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Broadbent P, Walsh D, Katikireddi SV, Gallagher C, Dundas R, McCartney G. Is Austerity Responsible for the Stalled Mortality Trends Across Many High-Income Countries? A Systematic Review. INTERNATIONAL JOURNAL OF SOCIAL DETERMINANTS OF HEALTH AND HEALTH SERVICES 2024:27551938241255041. [PMID: 38767141 DOI: 10.1177/27551938241255041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
This article systematically reviews evidence evaluating whether macroeconomic austerity policies impact mortality, reviewing high-income country data compiled through systematic searches of nine databases and gray literature using pre-specified methods (PROSPERO registration: CRD42020226609). Eligible studies were quantitatively assessed to determine austerity's impact on mortality. Two reviewers independently assessed eligibility and risk of bias using ROBINS-I. Synthesis without meta-analysis was conducted due to heterogeneity. Certainty of evidence was assessed using the GRADE framework. Of 5,720 studies screened, seven were included, with harmful effects of austerity policies demonstrated in six, and no effect in one. Consistent harmful impacts of austerity were demonstrated for all-cause mortality, life expectancy, and cause-specific mortality across studies and different austerity measures. Excess mortality was higher in countries with greater exposure to austerity. Certainty of evidence was low. Risk of bias was moderate to critical. A typical austerity dose was associated with 74,090 [-40,632, 188,792] and 115,385 [26,324, 204,446] additional deaths per year. Austerity policies are consistently associated with adverse mortality outcomes, but the magnitude of this effect remains uncertain and may depend on how austerity is implemented (e.g., balance between public spending reductions or tax rises, and distributional consequences). Policymakers should be aware of potential harmful health effects of austerity policies.
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Affiliation(s)
- Philip Broadbent
- University of Glasgow MRC/CSO Social and Public Health Sciences Unit, Glasgow, UK
| | - David Walsh
- University of Glasgow School of Health and Wellbeing, Glasgow, UK
| | | | | | - Ruth Dundas
- University of Glasgow MRC/CSO Social and Public Health Sciences Unit, Glasgow, UK
| | - Gerry McCartney
- University of Glasgow College of Social Sciences, Glasgow, UK
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Muhammad SA, Olaoye SO, Umar FK. Are preoperative serum cancer antigen 125 levels a prognostic factor for outcome in epithelial ovarian cancer? A systematic review. Niger Med J 2024; 65:108-118. [PMID: 39005560 PMCID: PMC11240199 DOI: 10.60787/nmj-v65i2-418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/16/2024] Open
Abstract
Background Most patients with epithelial ovarian cancers (EOC) present with advanced-stage disease because of non-specific symptoms and lack of reliable strategies for early diagnosis. Cancer antigen 125 (CA-125) is suggested as a useful prognostic biomarker, its serum level is raised in over 80.0% of patients with EOC. Primary debulking surgery (PDS) followed by chemotherapy is the conventional treatment, but neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS) is offered to patients with unresectable disease. There are inconsistencies regarding the role of preoperative CA-125 serum levels to adopt in stratifying patients for treatment choice that offers the most benefit. This review aimed to determine the role of preoperative CA-125 levels in predicting optimal cytoreduction and the association between optimal cytoreduction and survival outcome in patients with EOC. Methodology Three electronic databases CINAHL, Cochrane library and PubMed were searched for potentially relevant articles from 2016 to 2021 on the role of preoperative CA-125 levels in predicting optimal cytoreduction and survival in patients with epithelial ovarian carcinomas. Conclusion In patients who underwent NACT-IDS, a lower preoperative CA-125 value is a predictor of optimal cytoreduction and an increase in preoperative CA-125 value is consistently associated with a decrease in optimal cytoreduction. There was insufficient data to assess overall survival. However, a raised preoperative CA-125 level is poor predictor of chance of achieving optimal cytoreduction and the rate of optimal cytoreduction was a weak predictor of overall survival in women who had primary debulking surgery.
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Affiliation(s)
- Shittu Adamu Muhammad
- Department of Obstetrics and Gynaecology, Federal Medical Centre Gusau, Zamfara State, Nigeria
| | - Stephen Oyewole Olaoye
- Department of Obstetrics and Gynaecology, Federal Medical Centre Gusau, Zamfara State, Nigeria
| | - Farouk Kabir Umar
- Department of Radiology, Usman Danfodiyo University Teaching Hospital, Sokoto, Sokoto State, Nigeria
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SHIMONOVICH MICHAL, CAMPBELL MHAIRI, THOMSON RACHELM, BROADBENT PHILIP, WELLS VALERIE, KOPASKER DANIEL, McCARTNEY GERRY, THOMSON HILARY, PEARCE ANNA, KATIKIREDDI SVITTAL. Causal Assessment of Income Inequality on Self-Rated Health and All-Cause Mortality: A Systematic Review and Meta-Analysis. Milbank Q 2024; 102:141-182. [PMID: 38294094 PMCID: PMC10938942 DOI: 10.1111/1468-0009.12689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 10/18/2023] [Accepted: 11/13/2023] [Indexed: 02/01/2024] Open
Abstract
Policy Points Income is thought to impact a broad range of health outcomes. However, whether income inequality (how unequal the distribution of income is in a population) has an additional impact on health is extensively debated. Studies that use multilevel data, which have recently increased in popularity, are necessary to separate the contextual effects of income inequality on health from the effects of individual income on health. Our systematic review found only small associations between income inequality and poor self-rated health and all-cause mortality. The available evidence does not suggest causality, although it remains methodologically flawed and limited, with very few studies using natural experimental approaches or examining income inequality at the national level. CONTEXT Whether income inequality has a direct effect on health or is only associated because of the effect of individual income has long been debated. We aimed to understand the association between income inequality and self-rated health (SRH) and all-cause mortality (mortality) and assess if these relationships are likely to be causal. METHODS We searched Medline, ISI Web of Science, Embase, and EconLit (PROSPERO: CRD42021252791) for studies considering income inequality and SRH or mortality using multilevel data and adjusting for individual-level socioeconomic position. We calculated pooled odds ratios (ORs) for poor SRH and relative risk ratios (RRs) for mortality from random-effects meta-analyses. We critically appraised included studies using the Risk of Bias in Nonrandomized Studies - of Interventions tool. We assessed certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation framework and causality using Bradford Hill (BH) viewpoints. FINDINGS The primary meta-analyses included 2,916,576 participants in 38 cross-sectional studies assessing SRH and 10,727,470 participants in 14 cohort studies of mortality. Per 0.05-unit increase in the Gini coefficient, a measure of income inequality, the ORs and RRs (95% confidence intervals) for SRH and mortality were 1.06 (1.03-1.08) and 1.02 (1.00-1.04), respectively. A total of 63.2% of SRH and 50.0% of mortality studies were at serious risk of bias (RoB), resulting in very low and low certainty ratings, respectively. For SRH and mortality, we did not identify relevant evidence to assess the specificity or, for SRH only, the experiment BH viewpoints; evidence for strength of association and dose-response gradient was inconclusive because of the high RoB; we found evidence in support of temporality and plausibility. CONCLUSIONS Increased income inequality is only marginally associated with SRH and mortality, but the current evidence base is too methodologically limited to support a causal relationship. To address the gaps we identified, future research should focus on income inequality measured at the national level and addressing confounding with natural experiment approaches.
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Affiliation(s)
- MICHAL SHIMONOVICH
- MRC/CSO Social and Public Health Sciences Unit, School of Health and WellbeingUniversity of Glasgow
| | - MHAIRI CAMPBELL
- MRC/CSO Social and Public Health Sciences Unit, School of Health and WellbeingUniversity of Glasgow
| | - RACHEL M. THOMSON
- MRC/CSO Social and Public Health Sciences Unit, School of Health and WellbeingUniversity of Glasgow
| | - PHILIP BROADBENT
- MRC/CSO Social and Public Health Sciences Unit, School of Health and WellbeingUniversity of Glasgow
| | - VALERIE WELLS
- MRC/CSO Social and Public Health Sciences Unit, School of Health and WellbeingUniversity of Glasgow
| | - DANIEL KOPASKER
- MRC/CSO Social and Public Health Sciences Unit, School of Health and WellbeingUniversity of Glasgow
| | - GERRY McCARTNEY
- School of Social and Political SciencesUniversity of Glasgow
| | - HILARY THOMSON
- MRC/CSO Social and Public Health Sciences Unit, School of Health and WellbeingUniversity of Glasgow
| | - ANNA PEARCE
- MRC/CSO Social and Public Health Sciences Unit, School of Health and WellbeingUniversity of Glasgow
| | - S. VITTAL KATIKIREDDI
- MRC/CSO Social and Public Health Sciences Unit, School of Health and WellbeingUniversity of Glasgow
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Al Masri A, Schiffner U, Mourad MS, Schmoeckel J, Joseph P, Splieth CH. The impact of bias of underlying literature in guidelines on its recommendations: assessment of the German fluoride guideline. Eur Arch Paediatr Dent 2024; 25:65-73. [PMID: 38007707 PMCID: PMC10942900 DOI: 10.1007/s40368-023-00854-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 10/20/2023] [Indexed: 11/28/2023]
Abstract
PURPOSE The significance of the underlying literature in clinical guidelines can be weakened by the risk of bias, which could negatively affect the recommendations. Especially in controversial matters, such as fluoride use for caries prevention in children, biased results may be not reliable and lead to incorrect conclusions. This study was performed to detect bias in underlying literature of the German guideline for caries prevention using fluoride in children, where no consensus was reached between paediatricians and paediatric dentists. METHODS Three tools used for risk of bias assessments of different study designs were RoB 2 for RCTs, ROBINS-I for non-randomized studies, and ROBIS for systematic reviews. For each study cited in the guideline two independent risk of bias assessments were performed. Disagreements were resolved by consensus. RESULTS Out of 58 papers, 48.3% (n = 28) showed high risk of bias, with the majority in sections regarding fluoride tablets, fluoridated toothpaste, and paediatricians' recommendations. 9 out of 20 recommendations and statements were based on studies with high risk of bias, all of which were in these three controversial sections. 13 out of 29 RCTs showed high risk of bias (44.8%), as all 13 non-randomized trials did, while only 2 of 16 (12.5%) systematic reviews had high risk of bias. CONCLUSION Considering risk of bias of cited studies in clinical guidelines may result in substantial changes in its recommendations and aid in reaching consensus. Efforts should be made to assess risk of bias of underlying literature in future clinical guidelines.
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Affiliation(s)
- A Al Masri
- Department of Preventive and Pediatric Dentistry, Greifswald University Dental Clinics, Walther-Rathenau-Straße 42a, 17475, Greifswald, Germany.
| | - U Schiffner
- Department for Periodontology, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
| | - M S Mourad
- Department of Preventive and Pediatric Dentistry, Greifswald University Dental Clinics, Walther-Rathenau-Straße 42a, 17475, Greifswald, Germany
- Department of Orthodontics, Greifswald University Dental Clinics, Walther-Rathenau-Straße 42a, 17475, Greifswald, Germany
| | - J Schmoeckel
- Department of Preventive and Pediatric Dentistry, Greifswald University Dental Clinics, Walther-Rathenau-Straße 42a, 17475, Greifswald, Germany
| | - P Joseph
- Department of Preventive and Pediatric Dentistry, Greifswald University Dental Clinics, Walther-Rathenau-Straße 42a, 17475, Greifswald, Germany
| | - C H Splieth
- Department of Preventive and Pediatric Dentistry, Greifswald University Dental Clinics, Walther-Rathenau-Straße 42a, 17475, Greifswald, Germany
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King JD, Cheng S, Fok MLY, Pappa S, Munjiza J. Interventions to improve the sleep quality of adults with personality disorder: A systematic review. Personal Ment Health 2024; 18:19-31. [PMID: 37674476 DOI: 10.1002/pmh.1591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/18/2023] [Accepted: 08/14/2023] [Indexed: 09/08/2023]
Abstract
Poor quality sleep is common for people who have a diagnosis of personality disorder (PD). Core cognitive and behavioral features of PD may cause and perpetuate poor sleep, but to date, no review has collated the evidence on the efficacy of interventions to improve sleep quality for people with PD. Structured searches for interventional studies among adults with PD and reporting validated measures of sleep quality were conducted up to November 2022 in multiple databases. Single-case reports were excluded. Study quality was assessed with standardized risk of bias tools. Unreported data was sought systematically from authors. This review was pre-registered with an international prospective register of systematic reviews (PROSPERO) (CRD42021282105). Of the 3503 identified studies, nine met inclusion criteria, representing a range of psychological, pharmaceutical, and other interventions and outcome measures. Meta-analytic methods were not feasible because of the serious risk of bias in all studies, and results were therefore synthesized narratively. There is limited and low-quality evidence of the effects of a variety of interventions to improve the sleep quality of people living with PD. Further research might consider specifically including people diagnosed with PD in trials of sleep interventions and using sleep outcome measures in trials of established PD treatments.
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Affiliation(s)
- Jacob D King
- Central and North West London NHS Foundation Trust, London, UK
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
| | - Shee Cheng
- Central and North West London NHS Foundation Trust, London, UK
| | | | - Sofia Pappa
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
- West London NHS Trust, Southhall, UK
| | - Jasna Munjiza
- Central and North West London NHS Foundation Trust, London, UK
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
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San A, Rahman RK, Sanmugananthan P, Dubé MD, Panico N, Ariwodo O, Shah V, D’Amico RS. Health-Related Quality of Life Outcomes in Meningioma Patients Based upon Tumor Location and Treatment Modality: A Systematic Review and Meta-Analysis. Cancers (Basel) 2023; 15:4680. [PMID: 37835374 PMCID: PMC10571784 DOI: 10.3390/cancers15194680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/14/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
Patients with meningiomas may have reduced health-related quality of life (HRQoL) due to postoperative neurological deficits, cognitive dysfunction, and psychosocial burden. Although advances in surgery and radiotherapy have improved progression-free survival rates, there is limited evidence regarding treatment outcomes on HRQoL. This review examines HRQoL outcomes based on tumor location and treatment modality. A systematic search in PubMed yielded 28 studies with 3167 patients. The mean age was 54.27 years and most patients were female (70.8%). Approximately 78% of meningiomas were located in the skull base (10.8% anterior, 23.3% middle, and 39.7% posterior fossae). Treatment modalities included craniotomy (73.6%), radiotherapy (11.4%), and endoscopic endonasal approach (EEA) (4.0%). The Karnofsky Performance Scale (KPS) was the most commonly utilized HRQoL instrument (27%). Preoperative KPS scores > 80 were associated with increased occurrence of postoperative neurological deficits. A significant difference was found between pre- and post-operative KPS scores for anterior/middle skull base meningiomas (SBMs) in comparison to posterior (SBMs) when treated with craniotomy. Post-craniotomy SF-36 scores were lower for posterior SBMs in comparison to those in the anterior and middle fossae. Risk factors for poor neurological outcomes include a high preoperative KPS score and patients with posterior SBMs may experience a greater burden in HRQoL.
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Affiliation(s)
- Ali San
- College of Osteopathic Medicine, Kansas City University, Kansas City, MO 64106, USA
| | - Raphia K. Rahman
- Department of Neurological Surgery, Riverside University Health System, Moreno Valley, CA 92501, USA
| | | | | | - Nicholas Panico
- Lake Erie College of Osteopathic Medicine, Erie, PA 16509, USA
| | - Ogechukwu Ariwodo
- Philadelphia College of Osteopathic Medicine, Moultrie, GA 31768, USA
| | - Vidur Shah
- College of Osteopathic Medicine, Kansas City University, Kansas City, MO 64106, USA
| | - Randy S. D’Amico
- Department of Neurological Surgery, Lenox Hill Hospital, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY 11030, USA;
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Sendra-Pérez C, Sanchez-Jimenez JL, Marzano-Felisatti JM, Encarnación-Martínez A, Salvador-Palmer R, Priego-Quesada JI. Reliability of threshold determination using portable muscle oxygenation monitors during exercise testing: a systematic review and meta-analysis. Sci Rep 2023; 13:12649. [PMID: 37542055 PMCID: PMC10403529 DOI: 10.1038/s41598-023-39651-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 07/28/2023] [Indexed: 08/06/2023] Open
Abstract
Over the last few years, portable Near-Infrared Spectroscopy (NIRS) technology has been suggested for determining metabolic/ventilator thresholds. This systematic review and meta-analysis aimed to assess the reliability of a portable muscle oxygenation monitor for determining thresholds during exercise testing. The proposed PICO question was: Is the exercise intensity of muscle oxygenation thresholds, using portable NIRS, reliable compared with lactate and ventilatory thresholds for exercise intensity determined in athletes? A search of Pubmed, Scopus and Web of Science was undertaken and the review was conducted following PRISMA guidelines. Fifteen articles were included. The domains which presented the highest biases were confounders (93% with moderate or high risk) and participant selection (100% with moderate or high risk). The intra-class correlation coefficient between exercise intensity of the first ventilatory or lactate threshold and the first muscle oxygenation threshold was 0.53 (obtained with data from only 3 studies), whereas the second threshold was 0.80. The present work shows that although a portable muscle oxygenation monitor has moderate to good reliability for determining the second ventilatory and lactate thresholds, further research is necessary to investigate the mathematical methods of detection, the capacity to detect the first threshold, the detection in multiple regions, and the effect of sex, performance level and adipose tissue in determining thresholds.
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Affiliation(s)
- Carlos Sendra-Pérez
- Research Group in Sports Biomechanics (GIBD), Department of Physical Education and Sports, Faculty of Physical Activity and Sport Sciences, Universitat de València, C/Gascó Oliag, 3, 46010, Valencia, Spain
| | - Jose Luis Sanchez-Jimenez
- Research Group in Sports Biomechanics (GIBD), Department of Physical Education and Sports, Faculty of Physical Activity and Sport Sciences, Universitat de València, C/Gascó Oliag, 3, 46010, Valencia, Spain
| | - Joaquín Martín Marzano-Felisatti
- Research Group in Sports Biomechanics (GIBD), Department of Physical Education and Sports, Faculty of Physical Activity and Sport Sciences, Universitat de València, C/Gascó Oliag, 3, 46010, Valencia, Spain
| | - Alberto Encarnación-Martínez
- Research Group in Sports Biomechanics (GIBD), Department of Physical Education and Sports, Faculty of Physical Activity and Sport Sciences, Universitat de València, C/Gascó Oliag, 3, 46010, Valencia, Spain
- Red Española de Investigación del Rendimiento Deportivo en Ciclismo y Mujer (REDICYM), Consejo Superior de Deportes (CSD), Facultad de Ciencias de la Actividad Física y del Deporte, Campus d'Ontinyent, Laboratorio Biomecánica, Avda. Conde de Torrefiel n° 22, 46870, Ontinyent, Spain
| | - Rosario Salvador-Palmer
- Red Española de Investigación del Rendimiento Deportivo en Ciclismo y Mujer (REDICYM), Consejo Superior de Deportes (CSD), Facultad de Ciencias de la Actividad Física y del Deporte, Campus d'Ontinyent, Laboratorio Biomecánica, Avda. Conde de Torrefiel n° 22, 46870, Ontinyent, Spain
- Biophysics and Medical Physics Group, Department of Physiology, Universitat de València, Faculty of Medicine and Odontology, Avd. Blasco Ibañez 15, 46010, Valencia, Spain
| | - Jose I Priego-Quesada
- Research Group in Sports Biomechanics (GIBD), Department of Physical Education and Sports, Faculty of Physical Activity and Sport Sciences, Universitat de València, C/Gascó Oliag, 3, 46010, Valencia, Spain.
- Red Española de Investigación del Rendimiento Deportivo en Ciclismo y Mujer (REDICYM), Consejo Superior de Deportes (CSD), Facultad de Ciencias de la Actividad Física y del Deporte, Campus d'Ontinyent, Laboratorio Biomecánica, Avda. Conde de Torrefiel n° 22, 46870, Ontinyent, Spain.
- Biophysics and Medical Physics Group, Department of Physiology, Universitat de València, Faculty of Medicine and Odontology, Avd. Blasco Ibañez 15, 46010, Valencia, Spain.
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Ma Y, Li B, Cui Y, Zhang Z, Jiang S, Yan X, He J, Du Y. The Top 100 Cited Articles on Acupuncture in the Last 20 Years: A Bibliometric Analysis. Complement Med Res 2023; 30:393-407. [PMID: 37263232 DOI: 10.1159/000530778] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 04/14/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Acupuncture has gained increasing international attention in recent decades. The act of incorporating acupuncture treatment into the routine treatment of COVID-19 in China drove us to review the 100 most influential articles of the last 20 years to learn about the current status and trends of acupuncture. METHOD Articles related to acupuncture from January 1, 2001, to July 4, 2022, were searched in the Clarivate Analytics Web of Science Core Collection database. The top 100 most cited publications were selected, and information was extracted. Software such as VOSviewer, GraphPad Prism, Scimago Graphica, and CiteSpace were used to visualize and analyze the extracted data. RESULT The 100 most cited articles were identified, with an average of 218 citations (range: 131-625). The majority of the top 100 articles were from the USA (n = 53). The institution that published the most highly cited papers was Harvard University (n = 16). The most influential team was Klaus Linde's group. Pain was the top-ranked journal in terms of the number of publications. The largest clusters for co-occurrence keyword analysis focused on acupuncture and electroacupuncture analgesia and brain imaging responses to acupuncture stimulation via functional MRI. The two highest strength burst keywords were "randomized controlled trials" and "osteoarthritis," with "randomized controlled trials" being a consistent burst keyword from 2011 to the present. CONCLUSION This study provides insight into articles of historical significance in the field of acupuncture through bibliometric analysis. These data should provide clinicians and researchers with insight into future directions related to acupuncture. Hintergrund Die Akupunktur hat in den vergangenen Jahrzehnten zunehmend die internationale Aufmerksamkeit auf sich gezogen. Die Einbeziehung der Akupunktur in die Routinebehandlung von COVID-19 in China hat uns dazu veranlasst, die 100 einflussreichsten Artikel der letzten 20 Jahre zu überprüfen, um etwas über den aktuellen Stand und die Trends in der Akupunktur zu erfahren. Methode Artikel mit Bezug zu Akupunktur vom 1. Januar 2001 bis 4. Juli 2022 wurden in der Clarivate Analytics Web of Science Core Collection Datenbank gesucht. Die 100 am häufigsten zitierten Veröffentlichungen wurden ausgewählt und die Informationen wurden extrahiert. Visualisierung und Analyse der extrahierten Daten erfolgten mithilfe der Software VOSviewer, GraphPad Prism, Scimago Graphica und CiteSpace. Ergebnis Es wurden die 100 am häufigsten zitierten Artikel ermittelt mit durchschnittlich 218 Zitierungen (Spanne: 131 bis 625). Der Großteil der 100 meistzitierten Artikel stammte aus den Vereinigten Staaten ( n = 53). Die Institution, die die meisten zitierten Artikel veröffentlichte, war die Harvard-Universität ( n = 16). Das einflussreichste Team war die Gruppe von Klaus Linde. Was die Zahl der Veröffentlichungen betrifft, war Pain die am häufigsten zitierte Zeitschrift. Bei der Analyse der Koinzidenz von Schlüsselwörtern lag der Fokus der größten Cluster auf Akupunktur-und Elektroakupunktur-Analgesie sowie auf den Reaktionen auf Akupunkturstimulation in den bildgebenden Untersuchungen des Gehirns mittels funktioneller MRT. Die beiden stärksten Burst-Schlüsselwörter waren “randomisierte kontrollierte Studien” und “Osteoarthritis,” wobei “randomisierte kontrollierte Studien” von 2011 bis heute durchgängig ein Burst-Schlüsselwort ist. Schlussfolgerung Diese Studie bietet einen Einblick in historisch bedeutsame Artikel auf dem Gebiet der Akupunktur mittels bibliometrischer analyse. Diese Daten sollen Klinikern und Forschern einen Einblick in zukünftige Richtungen im Zusammenhang mit Akupunktur geben.
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Affiliation(s)
- Yuping Ma
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China,
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China,
| | - Bo Li
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Ying Cui
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Zixing Zhang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Shiyi Jiang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Xiong Yan
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Junpeng He
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Yuzheng Du
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
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Pinna Pintor M, Suhrcke M, Hamelmann C. The impact of economic sanctions on health and health systems in low-income and middle-income countries: a systematic review and narrative synthesis. BMJ Glob Health 2023; 8:bmjgh-2022-010968. [PMID: 36759018 PMCID: PMC9923316 DOI: 10.1136/bmjgh-2022-010968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/30/2022] [Indexed: 02/11/2023] Open
Abstract
INTRODUCTION Economic sanctions restrict customary commercial and financial ties between states to induce change in political constitution or conduct of the targeted country. Although the stated goals of sanctions often include humanitarian objectives, prospective procedures for health risk assessment are not regularly incorporated in their implementation. Moreover, past experience suggests that the burden of economic isolation may fall on the civilian population. We present key findings from a WHO-sponsored evidence review on the impact of economic sanctions on health and health systems in low-income and middle-income countries, aiming at comprehensive coverage and explicit consideration of issues of causality and mechanisms. METHODS Broad searches of PubMed and Google Scholar (1970-2021) were designed to retrieve published and grey English-language literature expected to cut across disciplines, terminology and research methods. Studies providing an impact estimate were rated by a structured assessment based on ROBINS-I risk of bias domains, synthesised via vote counting and contextualised into the broader literature through a thematic synthesis. RESULTS Included studies (185) were mostly peer-reviewed, mostly single-country, largely coming from medicine and public health, and chiefly concerned with three important target countries-Iraq, Haiti and Iran. Among studies providing impact estimates (31), most raised multiple risk-of-bias concerns. Excluding those with data integrity issues, a significant proportion (21/27) reported consistently adverse effects of sanctions across examined outcomes, with no apparent association to assessed quality, focus on early episodes or publication period. The thematic synthesis highlights the complexity of sanctions, their multidimensionality and the possible mechanisms of impact. CONCLUSION Future research should draw on qualitative knowledge to collect domain-relevant data, combining it with better estimation techniques and study design. However, only the adoption of a risk assessment framework based on prospective data collection and monitoring can certify claims that civilians are adequately protected.
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Affiliation(s)
- Matteo Pinna Pintor
- Living Conditions, Luxembourg Institute of Socio-Economic Research, Esch-sur-Alzette, Luxembourg
| | - Marc Suhrcke
- Living Conditions, Luxembourg Institute of Socio-Economic Research, Esch-sur-Alzette, Luxembourg,University of York Centre for Health Economics, York, UK
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10
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Piers R, Williams JM, Sharpe H. Review: Can digital mental health interventions bridge the 'digital divide' for socioeconomically and digitally marginalised youth? A systematic review. Child Adolesc Ment Health 2023; 28:90-104. [PMID: 36510375 DOI: 10.1111/camh.12620] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/23/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Digital mental health interventions (DMHIs) have the potential to improve the efficiency, accessibility and effectiveness of mental health services for young people, with the potential to reach socioeconomically and digitally marginalised young people with mental health needs who would otherwise not seek help in person. This review aims to investigate the characteristics, acceptability and efficacy of DMHIs specifically developed for socioeconomically and digitally marginalised youth. METHOD Key databases were searched widely and systematically (EMBASE, MEDLINE, PsycINFO, OpenGrey). Final inclusion in this review required studies to evaluate DMHIs specifically targeting socioeconomically and digitally marginalised children and young people through a broad range of research designs. RESULTS Ten studies, describing seven DHMIs, were included in this review. Studies varied in terms of methodology, population, intervention, outcome measures, technologies used and methodological quality. Qualitative and quantitative results are synthesised across three key phenomena of interest: effectiveness, acceptability and feasibility. Findings suggest that there is moderate but limited evidence supporting DMHIs for improving mental health outcomes among these populations. CONCLUSIONS While there is moderate evidence suggesting that digitally delivered interventions can be effective in improving mental health outcomes among socioeconomically and digitally marginalised youth, more high-quality research is needed in order to determine whether DMHIs can fully bridge the so-called 'digital divide'.
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Affiliation(s)
- Rowena Piers
- Department of Clinical and Health Psychology, School of Health in Social Science, The University of Edinburgh, Edinburgh, UK
| | - Joanne M Williams
- Department of Clinical and Health Psychology, School of Health in Social Science, The University of Edinburgh, Edinburgh, UK
| | - Helen Sharpe
- Department of Clinical and Health Psychology, School of Health in Social Science, The University of Edinburgh, Edinburgh, UK
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11
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Zou C, Harvard A, Qian J, Fox BI. A systematic review of digital health technologies for the care of older adults during COVID-19 pandemic. Digit Health 2023; 9:20552076231191050. [PMID: 37529545 PMCID: PMC10388634 DOI: 10.1177/20552076231191050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/13/2023] [Indexed: 08/03/2023] Open
Abstract
Objective During the Coronavirus Disease 2019 (COVID-19) pandemic, digital health technologies (DHTs) became increasingly important, especially for older adults. The objective of this systematic review was to synthesize evidence on the rapid implementation and use of DHTs among older adults during the COVID-19 pandemic. Methods A structured, electronic search was conducted on 9 November 2021, and updated on 5 January 2023, among five databases to select DHT interventional studies conducted among older adults during the pandemic. The bias of studies was assessed using Version 2 of the Cochrane Risk-of-Bias Tool for randomized trials (RoB 2) and Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I). Results Among 20 articles included in the review, 14 (70%) focused on older adults with chronic diseases or symptoms, such as dementia or cognitive impairment, type 2 diabetes, and obesity. DHTs included traditional telehealth interventions via telephone, video, and social media, as well as emerging technologies such as Humanoid Robot and Laser acupuncture teletherapy. Using RoB 2 and ROBINS-I, four studies (20%) were evaluated as high or serious overall risk of bias. DHTs have shown to be effective, feasible, acceptable, and satisfactory for older adults during the COVID-19 pandemic compared to usual care. In addition, some studies also highlighted challenges with technology, hearing difficulties, and communication barriers within the vulnerable population. Conclusions During the COVID-19 pandemic, DHTs had the potential to improve various health outcomes and showed benefits for older adults' access to health care services.
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Affiliation(s)
- Chenyu Zou
- Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL, USA
| | - Abbey Harvard
- Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL, USA
| | - Jingjing Qian
- Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL, USA
| | - Brent I Fox
- Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL, USA
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12
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Emami E, Harnagea H, Shrivastava R, Ahmadi M, Giraudeau N. Patient satisfaction with e-oral health care in rural and remote settings: a systematic review. Syst Rev 2022; 11:234. [PMID: 36309732 PMCID: PMC9617039 DOI: 10.1186/s13643-022-02103-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/16/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND During the past decade e-oral health technology has been used to address the oral health care challenges in rural and remote settings. This review systematically evaluated the literature on patient satisfaction with e-oral health care in rural and remote communities. METHODS The systematic review included interventional and observational studies published between 1946 and 2021, in the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and Global Health. Patient satisfaction with received oral health care using self-reported measures, at any time after the intervention, was the main outcome of the review. The other primary outcomes were undesirable consequences of the health care (e-health or conventional) such as diagnostic error. The secondary outcomes considered were waiting time, number of visits, travel, and the cost of oral health care. Two independent researchers assessed the risk of bias using the ROBINS-I risk of bias assessment tool for non-randomized studies. RESULTS Among 898 studies, 16 studies were included in the review. In most studies reporting patient satisfaction, all patients had shown willingness for teleconsultation for a dental problem and they were mostly satisfied due to saved travel time, saved working days, and prompt treatment onset. Most of the studies acknowledged teledentistry as a cost-effective and cost-saving method. Moreover, the teledentistry consultations showed diagnostic reliability and validity values comparable to conventional dental consultations. The majority of studies were considered level 4 and 3b, due to limited sample populations, analysis based on limited alternatives or costs, non-consistent sensitivity analysis, failure to appropriately control known confounders, and/or failure to carry out an appropriate follow-up of patients. CONCLUSION Available evidence indicates that e-oral health is associated with higher patient satisfaction and has been found to be an effective and reliable method for patients in rural and remote areas. Therefore, in these areas, the use of e-oral health should be encouraged. However, methodological inconsistencies in the current evidence suggest the need for long-term cohort studies and clinical trials, as well as cost analysis on e-oral health in rural settings. SYSTEMATIC REVIEW REGISTRATION The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42016039942.
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Affiliation(s)
- Elham Emami
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, 2001 McGill College, suite 500, Montreal, QC, Canada.
| | - Hermina Harnagea
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, 2001 McGill College, suite 500, Montreal, QC, Canada
| | - Richa Shrivastava
- Faculty of Dentistry, Université de Montréal, Montréal, Québec, Canada.,Present Address: Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Motahareh Ahmadi
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, 2001 McGill College, suite 500, Montreal, QC, Canada
| | - Nicolas Giraudeau
- UMR 5112, CEPEL, CNRS, Université de Montpellier, Montpellier, France
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13
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Raghis TR, Alsulaiman TMA, Mahmoud G, Youssef M. Efficiency of maxillary total arch distalization using temporary anchorage devices (TADs) for treatment of Class II-malocclusions: A systematic review and meta-analysis. Int Orthod 2022; 20:100666. [PMID: 35871982 DOI: 10.1016/j.ortho.2022.100666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 06/20/2022] [Accepted: 07/01/2022] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To evaluate the treatment effects and post-treatment stability of the maxillary total arch distalization using TADs during the non-extraction treatment of class II malocclusions. MATERIALS AND METHODS Study involved an electronic search followed by hand searching for randomized and non-randomized clinical studies about maxillary total arch distalization using TADs. After data extraction and risk of bias assessment, meta-analysis was performed for dental, skeletal and soft tissue changes using the Generic-inverse variance approach by use of the mean difference and random-effect model. RESULTS In total, 1788 articles were identified, 88 full texts were screened and 22 studies were found eligible; 17 of them were included in the quantitative analysis. The means of distalization/distal tipping of the maxillary first molar were 4mm/3.17° in adults, 3.95mm/1.61° in adolescents after treatment with the Modified C-Palatal plate (MCPP), while they were 2.44mm/2.91° with the inter-radicular mini-screws. Both MCPP's treatment in adults and inter-radicular mini-screws resulted in significant intrusion of U6 (1.64 and 0.75mm, respectively), while insignificant extrusion of U6 was resulted in adolescents treated by MCPP. MCPP appliances resulted in palatal inclination/extrusion of maxillary incisors U1 (6.77°/2mm in adults, 7.46°/3.14mm in adolescents). In contrast, inter-radicular mini-screws resulted in less palatal less amount of palatal inclination/insignificant intrusion of U1 (2.42°/0.14mm). MCPP treatment also resulted in significant changes in the skeletal measurements (SNA, ANB, occlusal and mandibular planes). Insignificant differences were found between subgroups in the retraction amount of maxillary incisors, as well as the upper and lower lips. In the follow-up of adolescents treated with MCPP, a significant amount of mesial movement, mesial tipping, and extrusion (2.94mm, 2.84°, and 3.94mm, respectively) was found. However, skeletal and occlusal corrections of the Class II relationship were maintained. CONCLUSIONS Maxillary total arch distalization using TADs can be an effective and stable treatment procedure. However, RCTs or prospective cohort studies are highly recommended to establish a clinical evidence regarding their efficiency.
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Affiliation(s)
- Tuqa Rashad Raghis
- Department of Orthodontics, Faculty of Dentistry, Damascus University, Damascus, Syria.
| | | | - Ghiath Mahmoud
- Department of Orthodontics, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Mohamed Youssef
- Department of Orthodontics, Faculty of Dentistry, Damascus University, Damascus, Syria
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14
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Higgen S, Mueller JT, Mösko M. Review: Universal mental health interventions for young students in adverse environments - a systematic review of evaluated interventions. Child Adolesc Ment Health 2022; 27:281-293. [PMID: 34327812 DOI: 10.1111/camh.12493] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/05/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Universal classroom-based interventions are a useful method to increase the mental health and resilience in children. Resilience describes the process that leads to a positive development despite adversities. It comprises the seven resources access to material resources, relationships, identity, power and control, cultural adherence, social justice and cohesion. Yet there is a paucity of studies evaluating interventions that enhance resilience in children exposed to adverse childhood experiences. METHOD This systematic review investigates whether universal classroom-based interventions can increase the seven resilience-related resources in children that live in adverse environments. Search strings were formulated based on an adapted version of the PICO criteria. The risk of bias of the individual studies was assessed using the ROBINS-I tool. RESULTS Seventeen studies were included in the review, of which 15 found an increase in resilience. The resource power and control was targeted in every intervention. Not one intervention included all seven resources. Intervention outcomes related mostly to just two of the resources (power and control and identity) and were rarely linked to what was being trained in the intervention. CONCLUSION The results of this review show that classroom-based interventions are suitable for promoting resilience in children living in adverse environments. Yet more high-quality studies are needed that evaluate the effectiveness of universal interventions on children living in adverse environments and specifically the effectiveness of training each of the seven resources. Future developments of school-based interventions should be careful to target and assess all resilience-related resources.
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Affiliation(s)
- Sanna Higgen
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jessica T Mueller
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Head-Neck-Tumor Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mike Mösko
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Applied Human Sciences, Magdeburg-Stendal University of Applied Sciences, Stendal, Germany
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15
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Dinneen E, Grierson J, Almeida-Magana R, Clow R, Haider A, Allen C, Heffernan-Ho D, Freeman A, Briggs T, Nathan S, Mallett S, Brew-Graves C, Muirhead N, Williams NR, Pizzo E, Persad R, Aning J, Johnson L, Oxley J, Oakley N, Morgan S, Tahir F, Ahmad I, Dutto L, Salmond JM, Kelkar A, Kelly J, Shaw G. NeuroSAFE PROOF: study protocol for a single-blinded, IDEAL stage 3, multi-centre, randomised controlled trial of NeuroSAFE robotic-assisted radical prostatectomy versus standard robotic-assisted radical prostatectomy in men with localized prostate cancer. Trials 2022; 23:584. [PMID: 35869497 PMCID: PMC9306247 DOI: 10.1186/s13063-022-06421-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/24/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Robotic radical prostatectomy (RARP) is a first-line curative treatment option for localized prostate cancer. Postoperative erectile dysfunction and urinary incontinence are common associated adverse side effects that can negatively impact patients' quality of life. Preserving the lateral neurovascular bundles (NS) during RARP improves functional outcomes. However, selecting men for NS may be difficult when there is concern about incurring in positive surgical margin (PSM) which in turn risks adverse oncological outcomes. The NeuroSAFE technique (intra-operative frozen section examination of the neurovascular structure adjacent prostate margin) can provide real-time pathological consult to promote optimal NS whilst avoiding PSM. METHODS NeuroSAFE PROOF is a single-blinded, multi-centre, randomised controlled trial (RCT) in which men are randomly allocated 1:1 to either NeuroSAFE RARP or standard RARP. Men electing for RARP as primary treatment, who are continent and have good baseline erectile function (EF), defined by International Index of Erectile Function (IIEF-5) score > 21, are eligible. NS in the intervention arm is guided by the NeuroSAFE technique. NS in the standard arm is based on standard of care, i.e. a pre-operative image-based planning meeting, patient-specific clinical information, and digital rectal examination. The primary outcome is assessment of EF at 12 months. The primary endpoint is the proportion of men who achieve IIEF-5 score ≥ 21. A sample size of 404 was calculated to give a power of 90% to detect a difference of 14% between groups based on a feasibility study. Oncological outcomes are continuously monitored by an independent Data Monitoring Committee. Key secondary outcomes include urinary continence at 3 months assessed by the international consultation on incontinence questionnaire, rate of biochemical recurrence, EF recovery at 24 months, and difference in quality of life. DISCUSSION NeuroSAFE PROOF is the first RCT of intra-operative frozen section during radical prostatectomy in the world. It is properly powered to evaluate a difference in the recovery of EF for men undergoing RARP assessed by patient-reported outcome measures. It will provide evidence to guide the use of the NeuroSAFE technique around the world. TRIAL REGISTRATION NCT03317990 (23 October 2017). Regional Ethics Committee; reference 17/LO/1978.
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Affiliation(s)
- Eoin Dinneen
- Division of Surgery & Interventional Science, University College London, London, UK.
- University College Hospital London, Department of Urology, Westmoreland Street Hospital, 6-18 Westmoreland Street, W1G 8PH, London, UK.
| | - Jack Grierson
- Division of Surgery & Interventional Science, University College London, London, UK
- University College Hospital London, Department of Urology, Westmoreland Street Hospital, 6-18 Westmoreland Street, W1G 8PH, London, UK
| | | | - Rosie Clow
- Division of Surgery & Interventional Science, University College London, London, UK
- University College Hospital London, Department of Urology, Westmoreland Street Hospital, 6-18 Westmoreland Street, W1G 8PH, London, UK
| | - Aiman Haider
- University College Hospital London, Department of Histopathology, 235 Euston Road, Bristol, NW1 2BU, UK
| | - Clare Allen
- University College Hospital London, Department of Urology, Westmoreland Street Hospital, 6-18 Westmoreland Street, W1G 8PH, London, UK
| | - Daniel Heffernan-Ho
- University College Hospital London, Department of Urology, Westmoreland Street Hospital, 6-18 Westmoreland Street, W1G 8PH, London, UK
| | - Alex Freeman
- University College Hospital London, Department of Histopathology, 235 Euston Road, Bristol, NW1 2BU, UK
| | - Tim Briggs
- University College Hospital London, Department of Urology, Westmoreland Street Hospital, 6-18 Westmoreland Street, W1G 8PH, London, UK
| | - Senthil Nathan
- University College Hospital London, Department of Urology, Westmoreland Street Hospital, 6-18 Westmoreland Street, W1G 8PH, London, UK
| | - Susan Mallett
- Division of Medicine, University College London, Charles Bell House, 43-45 Foley Street, Sheffield, W1W 7JN, UK
| | - Chris Brew-Graves
- Division of Medicine, University College London, Charles Bell House, 43-45 Foley Street, Sheffield, W1W 7JN, UK
| | - Nicola Muirhead
- Division of Medicine, University College London, Charles Bell House, 43-45 Foley Street, Sheffield, W1W 7JN, UK
| | - Norman R Williams
- Division of Surgery & Interventional Science, University College London, London, UK
| | - Elena Pizzo
- Department of Applied Health Research, University College London, 1-19 Torrington Place, Glasgow, WC1E 7HB, UK
| | - Raj Persad
- North Bristol Hospitals Trust, Department of Urology, Southmead Hospital, Southmead Lane, Westbury-on-Trym, Bristol, BS10 5NB, UK
| | - Jon Aning
- North Bristol Hospitals Trust, Department of Urology, Southmead Hospital, Southmead Lane, Westbury-on-Trym, Bristol, BS10 5NB, UK
| | - Lyndsey Johnson
- North Bristol Hospitals Trust, Department of Urology, Southmead Hospital, Southmead Lane, Westbury-on-Trym, Bristol, BS10 5NB, UK
| | - Jon Oxley
- North Bristol Hospitals Trust, Department of Histopathology, Southmead Hospital, Southmead Lane, Westbury-on-Trym, BS10 5NB, Bristol, UK
| | - Neil Oakley
- Sheffield Teaching Hospitals NHS Trust, Department of Urology, Royal Hallamshire Hospital, Glossop Road, S10 2JF, UK
| | - Susan Morgan
- Sheffield Teaching Hospitals NHS Trust, Department of Histopathology, Royal Hallamshire Hospital, Glossop Road, S10 2JF, UK
| | - Fawzia Tahir
- Sheffield Teaching Hospitals NHS Trust, Department of Histopathology, Royal Hallamshire Hospital, Glossop Road, S10 2JF, UK
| | - Imran Ahmad
- Glasgow & Clyde NHS Trust, Department of Urology, Queen Elizabeth Hospital, 1345 Govan Road, Glasgow, UK
| | - Lorenzo Dutto
- Glasgow & Clyde NHS Trust, Department of Urology, Queen Elizabeth Hospital, 1345 Govan Road, Glasgow, UK
| | - Jonathan M Salmond
- Glasgow & Clude NHS Trust, Department of Histopathology, Queen Elizabeth Hospital, 1345 Govan Road, Glasgow, UK
| | - Anand Kelkar
- University College Hospital London, Department of Urology, Westmoreland Street Hospital, 6-18 Westmoreland Street, W1G 8PH, London, UK
- Barking Havering & Redbridge University Hospitals Trust, Rom Valley Way, Romford, RM7 0AG, UK
| | - John Kelly
- Division of Surgery & Interventional Science, University College London, London, UK
- University College Hospital London, Department of Urology, Westmoreland Street Hospital, 6-18 Westmoreland Street, W1G 8PH, London, UK
| | - Greg Shaw
- Division of Surgery & Interventional Science, University College London, London, UK
- University College Hospital London, Department of Urology, Westmoreland Street Hospital, 6-18 Westmoreland Street, W1G 8PH, London, UK
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16
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Yuan M, Wu J, Lee J, Cao D, Huynh MNQ, Gallo L, Neill ACO, Hofer SO. The Risk of Bias of Non-Randomized Observational Studies in Deep Inferior Epigastric Perforator Flap Breast Reconstruction: A Systematic Review using ROBINS-I. J Plast Reconstr Aesthet Surg 2022; 75:4096-4105. [DOI: 10.1016/j.bjps.2022.06.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/07/2022] [Accepted: 06/21/2022] [Indexed: 10/31/2022]
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Turner T, El Tobgy N, Russell K, Day C, Cheung K, Proven S, Ricci MF. Language abilities in preschool children with critical CHD: a systematic review. Cardiol Young 2022; 32:1-11. [PMID: 35510297 DOI: 10.1017/s1047951122001330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT Children with critical CHD are at risk for neurodevelopmental impairments, including delays in expressive and receptive language development. However, no study has synthesised the literature regarding language abilities in children with this condition. OBJECTIVE We summarised the literature regarding expressive and receptive language in preschool children with critical CHD. DATA SOURCES MEDLINE, Embase, Scopus, Child Development and Adolescent Studies, ERIC, PsycINFO, and CINAHL. STUDY SELECTION We included studies published between January, 1990 and 1 July, 2021, focused on children aged ≤5 years with critical CHD requiring a complex cardiac procedure at age <1 year. Language ability was documented using standardised, validated tools assessing both expressive and receptive language outcomes. DATA EXTRACTION Data (study, patient and language characteristics, and results) were extracted by two reviewers. RESULTS Seventeen studies were included. Among children 2-5 years old with critical CHD, there were statistically significant deficits in overall (standardised mean difference: -0.46; 95 % confidence interval: -0.56, -0.35), expressive (standardised mean difference: -0.45;95 % confidence interval: -0.54, -0.37), and receptive (standardised mean difference: -0.32; 95 % confidence interval: -0.40, -0.23) language compared to normative data. Results reported as medians were similar to meta-analysis findings. Subgroup analysis showed that children with univentricular physiology had lower language scores than children with biventricular physiology. CONCLUSIONS Preschool children with critical CHD had statistically significantly lower language outcomes compared to expected population norms. Healthcare professionals should test early and often for language deficits, referring to individually tailored supports.
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Affiliation(s)
- Tegan Turner
- University of Manitoba Advanced Degrees in Medicine Program, Winnipeg, Manitoba, Canada
| | - Nada El Tobgy
- University of Manitoba Advanced Degrees in Medicine Program, Winnipeg, Manitoba, Canada
| | - Kelly Russell
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Chelsea Day
- Specialized Services for Children and Youth (SSCY) Centre, Winnipeg, Manitoba, Canada
| | - Kristene Cheung
- Specialized Services for Children and Youth (SSCY) Centre, Winnipeg, Manitoba, Canada
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Shelley Proven
- Specialized Services for Children and Youth (SSCY) Centre, Winnipeg, Manitoba, Canada
| | - M Florencia Ricci
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Specialized Services for Children and Youth (SSCY) Centre, Winnipeg, Manitoba, Canada
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18
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Hilton Boon M, Burns J, Craig P, Griebler U, Heise TL, Vittal Katikireddi S, Rehfuess E, Shepperd S, Thomson H, Bero L. Value and Challenges of Using Observational Studies in Systematic Reviews of Public Health Interventions. Am J Public Health 2022; 112:548-552. [PMID: 35319925 PMCID: PMC8961824 DOI: 10.2105/ajph.2021.306658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Michele Hilton Boon
- Michele Hilton Boon, Peter Craig, S. Vittal Katikireddi, and Hilary Thomson are with the Medical Research Council/Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. Jacob Burns and Eva Rehfuess are with the Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Ursula Griebler is with the Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems an der Donau, Austria. Thomas L. Heise is with the Leibniz Institute for Prevention Research and Epidemiology-BIPS, University of Bremen, Bremen, Germany. Sasha Shepperd is with the Nuffield Department of Population Health, University of Oxford, Oxford, UK. Lisa Bero is with the School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Jacob Burns
- Michele Hilton Boon, Peter Craig, S. Vittal Katikireddi, and Hilary Thomson are with the Medical Research Council/Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. Jacob Burns and Eva Rehfuess are with the Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Ursula Griebler is with the Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems an der Donau, Austria. Thomas L. Heise is with the Leibniz Institute for Prevention Research and Epidemiology-BIPS, University of Bremen, Bremen, Germany. Sasha Shepperd is with the Nuffield Department of Population Health, University of Oxford, Oxford, UK. Lisa Bero is with the School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Peter Craig
- Michele Hilton Boon, Peter Craig, S. Vittal Katikireddi, and Hilary Thomson are with the Medical Research Council/Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. Jacob Burns and Eva Rehfuess are with the Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Ursula Griebler is with the Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems an der Donau, Austria. Thomas L. Heise is with the Leibniz Institute for Prevention Research and Epidemiology-BIPS, University of Bremen, Bremen, Germany. Sasha Shepperd is with the Nuffield Department of Population Health, University of Oxford, Oxford, UK. Lisa Bero is with the School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Ursula Griebler
- Michele Hilton Boon, Peter Craig, S. Vittal Katikireddi, and Hilary Thomson are with the Medical Research Council/Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. Jacob Burns and Eva Rehfuess are with the Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Ursula Griebler is with the Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems an der Donau, Austria. Thomas L. Heise is with the Leibniz Institute for Prevention Research and Epidemiology-BIPS, University of Bremen, Bremen, Germany. Sasha Shepperd is with the Nuffield Department of Population Health, University of Oxford, Oxford, UK. Lisa Bero is with the School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Thomas L Heise
- Michele Hilton Boon, Peter Craig, S. Vittal Katikireddi, and Hilary Thomson are with the Medical Research Council/Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. Jacob Burns and Eva Rehfuess are with the Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Ursula Griebler is with the Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems an der Donau, Austria. Thomas L. Heise is with the Leibniz Institute for Prevention Research and Epidemiology-BIPS, University of Bremen, Bremen, Germany. Sasha Shepperd is with the Nuffield Department of Population Health, University of Oxford, Oxford, UK. Lisa Bero is with the School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - S Vittal Katikireddi
- Michele Hilton Boon, Peter Craig, S. Vittal Katikireddi, and Hilary Thomson are with the Medical Research Council/Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. Jacob Burns and Eva Rehfuess are with the Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Ursula Griebler is with the Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems an der Donau, Austria. Thomas L. Heise is with the Leibniz Institute for Prevention Research and Epidemiology-BIPS, University of Bremen, Bremen, Germany. Sasha Shepperd is with the Nuffield Department of Population Health, University of Oxford, Oxford, UK. Lisa Bero is with the School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Eva Rehfuess
- Michele Hilton Boon, Peter Craig, S. Vittal Katikireddi, and Hilary Thomson are with the Medical Research Council/Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. Jacob Burns and Eva Rehfuess are with the Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Ursula Griebler is with the Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems an der Donau, Austria. Thomas L. Heise is with the Leibniz Institute for Prevention Research and Epidemiology-BIPS, University of Bremen, Bremen, Germany. Sasha Shepperd is with the Nuffield Department of Population Health, University of Oxford, Oxford, UK. Lisa Bero is with the School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Sasha Shepperd
- Michele Hilton Boon, Peter Craig, S. Vittal Katikireddi, and Hilary Thomson are with the Medical Research Council/Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. Jacob Burns and Eva Rehfuess are with the Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Ursula Griebler is with the Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems an der Donau, Austria. Thomas L. Heise is with the Leibniz Institute for Prevention Research and Epidemiology-BIPS, University of Bremen, Bremen, Germany. Sasha Shepperd is with the Nuffield Department of Population Health, University of Oxford, Oxford, UK. Lisa Bero is with the School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Hilary Thomson
- Michele Hilton Boon, Peter Craig, S. Vittal Katikireddi, and Hilary Thomson are with the Medical Research Council/Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. Jacob Burns and Eva Rehfuess are with the Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Ursula Griebler is with the Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems an der Donau, Austria. Thomas L. Heise is with the Leibniz Institute for Prevention Research and Epidemiology-BIPS, University of Bremen, Bremen, Germany. Sasha Shepperd is with the Nuffield Department of Population Health, University of Oxford, Oxford, UK. Lisa Bero is with the School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Lisa Bero
- Michele Hilton Boon, Peter Craig, S. Vittal Katikireddi, and Hilary Thomson are with the Medical Research Council/Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. Jacob Burns and Eva Rehfuess are with the Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany. Ursula Griebler is with the Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems an der Donau, Austria. Thomas L. Heise is with the Leibniz Institute for Prevention Research and Epidemiology-BIPS, University of Bremen, Bremen, Germany. Sasha Shepperd is with the Nuffield Department of Population Health, University of Oxford, Oxford, UK. Lisa Bero is with the School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
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Igelström E, Campbell M, Craig P, Katikireddi SV. Cochrane's risk of bias tool for non-randomized studies (ROBINS-I) is frequently misapplied: A methodological systematic review. J Clin Epidemiol 2021; 140:22-32. [PMID: 34437948 PMCID: PMC8809341 DOI: 10.1016/j.jclinepi.2021.08.022] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/16/2021] [Accepted: 08/18/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVES We aimed to review how 'Risk of Bias In Non-randomized Studies-of Interventions' (ROBINS-I), a Cochrane risk of bias assessment tool, has been used in recent systematic reviews. STUDY DESIGN AND SETTING Database and citation searches were conducted in March 2020 to identify recently published reviews using ROBINS-I. Reported ROBINS-I assessments and data on how ROBINS-I was used were extracted from each review. Methodological quality of reviews was assessed using AMSTAR 2 ('A MeaSurement Tool to Assess systematic Reviews'). RESULTS Of 181 hits, 124 reviews were included. Risk of bias was serious/critical in 54% of assessments on average, most commonly due to confounding. Quality of reviews was mostly low, and modifications and incorrect use of ROBINS-I were common, with 20% reviews modifying the rating scale, 20% understating overall risk of bias, and 19% including critical-risk of bias studies in evidence synthesis. Poorly conducted reviews were more likely to report low/moderate risk of bias (predicted probability 57% [95% CI: 47-67] in critically low-quality reviews, 31% [19-46] in high/moderate-quality reviews). CONCLUSION Low-quality reviews frequently apply ROBINS-I incorrectly, and may thus inappropriately include or give too much weight to uncertain evidence. Readers should be aware that such problems can lead to incorrect conclusions in reviews.
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Affiliation(s)
- Erik Igelström
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square 99 Berkeley Street, Glasgow, G3 7HR.
| | - Mhairi Campbell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square 99 Berkeley Street, Glasgow, G3 7HR
| | - Peter Craig
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square 99 Berkeley Street, Glasgow, G3 7HR
| | - Srinivasa Vittal Katikireddi
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square 99 Berkeley Street, Glasgow, G3 7HR
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Kelly SE, Greene-Finestone LS, Yetley EA, Benkhedda K, Brooks SPJ, Wells GA, MacFarlane AJ. NUQUEST-NUtrition QUality Evaluation Strengthening Tools: development of tools for the evaluation of risk of bias in nutrition studies. Am J Clin Nutr 2021; 115:256-271. [PMID: 34605544 PMCID: PMC8755056 DOI: 10.1093/ajcn/nqab335] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 09/29/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Dietary exposure assessments are a critical issue in evaluating human nutrition studies; however, nutrition-specific criteria are not consistently included in existing bias assessment tools. OBJECTIVES Our objective was to develop a set of risk of bias (RoB) tools that integrated nutrition-specific criteria into validated generic assessment tools to address RoB issues, including those specific to dietary exposure assessment. METHODS The Nutrition QUality Evaluation Strengthening Tools (NUQUEST) development and validation process included 8 steps. The first steps identified 1) a development strategy; 2) generic assessment tools with demonstrated validity; and 3) nutrition-specific appraisal issues. This was followed by 4) generation of nutrition-specific items and 5) development of guidance to aid users of NUQUEST. The final steps used established ratings of selected studies and feedback from independent raters to 6) assess reliability and validity; 7) assess formatting and usability; and 8) finalize NUQUEST. RESULTS NUQUEST is based on the Scottish Intercollegiate Guidelines Network checklists for randomized controlled trials, cohort studies, and case-control studies. Using a purposive sample of 45 studies representing the 3 study designs, interrater reliability was high (Cohen's κ: 0.73; 95% CI: 0.52, 0.93) across all tools and at least moderate for individual tools (range: 0.57-1.00). The use of a worksheet improved usability and consistency of overall interrater agreement across all study designs (40% without worksheet, 80%-100% with worksheet). When compared to published ratings, NUQUEST ratings for evaluated studies demonstrated high concurrent validity (93% perfect or near-perfect agreement). Where there was disagreement, the nutrition-specific component was a contributing factor in discerning exposure methodological issues. CONCLUSIONS NUQUEST integrates nutrition-specific criteria with generic criteria from assessment tools with demonstrated reliability and validity. NUQUEST represents a consistent and transparent approach for evaluating RoB issues related to dietary exposure assessment commonly encountered in human nutrition studies.
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Affiliation(s)
- Shannon E Kelly
- Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | | | | | - Karima Benkhedda
- Bureau of Nutritional Sciences, Health Canada, Ottawa, Ontario, Canada
| | - Stephen P J Brooks
- Bureau of Nutritional Sciences, Health Canada, Ottawa, Ontario, Canada,Department of Biology, Carleton University, Ottawa, Ontario, Canada
| | - George A Wells
- Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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21
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Jain AD, Goyal M, Kumar M, Premsagar S, Mishra S, Tomar S. Evaluating the Lower Anterior Facial Height in Patients Treated with Extraction Versus Non-extraction Fixed Mechanotherapy: “A Systematic Review and Meta-analysis”. JOURNAL OF INDIAN ORTHODONTIC SOCIETY 2021. [DOI: 10.1177/03015742211011689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: The objective of this study was to evaluate the effects of the four first premolars extraction compared with a non-extraction treated control group on the lower anterior facial height. Methods: Electronic search was conducted on PubMed, Cochrane, Scopus, Lilacs, Scielo, clinical trials, and opengrey.eu databases; only article published in English were included. The eligibility criteria were extraction of four first premolars compared with a non-extraction control group treated with fixed mechanotherapy. Anterior Nasal Spine to Menton (ANS-Me) (mm) was taken as the primary outcome; Frankfurt mandibular plane angle (FMA) and Nasion to Menton (N-Me) were selected as secondary outcomes. Non-randomized Studies-of Intervention (ROBINS-I) tool was used for the quality assessment and risk of bias. Heterogeneity was analyzed using statistical tests, including chi-squared-based Q-statistic, tau-square, and I-squared statistics. Review Manager was used for quantitative assessment and meta-analysis. Results: Five retrospective studies were included for quantitative assessment and three were included in the meta-analysis due to certain missing data. Extraction of four first premolars did not affect both primary and secondary outcomes with P = .65, P = .93, and P = .91, respectively, for ANS-Me, FMA, and N-Me. Conclusion: This review and meta-analysis concluded that there was no statistically significant effect of extraction of four first premolars on lower anterior facial height.
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Affiliation(s)
- Atam Dev Jain
- Department of Orthodontics and Dentofacial Orthpaedics, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Manish Goyal
- Department of Orthodontics and Dentofacial Orthpaedics, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Mukesh Kumar
- Department of Orthodontics and Dentofacial Orthpaedics, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Shruti Premsagar
- Department of Orthodontics and Dentofacial Orthpaedics, ITS Dental College, Greater Noida, Uttar Pradesh, India
| | - Shalini Mishra
- Department of Orthodontics and Dentofacial Orthpaedics, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Sumit Tomar
- Department of Orthodontics and Dentofacial Orthpaedics, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
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Zhang Y, Huang L, Wang D, Ren P, Hong Q, Kang D. The ROBINS-I and the NOS had similar reliability but differed in applicability: A random sampling observational studies of systematic reviews/meta-analysis. J Evid Based Med 2021; 14:112-122. [PMID: 34002466 DOI: 10.1111/jebm.12427] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 02/07/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE There is a lack of evidence on the usage of the quality assessment tool-the Risk Of Bias In Nonrandomized Studies-of Interventions (ROBINS-I). This article aimed to measure the reliability, criterion validity, and feasibility of the ROBINS-I and the Newcastle-Ottawa Scale (NOS). METHODS A sample of systematic reviews or meta-analyses of observational studies were selected from Medline (2013-2017) and assessed by two reviewers using ROBINS-I and the NOS. We reported on reliability in terms of the first-order agreement coefficient (AC1) statistic. Correlation coefficient statistic was used to explore the criterion validity of the ROBINS-I. We compared the feasibility of the ROBINS-I and NOS by recording the time to complete an assessment and the instances where assessing was difficult. RESULTS Five systematic reviews containing 41 cohort studies were finally included. Interobserver agreement on the individual domain of the ROBINS-I as well as the NOS was substantial with a mean AC1 statistic of 0.67 (95% CI: 0.50-0.83) and 0.73 (95% CI: 0.65-0.81), respectively. The criterion validity of the ROBNS-I was moderate (K = 0.52) against NOS. The time in assessing a single study by ROBINS-I varied from 7 hours initially to 3 hours compared with 30 minutes for the NOS. Both reviewers rated "bias due to departure from the intended interventions" the most time-consuming domain in the ROBINS-I, items in the NOS were equal. CONCLUSIONS The ROBINS-I and the NOS seem to provide the same reliability but vary in applicability. The over-complicated feature of ROBINS-I may limit its usage and a simplified version is needed.
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Affiliation(s)
- Yuhui Zhang
- Department of Evidence-based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Litao Huang
- Department of Evidence-based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Dandan Wang
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, Gansu, China
| | - Pengwei Ren
- Clinical Research Center for Respiratory Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qi Hong
- Department of Evidence-based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Deying Kang
- Department of Evidence-based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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23
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Martha BA, Vacchi CDO, Fattori RA, Macagnan FE. Effect of physical exercise on the functional capacity of children and adolescents submitted to transplantation of hematopoietic stem cells-A systematic review with meta-analysis. J Child Health Care 2021; 25:18-30. [PMID: 32013540 DOI: 10.1177/1367493520903626] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Previous studies have shown beneficial effects of physical exercise (PE) in adults submitted to hematopoietic stem cell transplantation (HSCT). Conduct a systematic review about the effects of PE on the functional capacity of children and adolescents submitted to HSCT. The studies were searched in the databases MEDLINE (via PubMed), Central Register of Controlled Trials (Cochrane CENTRAL), EMBASE, LILACS, and Evidence Database in Physical Therapy (PEDro) (CRD42018080093). Two independent reviewers performed the article selection, data extraction, and methodological quality assessment. Randomized and nonrandomized clinical trials comparing PE with usual treatment in children and adolescents aged 3-18 years were included. The risk of bias was assessed using the Cochrane Collaboration tool and ROBINS-I tool, and the overall quality of the evidence was determined by the GRADE system. We included three studies with 91 patients. PE improved the functional capacity assessed by the timed up and down stairs test (MD -1.23 [95% CI, 2.27 to -.20, I2 = 0%]), but there was no significant effect in the six-minute walk test (MD 44.63 [95% CI, -20.86 to 110.13, I2 = 83%]). The benefits regarding quality of life and peripheral muscle strength of these individuals were not clearly demonstrated, but positive responses were observed in relation to the analyzed data. None of the studies evaluated the fatigue. The limitations found were the high heterogeneity between studies, as well as the sample size and the low methodological rigor. PE might be favorable to improve the functional capacity of children and adolescents treated with HSCT. However, further studies are needed to clarify the best PE program.
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Affiliation(s)
- Bianca Andrade Martha
- Postgraduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Cindy de Oliveira Vacchi
- Postgraduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Rafael Ailton Fattori
- Multiprofessional Residency Program in Oncohematology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Fabrício Edler Macagnan
- Postgraduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil.,Multiprofessional Residency Program in Oncohematology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil.,Department of Physiotherapy of the Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
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Mancini JD, Yao S, Martinez LR, Shakil H, Li TS. Gut Microbiome Changes with Osteopathic Treatment of Constipation in Parkinson's Disease: A Pilot Study. NEUROLOGY (E-CRONICON) 2021; 13:19-33. [PMID: 33899052 PMCID: PMC8061899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION The gut microbiome appears to be predictive of Parkinson's disease (PD) with constipation. Chronic constipation frequently manifests prior to motor symptoms and impairs quality of life. An osteopathic manipulative medicine (OMM) sequence used physical exam assessment and manual treatment of neuromusculoskeletal dysfunctions pertinent to constipation in PD for this prospective ABA-design study, IRB-NYITBHS1065. The effects of 4 weekly treatments on the gut microbiome among men and women over 40 years old with chronic constipation and PD were investigated. Severity of PD was rated with the Movement Disorders Society-Unified PD rating scale (UPDRS) in six subjects with constipation. Also, the Bristol stool scale and questionnaires validated for constipation were administered for diagnosis, symptom severity, and quality of life during a 4-week control-period (A), 4-weekly OMM-treatments (B), and 2-weeks no-intervention (A). Biweekly stool samples were assessed for normalized microbiota abundance. RESULTS The mean Bristol rating improved from type 2 (± 1) Pre-OMM to 3 (± 1; p = .167; d = 0.677) Post-OMM. Mean constipation severity significantly decreased (p = .010; d = 1.508) Post-OMM. Mean quality of life significantly improved (p = .041; d = 1.072) Post-OMM. The Pre-OMM mean number of families within the phylum Firmicutes decreased by 3 (p = .043; d = 1.177) Post-OMM. There were significant changes in the normalized abundance of phyla Actinobacteria (p = .040; d = 0.845) and Verrucomicrobia (p = .024; d = 0.675) as well as in genus Roseburia (p = .033; d = 1.109), Intestinimonas (p = .035; d = 0.627) and Anaerotruncus (p = .004) Post-OMM. CONCLUSION The gut microbiome shifted among individuals with constipation and PD after four weekly treatments with the OMM-sequence. Changes in the gut microbiome Post-OMM were associated with UPDRS results and constipation measures. Clinical trials and studies to develop the gut microbiome into a validated biomarker for PD are necessary to understand the impact of OMM in patients with PD and constipation.
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Affiliation(s)
- Jayme D Mancini
- New York Institute of Technology College of Osteopathic Medicine, Northern Boulevard, Old Westbury, NY, USA
| | - Sheldon Yao
- New York Institute of Technology College of Osteopathic Medicine, Northern Boulevard, Old Westbury, NY, USA
| | - Luis R Martinez
- Department of Oral Biology, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Haque Shakil
- New York Institute of Technology College of Osteopathic Medicine, Northern Boulevard, Old Westbury, NY, USA
| | - To Shan Li
- New York Institute of Technology College of Osteopathic Medicine, Northern Boulevard, Old Westbury, NY, USA
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25
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Stone JC, Glass K, Clark J, Ritskes-Hoitinga M, Munn Z, Tugwell P, Doi SAR. The MethodologicAl STandards for Epidemiological Research (MASTER) scale demonstrated a unified framework for bias assessment. J Clin Epidemiol 2021; 134:52-64. [PMID: 33485928 DOI: 10.1016/j.jclinepi.2021.01.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 12/28/2020] [Accepted: 01/18/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE This paper presents a unified framework for assessment of the methodological quality of analytic study designs. STUDY DESIGN AND SETTING A systematic review of 393 methodological quality assessment tools that updated a previous assessment with 100 tools. Tool items were extracted, examined and reworded. Bias domains and finally methodological standards to be fulfilled were defined. RESULTS There were 36 unique methodological safeguards that were categorized into seven methodological standards to be fulfilled in the MASTER scale. These methodological standards reflect initial and ongoing equivalence in particular areas, including equal recruitment, equal retention, equal ascertainment, equal implementation, equal prognosis, sufficient analysis, and temporal precedence. CONCLUSION This approach unifies existing methods for methodological quality assessment and will be useful for (1) clinical researchers when a bias assessment of clinical research studies is required across analytical designs, (2) promoting a unified framework for bias assessment.
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Affiliation(s)
- Jennifer C Stone
- Department of Health Services Research and Policy, Research School of Population Health, Australian National University, 62 Mills Road, Acton, ACT 2601, Australia; Department for Health Evidence, SYRCLE, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Kathryn Glass
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Justin Clark
- Centre for Research in Evidence Based Practice, Bond University, QLD, Australia
| | - Merel Ritskes-Hoitinga
- Department for Health Evidence, SYRCLE, Radboud University Medical Center, Nijmegen, The Netherlands; Department for Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Zachary Munn
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Peter Tugwell
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Suhail A R Doi
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar P.O. Box 2713, Qatar University Drive, Al Tarfa, Doha, Qatar.
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Kristianto H, Waluyo A, Yunir E, Gayatri D, Blow D. Neuromuscular taping application opportunities in nursing: a literature review. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2020. [DOI: 10.15452/cejnm.2020.11.0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Lhachimi SK. Systematic reviews in public health: Exploring challenges and potential solutions. JOURNAL OF HEALTH MONITORING 2020; 5:15-16. [PMID: 35146288 PMCID: PMC8734153 DOI: 10.25646/6504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 01/20/2020] [Indexed: 11/13/2022]
Affiliation(s)
- Stefan K. Lhachimi
- Corresponding author Prof Dr Stefan K. Lhachimi, University of Bremen, Institute for Public Health and Nursing Research, Grazer Straße 4, 28359 Bremen, Germany, E-mail:
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Wilkens OE, Hannink G, van de Groes SAW. Recurrent patellofemoral instability rates after MPFL reconstruction techniques are in the range of instability rates after other soft tissue realignment techniques. Knee Surg Sports Traumatol Arthrosc 2020; 28:1919-1931. [PMID: 31392368 PMCID: PMC7253385 DOI: 10.1007/s00167-019-05656-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 07/29/2019] [Indexed: 12/26/2022]
Abstract
PURPOSE Recurrent patellofemoral instability is a common knee injury in skeletally immature patients. Many surgical techniques have been described in the literature, all with different success rates. Purpose of this study was to perform a systematic review and meta-analysis of the available literature to assess recurrent patellofemoral instability rates after surgical treatment using MPFL reconstruction techniques and other soft tissue realignment techniques in skeletally immature patients. METHODS PubMed, Embase, Web of Science, and The Cochrane Library were searched to identify all original articles concerning the surgical treatment for patellofemoral instability in skeletally immature patients and that reported post-operative recurrent patellofemoral instability rates. Subsequently a risk of bias assessment was conducted and a meta-analysis was performed on reported post-operative recurrent patellofemoral instability rates after MPFL reconstruction techniques and other soft tissue realignment techniques. RESULTS Of the 21 eligible studies (448 knees in 389 patients), 10 studies reported on MPFL reconstruction techniques using different grafts and fixation techniques and 11 reported on other soft tissue realignment procedures. In total, 62 of the 448 (13.8%) treated knees showed recurrent patellofemoral instability during follow-up. The overall pooled recurrent patellofemoral instability rate was estimated to be 0.08 (95% CI 0.02-0.16). For MPFL reconstruction techniques, the pooled recurrent patellofemoral instability rate was estimated to be 0.02 (95% CI 0.00-0.09). For the other soft tissue realignment techniques, the pooled rate was estimated to be 0.15 (95% CI 0.04-0.31). No statistically significant difference in recurrent patellofemoral instability rates between MPFL reconstruction techniques and other soft tissue realignment techniques were found (n.s.). There was a large variation in treatment effects over different settings, including what effect is to be expected in future patients. CONCLUSION This systematic review and meta-analysis found that recurrent patellofemoral instability rates after MPFL reconstruction techniques are in the range of instability rates after other soft tissue realignment techniques. The clinical relevance of this study is that it provides clinicians with the best currently available evidence on recurrent patellofemoral instability rates after surgical treatment for patellofemoral instability in skeletally immature patients. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Olivier E Wilkens
- Department of Orthopedics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Gerjon Hannink
- Department of Operating Rooms, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
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Niederkrotenthaler T, Braun M, Pirkis J, Till B, Stack S, Sinyor M, Tran US, Voracek M, Cheng Q, Arendt F, Scherr S, Yip PSF, Spittal MJ. Association between suicide reporting in the media and suicide: systematic review and meta-analysis. BMJ 2020; 368:m575. [PMID: 32188637 PMCID: PMC7190013 DOI: 10.1136/bmj.m575] [Citation(s) in RCA: 140] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To examine the association between reporting on suicides, especially deaths of celebrities by suicide, and subsequent suicides in the general population. DESIGN Systematic review and meta-analysis. DATA SOURCES PubMed/Medline, PsychInfo, Scopus, Web of Science, Embase, and Google Scholar, searched up to September 2019. REVIEW METHODS Studies were included if they compared at least one time point before and one time point after media reports on suicide; follow-up was two months or less; the outcome was death by suicide; and the media reports were about non-fictional suicides. Data from studies adopting an interrupted time series design, or single or multiple arm before and after comparisons, were reviewed. RESULTS 31 studies were identified and analysed, and 20 studies at moderate risk of bias were included in the main analyses. The risk of suicide increased by 13% in the period after the media reported a death of a celebrity by suicide (rate ratio 1.13, 95% confidence interval 1.08 to 1.18; 14 studies; median follow-up 28 days, range 7-60 days). When the suicide method used by the celebrity was reported, there was an associated 30% increase in deaths by the same method (rate ratio 1.30, 95% confidence interval 1.18 to 1.44; 11 studies; median follow-up 28 days, range 14-60 days). For general reporting of suicide, the rate ratio was 1.002 (0.997 to 1.008; five studies; median follow-up 1 day, range 1-8 days) for a one article increase in the number of reports on suicide. Heterogeneity was large and partially explained by celebrity and methodological factors. Enhanced funnel plots suggested some publication bias in the literature. CONCLUSIONS Reporting of deaths of celebrities by suicide appears to have made a meaningful impact on total suicides in the general population. The effect was larger for increases by the same method as used by the celebrity. General reporting of suicide did not appear to be associated with suicide although associations for certain types of reporting cannot be excluded. The best available intervention at the population level to deal with the harmful effects of media reports is guidelines for responsible reporting. These guidelines should be more widely implemented and promoted, especially when reporting on deaths of celebrities by suicide. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019086559.
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Affiliation(s)
- Thomas Niederkrotenthaler
- Unit Suicide Research and Mental Health Promotion, Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15, A-1090 Vienna, Austria
- Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Marlies Braun
- Unit Suicide Research and Mental Health Promotion, Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15, A-1090 Vienna, Austria
- Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Benedikt Till
- Unit Suicide Research and Mental Health Promotion, Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15, A-1090 Vienna, Austria
- Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Steven Stack
- Department of Criminology and Department of Psychiatry, Wayne State University, Detroit, MI, USA
| | - Mark Sinyor
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Ulrich S Tran
- Wiener Werkstaette for Suicide Research, Vienna, Austria
- Department of Basic Psychological Research and Research Methods, School of Psychology, University of Vienna, Vienna, Austria
| | - Martin Voracek
- Wiener Werkstaette for Suicide Research, Vienna, Austria
- Department of Basic Psychological Research and Research Methods, School of Psychology, University of Vienna, Vienna, Austria
| | - Qijin Cheng
- Department of Social Work, Chinese University of Hong Kong, Hong Kong, China
| | - Florian Arendt
- Wiener Werkstaette for Suicide Research, Vienna, Austria
- Department of Communication, University of Vienna, Vienna, Austria
| | - Sebastian Scherr
- School for Mass Communication Research, KU Leuven, Leuven, Belgium
| | - Paul S F Yip
- Centre for Suicide Research and Prevention, and Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Matthew J Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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Dinneen EP, Van Der Slot M, Adasonla K, Tan J, Grierson J, Haider A, Freeman A, Oakley N, Shaw G. Intraoperative Frozen Section for Margin Evaluation During Radical Prostatectomy: A Systematic Review. Eur Urol Focus 2019; 6:664-673. [PMID: 31787570 DOI: 10.1016/j.euf.2019.11.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 09/27/2019] [Accepted: 11/05/2019] [Indexed: 01/12/2023]
Abstract
CONTEXT Surgical margin status and preservation of the neurovascular bundles (NVB) are important prognostic indicators for oncological and functional outcomes of patients undergoing radical prostatectomy (RP). Intraoperative frozen section (IFS) has been used to evaluate margin status during surgery with the intention of reducing positive surgical margins (PSMs) and guiding safe preservation of the NVBs during RP, but its value is controversial. OBJECTIVE To evaluate current literature comparing outcomes of men undergoing RP with IFS versus RP without IFS. EVIDENCE ACQUISITION Medline, Embase, and Cochrane Library searches for all relevant publications (PROSPERO ID CRD42019125940), including comparative studies reporting on men undergoing RP with and without IFS, were performed. Outcomes of interest were surgical margin status, long-term oncological outcomes, NVB status, and erectile function (EF) recovery. Data were narratively synthesised in light of methodological and clinical heterogeneity of included studies. EVIDENCE SYNTHESIS After screening 834 publications, 10 nonrandomised retrospective comparative studies (including 16 897 patients) were retrieved. The technique of IFS differed considerably between studies. Eight studies reported a reduction in PSM rates (-1.4% to -14.5%) with IFS, though two studies report higher PSM rates (+0.4% and +10%) with IFS. Three studies reported on long-term oncological outcomes, and no difference was seen with IFS. Three studies reported on the performance of IFS systematically at the posterolateral margin of the prostate (neurovascular structure-adjacent frozen-section examination [NeuroSAFE] technique). In all these three studies, either NVB preservation or EF recovery was improved. All studies were deemed to be at either a serious or a moderate risk of bias. CONCLUSIONS No randomised controlled trials were identified, and significant heterogeneity existed with regard to many features of the studies included. Within the limitations of this review, the evidence suggests that IFS during RP can facilitate a modest reduction in PSM rates. There is evidence that IFS performed systematically at the posterolateral margin of the prostate can facilitate more NVB preservation. However, in the main, the lack of prospective, randomised, standardised research with long-term oncological and functional outcomes precludes strong conclusions and highlights the need for such studies. PATIENT SUMMARY The data of this review suggest that frozen section sampling of the prostate (ie, whilst the patient is still asleep) during prostate cancer surgery can reduce the likelihood of cancer being detected at the edge of the removed prostate. It also finds that a type of frozen section analysis (neurovascular structure-adjacent frozen-section examination [NeuroSAFE] technique) can help allow the nerves around the prostate to be left intact safely during surgery. However, the studies in this review are very different from one another and generally at a high risk of errors. Therefore, comparisons and conclusions must be made carefully.
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Affiliation(s)
- Eoin P Dinneen
- Division of Surgery and Interventional Science, University College London, Fitzrovia, London, UK; Department of Urology, University College London Hospital, London, UK.
| | - Michelle Van Der Slot
- Department of Pathology and Urology, Anser Prostate Operation Clinic, Maasstad Hospital, Rotterdam, The Netherlands
| | - Kelvin Adasonla
- Department of Urology, University College London Hospital, London, UK
| | - Jin Tan
- Department of Urology, University College London Hospital, London, UK
| | - Jack Grierson
- Surgical & Interventional Trials Unit, University College London, Fitzrovia, London, UK
| | - Aiman Haider
- Department of Histopathology, University College Hospital London, London, UK
| | - Alex Freeman
- Department of Histopathology, University College Hospital London, London, UK
| | - Neil Oakley
- Department of Urology, Sheffield Teaching Hospitals NHS Trust, Royal Hallamshire Hospital, Sheffield, UK
| | - Greg Shaw
- Division of Surgery and Interventional Science, University College London, Fitzrovia, London, UK; Department of Urology, University College London Hospital, London, UK
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Nkhata LA, Brink Y, Ernstzen D, Louw QA. A systematic review on self-management education campaigns for back pain. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2019; 75:1314. [PMID: 31535051 PMCID: PMC6739526 DOI: 10.4102/sajp.v75i1.1314] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 06/04/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Evidence-based clinical practice guidelines on back pain recommend early management and use of approaches that emphasise self-management, psychological and physical therapies. Lately, mass media campaigns, addressing misconceptions about back pain, have been conducted in developed countries. OBJECTIVES This study retrieved and synthesised the contents of back pain messages and described the outcomes and effectiveness of the media campaigns. METHOD Seventeen key words and 10 electronic databases were used to conduct a search between February and July 2018. Authors screened titles, abstracts and full-text articles independently to identify eligible studies. Data were reported using narratives because of heterogeneity in the outcomes. RESULTS Appraisal of articles was done using the Physiotherapy Evidence Database scale for randomised controlled trials (RCT) (one) or the Joanna Briggs Institute checklist for non-RCT (four). The campaigns were conducted in the general population in Australia, Canada, Norway, the Netherlands and Scotland. The message 'stay as active as possible' increased participants' awareness and influenced their health beliefs and healthcare utilisation behaviours resulting in reductions in sick leave days, work disability, healthcare utilisation and claims. CONCLUSION The back pain campaign message 'stay as active as possible' increased participants' awareness and influenced their health beliefs and healthcare utilisation behaviours. Even though the campaigns were done in high-income countries, their contents and methods are transferable to developing countries. However, their implementation must be tailored and efficient and cost-effective methods need to be explored. CLINICAL IMPLICATIONS Providing information on back pain can contribute to significant changes in sickness behaviours and beliefs.
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Affiliation(s)
- Loveness A Nkhata
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa
- Department of Physiotherapy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Yolandi Brink
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa
| | - Dawn Ernstzen
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa
| | - Quinnette A Louw
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa
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Schlesinger S, Schwingshackl L, Neuenschwander M, Barbaresko J. A critical reflection on the grading of the certainty of evidence in umbrella reviews. Eur J Epidemiol 2019; 34:889-890. [PMID: 31222608 PMCID: PMC6759658 DOI: 10.1007/s10654-019-00531-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 05/31/2019] [Indexed: 01/01/2023]
Affiliation(s)
- Sabrina Schlesinger
- Institute for Biometry and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany.
| | - Lukas Schwingshackl
- Institute for Evidence in Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Manuela Neuenschwander
- Institute for Biometry and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
| | - Janett Barbaresko
- Institute for Biometry and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
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Horner D, Pandor A, Goodacre S, Clowes M, Hunt BJ. Individual risk factors predictive of venous thromboembolism in patients with temporary lower limb immobilization due to injury: a systematic review. J Thromb Haemost 2019; 17:329-344. [PMID: 30580466 PMCID: PMC6392108 DOI: 10.1111/jth.14367] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Indexed: 01/21/2023]
Abstract
Essentials Thromboprophylaxis after lower limb injury is often based on complex risk stratification. Our systematic review identified variables predicting venous thromboembolism (VTE) in this group. Age and injury type were commonly reported to increase the odds of VTE (odds ratio 1.5-3.48). We found limited evidence to support the use of other risk factors within prediction models. SUMMARY: Background Patients immobilized after lower limb injury are at risk of venous thromboembolism (VTE). There is international variation in the use of thromboprophylaxis for such patients. Risk-based strategies have been adopted to aid decision making in many settings. The accuracy of these strategies is unclear. Objectives A systematic review was undertaken to identify all individual patient-identifiable risk factors linked to any VTE outcome following lower limb immobilization. Methods Several electronic databases were searched from inception to May 2017. Any studies that included a measurement of VTE as a patient outcome in adults requiring temporary immobilization (e.g. leg cast or brace in an ambulatory setting) for an isolated lower limb injury and reported risk factor variables were included. Descriptive statistics and thematic analysis were used to synthesize the evidence. Results Our database search returned 4771 citations, of which 15 studies reporting outcome data on 80 678 patients were eligible for analysis. Risk-factor associations were reported through regression analyses, non-parametric tests and descriptive statistics. All studies were assessed as at moderate or serious risk of bias using the ROBINS-I risk of bias tool. Advancing age and injury type were the only individual risk factors demonstrating a reproducible association with increased symptomatic and/or asymptomatic VTE rates. Several risk factors currently used in scoring tools did not appear to be robustly evaluated for subsequent association with VTE within these studies. Conclusions Clinicians should be aware of the limited evidence to support individual risk factors in guiding thromboprophylaxis use for this patient cohort.
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Affiliation(s)
- Daniel Horner
- Emergency DepartmentSalford Royal NHS Foundation TrustSalfordUK
- School for Health and Related ResearchThe University of SheffieldSheffieldUK
- The Royal College of Emergency MedicineLondonUK
| | - Abdullah Pandor
- School for Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Steve Goodacre
- School for Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Mark Clowes
- School for Health and Related ResearchThe University of SheffieldSheffieldUK
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Bero L, Chartres N, Diong J, Fabbri A, Ghersi D, Lam J, Lau A, McDonald S, Mintzes B, Sutton P, Turton JL, Woodruff TJ. The risk of bias in observational studies of exposures (ROBINS-E) tool: concerns arising from application to observational studies of exposures. Syst Rev 2018; 7:242. [PMID: 30577874 PMCID: PMC6302384 DOI: 10.1186/s13643-018-0915-2] [Citation(s) in RCA: 136] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 12/09/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Systematic reviews, which assess the risk of bias in included studies, are increasingly used to develop environmental hazard assessments and public health guidelines. These research areas typically rely on evidence from human observational studies of exposures, yet there are currently no universally accepted standards for assessing risk of bias in such studies. The risk of bias in non-randomised studies of exposures (ROBINS-E) tool has been developed by building upon tools for risk of bias assessment of randomised trials, diagnostic test accuracy studies and observational studies of interventions. This paper reports our experience with the application of the ROBINS-E tool. METHODS We applied ROBINS-E to 74 exposure studies (60 cohort studies, 14 case-control studies) in 3 areas: environmental risk, dietary exposure and drug harm. All investigators provided written feedback, and we documented verbal discussion of the tool. We inductively and iteratively classified the feedback into 7 themes based on commonalities and differences until all the feedback was accounted for in the themes. We present a description of each theme. RESULTS We identified practical concerns with the premise that ROBINS-E is a structured comparison of the observational study being rated to the 'ideal' randomised controlled trial. ROBINS-E assesses 7 domains of bias, but relevant questions related to some critical sources of bias, such as exposure and funding source, are not assessed. ROBINS-E fails to discriminate between studies with a single risk of bias or multiple risks of bias. ROBINS-E is severely limited at determining whether confounders will bias study outcomes. The construct of co-exposures was difficult to distinguish from confounders. Applying ROBINS-E was time-consuming and confusing. CONCLUSIONS Our experience suggests that the ROBINS-E tool does not meet the need for an international standard for evaluating human observational studies for questions of harm relevant to public and environmental health. We propose that a simpler tool, based on empirical evidence of bias, would provide accurate measures of risk of bias and is more likely to meet the needs of the environmental and public health community.
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Affiliation(s)
- Lisa Bero
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, D17, The Hub, 6th floor, Sydney, New South Wales, 2006, Australia.
| | - Nicholas Chartres
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, D17, The Hub, 6th floor, Sydney, New South Wales, 2006, Australia
| | - Joanna Diong
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Alice Fabbri
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, D17, The Hub, 6th floor, Sydney, New South Wales, 2006, Australia
| | - Davina Ghersi
- National Health and Medical Research Council, Canberra, Australia
| | - Juleen Lam
- Department of Ob/Gyn & the Institute for Health Policy Studies, University of California, San Francisco, USA.,Department of Health Sciences, California State University, East Bay, San Francisco, USA
| | - Agnes Lau
- School of Pharmacy, University of California, San Francisco, USA
| | - Sally McDonald
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Barbara Mintzes
- School of Pharmacy, Faculty of Medicine and Health and Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Patrice Sutton
- Department of Ob/Gyn & the Institute for Health Policy Studies, University of California, San Francisco, USA
| | | | - Tracey J Woodruff
- Department of Ob/Gyn & the Institute for Health Policy Studies, University of California, San Francisco, USA
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