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Zhao P, Yu Y, Du M, Xu J, Lu W. Second curettage versus conventional chemotherapy in avoiding unnecessary chemotherapy and reducing the number of chemotherapy courses for patients with gestational trophoblastic neoplasia: A systematic review and meta-analysis. Int J Gynaecol Obstet 2024; 165:34-42. [PMID: 37753799 DOI: 10.1002/ijgo.15140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Chemotherapy is the recommended treatment for gestational trophoblastic neoplasia (GTN). Second curettage had been advocated to avoid unnecessary chemotherapy and to reduce the courses of chemotherapy; however, consensus has not been reached as there are arguments claiming its inability of inducing complete regression. OBJECTIVES The present study was performed to clarify the effectiveness of second curettage for avoiding unnecessary chemotherapy and lowering the number of chemotherapy courses in patients with post-molar GTN. SEARCH STRATEGY Seven predominant electronic databases were searched, including four English databases and three Chinese databases, from the inception of each database until January 31, 2023. SELECTION CRITERIA Studies were included if they were: (1) human, (2) explicitly indicated exposure to second curettage, (3) explicitly indicated control to conventional chemotherapy, (4) explicitly indicated the participants were patients with gestational trophoblastic neoplasia (GTN), and (5) compared the outcome of interest as the number of the course of chemotherapy. DATA COLLECTION AND ANALYSIS Two authors extracted and analyzed the data independently. Disagreements were reconciled by reviewing the full text by a third author. The data of study location, data collection, study design, number of participants, intervention strategy, control strategy, the follow-up period, outcome, adverse events were analyzed. MAIN RESULTS With regard to avoiding unnecessary chemotherapy, the overall pooled effect size of the second curettage group had a significant advantage over the conventional chemotherapy group with an OR of 0.02 (95% CI: 0.00-0.06). Meanwhile, for reducing the number of chemotherapy courses, the overall pooled effect size of the second curettage group had significant advantage over the conventional chemotherapy group with a mean difference of -2.11 (95% CI: -3.72 to -0.51). CONCLUSION The second curettage group had a significant advantage over the conventional chemotherapy group in avoiding unnecessary chemotherapy and reducing the number of chemotherapy courses. Further larger multi-center randomized controlled trials should be conducted to confirm our results and to clarify the optimal patients' group for second curettage in patients with post-molar GTN.
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Affiliation(s)
- Peng Zhao
- Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, China
| | - Yan Yu
- Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, China
- Department of Gynecologic Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Minmin Du
- Department of Obstetrics and Genecology, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Junbi Xu
- Department of Obstetrics and Genecology, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Weiguo Lu
- Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, China
- Department of Gynecologic Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Women's Reproductive Health Laboratory of Zhejiang Province, Hangzhou, China
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van Velkinburgh JC, Herbst MD, Casper SM. Diffusion tensor imaging in the courtroom: Distinction between scientific specificity and legally admissible evidence. World J Clin Cases 2023; 11:4477-4497. [PMID: 37469746 PMCID: PMC10353495 DOI: 10.12998/wjcc.v11.i19.4477] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/26/2023] [Accepted: 06/13/2023] [Indexed: 06/30/2023] Open
Abstract
Interest and uptake of science and medicine peer-reviewed literature by readers outside of a paper’s topical subject, field or even discipline is ever-expanding. While the application of knowledge from one field or discipline to others can stimulate innovative solutions to problems facing modern society, it is also fraught with danger for misuse. In the practice of law in the United States, academic papers are submitted to the courts as evidence in personal injury litigation from both the plaintiff (complainant) and defendant. Such transcendence of an academic publication over disciplinary boundaries is immediately met with the challenge of application by a group that inherently lacks in-depth knowledge on the scientific method, the practice of evidence-based medicine, or the publication process as a structured and internationally synthesized process involving peer review and guided by ethical standards and norms. A modern-day example of this is the ongoing conflict between the sensitivity of diffusion tensor imaging (DTI) and the legal standards for admissibility of evidence in litigation cases of mild traumatic brain injury (mTBI). In this review, we amalgamate the peer-reviewed research on DTI in mTBI with the court’s rationale underlying decisions to admit or exclude evidence of DTI abnormalities to support claims of brain injury. We found that the papers which are critical of the use of DTI in the courtroom reflect a primary misunderstanding about how diagnostic biomarkers differ legally from relevant and admissible evidence. The clinical use of DTI to identify white matter abnormalities in the brain at the chronic stage is a valid methodology both clinically as well as forensically, contributes data that may or may not corroborate the existence of white matter damage, and should be admitted into evidence in personal injury trials if supported by a clinician. We also delve into an aspect of science publication and peer review that can be manipulated by scientists and clinicians to publish an opinion piece and misrepresent it as an unbiased, evidence-based, systematic research article in court cases, the decisions of which establish precedence for future cases and have implications on future legislation that will impact the lives of every citizen and erode the integrity of science and medicine practitioners.
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Affiliation(s)
| | - Mark D Herbst
- Diagnostic Radiology, Independent Diagnostic Radiology Inc, St Petersburg, FL 33711, United States
| | - Stewart M Casper
- Personal Injury Law, Casper & DeToledo LLC, Stamford, CT 06905, United States
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Zhang X, Zhang F, Li Q, Feng C, Teng W. Iodine nutrition and papillary thyroid cancer. Front Nutr 2022; 9:1022650. [PMID: 36337631 PMCID: PMC9631789 DOI: 10.3389/fnut.2022.1022650] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 09/30/2022] [Indexed: 09/19/2023] Open
Abstract
Thyroid cancer (TC) is the most frequent endocrine malignancy. The incidence of TC, especially papillary thyroid carcinoma (PTC), has continued to rise all over the world during the past few years, for reasons that are not entirely clear. Though the phenomenon of overdiagnosis is occurring, it is not the sole driver of the substantial increase in incidence. Lifestyle, environmental factors, or complications are considered to be potential risk factors. Among these factors, iodine is a micronutrient that is vital to thyroid function. The effect of iodine intake on PTC has been controversial for many years and the epidemiological or experimental studies provided diametrically opposite conclusions. Combining all these studies, we found that iodine nutrition may affect the overall prevalence, distribution of the histological types, and clinicopathological aggressiveness of TC, especially PTC. However, the available evidence is poor due to the impact of various internal and external related factors. Therefore, this article sums up available results from both epidemiological and experimental studies, future studies are also warranted to expound on the relationship between overall PTC prevalence and iodine intake.
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Stanley TD, Doucouliagos H, Ioannidis JPA, Carter EC. Detecting publication selection bias through excess statistical significance. Res Synth Methods 2021; 12:776-795. [PMID: 34196473 DOI: 10.1002/jrsm.1512] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 05/08/2021] [Accepted: 06/09/2021] [Indexed: 11/11/2022]
Abstract
We introduce and evaluate three tests for publication selection bias based on excess statistical significance (ESS). The proposed tests incorporate heterogeneity explicitly in the formulas for expected and ESS. We calculate the expected proportion of statistically significant findings in the absence of selective reporting or publication bias based on each study's SE and meta-analysis estimates of the mean and variance of the true-effect distribution. A simple proportion of statistical significance test (PSST) compares the expected to the observed proportion of statistically significant findings. Alternatively, we propose a direct test of excess statistical significance (TESS). We also combine these two tests of excess statistical significance (TESSPSST). Simulations show that these ESS tests often outperform the conventional Egger test for publication selection bias and the three-parameter selection model (3PSM).
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Affiliation(s)
- T D Stanley
- School of Business and Law, Deakin University, Burwood, Victoria, Australia
| | | | - John P A Ioannidis
- Epidemiology and Population Health, and (by courtesy) of Biomedical Data Science, and of Statistics, and Co-Director, METRICS, Stanford University, Stanford, California, USA.,METRIC B, Berlin Institute of Health, Berlin, Germany
| | - Evan C Carter
- Human Research and Engineering Directorate, United States Army Research Laboratory, Aberdeen Proving Ground, Aberdeen, Maryland, USA
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Jiao R, Przepiorka W, Buskens V. Reputation effects in peer-to-peer online markets: A meta-analysis ∗. SOCIAL SCIENCE RESEARCH 2021; 95:102522. [PMID: 33653586 DOI: 10.1016/j.ssresearch.2020.102522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 11/11/2020] [Accepted: 12/23/2020] [Indexed: 06/12/2023]
Abstract
Most online market exchanges are governed by reputation systems, which allow traders to comment on one another's behavior and attributes with ratings and text messages. These ratings then constitute sellers' reputations that serve as signals of their trustworthiness and competence. The large body of research investigating the effect of reputation on selling performance has produced mixed results, and there is a lack of consensus on whether the reputation effect exists and what it means. After showing how the reputation effect can be derived from a game-theoretic model, we use meta-analysis to synthesize evidence from 107 studies investigating the reputation effect in peer-to-peer online markets. Our results corroborate the existence of the reputation effect across different operationalizations of seller reputation and selling performance. Our results also show the extent to which the reputation effect varies. We discuss potential explanations for the variation in reputation effects that cannot be attributed to sampling error and thereby point out promising avenues for future research.
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Affiliation(s)
- Ruohuang Jiao
- Utrecht University, Department of Sociology / ICS, Padualaan 14, 3584, CH, Utrecht, Netherlands
| | - Wojtek Przepiorka
- Utrecht University, Department of Sociology / ICS, Padualaan 14, 3584, CH, Utrecht, Netherlands.
| | - Vincent Buskens
- Utrecht University, Department of Sociology / ICS, Padualaan 14, 3584, CH, Utrecht, Netherlands
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Zhou J, Xu X, Liang Y, Zhang X, Tu H, Chu H. Risk factors of postoperative delirium after liver transplantation: a systematic review and meta-analysis. Minerva Anestesiol 2021; 87:684-694. [PMID: 33594873 DOI: 10.23736/s0375-9393.21.15163-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
INTRODUCTION The aim of this study was to summarize the incidence and risk factors of postoperative delirium (POD) after liver transplantation (LT) and associations of POD after LT with outcomes. EVIDENCE ACQUISITION A literature search of Pubmed, EMBASE, and the Cochrane Databases was performed to identify studies reporting POD after LT. The Newcastle-Ottawa Scale was used to rate study quality. Effect estimates were extracted and combined using random-effect model. Pooled mean differences and odds ratios for individual risk factors were calculated using inverse-variance method and Mantel-Haenszel method, as appropriate. EVIDENCE SYNTHESIS Eight articles with 1434 patients were included in the meta-analysis. Overall, the pooled estimated incidence rates of POD after LT were 30% (95% confidence interval: 20-39%). Fourteen statistically significant risk factors were identified in the pooled analysis: alcohol excess, preoperative renal replacement therapy (RRT), preoperative hospital length of stay (LOS), depression, hepatic encephalopathy, alcohol etiology of liver failure, Child-Turcotte-Pugh Score, APACHE II Score, MELD Score, preoperative INR, preoperative bilirubin, intraoperative use of fentanyl, intraoperative RBC transfusion, postoperative ammonia. Patients with POD had a significantly increased mechanical ventilation, postoperative RRT, LOS and mortality rate compared with those without POD. CONCLUSIONS POD after LT was common and multifactorial in etiology. There are significant associations of POD after LT with some clinical outcomes. Effective interventions during perioperative period may be promising to reduce the risk of POD after LT.
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Affiliation(s)
- Jian Zhou
- Department of Anesthesiology, The Affiliated Hospital of Qingdao University, School of Clinical Medicine, Qingdao University, Qingdao, China
| | - Xiaolin Xu
- Department of Anesthesiology, The Affiliated Hospital of Qingdao University, School of Clinical Medicine, Qingdao University, Qingdao, China
| | - Yongxin Liang
- Department of Anesthesiology, The Affiliated Hospital of Qingdao University, School of Clinical Medicine, Qingdao University, Qingdao, China
| | - Xueying Zhang
- Department of Anesthesiology, The Affiliated Hospital of Qingdao University, School of Clinical Medicine, Qingdao University, Qingdao, China
| | - Houan Tu
- Department of Anesthesiology, The Affiliated Hospital of Qingdao University, School of Clinical Medicine, Qingdao University, Qingdao, China
| | - Haichen Chu
- Department of Anesthesiology, The Affiliated Hospital of Qingdao University, School of Clinical Medicine, Qingdao University, Qingdao, China -
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Li D, Niu Z, Huang Q, Sheng W, Wang T. A meta-analysis of the incidence rate of postoperative acute kidney injury in patients with congenital heart disease. BMC Nephrol 2020; 21:350. [PMID: 32807107 PMCID: PMC7433101 DOI: 10.1186/s12882-020-02005-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 08/03/2020] [Indexed: 01/07/2023] Open
Abstract
Background Acute kidney injury (AKI) is a common complication of cardiac surgery. However, the incidence rate of AKI in patients with congenital heart disease (CHD) greatly varies between reports owing to the different definitions used for AKI. Therefore, this study was designed as a meta-analysis aimed at summarizing the incidence rate of AKI in patients with congenital heart disease (CHD) on the basis of different AKI criteria. Methods Studies published till April 24, 2020, on the incidence rate of AKI in patients with CHD, were retrieved from electronic databases and printed literature. To pool data from the included studies, the effect size, a combined statistics, was chosen and presented with the incidence rate and 95% confidence interval (CI). Heterogeneity was evaluated using I2 statistics and Cochran Q test. The incidence rates obtained from the subgroup analysis according to study location, type of surgery, type of cohort, age, and AKI criteria) were also evaluated to determine the correlation of AKI with these factors. Publication bias was estimated using the Egger test. Results Thirty studies, comprising 9925 patients with AKI who had CHD, were included. Overall, the pooled incidence rate of AKI in the patients with CHD was 38.4% (95% CI, 32.0–44.7%). However, the incidence rate was not significantly affected by gender, study location, type of surgery, type of cohort, and AKI criteria. Moreover, age was significantly associated with the incidence of AKI, and the incidence rate was higher in the patients aged < 1 month than in those aged 1 month to 18 years, < 18 years, and ≥ 18 years (P < 0.05). Conclusions In this study, the estimated incidence rate of AKI in patients with CHD was 38.4% and may be influenced by age. These findings highlight the importance of further investigation of the specific causes of and effective preventive measures for AKI.
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Affiliation(s)
- Dandan Li
- Department of Environmental Health, Qingdao Centers for Disease Control and Prevention, Qingdao, 266033, Shandong, China
| | - Zhaozhuo Niu
- Department of Cardiovascular Surgery, Qingdao Municipal Hospital, No. 5 Donghai Middle Road, Shinan District, Qingdao, 266000, Shandong, China
| | - Qiang Huang
- Department of Cardiovascular Surgery, Qingdao Municipal Hospital, No. 5 Donghai Middle Road, Shinan District, Qingdao, 266000, Shandong, China
| | - Wei Sheng
- Department of Cardiovascular Surgery, Qingdao Municipal Hospital, No. 5 Donghai Middle Road, Shinan District, Qingdao, 266000, Shandong, China
| | - Tianyi Wang
- Department of Cardiovascular Surgery, Qingdao Municipal Hospital, No. 5 Donghai Middle Road, Shinan District, Qingdao, 266000, Shandong, China.
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Bai J, Liang Y, Zhang P, Liang X, He J, Wang J, Wang Y. Association between postoperative delirium and mortality in elderly patients undergoing hip fractures surgery: a meta-analysis. Osteoporos Int 2020; 31:317-326. [PMID: 31741024 DOI: 10.1007/s00198-019-05172-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 09/18/2019] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Postoperative delirium (POD) is a common complication in elderly surgical patients. Patients undergoing hip fractures surgery who are often characterized by advanced age could be particularly prone to suffering POD. We performed a meta-analysis to assess the association between POD and mortality in elderly patients undergoing hip fractures surgery. This meta-analysis included twenty-one cohort studies, and the pooled outcomes demonstrated that approximated one-fourth of patients undergoing hipfracture surgery would develop POD, and delirium increased the mortality in these patients. METHODS We searched PubMed, Embase, Web of Science, and Scopus for studies that investigated the effect of POD on mortality in elderly patients undergoing hip fracture surgery. Two reviewers independently selected studies, assessed quality, and extracted data. Statistical analyses were performed by STATA 14.0 and RevMan 5.3. Risk ratios (RRs) with 95% confidence intervals (CIs) were derived using random or fixed-effects model. RESULTS Twenty-one cohort studies enrolling a total of 6288 patients were included, and the pooled prevalence (95% CI) of POD was 28% (23-34%). POD was associated with an increase in perioperative mortality (30-day or in-hospital mortality) [12 studies, 3123 patients, relative risk (RR) (95% CI) 2.79 (1.97-3.93)], 6-month mortality [6 studies, 1673 patients, 2.51 (1.99-3.16)], 1-year mortality [6 studies, 1896 patients, 1.98 (1.62-2.41)], and more than 1-year mortality [8 studies, 1926 patients, 2.06 (1.60-2.64)]. CONCLUSIONS Our meta-analysis demonstrated that approximated one-fourth of patients undergoing hip fracture surgery would develop POD, and delirium increased the short-term and long-term mortality in these patients.
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Affiliation(s)
- J Bai
- Department of Orthopedics, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, 233000, China
| | - Y Liang
- Department of Orthopedics, Northern Jiangsu People's Hospital, Clinical Medical College of Yangzhou University, Nantong West Road 98, Yangzhou, 225001, China
| | - P Zhang
- Department of Orthopedics, The Second XiangYa Hospital, Central South University, Changsha, 410011, China
| | - X Liang
- Educational Administration Section, The Second Hospital of Dalian Medical University, Dalian, 116027, China
| | - J He
- Department of Orthopedics, Northern Jiangsu People's Hospital, Clinical Medical College of Yangzhou University, Nantong West Road 98, Yangzhou, 225001, China
| | - J Wang
- Department of Orthopedics, Northern Jiangsu People's Hospital, Clinical Medical College of Yangzhou University, Nantong West Road 98, Yangzhou, 225001, China.
| | - Y Wang
- Department of Orthopedics, Northern Jiangsu People's Hospital, Clinical Medical College of Yangzhou University, Nantong West Road 98, Yangzhou, 225001, China.
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Bom PRD, Rachinger H. A kinked meta-regression model for publication bias correction. Res Synth Methods 2019; 10:497-514. [PMID: 31039283 DOI: 10.1002/jrsm.1352] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 04/08/2019] [Accepted: 04/23/2019] [Indexed: 11/08/2022]
Abstract
Publication bias distorts the available empirical evidence and misinforms policymaking. Evidence of publication bias is mounting in virtually all fields of empirical research. This paper proposes the endogenous kink (EK) meta-regression model as a novel method of publication bias correction. The EK method fits a piecewise linear meta-regression of the primary estimates on their standard errors, with a kink at the cutoff value of the standard error below which publication selection is unlikely. We provide a simple method of endogenously determining this cutoff value as a function of a first-stage estimate of the true effect and an assumed threshold of statistical significance. Our Monte Carlo simulations show that EK is less biased and more efficient than other related regression-based methods of publication bias correction in a variety of research conditions.
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Affiliation(s)
- Pedro R D Bom
- Deusto Business School, University of Deusto, Bilbao, Spain
| | - Heiko Rachinger
- Department of Applied Economics, Universitat de les Illes Balears, Palma de Mallorca, Spain
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Yan AR, Zhang X, Shen H, Zhou X, Li R, Yuan Z. Urinary iodine is increased in papillary thyroid carcinoma but is not altered by regional population iodine intake status: a meta-analysis and implications. Endocr J 2019; 66:497-514. [PMID: 30890682 DOI: 10.1507/endocrj.ej18-0532] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Excessive iodine intake has been associated with increased risk of thyroid cancer (TC) in many studies, but the results have not been consistent. Since it was common knowledge that urinary iodine (UI) is considered a sensitive marker of current iodine intake, we conducted a meta-analysis to clarify the association between high UI and TC. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and the Cochrane Collaboration. Between-group meta-analyses were performed to compare UI between TC patients and the healthy/euthyroid subjects in local residents and benign thyroid nodules (BTN) patients. Then, between-group meta-analyses to compare the incidence rate of iodine excess were also conducted. The 22 case-control studies included in the meta-analyses represented 15,476 participants. It is the first time to clarify that UI was increased in PTC patients, but was not altered by regional population iodine intake status. Compared with BTN patients, PTC patients exhibited both higher UIC and higher odds ratio of iodine excess only in adequate iodine intake status subgroup; UIC, not the odds ratio of iodine excess, was higher in patients with PTC than those with BTN in above requirements iodine intake subgroup. A novel insight is offered that high UI in PTC patients was less influenced by regional population iodine intake status. It is indicted that high iodine intake is not a risk factor for PTC and high urinary iodine is just a specific characteristic of the disease.
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Affiliation(s)
- Ann-Rong Yan
- Faculty of Health, University of Canberra, Canberra 2617, Australia
| | - Xiaojuan Zhang
- Zhenghua South Street Community Healthcare Center, Datong 037000, China
| | - Hong Shen
- Neuro-psychiatric Institute, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xia Zhou
- Neuro-psychiatric Institute, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Rui Li
- School of Pharmacy, Nanjing Medical University, Nanjing 210029, China
| | - Zhexing Yuan
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
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Affiliation(s)
- Nicholas J DeVito
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Ben Goldacre
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Hassanipour S, Ghaem H, Arab-Zozani M, Seif M, Fararouei M, Abdzadeh E, Sabetian G, Paydar S. Comparison of artificial neural network and logistic regression models for prediction of outcomes in trauma patients: A systematic review and meta-analysis. Injury 2019; 50:244-250. [PMID: 30660332 DOI: 10.1016/j.injury.2019.01.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/10/2018] [Accepted: 01/10/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Currently, two models of artificial neural network (ANN) and logistic regression (LR) are known as models that extensively used in medical sciences. The aim of this study was to compare the ANN and LR models in prediction of Health-related outcomes in traumatic patients using a systematic review. METHODS The study was planned and conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. A literature search of published studies was conducted using PubMed, Embase, Web of knowledge, Scopus, and Google Scholar in May 2018. Joanna Briggs Institute (JBI) checklists was used for assessing the quality of the included articles. RESULTS The literature searches yielded 326 potentially relevant studies from the primary searches. Overall, the review included 10 unique studies. The results of this study showed that the area under curve (AUC) for the ANN was 0.91, (95% CI 0.89-0.83) and 0.89, (95% CI 0.87-90) for the LR in random effect model. The accuracy rate for ANN and LR in random effect models were 90.5, (95% CI, 87.6-94.2) and 83.2, (95% CI 75.1-91.2), respectively. CONCLUSION The results of our study showed that ANN has better performance than LR in predicting the terminal outcomes of traumatic patients in both the AUC and accuracy rate. Using an ANN to predict the final implications of trauma patients can provide more accurate clinical decisions.
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Affiliation(s)
- Soheil Hassanipour
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Haleh Ghaem
- Research Center for Health Sciences, Institute of Health, Epidemiology Department, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Morteza Arab-Zozani
- Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mozhgan Seif
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Fararouei
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elham Abdzadeh
- Department of Biology, Faculty of Science, University of Guilan, Rasht, Iran
| | - Golnar Sabetian
- Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahram Paydar
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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Zhao P, Lu Y, Huang W, Tong B, Lu W. Total hysterectomy versus uterine evacuation for preventing post-molar gestational trophoblastic neoplasia in patients who are at least 40 years old: a systematic review and meta-analysis. BMC Cancer 2019; 19:13. [PMID: 30612545 PMCID: PMC6322260 DOI: 10.1186/s12885-018-5168-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/30/2018] [Indexed: 12/23/2022] Open
Abstract
Background The clinical value of total hysterectomy for patients with hydatidiform mole (HM) being at least 40 years old remains highly controversial. Since the practice of hysterectomy has been applied globally for decades, there is an urgent need to perform a systematic review to assess its risks and benefits. Methods Six electronic databases, including four English databases and one Chinese database, were searched from the inception of each database till October 6th 2017. Studies were included if they: 1) were human studies, 2) explicitly indicated exposure to hysterectomy, 3) explicitly indicated control to uterine evacuation, 4) explicitly indicated the participants were older patients with HM being at least 40 years in age, 5) compared the outcome of interest as the incidence of post-molar GTN. Two authors independently conducted the literature search, study selection, data extraction. Pooled odds ratios were analyzed using Review Manager 5.3. Results The overall pooled effect size of total hysterectomy had a significant advantage in preventing post-molar gestational trophoblastic neoplasia over uterine evacuation with an OR of 0.19 (95% CI, 0.08–0.48; P = 0.0004) and a low heterogeneity (I2 = 21%, P = 0.28). Subgroup analysis and sensitivity analysis also showed similar results. Conclusions Total hysterectomy, as compared to uterine evacuation, is a better therapeutic method for patients with HM being at least 40 years old unless fertility is still desired. Electronic supplementary material The online version of this article (10.1186/s12885-018-5168-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Peng Zhao
- Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, No.1 Xueshi Road, Hangzhou, 310006, Zhejiang Province, China
| | - Yongchao Lu
- Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, No.1 Xueshi Road, Hangzhou, 310006, Zhejiang Province, China
| | - Wei Huang
- Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, No.1 Xueshi Road, Hangzhou, 310006, Zhejiang Province, China
| | - Baoqin Tong
- Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, No.1 Xueshi Road, Hangzhou, 310006, Zhejiang Province, China
| | - Weiguo Lu
- Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, No.1 Xueshi Road, Hangzhou, 310006, Zhejiang Province, China.
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