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Carrasco-Labra A, Verdugo-Paiva F, Matanhire-Zihanzu CN, Booth E, Kohler IV, Urquhart O, Makino Y, Glick M. Barriers to and facilitators for the creation, dissemination, implementation, monitoring, and evaluation of oral health policies in the WHO Africa region: A scoping review protocol. F1000Res 2024; 12:1160. [PMID: 38571571 PMCID: PMC10988199 DOI: 10.12688/f1000research.139689.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/12/2024] [Indexed: 04/05/2024] Open
Abstract
Background Evidence-informed oral health policies (OHP) can be instrumental in ending the neglect of oral health globally. When appropriately developed and implemented, OHP can improve the efficiency of healthcare systems and the quality of health outcomes. However, more than half of the countries in the World Health Organization (WHO) African region do not have an oral health policy or even the existence of a policy in need of additional and more national-specific OHP as part of non-communicable diseases and universal health coverage agendas. The objective of this protocol's study is to determine the barriers to and facilitators for the creation, dissemination, implementation, monitoring, and evaluation of OHP in the WHO Africa region. Methods We will conduct a systematic search in Global Health, Embase, PubMed, PAIS, ABI/Inform, Web of Science, Academic Search Complete, Scopus, databases that index gray literature, and the WHO policy repositories. We will include qualitative, quantitative, or mixed-methods research studies and OHP documents published since January 1, 2002, which address stakeholders' perceptions and experiences regarding barriers to and facilitators for the creation, dissemination, implementation, monitoring, and evaluation of OHP in countries part of the WHO African region. We will produce descriptive statistics (frequencies and proportions) for quantitative data and conduct descriptive content analysis for qualitative data. Discussion To effectively establish evidence-based OHP in the WHO African region, it is crucial to recognize existing challenges and opportunities for progress. The findings of this review will be relevant for Chief Dental Officers at ministries of health, administrators of dental schools, or academic institutions in the WHO African region and will inform a stakeholder dialogue meeting in Kenya in November of 2023. Registration Open Science Framework: https://doi.org/10.17605/OSF.IO/9KMWR.
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Affiliation(s)
- Alonso Carrasco-Labra
- Center for Integrative Global Oral Health, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
| | - Francisca Verdugo-Paiva
- Programa de TTM y Dolor Orofacial, Facultad de Odontología, Universidad Andres Bello, Santiago, Santiago Metropolitan Region, Chile
- Department of Paediatrics, Obstetrics & Gynaecology and Preventive Medicine and Public Health, Universitat Autonoma de Barcelona, Barcelona, Catalonia, Spain
- Epistemonikos Foundation, Santiago, Santiago Metropolitan Region, Chile
| | - Cleopatra N. Matanhire-Zihanzu
- Department of Oral Health, Faculty of Medicine and Health Sciences, University of Zimbabwe, Avondale, Harare, P.O Box A178, Zimbabwe
| | - Emmett Booth
- Temple University Libraries, Temple University, Philadelphia, Pennsylvania, USA
| | - Iliana V. Kohler
- Population Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
| | - Olivia Urquhart
- Center for Integrative Global Oral Health, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
| | - Yuka Makino
- Noncommunicable Diseases Management Team, WHO Regional Office for Africa, Cité Djoué, Brazzaville, P.O. Box 06, Congo
| | - Michael Glick
- Center for Integrative Global Oral Health, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
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Verdugo-Paiva F, Bonfill Cosp X, Alonso-Coello P, Ávila-Oliver C, Glick M, Carrasco-Labra A. How oral health care organizations formulate actionable statements to inform practice and policy: A protocol for a systematic survey. F1000Res 2023; 12:1261. [PMID: 37981981 PMCID: PMC10656514 DOI: 10.12688/f1000research.141423.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 11/21/2023] Open
Abstract
Background: Oral diseases are a major global public health problem that impacts the quality of life of those affected. While widespread consensus exists on the importance of high-quality, evidence-informed guidelines to inform practice and public health decisions in medicine, appropriate methodologies and standards are not commonly adhered to among producers of oral health guidelines. This systematic survey aims to identify organizations developing evidence-informed guidelines and policy documents in oral health globally, and describe the methods and processes used. Methods: We will conduct manual searches on the websites of guideline developers, Ministries of Health, and scientific societies. Additionally, we will systematically search electronic databases to identify published guidelines and collect the name of the responsible entity. We will include organizations that regularly develop guidelines on any oral health topic and that explicitly declare the inclusion of research evidence in its development process. Subsequently, we will use a standardized form to extract data about the characteristics of the organization, the characteristics of their guideline or policy documents, and their formal recommendation development processes. These data will be extracted from various sources, such as the organization's official website, the methods section of each guideline, or methodological handbooks. We will use descriptive statistics to analyze the extracted data. Discussion: This systematic survey will synthesize key characteristics and methodologies used by organizations developing evidence-informed guidelines. This study will provide the basis for future development of a sustainable and connected collaborative network for evidence-informed guidelines and policy documents in oral health globally. The results will be disseminated through peer-reviewed publications, conference presentations, and targeted dissemination of findings with the identified organizations. Our systematic survey represents a necessary first step toward improving the field of oral health policies and guidelines.
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Affiliation(s)
- Francisca Verdugo-Paiva
- Epistemonikos Foundation, Santiago, Santiago Metropolitan Region, Chile
- Programa de TTM y Dolor Orofacial, Facultad de Odontología, Universidad Andres Bello, Santiago, Santiago Metropolitan Region, Chile
- Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine and Public Health, Universitat Autonoma de Barcelona, Barcelona, Catalonia, Spain
| | - Xavier Bonfill Cosp
- Clinical Epidemiology Service, Hospital Sant Pau, Barcelona, Spain
- Iberoamerican Cochrane Centre, Sant Pau Biomedical Research Institute, Barcelona, Spain
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre, Sant Pau Biomedical Research Institute, Barcelona, Spain
| | - Camila Ávila-Oliver
- Epistemonikos Foundation, Santiago, Santiago Metropolitan Region, Chile
- Escuela de Odontología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Santiago, Santiago Metropolitan Region, Chile
| | - Michael Glick
- Escuela de Odontología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Santiago, Santiago Metropolitan Region, Chile
| | - Alonso Carrasco-Labra
- Escuela de Odontología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Santiago, Santiago Metropolitan Region, Chile
- Center for Integrative Global Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Miroshnychenko A, Azab M, Ibrahim S, Roldan Y, Diaz Martinez JP, Tamilselvan D, He L, Urquhart O, Verdugo-Paiva F, Tampi M, Polk DE, Moore PA, Hersh EV, Brignardello-Petersen R, Carrasco-Labra A. Corticosteroids for managing acute pain subsequent to surgical extraction of mandibular third molars: A systematic review and meta-analysis. J Am Dent Assoc 2023; 154:727-741.e10. [PMID: 37500235 PMCID: PMC10910594 DOI: 10.1016/j.adaj.2023.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 04/25/2023] [Accepted: 04/30/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Corticosteroids are used to manage pain after surgical tooth extractions. The authors assessed the effect of corticosteroids on acute postoperative pain in patients undergoing surgical tooth extractions of mandibular third molars. TYPES OF STUDIES REVIEWED The authors conducted a systematic review and meta-analysis. The authors searched the Epistemonikos database, including MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and the US clinical trials registry (ClinicalTrials.gov) from inception until April 2023. Pairs of reviewers independently screened titles and abstracts, then full texts of trials were identified as potentially eligible. After duplicate data abstraction, the authors conducted random-effects meta-analyses. Risk of bias was assessed using Version 2 of the Cochrane Risk of Bias tool and certainty of the evidence was determined using the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS Forty randomized controlled trials proved eligible. The evidence suggested that corticosteroids compared with a placebo provided a trivial reduction in pain intensity measured 6 hours (mean difference, 8.79 points lower; 95% CI, 14.8 to 2.77 points lower; low certainty) and 24 hours after surgical tooth extraction (mean difference, 8.89 points lower; 95% CI, 10.71 to 7.06 points lower; very low certainty). The authors found no important difference between corticosteroids and a placebo with regard to incidence of postoperative infection (risk difference, 0%; 95% CI, -1% to 1%; low certainty) and alveolar osteitis (risk difference, 0%; 95% CI, -3% to 4%; very low certainty). PRACTICAL IMPLICATIONS Low and very low certainty evidence suggests that there is a trivial difference regarding postoperative pain intensity and adverse effects of corticosteroids administered orally, submucosally, or intramuscularly compared with a placebo in patients undergoing third-molar extractions.
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Annesi-Maesano I, Cecchi L, Benedetta B, Chung KF, Clot B, Collaud Coen M, D'Amato G, Damialis A, Dominguez-Ortega J, Galàn C, Gilles S, Holgate S, Jeebhay M, Kazadzis S, Papadopoulos NG, Quirce S, Sastre J, Tummon F, Traidl-Hoffmann C, Walusiak-Skorupa J, Alonso-Coello P, Canelo-Aybar C, Cantero-Fortiz Y, Rigau D, Salazar J, Verdugo-Paiva F, Jutel M, Akdis CA, Agache I. Is exposure to pollen a risk factor for moderate and severe asthma exacerbations? Allergy 2023. [PMID: 36961370 DOI: 10.1111/all.15724] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 02/13/2023] [Accepted: 02/21/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND Limited number of studies have focused on the impact of pollen exposure on asthma. As a part of the EAACI Guidelines on Environment Science, this first systematic review on the relationship of pollen exposure to asthma exacerbations aimed to bridge this knowledge gap in view of implementing recommendations of prevention. METHODS We searched electronic iPubMed, Embase, and Web of Science databases using a set of MeSH terms and related synonyms and identified 73 eligible studies that were included for systemic review. When possible, meta-analyses were conducted. RESULTS Overall meta-analysis suggests that outdoor pollen exposure may have an effect on asthma exacerbation but caution is needed due to the low number of studies and their heterogeneity. The strongest associations were found between asthma attacks, asthma-related ED admissions or hospitalizations and an increase of grass pollen concentration in the previous 2 days overall in children aged less than 18 years of age. Tree pollen may increase asthma-related ED visits or admissions lagged up to 7 days overall in individuals younger than 18 years. Rare data show that among subjects under 18 years of age an exposure to grass pollen lagged up to 3 days may lower lung function. CONCLUSIONS Further research considering effect modifiers of pollen sensitization, hay fever, asthma, air pollution, green spaces and pre-existing medications is urgently warranted to better evaluate the impacts of pollen on asthma exacerbation. Preventive measures in relation to pollen exposure should be integrated in asthma control as pollen increase continues due to climate change.
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Affiliation(s)
- Isabella Annesi-Maesano
- Institute Desbrest of Epidemiology and Public Health, University of Montpellier and INSERM, Department of Allergic and Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - Lorenzo Cecchi
- Centre of Bioclimatology, University of Florence, Florence; SOS Allergy and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | - Biagioni Benedetta
- Allergy and Clinical Immunology Unit San Giovanni di Dio Hospital Florence, Italy
| | - Kian Fan Chung
- National Heart & Lung Institute, Imperial College London, London, UK
| | - Bernard Clot
- Federal Office of Meteorology and Climatology MeteoSwiss, Payerne, Switzerland
| | | | - Gennaro D'Amato
- Respiratory Disease Department, Hospital Cardarelli, Naples, Italy
| | - Athanasios Damialis
- Terrestrial Ecology and Climate Change, Department of Ecology, School of Biology, Faculty of Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Javier Dominguez-Ortega
- Department of Allergy, La Paz University Hospital, IdiPAZ, and CIBER of Respiratory, Diseases (CIBERES), Madrid, Spain
| | - Carmen Galàn
- International Campus of Excellence on Agrifood (ceiA3), University of Cordoba, Córdoba, Spain; and Andalusian Inter-University Institute for Earth System Research (IISTA), University of Cordoba, Córdoba, Spain
| | - Stefanie Gilles
- Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Stephen Holgate
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, United Kingdom
| | - Mohamed Jeebhay
- Occupational Medicine Division and Centre for Environmental & Occupational Health Research, School of Public Health, University of Cape Town, South Africa
| | - Stelios Kazadzis
- Physikalisch-Meteorologisches Observatorium Davos, World Radiation Center, Davos, Switzerland
| | - Nikolaos G Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece; and Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, United Kingdom
| | - Santiago Quirce
- Department of Allergy, La Paz University Hospital, IdiPAZ, and CIBER of Respiratory, Diseases (CIBERES), Madrid, Spain
| | - Joaquin Sastre
- Allergy Service. Fundación Jiménez Díaz, Faculty of Medicine Universidad Autónoma de Madrid, and CIBERES, Instituto Carlos III, Ministry of Science and Innovation, Madrid, Spain
| | - Fiona Tummon
- Federal Office of Meteorology and Climatology MeteoSwiss, Payerne, Switzerland
| | - Claudia Traidl-Hoffmann
- Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany; Institute of Environmental Medicine, Helmholtz Center Munich - German Research Center for Environmental Health, Augsburg, Germany; and Christine Kühne Center for Allergy Research and Education, Davos, Switzerland
| | - Jolanta Walusiak-Skorupa
- Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre, Department of Clinical Epidemiology and Public Health, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain, and CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Carlos Canelo-Aybar
- Department of Clinical Immunology, Wrocław Medical University, and ALL-MED Medical Research Institute, Wroclaw, Poland
| | - Yahveth Cantero-Fortiz
- Iberoamerican Cochrane Centre, Department of Clinical Epidemiology and Public Health, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain, and CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - David Rigau
- Iberoamerican Cochrane Centre, Department of Clinical Epidemiology and Public Health, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain, and CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Josefina Salazar
- Iberoamerican Cochrane Centre, Department of Clinical Epidemiology and Public Health, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain, and CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Francisca Verdugo-Paiva
- Iberoamerican Cochrane Centre, Department of Clinical Epidemiology and Public Health, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain, and CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Marek Jutel
- Department of Clinical Immunology, Wrocław Medical University, and ALL-MED Medical Research Institute, Wroclaw, Poland
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Ashma Research (SIAF), University Zurich, Davos, Switzerland
| | - Ioana Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
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Verdugo-Paiva F, Bonfill X, Ortuño D, Glick M, Carrasco-Labra A. Policymakers' perceived barriers and facilitators in the use of research evidence in oral health policies and guidelines: a qualitative study protocol. BMJ Open 2023; 13:e066048. [PMID: 36828656 PMCID: PMC9972458 DOI: 10.1136/bmjopen-2022-066048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 01/05/2023] [Indexed: 02/26/2023] Open
Abstract
INTRODUCTION Evidence-informed oral health policies are crucial to improving patient and population outcomes, but policymakers and organisational leaders infrequently systematically incorporate research evidence. Although there is indirect evidence regarding challenges in other healthcare sectors, the use of evidence-informed oral health policies remains unstudied in oral health. This study aims to assess policymakers' perceived needs, barriers and facilitators in using research evidence to inform policies in oral health. METHODS AND ANALYSIS This is a qualitative study situated within a phenomenological paradigm. We will conduct semistructured interviews with policymakers (5-10) affiliated with key organisations conducting guidance, policy statements, guidelines or any knowledge transfer deliverables in oral health. Organisations will be sampled purposively and with no geographical restrictions. All interviews will be recorded, and an audio transcript will be generated. Subsequently, a researcher will review and validate the transcripts. Data will be analysed using thematic analysis supported by ATLAS.ti software. ETHICS AND DISSEMINATION Ethical approval was not sought because the study protocol met the criteria for exemption from such review according to the Clinical Research Ethics Committee of the Hospital de la Santa Creu i Sant Pau and the Spanish legislation (Law 14/2007 of 3 July, on biomedical research). Informed consent will be obtained from all subjects involved in this study. The findings of this study will be shared with participating organisations for feedback, disseminated in conferences and published in a peer-reviewed journal adopting open science practices. STUDY REGISTRATION Open Science Framework (DOI:10.17605/OSF.IO/W4KG7).
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Affiliation(s)
- Francisca Verdugo-Paiva
- Epistemonikos Foundation, Santiago, Chile
- Iberoamerican Cochrane Centre, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
| | - Xavier Bonfill
- Iberoamerican Cochrane Centre, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- Clinical Epidemiology Service, Hospital de Sant Pau, Barcelona, Spain
| | - Duniel Ortuño
- Facultad de Odontología, Universidad de Los Andes, Santiago, Chile
| | - Michael Glick
- Department of Preventive and Restorative Sciences, Center for Integrative Global Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Alonso Carrasco-Labra
- Department of Preventive and Restorative Sciences, Center for Integrative Global Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Zeraatkar D, Pitre T, Leung G, Cusano E, Agarwal A, Khalid F, Escamilla Z, Cooper MA, Ghadimi M, Wang Y, Verdugo-Paiva F, Rada G, Kum E, Qasim A, Bartoszko JJ, Siemieniuk RAC, Patel C, Guyatt G, Brignardello-Petersen R. Consistency of covid-19 trial preprints with published reports and impact for decision making: retrospective review. BMJ Med 2022; 1:e000309. [PMID: 36936583 PMCID: PMC9951374 DOI: 10.1136/bmjmed-2022-000309] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/30/2022] [Indexed: 12/04/2022]
Abstract
Objective To assess the trustworthiness (ie, complete and consistent reporting of key methods and results between preprint and published trial reports) and impact (ie, effects of preprints on meta-analytic estimates and the certainty of evidence) of preprint trial reports during the covid-19 pandemic. Design Retrospective review. Data sources World Health Organization covid-19 database and the Living Overview of the Evidence (L-OVE) covid-19 platform by the Epistemonikos Foundation (up to 3 August 2021). Main outcome measures Comparison of characteristics of covid-19 trials with and without preprints, estimates of time to publication of covid-19 preprints, and description of differences in reporting of key methods and results between preprints and their later publications. For the effects of eight treatments on mortality and mechanical ventilation, the study comprised meta-analyses including preprints and excluding preprints at one, three, and six months after the first trial addressing the treatment became available either as a preprint or publication (120 meta-analyses in total, 60 of which included preprints and 60 of which excluded preprints) and assessed the certainty of evidence using the GRADE framework. Results Of 356 trials included in the study, 101 were only available as preprints, 181 as journal publications, and 74 as preprints first and subsequently published in journals. The median time to publication of preprints was about six months. Key methods and results showed few important differences between trial preprints and their subsequent published reports. Apart from two (3.3%) of 60 comparisons, point estimates were consistent between meta-analyses including preprints versus those excluding preprints as to whether they indicated benefit, no appreciable effect, or harm. For nine (15%) of 60 comparisons, the rating of the certainty of evidence was different when preprints were included versus being excluded-the certainty of evidence including preprints was higher in four comparisons and lower in five comparisons. Conclusion No compelling evidence indicates that preprints provide results that are inconsistent with published papers. Preprints remain the only source of findings of many trials for several months-an unsuitable length of time in a health emergency that is not conducive to treating patients with timely evidence. The inclusion of preprints could affect the results of meta-analyses and the certainty of evidence. Evidence users should be encouraged to consider data from preprints.
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Affiliation(s)
- Dena Zeraatkar
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | | | | | - Ellen Cusano
- Internal Medicine Residency Program, University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | - Arnav Agarwal
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | | | | | - Matthew Adam Cooper
- Department of Medicine, University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada
| | | | - Ying Wang
- Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Francisca Verdugo-Paiva
- Epistemonikos Foundation, Santiago, Chile
- UC Evidence Centre, Cochrane Chile Associated Centre, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Elena Kum
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Anila Qasim
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | | | | | - Chirag Patel
- Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | | | - Romina Brignardello-Petersen
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Faculty of Dentistry, University of Chile, Santiago, Chile
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Rodríguez-Grande EI, Buitrago-López A, Torres-Narváez MR, Serrano-Villar Y, Verdugo-Paiva F, Ávila C. Therapeutic exercise to improve motor function among children with Down Syndrome aged 0 to 3 years: a systematic literature review and meta‑analysis. Sci Rep 2022; 12:13051. [PMID: 35906275 PMCID: PMC9338268 DOI: 10.1038/s41598-022-16332-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 07/08/2022] [Indexed: 11/09/2022] Open
Abstract
The effects and the prescription parameters of therapeutic exercise are not clear. For this reason, is needed to determine the effect of therapeutic exercises on the motor function of children with Down Syndrome (DS) aged 0 to 3 years. The present study is systematic review and meta-analysis of effectiveness outcomes in this population: gait, balance, motor development, fine motor skills, and executive functions. The databases of PubMed, PEDro, EMBASE, SCIELO, Lilacs, Cochrane library were searched from January to December 2019. We recruited Randomized Controlled Trials (RCTs) which met the inclusion criteria in our study. Six studies and 151 participants were included. Two types of therapeutic exercises, aerobic and neuromuscular, were identified. Both types of exercise were effective in improving outcomes. There were no differences between the modes of application of the exercise. No differences were identified between the treadmill and the physiotherapy plan for the reduction of the time to reach independent walking, Mean Difference (MD) 46.79, 95% Confidence Interval (IC) (− 32.60, 126.19), nor for the increase in walking speed MD 0.10 IC (− 0.02, 0.21) m/s. This study suggests that aerobic exercise therapy has a potentially effective role to promote the gait and motor development of children with DS aged 0 to 3 years when it is applied using a treadmill with a frequency of 5 days, a duration of 6–8 min, and an intensity of between 0.2 and 0.5 m/s. Studies with less heterogeneity and larger sample sizes are required.
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Affiliation(s)
- Eliana-Isabel Rodríguez-Grande
- Master's and PhD programs in Clinical Epidemiology, Pontificia Universidad Javeriana, Bogotá, Colombia. .,School of Medicine and Health Sciences, Universidad del Rosario, GI Rehabilitation Sciences, Carrera 24 N. 63D - 69, PBX 2970200 Ext. 3420, Bogotá, Cundinamarca, Colombia.
| | - Adriana Buitrago-López
- Erasmus University Rotterdam, Rotterdam, The Netherlands.,Universidad Católica de Paraná, Curitiba, Brazil.,Department of Clinical Epidemiology and Biostatistics, School of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Martha-Rocio Torres-Narváez
- School of Medicine and Health Sciences, Universidad del Rosario, GI Rehabilitation Sciences, Physiotherapy Program, Bogotá, Colombia
| | | | - Francisca Verdugo-Paiva
- Centro Evidencia UC, School of Medicine, Pontificia Universidad Católica, Santiago de Chile, Chile.,Fundación Epistemonikos, Santiago de Chile, Chile
| | - Camila Ávila
- Fundación Epistemonikos, Santiago de Chile, Chile
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Salas GA, Lai SA, Verdugo-Paiva F, Requena RA. Platelet-Rich Fibrin in Third Molar Surgery: Systematic Review and Meta-Analysis Protocol. Craniomaxillofac Trauma Reconstr 2022; 15:164-168. [DOI: 10.1177/19433875211016203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: The objective of this systematic review is to assess the effectiveness and safety of platelet-rich fibrin (PRF) in third molar surgery. Data Sources: A comprehensive search strategy is meant to be used in an attempt to identify all relevant randomized controlled trials (RCTs), ongoing investigation reported in specialty congresses and trials regardless of language or publication status (published, unpublished, in press and in progress). Searches will be conducted in the Cochrane Central Register of Controlled Trials (CENTRAL), PUBMED, Embase, Lilacs, the International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov , US National Institutes of Health (NIH), grey literature and in specialized congresses and conferences. Eligibility Criteria: We will include randomized trials evaluating the effect of PRF on wound healing after third molar surgery. Two reviewers will independently screen each study for eligibility, data extraction and risk of bias assessment using Cochrane “risk of bias” tool. We will pool the results using meta-analysis and will apply the GRADE system to assess the certainty of the evidence for each outcome. Ethics and Dissemination: As researchers will not access information that could lead to the identification of an individual participant, obtaining ethical approval was waived.
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Affiliation(s)
- Gaston A. Salas
- Department of Research in Health Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile
- Oral and Maxillofacial Surgery Program, Universidad de los Andes, Santiago, Chile
| | - Shuheng A. Lai
- Department of Research in Health Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisca Verdugo-Paiva
- Fundación Epistemonikos, Santiago, Chile
- UC Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Roberto A. Requena
- Universidad de los Andes, Santiago, Chile
- Hospital Dr. Sótero del Río, Santiago, Chile
- Instituto de Neurocirugía Dr. Asenjo, Santiago, Chile
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Verdugo-Paiva F, Vergara C, Ávila C, Castro J, Cid J, Contreras V, Jara I, Jiménez V, Lee MH, Muñoz M, Rojas-Gómez AM, Rosón-Rodríguez P, Serrano-Arévalo K, Silva-Ruz I, Vásquez-Laval J, Zambrano-Achig P, Zavadzki G, Rada G. COVID-19 L·OVE repository is highly comprehensive and can be used as a single source for COVID-19 studies. J Clin Epidemiol 2022; 149:195-202. [PMID: 35597369 PMCID: PMC9116966 DOI: 10.1016/j.jclinepi.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 04/05/2022] [Accepted: 05/04/2022] [Indexed: 11/15/2022]
Abstract
Background and Objective The coronavirus disease 2019 Living OVerview of Evidence (COVID-19 L·OVE) is a public repository and classification platform for COVID-19 articles. The repository contains more than 430,000 articles as of September 20, 2021 and intends to provide a one-stop shop for COVID-19 evidence. Considering that systematic reviews conduct high-quality searches, this study assesses the comprehensiveness and currency of the repository against the total number of studies in a representative sample of COVID-19 systematic reviews. Methods Our sample was generated from all the studies included in the systematic reviews of COVID-19 published during April 2021. We estimated the comprehensiveness of COVID-19 L·OVE repository by determining how many of the individual studies in the sample were included in the COVID-19 L·OVE repository. We estimated the currency as the percentage of studies that was available in the COVID-19 L·OVE repository at the time the systematic reviews conducted their own search. Results We identified 83 eligible systematic reviews that included 2,132 studies. COVID-19 L·OVE had an overall comprehensiveness of 99.67% (2,125/2,132). The overall currency of the repository, that is, the proportion of articles that would have been obtained if the search of the reviews was conducted in COVID-19 L·OVE instead of searching the original sources, was 96.48% (2,057/2,132). Both the comprehensiveness and the currency were 100% for randomized trials (82/82). Conclusion The COVID-19 L·OVE repository is highly comprehensive and current. Using this repository instead of traditional manual searches in multiple databases can save a great amount of work to people conducting systematic reviews and would improve the comprehensiveness and timeliness of evidence syntheses. This tool is particularly important for supporting living evidence synthesis processes.
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Affiliation(s)
| | - C Vergara
- Epistemonikos Foundation, Santiago, Chile
| | - C Ávila
- Epistemonikos Foundation, Santiago, Chile
| | - J Castro
- Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - J Cid
- School of Dentistry, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - I Jara
- Epistemonikos Foundation, Santiago, Chile
| | - V Jiménez
- Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - M H Lee
- Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - M Muñoz
- Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - A M Rojas-Gómez
- Epistemonikos Foundation, Santiago, Chile; Unidad de investigación en medicina estomatológica preventiva y social (UIMEPS), Universidad del Magdalena, Santa Marta, Colombia
| | | | | | - I Silva-Ruz
- School of Dentistry, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | | | - G Zavadzki
- School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - G Rada
- Epistemonikos Foundation, Santiago, Chile; UC Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile, Santiago, Chile; Internal Medicine Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
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10
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Schulze-Schiappacasse C, Durán J, Bravo-Jeria R, Verdugo-Paiva F, Morel M, Rada G. Are Cannabis, Cannabis-Derived Products, and Synthetic Cannabinoids a Therapeutic Tool for Rheumatoid Arthritis? A Friendly Summary of the Body of Evidence. J Clin Rheumatol 2022; 28:e563-e567. [PMID: 33859125 PMCID: PMC8860218 DOI: 10.1097/rhu.0000000000001745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Symptom management in rheumatoid arthritis (RA) remains a complex challenge. Widespread use of cannabis-based medicines for a myriad of symptoms has fostered rheumatology patients' interest. However, their safety and efficacy in RA remain unclear. OBJECTIVE The aim of this study was to perform a structured summary of the body of evidence in order to determine whether cannabis, cannabis-derived products, and synthetic cannabinoids are an effective treatment for rheumatoid arthritis. METHODS An electronic search in Epistemonikos database was performed to identify systematic reviews and their primary studies that addressed our clinical question. The body of evidence was collected in a pivot table in Epistemonikos. Information and data from the primary studies were extracted from the identified reviews. Finally, extracted data were reanalyzed, and a summary of findings table was generated using the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS Twenty-six systematic reviews were identified which included in total only 1 randomized trial assessing our clinical question. CONCLUSIONS Cannabis, cannabis-derived products and synthetic cannabinoids may slightly reduce disease activity in patients with RA. Its use may result in little to no difference in pain reduction and may slightly increase nervous system adverse events. The evidence is very uncertain about the effect of cannabis, cannabis-derived products, and synthetic cannabinoids on serious adverse events risk.
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Affiliation(s)
| | - Josefina Durán
- Internal Medicine Department
- Clinical Immunology and Rheumatology Department, Faculty of Medicine
| | - Rocío Bravo-Jeria
- UC Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile
| | - Francisca Verdugo-Paiva
- UC Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile
- Epistemonikos Foundation, Santiago, Chile
| | - Macarena Morel
- UC Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile
| | - Gabriel Rada
- Internal Medicine Department
- UC Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile
- Epistemonikos Foundation, Santiago, Chile
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11
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Zambrano-Achig P, Viteri-García A, Verdugo-Paiva F. Chemo-mechanical removal versus conventional removal for deep caries lesion. Medwave 2022; 22:e8320. [PMID: 35100249 DOI: 10.5867/medwave.2022.01.8320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 01/15/2021] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Dental caries have been traditionally managed with the non-selective removal of carious tissue (total removal). However, the adverse effects and fear that this technique produces in patients has promoted the use of more conservative caries removal techniques such as chemo-mechanical removal, but there is still controversy regarding its effectiveness and safety. METHODS We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings tables using the GRADE approach. RESULTS AND CONCLUSIONS We identified seven systematic reviews including 34 studies overall, of which 30 correspond to randomized trials. We concluded that chemo-mechanical caries removal probably reduces the need for anesthesia. Additionally, chemo-mechanical caries removal may decrease the pain experienced by the patient, decrease the risk of restoration failure and increase the time of the procedure for the removal of deep caries, but the certainty of the evidence is low. We are uncertain whether chemo-mechanical caries removal reduces the risk of pulp exposure as the certainty of the evidence has been assessed as very low.
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Affiliation(s)
- Paula Zambrano-Achig
- Universidad UTE, Centro Asociado Cochrane de Ecuador, Centro de Investigación de Salud Pública y Epidemiología Clínica (CISPEC), Quito, Ecuador; Proyecto Epistemonikos, Santiago, Chile
| | - Andrés Viteri-García
- Universidad UTE, Centro Asociado Cochrane de Ecuador, Centro de Investigación de Salud Pública y Epidemiología Clínica (CISPEC), Quito, Ecuador; Proyecto Epistemonikos, Santiago, Chile
| | - Francisca Verdugo-Paiva
- Proyecto Epistemonikos, Santiago, Chile; Centro Evidencia UC, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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12
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Massón M, Viteri-García A, Verdugo-Paiva F. Stepwise removal compared to complete removal for deep carious lesions. Medwave 2022; 22:e8227. [PMID: 35100250 DOI: 10.5867/medwave.2022.01.8226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 08/17/2020] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Carious lesions have traditionally been treated by non-selective (complete or total) removal of carious tissue. However, due to its risks and adverse effects, carious tissue removal techniques have been developed, based on the preservation of tooth tissue, including the stepwise removal. The objective of this summary is to clarify the uncertainty about the effectiveness and safety of the stepwise removal technique compared to complete removal. METHODS To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by searching multiple sources of information, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from identified reviews, reanalyzed data from primary studies, performed a meta-analysis, and prepared summary tables of results using the GRADE method. RESULTS AND CONCLUSIONS We identified three systematic reviews that included five primary studies, four of them corresponding to randomized trials. We concluded that stepwise removal may reduce the risk of pulp exposure, the risk of signs and symptoms of pulp disease and the risk of restoration failure, but the certainty of the evidence is low.
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Affiliation(s)
- María Massón
- Universidad UTE, Facultad de Ciencias de la Salud Eugenio Espejo, Centro de Investigación de Salud Pública y Epidemiología Clínica (CISPEC); Proyecto Epistemonikos
| | - Andrés Viteri-García
- Universidad UTE, Facultad de Ciencias de la Salud Eugenio Espejo, Centro de Investigación de Salud Pública y Epidemiología Clínica (CISPEC); Proyecto Epistemonikos
| | - Francisca Verdugo-Paiva
- Proyecto Epistemonikos; Centro Evidencia UC, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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13
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Yaacoub S, Khabsa J, El-Khoury R, El-Harakeh A, Lotfi T, Saad Z, Itani Z, Khamis AM, El Mikati I, Cuello-Garcia CA, Verdugo-Paiva F, Rada G, Schünemann HJ, Rizk N, Akl EA. COVID-19 transmission during swimming-related activities: a rapid systematic review. BMC Infect Dis 2021; 21:1112. [PMID: 34711198 PMCID: PMC8553516 DOI: 10.1186/s12879-021-06802-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 09/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There are uncertainties about mitigating strategies for swimming-related activities in the context of the COVID-19 pandemic. There is an opportunity to learn from the experience of previous re-openings to better plan the future one. Our objectives are to systematically review the evidence on (1) the association between engaging in swimming-related activities and COVID-19 transmission; and (2) the effects of strategies for preventing COVID-19 transmission during swimming-related activities. METHODS We conducted a rapid systematic review. We searched in the L·OVE (Living OVerview of Evidence) platform for COVID-19. The searches covered the period from the inception date of each database until April 19, 2021. We included non-randomized studies for the review on association of COVID-19 transmission and swimming-related activities. We included guidance documents reporting on the strategies for prevention of COVID-19 transmission during swimming-related activities. We also included studies on the efficacy and safety of the strategies. Teams of two reviewers independently assessed article eligibility. For the guidance documents, a single reviewer assessed the eligibility and a second reviewer verified the judgement. Teams of two reviewers extracted data independently. We summarized the findings of included studies narratively. We synthesized information from guidance documents according to the identified topics and subtopics, and presented them in tabular and narrative formats. RESULTS We identified three studies providing very low certainty evidence for the association between engaging in swimming-related activities and COVID-19 transmission. The analysis of 50 eligible guidance documents identified 11 topics: ensuring social distancing, ensuring personal hygiene, using personal protective equipment, eating and drinking, maintaining the pool, managing frequently touched surfaces, ventilation of indoor spaces, screening and management of sickness, delivering first aid, raising awareness, and vaccination. One study assessing the efficacy of strategies to prevent COVID-19 transmission did not find an association between compliance with precautionary restrictions and COVID-19 transmission. CONCLUSIONS There are major gaps in the research evidence of relevance to swimming-related activities in the context of the COVID-19 pandemic. However, the synthesis of the identified strategies from guidance documents can inform public health management strategies for swimming-related activities, particularly in future re-opening plans.
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Affiliation(s)
- Sally Yaacoub
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Joanne Khabsa
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rayane El-Khoury
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Amena El-Harakeh
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Tamara Lotfi
- Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada.,WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations; Michael G DeGroote Cochrane Canada Centre; GRADE Canada Centre, Hamilton, Canada
| | - Zahra Saad
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Zeina Itani
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Assem M Khamis
- Hull York Medical School, University of Hull, Hull, England
| | | | | | - Francisca Verdugo-Paiva
- Epistemonikos Foundation, Santiago, Chile.,UC Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Gabriel Rada
- Epistemonikos Foundation, Santiago, Chile.,UC Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Holger J Schünemann
- Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada.,WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations; Michael G DeGroote Cochrane Canada Centre; GRADE Canada Centre, Hamilton, Canada
| | - Nesrine Rizk
- Department of Internal Medicine, American University of Beirut, 11-0236 / CRI (E15), Beirut, 1107 2020, Lebanon
| | - Elie A Akl
- Department of Internal Medicine, American University of Beirut, 11-0236 / CRI (E15), Beirut, 1107 2020, Lebanon.
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14
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Antequera A, Lawson DO, Noorduyn SG, Dewidar O, Avey M, Bhutta ZA, Chamberlain C, Ellingwood H, Francis D, Funnell S, Ghogomu E, Greer-Smith R, Horsley T, Juando-Prats C, Jull J, Kristjansson E, Little J, Nicholls SG, Nkangu M, Petticrew M, Rada G, Rizvi A, Shamseer L, Sharp MK, Tufte J, Tugwell P, Verdugo-Paiva F, Wang H, Wang X, Mbuagbaw L, Welch V. Improving Social Justice in COVID-19 Health Research: Interim Guidelines for Reporting Health Equity in Observational Studies. Int J Environ Res Public Health 2021; 18:9357. [PMID: 34501949 PMCID: PMC8431098 DOI: 10.3390/ijerph18179357] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/26/2021] [Accepted: 09/01/2021] [Indexed: 01/12/2023]
Abstract
The COVID-19 pandemic has highlighted the global imperative to address health inequities. Observational studies are a valuable source of evidence for real-world effects and impacts of implementing COVID-19 policies on the redistribution of inequities. We assembled a diverse global multi-disciplinary team to develop interim guidance for improving transparency in reporting health equity in COVID-19 observational studies. We identified 14 areas in the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist that need additional detail to encourage transparent reporting of health equity. We searched for examples of COVID-19 observational studies that analysed and reported health equity analysis across one or more social determinants of health. We engaged with Indigenous stakeholders and others groups experiencing health inequities to co-produce this guidance and to bring an intersectional lens. Taking health equity and social determinants of health into account contributes to the clinical and epidemiological understanding of the disease, identifying specific needs and supporting decision-making processes. Stakeholders are encouraged to consider using this guidance on observational research to help provide evidence to close the inequitable gaps in health outcomes.
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Affiliation(s)
- Alba Antequera
- Biomedical Research Institute Sant Pau, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain
| | - Daeria O. Lawson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada; (D.O.L.); (S.G.N.); (L.M.)
| | - Stephen G. Noorduyn
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada; (D.O.L.); (S.G.N.); (L.M.)
| | - Omar Dewidar
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada; (O.D.); (T.H.); (J.L.); (M.N.); (P.T.); (V.W.)
| | - Marc Avey
- Public Health Agency of Canada, Ottawa, ON K1A 0K9, Canada;
| | - Zulfiqar A. Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada;
- Institute for Global Health & Development, The Aga Khan University, Karachi 74800, Pakistan
| | - Catherine Chamberlain
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC 3086, Australia;
- Ngangk Yira Research Centre for Aboriginal Health and Social Equity, Murdoch University, Perth, WA 6150, Australia
| | - Holly Ellingwood
- Department of Psychology, Faculty of Arts and Social Sciences, Carleton University, Ottawa, ON K1S 5B6, Canada;
- Public Safety, Ottawa, ON K1A 0P8, Canada
| | - Damian Francis
- Center for Health and Social Issues, School of Health and Human Performance, Georgia College, Milledgville, GA 31061, USA;
| | - Sarah Funnell
- Department of Family Medicine, Queen’s University, Kingston, ON K7L 3G2, Canada;
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - Elizabeth Ghogomu
- Bruyère Research Institute, University of Ottawa, Ottawa, ON K1N 5C8, Canada;
| | - Regina Greer-Smith
- Healthcare Research Associates, LLC/The S.T.A.R. Initiative, Los Angeles, CA 90033, USA;
| | - Tanya Horsley
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada; (O.D.); (T.H.); (J.L.); (M.N.); (P.T.); (V.W.)
- Research Unit, Royal College of Physicians and Surgeons of Canada, Ottawa, ON K1S 5N8, Canada
| | - Clara Juando-Prats
- Applied Health Research Center, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada;
- Dalla School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| | - Janet Jull
- Faculty of Health Sciences, School of Rehabilitation Therapy, Queen’s University, Kingston, ON K7L 3N6, Canada; (J.J.); (A.R.)
| | - Elizabeth Kristjansson
- Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Julian Little
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada; (O.D.); (T.H.); (J.L.); (M.N.); (P.T.); (V.W.)
| | - Stuart G. Nicholls
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada;
| | - Miriam Nkangu
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada; (O.D.); (T.H.); (J.L.); (M.N.); (P.T.); (V.W.)
| | - Mark Petticrew
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK;
| | - Gabriel Rada
- Epistemonikos Foundation, Santiago 7510299, Chile; (G.R.); (F.V.-P.)
- UC Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile, Santiago Región Metropolitana, Santiago 8331150, Chile
| | - Anita Rizvi
- Faculty of Health Sciences, School of Rehabilitation Therapy, Queen’s University, Kingston, ON K7L 3N6, Canada; (J.J.); (A.R.)
| | - Larissa Shamseer
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON M5B 1T8, Canada;
| | - Melissa K. Sharp
- Health Research Board Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin DO2 H638, Ireland;
| | | | - Peter Tugwell
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada; (O.D.); (T.H.); (J.L.); (M.N.); (P.T.); (V.W.)
- Bruyère Research Institute, University of Ottawa, Ottawa, ON K1N 5C8, Canada;
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada;
| | - Francisca Verdugo-Paiva
- Epistemonikos Foundation, Santiago 7510299, Chile; (G.R.); (F.V.-P.)
- UC Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile, Santiago Región Metropolitana, Santiago 8331150, Chile
| | - Harry Wang
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada;
| | - Xiaoqin Wang
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, ON L8S 4L8, Canada;
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada; (D.O.L.); (S.G.N.); (L.M.)
| | - Vivian Welch
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada; (O.D.); (T.H.); (J.L.); (M.N.); (P.T.); (V.W.)
- Bruyère Research Institute, University of Ottawa, Ottawa, ON K1N 5C8, Canada;
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15
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Arce Pardo S, Lai S, Ortiz-Muñoz L, Bravo-Jeria R, Verdugo-Paiva F, Rada G. Pulmonary rehabilitation for COVID-19: A living systematic review protocol. Medwave 2021; 21:e8224. [PMID: 34292923 DOI: 10.5867/medwave.2021.06.8223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/11/2021] [Indexed: 11/27/2022] Open
Abstract
Objective This living systematic review aims to provide a timely, rigorous and continuously updated summary of the evidence available on the role of pulmonary rehabilitation in the treatment of patients with COVID-19. Design This is the protocol of a living systematic review. Data sources We will conduct searches in the L·OVE (Living OVerview of Evidence) platform for COVID-19, a system that maps PICO questions to a repository maintained through regular searches in electronic databases, preprint servers, trial registries and other resources relevant to COVID-19. No date or language restrictions will be applied. Eligibility criteria for selecting studies and methods We adapted an already published common protocol for multiple parallel systematic reviews to the specificities of this question. We will include randomized trials evaluating the effect of pulmonary rehabilitation as monotherapy or in combination with other interventions-versus sham or no treatment in patients with COVID-19. Two reviewers will independently screen each study for eligibility, extract data, and assess the risk of bias. We will pool the results using meta-analysis and will apply the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to assess the certainty of the evidence for each outcome. Ethics and dissemination No ethics approval is considered necessary. The results of this review will be widely disseminated via peer-reviewed publications, social networks and traditional media.
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Affiliation(s)
- Stefanie Arce Pardo
- Dr. Exequiel González Cortés Hospital, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. ORCID: 0000-0002-1069-2894
| | - Shuheng Lai
- Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. ORCID: 0000-0002-5419-1303
| | - Luis Ortiz-Muñoz
- UC Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile, Santiago, Chile; Chilean satellite of The Cochrane Effective Practice and Organisation of Care (EPOC), Santiago, Chile. Address: Diagonal Paraguay 476, Santiago, Chile. . ORCID: 0000-0001-6449-2153
| | - Rocío Bravo-Jeria
- Departamento de Evaluación de Tecnologías Sanitarias y Salud Basada en Evidencia, División de Planificación Sanitaria, Ministerio de Salud, Santiago, Chile. ORCID: 0000-0002-3744-5578
| | - Francisca Verdugo-Paiva
- Epistemonikos Foundation, Santiago, Chile UC Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile, Santiago, Chile. ORCID: 0000-0003-0199-9744
| | - Gabriel Rada
- Epistemonikos Foundation, Santiago, Chile; UC Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile, Santiago, Chile; Internal Medicine Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. ORCID: 0000-0003-2435-0710
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16
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Abstract
This cross-sectional study maps a coronavirus research question to illustrate the overlap and shortcomings of the evidence syntheses in this area.
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Affiliation(s)
| | | | | | - Iván D. Flórez
- Department of Pediatrics, University of Antioquia, Medellin, Colombia
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17
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Wallach M, Cuéllar J, Verdugo-Paiva F, Alarcón A. Long-term antibiotic prophylaxis regimen compared to short-term antibiotic prophylaxis regimen in patients undergoing orthognathic surgery. Medwave 2020; 20:e8072. [PMID: 33382392 DOI: 10.5867/medwave.2020.11.8071] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 08/03/2020] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Orthognathic surgery, being an invasive surgical procedure, may present significant postoperative morbidities for the patient. Among the most frequently described complications is surgical site infection. The administration of prophylactic antibiotics prior to this type of procedure is a common practice, however, the cost-benefit of the use of antibiotics, the type of antibiotics, the route of administration, the dosage, and the regimen to be used have not been clearly defined and are still considered a controversial issue. In this summary of evidence, we will compare long-term antibiotic prophylaxis with short-term prophylaxis. METHODS We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS We identified five systematic reviews including nine studies overall, of which all nine were randomized trials. We conclude that administering a long-term prophylactic antibiotic regimen probably decreases the risk of surgical site infection and that it may increase the risk of hospital stay longer than two days, nevertheless, regarding this last point, the certainty of the evidence is low.
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Affiliation(s)
- Matthias Wallach
- Servicio Maxilofacial, Hospital Clínico San Borja Arriarán, Santiago, Chile. . Address: Centro Evidencia UC, Pontificia Universidad Católica de Chile, Diagonal Paraguay 476, Santiago, Chile
| | - Javier Cuéllar
- Servicio Maxilofacial, Hospital Clínico San Borja Arriarán, Santiago, Chile
| | - Francisca Verdugo-Paiva
- Proyecto Epistemonikos, Santiago, Chile; Centro Evidencia UC, Facultad de Medicina, Pontificia Universidad Católica de Chile
| | - Ana Alarcón
- Servicio Maxilofacial, Hospital Clínico San Borja Arriarán, Santiago, Chile; Departamento de Cirugía y Traumatología Bucal y Maxilofacial, Facultad de Odontología, Universidad de Chile
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Verdugo-Paiva F, Acuña MP, Solá I, Rada G. Remdesivir for the treatment of COVID-19: a living systematic review. Medwave 2020; 20:e8080. [PMID: 33361753 DOI: 10.5867/medwave.2020.11.8080] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/17/2020] [Indexed: 11/27/2022] Open
Abstract
Objective Provide a timely, rigorous and continuously updated summary of the evidence on the role of remdesivir in the treatment of patients with COVID-19. Methods Eligible studies were randomized trials evaluating the effect of remdesivir versus placebo or no treatment. We conducted searches in the special L·OVE (Living OVerview of Evidence) platform for COVID-19, a system that performs regular searches in databases, trial registries, preprint servers and websites relevant to COVID-19. All the searches covered the period until 25 August 2020. No date or language restrictions were applied. Two reviewers independently evaluated potentially eligible studies according to predefined selection criteria, and extracted data on study characteristics, methods, outcomes, and risk of bias, using a predesigned, standardized form. We performed meta-analyses using random-effect models and assessed overall certainty in evidence using the GRADE approach. A living, web-based version of this review will be openly available during the COVID-19 pandemic. Results Our search strategy yielded 574 references. Finally, we included three randomized trials evaluating remdesivir in addition to standard care versus standard care alone. The evidence is very uncertain about the effect of remdesivir on mortality (RR 0.7, 95% CI 0.46 to 1.05; very low certainty evidence) and the need for invasive mechanical ventilation (RR 0.69, 95% CI 0.39 to 1.24; very low certainty evidence). On the other hand, remdesivir likely results in a large increase in the incidence of adverse effects in patients with COVID-19 (RR 1.29, 95% CI 0.58 to 2.84; moderate certainty evidence). Conclusions The evidence is insufficient for the outcomes critical for making decisions on the role of remdesivir in the treatment of patients with COVID-19, so it is impossible to balance potential benefits, if there are any, with the adverse effects and costs. PROSPERO registration number CRD42020183384.
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Affiliation(s)
- Francisca Verdugo-Paiva
- Epistemonikos Foundation, Santiago, Chile; UC Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile, Santiago, Chile. Dirección: Holanda 895, Providencia, Santiago, Chile. . ORCID: 0000-0003-0199-9744
| | - María Paz Acuña
- Unidad de Infectología, Hospital Dr Sótero del Río, Santiago, Chile; Unidad de Infectología, Hospital Clínico Dra Eloísa Díaz, La Florida, Santiago, Chile. ORCID: 0000-0001-7003-495X
| | - Iván Solá
- Biomedical Research Institute Sant Pau, Barcelona, Spain; Iberoamerican Cochrane Centre, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP). ORCID: 0000-0003-0078-3706
| | - Gabriel Rada
- Epistemonikos Foundation, Santiago, Chile; UC Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile, Santiago, Chile; Internal Medicine Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. ORCID: 0000-0003-2435-0710
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Rada G, Pérez D, Araya-Quintanilla F, Ávila C, Bravo-Soto G, Bravo-Jeria R, Cánepa A, Capurro D, Castro-Gutiérrez V, Contreras V, Edwards J, Faúndez J, Garrido D, Jiménez M, Llovet V, Lobos D, Madrid F, Morel-Marambio M, Mendoza A, Neumann I, Ortiz-Muñoz L, Peña J, Pérez M, Pesce F, Rain C, Rivera S, Sepúlveda J, Soto M, Valverde F, Vásquez J, Verdugo-Paiva F, Vergara C, Zavala C, Zilleruelo-Ramos R. Epistemonikos: a comprehensive database of systematic reviews for health decision-making. BMC Med Res Methodol 2020; 20:286. [PMID: 33256642 PMCID: PMC7708132 DOI: 10.1186/s12874-020-01157-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 11/09/2020] [Indexed: 12/20/2022] Open
Abstract
Background Systematic reviews allow health decisions to be informed by the best available research evidence. However, their number is proliferating quickly, and many skills are required to identify all the relevant reviews for a specific question. Methods and findings We screen 10 bibliographic databases on a daily or weekly basis, to identify systematic reviews relevant for health decision-making. Using a machine-based approach developed for this project we select reviews, which are then validated by a network of more than 1000 collaborators. After screening over 1,400,000 records we have identified more than 300,000 systematic reviews, which are now stored in a single place and accessible through an easy-to-use search engine. This makes Epistemonikos the largest database of its kind. Conclusions Using a systematic approach, recruiting a broad network of collaborators and implementing automated methods, we developed a one-stop shop for systematic reviews relevant for health decision making. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-020-01157-x.
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Affiliation(s)
- Gabriel Rada
- Centro Evidencia UC, Pontificia Universidad Católica de Chile, Santiago, Chile. .,Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile.
| | - Daniel Pérez
- Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile
| | - Felipe Araya-Quintanilla
- Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile.,Rehabilitation in Health Research Center (CIRES), Universidad de las Américas, Santiago, Chile.,Faculty of Health Sciences, Universidad SEK, Santiago, Chile
| | - Camila Ávila
- Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile
| | - Gonzalo Bravo-Soto
- Centro Evidencia UC, Pontificia Universidad Católica de Chile, Santiago, Chile.,Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile
| | - Rocío Bravo-Jeria
- Centro Evidencia UC, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Aldo Cánepa
- Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile
| | - Daniel Capurro
- Centro Evidencia UC, Pontificia Universidad Católica de Chile, Santiago, Chile.,Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile.,School of Computing and Information Systems, University of Melbourne, Melbourne, Australia
| | | | - Valeria Contreras
- Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile
| | - Javiera Edwards
- Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile
| | - Jorge Faúndez
- Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile
| | - Damián Garrido
- Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile
| | - Magdalena Jiménez
- Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile
| | - Valentina Llovet
- Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile
| | - Diego Lobos
- Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile
| | - Francisco Madrid
- Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile
| | | | - Antonia Mendoza
- Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile
| | - Ignacio Neumann
- Centro Evidencia UC, Pontificia Universidad Católica de Chile, Santiago, Chile.,Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile.,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
| | - Luis Ortiz-Muñoz
- Centro Evidencia UC, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - José Peña
- Centro Evidencia UC, Pontificia Universidad Católica de Chile, Santiago, Chile.,Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile
| | - Marcelo Pérez
- Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile
| | | | - Carmen Rain
- Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile
| | - Solange Rivera
- Centro Evidencia UC, Pontificia Universidad Católica de Chile, Santiago, Chile.,Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile
| | - Javiera Sepúlveda
- Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile
| | - Mauricio Soto
- Centro Evidencia UC, Pontificia Universidad Católica de Chile, Santiago, Chile.,Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile
| | - Felipe Valverde
- Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile
| | - Juan Vásquez
- Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile
| | - Francisca Verdugo-Paiva
- Centro Evidencia UC, Pontificia Universidad Católica de Chile, Santiago, Chile.,Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile
| | - Camilo Vergara
- Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile
| | - Cynthia Zavala
- Centro Evidencia UC, Pontificia Universidad Católica de Chile, Santiago, Chile.,Epistemonikos Foundation, Avenida Holanda 895, Providencia, Santiago, Chile
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Pablo Vargas J, Uribe M, Ortuño D, Verdugo-Paiva F. Silver diamine fluoride compared to atraumatic restorative technique for the treatment of caries in primary and mixed first phase dentition Juan Pablo Vargas, Macarena Uribe. Medwave 2020; 20:e8003. [DOI: 10.5867/medwave.2020.07.8002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 06/02/2020] [Indexed: 11/27/2022] Open
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Santillán-García A, Bravo-Jeria R, Verdugo-Paiva F, Rada G. Evidencia viva como respuesta a las controversias en el uso de antimaláricos en COVID-19. Rev Esp Cardiol (Engl Ed) 2020; 73:693-694. [PMID: 32395001 PMCID: PMC7211742 DOI: 10.1016/j.recesp.2020.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Santillán-García A, Bravo-Jeria R, Verdugo-Paiva F, Rada G. Living evidence in response to controversies about the use of antimalarials in COVID-19. Revista Española de Cardiología (English Edition) 2020; 73:693-694. [PMID: 32536565 PMCID: PMC7256600 DOI: 10.1016/j.rec.2020.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 05/07/2020] [Indexed: 11/12/2022]
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Verdugo-Paiva F, Izcovich A, Ragusa M, Rada G. Lopinavir-ritonavir for COVID-19: A living systematic review. Medwave 2020; 20:e7967. [PMID: 32678815 DOI: 10.5867/medwave.2020.06.7966] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 06/25/2020] [Indexed: 01/08/2023] Open
Abstract
Objective Provide a timely, rigorous, and continuously updated summary of the evidence on the role of lopinavir/ritonavir in the treatment of patients with COVID-19. Methods We conducted searches in the special L·OVE (Living OVerview of Evidence) platform for COVID-19, a system that performs regular searches in PubMed, Embase, CENTRAL, and other 33 sources. We searched for randomized trials and non-randomized studies evaluating the effect of lopinavir/ritonavir versus placebo or no treatment in patients with COVID-19. Two reviewers independently evaluated potentially eligible studies, according to predefined selection criteria, and extracted data using a predesigned standardized form. We performed meta-analyses using random-effect models and assessed overall certainty in evidence using the GRADE approach. A living, web-based version of this review will be openly available during the COVID-19 pandemic. Results Our search strategy yielded 862 references. Finally, we identified 12 studies, including two randomized trials, evaluating lopinavir/ritonavir, in addition to standard care versus standard care alone in 250 adult inpatients with COVID-19. The evidence from randomized trials shows lopinavir/ritonavir may reduce mortality (relative risk: 0.77; 95% confidence interval: 0.45 to 1.3; low certainty evidence), but the anticipated magnitude of the absolute reduction in mortality, varies across different risk groups. Lopinavir/ritonavir also had a slight reduction in the risk of requiring invasive mechanical ventilation, developing respiratory failure, or acute respiratory distress syndrome. However, it did not lead to any difference in the duration of hospitalization and may lead to an increase in the number of total adverse effects. The overall certainty of the evidence was low or very low. Conclusions For severe and critical patients with COVID-19, lopinavir/ritonavir might play a role in improving outcomes, but the available evidence is still limited. A substantial number of ongoing studies should provide valuable evidence to inform researchers and decision-makers soon.
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Affiliation(s)
- Francisca Verdugo-Paiva
- Epistemonikos Foundation, Santiago, Chile; UC Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile, Santiago, Chile. Adress: Holanda 895 Providencia, Santiago, Chile. . ORCID: 0000-0003-0199-9744
| | - Ariel Izcovich
- Internal Medicine Service, German Hospital, Buenos Aires, Argentina. ORCID: 0000-0001-9053-4396
| | - Martín Ragusa
- Internal Medicine Service, German Hospital, Buenos Aires, Argentina; Internal Medicine Service, Fernandez Hospital, Buenos Aires, Argentina. ORCID: 0000-0002-3182-8041
| | - Gabriel Rada
- Epistemonikos Foundation, Santiago, Chile; UC Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile, Santiago, Chile; Internal Medicine Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. ORCID: 0000-0003-2435-0710
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Vargas-Buratovic JP, Verdugo-Paiva F, Véliz-Paiva C, López-Tagle E, Ahumada-Salinas A, Ortuño-Borroto D. [Dental recommendations in the COVID-19 pandemic: A narrative review]. Medwave 2020; 20:e7916. [PMID: 32678809 DOI: 10.5867/medwave.2020.05.7916] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 05/08/2020] [Indexed: 12/12/2022] Open
Abstract
Introduction COVID-19 is a world public health problem due to its morbidity and mortality, especially in at-risk groups. The dental environment has a high risk of viral transmission; accordingly, this study aimed to identify recommendations based on the best available evidence for dental care during this pandemic. Methods We performed a search for scientific evidence published since 2002 to March 23th 2020 in electronic databases (MEDLINE/PubMed, EMBASE, Cochrane, and Epistemonikos) and the web pages of the American Dental Association, Centers for Disease Control and Prevention Oral Health, the Ministry of Health in Chile and scientific societies. Results We included nine published studies. The recommendations were the following: unrestricted use of personal protection elements, use of extraoral radiographic techniques, use of mouth rinses with 1% hydrogen peroxide or 0.2% iodine povidone, a four-hand technique with ongoing aspiration and the use of absorbable sutures. Furthermore, there is a consensus that non-urgent treatments should be postponed during periods of community transmission. Conclusions Dental practitioners are exposed to a high risk of cross-infection, meaning they must implement recommendations based on the best available evidence to preserve the health of team members and the population they are caring for.
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Affiliation(s)
- Juan Pablo Vargas-Buratovic
- Escuela de Odontología, Pontificia Universidad Católica de Chile, Santiago, Chile. ORCID: 0000-0003-2486-624X
| | - Francisca Verdugo-Paiva
- Fundación Epistemonikos, Santiago, Chile. Centro Evidencia Universidad Católica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. ORCID: 0000-0003-0199-9744
| | - Claudia Véliz-Paiva
- Escuela de Odontología, Pontificia Universidad Católica de Chile, Santiago, Chile. ORCID: 0000-0002-9448-8224
| | - Elizabeth López-Tagle
- Facultad de Odontología, Universidad Andres Bello, Santiago, Chile. ORCID: 0000-0002-7185-9256
| | - Alexis Ahumada-Salinas
- Dirección de Salud, Municipalidad de Recoleta, Santiago, Chile. ORCID: 0000-0002-4810-3477
| | - Duniel Ortuño-Borroto
- Escuela de Odontología, Pontificia Universidad Católica de Chile, Santiago, Chile. . ORCID: 0000-0001-5425-5779
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Rada G, Verdugo-Paiva F, Ávila C, Morel-Marambio M, Bravo-Jeria R, Pesce F, Madrid E, Izcovich A. Evidence synthesis relevant to COVID-19: a protocol for multiple systematic reviews and overviews of systematic reviews. Medwave 2020; 20:e7868. [PMID: 32255438 DOI: 10.5867/medwave.2020.03.7867] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 03/30/2020] [Indexed: 11/27/2022] Open
Abstract
Introduction The evidence on COVID-19 is being produced at high speed, so it is challenging for decision-makers to keep up. It seems appropriate, then, to put into practice a novel approach able to provide the scientific community and other interested parties with quality evidence that is actionable, and rapidly and efficiently produced. Methods and analysis We designed a protocol for multiple parallel systematic reviews and overviews of systematic reviews in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). We will search for primary studies and systematic reviews that answer different questions related to COVID-19 using both a centralized repository (Epistemonikos database) and a manual search in MEDLINE/PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials. We will also search for literature in several other sources. At least two researchers will independently undertake the selection of studies, data extraction, and assessment of the quality of the included studies. We will synthesize data for each question using meta-analysis, when possible, and we will prepare Summary of Findings tables according to the GRADE approach. All the evidence will be organized in an open platform (L·OVE - Living OVerview of Evidence) that will be continuously updated using artificial intelligence and a broad network of experts. Ethics and dissemination No ethics approval is considered necessary. The results of these articles will be widely disseminated via peer-reviewed publications, social networks, and traditional media, and will be sent to relevant international organizations discussing this topic.
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Affiliation(s)
- Gabriel Rada
- Epistemonikos Foundation, Santiago, Chile. Centro Evidencia UC, Cochrane Chile partner center, Pontificia Universidad Católica de Chile, Santiago, Chile. Internal Medicine Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. . ORCID: 0000-0003-2435-0710
| | - Francisca Verdugo-Paiva
- Epistemonikos Foundation, Santiago, Chile. Centro Evidencia UC, Cochrane Chile partner center, Pontificia Universidad Católica de Chile, Santiago, Chile. ORCID: 0000-0003-0199-9744
| | - Camila Ávila
- Epistemonikos Foundation, Santiago, Chile. ORCID: 0000-0001-5348-6284
| | - Macarena Morel-Marambio
- Centro Evidencia UC, Cochrane Chile partner center, Pontificia Universidad Católica de Chile, Santiago, Chile. ORCID: 0000-0003-3410-3131
| | - Rocío Bravo-Jeria
- Centro Evidencia UC, Cochrane Chile partner center, Pontificia Universidad Católica de Chile, Santiago, Chile. ORCID: 0000-0002-3744-5578
| | - Franco Pesce
- Living Knowledge, Santiago, Chile. ORCID: 0000-0002-9209-4109
| | - Eva Madrid
- Centro Interdisciplinario de Estudios en Salud (CIESAL), Escuela de Medicina, Universidad de Valparaíso, Viña del Mar, Chile. Cochrane Chile partner center, Universidad de Valparaíso, Valparaíso, Chile. ORCID: 0000-0002-8095-5549
| | - Ariel Izcovich
- Servicio de Medicina Interna, Hospital Alemán, Buenos Aires, Argentina. ORCID: 0000-0001-9053-4396
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Verdugo-Paiva F, Zambrano-Achig P, Simancas-Racines D, Viteri-García A. Selective removal compared to complete removal for deep carious lesions. Medwave 2020; 20:e7758. [PMID: 31999678 DOI: 10.5867/medwave.2020.01.7758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 11/28/2019] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Dental caries have been conventionally managed by non-selective removal of carious tissue (total complete removal); however, the adverse effects of this procedure have promoted the use of conservative caries removal techniques (selective removal), but there is still controversy regarding its effectiveness. METHODS We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS We identified seven systematic reviews including seven studies overall, of which all were randomized trials. We concluded that selective caries removal may decrease the need for root canal treatment and the risk of pulp exposure in teeth with deep caries, but the certainty of the evidence is low. It is not clear whether the selective removal of caries reduces the risk of appearance of signs and symptoms of pulp disease and the risk of restorations failure, as the certainty of the evidence is very low.
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Affiliation(s)
- Francisca Verdugo-Paiva
- Centro Evidencia UC, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile. ORCID: 0000-0003-0199-9744
| | - Paula Zambrano-Achig
- Universidad UTE, Facultad de Ciencias de la Salud Eugenio Espejo, Centro de Investigación de Salud Pública y Epidemiología Clínica (CISPEC); Proyecto Epistemonikos, Santiago, Chile. ORCID: 0000-0003-3632-4296
| | - Daniel Simancas-Racines
- Universidad UTE, Facultad de Ciencias de la Salud Eugenio Espejo, Centro de Investigación de Salud Pública y Epidemiología Clínica (CISPEC); Proyecto Epistemonikos, Santiago, Chile. ORCID: 0000-0002-3641-1501
| | - Andrés Viteri-García
- Universidad UTE, Facultad de Ciencias de la Salud Eugenio Espejo, Centro de Investigación de Salud Pública y Epidemiología Clínica (CISPEC); Proyecto Epistemonikos, Santiago, Chile. Address: Centro Evidencia UC, Pontificia Universidad Católica de Chile, Diagonal Paraguay 476, Santiago, Chile. . ORCID: 0000-0003-0393-2404
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Verdugo-Paiva F, Würth C, Godoy S, Santelices P. Prevalence of OSA in chilean children and adolescents based on subscale of pediatric sleep questionnaire. J Oral Res 2020. [DOI: 10.17126/joralres.2019.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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