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Fernández-Moreno MC, Pérez-Santiago L, Sabater L. Use of systematic review and meta-analysis in surgery: Quality assessment, identification of deficient areas, and points for improvement. Cir Esp 2024; 102:496-497. [PMID: 38697348 DOI: 10.1016/j.cireng.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 04/02/2024] [Indexed: 05/04/2024]
Affiliation(s)
- M Carmen Fernández-Moreno
- Servicio de Cirugía General y del Aparato Digestivo, Departamento de Cirugía, Hospital Clínico Universitario de Valencia, Instituto de Investigación Biomédica INCLIVA, Universitat de Valencia, Valencia, Spain.
| | - Leticia Pérez-Santiago
- Servicio de Cirugía General y del Aparato Digestivo, Departamento de Cirugía, Hospital Clínico Universitario de Valencia, Instituto de Investigación Biomédica INCLIVA, Universitat de Valencia, Valencia, Spain
| | - Luis Sabater
- Servicio de Cirugía General y del Aparato Digestivo, Departamento de Cirugía, Hospital Clínico Universitario de Valencia, Instituto de Investigación Biomédica INCLIVA, Universitat de Valencia, Valencia, Spain
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Leite KLDEF, Rodrigues GF, Chevitarese AB, Magno MB, Marañón-Vásquez GA, Pintor AVB, Maia LC. ARE PIT AND FISSURE SEALANTS EFFECTIVE IN PREVENTING AND ARRESTING OCCLUSAL CARIES IN PRIMARY AND PERMANENT TEETH? AN OVERVIEW OF SYSTEMATIC REVIEWS. J Evid Based Dent Pract 2024; 24:102010. [PMID: 39174168 DOI: 10.1016/j.jebdp.2024.102010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 04/30/2024] [Accepted: 05/17/2024] [Indexed: 08/24/2024]
Abstract
OBJECTIVES To compile the evidence from systematic reviews (SRs) about the use of sealants for preventing and arresting pit and fissure occlusal caries in primary and permanent teeth. MATERIALS AND METHODS A search was performed in six databases and gray literature up to May 2023. Systematic reviews (SRs) that included randomized trials (RCTs) and nonrandomized clinical trials (n-RCTs) aiming to answer the PICO-based focused question "are pit and fissure sealants (I) more effective than other interventions, control or no treatment (C) in preventing and arresting occlusal caries (O) in primary and permanent teeth (P)?", were included. The methodological quality was assessed using the AMSTAR-2. The overlap between reviews was calculated (corrected covered, CCA). RESULTS Among the 25 included SRs, 18 underwent meta-analysis. Eighteen SRs considered sealing enamel caries lesions, one considered sealing dentine caries, and six considered both. Seventeen SRs were devoted to preventive sealing (RCT only, n = 12; RCT and n-RCT, n = 5), while eight were devoted to prevention and arrest of dental caries (RCT only, n = 5; RCT and n-RCT, n = 3). Nine SRs showed positive results for the primary dentition, and the most frequent periods of follow-up were at least 6 (n = 5) and 12 months (n = 4). According to our meta-analysis, a significant association between resin-based sealants (RBS) and dental caries prevention was detected at 6 months (n = 1) and over longer follow-up periods (n = 4), and the DMFT and dmft indices decreased (n = 2). RBS was better than fluoride varnish at preventing dentine caries (n = 1). A lower caries incidence rate was observed in the resin-modified glass ionomer group at 6 months (n = 1). Overall, the sealants were superior (n = 11), similar (n = 21), or inferior (n = 1) to the other treatments. The AMSTAR-2 scores for studies on preventive sealing were critically low (n = 8), low (n = 6), moderate (n = 1) and high (n = 2) for studies on preventive sealing and critically low (n = 5), low (n = 2) and high (n = 1) for studies on the prevention and arrest of caries lesions. The overlap was low (CCA = 3%). CONCLUSION This overview suggests that pit and fissure sealants are not inferior to other interventions in preventing and arresting dental caries lesions in primary and permanent teeth.
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Affiliation(s)
- Karla Lorene DE França Leite
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - Gabriella Fernandes Rodrigues
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Ana Beatriz Chevitarese
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Marcela Baraúna Magno
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Guido Artemio Marañón-Vásquez
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Andréa Vaz Braga Pintor
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Maghraby H, Elsuity MA, Adel N, Magdi Y, Abdelbadie AS, Rashwan MM, Ahmed OY, Elmahdy M, Khan KS, Fawzy M. Quantifying the association of sperm DNA fragmentation with assisted reproductive technology outcomes: An umbrella review. BJOG 2024; 131:1181-1196. [PMID: 38450853 DOI: 10.1111/1471-0528.17796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Systematic reviews and meta-analyses are instrumental in shaping clinical practice. However, their findings can sometimes be marred by discrepancies and potential biases, thereby diluting the strength of the evidence presented. Umbrella reviews serve to comprehensively assess and synthesise these reviews, offering a clearer insight into the quality of the evidence presented. In the context of the relationship between sperm DNA fragmentation (SDF) and assisted conception outcomes, there is a divergence in the literature. Some reviews suggest a clear cause-and-effect linkage, whereas others present conflicting or inconclusive results. OBJECTIVES In this umbrella review we aimed to synthesise the evidence collated in systematic reviews and meta-analyses summarising the association of SDF with assisted reproductive technology (ART) outcomes. SEARCH STRATEGY After preregistration (https://doi.org/10.17605/OSF.IO/6JHDP), we performed a comprehensive search of the PubMed, Scopus, Cochrane Library, Web of Science and Embase databases. We conducted a search for systematic reviews on the association between SDF and ART without any restrictions on language or publication date. SELECTION CRITERIA Systematic reviews and meta-analyses assessing the association between SDF and ART outcomes were eligible. DATA COLLECTION AND ANALYSIS We assessed the quality of the included reviews using AMSTAR 2 and ROBIS, and determined the degree of overlap of primary studies between reviews estimating the corrected covered area (CCA), adjusted for structural missingness. We evaluated the most recent reviews assessing the association of SDF with live birth, pregnancy, miscarriage, implantation, blastulation and fertilisation. The synthesis of evidence was harmonised across all included quantitative syntheses, re-estimating the odds ratio (eOR) in random-effects meta-analyses with 95% confidence intervals (95% CIs) and 95% prediction intervals (95% PIs). We categorised the evidence strength into convincing, highly suggestive, suggestive, weak or nonsignificant, according to the meta-analysis re-estimated P-value, total sample size, I2 statistic for heterogeneity, small study effect, excess significance bias and the largest study significance. MAIN RESULTS We initially captured and screened 49 332 records. After excluding duplicate and ineligible articles, 22 systematic reviews, 15 of which were meta-analyses, were selected. The 22 reviews showed a moderate degree of overlap (adjusted CCA 9.2%) in their included studies (overall n = 428, with 180 unique studies). The 15 meta-analyses exhibited a high degree of overlap (adjusted CCA = 13.6%) in their included studies (overall n = 274, with 118 unique studies). AMSTAR 2 categorised the quality of evidence in 18 reviews as critically low and the quality of evidence in four reviews as low. ROBIS categorised all the reviews as having a high risk of bias. The re-estimated results showed that the association of SDF with live birth was weak in one and nonsignificant in four meta-analyses. Similarly, the association of SDF with pregnancy, miscarriage, implantation, blastulation and fertilisation was also weak or nonsignificant. The association of high SDF with different ART outcomes was also weak or nonsignificant for different interventions (IVF, ICSI and IUI) and tests. CONCLUSIONS This umbrella review did not find convincing or suggestive evidence linking SDF with ART outcomes. Caution should be exercised in making any claims, policies or recommendations concerning SDF.
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Affiliation(s)
- Hassan Maghraby
- Obstetrics and Gynaecology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
- Egyptian Foundation for Reproductive Medicine and Embryology (EFRE), Alexandria, Egypt
| | - Mohamad AlaaEldein Elsuity
- Egyptian Foundation for Reproductive Medicine and Embryology (EFRE), Alexandria, Egypt
- Dermatology, Venereology and Andrology Department, Sohag University, Sohag, Egypt
- Ibnsina, Ajyal, Qena, Amshag IVF Facilities, Sohag and Assiut, Egypt
| | - Nehal Adel
- Egyptian Foundation for Reproductive Medicine and Embryology (EFRE), Alexandria, Egypt
- Madina Fertility Centre, Madina Women's Hospital, Alexandria, Egypt
| | - Yasmin Magdi
- Egyptian Foundation for Reproductive Medicine and Embryology (EFRE), Alexandria, Egypt
- Al-Yasmeen Fertility and Gynaecology Centre, Benha, Qalubyia, Egypt
| | - Amr S Abdelbadie
- Egyptian Foundation for Reproductive Medicine and Embryology (EFRE), Alexandria, Egypt
- Department of Obstetrics and Gynaecology, Aswan University, Aswan, Egypt
| | - Mosab M Rashwan
- Ibnsina, Ajyal, Qena, Amshag IVF Facilities, Sohag and Assiut, Egypt
- Forensic Medicine & Clinical Toxicology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Ola Youssef Ahmed
- Obstetrics and Gynaecology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
- Egyptian Foundation for Reproductive Medicine and Embryology (EFRE), Alexandria, Egypt
| | - Mohamed Elmahdy
- Obstetrics and Gynaecology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
- Egyptian Foundation for Reproductive Medicine and Embryology (EFRE), Alexandria, Egypt
| | - Khalid S Khan
- Centre for Biomedical Research in Epidemiology and Public Health Network (CIBERESP), University of Granada, Granada, Spain
| | - Mohamed Fawzy
- Egyptian Foundation for Reproductive Medicine and Embryology (EFRE), Alexandria, Egypt
- Ibnsina, Ajyal, Qena, Amshag IVF Facilities, Sohag and Assiut, Egypt
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Cao H, Chen Y, Ge L, Kwong JSW, Lai H, Hu F, Zhang R, Zhao H, Hu L, He R, Zheng W, Zhang J. An umbrella review of the diagnostic value of next-generation sequencing in infectious diseases. Int J Clin Pharm 2024; 46:780-794. [PMID: 38570474 DOI: 10.1007/s11096-024-01704-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 01/18/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND An increasing number of systematic reviews (SRs) have evaluated the diagnostic values of next-generation sequencing (NGS) in infectious diseases (IDs). AIM This umbrella analysis aimed to assess the potential risk of bias in existing SRs and to summarize the published diagnostic values of NGS in different IDs. METHOD We searched PubMed, Embase, and the Cochrane Library until September 2023 for SRs assessing the diagnostic validity of NGS for IDs. Two investigators independently determined review eligibility, extracted data, and evaluated reporting quality, risk of bias, methodological quality, and evidence certainty in the included SRs. RESULTS Eleven SRs were analyzed. Most SRs exhibited a moderate level of reporting quality, while a serious risk of bias was observed in all SRs. The diagnostic performance of NGS in detecting pneumocystis pneumonia and periprosthetic/prosthetic joint infection was notably robust, showing excellent sensitivity (pneumocystis pneumonia: 0.96, 95% CI 0.90-0.99, very low certainty; periprosthetic/prosthetic joint infection: 0.93, 95% CI 0.83-0.97, very low certainty) and specificity (pneumocystis pneumonia: 0.96, 95% CI 0.92-0.98, very low certainty; periprosthetic/prosthetic joint infection: 0.95, 95% CI 0.92-0.97, very low certainty). NGS exhibited high specificity for central nervous system infection, bacterial meningoencephalitis, and tuberculous meningitis. The sensitivity to these infectious diseases was moderate. NGS demonstrated moderate sensitivity and specificity for multiple infections and pulmonary infections. CONCLUSION This umbrella analysis indicates that NGS is a promising technique for diagnosing pneumocystis pneumonia and periprosthetic/prosthetic joint infection with excellent sensitivity and specificity. More high-quality original research and SRs are needed to verify the current findings.
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Affiliation(s)
- Hong Cao
- School of Pharmaceutical Sciences, Guizhou University, 2708 South of Huaxi Avenue Road, Guiyang, Guizhou Province, China
- Department of Pharmacy, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China
| | - Yan Chen
- School of Pharmaceutical Sciences, Guizhou University, 2708 South of Huaxi Avenue Road, Guiyang, Guizhou Province, China
- Department of Pharmacy, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China
| | - Long Ge
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, No. 199, Donggang West Road, Chengguan District, Lanzhou City, Gansu Province, China
| | - Joey Sum-Wing Kwong
- Global Health Nursing, Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-0044, Japan
| | - Honghao Lai
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, No. 199, Donggang West Road, Chengguan District, Lanzhou City, Gansu Province, China
| | - Fangfang Hu
- Department of Laboratory, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, 550002, Guizhou Province, China
| | - Rui Zhang
- Department of Pharmacy, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China
| | - Huaye Zhao
- Department of Pharmacy, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China
| | - Linfang Hu
- Department of Pharmacy, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China
| | - Rui He
- Experimental Cancer Medicine, Department of Laboratory Medicine, Karolinska Institute, Room 601, Novum PI 6, Hälsovägen 7, Huddinge, 14157, Stockholm, Sweden
| | - Wenyi Zheng
- Experimental Cancer Medicine, Department of Laboratory Medicine, Karolinska Institute, Room 601, Novum PI 6, Hälsovägen 7, Huddinge, 14157, Stockholm, Sweden
| | - Jiaxing Zhang
- Department of Pharmacy, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China.
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Nagendrababu V, Gopinath VK, Narasimhan S, Acharya AB, Dummer PMH, Faggion CM. Methodological quality of umbrella reviews in endodontics: A cross-sectional study. Int Endod J 2024. [PMID: 39016048 DOI: 10.1111/iej.14114] [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: 03/14/2024] [Revised: 04/25/2024] [Accepted: 06/10/2024] [Indexed: 07/18/2024]
Abstract
INTRODUCTION In endodontics, the number of umbrella reviews has increased significantly over the last few years, but there is no evidence that they were methodologically sound. The aim of the current study was to appraise the methodological quality of umbrella reviews in endodontics, and to identify possible predictive factors associated with methodological quality. METHODS Umbrella reviews published in the discipline of endodontics until December 2023 were included. The methodological quality of the reviews was evaluated using a checklist consisting of 11 items. Each item in the checklist was evaluated by two independent assessors who assigned a score of '1' if it was fully addressed, '0.5' if it was partially ddressed, and '0' if it was not addressed. Bootstrapped multiple linear regression analysis was used to examine the association between the total scores awarded and five predictor variables (a priori protocol registration, year of publication, number of authors, journal impact factor (IF) and continent of the corresponding author). The statistical significance level was set as 5%. RESULTS A total of 27 reviews were included. Ninety-six per cent of the reviews adequately reported: eligibility criteria for selecting the reviews, details of the reviews, techniques for assessing the risk of bias or methodological quality of the individual systematic reviews they included. Only 30% of the reviews adequately managed overlapping primary studies within individual systematic reviews. Among the five predictors analysed, a priori protocol registration and journals with IFs were associated with significantly greater total methodological quality scores. DISCUSSION Several methodological shortcomings in the umbrella reviews published within the field of endodontics were revealed. Umbrella reviews published in journals with IFs and those with protocols registered a priori had significantly superior methodological quality scores. CONCLUSION In endodontics, authors intending to publish umbrella reviews should consider the limitations revealed in this study and follow the appropriate rules to ensure their reviews comply with the highest standards and provide accurate and dependable information and conclusions.
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Affiliation(s)
- Venkateshbabu Nagendrababu
- Department of Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Vellore Kannan Gopinath
- Department of Orthodontics, Pediatric and Community Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | | | - Anirudh B Acharya
- Department of Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Paul M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Clovis Mariano Faggion
- Department of Periodontology and Operative Dentistry, Faculty of Dentistry, University Hospital Münster, Münster, Germany
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Aiyar A, Pedersen TK, Resnick CM, Nørholt SE, Verna C, Stoustrup PB. Management of unilateral craniofacial microsomia with orthopaedic functional appliances: A systematic literature review. Orthod Craniofac Res 2024; 27 Suppl 1:131-140. [PMID: 37987216 DOI: 10.1111/ocr.12729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2023] [Indexed: 11/22/2023]
Abstract
The study aimed to summarize current knowledge regarding the use of orthopaedic functional appliances (OFA) in managing unilateral craniofacial microsomia (UCM). The eligibility criteria for the review were (1) assessing use of OFA as a stand-alone treatment and (2) using OFA in combination during or after MDO. The PICO (population, intervention, comparison and outcome) format formulated clinical questions with defined inclusion and exclusion criteria. No limitations concerning language and publication year were applied. Information sources: A literature search of Medline, Scopus, Embase, Cochrane Central Register of Controlled Trials, Web of Science databases without restrictions up to 30 September 2022. The risk of bias was assessed. According to Cochrane and PRISMA guidelines, two independent authors conducted data extraction. The level of evidence for included articles was evaluated based on the Oxford evidence-based medicine database. Due to the heterogeneity of studies and insufficient data for statistical pooling, meta-analysis was not feasible. Therefore, the results were synthesized narratively. A total of 437 articles were retrieved. Of these, nine met inclusion criteria: five assessing OFA and four assessing OFA during or after MDO. There is limited evidence to suggest that stand-alone and combination treatment with OFA is beneficial for treating mild-to-moderate UCM-related dentofacial deformities in short term. No studies assessed the burden of care. In the management of UCM, there is insufficient evidence supporting the efficacy of OFA as a stand-alone treatment or when combined with MDO. Additionally, there is a lack of evidence regarding treatment protocols and the effect on the condyles and the TMJ. The study was registered at Prospero database number CRD42020204969.
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Affiliation(s)
- Akila Aiyar
- Section for Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Thomas Klit Pedersen
- Section for Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Cory M Resnick
- Harvard School of Dental Medicine and Harvard Medical School, Boston, Massachusetts, USA
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Sven Erik Nørholt
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
- Section of Oral and Maxillofacial Surgery and Oral Pathology, Department of Dentistry and Oral Health, Aarhus Univerisity, Aarhus, Denmark
| | - Carlalberta Verna
- Department of Paediatric Oral Heath and Orthodontics, University Centre for Dental Medicine UZB University of Basel, Basel, Switzerland
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Heredia-Rizo AM, Martinez-Calderon J, Piña-Pozo F, González-García P, García-Muñoz C. Effectiveness of mind-body exercises in chronic respiratory diseases: an overview of systematic reviews with meta-analyses. Disabil Rehabil 2024; 46:2496-2511. [PMID: 37480272 DOI: 10.1080/09638288.2023.2233899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 07/04/2023] [Indexed: 07/23/2023]
Abstract
PURPOSE To gather evidence on the effectiveness and safety of qigong, tai chi, and yoga to modulate symptoms associated with chronic respiratory diseases. METHODS A search of systematic reviews was conducted in CINHAL, Embase, PubMed, PsycINFO, SPORTDiscus, and the Cochrane Library from inception to November 2022. Systematic reviews with meta-analyses investigating physical and psychological measures were eligible. The methodological quality of systematic reviews (AMSTAR-2), the spin of information in abstracts, and the overlap of primary studies were explored. RESULTS Twenty-seven systematic reviews involving 37 000 participants, 146 studies, and 150 meta-analyses were included. Reviews investigated asthma (n = 4) and chronic obstructive pulmonary disease (COPD) (n = 23). Most reviews discussed their findings without considering the risk of bias of primary studies. The overlap ranged between slight (5%) and very high (35%). Yoga was better than control interventions to improve symptoms related with asthma. In adults with COPD, qigong improved dyspnoea, exercise endurance, lung function, and quality of life, while tai chi and yoga increased exercise endurance. CONCLUSIONS The impact of yoga on symptoms associated with asthma varied depending on the lung function parameter and the control group. Qigong, tai chi, and yoga could be effective to improve COPD-related symptoms, especially exercise endurance.
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Affiliation(s)
- Alberto Marcos Heredia-Rizo
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, c/Avicena s/n, Sevilla, Spain
- Instituto de Biomedicina de Sevilla, IBiS, Departamento de Fisioterapia, Universidad de Sevilla, Seville, Spain
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMMS) Research Group, Andalusia, Spain
| | - Javier Martinez-Calderon
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, c/Avicena s/n, Sevilla, Spain
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMMS) Research Group, Andalusia, Spain
| | - Fernando Piña-Pozo
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMMS) Research Group, Andalusia, Spain
- Departamento de Fisioterapia, Escuela Universitaria Francisco Maldonado, Universidad de Sevilla, Osuna, Spain
| | - Paula González-García
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, c/Avicena s/n, Sevilla, Spain
- Instituto de Biomedicina de Sevilla, IBiS, Departamento de Fisioterapia, Universidad de Sevilla, Seville, Spain
| | - Cristina García-Muñoz
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMMS) Research Group, Andalusia, Spain
- Departamento de Enfermería y Fisioterapia, Facultad de Enfermería y Fisioterapia, Universidad de Cádiz, Cádiz, Spain
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Lunny C, Kanji S, Thabet P, Haidich AB, Bougioukas KI, Pieper D. Assessing the methodological quality and risk of bias of systematic reviews: primer for authors of overviews of systematic reviews. BMJ MEDICINE 2024; 3:e000604. [PMID: 38826514 PMCID: PMC11141200 DOI: 10.1136/bmjmed-2023-000604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 05/03/2024] [Indexed: 06/04/2024]
Affiliation(s)
- Carole Lunny
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
- Cochrane Hyptertension Review Group, Cochrane Canada, Vancouver, BC, Canada
| | - Salmaan Kanji
- Ottawa Hospital, Ottawa, ON, Canada
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Pierre Thabet
- School of Pharmaceutical Sciences University of Ottawa, Hôpital Montfort, Ottawa, ON, Canada
| | - Anna-Bettina Haidich
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, Aristotle University of Thessaloniki Faculty of Health Sciences, Thessaloniki, Central Macedonia, Greece
| | - Konstantinos I Bougioukas
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, Aristotle University of Thessaloniki Faculty of Health Sciences, Thessaloniki, Central Macedonia, Greece
| | - Dawid Pieper
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane Ruppin Clinics, Neuruppin, Brandenburg, Germany
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Burton R, Sharpe C, Bhuptani S, Jecks M, Henn C, Pearce-Smith N, Knight S, Regan M, Sheron N. The relationship between the price and demand of alcohol, tobacco, unhealthy food, sugar-sweetened beverages, and gambling: an umbrella review of systematic reviews. BMC Public Health 2024; 24:1286. [PMID: 38730332 PMCID: PMC11088175 DOI: 10.1186/s12889-024-18599-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 04/15/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND The WHO highlight alcohol, tobacco, unhealthy food, and sugar-sweetened beverage (SSB) taxes as one of the most effective policies for preventing and reducing the burden of non-communicable diseases. This umbrella review aimed to identify and summarise evidence from systematic reviews that report the relationship between price and demand or price and disease/death for alcohol, tobacco, unhealthy food, and SSBs. Given the recent recognition as gambling as a public health problem, we also included gambling. METHODS The protocol for this umbrella review was pre-registered (PROSPERO CRD42023447429). Seven electronic databases were searched between 2000-2023. Eligible systematic reviews were those published in any country, including adults or children, and which quantitatively examined the relationship between alcohol, tobacco, gambling, unhealthy food, or SSB price/tax and demand (sales/consumption) or disease/death. Two researchers undertook screening, eligibility, data extraction, and risk of bias assessment using the ROBIS tool. RESULTS We identified 50 reviews from 5,185 records, of which 31 reported on unhealthy food or SSBs, nine reported on tobacco, nine on alcohol, and one on multiple outcomes (alcohol, tobacco, unhealthy food, and SSBs). We did not identify any reviews on gambling. Higher prices were consistently associated with lower demand, notwithstanding variation in the size of effect across commodities or populations. Reductions in demand were large enough to be considered meaningful for policy. CONCLUSIONS Increases in the price of alcohol, tobacco, unhealthy food, and SSBs are consistently associated with decreases in demand. Moreover, increasing taxes can be expected to increase tax revenue. There may be potential in joining up approaches to taxation across the harm-causing commodities.
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Affiliation(s)
- Robyn Burton
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, England.
- Institute for Social Marketing and Health UK, University of Stirling, Stirling, FK9 4LA, Scotland, UK.
| | - Casey Sharpe
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, England
| | - Saloni Bhuptani
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, England
| | - Mike Jecks
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, England
| | - Clive Henn
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, England
| | - Nicola Pearce-Smith
- UK Health Security Agency (UKHSA), 10 South Colonnade, Canary Wharf, London, England
| | - Sandy Knight
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, England
| | - Marguerite Regan
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, England
| | - Nick Sheron
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, England
- The Roger Williams Institute of Hepatology, Kings College London, London, England
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10
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Valente V, Machado D, Jorge S, Drake CL, Marques DR. Does valerian work for insomnia? An umbrella review of the evidence. Eur Neuropsychopharmacol 2024; 82:6-28. [PMID: 38359657 DOI: 10.1016/j.euroneuro.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 01/22/2024] [Accepted: 01/25/2024] [Indexed: 02/17/2024]
Abstract
Valerian is one of the most used herbal agents (phytotherapeutics) to manage sleep disturbances, in particular, sleep-onset difficulties in young adults. However, the evidence based on primary studies and systematic reviews that supports its use in this domain is weak or inconclusive. In the current study, an umbrella review was performed on the efficacy of valerian for sleep disturbances with a focus on insomnia. As such, only systematic reviews (with or without meta-analysis) were considered for this study. Systematic searches in PubMed, Web of Science, Scopus, Cochrane Database of Systematic Reviews, PROSPERO and CNKI databases retrieved 70 records. Only 8 articles were considered eligible for qualitative analysis. Overall, data suggested that valerian has a good safety profile, however, the results showed no evidence of efficacy for the treatment of insomnia. Moreover, valerian appears to be effective concerning subjective improvement of sleep quality, although its effectiveness has not been demonstrated with quantitative or objective measurements. Despite its widespread use and prescription by general practitioners, psychiatrists and other professionals, valerian does not have empirical support for insomnia. Further studies, in particular high quality randomized controlled trials, are highly recommended since there are scarce studies and the existing ones are quite heterogeneous and with low methodological quality. The implications of our findings for clinical practice are critically discussed.
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Affiliation(s)
- Valéria Valente
- University of Aveiro, Department of Education and Psychology, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - Daniela Machado
- University of Aveiro, Department of Education and Psychology, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - Susana Jorge
- University of Aveiro, Department of Education and Psychology, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - Christopher L Drake
- Sleep Disorders and Research Center, Henry Ford Hospital, Detroit, MI 48202, USA
| | - Daniel Ruivo Marques
- University of Aveiro, Department of Education and Psychology, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal; CINEICC - Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal.
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11
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Salem A, Trabelsi K, Jahrami H, AlRasheed MM, Boukhris O, Puce L, Bragazzi NL, Ammar A, Glenn JM, Chtourou H. Branched-Chain Amino Acids Supplementation and Post-Exercise Recovery: An Overview of Systematic Reviews. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2024; 43:384-396. [PMID: 38241335 DOI: 10.1080/27697061.2023.2297899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 12/17/2023] [Indexed: 01/21/2024]
Abstract
Objective: This overview of systematic reviews (OoSRs) aimed, firstly, to systematically review, summarize, and appraise the findings of published systematic reviews with or without meta-analyses that investigate the effects of branched-chain amino acids (BCAA) on post-exercise recovery of muscle damage biomarkers, muscle soreness, and muscle performance. The secondary objective was to re-analyze and standardize the results of meta-analyses using the random-effects Hartung-Knapp-Sidik-Jonkman (HKSJ) method.Methods: The methodological quality of the reviews was assessed using A Measurement Tool to Assess Systematic Reviews 2.We searched on five databases (i.e., PubMed, Web of Science, Scopus, SPORTDiscus, ProQuest) for systematic reviews with or without meta-analyses that investigated the effects of BCAA supplementation on the post-exercise recovery of muscle damage biomarkers, muscle soreness, and muscle performance.Results: Eleven systematic reviews (seven with meta-analyses) of individual studies were included. Evidence suggests BCAA ingestion attenuates creatine kinase (CK) levels (medium effects) and muscle soreness (small effects) immediately post-exercise and accelerates their recovery process, with trivial-to-large effects for CK levels and small-to-large effects for muscle soreness. BCAA supplementation has no effect on lactate dehydrogenase, myoglobin, and muscle performance recovery. The re-analyses with HKSJ method using the original data reported a slight change in results significance, concluding the same evidence as the original results. The major flaws found in the analyzed reviews were the absence of justification for excluding studies, and the lack of provision of sources of funding for primary studies and sources of conflict of interest and/or funding description.Conclusions: BCAA supplementation is an effective method to reduce post-exercise muscle damage biomarkers, particularly CK levels, and muscle soreness, with no effect on muscle performance. Future systematic reviews with/without meta-analyses, with greater methodological rigor, are needed.
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Affiliation(s)
- Atef Salem
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis, Tunisia
| | - Khaled Trabelsi
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Haitham Jahrami
- Ministry of Health, Manama, Bahrain
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Maha M AlRasheed
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Omar Boukhris
- Sport and Exercise Science, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Luca Puce
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Ital
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Achraf Ammar
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jordan M Glenn
- Department of Health, Exercise Science Research Center Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA
| | - Hamdi Chtourou
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis, Tunisia
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12
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Xie K, Jing H, Guan S, Kong X, Ji W, Du C, Jia M, Wang H. Extracorporeal membrane oxygenation technology for adults: an evidence mapping based on systematic reviews. Eur J Med Res 2024; 29:247. [PMID: 38650017 PMCID: PMC11036703 DOI: 10.1186/s40001-024-01837-0] [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: 07/12/2023] [Accepted: 04/10/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Extracorporeal membrane oxygenation (ECMO) is a cutting-edge life-support measure for patients with severe cardiac and pulmonary illnesses. Although there are several systematic reviews (SRs) about ECMO, it remains to be seen how quality they are and how efficacy and safe the information about ECMO they describe is in these SRs. Therefore, performing an overview of available SRs concerning ECMO is crucial. METHODS We searched four electronic databases from inception to January 2023 to identify SRs with or without meta-analyses. The Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) tool, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system were used to assess the methodological quality, and evidence quality for SRs, respectively. A bubble plot was used to visually display clinical topics, literature size, number of SRs, evidence quality, and an overall estimate of efficacy. RESULTS A total of 17 SRs met eligibility criteria, which were combined into 9 different clinical topics. The methodological quality of the included SRs in this mapping was "Critically low" to "Moderate". One of the SRs was high-quality evidence, three on moderate, three on low, and two on very low-quality evidence. The most prevalent study used to evaluate ECMO technology was observational or cohort study with frequently small sample sizes. ECMO has been proven beneficial for severe ARDS and ALI due to the H1N1 influenza infection. For ARDS, ALF or ACLF, and cardiac arrest were concluded to be probably beneficial. For dependent ARDS, ARF, ARF due to the H1N1 influenza pandemic, and cardiac arrest of cardiac origin came to an inconclusive conclusion. There was no evidence for a harmful association between ECMO and the range of clinical topics. CONCLUSIONS There is limited available evidence for ECMO that large sample, multi-center, and multinational RCTs are needed. Most clinical topics are reported as beneficial or probably beneficial of SRs for ECMO. Evidence mapping is a valuable and reliable methodology to identify and present the existing evidence about therapeutic interventions.
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Affiliation(s)
- Kai Xie
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of People's Republic of China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Hui Jing
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of People's Republic of China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Shengnan Guan
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of People's Republic of China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Xinxin Kong
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of People's Republic of China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Wenshuai Ji
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of People's Republic of China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Chen Du
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of People's Republic of China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Mingyan Jia
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of People's Republic of China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Haifeng Wang
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China.
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China.
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of People's Republic of China, Henan University of Chinese Medicine, Zhengzhou, China.
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13
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Romantsik O, Bank M, Menon JML, Malhotra A, Bruschettini M. Value of preclinical systematic reviews and meta-analyses in pediatric research. Pediatr Res 2024:10.1038/s41390-024-03197-1. [PMID: 38615075 DOI: 10.1038/s41390-024-03197-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 03/15/2024] [Accepted: 03/23/2024] [Indexed: 04/15/2024]
Abstract
Similar to systematic reviews (SRs) in clinical fields, preclinical SRs address a specific research area, furnishing information on current knowledge, possible gaps, and potential methodological flaws of study design, conduct, and report. One of the main goals of preclinical SRs is to identify aspiring treatment strategies and evaluate if currently available data is solid enough to translate to clinical trials or highlight the gaps, thus justifying the need for new studies. It is imperative to rigorously follow the methodological standards that are widely available. These include registration of the protocol and adherence to guidelines for assessing the risk of bias, study quality, and certainty of evidence. A special consideration should be made for pediatric SRs, clinical and preclinical, due to the unique characteristics of this age group. These include rationale for intervention and comparison of primary and secondary outcomes. Outcomes measured should acknowledge age-related physiological changes and maturational processes of different organ systems. It is crucial to choose the age of the animals appropriately and its possible correspondence for specific pediatric age groups. The findings of well-conducted SRs of preclinical studies have the potential to provide a reliable evidence synthesis to guide the design of future preclinical and clinical studies. IMPACT: This narrative review highlights the importance of rigorous design, conduct and reporting of preclinical primary studies and systematic reviews. A special consideration should be made for pediatric systematic reviews of preclinical studies, due to the unique characteristics of this age group.
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Affiliation(s)
- Olga Romantsik
- Department of Clinical Sciences Lund, Division of Pediatrics, Lund University, Skåne University Hospital, Lund, 21185, Sweden.
| | - Matthias Bank
- Library and ICT, Faculty of Medicine, Lund University, Lund, Sweden
| | - Julia M L Menon
- Preclinicaltrials.eu, Netherlands Heart Institute, Utrecht, The Netherlands
| | - Atul Malhotra
- Department of Pediatrics, Monash University, Melbourne, Australia
- Monash Newborn, Monash Children's Hospital, Melbourne, Australia
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia
| | - Matteo Bruschettini
- Department of Clinical Sciences Lund, Division of Pediatrics, Lund University, Skåne University Hospital, Lund, 21185, Sweden
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Martinez-Calderon J, Villar-Alises O, García-Muñoz C, Pineda-Escobar S, Matias-Soto J. Exercise or mind-body exercises for psychiatry symptoms and quality of life in schizophrenia spectrum and other psychotic disorders: an overview of systematic reviews with meta-analysis. Disabil Rehabil 2024:1-17. [PMID: 38436073 DOI: 10.1080/09638288.2024.2321318] [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: 06/13/2023] [Accepted: 02/14/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE This overview of systematic reviews with meta-analysis aimed to summarize the effects of exercise, regular physical activity, and mind-body exercises on negative symptoms, depression symptoms, and quality of life in schizophrenia spectrum and other psychotic disorders. MATERIAL AND METHODS The CINAHL, Embase, PubMed, SPORTDiscus, and the Cochrane Library databases were searched up to November 10, 2023. AMSTAR 2 was used and the overlap between reviews was calculated. RESULTS Eighteen reviews were included. No reviews meta-analyzed regular physical activity. Aerobic exercise may be more effective than yoga, treatment-as-usual, or multiple controls for reducing negative symptoms. Tai chi may be more effective than multiple controls for decreasing negative symptoms. Aerobic exercise or multimodal exercise programs may be more effective than multiple controls for reducing depression symptoms. Yoga may be more effective than waitlist for decreasing depression symptoms. Aerobic exercise may be more effective than multiple controls for improving quality of life. Yoga may be more effective than treatment-as-usual for improving quality of life. The rest of the meta-analyses found no differences between groups or combined different types of interventions in their meta-analyses. CONCLUSIONS Despite these results, important methodological concerns were detected that precluded us from making sound clinical recommendations. PROTOCOL REGISTRATION https://doi.org/10.17605/OSF.IO/7V5QZ.
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Affiliation(s)
- Javier Martinez-Calderon
- Instituto de Biomedicina de Sevilla, IBiS, Departamento de Fisioterapia, Universidad de Sevilla, Sevilla, Spain
- CTS 1110: Understanding Movement and Self in health from Science (UMSS) Research Group, Andalusia, Spain
| | - Olga Villar-Alises
- CTS 1110: Understanding Movement and Self in health from Science (UMSS) Research Group, Andalusia, Spain
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
| | - Cristina García-Muñoz
- CTS 1110: Understanding Movement and Self in health from Science (UMSS) Research Group, Andalusia, Spain
- Departamento de Ciencias de la Salud y Biomédicas, Universidad Loyola de Andalucía, Sevilla, Spain
| | - Saul Pineda-Escobar
- CTS 1110: Understanding Movement and Self in health from Science (UMSS) Research Group, Andalusia, Spain
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
| | - Javier Matias-Soto
- CTS 1110: Understanding Movement and Self in health from Science (UMSS) Research Group, Andalusia, Spain
- Faculty of Health Sciences, Department of Physical Therapy, Universidad de Malaga, Malaga, Spain
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15
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Arora NK, Donath L, Owen PJ, Miller CT, Saueressig T, Winter F, Hambloch M, Neason C, Karner V, Belavy DL. The Impact of Exercise Prescription Variables on Intervention Outcomes in Musculoskeletal Pain: An Umbrella Review of Systematic Reviews. Sports Med 2024; 54:711-725. [PMID: 38093145 PMCID: PMC10978700 DOI: 10.1007/s40279-023-01966-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2023] [Indexed: 04/01/2024]
Abstract
BACKGROUND Musculoskeletal pain conditions are the largest contributors to disability and healthcare burden globally. Exercise interventions improve physical function and quality of life in individuals with musculoskeletal pain, yet optimal exercise prescription variables (e.g. duration, frequency, intensity) are unclear. OBJECTIVE We aimed to examine evidence gaps, methodological quality and exercise prescription recommendations in systematic reviews of exercise for musculoskeletal pain. METHODS In our prospectively registered umbrella review, PubMed, SPORTDiscus, Cochrane Database of Systematic Reviews, EMBASE, and CINAHL were searched from inception to 14 February 2023. Backward citation tracking was performed. We included peer-reviewed, English language, systematic reviews and meta-analyses of randomized controlled trials (RCTs) and controlled clinical trials (CCTs) that compared exercise with conservative treatment, placebo or other exercise interventions in adults with musculoskeletal pain. Data were extracted from the following groups of reviews based on their reporting of exercise prescription data and analysis of the relationship between prescription variables and outcomes: (1) those that did not report any exercise prescription data, (2) those that reported exercise prescription data but did not perform a quantitative analysis and (3) those that performed a quantitative analysis of the relationship between exercise prescription variables and outcomes. Outcome measures were physical function, pain, mental health, adverse effects and adherence to treatment. AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews) was used to assess methodological quality. RESULTS From 6757 records, 274 systematic reviews were included. 6.6% of reviews did not report any exercise prescription data, and only 10.9% quantitatively analyzed the relationship between prescription variables and the outcome(s). The overall methodological quality was critically low in 85% of reviews. CONCLUSION High methodological quality evidence is lacking for optimal exercise training prescription variables in individuals with musculoskeletal pain. To better inform practice and evidence gaps, future systematic reviews should (1) identify optimum exercise prescription variables, for example, via dose-response (network) meta-analysis, (2) perform high-quality reviews per AMSTAR-2 criteria and (3) include outcomes of mental health, adverse events and exercise adherence. PROSPERO REGISTRATION NUMBER CRD42021287440 ( https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021287440 ).
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Affiliation(s)
- Nitin Kumar Arora
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Sciences), Gesundheitscampus 6-8, 44801, Bochum, Germany
- Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne, Germany
| | - Lars Donath
- Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne, Germany
| | - Patrick J Owen
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Clint T Miller
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Tobias Saueressig
- Science and Research, Physio Meets Science GmbH, Leimen, Baden-Württemberg, Germany
| | - Felicitas Winter
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Sciences), Gesundheitscampus 6-8, 44801, Bochum, Germany
| | - Marina Hambloch
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Sciences), Gesundheitscampus 6-8, 44801, Bochum, Germany
| | - Christopher Neason
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Vera Karner
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Sciences), Gesundheitscampus 6-8, 44801, Bochum, Germany
| | - Daniel L Belavy
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Sciences), Gesundheitscampus 6-8, 44801, Bochum, Germany.
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16
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Martinez-Calderon J, García-Muñoz C, Rufo-Barbero C, Matias-Soto J, Cano-García FJ. Acceptance and Commitment Therapy for Chronic Pain: An Overview of Systematic Reviews with Meta-Analysis of Randomized Clinical Trials. THE JOURNAL OF PAIN 2024; 25:595-617. [PMID: 37748597 DOI: 10.1016/j.jpain.2023.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/08/2023] [Accepted: 09/18/2023] [Indexed: 09/27/2023]
Abstract
This overview of reviews aimed to summarize the evidence from systematic reviews and meta-analyses of randomized clinical trials of the efficacy of acceptance and commitment therapy (ACT) for adults with chronic pain in relation to pain intensity, pain-related functioning, quality of life, and psychological factors. The Cumulative Index of Nursing and Allied Health Literature (CINAHL), Embase, PsycINFO, PubMed, and the Cochrane Library databases were searched from inception to July 2, 2023. AMSTAR 2 was used to assess the methodological quality of systematic reviews. The overlap among reviews was calculated. Nine reviews comprising 84 meta-analyses of interest were included. At post-treatment, some meta-analyses mainly showed that ACT can reduce depression symptoms, anxiety symptoms, psychological inflexibility, and pain catastrophizing; and can improve mindfulness, pain acceptance, and psychological flexibility. At three-month follow-up, ACT can reduce depression symptoms and psychological inflexibility, as well as improve pain-related functioning and psychological flexibility. At six-month follow-up, ACT can improve mindfulness, pain-related functioning, pain acceptance, psychological flexibility, and quality of life. At six-twelve-month follow-up, ACT can reduce pain catastrophizing and can improve pain-related functioning. Some methodological and clinical issues are identified in the reviews, such as a very high overlap between systematic reviews, the fact that the certainty of the evidence is often not rated and specific details needed to replicate the interventions reviewed are often not reported. Overall, however, randomized clinical trials and systematic reviews show that ACT can improve outcomes related to chronic pain (eg, pain-related functioning). Future systematic reviews should address the methodological and clinical concerns identified here to produce higher-quality findings. PERSPECTIVE: Despite certain methodological and clinical issues, randomized clinical trials and systematic reviews of ACT appear to show that it can improve outcomes related to chronic pain (eg, psychological factors).
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Affiliation(s)
- Javier Martinez-Calderon
- Instituto de Biomedicina de Sevilla, IBiS, Departamento de Fisioterapia, Universidad de Sevilla, Sevilla, Spain; CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMSS) Research Group, Andalusia, Spain
| | - Cristina García-Muñoz
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMSS) Research Group, Andalusia, Spain; Universidad Loyola de Andalucía, Sevilla, Spain
| | - Carmen Rufo-Barbero
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos, Universidad de Sevilla, Sevilla, Spain
| | - Javier Matias-Soto
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMSS) Research Group, Andalusia, Spain; Universidad de Malaga, Faculty of Health Sciences, Department of Physical Therapy, Malaga, Spain
| | - Francisco J Cano-García
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos, Universidad de Sevilla, Sevilla, Spain
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Meng TT, You YP, Li M, Guo JB, Song XB, Ding JY, Xie XL, Li AQ, Li SJ, Yin XJ, Wang P, Wang Z, Wang BL, He QY. Chinese herbal medicine Ginkgo biloba L. preparations for ischemic stroke: An overview of systematic reviews and meta-analyses. JOURNAL OF INTEGRATIVE MEDICINE 2024; 22:163-179. [PMID: 38519277 DOI: 10.1016/j.joim.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/25/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND Ginkgo biloba L. preparations (GBLPs) are a class of Chinese herbal medicine used in the adjuvant treatment of ischemic stroke (IS). Recently, several systematic reviews (SRs) and meta-analyses (MAs) of GBLPs for IS have been published. OBJECTIVE This overview aims to assess the quality of related SRs and MAs. SEARCH STRATEGY PubMed, Embase, Cochrane Library, Web of Science, Chinese Biological Medicine, China National Knowledge Infrastructure, Wanfang, and Chinese Science and Technology Journals databases were searched from their inception to December 31, 2022. INCLUSION CRITERIA SRs and MAs of randomized controlled trials (RCTs) that explored the efficacy of GBLPs for patients with IS were included. DATA EXTRACTION AND ANALYSIS Two independent reviewers extracted data and assessed the methodological quality, risk of bias (ROB), reporting quality, and credibility of evidence of the included SRs and MAs using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2), Risk of Bias in Systematic Reviews (ROBIS), the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), and the Grading of Recommendations Assessment, Development and Evaluation (GRADE), respectively. Additionally, descriptive analysis and data synthesis were conducted. RESULTS Twenty-nine SRs/MAs involving 119 outcomes were included in this review. The overall methodological quality of all SRs/MAs was critically low based on AMSTAR 2, and 28 had a high ROB based on the ROBIS. According to the PRISMA statement, the reporting items of the included SRs/MAs are relatively complete. The results based on GRADE showed that of the 119 outcomes, 8 were rated as moderate quality, 24 as low quality, and 87 as very low quality. Based on the data synthesis, GBLPs used in conjunction with conventional treatment were superior to conventional treatment alone for decreasing neurological function scores. CONCLUSION GBLPs can be considered a beneficial supplemental therapy for IS. However, because of the low quality of the existing evidence, high-quality RCTs and SRs/MAs are warranted to further evaluate the benefits of GBLPs for treating IS. Please cite this article as: Meng TT, You YP, Li M, Guo JB, Song XB, Ding JY, Xie XL, Li AQ, Li SJ, Yin XJ, Wang P, Wang Z, Wang BL, He QY. Chinese herbal medicine Ginkgo biloba L. preparations for ischemic stroke: An overview of systematic reviews and meta-analyses. J Integr Med. 2024;22(2): 163-179.
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Affiliation(s)
- Tian-Tian Meng
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100032, China; Department of Rehabilitation, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100071, China
| | - Ya-Ping You
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100032, China
| | - Min Li
- School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Jian-Bo Guo
- School of Chinese Medicine, the University of Hong Kong, Hong Kong, China
| | - Xin-Bin Song
- Graduate School, Henan University of Chinese Medicine, Zhengzhou 450008, Henan Province, China
| | - Jing-Yi Ding
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100032, China
| | - Xiao-Long Xie
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100010, China
| | - An-Qi Li
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100032, China
| | - Shang-Jin Li
- School of Integrated Traditional Chinese and Western Medicine, Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Xiang-Jun Yin
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Peng Wang
- Graduate School, Henan University of Chinese Medicine, Zhengzhou 450008, Henan Province, China
| | - Zhe Wang
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100032, China
| | - Bao-Liang Wang
- Department of Neurology, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450003, Henan Province, China.
| | - Qing-Yong He
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100032, China.
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Hasanoff S, Pollock D, Barker TH, Munn Z. Tools to assess the risk of bias of evidence syntheses: a scoping review protocol. JBI Evid Synth 2024; 22:472-480. [PMID: 38044843 DOI: 10.11124/jbies-23-00316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
OBJECTIVE The aim of this scoping review is to identify and examine risk of bias tools, critical appraisal tools, and/or assessment of methodological quality tools (including their items and domains) developed to assess all types of evidence syntheses. INTRODUCTION Evidence synthesis is often the basis for policies, procedures, decisions, and evidence-based practice. It is imperative that evidence syntheses are of good quality, reproducible, and reliable. Despite methodological advancements, there remains a substantial risk that bias is present in the conduct of an evidence synthesis project, hindering the validity and reliability of the findings. One way to assess bias is through formal tools and assessments for assessing the risk of bias and/or methodological quality. INCLUSION CRITERIA Published and unpublished papers presenting a risk of bias, critical appraisal, or methodological quality assessment tool for assessing an evidence synthesis will be included. Individual umbrella reviews proposing a de novo tool or modified tool will be excluded from the review, as will texts that do not present a tool. METHODS A 3-step search strategy will be conducted to locate both published and unpublished documents. An initial search of PubMed was developed with a librarian, which identified keywords and MeSH terms. A second search of MEDLINE (Ovid), CINAHL (EBSCOhost), Embase (Ovid), Scopus, and Compendex will follow. Websites and databases, including Google, Cochrane, and JBI, will be searched for difficult-to-locate and unpublished literature. Documents will be independently screened, selected, and extracted by 2 researchers, and the data will be presented narratively and in tables. REVIEW REGISTRATION Open Science Framework osf.io/mjcfy.
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Affiliation(s)
- Sabira Hasanoff
- JBI, School of Public Health, Faculty of Health and Medical Science, The University of Adelaide, Adelaide, SA, Australia
- Health Evidence Synthesis, Recommendations, and Impact (HESRI), School of Public Health, Faculty of Health and Medical Science, The University of Adelaide, Adelaide, SA, Australia
| | - Danielle Pollock
- Health Evidence Synthesis, Recommendations, and Impact (HESRI), School of Public Health, Faculty of Health and Medical Science, The University of Adelaide, Adelaide, SA, Australia
| | - Timothy H Barker
- Health Evidence Synthesis, Recommendations, and Impact (HESRI), School of Public Health, Faculty of Health and Medical Science, The University of Adelaide, Adelaide, SA, Australia
| | - Zachary Munn
- Health Evidence Synthesis, Recommendations, and Impact (HESRI), School of Public Health, Faculty of Health and Medical Science, The University of Adelaide, Adelaide, SA, Australia
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Kengne Talla P, Allison P, Bussières A, Giraudeau N, Komarova S, Basiren Q, Bergeron F, Emami E. Teledentistry for improving access to, and quality of oral health care: A protocol for an overview of systematic reviews and meta-analyses. PLoS One 2024; 19:e0288677. [PMID: 38165889 PMCID: PMC10760664 DOI: 10.1371/journal.pone.0288677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 11/28/2023] [Indexed: 01/04/2024] Open
Abstract
Digital technologies are becoming essential to address and optimize the suboptimal performance of healthcare systems. Teledentistry involves the use of information and communication technology to improve access to oral health care and the quality of oral health care delivery. Several systematic reviews (SRs) have been conducted to synthesize evidence on the effectiveness of teledentistry but with conflicting results. The aim of this review is to comprehensively summarize available SRs and provide evidence on the impact of teledentistry on access to oral care, patients' and oral healthcare providers' outcomes, quality of oral health care and costs. This protocol has been registered with the International Prospective Register of Systematic Reviews (PROSPERO CRD42022373964). Six electronic databases including MEDLINE (Ovid), Embase (Embase.com), CINAHL (EBSCO), Web of Science, Cochrane Library and Epistemonikos will be searched for SRs of quantitative, qualitative, and mixed reviews evaluating teledentistry modalities involving both patients and/or oral health care providers (OHCPs). We will include studies published in English or French. The outcomes will include patients' outcomes (e.g., access to oral health care, patient-reported outcomes, and patient-reported experiences); patient indicators (e.g., clinical outcomes, adherence to treatment, adverse outcomes and costs); and OHCP indicators (e.g., diagnostic accuracy, barriers and enablers costs and equity). Two independent reviewers will perform data screening, data extraction and will assess the quality of included studies using AMSTAR 2 and ROBIS tools. Data will be synthesized narratively and presented by tables and graphs. We will report any overlap of primary studies in the SRs. A statement on the strength of evidence for each outcome will be provided if possible. This review will inform decision-makers, patients, OHCPs, and researchers on the potential effectiveness, benefits, and challenges of teledentistry and support them in making recommendations for its use. Results will be disseminated through peer-reviewed publications, presentations at conferences, and on social media.
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Affiliation(s)
- Pascaline Kengne Talla
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Paul Allison
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Quebec, Canada
| | - André Bussières
- Département de Chiropratique, Université de Québec à Trois Rivières, Trois-Rivières, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Nicolas Giraudeau
- Faculté d’Odontologie, Université de Montpellier, Montpellier, France
| | - Svetlana Komarova
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Quentin Basiren
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Frédéric Bergeron
- Laval University, Department of Preventive and Social Medicine, Quebec City, Quebec, Canada
| | - Elham Emami
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Quebec, Canada
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20
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Kolaski K, Logan LR, Ioannidis JPA. Guidance to best tools and practices for systematic reviews. Br J Pharmacol 2024; 181:180-210. [PMID: 37282770 DOI: 10.1111/bph.16100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 04/26/2023] [Indexed: 06/08/2023] Open
Abstract
Data continue to accumulate indicating that many systematic reviews are methodologically flawed, biased, redundant, or uninformative. Some improvements have occurred in recent years based on empirical methods research and standardization of appraisal tools; however, many authors do not routinely or consistently apply these updated methods. In addition, guideline developers, peer reviewers, and journal editors often disregard current methodological standards. Although extensively acknowledged and explored in the methodological literature, most clinicians seem unaware of these issues and may automatically accept evidence syntheses (and clinical practice guidelines based on their conclusions) as trustworthy. A plethora of methods and tools are recommended for the development and evaluation of evidence syntheses. It is important to understand what these are intended to do (and cannot do) and how they can be utilized. Our objective is to distill this sprawling information into a format that is understandable and readily accessible to authors, peer reviewers, and editors. In doing so, we aim to promote appreciation and understanding of the demanding science of evidence synthesis among stakeholders. We focus on well-documented deficiencies in key components of evidence syntheses to elucidate the rationale for current standards. The constructs underlying the tools developed to assess reporting, risk of bias, and methodological quality of evidence syntheses are distinguished from those involved in determining overall certainty of a body of evidence. Another important distinction is made between those tools used by authors to develop their syntheses as opposed to those used to ultimately judge their work. Exemplar methods and research practices are described, complemented by novel pragmatic strategies to improve evidence syntheses. The latter include preferred terminology and a scheme to characterize types of research evidence. We organize best practice resources in a Concise Guide that can be widely adopted and adapted for routine implementation by authors and journals. Appropriate, informed use of these is encouraged, but we caution against their superficial application and emphasize their endorsement does not substitute for in-depth methodological training. By highlighting best practices with their rationale, we hope this guidance will inspire further evolution of methods and tools that can advance the field.
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Affiliation(s)
- Kat Kolaski
- Departments of Orthopaedic Surgery, Pediatrics, and Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Lynne Romeiser Logan
- Department of Physical Medicine and Rehabilitation, SUNY Upstate Medical University, Syracuse, New York, USA
| | - John P A Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University School of Medicine, Stanford, California, USA
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21
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Shen A, Qiang W, Zhang L, Bian J, Zhu F, Zhang Z, Lu Q. Risk Factors for Breast Cancer-Related Lymphedema: An Umbrella Review. Ann Surg Oncol 2024; 31:284-302. [PMID: 37725224 DOI: 10.1245/s10434-023-14277-7] [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: 05/03/2023] [Accepted: 08/25/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Identification of risk factors facilitates the prevention of breast cancer-related lymphedema (BCRL). Several published systematic reviews have already addressed the risk factors for BCRL. This study aimed to systematically identify potential risk factors for BCRL and evaluate the quality of evidence. METHODS The study followed methodologic guidance from the Joanna Briggs Institute, and the Cochrane Handbook. The following electronic databases were systematically searched from inception to 15 November 2022: PubMed, Embase, CINAHL, Web of Science, Scopus, CNKI, SinoMed, Wanfang, JBI Database, Cochrane Database, ProQuest, and PROSPERO. Two authors independently screened studies, extracted data, and assessed methodologic quality using AMSTAR2, risk of bias using ROBIS, and evidence quality using GRADE. The study evaluated overlap, assessed the small-study effect, and calculated the I2 statistic and Egger's P value as needed. RESULTS The study included 14 publications comprising 10 meta-analyses and 4 systematic reviews. The authors identified 39 factors and 30 unique meta-analyses. In the study, 13 innate personal trait-related risk factors, such as higher body mass index (BMI) and axillary lymph nodes dissection, showed statistically significant associations with BCRL incidence. Breast reconstruction was found to be a protective factor. The methodologic quality was low or critically low. The majority of the systematic reviews and/or meta-analyses were rated as having a high risk of bias. Evidence quality was low for 22 associations and moderate for 8 associations. CONCLUSIONS The currently identified risk factors for BCRL all are innate personal trait-related factors. Future well-designed studies and robust meta-analyses are needed to explore potential associations between behavioral-, interpersonal-, and environmental-related factors and BCRL, as well as the role of genetic variations and pathophysiologic factors.
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Affiliation(s)
- Aomei Shen
- Department of Nursing, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Division of Medical and Surgical Nursing, School of Nursing, Peking University, Beijing, China
- Peking University Health Science Centre for Evidence-Based Nursing: A Joanna Briggs Institute Affiliated Group, Beijing, China
| | - Wanmin Qiang
- Department of Nursing, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Liyuan Zhang
- Department of Nursing, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Jingru Bian
- Department of Nursing, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Fei Zhu
- School of Nursing, Hebei University, Baoding, China
| | - Zijuan Zhang
- Division of Medical and Surgical Nursing, School of Nursing, Peking University, Beijing, China
- Peking University Health Science Centre for Evidence-Based Nursing: A Joanna Briggs Institute Affiliated Group, Beijing, China
| | - Qian Lu
- Division of Medical and Surgical Nursing, School of Nursing, Peking University, Beijing, China.
- Peking University Health Science Centre for Evidence-Based Nursing: A Joanna Briggs Institute Affiliated Group, Beijing, China.
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Kolaski K, Logan LR, Ioannidis JPA. Guidance to best tools and practices for systematic reviews. Acta Anaesthesiol Scand 2023; 67:1148-1177. [PMID: 37288997 DOI: 10.1111/aas.14295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 04/26/2023] [Indexed: 06/09/2023]
Abstract
Data continue to accumulate indicating that many systematic reviews are methodologically flawed, biased, redundant, or uninformative. Some improvements have occurred in recent years based on empirical methods research and standardization of appraisal tools; however, many authors do not routinely or consistently apply these updated methods. In addition, guideline developers, peer reviewers, and journal editors often disregard current methodological standards. Although extensively acknowledged and explored in the methodological literature, most clinicians seem unaware of these issues and may automatically accept evidence syntheses (and clinical practice guidelines based on their conclusions) as trustworthy. A plethora of methods and tools are recommended for the development and evaluation of evidence syntheses. It is important to understand what these are intended to do (and cannot do) and how they can be utilized. Our objective is to distill this sprawling information into a format that is understandable and readily accessible to authors, peer reviewers, and editors. In doing so, we aim to promote appreciation and understanding of the demanding science of evidence synthesis among stakeholders. We focus on well-documented deficiencies in key components of evidence syntheses to elucidate the rationale for current standards. The constructs underlying the tools developed to assess reporting, risk of bias, and methodological quality of evidence syntheses are distinguished from those involved in determining overall certainty of a body of evidence. Another important distinction is made between those tools used by authors to develop their syntheses as opposed to those used to ultimately judge their work. Exemplar methods and research practices are described, complemented by novel pragmatic strategies to improve evidence syntheses. The latter include preferred terminology and a scheme to characterize types of research evidence. We organize best practice resources in a Concise Guide that can be widely adopted and adapted for routine implementation by authors and journals. Appropriate, informed use of these is encouraged, but we caution against their superficial application and emphasize their endorsement does not substitute for in-depth methodological training. By highlighting best practices with their rationale, we hope this guidance will inspire further evolution of methods and tools that can advance the field.
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Affiliation(s)
- Kat Kolaski
- Departments of Orthopaedic Surgery, Pediatrics, and Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Lynne Romeiser Logan
- Department of Physical Medicine and Rehabilitation, SUNY Upstate Medical University, Syracuse, New York, USA
| | - John P A Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University School of Medicine, Stanford, California, USA
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Xie K, Guan S, Jing H, Ji W, Kong X, Du S, Jia M, Wang H. Efficacy and safety of traditional Chinese medicine adjuvant therapy for severe pneumonia: evidence mapping of the randomized controlled trials, systematic reviews, and meta-analyses. Front Pharmacol 2023; 14:1227436. [PMID: 37841930 PMCID: PMC10570726 DOI: 10.3389/fphar.2023.1227436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/05/2023] [Indexed: 10/17/2023] Open
Abstract
Background and Objective: Severe pneumonia is a critical respiratory disease with high mortality. There is insufficient evidence on the efficacy and safety of traditional Chinese medicine (TCM) adjuvant therapy for severe pneumonia. This study aims to identify, describe, assess, and summarize the currently available high-quality design evidence on TCM adjuvant therapy for severe pneumonia to identify evidence gaps using the evidence mapping approach. Methods: Systematic searches were performed on English and Chinese online databases (PubMed, EMBASE, Cochrane Library, Web of Science, CNKI, WanFang Data, CQVIP, and SinoMed) to identify papers from inception until August 2023 for inclusion into the review. Randomized controlled trials (RCTs), systematic reviews (SRs), and meta-analyses concerning TCM adjuvant therapy for severe pneumonia or its complications in adults were included. The risk of bias in RCTs was evaluated by using the Cochrane Handbook ROB tool. The Assessment of Multiple Systematic Reviews 2 (AMSTAR-2), the Risk of Bias in Systematic Review (ROBIS) tool, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system were used to assess the methodological quality, risk of bias, and evidence quality of SRs or meta-analyses, respectively. Then, a bubble plot was designed to visually display information in four dimensions. Results: A total of 354 RCTs and 17 SRs or meta-analyses met the inclusion criteria. The published RCTs had several flaws, such as unreasonable design, limited sample size, insufficient attention to non-drug therapy studies and syndrome differentiation, improper selection or use of outcome indicators, and failure to provide high-quality evidence. Sixteen SRs or meta-analyses of methodological quality scored "Critically Low" confidence. Twelve SRs or meta-analyses were rated as "High Risk." Most outcomes were rated as "Low" evidence quality. We found that TCM combined with conventional treatment could improve the clinical total effective rate and the TCM syndromes efficacy. The combined approach could also shorten mechanical ventilation time, infection control time, and length of hospital and ICU stay; significantly reduce temperature, respiratory rate, heart rate, white blood cell counts, levels of C-reactive protein, procalcitonin, blood inflammatory factors, bacteriological response, and D-dimer; decrease CPIS, APACHE II score, and PSI score; improve pulmonary imaging features, arterial blood gas indicators (including arterial oxygen pressure, arterial oxygen saturation, and oxygen index), and lung function (including forced vital capacity and forced expiratory volume in the first second) for severe pneumonia compared with conventional treatment only (p < 0.05). There was no significant difference in adverse reactions and incidence of adverse events (p > 0.05). In addition, compared with conventional treatment only, most SRs or meta-analyses concluded that TCM combined with conventional treatment was "Beneficial" or "Probably beneficial." Conclusion: TCM combined with conventional treatment had advantages in efficacy, clinical signs, laboratory results, and life quality outcomes of severe pneumonia, with no difference in safety outcomes compared with conventional treatment only. QingJin Huatan decoction is the most promising target, and Xuanbai Chengqi decoction has a "Probably beneficial" conclusion. XueBiJing injection and TanReQing injection are two commonly used Chinese herbal injections for treating severe pneumonia, and both are "Probably beneficial." However, there was a need for multicenter RCTs with large sample sizes and high methodological quality in the future. In addition, the methodological design and quality of SRs or meta-analyses should be improved to form high-quality, evidence-based medical evidence and provide evidence for the effectiveness and safety of TCM adjuvant therapy for severe pneumonia.
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Affiliation(s)
- Kai Xie
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Shengnan Guan
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Hui Jing
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Wenshuai Ji
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Xinxin Kong
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Shen Du
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Mingyan Jia
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Haifeng Wang
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
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Mills CM, Trinca V. The Evidence for Screening Older Adults for Nutrition Risk in Primary Care: An Umbrella Review. CAN J DIET PRACT RES 2023; 84:159-166. [PMID: 36920030 DOI: 10.3148/cjdpr-2022-043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
It is not known if nutrition risk screening of older adults should be a standard practice in primary care. The evidence in support of nutrition risk screening of older adults in primary care was examined and critically analyzed using an umbrella review. The peer reviewed and grey literature were searched for clinical practice guidelines (CPGs) and systematic reviews (SRs). Titles and abstracts were independently screened by the two authors. Resources were excluded if they did not apply to older adults, did not discuss nutrition/malnutrition risk screening, or were in settings other than primary care. Full texts were independently screened by both authors, resulting in the identification of six CPGs and three SRs that met the review criteria. Guidelines were appraised with the AGREE II tool and SRs with the AMSTAR 2 tool. The quality of the CPGs was high, while the quality of the SRs was low. The CPGs and SRs acknowledged a lack of high-quality research on the benefits of regular nutrition risk screening for older adults in primary care; however, CPGs recommended annual screening for older adults in primary care practices or other community settings. High-quality research investigating nutrition risk screening of older adults in primary care is needed.
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Affiliation(s)
- Christine Marie Mills
- Aging & Health Program, School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Vanessa Trinca
- Schlegel-UW Research Institute for Aging, Waterloo, ON, Canada
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Abstract
Data continue to accumulate indicating that many systematic reviews are methodologically flawed, biased, redundant, or uninformative. Some improvements have occurred in recent years based on empirical methods research and standardization of appraisal tools; however, many authors do not routinely or consistently apply these updated methods. In addition, guideline developers, peer reviewers, and journal editors often disregard current methodological standards. Although extensively acknowledged and explored in the methodological literature, most clinicians seem unaware of these issues and may automatically accept evidence syntheses (and clinical practice guidelines based on their conclusions) as trustworthy. A plethora of methods and tools are recommended for the development and evaluation of evidence syntheses. It is important to understand what these are intended to do (and cannot do) and how they can be utilized. Our objective is to distill this sprawling information into a format that is understandable and readily accessible to authors, peer reviewers, and editors. In doing so, we aim to promote appreciation and understanding of the demanding science of evidence synthesis among stakeholders. We focus on well-documented deficiencies in key components of evidence syntheses to elucidate the rationale for current standards. The constructs underlying the tools developed to assess reporting, risk of bias, and methodological quality of evidence syntheses are distinguished from those involved in determining overall certainty of a body of evidence. Another important distinction is made between those tools used by authors to develop their syntheses as opposed to those used to ultimately judge their work. Exemplar methods and research practices are described, complemented by novel pragmatic strategies to improve evidence syntheses. The latter include preferred terminology and a scheme to characterize types of research evidence. We organize best practice resources in a Concise Guide that can be widely adopted and adapted for routine implementation by authors and journals. Appropriate, informed use of these is encouraged, but we caution against their superficial application and emphasize their endorsement does not substitute for in-depth methodological training. By highlighting best practices with their rationale, we hope this guidance will inspire further evolution of methods and tools that can advance the field.
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Affiliation(s)
- Kat Kolaski
- Departments of Orthopaedic Surgery, Pediatrics, and Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Lynne Romeiser Logan
- Department of Physical Medicine and Rehabilitation, SUNY Upstate Medical University, Syracuse, NY, USA
| | - John P.A. Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University School of Medicine, Stanford, CA, USA
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Chimbinha ÍGM, Ferreira BNC, Miranda GP, Guedes RS. Oral-health-related quality of life in adolescents: umbrella review. BMC Public Health 2023; 23:1603. [PMID: 37612682 PMCID: PMC10464260 DOI: 10.1186/s12889-023-16241-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/04/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND To evaluate oral conditions, demographic and socioeconomic characteristics of oral health-related quality of life (OHRQoL) in adolescents. METHODS Umbrella review, conducted according to the Preferred Reporting Items for Systematic Reviews and Meta Analyzes (PRISMA) checklist. The search strategy used a combination of words, applied in the electronic databases PubMed, WebScience, Embase, Lilacs, Scopus and Cochrane. Included publications until January 2022, without restrictions. Data collection took place with systematized practices and the eligibility criteria were studies focusing on OHRQoL; teenagers; adolescentes; present the term "systematic review" and/or "meta-analysis" in the title or abstract. The quality assessment followed the Assessment of Multiple Systematic Reviews (AMSTAR 2) and the adherence of the article to the PRISMA was verified. RESULTS Three hundred sixty-two articles were identified, and 22 were included, published between 2009 and 2022. 21 Systematic reviews focused on the English language. Most studies showed heterogeneity in the methodological structuring process: 10 articles were considered of low and 10 critically low quality. Clinical conditions associated with worsening in quality of life were dental caries, malocclusion, dental trauma, toothache, edentulism, need for orthodontic treatment, irregular brushing, and periodontal disease. Socioeconomic factors related to housing, parental education, access to health care, absence of siblings and nuclear family influence OHRQoL. Completion of orthodontic treatment, health promotion programs, dental care and safe housing all have a positive impact. CONCLUSION Worse oral health status, older age, female sex and worse socioeconomic status were significantly associated with worse OHRQoL. TRIAL REGISTRATION PROSPERO CRD4202129352.
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Smela B, Toumi M, Świerk K, Gawlik K, Clay E, Boyer L. Systematic literature reviews over the years. JOURNAL OF MARKET ACCESS & HEALTH POLICY 2023; 11:2244305. [PMID: 37614556 PMCID: PMC10443963 DOI: 10.1080/20016689.2023.2244305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/19/2023] [Accepted: 08/01/2023] [Indexed: 08/25/2023]
Abstract
Purpose: Nowadays, systematic literature reviews (SLRs) and meta-analyses are often placed at the top of the study hierarchy of evidence. The main objective of this paper is to evaluate the trends in SLRs of randomized controlled trials (RCTs) throughout the years. Methods: Medline database was searched, using a highly focused search strategy. Each paper was coded according to a specific ICD-10 code; the number of RCTs included in each evaluated SLR was also retrieved. All SLRs analyzing RCTs were included. Protocols, commentaries, or errata were excluded. No restrictions were applied. Results: A total of 7,465 titles and abstracts were analyzed, from which 6,892 were included for further analyses. There was a gradual increase in the number of annual published SLRs, with a significant increase in published articles during the last several years. Overall, the most frequently analyzed areas were diseases of the circulatory system (n = 750) and endocrine, nutritional, and metabolic diseases (n = 734). The majority of SLRs included between 11 and 50 RCTs each. Conclusions: The recognition of SLRs' usefulness is growing at an increasing speed, which is reflected by the growing number of published studies. The most frequently evaluated diseases are in alignment with leading causes of death and disability worldwide.
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Affiliation(s)
| | - Mondher Toumi
- Public Health Department, Aix-Marseille University, Marseille, France
| | | | | | | | - Laurent Boyer
- Public Health Department, Aix-Marseille University, Marseille, France
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Pereira AG, Martins CC, Campos JR, Faria SFS, Notaro SQ, Poklepović-Peričić T, Costa LCM, Costa FO, Cota LOM. Critical appraisal of systematic reviews of intervention studies in periodontology using AMSTAR 2 and ROBIS tools. J Clin Exp Dent 2023; 15:e678-e694. [PMID: 37674600 PMCID: PMC10478201 DOI: 10.4317/jced.60197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 05/22/2023] [Indexed: 09/08/2023] Open
Abstract
Background Systematic reviews of intervention studies are used to support treatment recommendations. The aim of this study was to assess the methodological quality and risk of bias of systematic reviews of intervention studies in in the field of periodontology using AMSTAR 2 and ROBIS. Material and Methods Systematic reviews of randomized and non-randomized clinical trials, published between 2019 and 2020, were searched at MedLine, Embase, Web of Science, Scopus, Cochrane Library, LILACS with no language restrictions between October 2019 to October 2020. Additionally, grey literature and hand search was performed. Paired independent reviewers screened studies, extracted data and assessed the methodological quality and risk of bias through the AMSTAR 2 and ROBIS tools. Results One hundred twenty-seven reviews were included. According to AMSTAR 2, the methodological quality was mainly critically low (64.6%) and low (24.4%), followed by moderate (0.8%) and high (10.2%). According to ROBIS, 90.6% were at high risk of bias, followed by 7.1% low, and 2.4% unclear risk of bias. The risk of bias decreased with the increased in the impact factor of the journal. Conclusions Current systematic reviews of intervention studies in periodontics were classified as low or critically low methodological quality and high risk of bias. Both tools led to similar conclusions. Better adherence to established reporting guidelines and stricter research practices when conducting systematic reviews are needed. Key words:Bias, evidence-based dentistry, methods, periodontics, systematic review.
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Affiliation(s)
- Alexandre-Godinho Pereira
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, BrazilDepartment of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Carolina-Castro Martins
- Department of Pediatric Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Julya-Ribeiro Campos
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, BrazilDepartment of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Sandro-Felipe-Santos Faria
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, BrazilDepartment of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Sarah-Queiroz Notaro
- Department of Pediatric Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Tina Poklepović-Peričić
- Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia
| | | | - Fernando-Oliveira Costa
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, BrazilDepartment of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Luís-Otávio-Miranda Cota
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, BrazilDepartment of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Luo J, Chen Z, Liu D, Li H, He S, Zeng L, Yang M, Liu Z, Xiao X, Zhang L. Methodological quality and reporting quality of COVID-19 living systematic review: a cross-sectional study. BMC Med Res Methodol 2023; 23:175. [PMID: 37525117 PMCID: PMC10388517 DOI: 10.1186/s12874-023-01980-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 06/18/2023] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVES The main objective of this study is to evaluate the methodological quality and reporting quality of living systematic reviews (LSRs) on Coronavirus disease 2019 (COVID-19), while the secondary objective is to investigate potential factors that may influence the overall quality of COVID-19 LSRs. METHODS Six representative databases, including Medline, Excerpta Medica Database (Embase), Cochrane Library, China national knowledge infrastructure (CNKI), Wanfang Database, and China Science, Technology Journal Database (VIP) were systematically searched for COVID-19 LSRs. Two authors independently screened articles, extracted data, and then assessed the methodological and reporting quality of COVID-19 LSRs using the "A Measurement Tool to Assess systematic Reviews-2" (AMSTAR-2) tool and "Preferred Reporting Items for Systematic reviews and Meta-Analyses" (PRISMA) 2020 statement, respectively. Univariate linear regression and multivariate linear regression were used to explore eight potential factors that might affect the methodological quality and reporting quality of COVID-19 LSRs. RESULTS A total of 64 COVID-19 LSRs were included. The AMSTAR-2 evaluation results revealed that the number of "yes" responses for each COVID-19 LSR was 13 ± 2.68 (mean ± standard deviation). Among them, 21.9% COVID-19 LSRs were rated as "high", 4.7% as "moderate", 23.4% as "low", and 50% as "critically low". The evaluation results of the PRISMA 2020 statement showed that the sections with poor adherence were methods, results and other information. The number of "yes" responses for each COVID-19 LSR was 21 ± 4.18 (mean ± standard deviation). The number of included studies and registration are associated with better methodological quality; the number of included studies and funding are associated with better reporting quality. CONCLUSIONS Improvement is needed in the methodological and reporting quality of COVID-19 LSRs. Researchers conducting COVID-19 LSRs should take note of the quality-related factors identified in this study to generate evidence-based evidence of higher quality.
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Affiliation(s)
- Jiefeng Luo
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- NMPA Key Laboratory for Technical Research On Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
- West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Zhe Chen
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- NMPA Key Laboratory for Technical Research On Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
- West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Dan Liu
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- NMPA Key Laboratory for Technical Research On Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
- West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Hailong Li
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- NMPA Key Laboratory for Technical Research On Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Siyi He
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- NMPA Key Laboratory for Technical Research On Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
- West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Linan Zeng
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- NMPA Key Laboratory for Technical Research On Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Mengting Yang
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- NMPA Key Laboratory for Technical Research On Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Zheng Liu
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- NMPA Key Laboratory for Technical Research On Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Xue Xiao
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China.
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China.
| | - Lingli Zhang
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China.
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China.
- NMPA Key Laboratory for Technical Research On Drug Products In Vitro and In Vivo Correlation, Chengdu, China.
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China.
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Kolaski K, Logan LR, Ioannidis JPA. Improving systematic reviews: guidance on guidance and other options and challenges. J Clin Epidemiol 2023; 159:266-273. [PMID: 37196861 DOI: 10.1016/j.jclinepi.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/07/2023] [Accepted: 05/09/2023] [Indexed: 05/19/2023]
Affiliation(s)
- Kat Kolaski
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Lynne Romeiser Logan
- Department of Physical Medicine and Rehabilitation, SUNY Upstate Medical University, Syracuse, NY, USA
| | - John P A Ioannidis
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA; Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA; Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA; Department of Statistics, Stanford University School of Humanities and Sciences, Stanford, CA, USA; Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA.
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Kolaski K, Logan LR, Ioannidis JPA. Guidance to best tools and practices for systematic reviews. BMC Infect Dis 2023; 23:383. [PMID: 37286949 DOI: 10.1186/s12879-023-08304-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 05/03/2023] [Indexed: 06/09/2023] Open
Abstract
Data continue to accumulate indicating that many systematic reviews are methodologically flawed, biased, redundant, or uninformative. Some improvements have occurred in recent years based on empirical methods research and standardization of appraisal tools; however, many authors do not routinely or consistently apply these updated methods. In addition, guideline developers, peer reviewers, and journal editors often disregard current methodological standards. Although extensively acknowledged and explored in the methodological literature, most clinicians seem unaware of these issues and may automatically accept evidence syntheses (and clinical practice guidelines based on their conclusions) as trustworthy.A plethora of methods and tools are recommended for the development and evaluation of evidence syntheses. It is important to understand what these are intended to do (and cannot do) and how they can be utilized. Our objective is to distill this sprawling information into a format that is understandable and readily accessible to authors, peer reviewers, and editors. In doing so, we aim to promote appreciation and understanding of the demanding science of evidence synthesis among stakeholders. We focus on well-documented deficiencies in key components of evidence syntheses to elucidate the rationale for current standards. The constructs underlying the tools developed to assess reporting, risk of bias, and methodological quality of evidence syntheses are distinguished from those involved in determining overall certainty of a body of evidence. Another important distinction is made between those tools used by authors to develop their syntheses as opposed to those used to ultimately judge their work.Exemplar methods and research practices are described, complemented by novel pragmatic strategies to improve evidence syntheses. The latter include preferred terminology and a scheme to characterize types of research evidence. We organize best practice resources in a Concise Guide that can be widely adopted and adapted for routine implementation by authors and journals. Appropriate, informed use of these is encouraged, but we caution against their superficial application and emphasize their endorsement does not substitute for in-depth methodological training. By highlighting best practices with their rationale, we hope this guidance will inspire further evolution of methods and tools that can advance the field.
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Affiliation(s)
- Kat Kolaski
- Departments of Orthopaedic Surgery, Pediatrics, and Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - Lynne Romeiser Logan
- Department of Physical Medicine and Rehabilitation, SUNY Upstate Medical University, Syracuse, NY, USA
| | - John P A Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University School of Medicine, Stanford, CA, USA
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Kolaski K, Logan LR, Ioannidis JPA. Guidance to best tools and practices for systematic reviews. Syst Rev 2023; 12:96. [PMID: 37291658 DOI: 10.1186/s13643-023-02255-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 02/19/2023] [Indexed: 06/10/2023] Open
Abstract
Data continue to accumulate indicating that many systematic reviews are methodologically flawed, biased, redundant, or uninformative. Some improvements have occurred in recent years based on empirical methods research and standardization of appraisal tools; however, many authors do not routinely or consistently apply these updated methods. In addition, guideline developers, peer reviewers, and journal editors often disregard current methodological standards. Although extensively acknowledged and explored in the methodological literature, most clinicians seem unaware of these issues and may automatically accept evidence syntheses (and clinical practice guidelines based on their conclusions) as trustworthy.A plethora of methods and tools are recommended for the development and evaluation of evidence syntheses. It is important to understand what these are intended to do (and cannot do) and how they can be utilized. Our objective is to distill this sprawling information into a format that is understandable and readily accessible to authors, peer reviewers, and editors. In doing so, we aim to promote appreciation and understanding of the demanding science of evidence synthesis among stakeholders. We focus on well-documented deficiencies in key components of evidence syntheses to elucidate the rationale for current standards. The constructs underlying the tools developed to assess reporting, risk of bias, and methodological quality of evidence syntheses are distinguished from those involved in determining overall certainty of a body of evidence. Another important distinction is made between those tools used by authors to develop their syntheses as opposed to those used to ultimately judge their work.Exemplar methods and research practices are described, complemented by novel pragmatic strategies to improve evidence syntheses. The latter include preferred terminology and a scheme to characterize types of research evidence. We organize best practice resources in a Concise Guide that can be widely adopted and adapted for routine implementation by authors and journals. Appropriate, informed use of these is encouraged, but we caution against their superficial application and emphasize their endorsement does not substitute for in-depth methodological training. By highlighting best practices with their rationale, we hope this guidance will inspire further evolution of methods and tools that can advance the field.
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Affiliation(s)
- Kat Kolaski
- Departments of Orthopaedic Surgery, Pediatrics, and Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - Lynne Romeiser Logan
- Department of Physical Medicine and Rehabilitation, SUNY Upstate Medical University, Syracuse, NY, USA
| | - John P A Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University School of Medicine, Stanford, CA, USA
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Riley SP, Swanson BT, Shaffer SM, Somma MJ, Flowers DW, Sawyer SF. Is the quality of systematic reviews influenced by prospective registration: a methods review of systematic musculoskeletal physical therapy reviews. J Man Manip Ther 2023; 31:184-197. [PMID: 35942578 PMCID: PMC10288892 DOI: 10.1080/10669817.2022.2110419] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
INTRODUCTION It is unknown if verified prospective registration of systematic reviews (SRs) and the randomized clinical trials (RCTs) that they use affect an SR's methodological quality on A MeaSurement Tool to Assess Systematic Reviews 2 (AMSTAR 2). METHODS Data originated from interventional SRs published in International Society of Physiotherapy Journals Editors (ISPJE) member journals, indexed in MEDLINE, between 1 January 2018 and 18 August 2021. Blinded reviewers identified the SRs and extracted the data for the variables of interest for the SRs and the RCTs. RESULTS Two of 14 ISPJE member journals required prospective SR registration. Twenty SRs were identified, and 169 unique, retrievable RCTs were included within those SRs. One (5.0%) of the 20 SRs and 15 of the 169 (8.9%) RCTs were prospectively registered and published consistent with this intent. Nineteen (95.0%) of the 20 identified SRs was categorized as 'critically low' on the AMSTAR 2. DISCUSSION SRs and the RCTs identified within them were infrequently prospectively registered, prospectively verifiable, or prospectively verified based on the established research record. CONCLUSIONS Ensuring that SRs and RCTs have fidelity with the research record from conception to publication may help rule out low-value interventions, decrease variability in physical therapy practice, and solidify evidence-based physical therapy practice.
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Affiliation(s)
- Sean P. Riley
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT, USA
| | - Brian T. Swanson
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT, USA
| | - Stephen M. Shaffer
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT, USA
| | - Matthew J. Somma
- Doctor of Physical Therapy Program, University of New England, Portland, ME, USA
| | - Daniel W. Flowers
- Doctor of Physical Therapy Program, Louisiana State University Health Sciences Center, Shreveport, LA, USA
| | - Steven F. Sawyer
- Department of Rehabilitation Sciences and Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
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Kolaski K, Logan LR, Ioannidis JPA. Guidance to Best Tools and Practices for Systematic Reviews. JBJS Rev 2023; 11:01874474-202306000-00009. [PMID: 37285444 DOI: 10.2106/jbjs.rvw.23.00077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
» Data continue to accumulate indicating that many systematic reviews are methodologically flawed, biased, redundant, or uninformative. Some improvements have occurred in recent years based on empirical methods research and standardization of appraisal tools; however, many authors do not routinely or consistently apply these updated methods. In addition, guideline developers, peer reviewers, and journal editors often disregard current methodological standards. Although extensively acknowledged and explored in the methodological literature, most clinicians seem unaware of these issues and may automatically accept evidence syntheses (and clinical practice guidelines based on their conclusions) as trustworthy.» A plethora of methods and tools are recommended for the development and evaluation of evidence syntheses. It is important to understand what these are intended to do (and cannot do) and how they can be utilized. Our objective is to distill this sprawling information into a format that is understandable and readily accessible to authors, peer reviewers, and editors. In doing so, we aim to promote appreciation and understanding of the demanding science of evidence synthesis among stakeholders. We focus on well-documented deficiencies in key components of evidence syntheses to elucidate the rationale for current standards. The constructs underlying the tools developed to assess reporting, risk of bias, and methodological quality of evidence syntheses are distinguished from those involved in determining overall certainty of a body of evidence. Another important distinction is made between those tools used by authors to develop their syntheses as opposed to those used to ultimately judge their work.» Exemplar methods and research practices are described, complemented by novel pragmatic strategies to improve evidence syntheses. The latter include preferred terminology and a scheme to characterize types of research evidence. We organize best practice resources in a Concise Guide that can be widely adopted and adapted for routine implementation by authors and journals. Appropriate, informed use of these is encouraged, but we caution against their superficial application and emphasize their endorsement does not substitute for in-depth methodological training. By highlighting best practices with their rationale, we hope this guidance will inspire further evolution of methods and tools that can advance the field.
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Affiliation(s)
- Kat Kolaski
- Departments of Orthopaedic Surgery, Pediatrics, and Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Lynne Romeiser Logan
- Department of Physical Medicine and Rehabilitation, SUNY Upstate Medical University, Syracuse, New York
| | - John P A Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University School of Medicine, Stanford, California
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Matterne U, Theurich MA, Pröbstl S, Pieper D, Wang J, Xu A, Apfelbacher C. Quality of systematic reviews on timing of complementary feeding for early childhood allergy prevention. BMC Med Res Methodol 2023; 23:80. [PMID: 37016313 PMCID: PMC10071735 DOI: 10.1186/s12874-023-01899-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 03/21/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Only rigorously prepared analyses can provide the highest level of evidence to inform decision-making. Several recent systematic reviews (SRs) examined the hypothesis that the early introduction of specific allergenic complementary foods (CFs) to infants may lead to a lower incidence of one or more allergic outcomes. However, the methodological rigour and quality of reporting of SRs in this area has not yet been systematically evaluated. METHODS We comprehensively searched PubMed, Medline (Ovid), and Web of Science Core Collection on 13th January 2022, using a pre-specified and tested search syntax for SRs with RCT evidence on the early introduction of allergenic CFs as a means for allergy prevention in infants and children. We examined the quality and risk of bias (RoB) using AMSTAR-2 and ROBIS tools, examined adherence to the Preferred Reporting Items for SRs and Meta-Analyses (PRISMA), and checked whether certainty of the evidence was assessed. RESULTS Twelve SRs were included. Application of both tools resulted in similar overall judgements in terms of direction and extent for nine of the 12 SRs. Nine SRs were found to be of critically low to low quality according to AMSTAR-2 and to be at high RoB according to ROBIS. One SR received a moderate quality rating (AMSTAR-2) and high RoB rating (ROBIS). However, for two SRs, judgements between AMSTAR-2 and ROBIS were at stark variance. Only two SRs fully adhered to the PRISMA checklist. Six SRs evaluated the certainty of the body of RCT evidence. Several SRs failed to consider unpublished studies either by an explicit a priori exclusion or by inadequate search strategies. CONCLUSIONS Well-conducted SRs are important for decision-making and informing guideline development, the quality of their methodology should therefore be considered. The methodological rigour and the reporting quality of SRs on the timing of CF for allergy prevention must be improved. REGISTRATION https://osf.io/7cs4b .
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Affiliation(s)
- Uwe Matterne
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Melissa A Theurich
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Simone Pröbstl
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Dawid Pieper
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School (Theodor Fontane), Institute for Health Services and Health Systems Research, Rüdersdorf, Germany
- Center for Health Services Research, Brandenburg Medical School (Theodor Fontane), Rüdersdorf, Germany
| | - Jiancong Wang
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Anna Xu
- University of Oxford, Oxford, UK
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany.
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Alkhalaf A, Aljaroudi E, Al-Hulami M, Gaffar B, Almas K. Efficacy of Surgical Masks Versus N95 Respirators for the Prevention of COVID-19 in Dental Settings: A Systematic Review. Cureus 2023; 15:e37631. [PMID: 37200654 PMCID: PMC10186565 DOI: 10.7759/cureus.37631] [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] [Accepted: 04/15/2023] [Indexed: 05/20/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2. (SARS-CoV-2). It spreads mainly through saliva droplets or nasal discharge. Dentists are among the professionals with the greatest risk of contracting and transmitting COVID-19. We compared the efficacy of surgical masks versus N95 respirators in preventing COVID-19 infection in dental settings. PubMed, Scopus, Web of Science, and Cochrane Library databases were searched. Search terms corresponded to a predefined PICOS (patient/population, intervention, comparison, and outcomes) question. The risk of bias was evaluated using AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews-2), ROBIS (Risk of Bias in Systematic Reviews), and Health Evidence tools. A total of 191 articles were screened, and nine of them were further evaluated for eligibility, of which five articles (fulfilled the selection criteria) and were included in this study. Two studies concluded that surgical masks could provide equivalent protection to N95 respirators. Another study found that N95 respirators were superior to surgical masks. The fourth study found that better protection can be achieved when using surgical masks by the aerosol source than when the recipient uses an N95 respirator, while the last study concluded that surgical masks or N95 respirators alone do not provide full protection. Thus, according to this systematic review, N95 respirators provide better protection against COVID-19 infection compared to surgical masks.
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Affiliation(s)
- Ali Alkhalaf
- Dentistry, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, SAU
| | - Essa Aljaroudi
- Dentistry, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, SAU
| | - Mohammed Al-Hulami
- Dentistry, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, SAU
| | - Balgis Gaffar
- Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, SAU
| | - Khalid Almas
- Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, SAU
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De Santis KK, Pieper D, Lorenz RC, Wegewitz U, Siemens W, Matthias K. User experience of applying AMSTAR 2 to appraise systematic reviews of healthcare interventions: a commentary. BMC Med Res Methodol 2023; 23:63. [PMID: 36927334 PMCID: PMC10018966 DOI: 10.1186/s12874-023-01879-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 02/27/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND 'A Measurement Tool to Assess Systematic Reviews, version 2' (AMSTAR 2) is a validated 16-item scale designed to appraise systematic reviews (SRs) of healthcare interventions and to rate the overall confidence in their results. This commentary aims to describe the challenges with rating of the individual items and the application of AMSTAR 2 from the user perspective. DISCUSSION A group of six experienced users (methodologists working in different clinical fields for at least 10 years) identified and discussed the challenges in rating of each item and the general use of AMSTAR 2 to appraise SRs. A group discussion was used to develop recommendations on how users could deal with the identified challenges. We identified various challenges with the content of items 2-16 and with the derivation of the overall confidence ratings on AMSTAR 2. These challenges include the need (1) to provide additional definitions (e.g., what constitutes major deviations from SR protocol on item 2), (2) to choose a rating strategy for multiple conditions on single items (e.g., how to rate item 5 if studies were selected in duplicate, but consensus between two authors was not reported), and (3) to determine rules for deriving the confidence ratings (e.g., what items are critical for such ratings). Based on these challenges we formulated specific recommendations for items 2-16 that AMSTAR 2 users could consider before applying the tool. Our commentary adds to the existing literature by providing the first in-depth examination of the AMSTAR 2 tool from the user perspective. The identified challenges could be addressed by additional decision rules including definitions for ambiguous items and guidance for rating of complex items and derivation of confidence ratings. We recommend that a team consensus regarding such decision rules is required before appraisal procedure begins. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Karina Karolina De Santis
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany
| | - Dawid Pieper
- Brandenburg Medical School Theodor Fontane (MHB), Center for Health Services Research (ZVF-BB), Brandenburg an der Havel, Germany
| | - Robert C Lorenz
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany
| | - Uta Wegewitz
- Federal Institute for Occupational Safety and Health (BAuA), Division 3 Work and Health, Berlin, Germany
| | - Waldemar Siemens
- Faculty of Medicine, Institute for Evidence in Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Katja Matthias
- Faculty of Electrical Engineering and Computer Science, University of Applied Sciences Stralsund, Stralsund, Germany.
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García-Muñoz C, González-García P, Casuso-Holgado MJ, Martínez-Calderón J, Heredia-Rizo AM. Are movement-based mindful exercises (QIGONG, TAI CHI, AND YOGA) beneficial for stroke and Parkinson's disease? A scoping review. Complement Ther Med 2023; 72:102912. [PMID: 36565791 DOI: 10.1016/j.ctim.2022.102912] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/04/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To synthesize evidence from systematic reviews on the effects of qigong, tai chi, and yoga in people with neurological diseases. METHODS A systematic search was conducted in PubMed, PsycINFO, Embase, CINAHL and Cochrane Library until September 2022. Methodological quality was assessed using the AMSTAR 2 tool. A qualitative synthesis of included reviews and meta-analyses was performed. Citation matrices and the corrected covered area were used to explore the overlap of randomized controlled trials among reviews. RESULTS Nineteen systematic reviews (containing 74 trials and 80 meta-analyses) in people with Parkinson's disease (PD) or stroke were included. The critical domains of the AMSTAR 2 were not satisfied in more than half of the reviews, and only 4 evaluated the certainty of the evidence. The overlap was very high (21.7%) and high (11%) for tai chi studies in PD and stroke, respectively. In people with PD, qigong, yoga, and tai chi can improve balance, with tai chi being beneficial to increase functional mobility. For stroke patients, tai chi was better than controls to enhance motor function and independence, but not for health-related quality of life and quality of sleep. Findings on balance, walking ability and depression were inconclusive in stroke population. CONCLUSIONS Qigong, tai chi, and yoga appear to be effective to improve balance performance in people with PD. Tai chi practice enhances motor function and independency in stroke patients.
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Affiliation(s)
- Cristina García-Muñoz
- Departamento de Enfermería y Fisioterapia, Facultad de Enfermería y Fisioterapia, Universidad de Cádiz, Avda. Ana de Viya 52, 11009 Cádiz, Spain; Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Universidad de Sevilla, Sevilla, Spain
| | - Paula González-García
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, c/ Avicena s/n, 41009 Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain..
| | - María Jesús Casuso-Holgado
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, c/ Avicena s/n, 41009 Sevilla, Spain; Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Universidad de Sevilla, Sevilla, Spain
| | - Javier Martínez-Calderón
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, c/ Avicena s/n, 41009 Sevilla, Spain; Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Universidad de Sevilla, Sevilla, Spain
| | - Alberto Marcos Heredia-Rizo
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, c/ Avicena s/n, 41009 Sevilla, Spain; Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Universidad de Sevilla, Sevilla, Spain
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Grammatopoulos T, Hunter JWS, Munn Z, Stone JC, Barker TH. Reporting quality and risk of bias in JBI systematic reviews evaluating the effectiveness of interventions: a methodological review protocol. JBI Evid Synth 2023; 21:584-591. [PMID: 36632760 DOI: 10.11124/jbies-22-00317] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE The objective of this methodological review is to evaluate the adherence of systematic reviews of effectiveness published in JBI Evidence Synthesis to reporting guidelines and methodological quality. INTRODUCTION Systematic reviews of effectiveness are essential tools for health practitioners and policy-makers. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and the Risk of Bias in Systematic Reviews (ROBIS) tool are used to ensure maintenance of high reporting standards and methodological quality, respectively. This review will utilize these tools to identify strengths and shortfalls in the reporting quality of JBI systematic reviews of effectiveness. INCLUSION CRITERIA This review will include the 20 most recent systematic reviews of effectiveness published in JBI Evidence Synthesis . METHODS This review will search MEDLINE (PubMed) for effectiveness reviews published in JBI Evidence Synthesis . Abstract and full-text screening will be performed by 2 independent reviewers, and the most recent 20 studies will be selected for inclusion. Data regarding adherence to PRISMA 2020 and ROBIS will be extracted by 2 independent reviewers. Data will be presented descriptively with tables and synthesized narratively.
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Affiliation(s)
- Tahlia Grammatopoulos
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
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Blanc A, Ho V, Cameron J. Critical Appraisal Tools to Aid Pharmacists in Evidence-Based Practice: A Narrative Review. Can J Hosp Pharm 2023; 76:131-140. [PMID: 36998756 PMCID: PMC10049769 DOI: 10.4212/cjhp.3281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
Background Pharmacists and allied health researchers need to ensure that their practice is supported by current, evidence-based information. Critical appraisal tools have been developed to aid in this process. Objectives To analyze the current landscape of critical appraisal tools and to create an aid for pharmacists and other allied health researchers to use in comparing various tools and choosing the best one for each particular study design. Data Sources A literature search of the PubMed, University of Toronto Libraries, and Cochrane Library databases was conducted in December 2021, to generate an up-to-date list of critical appraisal tools. The tools were then summarized in a descriptive table. Study Selection and Data Extraction Review articles, original manuscripts, and tool webpages were examined to develop a comparison chart based on the user-friendliness, efficiency, comprehensiveness, and reliability of each tool. Results Fourteen tools were found through the literature search. These tools were compared using the findings of included review articles, and a comparison chart was created to aid pharmacists and allied health researchers in selecting the appropriate tool for their practice. Conclusions There are many standardized critical appraisal tools that can help in assessing the quality of evidence, and the summary list of tools developed and reported here can help health care researchers to compare among them and choose the best one. No tools were found that have been specifically adapted to serve the needs of pharmacists when assessing scientific articles. Future research should examine how existing critical appraisal tools can better identify common data elements that are essential to evidence-based decision-making in pharmacy practice.
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Affiliation(s)
- Ariane Blanc
- , BPharm, MSc, RPEBC, MBA, is Director of Pharmacy and Chief Clinical Pharmacist at the Children's Hospital of Eastern Ontario, Ottawa, Ontario
| | - Vivian Ho
- , PharmD, was, at the time this article was prepared, a pharmacy student in the University of Toronto Leslie Dean Faculty of Pharmacy, on rotation at the Children's Hospital of Eastern Ontario, Ottawa, Ontario. She has now graduated from the program
| | - Jameason Cameron
- , PhD, MSc, is the Pharmacy Project Coordinator at the Children's Hospital of Eastern Ontario, Ottawa, Ontario
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Kolaski K, Romeiser Logan L, Ioannidis JPA. Guidance to best tools and practices for systematic reviews1. J Pediatr Rehabil Med 2023; 16:241-273. [PMID: 37302044 DOI: 10.3233/prm-230019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023] Open
Abstract
Data continue to accumulate indicating that many systematic reviews are methodologically flawed, biased, redundant, or uninformative. Some improvements have occurred in recent years based on empirical methods research and standardization of appraisal tools; however, many authors do not routinely or consistently apply these updated methods. In addition, guideline developers, peer reviewers, and journal editors often disregard current methodological standards. Although extensively acknowledged and explored in the methodological literature, most clinicians seem unaware of these issues and may automatically accept evidence syntheses (and clinical practice guidelines based on their conclusions) as trustworthy.A plethora of methods and tools are recommended for the development and evaluation of evidence syntheses. It is important to understand what these are intended to do (and cannot do) and how they can be utilized. Our objective is to distill this sprawling information into a format that is understandable and readily accessible to authors, peer reviewers, and editors. In doing so, we aim to promote appreciation and understanding of the demanding science of evidence synthesis among stakeholders. We focus on well-documented deficiencies in key components of evidence syntheses to elucidate the rationale for current standards. The constructs underlying the tools developed to assess reporting, risk of bias, and methodological quality of evidence syntheses are distinguished from those involved in determining overall certainty of a body of evidence. Another important distinction is made between those tools used by authors to develop their syntheses as opposed to those used to ultimately judge their work.Exemplar methods and research practices are described, complemented by novel pragmatic strategies to improve evidence syntheses. The latter include preferred terminology and a scheme to characterize types of research evidence. We organize best practice resources in a Concise Guide that can be widely adopted and adapted for routine implementation by authors and journals. Appropriate, informed use of these is encouraged, but we caution against their superficial application and emphasize their endorsement does not substitute for in-depth methodological training. By highlighting best practices with their rationale, we hope this guidance will inspire further evolution of methods and tools that can advance the field.
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Affiliation(s)
- Kat Kolaski
- Departments of Orthopaedic Surgery, Pediatrics, and Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Lynne Romeiser Logan
- Department of Physical Medicine and Rehabilitation, SUNY Upstate Medical University, Syracuse, NY, USA
| | - John P A Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University School of Medicine, Stanford, CA, USA
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Bouzalmate-Hajjaj A, Massó Guijarro P, Khan KS, Bueno-Cavanillas A, Cano-Ibáñez N. Benefits of Participation in Clinical Trials: An Umbrella Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15368. [PMID: 36430100 PMCID: PMC9691211 DOI: 10.3390/ijerph192215368] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/10/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
Participation in randomised clinical trials (RCTs) entails taking part in the discovery of effects of health care interventions. The question of whether participants' outcomes are different to those of non-participants remains controversial. This umbrella review was aimed at assessing whether there are health benefits of participation in RCTs, compared to non-participation. After prospective registration (PROSPERO CRD42021287812), we searched the Medline, Scopus, Web of Science and Cochrane Library databases from inception to June 2022 to identify relevant systematic reviews with or without meta-analyses. Data extraction and study quality assessment (AMSTAR-2) were performed by two independent reviewers. Of 914 records, six systematic reviews summarising 380 comparisons of RCT participants with non-participants met the inclusion criteria. In two reviews, the majority of comparisons were in favour of participation in RCTs. Of the total of comparisons, 69 (18.7%) were in favour of participation, reporting statistically significant better outcomes for patients treated within RCTs, 264 (71.7%) comparisons were not statistically significant, and 35 (9.5%) comparisons were in favour of non-participation. None of the reviews found a harmful effect of participation in RCTs. Our findings suggest that taking part in RCTs may be beneficial compared to non-participation.
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Affiliation(s)
- Amira Bouzalmate-Hajjaj
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain
| | - Paloma Massó Guijarro
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain
- Preventive Medicine Unit, Universitary Hospital Virgen de las Nieves, 18014 Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (IBS.GRANADA), 18012 Granada, Spain
| | - Khalid Saeed Khan
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP-Spain), 28029 Madrid, Spain
| | - Aurora Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (IBS.GRANADA), 18012 Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP-Spain), 28029 Madrid, Spain
| | - Naomi Cano-Ibáñez
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (IBS.GRANADA), 18012 Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP-Spain), 28029 Madrid, Spain
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Matthias K, Honekamp I, De Santis KK. The Influence of Sex, Gender, or Age on Outcomes of Digital Technologies for Treatment and Monitoring of Chronic Obstructive Pulmonary Disease: Protocol for an Overview of Systematic Reviews. JMIR Res Protoc 2022; 11:e40538. [PMID: 36222803 PMCID: PMC9607912 DOI: 10.2196/40538] [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: 06/25/2022] [Revised: 08/11/2022] [Accepted: 09/21/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a common chronic disease that can be treated and monitored with various digital technologies. Digital technologies offer unique opportunities for treating and monitoring people with chronic diseases, but little is known about whether the outcomes of such technologies depend on sex, gender, or age in people with COPD. OBJECTIVE The general objective of this study is to assess the possible influence of sex, gender, or age on outcomes of digital technologies for treatment and monitoring of COPD through an overview of systematic reviews. METHODS The study is planned as an overview of systematic reviews. Study reporting is based on the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) 2020 guidelines because guidelines for overviews are not available as of this writing. The information sources for the overview will include 4 bibliographic databases (MEDLINE, Cochrane Library, Epistemonikos, and Web of Science) as well as the bibliographies of the included systematic reviews. The electronic search strategy will be developed and conducted in collaboration with an experienced database specialist. The search results will be presented in accordance with the PRISMA 2020 guidelines. The eligibility of studies is based on the population, intervention, comparison, outcomes, and study design (PICOS) criteria: (1) people with COPD (population), (2) digital technology intervention for treatment or monitoring (intervention), (3) any control group or no control group (comparison), (4) any outcome, and (5) systematic review of randomized controlled trials or non-randomized controlled trials with or without a meta-analysis (study design). Critical appraisal of the included systematic reviews will be performed using A Measurement Tool to Assess Systematic Reviews, version 2 (AMSTAR 2). Data will be extracted using a standardized data extraction sheet. RESULTS The literature search is scheduled for June 2022. We expect to select the relevant systematic reviews, code the data, and appraise the systematic reviews by December 2022. CONCLUSIONS There is a growing recognition that the influence of sex, gender, or age should be considered in research design and outcome reporting in the context of health care interventions. Our overview will identify systematic reviews of various digital technologies for treatment or monitoring of COPD. The most interesting aspect of the overview will be to investigate if any systematic reviews considered the influence of sex, gender, or age on the outcomes of such digital technologies in COPD. Evidence from the overview could be used to guide more individualized (sex, gender, or age-based) recommendations for the use of digital technologies among people with COPD. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42022322924; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=322924.
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Affiliation(s)
- Katja Matthias
- Faculty of Electrical Engineering and Computer Science, University of Applied Science Stralsund, Stralsund, Germany
| | - Ivonne Honekamp
- Faculty of Business and Economics, University of Applied Science Stralsund, Stralsund, Germany
| | - Karina Karolina De Santis
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany
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Travis N, Knoll M, Cadham CJ, Cook S, Warner KE, Fleischer NL, Douglas CE, Sánchez-Romero LM, Mistry R, Meza R, Hirschtick JL, Levy DT. Health Effects of Electronic Cigarettes: An Umbrella Review and Methodological Considerations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9054. [PMID: 35897421 PMCID: PMC9330875 DOI: 10.3390/ijerph19159054] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/19/2022] [Accepted: 07/19/2022] [Indexed: 02/04/2023]
Abstract
E-cigarettes are often marketed as a safer alternative to combustible cigarettes. However, their health effects, especially those associated with long-term use, remain largely uncertain. We conducted an umbrella review of the cardiopulmonary and carcinogenic risks of e-cigarette use, distinguishing between short-term and long-term health effects. The search for systematic reviews was conducted across four electronic databases through 25 January 2022. Methodological quality was assessed using the AMSTAR-2 quality appraisal tool. Seventeen systematic reviews, including five meta-analyses, were included in our umbrella review. There was a clear underreporting of e-cigarette devices and e-liquid types, e-cigarette and cigarette exposure, and the health and smoking status of study participants. Overall, the findings suggest that short-term use of e-cigarettes may be associated with acute cardiopulmonary risks, although to a lesser extent than cigarette use. Long-term e-cigarette use may have pulmonary/respiratory benefits in those who switch from chronic cigarette smoking, particularly in individuals with asthma and chronic obstructive pulmonary disease (COPD). Evidence on intermediate and long-term carcinogenic effects is lacking. This umbrella review underscores the urgent need for systematic reviews with better adherence to established reporting guidelines, consistent definitions of duration of e-cigarette use, a focus on newer devices, and accounting for the impacts of former or current smoking.
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Affiliation(s)
- Nargiz Travis
- Lombardi Comprehensive Cancer Center, Georgetown Medical University, Washington, DC 20057, USA; (M.K.); (L.M.S.-R.); (D.T.L.)
| | - Marie Knoll
- Lombardi Comprehensive Cancer Center, Georgetown Medical University, Washington, DC 20057, USA; (M.K.); (L.M.S.-R.); (D.T.L.)
| | - Christopher J. Cadham
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (C.J.C.); (K.E.W.); (C.E.D.)
| | - Steven Cook
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (S.C.); (N.L.F.); (R.M.); (J.L.H.)
| | - Kenneth E. Warner
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (C.J.C.); (K.E.W.); (C.E.D.)
| | - Nancy L. Fleischer
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (S.C.); (N.L.F.); (R.M.); (J.L.H.)
| | - Clifford E. Douglas
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (C.J.C.); (K.E.W.); (C.E.D.)
| | - Luz María Sánchez-Romero
- Lombardi Comprehensive Cancer Center, Georgetown Medical University, Washington, DC 20057, USA; (M.K.); (L.M.S.-R.); (D.T.L.)
| | - Ritesh Mistry
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Rafael Meza
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (S.C.); (N.L.F.); (R.M.); (J.L.H.)
| | - Jana L. Hirschtick
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (S.C.); (N.L.F.); (R.M.); (J.L.H.)
| | - David T. Levy
- Lombardi Comprehensive Cancer Center, Georgetown Medical University, Washington, DC 20057, USA; (M.K.); (L.M.S.-R.); (D.T.L.)
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The role of prenatal vitamin D on the development of childhood asthma and wheeze: An umbrella review of systematic reviews and meta-analyses. Clin Nutr 2022; 41:1808-1817. [PMID: 35834913 DOI: 10.1016/j.clnu.2022.06.040] [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: 05/13/2022] [Revised: 06/22/2022] [Accepted: 06/26/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND & OBJECTIVE It has been suggested that prenatal vitamin D plays a role in the development of childhood asthma and wheeze. Several systematic reviews have been conducted, but the results are inconsistent, and the methodological quality has not been studied. Therefore, the objective of this umbrella review was to assess the internal validity of the evidence base and the evidence for an association between prenatal vitamin D and asthma or wheezing in the offspring. METHODS We searched the electronic databases Embase, PubMed, and Cochrane Library for studies on prenatal vitamin D using search words such as vitamin D, 25-hydroxyvitamin D, calcidiol, fetal, and neonatal. The search was conducted in June 2020, and the databases were searched from their date of establishment. We included systematic reviews and/or meta-analyses of experimental and observational studies assessing the association between prenatal vitamin D or asthma and wheeze. We excluded narrative reviews, commentaries, and other umbrella reviews. The methodological quality of systematic reviews was assessed using AMSTAR 2 tool. PROSPERO reg. no. CRD42020151329. RESULTS We identified 22 eligible systematic reviews (17 on asthma and 20 on wheeze). Using the AMSTAR 2 quality assessment tool, the methodological quality was rated as critically low in 21 out of 22 systematic reviews, suggesting that previous reviews and meta-analyses did not provide accurate and comprehensive summaries of the included studies and that conclusions reached were potentially flawed. The majority of the included reviews reported that prenatal vitamin D reduces the risk of wheeze in the offspring. CONCLUSION Prior to informing public guidelines, high-quality systematic reviews of the current evidence are greatly warranted.
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Zhou Q, Chen J, Yu W, Yang K, Guo T, Niu P, Ye Y, Liu A. The Effectiveness of Duloxetine for Knee Osteoarthritis: An Overview of Systematic Reviews. Front Physiol 2022; 13:906597. [PMID: 35860654 PMCID: PMC9292134 DOI: 10.3389/fphys.2022.906597] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Knee osteoarthritis (KOA) has become a public health problem. Several systematic reviews (SRs) have reported that duloxetine may be an effective treatment for improving pain and depressive symptoms in patients with KOA. Aim: To evaluate the available results and provide scientific evidence for the efficacy and safety of duloxetine for KOA. Methods: A comprehensive search strategy was conducted across eight databases from inception to 31 December 2021. Two researchers independently selected eligible studies, collected data and evaluated those included SRs’ quality. For assessing methodological quality, the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR 2) was employed. Risk of Bias in Systematic Reviews (ROBIS) was used to assess the risk of bias. Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) was utilized for assessing reporting quality. In addition, the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to determine primary outcome indicators’ evidence quality. Results: Totally 6 SRs were contained in this overview. After assessment based on AMSTAR 2, ROBIS, and PRISMA, unsatisfactory results in terms of methodological quality, risk of bias as well as reporting quality, were obtained. Limitations included a search of grey literature, the reasons for selecting the study type, an excluded study list and the specific reasons, reporting bias assessment, and reporting of potential sources of conflict of interest. According to the GRADE results, the evidence quality was high in 0, moderate in 5, low in 19, and very low in 36. Limitations were the most commonly downgraded factor, followed by publication bias and inconsistency. Conclusion: Duloxetine may be an effective treatment for improving pain and depressive symptoms in KOA patients with acceptable adverse events. However, due to the low quality of the available evidence, the original study design and the quality of evidence from SRs should be further improved, so as to provide strong scientific evidence for definitive conclusions. Systematic Review Registration: PROSPERO; (http://www.crd.york.ac.uk/PROSPERO/), identifier (CRD42021289823).
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Affiliation(s)
- Qinxin Zhou
- Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Jixin Chen
- Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Weijie Yu
- Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Kun Yang
- Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Tianci Guo
- Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Puyu Niu
- Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Yuntian Ye
- Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Aifeng Liu
- Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- *Correspondence: Aifeng Liu,
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Liu A, Yu W, Chen J, Guo T, Niu P, Feng H, Jia Y. Methodological quality and risk of bias of systematic reviews and meta-analyses on stem cells for knee osteoarthritis: A cross-sectional survey. Stem Cells Dev 2022; 31:431-444. [PMID: 35316077 DOI: 10.1089/scd.2022.0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Clinical guidelines need high-quality studies to support clinical decision-making, in which the evidence often was collected from systematic reviews (SRs) and/or meta-analyses (MAs). At present, the methodological quality and risk of bias (RoB) of SRs/MAs on stem cell therapy for the treatment of knee osteoarthritis (KOA) has been poorly investigated. This study aims to strictly evaluate the methodological quality and RoB in SRs/MAs of stem cell therapy for KOA. Four electronic databases (PubMed, Embase, Cochrane Library, and Web of Science databases) were searched, from inception to October 5th, 2021. SRs/MAs involving randomized control trials (RCTs) or cohort studies on stem cell therapy for the treatment of KOA were included. The methodological quality and RoB were assessed using AMSTAR 2 and ROBIS tool respectively. In total, 22 SRs/MAs were included. According to the results obtained by AMSTAR 2 tool, all SRs/MAs were rated as "Critically low". Main methodological weaknesses were as follows: up to 81.82% did not meet protocol registration requirements, only 13.64% provided a list of excluded studies and justification, and 13.64% investigated and discussed the publication bias.. ROBIS-based RoB assessment showed that all the SRs/MAs were rated as "High". Besides, the lack of following the implementation of the PRISMA reporting guideline seems to reduce the methodological quality of the studies. The overall methodological quality of the SRs/MAs concerning the application of stem cell therapy in treating KOA is "Critically low", while the RoB is high. It is difficult to provide effective evidence for the formulation of guidelines for KOA treatment. We suggest that the relevant methodological quality assessment should be carried out in the future before the SRs/MAs are used as clinical evidence. In addition, it may be necessary for many journals to include the checklist with a submitted manuscript.
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Affiliation(s)
- Aifeng Liu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, 74770, Tianjin, China.,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China;
| | - Weijie Yu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, 74770, Tianjin, China.,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China;
| | - Jixin Chen
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, 74770, Tianjin, China.,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China;
| | - Tianci Guo
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, 74770, Tianjin, China.,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China;
| | - Puyu Niu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, 74770, Tianjin, China.,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China;
| | - Huichuan Feng
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, 74770, Tianjin, China.,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China;
| | - Yizhen Jia
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, 74770, Tianjin, China.,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China;
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Radhwi O, Alkhamesi S, Almohammadi A, Alahwal H, Barefah A, Bahashwan S. Quality of systematic reviews/meta-analyses in coronavirus disease 2019 and venous thromboembolism: An analysis using a measurement tool to assess systematic reviews-2. JOURNAL OF APPLIED HEMATOLOGY 2022. [DOI: 10.4103/joah.joah_34_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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49
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Walker J, Hobbs H, Magill N, van Niekerk M, Sharpe M. PASS: A checklist for assessing the quality of systematic reviews of prevalence studies. Gen Hosp Psychiatry 2022; 74:133-134. [PMID: 35033365 DOI: 10.1016/j.genhosppsych.2022.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 02/05/2023]
Affiliation(s)
- Jane Walker
- Psychological Medicine Research, University of Oxford Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - Harriet Hobbs
- Psychological Medicine Research, University of Oxford Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - Nicholas Magill
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Maike van Niekerk
- Psychological Medicine Research, University of Oxford Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - Michael Sharpe
- Psychological Medicine Research, University of Oxford Department of Psychiatry, Warneford Hospital, Oxford, UK.
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