1
|
de Sousa PG, Mainka FF, Tonin FS, Pontarolo R. Mapping the characteristics, methodological quality and standards of reporting of network meta-analyses on antithrombotic therapies: An overview. Int J Cardiol 2023:S0167-5273(23)00729-5. [PMID: 37230428 DOI: 10.1016/j.ijcard.2023.05.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/20/2023] [Accepted: 05/19/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Although a large number of network meta-analyses (NMAs) in the field of cardiology are available, little is known about their methodological quality. We aimed to map the characteristics and critically appraised the standards of conduct and evidence reporting of NMAs assessing antithrombotic therapies for the treatment or prophylaxis of heart diseases and cardiac surgical procedures. METHODS We systematically searched PubMed and Scopus to identify NMAs comparing the clinical effects of antithrombotic therapies. Overall characteristics of the NMAs were extracted and their reporting quality and methodological quality were evaluated using the PRISMA-NMA checklist and AMSTAR-2, respectively. RESULTS We found 86 NMAs published between 2007 and 2022. Comparisons among direct-acting oral anticoagulants were available in 61 (71%) NMAs. Although around 75% of NMAs stated that they followed international guidelines for conduct and reporting, only one third provided a protocol/register. Complete search strategies and publication bias assessment were lacking in around 53% and 59% of studies, respectively. Most NMAs (n = 77, 90%) provided supplemental material; however, only 5 (6%) made the complete raw data available. Network diagrams were depicted in most studies (n = 67, 78%), yet network geometry was described in only 11 (12.8%) of them. Mean adherence to the PRISMA-NMA checklist was 65.1 ± 16.5%. AMSTAR-2 assessment showed 88% of the NMAs had critically low methodological quality. CONCLUSION Although there is a wide diffusion of NMA-type studies on antithrombotics for heart diseases, their methodological and reporting quality remains suboptimal. This may reflect fragile clinical practices due to misleading conclusions from critically low-quality NMAs.
Collapse
Affiliation(s)
- Patricia Guerrero de Sousa
- Department of Medical and Pharmaceutical Sciences, Universidade Estadual do Oeste do Paraná, Cascavel, Brazil.
| | - Felipe Fernando Mainka
- Pharmaceutical Sciences Postgraduate Programme, Universidade Federal do Paraná, Curitiba, Brazil
| | - Fernanda Stumpf Tonin
- Pharmaceutical Sciences Postgraduate Programme, Universidade Federal do Paraná, Curitiba, Brazil; Health & Technology Research Centre, Escola Superior de Tecnologia da Saúde (H&TRC-ESTeSL), Instituto Politécnico de Lisboa, Lisbon, Portugal.
| | - Roberto Pontarolo
- Department of Pharmacy, Universidade Federal do Paraná, Curitiba, Brazil.
| |
Collapse
|
2
|
Jin S, Park SM, Choi SY, Park SY, Kim JH. Quality assessment of systematic reviews with meta-analysis in undergraduate nursing education. NURSE EDUCATION TODAY 2023; 126:105833. [PMID: 37187084 DOI: 10.1016/j.nedt.2023.105833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 04/04/2023] [Accepted: 04/22/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Little attention has been given to the methodological quality of meta-analyses in nursing education. This warrants further improvements in meta-analyses in nursing education. OBJECTIVE This study aimed to assess the methodological quality of meta-analysis in the field of undergraduate nursing education. DESIGN This was a methodological study to review the methodological quality of systematic reviews (SRs) with meta-analysis. METHODS Exhaustive literature searches were performed using five comprehensive databases. Between 1994 and 2022, 11,827 studies were identified, and 41 full-text articles met the inclusion criteria. Two researchers extracted data using A Measurement Tool to Assess Systematic Reviews (AMSTAR)-2. The Chi-square test was conducted to make comparisons before and after 2017, the year AMSTAR-2 was released. RESULTS A comprehensive literature retrieval strategy, inclusion and exclusion criteria, literature selection, and data extraction were observed in nursing education more than in other disciplines. Improvements to be made include pre-specifying the protocol, providing a list of excluded studies with their exclusion reasons, reporting the source of funding for the included studies, assessing and discussing the potential impact of risk of bias, as well as investigating and discussing publication bias and its impact. CONCLUSIONS The number of SRs with meta-analyses in nursing education is increasing. This warrants efforts to improve the quality of research. In addition, guidelines for reporting SRs in the field of nursing education should be constantly updated.
Collapse
Affiliation(s)
- Songxian Jin
- College of Nursing, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul 06591, Republic of Korea
| | - Seon-Min Park
- College of Nursing, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul 06591, Republic of Korea
| | - Seung-Yi Choi
- College of Nursing, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul 06591, Republic of Korea
| | - So Young Park
- College of Nursing, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul 06591, Republic of Korea
| | - Jung-Hee Kim
- College of Nursing, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul 06591, Republic of Korea.
| |
Collapse
|
3
|
Li Z, Wong LCK, Sultana R, Lim HJ, Tan JWS, Tan QX, Wong JSM, Chia CS, Ong CAJ. A systematic review on quality of life (QoL) of patients with peritoneal metastasis (PM) who underwent pressurized intraperitoneal aerosol chemotherapy (PIPAC). Pleura Peritoneum 2022; 7:39-49. [PMID: 35812010 PMCID: PMC9166188 DOI: 10.1515/pp-2021-0154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/31/2022] [Indexed: 11/15/2022] Open
Abstract
Background Pressurized intraperitoneal aerosol chemotherapy (PIPAC) has recently emerged as a palliative alternative for patients with unresectable peritoneal metastasis (PM). Quality of life (QoL) has increasingly been used as an endpoint to evaluate treatment outcomes. This review aims to identify evidence on how PIPAC would impact the QoL of PM patients. Content A systematic review was performed on articles identified from Medline, EMBASE, PsycInfo, and Web of Sciences. A meta-analysis was conducted on further selected studies. ACROBAT-NRSI was attempted to assess the risk of bias (RoB). Summary Nine studies using the EORTC QLQ-C30 questionnaire to assess QoL after repeated PIPAC cycles were identified. Majority was found to be moderately biased and a great extent of heterogeneity was observed. Four studies on PM from either gastric cancer (GC) or epithelial ovarian cancer (EOC) were included for meta-analysis. In 31 GC patients and 104 EOC patients, QoL remained stable in 13/14 and 11/14 EORTC QLQ-C30 scales. PIPAC was inferior to cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) in global QoL and functioning but superior in symptom reduction. Outlook PIPAC is a well-tolerated option for most GC and EOC patients with irresectable PM. Future trials are warranted to confirm the findings.
Collapse
Affiliation(s)
- Zhenyue Li
- Department of Sarcoma , Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore , Singapore , Singapore
- Department of Sarcoma , Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital , Singapore , Singapore
- Duke-NUS Medical School , Singapore , Singapore
| | - Louis Choon Kit Wong
- Department of Sarcoma , Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore , Singapore , Singapore
- Department of Sarcoma , Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital , Singapore , Singapore
- Duke-NUS Medical School , Singapore , Singapore
| | | | - Hui Jun Lim
- Department of Sarcoma , Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore , Singapore , Singapore
- Department of Sarcoma , Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital , Singapore , Singapore
- Laboratory of Applied Human Genetics, Division of Medical Sciences, National Cancer Centre Singapore , Singapore , Singapore
| | - Joey Wee-Shan Tan
- Department of Sarcoma , Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore , Singapore , Singapore
- Department of Sarcoma , Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital , Singapore , Singapore
- Laboratory of Applied Human Genetics, Division of Medical Sciences, National Cancer Centre Singapore , Singapore , Singapore
| | - Qiu Xuan Tan
- Department of Sarcoma , Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore , Singapore , Singapore
- Department of Sarcoma , Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital , Singapore , Singapore
- Laboratory of Applied Human Genetics, Division of Medical Sciences, National Cancer Centre Singapore , Singapore , Singapore
| | - Jolene Si Min Wong
- Department of Sarcoma , Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore , Singapore , Singapore
- Department of Sarcoma , Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital , Singapore , Singapore
- SingHealth Duke-NUS Oncology Academic Clinical Program, Duke NUS Medical School , Singapore , Singapore
- SingHealth Duke-NUS Surgery Academic Clinical Program, Duke NUS Medical School , Singapore , Singapore
| | - Claramae Shulyn Chia
- Department of Sarcoma , Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore , Singapore , Singapore
- Department of Sarcoma , Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital , Singapore , Singapore
- SingHealth Duke-NUS Oncology Academic Clinical Program, Duke NUS Medical School , Singapore , Singapore
- SingHealth Duke-NUS Surgery Academic Clinical Program, Duke NUS Medical School , Singapore , Singapore
| | - Chin-Ann Johnny Ong
- Department of Sarcoma , Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore , Singapore , Singapore
- Department of Sarcoma , Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital , Singapore , Singapore
- Laboratory of Applied Human Genetics, Division of Medical Sciences, National Cancer Centre Singapore , Singapore , Singapore
- SingHealth Duke-NUS Oncology Academic Clinical Program, Duke NUS Medical School , Singapore , Singapore
- SingHealth Duke-NUS Surgery Academic Clinical Program, Duke NUS Medical School , Singapore , Singapore
| |
Collapse
|
4
|
Pega F, Momen NC, Gagliardi D, Bero LA, Boccuni F, Chartres N, Descatha A, Dzhambov AM, Godderis L, Loney T, Mandrioli D, Modenese A, van der Molen HF, Morgan RL, Neupane S, Pachito D, Paulo MS, Prakash KC, Scheepers PTJ, Teixeira L, Tenkate T, Woodruff TJ, Norris SL. Assessing the quality of evidence in studies estimating prevalence of exposure to occupational risk factors: The QoE-SPEO approach applied in the systematic reviews from the WHO/ILO Joint Estimates of the Work-related burden of disease and Injury. ENVIRONMENT INTERNATIONAL 2022; 161:107136. [PMID: 35182944 PMCID: PMC8885428 DOI: 10.1016/j.envint.2022.107136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 01/05/2022] [Accepted: 02/04/2022] [Indexed: 05/04/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) have produced the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury (WHO/ILO Joint Estimates). For these, systematic reviews of studies estimating the prevalence of exposure to selected occupational risk factors have been conducted to provide input data for estimations of the number of exposed workers. A critical part of systematic review methodology is to assess the quality of evidence across studies. In this article, we present the approach applied in these WHO/ILO systematic reviews for performing such assessments on studies of prevalence of exposure. It is called the Quality of Evidence in Studies estimating Prevalence of Exposure to Occupational risk factors (QoE-SPEO) approach. We describe QoE-SPEO's development to date, demonstrate its feasibility reporting results from pilot testing and case studies, note its strengths and limitations, and suggest how QoE-SPEO should be tested and developed further. METHODS Following a comprehensive literature review, and using expert opinion, selected existing quality of evidence assessment approaches used in environmental and occupational health were reviewed and analysed for their relevance to prevalence studies. Relevant steps and components from the existing approaches were adopted or adapted for QoE-SPEO. New steps and components were developed. We elicited feedback from other systematic review methodologists and exposure scientists and reached consensus on the QoE-SPEO approach. Ten individual experts pilot-tested QoE-SPEO. To assess inter-rater agreement, we counted ratings of expected (actual and non-spurious) heterogeneity and quality of evidence and calculated a raw measure of agreement (Pi) between individual raters and rater teams for the downgrade domains. Pi ranged between 0.00 (no two pilot testers selected the same rating) and 1.00 (all pilot testers selected the same rating). Case studies were conducted of experiences of QoE-SPEO's use in two WHO/ILO systematic reviews. RESULTS We found no existing quality of evidence assessment approach for occupational exposure prevalence studies. We identified three relevant, existing approaches for environmental and occupational health studies of the effect of exposures. Assessments using QoE-SPEO comprise three steps: (1) judge the level of expected heterogeneity (defined as non-spurious variability that can be expected in exposure prevalence, within or between individual persons, because exposure may change over space and/or time), (2) assess downgrade domains, and (3) reach a final rating on the quality of evidence. Assessments are conducted using the same five downgrade domains as the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach: (a) risk of bias, (b) indirectness, (c) inconsistency, (d) imprecision, and (e) publication bias. For downgrade domains (c) and (d), the assessment varies depending on the level of expected heterogeneity. There are no upgrade domains. The QoE-SPEO's ratings are "very low", "low", "moderate", and "high". To arrive at a final decision on the overall quality of evidence, the assessor starts at "high" quality of evidence and for each domain downgrades by one or two levels for serious concerns or very serious concerns, respectively. In pilot tests, there was reasonable agreement in ratings for expected heterogeneity; 70% of raters selected the same rating. Inter-rater agreement ranged considerably between downgrade domains, both for individual rater pairs (range Pi: 0.36-1.00) and rater teams (0.20-1.00). Sparse data prevented rigorous assessment of inter-rater agreement in quality of evidence ratings. CONCLUSIONS We present QoE-SPEO as an approach for assessing quality of evidence in prevalence studies of exposure to occupational risk factors. It has been developed to its current version (as presented here), has undergone pilot testing, and was applied in the systematic reviews for the WHO/ILO Joint Estimates. While the approach requires further testing and development, it makes steps towards filling an identified gap, and progress made so far can be used to inform future work in this area.
Collapse
Affiliation(s)
- Frank Pega
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
| | - Natalie C Momen
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland
| | - Diana Gagliardi
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy
| | - Lisa A Bero
- Charles Perkins Centre, The University of Sydney, Sydney, Australia; General Internal Medicine/Public Health/Center for Bioethics and Humanities, University of Colorado-Anschutz Medical Campus, Denver, CO, United States
| | - Fabio Boccuni
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy
| | - Nicholas Chartres
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, United States
| | - Alexis Descatha
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), Occupational Health Unit, University Hospital of West Suburb of Paris, Poincaré Site, Garches, France /Versailles St-Quentin Univ - Paris Saclay Univ (UVSQ), UMS 011, UMR-S 1168, France; Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S1085, CAPTV CDC, Angers, France
| | - Angel M Dzhambov
- Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria; Institute for Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria
| | - Lode Godderis
- Centre for Environment and Health, KU Leuven, Leuven, Belgium; KIR Department (Knowledge, Information & Research), IDEWE, External Service for Prevention and Protection at Work, Leuven, Belgium
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Henk F van der Molen
- Coronel Institute of Occupational Health, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence and Impact, McMaster University, Ontario, Canada
| | - Subas Neupane
- Faculty of Social Science (Health Sciences), University of Tampere, Tampere, Finland
| | - Daniela Pachito
- Evidence-based Health, Universidade Federal de São Paulo, Sao Paulo, Brazil; Cochrane Brazil, Sao Paulo, Brazil
| | - Marilia S Paulo
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
| | - K C Prakash
- Faculty of Social Science (Health Sciences), University of Tampere, Tampere, Finland
| | - Paul T J Scheepers
- Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands
| | - Liliane Teixeira
- Workers' Health and Human Ecology Research Center, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Thomas Tenkate
- School of Occupational and Public Health, Ryerson University, Toronto, Ontario, Canada
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, United States
| | - Susan L Norris
- Oregon Health & Science University, Portland, OR, United States; Department of Quality Assurance, Norms and Standards, World Health Organization, Geneva, Switzerland
| |
Collapse
|
5
|
Fan X, Shen W, Wang L, Zhang Y. Efficacy and Safety of DL-3-n-Butylphthalide in the Treatment of Poststroke Cognitive Impairment: A Systematic Review and Meta-Analysis. Front Pharmacol 2022; 12:810297. [PMID: 35145408 PMCID: PMC8823901 DOI: 10.3389/fphar.2021.810297] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 12/08/2021] [Indexed: 01/02/2023] Open
Abstract
Background: Poststroke cognitive impairment (PSCI) is a common complication observed after stroke. Current pharmacologic therapies have no definitive evidence for cognitive recovery or disease progression. Recent studies have verified the positive effect of DL-3-n-butylphthalide (NBP). However, the clinical efficacy and safety are still unclear. The aim of this study was to assess the efficacy of NBP and its harmful effect in the treatment of PSCI. Method: Eligible randomized controlled trials (RCTs) were retrieved from inception to June 2021 from seven medical databases and two clinical registries. The revised Cochrane risk of bias tool (RoB 2.0) was used for methodological quality. RevMan v5.4.1 from Cochrane Collaboration was used for statistical analysis, and Hartung-Knapp-Sidik-Jonkman (HKSJ) method was used for post hoc testing depend on the number of studies. This study has been submitted to PROSPERO with registration number is CRD42021274123. Result: We identified 26 studies with a total sample size of 2,571 patients. The results of this study showed that NBP as monotherapy or combination therapy had better performance in increasing the MoCA (monotherapy: SMDN = 1.05, 95% CI [0.69, 1.42], p < 0.00001; SMDP = 1.06, 95% CI [0.59, 1.52], p < 0.00001. combination: SMDO = 0.81, 95% CI [0.62, 1.01], p < 0.00001; SMDN = 0.90, 95% CI [0.46, 1.33], p < 0.0001; SMDD = 1.04, 95% CI [0.71, 1.38], p < 0.00001), MMSE (monotherapy: MDN = 4.89, 95% CI [4.14, 5.63]), p < 0.00001). combination: SMDO = 1.26, 95% CI [0.97, 1.56], p < 0.00001; SMDC = 1.63, 95% CI [1.28, 1.98], p < 0.00001; SMDN = 2.13, 95% CI [1.52, 2.75], p < 0.00001) and BI (monotherapy: MDN = 13.53, HKSJ 95% CI [9.84, 17.22], p = 0.014. combination: SMDO = 2.24, HKSJ 95%CI [0.37, 4.11], p = 0.032; SMDC = 3.36, 95%CI [2.80, 3.93], p < 0.00001; SMDD = 1.48, 95%CI [1.13, 1.83], p < 0.00001); and decreasing the NIHSS (monotherapy: MDN = −3.86, 95% CI [−5.22, −2.50], p < 0.00001. combination: SMDO = −1.15, 95% CI [−1.31, −0.98], p < 0.00001; SMDC = −1.82, 95% CI [−2.25, −1.40], p < 0.00001) and CSS (combination: MDO = −7.11, 95% CI [−8.42, −5.80], p < 0.00001), with no serious adverse reactions observed. The funnel plot verified the possibility of publication bias. Conclusion: NBP maintains a stable pattern in promoting the recovery of cognitive function and abilities of daily living, as well as reducing the symptoms of neurological deficits. However, there is still a need for more high-quality RCTs to verify its efficacy and safety.
Collapse
Affiliation(s)
| | - Wei Shen
- *Correspondence: Wei Shen, ; Yunling Zhang,
| | | | | |
Collapse
|
6
|
Momen NC, Streicher KN, da Silva DTC, Descatha A, Frings-Dresen MHW, Gagliardi D, Godderis L, Loney T, Mandrioli D, Modenese A, Morgan RL, Pachito D, Scheepers PTJ, Sgargi D, Paulo MS, Schlünssen V, Sembajwe G, Sørensen K, Teixeira LR, Tenkate T, Pega F. Assessor burden, inter-rater agreement and user experience of the RoB-SPEO tool for assessing risk of bias in studies estimating prevalence of exposure to occupational risk factors: An analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. ENVIRONMENT INTERNATIONAL 2022; 158:107005. [PMID: 34991265 PMCID: PMC8685606 DOI: 10.1016/j.envint.2021.107005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 11/19/2021] [Accepted: 11/23/2021] [Indexed: 05/08/2023]
Abstract
BACKGROUND As part of the development of the World Health Organization (WHO)/International Labour Organization (ILO) Joint Estimates of the Work-related Burden of Disease and Injury, WHO and ILO carried out several systematic reviews to determine the prevalence of exposure to selected occupational risk factors. Risk of bias assessment for individual studies is a critical step of a systematic review. No tool existed for assessing the risk of bias in prevalence studies of exposure to occupational risk factors, so WHO and ILO developed and pilot tested the RoB-SPEO tool for this purpose. Here, we investigate the assessor burden, inter-rater agreement, and user experience of this new instrument, based on the abovementioned WHO/ILO systematic reviews. METHODS Twenty-seven individual experts applied RoB-SPEO to assess risk of bias. Four systematic reviews provided a total of 283 individual assessments, carried out for 137 studies. For each study, two or more assessors independently assessed risk of bias across the eight RoB-SPEO domains selecting one of RoB-SPEO's six ratings (i.e., "low", "probably low", "probably high", "high", "unclear" or "cannot be determined"). Assessors were asked to report time taken (i.e. indicator of assessor burden) to complete each assessment and describe their user experience. To gauge assessor burden, we calculated the median and inter-quartile range of times taken per individual risk of bias assessment. To assess inter-rater reliability, we calculated a raw measure of inter-rater agreement (Pi) for each RoB-SPEO domain, between Pi = 0.00, indicating no agreement and Pi = 1.00, indicating perfect agreement. As subgroup analyses, Pi was also disaggregated by systematic review, assessor experience with RoB-SPEO (≤10 assessments versus > 10 assessments), and assessment time (tertiles: ≤25 min versus 26-66 min versus ≥ 67 min). To describe user experience, we synthesised the assessors' comments and recommendations. RESULTS Assessors reported a median of 40 min to complete one assessment (interquartile range 21-120 min). For all domains, raw inter-rater agreement ranged from 0.54 to 0.82. Agreement varied by systematic review and assessor experience with RoB-SPEO between domains, and increased with increasing assessment time. A small number of users recommended further development of instructions for selected RoB-SPEO domains, especially bias in selection of participants into the study (domain 1) and bias due to differences in numerator and denominator (domain 7). DISCUSSION Overall, our results indicated good agreement across the eight domains of the RoB-SPEO tool. The median assessment time was comparable to that of other risk of bias tools, indicating comparable assessor burden. However, there was considerable variation in time taken to complete assessments. Additional time spent on assessments may improve inter-rater agreement. Further development of the RoB-SPEO tool could focus on refining instructions for selected RoB-SPEO domains and additional testing to assess agreement for different topic areas and with a wider range of assessors from different research backgrounds.
Collapse
Affiliation(s)
- Natalie C Momen
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
| | - Kai N Streicher
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
| | - Denise T C da Silva
- Workers' Health and Human Ecology Research Center, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Alexis Descatha
- UNIV Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Angers, France; AP-HP (Paris Hospital), Occupational Health Unit, Poincaré University Hospital, Garches, France; Versailles St-Quentin Univ-Paris Saclay Univ (UVSQ), UMS 011, UMR-S 1168, France; Inserm, U1168 UMS 011, Villejuif, France.
| | - Monique H W Frings-Dresen
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health/Coronel Institute of Occupational Health, Amsterdam Research Institute, Amsterdam, the Netherlands.
| | - Diana Gagliardi
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy.
| | - Lode Godderis
- Centre for Environment and Health, KU Leuven, Leuven, Belgium; KIR Department (Knowledge, Information & Research), IDEWE, External Service for Prevention and Protection at Work, Leuven, Belgium.
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
| | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy.
| | - Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
| | - Daniela Pachito
- Núcleo de Avaliação de Tecnologias em Saúde, Hospital Sírio-Libanês, Bela Vista, São Paulo, SP, Brazil; Fundação Getúlio Vargas, Bela Vista, São Paulo, SP, Brazil.
| | - Paul T J Scheepers
- Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands.
| | - Daria Sgargi
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Marília Silva Paulo
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
| | - Vivi Schlünssen
- Aarhus University, Aarhus, Denmark; National Research Center for the Working Environment, Copenhagen, Denmark.
| | - Grace Sembajwe
- Department of Environmental, Occupational, and Geospatial Health Sciences, CUNY Graduate School of Public Health and Health Policy, CUNY Institute for Implementation Science in Population Health, New York, NY, United States.
| | - Kathrine Sørensen
- National Research Center for the Working Environment, Copenhagen, Denmark.
| | - Liliane R Teixeira
- Workers' Health and Human Ecology Research Center, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
| | - Thomas Tenkate
- School of Occupational and Public Health, Ryerson University, Toronto, ON, Canada.
| | - Frank Pega
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
| |
Collapse
|
7
|
de Sá-Caputo DDC, Coelho-Oliveira AC, Sonza A, Paineiras-Domingos LL, Taiar R, Das S, Bello AR, Bernardo-Filho M. Face Masks Use to Avoid Airborne Contamination during COVID-19 Pandemic and Related Conditions: A Systematic Review. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:2361-2373. [PMID: 36317023 PMCID: PMC9577161 DOI: 10.18502/ijph.v50i12.7920] [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: 07/09/2021] [Accepted: 09/10/2021] [Indexed: 06/16/2023]
Abstract
Background The facemasks use has been discussed to prevent respiratory disease due airborne contamination. The aim of this study was to perform a systematic review about the face masks use to avoid airborne contamination during COVID-19 pandemic and related conditions, registered (PROSPERO-CRD42020198347) and performed according PRISMA. Methods PubMed, Embase and Scopus databases were used to collect data. Observational studies, published in 2020, and English language, were included. Two reviewers independently identified records through database search and reference screening and disagreements were resolved by a third reviewer. Six studies were included. Results The works investigated about the use of masks (different types) to prevent droplets dissemination with virus or bacterial suspension and decrease COVID-19 transmission routes, comfort, or temperature. The studies have moderate to critical risk of bias and the level of evidence is III-2. Conclusion It is recommended facemask use to prevent droplets from escaping airborne and infecting other people, although there are different percentages of protection and can be possible a discomfort related the use. Further clinical trials to the effectiveness of face mask to avoid airborne contamination during the COVID-19 pandemic and the factors interfering with their effectiveness should be conducted.
Collapse
Affiliation(s)
- Danúbia da Cunha de Sá-Caputo
- Laboratory of Mechanical Vibrations and Integrative Practices, Department of Biophysics and Biometrics, Roberto Alcântara Gomes Institute of Biology and Piquet Carneiro Polyclinic, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Postgraduate Program in Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Bezerra de Araújo College, Rio de Janeiro, RJ, Brazil
- Postgraduate Program in Clinical and Experimental Pathophysiology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Ana Carolina Coelho-Oliveira
- Laboratory of Mechanical Vibrations and Integrative Practices, Department of Biophysics and Biometrics, Roberto Alcântara Gomes Institute of Biology and Piquet Carneiro Polyclinic, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Postgraduate Program in Clinical and Experimental Pathophysiology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Anelise Sonza
- Department of Physiotherapy, Graduate Program in Physiotherapy, State University of Santa Catarina, Florianópolis, SC, Brazil and Graduate Program in Human Movement Sciences, State University of Santa Catarina, Florianópolis, SC, Brazil
| | - Laisa Liane Paineiras-Domingos
- Laboratory of Mechanical Vibrations and Integrative Practices, Department of Biophysics and Biometrics, Roberto Alcântara Gomes Institute of Biology and Piquet Carneiro Polyclinic, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Postgraduate Program in Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Department of Physiotherapy, Institute of Health Sciences, Federal University of Bahia, Salvador, BA, Brazil
| | - Redha Taiar
- Physical and Rehabilitation Medicine Department, Sebastopol Hospital, University of Reims Champagne-Ardenne, France
| | | | | | - Mario Bernardo-Filho
- Laboratory of Mechanical Vibrations and Integrative Practices, Department of Biophysics and Biometrics, Roberto Alcântara Gomes Institute of Biology and Piquet Carneiro Polyclinic, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| |
Collapse
|
8
|
Igelström E, Campbell M, Craig P, Katikireddi SV. Cochrane's risk of bias tool for non-randomized studies (ROBINS-I) is frequently misapplied: A methodological systematic review. J Clin Epidemiol 2021; 140:22-32. [PMID: 34437948 PMCID: PMC8809341 DOI: 10.1016/j.jclinepi.2021.08.022] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/16/2021] [Accepted: 08/18/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVES We aimed to review how 'Risk of Bias In Non-randomized Studies-of Interventions' (ROBINS-I), a Cochrane risk of bias assessment tool, has been used in recent systematic reviews. STUDY DESIGN AND SETTING Database and citation searches were conducted in March 2020 to identify recently published reviews using ROBINS-I. Reported ROBINS-I assessments and data on how ROBINS-I was used were extracted from each review. Methodological quality of reviews was assessed using AMSTAR 2 ('A MeaSurement Tool to Assess systematic Reviews'). RESULTS Of 181 hits, 124 reviews were included. Risk of bias was serious/critical in 54% of assessments on average, most commonly due to confounding. Quality of reviews was mostly low, and modifications and incorrect use of ROBINS-I were common, with 20% reviews modifying the rating scale, 20% understating overall risk of bias, and 19% including critical-risk of bias studies in evidence synthesis. Poorly conducted reviews were more likely to report low/moderate risk of bias (predicted probability 57% [95% CI: 47-67] in critically low-quality reviews, 31% [19-46] in high/moderate-quality reviews). CONCLUSION Low-quality reviews frequently apply ROBINS-I incorrectly, and may thus inappropriately include or give too much weight to uncertain evidence. Readers should be aware that such problems can lead to incorrect conclusions in reviews.
Collapse
Affiliation(s)
- Erik Igelström
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square 99 Berkeley Street, Glasgow, G3 7HR.
| | - Mhairi Campbell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square 99 Berkeley Street, Glasgow, G3 7HR
| | - Peter Craig
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square 99 Berkeley Street, Glasgow, G3 7HR
| | - Srinivasa Vittal Katikireddi
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square 99 Berkeley Street, Glasgow, G3 7HR
| |
Collapse
|
9
|
Barnes C, McCrabb S, Stacey F, Nathan N, Yoong SL, Grady A, Sutherland R, Hodder R, Innes-Hughes C, Davies M, Wolfenden L. Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review. Transl Behav Med 2021; 11:1365-1410. [PMID: 34080618 PMCID: PMC8320878 DOI: 10.1093/tbm/ibab037] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Although best practice recommendations exist regarding school-based healthy eating and physical activity policies, practices, and programs, research indicates that implementation is poor. As the field of implementation science is rapidly evolving, an update of the recent review of strategies to improve the implementation of healthy eating and physical activity interventions in schools published in the Cochrane Library in 2017 was required. The primary aim of this review was to examine the effectiveness of strategies that aim to improve the implementation of school-based policies, practices, or programs to address child diet, physical activity, or obesity. A systematic review of articles published between August 31, 2016 and April 10, 2019 utilizing Cochrane methodology was conducted. In addition to the 22 studies included in the original review, eight further studies were identified as eligible. The 30 studies sought to improve the implementation of healthy eating (n = 16), physical activity (n = 11), or both healthy eating and physical activity (n = 3). The narrative synthesis indicated that effect sizes of strategies to improve implementation were highly variable across studies. For example, among 10 studies reporting the proportion of schools implementing a targeted policy, practice, or program versus a minimal or usual practice control, the median unadjusted effect size was 16.2%, ranging from -0.2% to 66.6%. Findings provide some evidence to support the effectiveness of strategies in enhancing the nutritional quality of foods served at schools, the implementation of canteen policies, and the time scheduled for physical education.
Collapse
Affiliation(s)
- Courtney Barnes
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Sam McCrabb
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Fiona Stacey
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Nicole Nathan
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Sze Lin Yoong
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
- Department of Nursing and Allied Health, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Alice Grady
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Rachel Sutherland
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Rebecca Hodder
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | | | - Marc Davies
- New South Wales Office of Preventive Health, Sydney, New South Wales, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| |
Collapse
|
10
|
Goodwin J, Saab MM, Dillon CB, Kilty C, McCarthy A, O'Brien M, Philpott LF. The use of film-based interventions in adolescent mental health education: A systematic review. J Psychiatr Res 2021; 137:158-172. [PMID: 33677219 DOI: 10.1016/j.jpsychires.2021.02.055] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 02/17/2021] [Accepted: 02/22/2021] [Indexed: 02/05/2023]
Abstract
Film-based interventions have been embraced by adolescents as educational tools, but their efficacy in mental health education remains under-explored. In this review, we systematically examined the use of film-based interventions in adolescent mental health education. A systematic review of the empirical literature was conducted using the following databases: Academic Search Complete, Education Full Text [H.W. Wilson], CINAHL Plus with Full Text, Humanities Full Text [H.W. Wilson], MEDLINE, APA PsycArticles, APA PsycInfo, Psychology and Behavioral Sciences Collection, Social Sciences Full Text [H.W. Wilson], Soc Index, ERIC. Risk of Bias were assessed using Version 2 of the Cochrane RoB tool for randomised trials (RoB2) or the Cochrane Collaboration Risk of Bias In Non-randomised Studies of Interventions (ROBINS-I). Ten peer-reviewed studies were included in this review. Film emerged as a promising education method for enhancing metal health literacy and reducing stigma. Mixed reports were found for improving attitudes towards help-seeking, with narrative-based films having a weaker effect on attitudes towards help-seeking when compared with more instructive approaches. No study focussed on resilience. This review highlights the utility and potential for film-based interventions in adolescent mental health education. Further research is warranted around how best to implement such interventions to engage adolescents.
Collapse
Affiliation(s)
- John Goodwin
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland; ENGAGE (Interdisciplinary Clinical Mental Health Research Network), Ireland.
| | - Mohamad M Saab
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Christina B Dillon
- Environmental Research Institute/School of Public Health, University College Cork, Cork, Ireland
| | - Caroline Kilty
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Aoibhie McCarthy
- Cork International Film Festival, Castle Chambers, 6 Castle Street, Cork, Ireland; Sample Studios, Exchange Business Park, Churchfield, Cork, Ireland
| | - Maidy O'Brien
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Lloyd F Philpott
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| |
Collapse
|
11
|
Zhang Y, Huang L, Wang D, Ren P, Hong Q, Kang D. The ROBINS-I and the NOS had similar reliability but differed in applicability: A random sampling observational studies of systematic reviews/meta-analysis. J Evid Based Med 2021; 14:112-122. [PMID: 34002466 DOI: 10.1111/jebm.12427] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 02/07/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE There is a lack of evidence on the usage of the quality assessment tool-the Risk Of Bias In Nonrandomized Studies-of Interventions (ROBINS-I). This article aimed to measure the reliability, criterion validity, and feasibility of the ROBINS-I and the Newcastle-Ottawa Scale (NOS). METHODS A sample of systematic reviews or meta-analyses of observational studies were selected from Medline (2013-2017) and assessed by two reviewers using ROBINS-I and the NOS. We reported on reliability in terms of the first-order agreement coefficient (AC1) statistic. Correlation coefficient statistic was used to explore the criterion validity of the ROBINS-I. We compared the feasibility of the ROBINS-I and NOS by recording the time to complete an assessment and the instances where assessing was difficult. RESULTS Five systematic reviews containing 41 cohort studies were finally included. Interobserver agreement on the individual domain of the ROBINS-I as well as the NOS was substantial with a mean AC1 statistic of 0.67 (95% CI: 0.50-0.83) and 0.73 (95% CI: 0.65-0.81), respectively. The criterion validity of the ROBNS-I was moderate (K = 0.52) against NOS. The time in assessing a single study by ROBINS-I varied from 7 hours initially to 3 hours compared with 30 minutes for the NOS. Both reviewers rated "bias due to departure from the intended interventions" the most time-consuming domain in the ROBINS-I, items in the NOS were equal. CONCLUSIONS The ROBINS-I and the NOS seem to provide the same reliability but vary in applicability. The over-complicated feature of ROBINS-I may limit its usage and a simplified version is needed.
Collapse
Affiliation(s)
- Yuhui Zhang
- Department of Evidence-based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Litao Huang
- Department of Evidence-based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Dandan Wang
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, Gansu, China
| | - Pengwei Ren
- Clinical Research Center for Respiratory Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qi Hong
- Department of Evidence-based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Deying Kang
- Department of Evidence-based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
12
|
Vinkers CH, Lamberink HJ, Tijdink JK, Heus P, Bouter L, Glasziou P, Moher D, Damen JA, Hooft L, Otte WM. The methodological quality of 176,620 randomized controlled trials published between 1966 and 2018 reveals a positive trend but also an urgent need for improvement. PLoS Biol 2021; 19:e3001162. [PMID: 33872298 PMCID: PMC8084332 DOI: 10.1371/journal.pbio.3001162] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 04/29/2021] [Accepted: 03/01/2021] [Indexed: 11/27/2022] Open
Abstract
Many randomized controlled trials (RCTs) are biased and difficult to reproduce due to methodological flaws and poor reporting. There is increasing attention for responsible research practices and implementation of reporting guidelines, but whether these efforts have improved the methodological quality of RCTs (e.g., lower risk of bias) is unknown. We, therefore, mapped risk-of-bias trends over time in RCT publications in relation to journal and author characteristics. Meta-information of 176,620 RCTs published between 1966 and 2018 was extracted. The risk-of-bias probability (random sequence generation, allocation concealment, blinding of patients/personnel, and blinding of outcome assessment) was assessed using a risk-of-bias machine learning tool. This tool was simultaneously validated using 63,327 human risk-of-bias assessments obtained from 17,394 RCTs evaluated in the Cochrane Database of Systematic Reviews (CDSR). Moreover, RCT registration and CONSORT Statement reporting were assessed using automated searches. Publication characteristics included the number of authors, journal impact factor (JIF), and medical discipline. The annual number of published RCTs substantially increased over 4 decades, accompanied by increases in authors (5.2 to 7.8) and institutions (2.9 to 4.8). The risk of bias remained present in most RCTs but decreased over time for allocation concealment (63% to 51%), random sequence generation (57% to 36%), and blinding of outcome assessment (58% to 52%). Trial registration (37% to 47%) and the use of the CONSORT Statement (1% to 20%) also rapidly increased. In journals with a higher impact factor (>10), the risk of bias was consistently lower with higher levels of RCT registration and the use of the CONSORT Statement. Automated risk-of-bias predictions had accuracies above 70% for allocation concealment (70.7%), random sequence generation (72.1%), and blinding of patients/personnel (79.8%), but not for blinding of outcome assessment (62.7%). In conclusion, the likelihood of bias in RCTs has generally decreased over the last decades. This optimistic trend may be driven by increased knowledge augmented by mandatory trial registration and more stringent reporting guidelines and journal requirements. Nevertheless, relatively high probabilities of bias remain, particularly in journals with lower impact factors. This emphasizes that further improvement of RCT registration, conduct, and reporting is still urgently needed. Many randomized controlled trials (RCTs) are biased and difficult to reproduce due to methodological flaws and poor reporting. Analysis of 176,620 RCTs published between 1966 and 2018 reveals that the risk of bias in RCTs generally decreased. Nevertheless, relatively high probabilities of bias remain, showing that further improvement of RCT registration, conduct, and reporting is still urgently needed.
Collapse
Affiliation(s)
- Christiaan H. Vinkers
- Department of Psychiatry and Department of Anatomy and Neurosciences, Amsterdam UMC, Amsterdam, the Netherlands
- * E-mail:
| | - Herm J. Lamberink
- Department of Child Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, and Utrecht University, Utrecht, the Netherlands
| | - Joeri K. Tijdink
- Department of Ethics, Law and Humanities, Amsterdam UMC, and Department of Philosophy, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Pauline Heus
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Lex Bouter
- Department of Epidemiology and Data Science, Amsterdam UMC, and Department of Philosophy, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Paul Glasziou
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Johanna A. Damen
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Lotty Hooft
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Willem M. Otte
- Department of Child Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, and Utrecht University, Utrecht, the Netherlands
| |
Collapse
|
13
|
Lopes-Júnior LC, Bomfim E, Olson K, Neves ET, Silveira DSC, Nunes MDR, Nascimento LC, Pereira-da-Silva G, Lima RAG. Effectiveness of hospital clowns for symptom management in paediatrics: systematic review of randomised and non-randomised controlled trials. BMJ 2020; 371:m4290. [PMID: 33328164 PMCID: PMC7737653 DOI: 10.1136/bmj.m4290] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/13/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To evaluate evidence from randomised controlled trials and non-randomised controlled trials on the effectiveness of hospital clowns for a range of symptom clusters in children and adolescents admitted to hospital with acute and chronic conditions. DESIGN Systematic review of randomised and non-randomised controlled trials. DATA SOURCES Medline, ISI of Knowledge, Cochrane Central Register of Controlled Trials, Science Direct, Scopus, American Psychological Association PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Latin American and Caribbean Health Sciences Literature. STUDY SELECTION Randomised and non-randomised controlled trials were peer reviewed using the following eligibility criteria: children and adolescents who were admitted to hospital for acute conditions or chronic disorders, studies comparing use of hospital clowns with standard care, and studies evaluating the effect of hospital clowns on symptom management of inpatient children and adolescents as a primary outcome. DATA EXTRACTION AND SYNTHESIS Two investigators independently screened studies, extracted data, and appraised the risk of bias. Methodological appraisal was assessed by two investigators independently using the Jadad scale, the revised Cochrane risk-of-bias tool for randomised controlled trials (RoB 2), and the risk of bias in non-randomised studies (ROBINS-I) tool for non-randomised controlled trials. RESULTS 24 studies (n=1612) met the inclusion criteria for data extraction and analysis. Most studies were randomised controlled trials (n=13). Anxiety was the most frequently analysed symptom (n=13), followed by pain (n=9), psychological and emotional responses and perceived wellbeing (n=4), stress (n=4), cancer related fatigue (n=3), and crying (n=2). Five studies used biomarkers, mainly cortisol, to assess stress or fatigue outcome following hospital clowns. Most of the randomised controlled trials (n=11; 85%) were rated as showing some concerns, and two trials were rated with a high risk of bias. Most non-randomised controlled trials (n=6; 55%) were rated with a moderate risk of bias according to ROBINS-I tool. Studies showed that children and adolescents who were in the presence of hospital clowns, either with or without a parent present, reported significantly less anxiety during a range of medical procedures, as well as improved psychological adjustment (P<0.05). Three studies that evaluated chronic conditions showed favourable results for the intervention of hospital clowns with significant reduction in stress, fatigue, pain, and distress (P<0.05). CONCLUSIONS These findings suggest that the presence of hospital clowns during medical procedures, induction of anaesthesia in the preoperative room, and as part of routine care for chronic conditions might be a beneficial strategy to manage some symptom clusters. Furthermore, hospital clowns might help improve psychological wellbeing in admitted children and adolescents with acute and chronic disorders, compared with those who received only standard care. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018107099.
Collapse
Affiliation(s)
- Luís Carlos Lopes-Júnior
- Federal University of Espírito Santo, Avenida Marechal Campus, 1468 Maruípe, Vitória, 29.043-900, ES, Brazil
| | - Emiliana Bomfim
- University of Saskatchewan, College of Medicine, Saskatoon, SK, Canada
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Tarassoli SP, Shield ME, Allen RS, Jessop ZM, Dobbs TD, Whitaker IS. Facial Reconstruction: A Systematic Review of Current Image Acquisition and Processing Techniques. Front Surg 2020; 7:537616. [PMID: 33365327 PMCID: PMC7750399 DOI: 10.3389/fsurg.2020.537616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 10/19/2020] [Indexed: 01/18/2023] Open
Abstract
Introduction: Plastic and reconstructive surgery is based on a culmination of technological advances, diverse techniques, creative adaptations and strategic planning. 3D imaging is a modality that encompasses several of these criteria while encouraging the others. Imaging techniques used in facial imaging come in many different modalities and sub-modalities which is imperative for such a complex area of the body; there is a clear clinical need for hyper-specialized practice. However, with this complexity comes variability and thus there will always be an element of bias in the choices made for imaging techniques. Aims and Objectives: The aim of this review is to systematically analyse the imaging techniques used in facial reconstruction and produce a comprehensive summary and comparison of imaging techniques currently available, including both traditional and novel methods. Methods: The systematic search was performed on EMBASE, PubMed, Scopus, Web of Science and Cochrane reviews using keywords such as "image technique/acquisition/processing," "3-Dimensional," "Facial," and "Reconstruction." The PRISMA guidelines were used to carry out the systematic review. Studies were then subsequently collected and collated; followed by a screening and exclusion process with a final full-text review for further clarification in regard to the selection criteria. A risk of bias assessment was also carried out on each study systematically using the respective tool in relation to the study in question. Results: From the initial 6,147 studies, 75 were deemed to fulfill all selection criteria and selected for meta-analysis. The majority of papers involved the use of computer tomography, though the use of magnetic resonance and handheld scanners using sonography have become more common in the field. The studies ranged in patient population, clinical indication. Seminal papers were highlighted within the group of papers for further analysis. Conclusions: There are clearly many factors that affect the choice of image acquisition techniques and their potential at being ideal for a given role. Ultimately the surgical team's choice will guide much of the decision, but it is crucial to be aware of not just the diagnostic ability of such modalities, but their treatment possibilities as well.
Collapse
Affiliation(s)
- Sam P. Tarassoli
- Reconstructive Surgery & Regenerative Medicine Research Group, Swansea University Medical School, Swansea, United Kingdom
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, United Kingdom
| | - Matthew E. Shield
- College of Medicine, Swansea University Medical School, Swansea, United Kingdom
| | - Rhian S. Allen
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, United Kingdom
| | - Zita M. Jessop
- Reconstructive Surgery & Regenerative Medicine Research Group, Swansea University Medical School, Swansea, United Kingdom
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, United Kingdom
| | - Thomas D. Dobbs
- Reconstructive Surgery & Regenerative Medicine Research Group, Swansea University Medical School, Swansea, United Kingdom
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, United Kingdom
| | - Iain S. Whitaker
- Reconstructive Surgery & Regenerative Medicine Research Group, Swansea University Medical School, Swansea, United Kingdom
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, United Kingdom
| |
Collapse
|
15
|
Perspective of the comparative effectiveness of non-pharmacologic managements on postpartum hemorrhage using a network meta-analysis. Obstet Gynecol Sci 2020; 63:605-614. [PMID: 32727171 PMCID: PMC7494765 DOI: 10.5468/ogs.20080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 05/25/2020] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide and is both unpredictable and inevitable. While uterotonic drugs are routinely recommended, there is ongoing debate on the ideal intervention to control uterine bleeding. This review aims to compare the use of non-pharmacologic treatments with peripartum hysterectomy in cases of life-threatening uncontrolled obstetric hemorrhage. The review's objective is to use a network meta-analysis to help prevent maternal deaths and rank the treatments according to success rates. METHODS We searched MEDLINE (PubMed), Embase, and the Cochrane Library, from January 2014 until December 2018. A second search was carried out in April 2019 before the final data analysis. Network meta-analysis allows for the calculation of the effect size between treatment groups through indirect treatment comparison. RESULTS We confirmed that balloon-assisted management is the best intervention for uncontrolled postpartum bleeding with pharmacologic treatment. This is followed by uterine artery embolization and surgical procedures, which can help avoid the need for a hysterectomy. The balloon tamponade demonstrated lower failure rate than the surgical procedure with odds ratio (OR) of 0.44 and 95% confidence intervals (CIs) 0.50-30.54. Uterine artery embolization had a lower risk for hysterectomy than the surgical procedure group (OR, 0.74; 95% CI, 0.22-2.50). CONCLUSION For the quick treatment of postpartum bleeding, balloon tamponade is the best method for uncontrolled postpartum bleeding with pharmacologic treatment, followed by uterine artery embolization and surgical procedures.
Collapse
|
16
|
Srivastava A, Chau K, Kwon H, Guo Q, Johnston BC. Early and frequent exposure to antibiotics in children and the risk of obesity: systematic review and meta-analysis of observational studies. F1000Res 2020; 9:711. [PMID: 32913641 PMCID: PMC7429923 DOI: 10.12688/f1000research.24553.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/02/2020] [Indexed: 01/01/2023] Open
Abstract
Background: This study aimed to systematically evaluate the available evidence on prenatal and early infancy antibiotic exposure and the association with overweight and obesity in later childhood. Methods: We conducted a comprehensive search of Embase, MEDLINE, and Web of Science for observational studies assessing prenatal and early antibiotic exposure on the risk of overweight and obesity. We independently assessed the risk of bias using the ROBINS instrument and the overall quality of evidence using the GRADE approach. Results: Our search identified thirteen observational studies including 554,983 participants; most studies were at moderate risk of bias. We found a statistically significant impact of early antibiotic exposure and the risk of being overweight later in childhood (OR 1.18; 95% CI 1.05 to 1.34) (very low quality evidence). We also found that early childhood antibiotic exposure was associated with the risk for childhood obesity (OR 1.14; 95% CI 1.04 to 1.24) (very low quality evidence). Conclusions: Very low quality evidence suggests that exposure to antibiotics early in life may be associated with an increased risk of being overweight and obese in later childhood. However, very low quality evidence raises serious questions about the plausibility of prenatal and early infancy antibiotic exposure being causally related to weight in children. PROSPERO registration:
CRD42016050011 (14/12/2016)
Collapse
Affiliation(s)
| | - Kim Chau
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
| | - Henry Kwon
- Department of Medicine, Wayne State University, Detroit, MI, USA
| | - Qin Guo
- Department of Pediatrics, West China Second University Hospital, Chengdu, China
| | | |
Collapse
|
17
|
Ariss T, Fairbairn CE. The effect of significant other involvement in treatment for substance use disorders: A meta-analysis. J Consult Clin Psychol 2020; 88:526-540. [PMID: 32162930 DOI: 10.1037/ccp0000495] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Substantial research has accrued in support of a key role for social processes in substance use disorders (SUD). Researchers have developed a range of interventions that capitalize on these social processes to bolster treatment outcomes by involving significant others (e.g., romantic partners, family, friends) in SUD treatment. Yet dissemination of these treatments to many contexts has been slow, and information on their broad efficacy is lacking. This meta-analysis aims to quantify the effect of significant other involvement in SUD treatments above and beyond individually-based therapies. METHOD A total of 4,901 records were screened for randomized controlled trials examining the effect of Significant Other Involved SUD Treatments (SOIT) versus individually-based active comparator treatments. Our search yielded 77 effect sizes based on data from 2,115 individuals enrolled in 16 independent trials. RESULTS Findings indicated a significant effect of SOIT above and beyond individually-based active comparator treatments for reducing substance use and substance-related problems, d = 0.242, 95% CI [0.148, 0.336], I² = 10.596, Q(15) = 16.778. This effect was consistent across SOIT treatment types and endured 12-18 months after the end of treatment. Analyses of raw mean differences indicated that this effect translates to a 5.7% reduction in substance use frequency-the equivalent of approximately 3 fewer weeks a year of drinking/drug use. CONCLUSION Findings indicate a significant advantage for SOIT in SUD treatment, and hold interesting conceptual implications for theories of SUD maintenance. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Collapse
|
18
|
Wolfenden L, Barnes C, Jones J, Finch M, Wyse RJ, Kingsland M, Tzelepis F, Grady A, Hodder RK, Booth D, Yoong SL. Strategies to improve the implementation of healthy eating, physical activity and obesity prevention policies, practices or programmes within childcare services. Cochrane Database Syst Rev 2020; 2:CD011779. [PMID: 32036618 PMCID: PMC7008062 DOI: 10.1002/14651858.cd011779.pub3] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Despite the existence of effective interventions and best-practice guideline recommendations for childcare services to implement evidence-based policies, practices and programmes to promote child healthy eating, physical activity and prevent unhealthy weight gain, many services fail to do so. OBJECTIVES The primary aim of the review was to examine the effectiveness of strategies aimed at improving the implementation of policies, practices or programmes by childcare services that promote child healthy eating, physical activity and/or obesity prevention. The secondary aims of the review were to: 1. Examine the cost or cost-effectiveness of such strategies; 2. Examine any adverse effects of such strategies on childcare services, service staff or children; 3. Examine the effect of such strategies on child diet, physical activity or weight status. 4. Describe the acceptability, adoption, penetration, sustainability and appropriateness of such implementation strategies. SEARCH METHODS We searched the following electronic databases on February 22 2019: Cochrane Central Register of Controlled trials (CENTRAL), MEDLINE, MEDLINE In Process, Embase, PsycINFO, ERIC, CINAHL and SCOPUS for relevant studies. We searched reference lists of included studies, handsearched two international implementation science journals, the World Health Organization International Clinical Trials Registry Platform (www.who.int/ictrp/) and ClinicalTrials.gov (www.clinicaltrials.gov). SELECTION CRITERIA We included any study (randomised or nonrandomised) with a parallel control group that compared any strategy to improve the implementation of a healthy eating, physical activity or obesity prevention policy, practice or programme by staff of centre-based childcare services to no intervention, 'usual' practice or an alternative strategy. Centre-based childcare services included preschools, nurseries, long daycare services and kindergartens catering for children prior to compulsory schooling (typically up to the age of five to six years). DATA COLLECTION AND ANALYSIS Two review authors independently screened study titles and abstracts, extracted study data and assessed risk of bias; we resolved discrepancies via consensus. We performed meta-analysis using a random-effects model where studies with suitable data and homogeneity were identified; otherwise, findings were described narratively. MAIN RESULTS Twenty-one studies, including 16 randomised and five nonrandomised, were included in the review. The studies sought to improve the implementation of policies, practices or programmes targeting healthy eating (six studies), physical activity (three studies) or both healthy eating and physical activity (12 studies). Studies were conducted in the United States (n = 12), Australia (n = 8) and Ireland (n = 1). Collectively, the 21 studies included a total of 1945 childcare services examining a range of implementation strategies including educational materials, educational meetings, audit and feedback, opinion leaders, small incentives or grants, educational outreach visits or academic detailing, reminders and tailored interventions. Most studies (n = 19) examined implementation strategies versus usual practice or minimal support control, and two compared alternative implementation strategies. For implementation outcomes, six studies (one RCT) were judged to be at high risk of bias overall. The review findings suggest that implementation strategies probably improve the implementation of policies, practices or programmes that promote child healthy eating, physical activity and/or obesity prevention in childcare services. Of the 19 studies that compared a strategy to usual practice or minimal support control, 11 studies (nine RCTs) used score-based measures of implementation (e.g. childcare service nutrition environment score). Nine of these studies were included in pooled analysis, which found an improvement in implementation outcomes (SMD 0.49; 95% CI 0.19 to 0.79; participants = 495; moderate-certainty evidence). Ten studies (seven RCTs) used dichotomous measures of implementation (e.g. proportion of childcare services implementing a policy or specific practice), with seven of these included in pooled analysis (OR 1.83; 95% CI 0.81 to 4.11; participants = 391; low-certainty evidence). Findings suggest that such interventions probably lead to little or no difference in child physical activity (four RCTs; moderate-certainty evidence) or weight status (three RCTs; moderate-certainty evidence), and may lead to little or no difference in child diet (two RCTs; low-certainty evidence). None of the studies reported the cost or cost-effectiveness of the intervention. Three studies assessed the adverse effects of the intervention on childcare service staff, children and parents, with all studies suggesting they have little to no difference in adverse effects (e.g. child injury) between groups (three RCTs; low-certainty evidence). Inconsistent quality of the evidence was identified across review outcomes and study designs, ranging from very low to moderate. The primary limitation of the review was the lack of conventional terminology in implementation science, which may have resulted in potentially relevant studies failing to be identified based on the search terms used. AUTHORS' CONCLUSIONS Current research suggests that implementation strategies probably improve the implementation of policies, practices or programmes by childcare services, and may have little or no effect on measures of adverse effects. However such strategies appear to have little to no impact on measures of child diet, physical activity or weight status.
Collapse
Affiliation(s)
- Luke Wolfenden
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Courtney Barnes
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Jannah Jones
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Meghan Finch
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Rebecca J Wyse
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Melanie Kingsland
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Flora Tzelepis
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Alice Grady
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Rebecca K Hodder
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Debbie Booth
- University of NewcastleAuchmuty LibraryUniversity DriveCallaghanNSWAustralia2308
| | - Sze Lin Yoong
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | | |
Collapse
|
19
|
Pega F, Norris SL, Backes C, Bero LA, Descatha A, Gagliardi D, Godderis L, Loney T, Modenese A, Morgan RL, Pachito D, Paulo MBS, Scheepers PTJ, Schlünssen V, Sgargi D, Silbergeld EK, Sørensen K, Sutton P, Tenkate T, Torreão Corrêa da Silva D, Ujita Y, van Deventer E, Woodruff TJ, Mandrioli D. RoB-SPEO: A tool for assessing risk of bias in studies estimating the prevalence of exposure to occupational risk factors from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. ENVIRONMENT INTERNATIONAL 2020; 135:105039. [PMID: 31864023 PMCID: PMC7479507 DOI: 10.1016/j.envint.2019.105039] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 07/10/2019] [Accepted: 07/19/2019] [Indexed: 05/20/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates). For this, systematic reviews of studies estimating the prevalence of exposure to selected occupational risk factors will be conducted to provide input data for estimations of the number of exposed workers. A critical part of systematic review methods is to assess risk of bias (RoB) of individual studies. In this article, we present and describe the development of such a tool, called the Risk of Bias in Studies estimating Prevalence of Exposure to Occupational risk factors (RoB-SPEO) tool; report results from RoB-SPEO's pilot testing; note RoB-SPEO's limitations; and suggest how the tool might be tested and developed further. METHODS Selected existing RoB tools used in environmental and occupational health systematic reviews were reviewed and analysed. From existing tools, we identified domains for the new tool and, if necessary, added new domains. For each domain, we then identified and integrated components from the existing tools (i.e. instructions, domains, guiding questions, considerations, ratings and rating criteria), and, if necessary, we developed new components. Finally, we elicited feedback from other systematic review methodologists and exposure scientists and agreed upon RoB-SPEO. Nine experts pilot tested RoB-SPEO, and we calculated a raw measure of inter-rater agreement (Pi) for each of its domain, rating Pi < 0.4 as poor, 0.4 ≤ Pi ≥ 0.8 as substantial and Pi > 0.80 as almost perfect agreement. RESULTS Our review found no standard tool for assessing RoB in prevalence studies of exposure to occupational risk factors. We identified six existing tools for environmental and occupational health systematic reviews and found that their components for assessing RoB differ considerably. With the new RoB-SPEO tool, assessors judge RoB for each of eight domains: (1) bias in selection of participants into the study; (2) bias due to a lack of blinding of study personnel; (3) bias due to exposure misclassification; (4) bias due to incomplete exposure data; (5) bias due to conflict of interest; (6) bias due to selective reporting of exposures; (7) bias due to difference in numerator and denominator; and (8) other bias. The RoB-SPEO's ratings are low, probably low, probably high, high or no information. Pilot testing of the RoB-SPEO tool found substantial inter-rater agreement for six domains (range of Pi for these domains: 0.51-0.80), but poor agreement for two domains (i.e. Pi of 0.31 and 0.33 for biases due to incomplete exposure data and in selection of participants into the study, respectively). Limitations of RoB-SPEO include that it has not yet been fully performance-tested. CONCLUSIONS We developed the RoB-SPEO tool for assessing RoB in prevalence studies of exposure to occupational risk factors. The tool will be applied and its performance tested in the ongoing systematic reviews for the WHO/ILO Joint Estimates.
Collapse
Affiliation(s)
- Frank Pega
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Susan L Norris
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Claudine Backes
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland
| | - Lisa A Bero
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Alexis Descatha
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), Occupational Health Unit, University Hospital of West Suburb of Paris, Poincaré Site, Garches, France; Versailles St-Quentin Univ - Paris Saclay Univ (UVSQ), UMS 011, UMR-S 1168, France; Inserm, U1168 (VIMA: Aging and chronic diseases. Epidemiological and public health approaches), UMS 011 (Population-based Epidemiologic Cohorts Unit), Villejuif, France
| | - Diana Gagliardi
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy
| | - Lode Godderis
- Centre for Environment and Health, KU Leuven, Leuven, Belgium; KIR Department (Knowledge, Information & Research), IDEWE, External Service for Prevention and Protection at Work, Leuven, Belgium
| | - Tom Loney
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence and Impact, McMaster University, Ontario, Canada
| | - Daniela Pachito
- Evidence-based Health, Universidade Federal de São Paulo, Sao Paulo, Brazil; Cochrane Brazil, Sao Paulo, Brazil
| | - Marilia B S Paulo
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Paul T J Scheepers
- Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands
| | - Vivi Schlünssen
- Department of Public Health, Aarhus University, Aarhus, Denmark; National Research Center for the Working Environment, Copenhagen, Denmark
| | - Daria Sgargi
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Ellen K Silbergeld
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Kathrine Sørensen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Patrice Sutton
- Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, United States of America
| | - Thomas Tenkate
- School of Occupational and Public Health, Ryerson University, Toronto, Ontario, Canada
| | - Denise Torreão Corrêa da Silva
- Workers' Health and Human Ecology Research Center, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland
| | - Emilie van Deventer
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, United States of America
| | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| |
Collapse
|
20
|
Young A, Reeves BC, Cheng HY, Wasiak J, Muir D, Davies A, Blazeby J. Risk of bias and reporting completeness of randomised controlled trials in burn care: protocol for a systematic review. BMJ Open 2019; 9:e033472. [PMID: 31857316 PMCID: PMC6937119 DOI: 10.1136/bmjopen-2019-033472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 11/11/2019] [Accepted: 11/12/2019] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Burn care represents a healthcare and economic burden to patients internationally. Choice of the most clinically effective treatment strategies requires evidence which is best obtained through high-quality randomised controlled trials (RCT). The number of published RCTs of burn care is increasing. However, trial quality and reporting standards are unclear. This study will assess the risk of bias and adequacy of reporting in recent burn care RCTs using tools endorsed by the Cochrane Collaboration. METHODS AND ANALYSIS A systematic literature review will be undertaken, assessing parallel group RCTs evaluating therapeutic interventions for patients with cutaneous burns. Literature searches will use Ovid Medline, Ovid Embase, Web of Science and the Cochrane Library. Separate searches for each database will include medical subject heading and free text terms including 'burn', 'scald', 'thermal injury' and 'RCT'. Two reviewers will independently assess each study for inclusion. Risk of bias (RoB) will be assessed with the revised tool (RoB 2) and reporting completeness with the CONsolidated Standards of Reporting Trials (CONSORT) 2010 guidelines. We will report a narrative synthesis of all studies, including domain specific, and overall risk of bias for the primary outcome of each trial. Inter-rater agreement for RoB 2 will be reported using Fleiss's Kappa. For adherence to the CONSORT guidelines, we will generate a completeness of reporting index for the five domains. ETHICS AND DISSEMINATION No ethics approval is required because published documents will be used. Findings of the study will be disseminated in a peer-reviewed journal and presented at conferences. PROSPERO REGISTRATION NUMBER CRD42018111020.
Collapse
Affiliation(s)
- Amber Young
- Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Paediatric Anaesthesia, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Barnaby C Reeves
- Bristol Trials Centre (BRI-Hub), Bristol Medical School, University of Bristol, Bristol, UK
| | - Hung-Yuan Cheng
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jason Wasiak
- Olivia Newton John Cancer Wellness & Research Centre, Department of Radiation Oncology, Austin Health, Heidelberg, Victoria, Australia
- Austin Health Clinical School of Nursing, Latrobe University, Heidelberg, Victoria, Australia
| | - Duncan Muir
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Anna Davies
- Centre for Academic Child Health, University of Bristol, Bristol, UK
| | - Jane Blazeby
- Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre, University of Bristol and University hospitals Bristol NHS Foundation Trust, Bristol, UK
| |
Collapse
|
21
|
Kang D, Fairbairn CE, Ariss TA. A meta-analysis of the effect of substance use interventions on emotion outcomes. J Consult Clin Psychol 2019; 87:1106-1123. [PMID: 31724427 PMCID: PMC6859954 DOI: 10.1037/ccp0000450] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Emotional distress has been posited as a key underlying mechanism in the development and maintenance of substance use disorder (SUD), and patients seeking SUD treatment are often experiencing high levels of negative emotion and/or low levels of positive emotion. But the extent to which SUD interventions impact emotional outcomes among general SUD populations is yet unquantified. The current meta-analysis aims to fill this gap. METHOD A total of 11,754 records were screened for randomized, controlled trials examining the effect of behavioral SUD interventions on emotion outcomes. Our search yielded a total of 138 effect sizes calculated based on data from 5,146 individuals enrolled in 30 independent clinical trials. Random-effects meta-analysis was used to calculate pooled effect sizes, and metaregression analyses examined study-level moderators (e.g., intervention type). RESULTS Findings indicated a small but significant effect of SUD interventions on emotion outcomes, d = 0.157, 95% CI [0.052, 0.262] (k = 30). The effect size for negative emotion was nominally bigger, d = 0.162, 95% CI [0.056, 0.269] (k = 30), whereas the effect for positive emotion did not reach statistical significance, d = 0.062, 95% CI [-0.089, 0.213] (k = 7). Studies featuring SUD interventions designed to specifically target emotions (i.e., affect-regulation, mindfulness-based treatments) produced larger reductions in negative emotion compared with studies featuring interventions that did not contain specific emotion modules (e.g., contingency management). CONCLUSIONS Findings suggest that SUD interventions-especially mindfulness-based and affect-regulation treatments-indeed significantly reduce negative emotion, although relatively small effect sizes indicate potential room for improvement. Conclusions regarding positive emotion should be considered preliminary because of the limited numbers of samples assessing these outcomes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Collapse
|
22
|
Philpott LF, Savage E, FitzGerald S, Leahy-Warren P. Anxiety in fathers in the perinatal period: A systematic review. Midwifery 2019; 76:54-101. [PMID: 31176080 DOI: 10.1016/j.midw.2019.05.013] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 03/13/2019] [Accepted: 05/25/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND fatherhood in the perinatal period can be a time of great excitement, happiness and joy. However, a growing body of literature indicates that fathers are at risk for elevated levels of anxiety symptoms during the perinatal period. PURPOSE the purpose of this systematic review is to determine the prevalence and levels of anxiety in fathers during the perinatal period, identify the risk factors and impact of anxiety, and establish if there are effective interventions that reduce father's anxiety. DESIGN Systematic review. METHODS A systematic review protocol was developed and registered with PROSPERO (reference number: CRD42017073760). The review was guided by the PRISMA reporting process. Electronic databases Medline, CINAHL, Embase, the Cochrane Library, PsycARTICLES, PsycINFO, and Psychology were searched to identify eligible studies. Studies that researched fathers during the perinatal period were included if anxiety was the primary focus of the research or was an outcome or dependent variable. Data were extracted and presented in narrative form including tables and figures. FINDINGS Thirty-four studies met the inclusion criteria. Findings from these studies indicate that fathers experience anxiety in the perinatal period, particularly at the time of birth. Anxiety increased from the antenatal period to the time of birth, with a decrease in anxiety from the time of birth to the later postnatal period. The prevalence of anxiety ranged between 3.4% and 25.0% during the antenatal period and 2.4% and 51.0% during the postnatal period. Factors contributing to anxiety included lower education levels, lower income levels, lower co-parenting support, lower social support, work-family conflict, a partner' anxiety and depression, and being present during a previous birth. Anxiety had a negative impact on fathers' mental health, physical health, social relationships and parenting skills. Anxiety contributed to stress, depression, fatigue and lower paternal self-efficacy. Five studies reported on interventions to reduce anxiety and all the studies found that anxiety significantly decreased following the intervention. KEY CONCLUSION Fathers experience increased anxiety from the antenatal period to the time of birth, with a decrease in anxiety from the time of birth to the later postnatal period. Anxiety during the perinatal period that can impact negatively on fathers physical and mental health, and social relationships.
Collapse
Affiliation(s)
- Lloyd Frank Philpott
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork T12AK54, Ireland.
| | - Eileen Savage
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork T12AK54, Ireland.
| | - Serena FitzGerald
- School of Nursing and, Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork T12AK54, Ireland.
| | - Patricia Leahy-Warren
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork T12AK54, Ireland.
| |
Collapse
|
23
|
Minozzi S, Cinquini M, Gianola S, Castellini G, Gerardi C, Banzi R. Risk of bias in nonrandomized studies of interventions showed low inter-rater reliability and challenges in its application. J Clin Epidemiol 2019; 112:28-35. [PMID: 30981833 DOI: 10.1016/j.jclinepi.2019.04.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 03/28/2019] [Accepted: 04/08/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To assess the inter-rater reliability (IRR) and usability of the risk of bias in nonrandomized studies of interventions tool (ROBINS-I). STUDY DESIGN AND SETTING We designed a cross-sectional study. Five raters independently applied ROBINS-I to the nonrandomized cohort studies in three systematic reviews on vaccines, opiate abuse, and rehabilitation. We calculated Fleiss' Kappa for multiple raters as a measure of IRR and discussed the application of ROBINS-I to identify difficulties and possible reasons for disagreement. RESULTS Thirty one studies were included (195 evaluations). IRRs were slight for overall judgment (IRR 0.06, 95% CI 0.001 to 0.12) and individual domains (from 0.04, 95% CI -0.04 to 0.12 for the domain "selection of reported results" to 0.18, 95% CI 0.10 to 0.26 for the domain "deviation from intended interventions"). Mean time to apply the tool was 27.8 minutes (SD 12.6) per study. The main difficulties were due to poor reporting of primary studies, misunderstanding of the question, translation of questions into a final judgment, and incomplete guidance. CONCLUSION We found ROBINS-I difficult and demanding, even for raters with substantial expertise in systematic reviews. Calibration exercises and intensive training before its application are needed to improve reliability.
Collapse
Affiliation(s)
- Silvia Minozzi
- Department of Epidemiology, Lazio Regional Health Service, via Cristoforo Colombo 112, 00147 Rome, Italy; Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal 36, 20133 Milan, Italy.
| | - Michela Cinquini
- Mario Negri Institute for Pharmacological Research IRCCS, Via Giuseppe La Masa 19, 20156, Milan, Italy
| | - Silvia Gianola
- IRCCS Istituto Ortopedico Galeazzi, Unit of Clinical Epidemiology, Via R.Galeazzi 4, 20162, Milan, Italy
| | - Greta Castellini
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal 36, 20133 Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, Unit of Clinical Epidemiology, Via R.Galeazzi 4, 20162, Milan, Italy
| | - Chiara Gerardi
- Mario Negri Institute for Pharmacological Research IRCCS, Via Giuseppe La Masa 19, 20156, Milan, Italy
| | - Rita Banzi
- Mario Negri Institute for Pharmacological Research IRCCS, Via Giuseppe La Masa 19, 20156, Milan, Italy
| |
Collapse
|
24
|
Peksa GD, DeMott JM, Slocum GW, Burkins J, Gottlieb M. Glucagon for Relief of Acute Esophageal Foreign Bodies and Food Impactions: A Systematic Review and Meta-Analysis. Pharmacotherapy 2019; 39:463-472. [PMID: 30779190 DOI: 10.1002/phar.2236] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Glucagon is frequently used for the relief of esophageal impactions. This systematic review and meta-analysis were performed to evaluate the efficacy and safety of glucagon for acute esophageal foreign body and food impactions. PubMed, CINAHL, Latin American and Caribbean Health Sciences Literature (LILACS), Scopus, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials were searched from inception to March 1, 2018. Retrospective, observational, and randomized controlled trials assessing glucagon for the relief of acute esophageal foreign body and food impaction were included. There were no language or age restrictions. Only studies conducted on humans and with a comparator (e.g., control or placebo) were included. Study quality analysis was performed using the Cochrane Risk of Bias tool. Quality of evidence analysis was performed using the Grading of Recommendations, Assessment, Development and Evaluations approach. A total of 1988 studies were identified, and five studies with a total of 1185 subjects were included. Treatment success occurred in 213 of 706 (30.2%) patients in the glucagon group and 158 of 479 (33.0%) patients in the control group (odds ratio [OR] 0.90, 95% confidence interval [CI] 0.69-1.17, p=0.42). There was minimal statistical heterogeneity (I2 = 14%, p=0.33). No publication bias was identified. Adverse events were identified in 24 (15.0%) patients in the glucagon group and 0 (0%) patients in the placebo group (risk difference [RD] 0.18, 95% CI 0.03-0.33, p=0.02). Vomiting events occurred more frequently in the glucagon group (17 of 160 [10.6%] vs 0 of 53 [0%]) but was not statistically significant (RD 0.07, 95% CI -0.03-0.17, p=0.19). Glucagon was not associated with a difference in treatment success but had a higher rate of adverse events for the treatment of esophageal foreign body and food impaction. Further controlled studies are needed to confirm the efficacy of glucagon with adequate power to assess adverse events.
Collapse
Affiliation(s)
- Gary D Peksa
- Department of Pharmacy, Rush University Medical Center, Chicago, Illinois.,Department of Emergency Medicine, Rush University Medical Center, Chicago, Illinois
| | - Joshua M DeMott
- Department of Pharmacy, Rush University Medical Center, Chicago, Illinois
| | - Giles W Slocum
- Department of Pharmacy, Rush University Medical Center, Chicago, Illinois
| | - Jaxson Burkins
- Department of Pharmacy, Mount Sinai Hospital, Chicago, Illinois
| | - Michael Gottlieb
- Department of Emergency Medicine, Rush University Medical Center, Chicago, Illinois
| |
Collapse
|
25
|
Elmajee M, Williams T, Ben-Nafa W, Arnall F, Pillai A. The Effectiveness of Surgical Interventions in the Management of Malunited Calcaneal Fractures: A Systematic Review. J Foot Ankle Surg 2019; 58:127-136. [PMID: 30583774 DOI: 10.1053/j.jfas.2018.08.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Indexed: 02/03/2023]
Abstract
Nonoperative management may result in calcaneal malunion with consequences of pain, deformity, and functional limitation. The aim of this review was to proffer an evidence-based scientific account of the effectiveness of contemporary surgical procedures in the management of malunited calcaneal fractures after initial conservative management. This systematic review included studies that evaluated the surgical procedures in the management of calcaneal malunion and systematically searched studies published between January 2005 and June 2016. The search was conducted using the following search engines: the Cochrane Library, Web of Science, PubMed/ MEDLINE, EMBASE, CINAHL, Academic Search Premier, and Open Grey. Methodologic assessment was conducted using the Cochrane Risk of Bias In nonrandomized Studies- of Interventions assessment tool version 7. Ten observational studies (212 patients) were included in this review. Five articles explored various means of achieving subtalar arthrodesis, 2 articles evaluated joint-sparing osteotomies, 1 examined corrective osteotomy for extra-articular os calcis malunion, and 2 articles explored combined procedures based on the Stephen and Sanders calcaneal malunion classification. Clinical and methodologic heterogeneity did not allow quantitative pooling of results. The overall risk of bias was considered moderate in 7 studies and 3 were considered at high risk of bias. The inability for any study to be considered at low risk of bias in this review might be mainly attributed to the lack of a valid and reliable outcome measure for the assessment of foot and ankle conditions. There is clear evidence that appropriately indicated procedures are effective in terms of pain alleviation, correction of deformity, and improved function. However, long-term outcomes may improve the acceptability to joint-preserving osteotomies, subtalar arthrodesis with the VIRA implant and subtalar distraction osteogenesis.
Collapse
Affiliation(s)
- Mohammed Elmajee
- Specialty Registrar, Trauma and Orthopaedics, Sandwell General Hospital, West Bromwich, UK
| | | | - Walid Ben-Nafa
- Clinical Fellow, Trauma and Orthopaedics, Manchester University NHS Foundation Trust, Manchester, UK.
| | - Frances Arnall
- Associate Lecturer and Consultant Physiotherapist, The University of Salford, Manchester, UK
| | - Anand Pillai
- Consultant, Trauma and Orthopaedics, Manchester University NHS Foundation Trust, Manchester, UK
| |
Collapse
|
26
|
Bero L, Chartres N, Diong J, Fabbri A, Ghersi D, Lam J, Lau A, McDonald S, Mintzes B, Sutton P, Turton JL, Woodruff TJ. The risk of bias in observational studies of exposures (ROBINS-E) tool: concerns arising from application to observational studies of exposures. Syst Rev 2018; 7:242. [PMID: 30577874 PMCID: PMC6302384 DOI: 10.1186/s13643-018-0915-2] [Citation(s) in RCA: 136] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 12/09/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Systematic reviews, which assess the risk of bias in included studies, are increasingly used to develop environmental hazard assessments and public health guidelines. These research areas typically rely on evidence from human observational studies of exposures, yet there are currently no universally accepted standards for assessing risk of bias in such studies. The risk of bias in non-randomised studies of exposures (ROBINS-E) tool has been developed by building upon tools for risk of bias assessment of randomised trials, diagnostic test accuracy studies and observational studies of interventions. This paper reports our experience with the application of the ROBINS-E tool. METHODS We applied ROBINS-E to 74 exposure studies (60 cohort studies, 14 case-control studies) in 3 areas: environmental risk, dietary exposure and drug harm. All investigators provided written feedback, and we documented verbal discussion of the tool. We inductively and iteratively classified the feedback into 7 themes based on commonalities and differences until all the feedback was accounted for in the themes. We present a description of each theme. RESULTS We identified practical concerns with the premise that ROBINS-E is a structured comparison of the observational study being rated to the 'ideal' randomised controlled trial. ROBINS-E assesses 7 domains of bias, but relevant questions related to some critical sources of bias, such as exposure and funding source, are not assessed. ROBINS-E fails to discriminate between studies with a single risk of bias or multiple risks of bias. ROBINS-E is severely limited at determining whether confounders will bias study outcomes. The construct of co-exposures was difficult to distinguish from confounders. Applying ROBINS-E was time-consuming and confusing. CONCLUSIONS Our experience suggests that the ROBINS-E tool does not meet the need for an international standard for evaluating human observational studies for questions of harm relevant to public and environmental health. We propose that a simpler tool, based on empirical evidence of bias, would provide accurate measures of risk of bias and is more likely to meet the needs of the environmental and public health community.
Collapse
Affiliation(s)
- Lisa Bero
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, D17, The Hub, 6th floor, Sydney, New South Wales, 2006, Australia.
| | - Nicholas Chartres
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, D17, The Hub, 6th floor, Sydney, New South Wales, 2006, Australia
| | - Joanna Diong
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Alice Fabbri
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, D17, The Hub, 6th floor, Sydney, New South Wales, 2006, Australia
| | - Davina Ghersi
- National Health and Medical Research Council, Canberra, Australia
| | - Juleen Lam
- Department of Ob/Gyn & the Institute for Health Policy Studies, University of California, San Francisco, USA.,Department of Health Sciences, California State University, East Bay, San Francisco, USA
| | - Agnes Lau
- School of Pharmacy, University of California, San Francisco, USA
| | - Sally McDonald
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Barbara Mintzes
- School of Pharmacy, Faculty of Medicine and Health and Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Patrice Sutton
- Department of Ob/Gyn & the Institute for Health Policy Studies, University of California, San Francisco, USA
| | | | - Tracey J Woodruff
- Department of Ob/Gyn & the Institute for Health Policy Studies, University of California, San Francisco, USA
| |
Collapse
|
27
|
Hajibandeh S, Hajibandeh S, Antoniou SA, Torella F, Antoniou GA. Effect of beta-blockers on perioperative outcomes in vascular and endovascular surgery: a systematic review and meta-analysis. Br J Anaesth 2018; 118:11-21. [PMID: 28039238 DOI: 10.1093/bja/aew380] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND To investigate the role of perioperative beta-blocker use in vascular and endovascular surgery. METHODS We performed a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards. The review protocol was registered with International Prospective Register of Systematic Reviews (registration number:CRD42016038111). We searched electronic databases to identify all randomized controlled trials and observational studies investigating outcomes of patients undergoing vascular and endovascular surgery with or without perioperative beta blockade. We used the Cochrane tool and the Newcastle-Ottawa scale to assess the risk of bias of trials and observational studies, respectively. Random-effects models were applied to calculate pooled outcome data. RESULTS We identified three randomized trials, five retrospective cohort studies, and three prospective cohort studies, enrolling a total of 32,602 patients. Our analyses indicated that perioperative use of beta-blockers did not reduce the risk of all-cause mortality [odds ratio (OR) 1.10, 95% confidence interval (CI) 0.59-2.04, P = 0.77], cardiac mortality (OR 2.62, 95% CI 0.86-8.05, P = 0.09), myocardial infarction (OR 0.89, 95% CI 0.59-1.35, P = 0.58), unstable angina (OR 1.34, 95% CI 0.41- 4.38, P = 0.63), stroke (OR 2.45, 95% CI 0.89-6.75, P = 0.08), arrhythmias (OR 0.76, 95% CI 0.41-1.43, P = 0.40), congestive heart failure (OR 1.12, 95% CI 0.77-1.63, P = 0.56), renal failure (OR 1.48, 95% CI 0.90-2.45, P = 0.13), composite cardiovascular events (OR 0.88, 95% CI 0.55-1.40, P = 0.58), rehospitalisation (OR 0.86, 95% CI 0.48-1.52, P = 0.60), and reoperation (OR 1.17, 95% CI 0.42-3.27, P = 0.77) in vascular surgery. CONCLUSIONS Beta-blockers do not improve perioperative outcomes in vascular and endovascular surgery.
Collapse
Affiliation(s)
- S Hajibandeh
- Department of General Surgery, Royal Blackburn Hospital, Blackburn, UK
| | - S Hajibandeh
- Department of General Surgery, Royal Blackburn Hospital, Blackburn, UK
| | - S A Antoniou
- Department of General Surgery, University Hospital of Heraklion, University of Crete, Heraklion, Greece
| | - F Torella
- Department of Mathematical Sciences, School of Physical Sciences, University of Liverpool, Liverpool, UK
| | - G A Antoniou
- Department of Vascular and Endovascular Surgery, The Royal Oldham Hospital, Pennine Acute Hospitals NHS Trust, Manchester, UK
| |
Collapse
|
28
|
Maleki S, Alexander M, Fua T, Liu C, Rischin D, Lingaratnam S. A systematic review of the impact of outpatient clinical pharmacy services on medication-related outcomes in patients receiving anticancer therapies. J Oncol Pharm Pract 2018; 25:130-139. [PMID: 29938594 DOI: 10.1177/1078155218783814] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Patients receiving anticancer therapies are frequently prescribed complex and high-risk medication regimens, which at times can result in medication misadventures. The objective of this review was to assess the effect of outpatient clinical pharmacy services on medication-related outcomes in patients receiving anticancer therapies, including patients undergoing radiotherapy. METHODS A systematic review of original publications indexed in EMBASE, MEDLINE and Cochrane Library from June 2007 to June 2017. Eligible studies evaluated outpatient pharmacy clinic services for cancer patients and reported at least one medication-related quantitative outcome measure. Two authors independently reviewed full-text articles for inclusion, then extracted data and performed quality and risk of bias assessments. RESULTS Of 908 identified publications, 13 met predefined eligibility criteria; 1 randomised control trial, 2 controlled cohort studies and 10 uncontrolled before-after studies. Many excluded studies described outpatient pharmacy services but lacked medication-related outcomes. All included studies had informative practice model designs, with interventions for drug-related problems including drug dose optimisation ( n = 8), reduced drug interaction ( n = 6) and adverse drug reaction reporting ( n = 3). Most studies ( n = 11) reported on symptom improvement, commonly nausea ( n = 7) and pain ( n = 5). Of four studies in radiotherapy cohorts, pharmacist involvement was associated with improved symptoms, satisfaction and wellbeing scores. CONCLUSION Few studies have objectively assessed outpatient pharmacy cancer services, even fewer in the radiotherapy settings. Although the results support these services, significant heterogeneity and bias in the study designs prohibit robust conclusions and further controlled trials are required.
Collapse
Affiliation(s)
- Sam Maleki
- 1 Department of Pharmacy, Peter MacCallum Cancer Centre, Victoria, Australia
| | - Marliese Alexander
- 1 Department of Pharmacy, Peter MacCallum Cancer Centre, Victoria, Australia
| | - Tsien Fua
- 2 Department of Radiation Oncology, Peter MacCallum Cancer Centre, Victoria, Australia
| | - Chen Liu
- 2 Department of Radiation Oncology, Peter MacCallum Cancer Centre, Victoria, Australia
| | - Danny Rischin
- 3 Department of Medical Oncology, Peter MacCallum Cancer Centre, Victoria, Australia
| | - Senthil Lingaratnam
- 1 Department of Pharmacy, Peter MacCallum Cancer Centre, Victoria, Australia
| |
Collapse
|
29
|
Di Girolamo N, Winter A, Meursinge Reynders R. High and unclear risk of bias assessments are predominant in diagnostic accuracy studies included in Cochrane reviews. J Clin Epidemiol 2018; 101:73-78. [PMID: 29777798 DOI: 10.1016/j.jclinepi.2018.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 04/13/2018] [Accepted: 05/09/2018] [Indexed: 10/16/2022]
Abstract
OBJECTIVES The validity of outcomes of systematic reviews is highly dependent on the extent of bias in the included primary studies. This study reports the risk of bias (ROB) of primary studies included in systematic reviews of diagnostic accuracy. STUDY DESIGN AND SETTING All systematic reviews of diagnostic accuracy studies published in the Cochrane database in 2015 and 2016 that used the Quality Assessment of Diagnostic Accuracy Studies-2 ROB tool and reported results with the ROB figure were eligible. The primary outcome was the prevalence of "high" or "unclear" ROB scores for the four Quality Assessment of Diagnostic Accuracy Studies-2 domains: "patient selection," "index test," "reference standard," and "flow and timing". RESULTS Of 46 eligible reviews, 35 fulfilled the inclusion criteria. A total of 1045 primary studies with 4133 bias assessments were identified. Of those, 56% (2319/4133) were assessed to be at "high" or "unclear" ROB and 44% (1814/4133) at low ROB. For all domains except "flow and timing," most outcomes were scored as "high" or "unclear" ROB. A total of 47 (47/1045; 4.5%, 3.4 to 5.9%) primary studies were scored at low ROB for all domains. Older article age was significantly associated with likelihood of "high" or "unclear" ROB (odds ratio: 1.02; 95% confidence interval: 1.01 to 1.03; P < 0.001). CONCLUSION Systematic reviews of diagnostic accuracy are based on studies with a majority of "high" or "unclear" bias assessments. The age of the articles explained only a small part of the variability of the score assessments, therefore not justifying an a priori exclusion of older articles in systematic reviews. There is an urgent need to improve the quality of design, conduct, and reporting of diagnostic accuracy studies.
Collapse
Affiliation(s)
| | | | - Reint Meursinge Reynders
- Private Practice of Orthodontics, Via Matteo Bandello 15, 20123 Milan, Italy; Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| |
Collapse
|
30
|
Athilingam P, Jenkins B. Mobile Phone Apps to Support Heart Failure Self-Care Management: Integrative Review. JMIR Cardio 2018; 2:e10057. [PMID: 31758762 PMCID: PMC6834210 DOI: 10.2196/10057] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 03/29/2018] [Accepted: 03/30/2018] [Indexed: 12/13/2022] Open
Abstract
Background With an explosive growth in mobile health, an estimated 500 million patients are potentially using mHealth apps for supporting health and self-care of chronic diseases. Therefore, this review focused on mHealth apps for use among patients with heart failure. Objective The aim of this integrative review was to identify and assess the functionalities of mHealth apps that provided usability and efficacy data and apps that are commercially available without supporting data, all of which are to support heart failure self-care management and thus impact heart failure outcomes. Methods A search of published, peer-reviewed literature was conducted for studies of technology-based interventions that used mHealth apps specific for heart failure. The initial database search yielded 8597 citations. After filters for English language and heart failure, the final 487 abstracts was reviewed. After removing duplicates, a total of 18 articles that tested usability and efficacy of mobile apps for heart failure self-management were included for review. Google Play and Apple App Store were searched with specified criteria to identify mHealth apps for heart failure. A total of 26 commercially available apps specific for heart failure were identified and rated using the validated Mobile Application Rating Scale. Results The review included studies with low-quality design and sample sizes ranging from 7 to 165 with a total sample size of 847 participants from all 18 studies. Nine studies assessed usability of the newly developed mobile health system. Six of the studies included are randomized controlled trials, and 4 studies are pilot randomized controlled trials with sample sizes of fewer than 40. There were inconsistencies in the self-care components tested, increasing bias. Thus, risk of bias was assessed using the Cochrane Collaboration’s tool for risk of selection, performance, detection, attrition, and reporting biases. Most studies included in this review are underpowered and had high risk of bias across all categories. Three studies failed to provide enough information to allow for a complete assessment of bias, and thus had unknown or unclear risk of bias. This review on the commercially available apps demonstrated many incomplete apps, many apps with bugs, and several apps with low quality. Conclusions The heterogeneity of study design, sample size, intervention components, and outcomes measured precluded the performance of a systematic review or meta-analysis, thus introducing bias of this review. Although the heart failure–related outcomes reported in this review vary, they demonstrated trends toward making an impact and offer a potentially cost-effective solution with 24/7 access to symptom monitoring as a point of care solution, promoting patient engagement in their own home care.
Collapse
|
31
|
Souza FD, de Souza MMM, Schuelter Trevisol F, Trevisol DJ. Letter in response to: concurrent aerobic plus resistance exercise versus aerobic exercise alone to improve health outcomes in paediatric obesity—a systematic review and meta-analysis. Br J Sports Med 2018; 52:e7. [DOI: 10.1136/bjsports-2018-099142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2018] [Indexed: 11/03/2022]
|
32
|
Abstract
BACKGROUND Several scales, checklists and domain-based tools for assessing risk of reporting biases exist, but it is unclear how much they vary in content and guidance. We conducted a systematic review of the content and measurement properties of such tools. METHODS We searched for potentially relevant articles in Ovid MEDLINE, Ovid Embase, Ovid PsycINFO and Google Scholar from inception to February 2017. One author screened all titles, abstracts and full text articles, and collected data on tool characteristics. RESULTS We identified 18 tools that include an assessment of the risk of reporting bias. Tools varied in regard to the type of reporting bias assessed (eg, bias due to selective publication, bias due to selective non-reporting), and the level of assessment (eg, for the study as a whole, a particular result within a study or a particular synthesis of studies). Various criteria are used across tools to designate a synthesis as being at 'high' risk of bias due to selective publication (eg, evidence of funnel plot asymmetry, use of non-comprehensive searches). However, the relative weight assigned to each criterion in the overall judgement is unclear for most of these tools. Tools for assessing risk of bias due to selective non-reporting guide users to assess a study, or an outcome within a study, as 'high' risk of bias if no results are reported for an outcome. However, assessing the corresponding risk of bias in a synthesis that is missing the non-reported outcomes is outside the scope of most of these tools. Inter-rater agreement estimates were available for five tools. CONCLUSION There are several limitations of existing tools for assessing risk of reporting biases, in terms of their scope, guidance for reaching risk of bias judgements and measurement properties. Development and evaluation of a new, comprehensive tool could help overcome present limitations.
Collapse
Affiliation(s)
- Matthew J Page
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Joanne E McKenzie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Julian P T Higgins
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| |
Collapse
|
33
|
Zou YQ, Li XB, Yang ZX, Zhou JM, Wu YN, Zhao ZH, Liu XZ, Hu CL. Impact of inhalational anesthetics on postoperative cognitive function: Study protocol of a systematic review and meta-analysis. Medicine (Baltimore) 2018; 97:e9316. [PMID: 29505513 PMCID: PMC5943090 DOI: 10.1097/md.0000000000009316] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Conflict findings of the impact of inhalational anesthetics on postoperative cognitive function are reported. No systematic review has been performed to solve the problem. The aim of the study was to assess the effect of different inhalational anesthetics on postoperative cognitive function in a network meta-analysis. METHODS We will search MEDLINE, EMBASE, the Central Register of Controlled Trials in the Cochrane library, and CINAHL for randomized controlled trials or cohort studies assessing the short-term or long-term cognitive function of elderly patients (over 60 years) receiving major surgeries and inhalational anesthetics (desflurane, isoflurane, sevoflurane, halothane, and nitrous oxide) during surgery. Two reviewers will independently screen study eligibility, extract information from eligible studies, and appraise study quality. The impact of inhalational anesthetics will be assessed through: incidence of postoperative cognitive dysfunction at 1 week, 3 months, 1 year, and over 1 year after surgery; incidence of post-operative delirium; test of postoperative cognitive function. RESULTS The results of this systematic review and meta-analysis will be published in a peer-reviewed journal. CONCLUSION To our knowledge, this systematic review will be the first to evaluate existing research on the incidence of postoperative cognitive function after inhalational anesthetics. Our study will assess the effect of different inhalational anesthetics on postoperative cognitive function. ETHICS AND DISSEMINATION The review will be finished in December 2017, and the result will be published in a peer-reviewed journal or disseminated through conference posters or abstracts. REVIEW REGISTRATION NUMBER CRD42017056675 (www.crd.york.ac.uk/PROSPERO).
Collapse
Affiliation(s)
- Yi-Qing Zou
- Department of Anesthesiology and Intensive Care Unit, the 476 Hospital of Fuzhou General Hospital
- College of Clinical Medicine of Fuzhou General Hospital, Fujian Medical University, Fujian Province, China
| | - Xiao-Bao Li
- Department of Anesthesiology and Intensive Care Unit, the 476 Hospital of Fuzhou General Hospital
| | - Zhi-Xing Yang
- Department of Anesthesiology and Intensive Care Unit, the 476 Hospital of Fuzhou General Hospital
| | - Jing-Min Zhou
- Department of Anesthesiology and Intensive Care Unit, the 476 Hospital of Fuzhou General Hospital
| | - Yi-Nan Wu
- Department of Anesthesiology and Intensive Care Unit, the 476 Hospital of Fuzhou General Hospital
| | - Zhi-Hu Zhao
- Department of Anesthesiology and Intensive Care Unit, the 476 Hospital of Fuzhou General Hospital
| | - Xiang-Zhu Liu
- Department of Anesthesiology and Intensive Care Unit, the 476 Hospital of Fuzhou General Hospital
| | - Chang-Li Hu
- Department of Anesthesiology and Intensive Care Unit, the 476 Hospital of Fuzhou General Hospital
| |
Collapse
|
34
|
Gottlieb M, Peksa GD. Comparison of the loop technique with incision and drainage for soft tissue abscesses: A systematic review and meta-analysis. Am J Emerg Med 2018; 36:128-133. [DOI: 10.1016/j.ajem.2017.09.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 09/07/2017] [Indexed: 11/25/2022] Open
|
35
|
Black L, Matvienko-Sikar K, Kearney PM. The association between childcare arrangements and risk of overweight and obesity in childhood: a systematic review. Obes Rev 2017; 18:1170-1190. [PMID: 28677302 DOI: 10.1111/obr.12575] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 04/21/2017] [Accepted: 05/14/2017] [Indexed: 12/13/2022]
Abstract
Over 80% of preschool-aged children experience non-parental childcare. Childcare type has the potential to influence weight outcomes, but its impact on childhood overweight/obesity is not well established. This review aims to (i) systematically evaluate the effects of childcare type on childhood overweight/obesity risk and (ii) investigate the impact of childcare intensity and age at commencement. Five electronic databases were searched for observational studies quantifying an association between childcare type ≤5 years and weight outcomes <18 years. Twenty-four studies were included (n = 127,529 children). Thirteen studies reported increased risk of overweight/obesity in children attending informal care (n = 9) or centre care (n = 4) vs. parental care. Seven studies reported decreased risk of overweight/obesity for children in centre vs. 'non-centre' care (parental and informal). Four studies reported no association between informal or centre care and overweight/obesity. Early (<3 years) informal care, especially by a relative, was associated with increased risk of overweight/obesity. Higher intensity childcare, especially when commenced early (<1 year), increased overweight/obesity risk. Later (≥3 years) centre care was associated with decreased risk of overweight/obesity. Early informal care, earlier commencement age and higher intensity represent a risk for childhood obesity. Exploration of the obesogenic aspects of these contexts is essential to inform preventative measures.
Collapse
Affiliation(s)
- L Black
- Department of Epidemiology and Public Health, University College Cork, Cork City, Ireland
| | - K Matvienko-Sikar
- Department of Epidemiology and Public Health, University College Cork, Cork City, Ireland
| | - P M Kearney
- Department of Epidemiology and Public Health, University College Cork, Cork City, Ireland
| |
Collapse
|
36
|
Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, Moher D, Tugwell P, Welch V, Kristjansson E, Henry DA. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ 2017; 358:j4008. [PMID: 28935701 PMCID: PMC5833365 DOI: 10.1136/bmj.j4008] [Citation(s) in RCA: 4538] [Impact Index Per Article: 648.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The number of published systematic reviews of studies of healthcare interventions has increased rapidly and these are used extensively for clinical and policy decisions. Systematic reviews are subject to a range of biases and increasingly include non-randomised studies of interventions. It is important that users can distinguish high quality reviews. Many instruments have been designed to evaluate different aspects of reviews, but there are few comprehensive critical appraisal instruments. AMSTAR was developed to evaluate systematic reviews of randomised trials. In this paper, we report on the updating of AMSTAR and its adaptation to enable more detailed assessment of systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. With moves to base more decisions on real world observational evidence we believe that AMSTAR 2 will assist decision makers in the identification of high quality systematic reviews, including those based on non-randomised studies of healthcare interventions.
Collapse
Affiliation(s)
- Beverley J Shea
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Canada
- Bruyère Research Institute, Ottawa, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | | | - George Wells
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- University of Ottawa Heart Institute, Ottawa, Canada
| | - Micere Thuku
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Canada
- Bruyère Research Institute, Ottawa, Canada
| | - Candyce Hamel
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Canada
| | - Julian Moran
- The Hospital for Sick Children, the Genetics and Genome Biology Program, Toronto, Canada
| | - David Moher
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Peter Tugwell
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Canada
- Bruyère Research Institute, Ottawa, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Department of Medicine, The Ottawa Hospital, Ottawa, Canada
| | - Vivian Welch
- Bruyère Research Institute, Ottawa, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Elizabeth Kristjansson
- Centre for Research in Educational and Community Services, School of Psychology, Faculty of Social Sciences, University of Ottawa, Canada
| | - David A Henry
- Centre for Research in Evidence-Based Practice, Bond University, Gold Coast, Australia
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Canada
| |
Collapse
|
37
|
Barnieh L, Collister D, Manns B, Lam NN, Shojai S, Lorenzetti D, Gill JS, Klarenbach S. A Scoping Review for Strategies to Increase Living Kidney Donation. Clin J Am Soc Nephrol 2017; 12:1518-1527. [PMID: 28818845 PMCID: PMC5586566 DOI: 10.2215/cjn.01470217] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 05/12/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES The literature on strategies to increase the number of potential living kidney donors is extensive and has yet to be characterized. Scoping reviews are a novel methodology for systematically assessing a wide breadth of a given body of literature and may be done before conducting a more targeted systematic review. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We performed a scoping review and summarized the evidence for existing strategies to increase living kidney donation. RESULTS Our review identified seven studies that tested interventions using rigorous methods (i.e., randomized, controlled trials) and outcome measures, all of which focused on using education targeted at potential recipients to increase living donation. Of these, two studies that targeted the potential recipients' close social network reported statistically significant results. Other interventions were identified, but their effect was assessed through quasiexperimental or observational study designs. CONCLUSIONS We identified an important gap in the literature for evidence-based strategies to increase living kidney donation. From the limited data available, strategies directed at potential recipients and their social networks are the most promising. These results can inform transplant programs that are considering strategies to increase living kidney donation and highlight the need for conduct of high-quality study to increase living donation.
Collapse
Affiliation(s)
- Lianne Barnieh
- Division of Nephrology, University of Alberta, Edmonton, Alberta, Canada
| | - David Collister
- Division of Nephrology, Department of Medicine, McMaster University, St. Joseph’s Hospital, Hamilton, Ontario, Canada
| | - Braden Manns
- Department of Community Health Sciences and
- Department of Medicine, Institute of Public Health and Libin Cardiovascular Institute, Foothills Medical Center, University of Calgary, Calgary, Alberta, Canada; and
| | - Ngan N. Lam
- Division of Nephrology, University of Alberta, Edmonton, Alberta, Canada
| | - Soroush Shojai
- Division of Nephrology, University of Alberta, Edmonton, Alberta, Canada
| | - Diane Lorenzetti
- Department of Medicine, Institute of Public Health and Libin Cardiovascular Institute, Foothills Medical Center, University of Calgary, Calgary, Alberta, Canada; and
| | - John S. Gill
- Division of Nephrology, Centre for Health Evaluation and Outcomes Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Scott Klarenbach
- Division of Nephrology, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
38
|
Faillie JL, Ferrer P, Gouverneur A, Driot D, Berkemeyer S, Vidal X, Martínez-Zapata MJ, Huerta C, Castells X, Rottenkolber M, Schmiedl S, Sabaté M, Ballarín E, Ibáñez L. A new risk of bias checklist applicable to randomized trials, observational studies, and systematic reviews was developed and validated to be used for systematic reviews focusing on drug adverse events. J Clin Epidemiol 2017; 86:168-175. [PMID: 28487158 DOI: 10.1016/j.jclinepi.2017.04.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 03/30/2017] [Accepted: 04/25/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The objective of the study was to develop and validate an adequate tool to evaluate the risk of bias of randomized controlled trials, observational studies, and systematic reviews assessing drug adverse events. STUDY DESIGN AND SETTING We developed a structured risk of bias checklist applicable to randomized trials, cohort, case-control and nested case-control studies, and systematic reviews focusing on drug safety. Face and content validity was judged by three experienced reviewers. Interrater and intrarater reliability were determined using 20 randomly selected studies, assessed by three other independent reviewers including one performing a 3-week retest. RESULTS The developed checklist examines eight domains: study design and objectives, selection bias, attrition, adverse events information bias, other information bias, statistical methods to control confounding, other statistical methods, and conflicts of interest. The total number of questions varied from 10 to 32 depending on the study design. Interrater and intrarater agreements were fair with Kendall's W of 0.70 and 0.74, respectively. Median time to complete the checklist was 8.5 minutes. CONCLUSION The developed checklist showed face and content validity and acceptable reliability to assess the risk of bias for studies analyzing drug adverse events. Hence, it might be considered as a novel useful tool for systematic reviews and meta-analyses focusing on drug safety.
Collapse
Affiliation(s)
- Jean-Luc Faillie
- Laboratory of Biostatistics, Epidemiology and Public Health (EA2415), Faculty of Medicine, Institut Universitaire de Recherche Clinique, University of Montpellier, 641 Avenue du Doyen Gaston Giraud, Montpellier 34093, France; Department of Medical Pharmacology and Toxicology, CHU Montpellier University Hospital, 371 Avenue du Doyen Gaston Giraud, Montpellier 34295, France
| | - Pili Ferrer
- Catalan Institute of Pharmacology Foundation (FICF), Department of Pharmacology Therapeutics and Toxicology, Autonomous University of Barcelona, Clinical Pharmacology Unit, Vall d'Hebron University Hospital, Pg. Vall d'Hebron 119-129, Barcelona 08035, Spain
| | - Amandine Gouverneur
- Univ. Bordeaux, Inserm UMR 1219, CHU de Bordeaux, Pôle de Santé Publique, Service de l'Information Médicale, 146 Rue Léo Saignat, Bordeaux 33076, France
| | - Damien Driot
- Department of Clinical and Medical Pharmacology, CHU Toulouse University Hospital, University of Toulouse, 37 Allées Jules-Guesde, Toulouse 31000, France
| | - Shoma Berkemeyer
- Department of Community Health, Hochschule fuer Gesundheit, Gesundheitscampus 6-8, North Rhine-Westphalia, Bochum 44801, Germany
| | - Xavier Vidal
- Catalan Institute of Pharmacology Foundation (FICF), Department of Pharmacology Therapeutics and Toxicology, Autonomous University of Barcelona, Clinical Pharmacology Unit, Vall d'Hebron University Hospital, Pg. Vall d'Hebron 119-129, Barcelona 08035, Spain
| | - Maria José Martínez-Zapata
- Iberoamerican Cochrane Centre, Institute of Biomedical Research (IIB Sant Pau), Barcelona, CIBER de Epidemiología y Salud Pública (CIBERESP), Sant Antoni Maria Claret 167, Barcelona 08025, Spain
| | - Consuelo Huerta
- Pharmacoepidemiology and Pharmacovigilance Division, Medicines for Human Use Department, Spanish Agency of Medicinal Products and Medical Devices (AEMPS), Calle Campezo 1, Madrid E28022, Spain
| | - Xavier Castells
- TransLab Research Group, Department of Medical Sciences, University of Girona, Girona, Spain
| | - Marietta Rottenkolber
- Diabetes Research Group, Medizinische Klinik und Poliklinik IV, Klinikum der Universitaet, Pettenkoferstrasse 8A, Munich 81377, Germany
| | - Sven Schmiedl
- Department of Clinical Pharmacology, School of Medicine, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Strasse 50, Witten D-58448, Germany; Philipp Klee-Institute for Clinical Pharmacology, HELIOS Clinic Wuppertal, Heusnerstrasse 40, Wuppertal D-42283, Germany
| | - Mònica Sabaté
- Catalan Institute of Pharmacology Foundation (FICF), Department of Pharmacology Therapeutics and Toxicology, Autonomous University of Barcelona, Clinical Pharmacology Unit, Vall d'Hebron University Hospital, Pg. Vall d'Hebron 119-129, Barcelona 08035, Spain
| | - Elena Ballarín
- Catalan Institute of Pharmacology Foundation (FICF), Department of Pharmacology Therapeutics and Toxicology, Autonomous University of Barcelona, Clinical Pharmacology Unit, Vall d'Hebron University Hospital, Pg. Vall d'Hebron 119-129, Barcelona 08035, Spain
| | - Luisa Ibáñez
- Catalan Institute of Pharmacology Foundation (FICF), Department of Pharmacology Therapeutics and Toxicology, Autonomous University of Barcelona, Clinical Pharmacology Unit, Vall d'Hebron University Hospital, Pg. Vall d'Hebron 119-129, Barcelona 08035, Spain.
| |
Collapse
|
39
|
Kalalinia F, Karimi-Sani I. Anticancer Properties of Solamargine: A Systematic Review. Phytother Res 2017; 31:858-870. [DOI: 10.1002/ptr.5809] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 03/10/2017] [Accepted: 03/14/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Fatemeh Kalalinia
- Biotechnology Research Center; Mashhad University of Medical Sciences; Mashhad Iran
| | - Iman Karimi-Sani
- Department of Biotechnology; Ferdowsi University of Mashhad; Mashhad Iran
| |
Collapse
|
40
|
Li T, Jiang S, Yang Z, Ma Z, Yi W, Wang D, Yang Y. Targeting the energy guardian AMPK: another avenue for treating cardiomyopathy? Cell Mol Life Sci 2017; 74:1413-1429. [PMID: 27815596 PMCID: PMC11107559 DOI: 10.1007/s00018-016-2407-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 10/25/2016] [Accepted: 11/01/2016] [Indexed: 12/11/2022]
Abstract
5'-AMP-activated protein kinase (AMPK) is a pivotal regulator of endogenous defensive molecules in various pathological processes. The AMPK signaling regulates a variety of intracellular intermedial molecules involved in biological reactions, including glycogen metabolism, protein synthesis, and cardiac fibrosis, in response to hypertrophic stimuli. Studies have revealed that the activation of AMPK performs a protective role in cardiovascular diseases, whereas its function in cardiac hypertrophy and cardiomyopathy remains elusive and poorly understood. In view of the current evidence of AMPK, we introduce the biological information of AMPK and cardiac hypertrophy as well as some upstream activators of AMPK. Next, we discuss two important types of cardiomyopathy involving AMPK, RKAG2 cardiomyopathy, and hypertrophic cardiomyopathy. Eventually, therapeutic research, genetic screening, conflicts, obstacles, challenges, and potential directions are also highlighted in this review, aimed at providing a comprehensive understanding of AMPK for readers.
Collapse
Affiliation(s)
- Tian Li
- Department of Thoracic and Cardiovascular Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China
- Department of Biomedical Engineering, The Fourth Military Medical University, 169 Changle West Road, Xi'an, 710032, China
| | - Shuai Jiang
- Department of Aerospace Medicine, The Fourth Military Medical University, 169 Changle West Road, Xi'an, 710032, China
| | - Zhi Yang
- Department of Biomedical Engineering, The Fourth Military Medical University, 169 Changle West Road, Xi'an, 710032, China
| | - Zhiqiang Ma
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, 1 Xinsi Road, Xi'an, 710038, China
| | - Wei Yi
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, 127 Changle West Road, Xi'an, 710038, China
| | - Dongjin Wang
- Department of Thoracic and Cardiovascular Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China.
| | - Yang Yang
- Department of Thoracic and Cardiovascular Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China.
- Department of Biomedical Engineering, The Fourth Military Medical University, 169 Changle West Road, Xi'an, 710032, China.
| |
Collapse
|
41
|
Larsson A. The Need for Research Infrastructures: A Narrative Review of Large-Scale Research Infrastructures in Biobanking. Biopreserv Biobank 2017; 15:375-383. [PMID: 28253021 DOI: 10.1089/bio.2016.0103] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Distributed Research Infrastructures are gaining political traction in Europe to facilitate scientific research. This development has gained particular momentum in the area of biobanking where cross-national attempts have been made toward harmonizing the biobanking standards across the European Union through the establishment of the organization BBMRI (BioBanking and Biomolecular Resources Research Infrastructure). BBMRI exists as separate national nodes across several European countries, although Sweden took on a pioneering role in its early stages. Thus, the Swedish node, BBMRI.se, was set up in 2009. PURPOSE To document publications addressing the current debate on large-scale distributed medical and/or biobank Research Infrastructures and identify the most pressing issues discussed by these articles through a narrative review. METHODS The Web of Science (WOS) and PubMed databases were searched to find prior studies of large-scale medical Research Infrastructures, with no limits set with regard to study design and/or time period. All identified articles published up until March 2016 were included in the initial review. RESULTS A total of 145 articles were retrieved from WOS and PubMed, though merely 17 ultimately made it past the final exclusion criteria. About two-thirds of the articles listed a first author affiliated to a European country. The articles most commonly discussed the need for developing and expanding the use of "infrastructures." PRACTICAL IMPLICATIONS The future of scientific research will call for a deeper and more widespread multidisciplinary collaboration. This will emphasize the need of research seeking to optimize the preconditions of securing sustainable scientific collaboration. Future investigators will thus need to understand the components and mechanisms of Research Infrastructures in addition to acquiring knowledge of how to build, manage, brand, and promote them as well.
Collapse
Affiliation(s)
- Anthony Larsson
- Department of Learning, Informatics, Management, and Ethics (LIME), Karolinska Institutet , Stockholm, Sweden
| |
Collapse
|
42
|
Benton JS, Anderson J, Hunter RF, French DP. The effect of changing the built environment on physical activity: a quantitative review of the risk of bias in natural experiments. Int J Behav Nutr Phys Act 2016; 13:107. [PMID: 27717360 PMCID: PMC5055702 DOI: 10.1186/s12966-016-0433-3] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 09/30/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidence regarding the association of the built environment with physical activity is influencing policy recommendations that advocate changing the built environment to increase population-level physical activity. However, to date there has been no rigorous appraisal of the quality of the evidence on the effects of changing the built environment. The aim of this review was to conduct a thorough quantitative appraisal of the risk of bias present in those natural experiments with the strongest experimental designs for assessing the causal effects of the built environment on physical activity. METHODS Eligible studies had to evaluate the effects of changing the built environment on physical activity, include at least one measurement before and one measurement of physical activity after changes in the environment, and have at least one intervention site and non-intervention comparison site. Given the large number of systematic reviews in this area, studies were identified from three exemplar systematic reviews; these were published in the past five years and were selected to provide a range of different built environment interventions. The risk of bias in these studies was analysed using the Cochrane Risk of Bias Assessment Tool: for Non-Randomized Studies of Interventions (ACROBAT-NRSI). RESULTS Twelve eligible natural experiments were identified. Risk of bias assessments were conducted for each physical activity outcome from all studies, resulting in a total of fifteen outcomes being analysed. Intervention sites included parks, urban greenways/trails, bicycle lanes, paths, vacant lots, and a senior citizen's centre. All outcomes had an overall critical (n = 12) or serious (n = 3) risk of bias. Domains with the highest risk of bias were confounding (due to inadequate control sites and poor control of confounding variables), measurement of outcomes, and selection of the reported result. CONCLUSIONS The present review focused on the strongest natural experiments conducted to date. Given this, the failure of existing studies to adequately control for potential sources of bias highlights the need for more rigorous research to underpin policy recommendations for changing the built environment to increase physical activity. Suggestions are proposed for how future natural experiments in this area can be improved.
Collapse
Affiliation(s)
- Jack S. Benton
- School of Psychological Sciences, University of Manchester, Coupland 1 Building, Oxford Road, Manchester, M13 9PL UK
| | - Jamie Anderson
- Department of Architecture, University of Cambridge, Cambridge, UK
| | - Ruth F. Hunter
- UKCRC Centre of Excellence for Public Health (NI)/Centre for Public Health, Queen’s University Belfast, Northern Ireland, UK
| | - David P. French
- School of Psychological Sciences, University of Manchester, Coupland 1 Building, Oxford Road, Manchester, M13 9PL UK
| |
Collapse
|