepted and coded to expand the initial CyPVICS framework. This paper presents the CyPVICS framework for use, not only in health professions' education, but also in other disciplines, since the incorporated models, theories, frameworks, and primary research studies were not specific to virtual clinical simulation.

Private groundwater contamination and risk management: A comparative scoping review of similarities, drivers and challenges across two socio-economically developed regions

Consolidation of multi-domain risk management research is essential for strategies facilitating the concerted government (educational) and population-level (behavioural) actions required to reduce microbial private groundwater contamination. However, few studies to date have synthesised this literature or sought to ascertain the causal generality and extent of supply contamination and preventive responses. In light of the Republic of Ireland (ROI) and Ontario's high reliance and research focus on private wells and consequent utility for empirical comparison, a scoping review of pertinent literature (1990-2022) from both regions was undertaken. The SPICE (Setting, Perspective, Intervention, Comparison, Evaluation) method was employed to inform literature searches, with Scopus and Web of Science selected as primary databases for article identification. The review identified 65 relevant articles (Ontario = 34, ROI = 31), with those investigating well user actions (n = 22) and groundwater quality (n = 28) the most frequent. A markedly higher pooled proportion of private supplies in the ROI exhibited microbial contamination (38.3 % vs. 4.1 %), despite interregional similarities in contamination drivers (e.g., weather, physical supply characteristics). While Ontarian well users demonstrated higher rates of historical (≥ 1) and annual well testing (90.6 % vs. 71.1 %; 39.1 % vs. 8.6 %) and higher rates of historical well treatment (42.3 % vs. 24.3 %), interregional levels of general supply knowledge were analogous (70.7 % vs. 71.0 %). Financial cost, organoleptic properties and residence on property during supply construction emerged as predictors of cognition and behaviour in both regions. Review findings suggest broad interregional similarities in drivers of supply contamination and individual-level risk mitigation, indicating that divergence in contamination rates may be attributable to policy discrepancies - particularly well testing incentivisation. The paucity of identified intervention-oriented studies further highlights the importance of renewed research and policy agendas for improved, targeted well user outreach and incentivised, convenience-based services promoting routine supply maintenance.

African primary research publications in plastic surgery: A PRISMA-S-compliant systematic review

BACKGROUND

Plastic surgery (PS) in Africa is a relatively young surgery specialty, and the number of available plastic surgeons on average is one or two surgeons per country in many African low-income countries. This systematic review aims to geographically map the research activities through scientific publications of African PS centres, between February 2012-February 2023.

METHODS

We searched four literature databases (Medline, Embase, Google Scholar and African Journal Online) and did a manual search. We included case reports, randomised controlled trials, and clinical, comparative, observational and multicentre studies conducted in Africa and published in English and French. In the Google Scholar database, we analysed the first 200 references (scientific articles) selected per relevance according to the Boolean terms. In the African Journals Online database, we analysed the references from the first five pages. The selected keywords were: burns, trauma reconstruction, pressure injuries, wound, cleft lip and palate, breast reconstruction, microsurgery, aesthetic surgery, face surgery, head and neck surgery, hand surgery, open fracture surgery, oculoplastic surgery, skin surgery, and soft tissue surgery.

RESULTS

We retrieved a total of 228 articles. Out of the 73 African centres we identified, 27 were in the North, 22 in the West, 8 in the East, 3 in the Centre, and 14 in the South. Most of the retrieved 228 articles involved burns (60, 26.31%), congenital abnormalities (52, 22.80%) and reconstruction (28,12.80%); however, other conditions, such as breast or skin cancer, hand surgery, microsurgery or aesthetics are emerging. The studies were case reports/case series (93, 40.78%), retrospective (78, 34.21%), prospective (36, 15.78%), randomised controlled studies (10, 4.38%), cross-sectional (5, 2,19%) and cohort (2, 0.87%).

CONCLUSIONS

Beyond burns, congenital abnormalities, or reconstructions, other PS indications are emerging, such as skin cancer, breast reconstruction, hand surgery, microsurgery, and aesthetics.

Responsible research in the practice of anatomy: Attributes relevant to body donors and human tissues sourced from them

Responsible Research involves setting moral examples before fellow academicians and the society as a whole. The concept of Responsible Research applies appropriately to ethical sourcing and handling of human tissues. The present study was undertaken to analyze present situation regarding implementation of attributes of Relevant Research in relation to body donors in anatomical research. A literature search of relevant, peer-reviewed, published articles was undertaken from indexed databases (Medline & PubMed, Scopus, Embase, CINAHL Plus, Web of Science and Google Scholar) for this study. The following attributes of Responsible Research were identified for possible intervention: the fact that research was conducted on human tissues from body donors and details regarding ethical handling thereof may be explicitly mentioned in method section; expression of gratitude towards body donors by authors may be included in acknowledgement section; editor's and publisher's note in support of adoption of attributes of Responsible Research may be included in published research. Adherence to best practices in terms of ethical guidelines requires anatomists to embrace a responsible approach in research from an inclusive perspective. Accordingly, practice of acknowledging the body donors may be nurtured and augmented to include the anonymised dead (human tissues from unclaimed bodies and unknown source) provided the research protocol received clearance from authorities concerned with ethical scrutiny. Moreover, adoption of the practice in review articles will enhance the boundaries of Responsible Research in anatomical science. Thus, few recommendations are proposed as epilogue for effectual implementation of the notion floated in present study.

The Implementation Success of Technology-Based Counseling in Dementia Care: Scoping Review

BACKGROUND

Implementing technology-based counseling as a complex intervention in dementia care poses challenges such as adaptation to stakeholders' needs and limited resources. While studies have examined the effectiveness of technology-based counseling, its successful implementation remains largely unexplored.

OBJECTIVE

We aimed to review the knowledge about the implementation success of technology-based counseling interventions for people with dementia and their informal caregivers.

METHODS

We conducted a scoping review and systematically searched CINAHL, the Cochrane Library including the Cochrane Central Register of Controlled Trials, MEDLINE, PsycINFO, and Web of Science Core Collection databases (April 2021) in combination with citation searching and web searching (November 2021). Studies reporting on technology-based counseling interventions for people with dementia or their informal caregivers were included, irrespective of the design. We used the conceptual framework for implementation outcomes to operationalize implementation success and applied the outcomes acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, penetration, and sustainability as categories to inform data extraction. We identified dimensions within the categories and synthesized results narratively and graphically.

RESULTS

We included 52 publications reporting on 27 technology-based counseling interventions. The studies were conducted in 9 countries and published between 1993 and 2021. As the design of the included studies varied, the number of participants and the type of data reported varied as well. The intervention programs were heterogeneous and ranged from single counseling interventions (such as helpline services) to counseling as part of a multicomponent program. Telephone, email, videoconferencing, social media (respectively chats), and web-based platforms were used for delivering counseling. We found data on appropriateness for all interventions and data on acceptability for most interventions, describing aspects such as consumer-perceived usefulness and helpfulness of services, as well as satisfaction. Information on the other categories of adoption, feasibility, fidelity, implementation cost, penetration, and sustainability was fragmented.

CONCLUSIONS

The scope and depth of information on conceptual categories of the implementation success of technology-based counseling for people with dementia and informal caregivers varied. The data only partially covered the concept of implementation success, which highlights the need for a systematic evaluation accompanying the implementation. The application of theoretical approaches for implementation and adherence to the framework for developing and evaluating complex interventions are required to promote the implementation of complex interventions and to comprehensively assess implementation success.

TRIAL REGISTRATION

PROSPERO CRD42021245473; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=245473.

Bioinspired silver nanoparticle-based nanocomposites for effective control of plant pathogens: A review

Plant pathogens, including bacteria, fungi, and viruses, pose significant challenges to the farming community due to their extensive diversity, the rapidly evolving phenomenon of multi-drug resistance (MDR), and the limited availability of effective control measures. Amid mounting global pressure, particularly from the World Health Organization, to limit the use of antibiotics in agriculture and livestock management, there is increasing consideration of engineered nanomaterials (ENMs) as promising alternatives for antimicrobial applications. Studies focusing on the application of ENMs in the fight against MDR pathogens are receiving increasing attention, driven by significant losses in agriculture and critical knowledge gaps in this crucial field. In this review, we explore the potential contributions of silver nanoparticles (AgNPs) and their nanocomposites in combating plant diseases, within the emerging interdisciplinary arena of nano-phytopathology. AgNPs and their nanocomposites are increasingly acknowledged as promising countermeasures against plant pathogens, owing to their unique physicochemical characteristics and inherent antimicrobial properties. This review explores recent advancements in engineered nanocomposites, highlights their diverse mechanisms for pathogen control, and draws attention to their potential in antibacterial, antifungal, and antiviral applications. In the discussion, we briefly address three crucial dimensions of combating plant pathogens: green synthesis approaches, toxicity-environmental concerns, and factors influencing antimicrobial efficacy. Finally, we outline recent advancements, existing challenges, and prospects in scholarly research to facilitate the integration of nanotechnology across interdisciplinary fields for more effective treatment and prevention of plant diseases.

Evaluation of marginal bone level, technical and biological complications between screw-retained and cement-retained all-ceramic implant-supported crowns on zirconia abutment: A systematic review and meta-analysis

PURPOSE

The purpose of this study was to evaluate the difference in marginal bone level, technical and biological complications between screw-retained and cemented all-ceramic implant-supported crowns fabricated on zirconia abutment at different follow-up periods.

MATERIALS AND METHODS

Independent search was conducted in Cochrane Library, EBSCO, and PubMed/PubMed Central/MEDLINE databases and the Google Scholar search engine for prospective studies and randomized controlled trials published between January 2014 and June 2023 evaluating the marginal bone level, technical and biological complications between screw-retained and cemented all-ceramic implant-supported crowns fabricated on zirconia abutment. Meta-analysis was conducted to assess the quantitative data on the marginal bone level and biological complications.

RESULTS

A total of eight studies were included for qualitative synthesis and six studies for quantitative synthesis. For marginal bone level, no statistically significant difference was observed (P = 0.83 and P = 0.69, respectively) during the follow-up period of 3 years and 5 years. For probing depth, the cemented group showed more amount of probing depth than the screw-retained group at a follow-up period of 3 years (P < 0.05) whereas no statistically significant difference was observed at a follow-up period of 5 years (P = 0.73). For bleeding on probing, the cemented group showed more probing depth than the screw-retained group at a follow-up period of 5 years (P = 0.10).

CONCLUSION

The evidence suggests that the screw-retained group showed no statistically significant difference in marginal bone level, comparatively fewer biological complications, and relatively higher technical complications than the cemented group at different follow-up periods.

Care of transgender patients by diagnostic radiographers: What can be learnt from the literature

INTRODUCTION

Transgender patients have described negative healthcare experiences, including discrimination and feeling unwelcome. Additionally, these patients are at risk of inadequate or unsafe care due to healthcare providers being unable to obtain and record transgender patients' correct gender and assigned birth sex. This literature review aims to review radiology and radiographer articles published since 2018 about transgender healthcare issues and make recommendations that can be applied by diagnostic radiographers, their managers and diagnostic radiography programme providers.

METHOD

A literature search used multiple databases containing peer-reviewed articles. Boolean operators and key words were utilised. Identified articles were searched to identify any articles not found by searching the databases. Themes and sub-themes from each paper were identified and discussed.

RESULTS

Three key themes were identified: education, systems and environment. Education sub-themes were knowledge and awareness. Systems sub-themes were recording gender correctly and discriminating/stigmatising policies. Environment sub-themes were transgender-friendly symbols and environmental dysphoria.

CONCLUSION

Transgender patients still face barriers to equitable care. Several recommendations were made based on the thematic discussion that could be applied by diagnostic radiographers, student radiographers, radiology managers, University training providers, and professional body organisations. Diagnostic radiography programmes should include training on both clinical topics and cultural competence. Radiology managers should display transgender-positive symbols in their departments and ensure their policies are non-discriminatory and non-stigmatising. Radiology hardware and software providers should provide the ability to record non-binary genders and birth-assigned sex.

IMPLICATIONS FOR PRACTICE

Transgender patients have the right to receive equitable care from diagnostic radiographers during their imaging examination and radiology attendance, and that any risks relating to their transgender status should be correctly managed with appropriate sensitivity.

A systematic review and meta-analysis of accuracy between protrusive interocclusal record and horizontal condylar guidance angle recording methods in dentulous patients

AIM

This systematic review and meta-analysis aimed to evaluate the accuracy of different methods used for measuring horizontal condylar guidance (HCG) angle in comparison with protrusive interocclusal record (IOR) for dentulous patients.

SETTINGS AND DESIGN

The design involves systematic review and meta-analysis following the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines.

MATERIALS AND METHODS

An electronic search was carried out by two reviewers in the Google Scholar search engine and the EBSCO host, Cochrane Library, and PubMed/MEDLINE databases for quasi-experimental studies, in vivo studies, and cross-sectional studies published from January 2005 to February 2023 determining the HCG angle in dentulous patients.

STATISTICAL ANALYSIS USED

Meta-analysis was performed to evaluate the quantitative data.

RESULTS

A total of 577 articles were identified, 29 analytical cross-sectional studies that fulfilled the eligibility criteria were included for qualitative synthesis and 26 studies were included for meta-analysis. A statistically significant difference was observed for the right and left HCG angles obtained by the panoramic radiograph method and cone-beam computed tomography (CBCT) method and for the right side HCG angle obtained by cephalogram method showing higher values than the protrusive IOR method. No statistically significant difference was observed for the left side HCG angle obtained by the cephalogram method and both the right and left side HCG angles obtained by the intraoral tracer method.

CONCLUSIONS

The panoramic radiograph, cephalogram, and CBCT obtained higher HCG angles in dentulous patients than the protrusive IOR method.

Cosmetic satisfaction and patient-reported outcomes following surgical treatment of single-suture craniosynostosis: a systematic review

PURPOSE

This study provides a systematic review on cosmetic satisfaction and other patient-reported outcomes (PROMs) of patients who underwent surgical treatment of SSC.

METHODS

A systematic review of all articles published from inception to 1 June 2022 was performed. Articles were included if they reported on subjective assessment of cosmetic satisfaction or other PROMs by patients or their families using questionnaires or interviews.

RESULTS

Twelve articles, describing 724 surgical treatments of SSC, met the inclusion criteria. Cosmetic satisfaction was evaluated in the following ways: 1) use of the VAS score, binary questions or a 5-point scale to rate general, facial or skull appearance; 2) use of an aesthetic outcome staging in which personal opinion was added to the treating surgeon's opinion; and 3) use of an evaluation of anatomical proportions of the skull and face. A trend towards an overall improvement in cosmetic satisfaction following surgical treatment of SSC was observed. Reported PROMs included general health, socioeconomic status, patients' and their families' rating of the normalcy and noticeability of their appearance and how much this bothered them, and patients' answers to the Youth Quality of Life with Facial Differences (YQOL-FD) questionnaire. No clear overall trend of the reported PROMs was identified.

CONCLUSION

This systematic review illuminates that there is a wide variation in outcomes for evaluating cosmetic satisfaction and other PROMs of patients who underwent surgical treatment of SSC, suggesting that further research is needed to develop an inclusive and uniform approach to assess these outcomes.

Rapid reviews methods series: Guidance on literature search

This paper is part of a series of methodological guidance from the Cochrane Rapid Reviews Methods Group. Rapid reviews (RR) use modified systematic review methods to accelerate the review process while maintaining systematic, transparent and reproducible methods. In this paper, we address considerations for RR searches. We cover the main areas relevant to the search process: preparation and planning, information sources and search methods, search strategy development, quality assurance, reporting, and record management. Two options exist for abbreviating the search process: (1) reducing time spent on conducting searches and (2) reducing the size of the search result. Because screening search results is usually more resource-intensive than conducting the search, we suggest investing time upfront in planning and optimising the search to save time by reducing the literature screening workload. To achieve this goal, RR teams should work with an information specialist. They should select a small number of relevant information sources (eg, databases) and use search methods that are highly likely to identify relevant literature for their topic. Database search strategies should aim to optimise both precision and sensitivity, and quality assurance measures (peer review and validation of search strategies) should be applied to minimise errors.

A global bibliometric and visualized analysis of gait analysis and artificial intelligence research from 1992 to 2022

Gait is an important basic function of human beings and an integral part of life. Many mental and physical abnormalities can cause noticeable differences in a person's gait. Abnormal gait can lead to serious consequences such as falls, limited mobility and reduced life satisfaction. Gait analysis, which includes joint kinematics, kinetics, and dynamic Electromyography (EMG) data, is now recognized as a clinically useful tool that can provide both quantifiable and qualitative information on performance to aid in treatment planning and evaluate its outcome. With the assistance of new artificial intelligence (AI) technology, the traditional medical environment has undergone great changes. AI has the potential to reshape medicine, making gait analysis more accurate, efficient and accessible. In this study, we analyzed basic information about gait analysis and AI articles that met inclusion criteria in the WoS Core Collection database from 1992-2022, and the VosViewer software was used for web visualization and keyword analysis. Through bibliometric and visual analysis, this article systematically introduces the research status of gait analysis and AI. We introduce the application of artificial intelligence in clinical gait analysis, which affects the identification and management of gait abnormalities found in various diseases. Machine learning (ML) and artificial neural networks (ANNs) are the most often utilized AI methods in gait analysis. By comparing the predictive capability of different AI algorithms in published studies, we evaluate their potential for gait analysis in different situations. Furthermore, the current challenges and future directions of gait analysis and AI research are discussed, which will also provide valuable reference information for investors in this field.

Facilitators and barriers to the implementation of surgical safety checklist: an integrative review

Surgical procedures pose an immense risk to patients, which can lead to various complications and adverse events. In order to safeguard patients' safety, the World Health Organization initiated the implementation of the Surgical Safety Checklist (SSC) in operating theatres worldwide. The aim of this integrative review was to summarize and evaluate the use and implementation of SSC, focusing on facilitators and barriers at the individual, professional, and organizational levels. This review followed closely the integrative review method by Whittemore and Knafl. An English literature search was conducted across three electronic databases (PubMed, CINAHL, and EMBASE) and other hand search references. Keywords search included: 'acute care', 'surgical', 'adult patients', 'pre-operative', 'intra-operative', and 'post-operative'. A total of 816 articles were screened by two reviewers independently and all articles that met the pre-specified inclusion criteria were retained. Data extracted from the articles were categorized, compared, and further analysed. A total of 34 articles were included with the majority being observational studies in developed and European countries. Checklists had been adopted in various surgical specialities. Findings indicated that safety checklists improved team cohesion and communication, resulting in enhanced patient safety. This resulted in high compliance rates as healthcare workers expressed the benefits of SSC to facilitate safety within operating theatres. Barriers included manpower limitations, hierarchical culture, lack of staff involvement and training, staff resistance, and appropriateness of checklist. Common facilitators and barriers at individual, professional, and organizational levels have been identified. Staff training and education, conducive workplace culture, timely audits, and appropriate checklist adaptations are crucial components for a successful implementation of the SSC. Methods have also been introduced to counter barriers of SSC.

Evaluation of accuracy between extraoral Gothic arch tracing and various other methods assessing horizontal condylar guidance angle in completely edentulous patients: A systematic review and meta-analysis

Aim

The aim of this systematic review and meta-analysis was to determine the accuracy of different methods of measuring horizontal condylar guidance (HCG) angle in comparison with extraoral Gothic arch tracing for completely edentulous patients.

Settings and Design

This was a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Materials and Methods

Two reviewers searched the EBSCOhost, Cochrane Library, and PubMed/MEDLINE databases and the Google Scholar search engine for in vivo studies, randomized controlled trials, cross-sectional studies, and quasi-experimental studies published from January 2005 to December 2022 on various other methods of determining HCG angle in completely edentulous patients compared with extraoral Gothic arch tracing method.

Statistical Analysis Used

Meta-analysis was conducted from the reported quantitative data.

Results

A total of 513 articles were obtained from different electronic databases, of which 22 studies were included for qualitative synthesis and 20 studies were included for meta-analysis. For the right side, a statistically significant difference was observed for panoramic radiograph (P < 0.05, pooled mean difference = 5.08 [2.17, 7]) and cephalogram (P < 0.05, pooled mean difference = 10.65 [8.81, 12.49]), whereas no statistically significant difference was observed for cone-beam computed tomography (CBCT) (P = 0.41, pooled mean difference = 4.39 [-6.10, 14.87]) and protrusive interocclusal wax record (P = 0.92, pooled mean difference = -0.45 [-9.62, 8.72]) as compared with extraoral Gothic arch tracing method. For the left side, a statistically significant difference was observed for panoramic radiograph (P < 0.05, pooled mean difference = 5.07 [1.95, 8.18]) and cephalogram (P < 0.05, pooled mean difference = 10.24 [8.65, 11.83]), whereas no statistically significant difference was observed for CBCT (P = 0.31, pooled mean difference = 4.05 [-3.74, 11.84]) and protrusive interocclusal wax record (P = 0.72, pooled mean difference = -1.21 [-7.86, 5.43]) as compared with extraoral Gothic arch tracing method.

Conclusion

The cephalogram and panoramic radiograph obtained higher HCG angles in completely edentulous patients than extraoral Gothic arch tracing.

Role of Perfusion Index and Pulse Variability Index in the Assessment of Neonatal Hemodynamics: A Systematic Review

Hemodynamic monitoring of neonates is crucial because neonates are easily and acutely susceptible to hemodynamic disturbances. As such, non-invasive monitoring of hemodynamics is preferable. It has been postulated that non-invasive pulse oximetry determines the perfusion index and pulse variability index and provides accurate measurements to predict hemodynamic changes in preterm or term infants. Equally, numerous studies have investigated the efficacy of perfusion and pulse variability indices in monitoring neonatal hemodynamics. The aim of this study was to systematically review studies that have delved into the role of perfusion and pulse variability indices in the assessment of neonatal hemodynamics. The study collected data from 2010-2023 using the patient, intervention, comparison, outcome (PICO) search strategy using the databases PubMed, Scopus, and Excerpta Medica database (Embase). A total of 616 articles were evaluated based on their appropriateness and relevance; we included seven studies. As per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic review. Our study concluded that these indices were effective in measuring hemodynamics.

Navigating the Landscape of Personalized Medicine: The Relevance of ChatGPT, BingChat, and Bard AI in Nephrology Literature Searches

BACKGROUND AND OBJECTIVES

Literature reviews are foundational to understanding medical evidence. With AI tools like ChatGPT, Bing Chat and Bard AI emerging as potential aids in this domain, this study aimed to individually assess their citation accuracy within Nephrology, comparing their performance in providing precise.

MATERIALS AND METHODS

We generated the prompt to solicit 20 references in Vancouver style in each 12 Nephrology topics, using ChatGPT, Bing Chat and Bard. We verified the existence and accuracy of the provided references using PubMed, Google Scholar, and Web of Science. We categorized the validity of the references from the AI chatbot into (1) incomplete, (2) fabricated, (3) inaccurate, and (4) accurate.

RESULTS

A total of 199 (83%), 158 (66%) and 112 (47%) unique references were provided from ChatGPT, Bing Chat and Bard, respectively. ChatGPT provided 76 (38%) accurate, 82 (41%) inaccurate, 32 (16%) fabricated and 9 (5%) incomplete references. Bing Chat provided 47 (30%) accurate, 77 (49%) inaccurate, 21 (13%) fabricated and 13 (8%) incomplete references. In contrast, Bard provided 3 (3%) accurate, 26 (23%) inaccurate, 71 (63%) fabricated and 12 (11%) incomplete references. The most common error type across platforms was incorrect DOIs.

CONCLUSIONS

In the field of medicine, the necessity for faultless adherence to research integrity is highlighted, asserting that even small errors cannot be tolerated. The outcomes of this investigation draw attention to inconsistent citation accuracy across the different AI tools evaluated. Despite some promising results, the discrepancies identified call for a cautious and rigorous vetting of AI-sourced references in medicine. Such chatbots, before becoming standard tools, need substantial refinements to assure unwavering precision in their outputs.

An idea to explore: Introduction to research methods

A curriculum description of a general introductory biology course titled "Introduction to Research Methods" is presented here. The course aims to provide a glimpse of biomedical research to students who have had no or limited exposure to research to encourage them to do research as freshmen. Thus, this course aims to better equip and invoke interest of high school and college students to undertake research by addressing specific knowledge gaps, recruiting students from underserved communities, and promoting teamwork, community learning, and equity. The course covers in broad strokes key topics like forming a hypothesis, chemical safety, research practices, chemical calculations, cloning and so forth, that is useful for undergraduate trainees initiated to research. The course also aims to put each topic in a social context that provides room for contemplating science for young trainee scientists thus addressing the gap between science and society. Student feedback reveals a positive learning experience and self-reported improvement of knowledge on the various topics taught. As a result, the concepts and pedagogical tools used in this course can be adapted to increase students' involvement and retainment in biomedical research from underrepresented communities.

Barriers to mental health treatment in primary care practice in low- and middle-income countries in a post-covid era: A systematic review

General primary care workers and family physicians are a crucial work force in managing the mental health of people in any given region. However, the barriers they face in low- and middle-income countries (LMICs) may be worsened by the pandemic. This review aims to bring together evidence about mental health treatment challenges experienced by people in LMICs in primary care settings. The review focuses on the shortage of essential mental healthcare services, stigma and lack of competent primary care professionals in establishing these services and their importance in the COVID-19 pandemic context. The systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the search strategy included keyword search terms (MeSH) to perform a search across three electronic databases - Critical Appraisal Skills Program assessed PubMed, SpringerLink, and Cochrane and quality of the articles. The articles selected were analyzed through thematic analysis to identify the main themes and conclude our findings. Findings indicate that out of 1792 publications found, 14 studies matched the desired criteria for the studies. Endnotes, database search filters, and Covidence data extraction tools were used to generate the relevant articles in this study. This study shows that primary care institutions have financial and management issues in providing mental health services and a shortage of competent mental health experts in primary care, especially mental health-trained family physicians. The study also identifies community stigma as the most prevalent barrier to seeking mental health therapy, reflecting the lack of community health education in LMICs.

Characterization of controlled trials on probiotic supplementation to dairy calves: A scoping review

The objective of this scoping review was to identify, describe, and characterize the literature on probiotic supplementation in dairy calves. Eligible studies were nonrandomized, quasi-randomized and randomized controlled trials in English, Spanish, or Portuguese that evaluated the effect of probiotic supplementation on growth and health of dairy calves. The search strategies were based on a modification of the PICO (Population, Intervention, Comparator, Outcome) framework and used synonyms and words related to "dairy calves" (population), "probiotics" (intervention), and "growth and health measurements" (outcomes). No restrictions for publication year or language were applied. Searches were conducted in Biosis, CAB Abstracts, Medline, Scopus, and the Dissertations and Theses Database. In total, the search identified 4,467 records, of which 103 studies (110 controlled trials) met the inclusion criteria. The studies were published between 1980 and 2021 and originated from 28 countries. Trials were randomized (80.0%), nonrandomized (16.4%), and quasi-randomized (3.6%), ranging in sample size from 5 to 1,801 dairy calves (mode = 24; average = 64). Enrolled calves were frequently Holstein (74.5%), males (43.6%), and younger than 15 d at the beginning of probiotic supplementation (71.8%). Often, trials were conducted in research facilities (47.3%). Trials evaluated probiotics with single or multiple species of the same genus: Lactobacillus (26.4%), Saccharomyces (15.4%), Bacillus (10.0%), Enterococcus (3.6%), or multiple species of various genera (31.8%). Eight trials did not report the probiotic species used. Lactobacillus acidophilus and Enterococcus faecium were the species most supplemented to calves. The duration of probiotic supplementation ranged from 1 to 462 d (mode = 56; average = 50). In trials with a constant dose, it ranged from 4.0 × 106 to 3.7 × 1011 cfu/calf per day. Most probiotics were administered mixed solely into feed (88.5%; whole milk, milk replacer, starter, or total mixed ration) and less frequently orally as a drench or oral paste (7.9%). Most trials evaluated weight gain (88.2%) as a growth indicator and fecal consistency score (64.5%) as a health indicator. Our scoping review summarizes the breadth of controlled trials evaluating probiotic supplementation in dairy calves. Differences in intervention design (mode of probiotic administration, dose, and duration of probiotic supplementation) and outcomes evaluation (type and methods) justify future efforts toward standardized guidelines in clinical trials.

Evaluation of implant stability and increase in bone height in indirect sinus lift done with the osseodensification and osteotome technique: A systematic review and meta-analysis

STATEMENT OF PROBLEM

Whether the use of osseodensification burs for indirect sinus lift improves primary implant stability and bone height as compared with the osteotome technique to overcome the challenges of the pneumatization of the maxillary sinus and vertical bone loss after extraction in the edentulous posterior maxilla is unclear.

PURPOSE

The purpose of this systematic review and meta-analysis was to evaluate the difference in primary implant stability and increase in bone height in indirect sinus lift using osseodensification and the osteotome technique.

MATERIAL AND METHODS

Two independent reviewers searched the MEDLINE/PubMed, EBSCO, and Cochrane Library databases and the Google Scholar Search engine for randomized clinical trials, nonrandomized clinical trials, and cross-sectional studies published from 2000 to 2022 to identify relevant studies evaluating the primary implant stability and increase in bone height in indirect sinus lift using osseodensification and the osteotome technique. A meta-analysis was performed to evaluate the cumulative data on primary implant stability and increase in bone height.

RESULTS

A total of 8521 titles were obtained by electronic database search, of which 75 were duplicates. A total of 8446 abstracts were screened, and 8411 that were not relevant to the topic were excluded. Thirty-five articles were eligible for full-text assessment. After the screening of full-text articles as per the selection criteria, 26 studies were excluded. For qualitative synthesis, 9 studies were included. For quantitative synthesis, 5 studies were included. For an increase in bone height, no statistically significant difference was observed (I² = 89%, P=.15, pooled mean difference=0.30 [-0.11, 0.70], CI=95%). For primary implant stability, the osseodensification group showed higher values than the osteotome group (I² = 20%, P<.001, pooled mean difference=10.61 [7.14, 14.08], CI=95%).

CONCLUSIONS

The evidence obtained from quantitative analysis of the studies determined that the osseodensification group showed higher primary implant stability than the osteotome group (P<.05). However, for mean increase in bone height, there was no statistically significant difference between the groups.

Impact of star ratings on Medicare health plan enrollment: A systematic literature review

BACKGROUND

The Medicare star ratings program was developed by the Centers for Medicare and Medicaid Services in 2007 as an approach to evaluate health plan performance and quality.

OBJECTIVE

This study aimed to identify and narratively describe studies that attempted to quantitatively assess the impact that Medicare star ratings have on health plan enrollment.

METHODS

A systematic literature review (SLR) was conducted of PubMed MEDLINE, Embase, and Google to identify articles that quantitatively assessed the impact of Medicare star ratings on health plan enrollment. Inclusion criteria consisted of studies that conducted quantitative analyses to estimate the potential impact. Exclusion criteria consisted of qualitative studies and studies that did not directly assess plan enrollment.

RESULTS

This SLR identified 10 studies that sought to measure the impact of Medicare star ratings on plan enrollment. Nine of the studies found that plan enrollment increased in accordance with increases in star ratings or that plan disenrollment increased with decreases in star ratings. One study conducted of data before the implementation of the Medicare quality bonus payment found contradictory results from one year to the next, whereas all the studies that assessed data after implementation found increases in enrollment in accordance to increases in star ratings or increases in disenrollment for decreases in star ratings. One concerning finding from some of the articles included in the SLR is that increases in star ratings had less of an impact on enrollment in higher-rated plans for ethnic and racial minorities and older adults.

CONCLUSIONS

Increases in Medicare star ratings led to statistically significant increases in health plan enrollment and decreases in health plan disenrollment. Future studies are needed to assess whether this increase has a causal association or is caused by additional factors outside of or in addition to increases in overall star rating.

Supplementary strategies identified additional eligible studies in qualitative systematic reviews

BACKGROUND AND OBJECTIVES

There is an increasing number of qualitative systematic reviews being produced. Searching for qualitative literature to include in these systematic reviews is, however, more challenging and may result in less than favorable recall. Database searches relying solely on key elements of the research question may not retrieve all relevant qualitative studies for synthesis, and supplementary searches may be pertinent to complement the searches. This study aimed to determine, if a) supplementary search strategies (citation searches and alternative search strategies) were able to identify relevant publications for qualitative systematic reviews that were nonretrievable, when conducting traditional database searches based on key elements; and b) to investigate the total number of identified publications when combining traditional database searches with these supplementary search strategies.

METHODS

From a previous study, a gold standard of 12 qualitative reviews including 101 PubMed-indexed publications was used. One of the reviews had only one included publication and in one review, the two included studies were identifiable in PubMed. In the remaining 10 reviews, 61 publications were retrievable through traditional database searches, and 37 were nonidentifiable. The 61 publications were used as basis for possible identification of the 37 publications by using the supplementary search strategies: citations searches (review of reference lists, PubMed "Cited by" function; Scopus "Cited by" function, Citationchaser, CoCites plugin for PubMed) and alternative search strategies (PubMed "similar articles" function; Scopus "Related documents based on references").

RESULTS

Traditional database searches retrieved 62.4% of the 101 publications. Citations searches in Scopus, Citationchaser and CoCites identified 21 (56.8%) of the 37 remaining publications. The PubMed "Cited by" function did not identify any of the 37 publications. The alternative search strategies, the PubMed "Similar articles" together with Scopus "Related documents based on references"-function) identified 15 (40.5%) of the 37 publications. Together, these supplementary search strategies identified 25 (67.6%) of the 37 publications, resulting in an overall retrieval of 87.1%, when combining traditional database searches and supplementary search strategies.

CONCLUSION

The results of this study indicate that supplementary search strategies (citation searches and alternative search strategies) increase the retrieval potential, when searching for qualitative publications and should be included, when identifying literature for qualitative reviews.

When policy hits the road: Safe System in Victoria's policy environment

The Safe System approach has globally become the dominant means to address road trauma, with bodies such as the Organisation for Economic Co-operation and Development, European Union, World Bank, World Health Organization, National and State Australian Governments and the United Nations encouraging its uptake. However, whilst there has been significant growth in its application, limited attention has been paid to the extent to which Safe System is integrated into public policy. Anecdotally, as an early adopter of the Safe System approach, Victoria's experience acts an instructive case for other jurisdictions applying the concept to policy. Using an interpretive qualitative case study approach, this study explored whether a) Safe System has influenced Victoria's road safety policy development to date, and b) if the extent to which Safe System has been integrated into public policy. Semi-structured interviews were conducted with Victoria's strategic, government-based, road safety decision-makers. Interviews were structured around the World Health Organization's Policy Development Process framework. The results indicate that Safe System has an implicit role in Victoria's road safety policy. When viewed through the lens of a policy integration framework, the analysis found only partial integration of the Safe System concept within road safety policy in Victoria, with limited flow-on effects of the framework on the policy frame, subsystems, goals and instruments. Governance frameworks, management structures and policy objectives are all influenced by Safe System, with the road safety problem having clearly been established as a cross-cutting issue. However, additional refinement of policy instruments to articulate the role of Safe System as well actively employing the approach in the policy development process is required. These findings confirm that while Victoria's use of Safe System is noteworthy, it may be beneficial for the framework to feature more prominently in policy for it to have the intended effect on road safety.

A Systematic Review of Using Deep Learning Technology in the Steady-State Visually Evoked Potential-Based Brain-Computer Interface Applications: Current Trends and Future Trust Methodology

The significance of deep learning techniques in relation to steady-state visually evoked potential- (SSVEP-) based brain-computer interface (BCI) applications is assessed through a systematic review. Three reliable databases, PubMed, ScienceDirect, and IEEE, were considered to gather relevant scientific and theoretical articles. Initially, 125 papers were found between 2010 and 2021 related to this integrated research field. After the filtering process, only 30 articles were identified and classified into five categories based on their type of deep learning methods. The first category, convolutional neural network (CNN), accounts for 70% (n = 21/30). The second category, recurrent neural network (RNN), accounts for 10% (n = 3/30). The third and fourth categories, deep neural network (DNN) and long short-term memory (LSTM), account for 6% (n = 30). The fifth category, restricted Boltzmann machine (RBM), accounts for 3% (n = 1/30). The literature's findings in terms of the main aspects identified in existing applications of deep learning pattern recognition techniques in SSVEP-based BCI, such as feature extraction, classification, activation functions, validation methods, and achieved classification accuracies, are examined. A comprehensive mapping analysis was also conducted, which identified six categories. Current challenges of ensuring trustworthy deep learning in SSVEP-based BCI applications were discussed, and recommendations were provided to researchers and developers. The study critically reviews the current unsolved issues of SSVEP-based BCI applications in terms of development challenges based on deep learning techniques and selection challenges based on multicriteria decision-making (MCDM). A trust proposal solution is presented with three methodology phases for evaluating and benchmarking SSVEP-based BCI applications using fuzzy decision-making techniques. Valuable insights and recommendations for researchers and developers in the SSVEP-based BCI and deep learning are provided.

Technology-Based Counselling for People with Dementia and Their Informal Carers: A Systematic Review and Meta-Analysis

BACKGROUND

Information technology can enhance timely and individual support for people with Alzheimer's disease and other dementias and their informal carers.

OBJECTIVE

To review the effectiveness of technology-based counselling interventions for people with dementia and informal carers.

METHODS

Randomized controlled trials of remote dementia counselling interventions were included. We searched CINAHL, Cochrane Library, MEDLINE, PsycINFO, and the Web of Science Core Collection (April 2021) in combination with citation tracking and free web searching (October to November 2021). We provide meta-analyses for caregiver depression, burden, and self-efficacy/mastery and structured reporting for other outcomes. The Grading of Recommendations Assessment, Development and Evaluation approach and the Risk of Bias 2 tool were applied.

RESULTS

We included five randomized controlled trials involving 880 participants. Interventions were provided for carers (four studies) or dyads (one study). Carers were predominantly women and were the spouses or children of people with dementia. Counselling was delivered via telephone or videoconference with two to 23 sessions over 1 to 12 months. Control groups received educational and resource materials only, standard (helpline) services, non-directive support, or home visits. Meta-analysis for our primary outcome, depressive symptoms in carers, revealed no statistically significant effect (SMD -0.15; 95% CI -0.40 to 0.10). There were also no significant effects on burden and self-efficacy/mastery. We rated the certainty of evidence as low to very low and all outcomes at an overall high risk of bias.

CONCLUSION

The effectiveness of technology-based counselling interventions for people with dementia and informal carers remains uncertain. Theory-based approaches are needed for the development and evaluation of these interventions.

The association between social class and the impact of treatment for mental health problems: a systematic review and narrative synthesis

PURPOSE

This systematic review aimed to synthesise all quantitative literature on the association between social class and the effectiveness of interventions for mental health disorders.

METHODS

Systematic literature searches (inception-March 2021) were conducted across 7 databases, and all quantitative studies meeting inclusion criteria, examining the impact of social class on access to treatment, or intervention effectiveness, or the impact of treatment on social mobility, were synthesised narratively.

RESULTS

Evidence suggests that lower social class may be associated with reduced access to primary and secondary mental health care and increased likelihood of access via crisis services, and patients of lower social class may not benefit from all mental health interventions, with reduced effectiveness. While limited, there was some indication that psychosocial interventions could encourage increased employment rates.

CONCLUSION

Social class is associated with the effectiveness of psychological interventions, and should be considered when designing new interventions to prevent barriers to access and improve effectiveness.

Effectiveness of cognitive behavioural therapy-based interventions for maternal perinatal depression: a systematic review and meta-analysis

BACKGROUND

Depression during the perinatal period (during pregnancy and the year after childbirth) is common and associated with a range of negative effects for mothers, infants, family members, and wider society. Although existing evidence suggests cognitive behavioral therapy (CBT) based interventions are effective for perinatal depression, less is known about the effect of CBT-based interventions on important secondary outcomes, and a number of potential clinical and methodological moderators have not been examined.

METHODS

A systematic review and meta-analysis primarily examined the effectiveness of CBT-based interventions for perinatal depression on symptoms of depression. Secondary aims examined the effectiveness of CBT-based interventions for perinatal depression on symptoms of anxiety, stress, parenting, perceived social support, and perceived parental competence; and explored clinical and methodological moderators potentially associated with effectiveness. A systematic search of electronic databases and other sources was performed up to November 2021. We included randomized controlled trials comparing CBT-based interventions for perinatal depression with control conditions allowing for the isolation of the effects of CBT.

RESULTS

In total, 31 studies (5291 participants) were included in the systematic review and 26 studies (4658 participants) were included in the meta-analysis. The overall effect size was medium (hedges g = - 0.53 [95% CI - 0.65 to - 0.40]); with high heterogeneity. Significant effects were also found for anxiety, individual stress, and perceived social support, however few studies examined secondary outcomes. Subgroup analysis identified type of control, type of CBT, and type of health professional as significant moderators of the main effect (symptoms of depression). Some concerns of risk of bias were present in the majority of studies and one study had a high risk of bias.

CONCLUSIONS

CBT-based interventions for depression during the perinatal period appear effective, however results should be interpreted with caution given high levels of heterogeneity and low quality of included studies. There is a need to further investigate possibly important clinical moderators of effect, including the type of health professional delivering interventions. Further, results indicate a need to establish a minimum core data set to improve the consistency of secondary outcome collection across trials and to design and conduct trials with longer-term follow-up periods.

TRIAL REGISTRATION

CRD42020152254 .

Rapid methods for identifying barriers and solutions to improve access to community health services: a scoping review protocol

OBJECTIVES

Low attendance rates for community health services reflect important barriers that prevent people from receiving the care they need. Services and health systems that seek to advance Universal Health Coverage need to understand and act on these factors. Formal qualitative research is the best way to elicit barriers and identify potential solutions, however traditional approaches take months to complete and can be very expensive. We aim to map the methods that have been used to rapidly elicit barriers to accessing community health services and identify potential solutions.

METHODS AND ANALYSIS

We will search MEDLINE, Embase, the Cochrane Library and Global Health for empirical studies that use rapid methods (<14 days) to elicit barriers and potential solutions from intended service beneficiaries. We will exclude hospital-based and 100% remotely delivered services. We will include studies conducted in any country from 1978 to present. We will not limit by language. Two reviewers will independently perform screening and data extraction, with disagreements resolved by a third reviewer. We will tabulate the different approaches used and present data on time, skills and financial requirements for each approach, as well as the governance framework and any strengths and weaknesses presented by the study authors. We will follow Joanna Briggs Institute (JBI) scoping review guidance and report the review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews.

ETHICS AND DISSEMINATION

Ethical approval is not required. We will share our findings in the peer-reviewed literature, at conferences, and with WHO policymakers working in this space.

REGISTRATION

Open Science Framework (https://osf.io/a6r2m).

Plastic waste reprocessing for circular economy: A systematic scoping review of risks to occupational and public health from legacy substances and extrusion

The global plastics reprocessing sector is likely expand as the circular economy becomes more established and efforts to curb plastic pollution increase. Via a critical systematic scoping review (PRISMA-ScR), we focused on two critical challenges for occupational and public health that will require consideration along with this expansion: (1) Legacy contamination in secondary plastics, addressing the risk of materials and substances being inherited from the previous use and carried (circulated or transferred) through into new products when reprocessed material enters its subsequent use phase (recycled, secondary plastic); and, (2) Extrusion of secondary plastics during the final stage of conventional mechanical reprocessing. Based on selected literature, we semi-quantitatively assessed nine risk scenarios and ranked them according to the comparative magnitude of risk to human health. Our analysis highlights that despite stringent regulation, industrial diligence and enforcement, occasionally small amounts of potentially hazardous substances contained in waste plastics are able to pass through established safeguards and re-enter (cascade into) the next use phase (product cycle) after being recycled. Although many of these 'inherited' chemical substances are present at concentrations unlikely to pose a serious and imminent threat, their existence may indicate a wider or possible increase in pollution dispersion. Our assessment indicates that the highest risk results from exposure to these substances during extrusion by mechanical reprocessors in contexts where only passive ventilation, dilution and dispersion are used as control measures. Our work sets the basis to inform improved future risk management protocols for a non-polluting circular economy for plastics.

Systematized Nomenclature of Medicine-Clinical Terminology (SNOMED CT) Clinical Use Cases in the Context of Electronic Health Record Systems: Systematic Literature Review

BACKGROUND

The Systematized Medical Nomenclature for Medicine-Clinical Terminology (SNOMED CT) is a clinical terminology system that provides a standardized and scientifically validated way of representing clinical information captured by clinicians. It can be integrated into electronic health records (EHRs) to increase the possibilities for effective data use and ensure a better quality of documentation that supports continuity of care, thus enabling better quality in the care process. Even though SNOMED CT consists of extensively studied clinical terminology, previous research has repeatedly documented a lack of scientific evidence for SNOMED CT in the form of reported clinical use cases in electronic health record systems.

OBJECTIVE

The aim of this study was to explore evidence in previous literature reviews of clinical use cases of SNOMED CT integrated into EHR systems or other clinical applications during the last 5 years of continued development. The study sought to identify the main clinical use purposes, use phases, and key clinical benefits documented in SNOMED CT use cases.

METHODS

The Cochrane review protocol was applied for the study design. The application of the protocol was modified step-by-step to fit the research problem by first defining the search strategy, identifying the articles for the review by isolating the exclusion and inclusion criteria for assessing the search results, and lastly, evaluating and summarizing the review results.

RESULTS

In total, 17 research articles illustrating SNOMED CT clinical use cases were reviewed. The use purpose of SNOMED CT was documented in all the articles, with the terminology as a standard in EHR being the most common (8/17). The clinical use phase was documented in all the articles. The most common category of use phases was SNOMED CT in development (6/17). Core benefits achieved by applying SNOMED CT in a clinical context were identified by the researchers. These were related to terminology use outcomes, that is, to data quality in general or to enabling a consistent way of indexing, storing, retrieving, and aggregating clinical data (8/17). Additional benefits were linked to the productivity of coding or to advances in the quality and continuity of care.

CONCLUSIONS

While the SNOMED CT use categories were well supported by previous research, this review demonstrates that further systematic research on clinical use cases is needed to promote the scalability of the review results. To achieve the best out-of-use case reports, more emphasis is suggested on describing the contextual factors, such as the electronic health care system and the use of previous frameworks to enable comparability of results. A lesson to be drawn from our study is that SNOMED CT is essential for structuring clinical data; however, research is needed to gather more evidence of how SNOMED CT benefits clinical care and patient safety.