Effectiveness of seasonal influenza vaccination in community-dwelling elderly people: an individual participant data meta-analysis of test-negative design case-control studies

2017 ◽  
Vol 5 (3) ◽  
pp. 200-211 ◽  
Author(s):  
Maryam Darvishian ◽  
Edwin R van den Heuvel ◽  
Ange Bissielo ◽  
Jesus Castilla ◽  
Cheryl Cohen ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Elderly People ◽  
Seasonal Influenza ◽  
Meta Analysis ◽  
Case Control ◽  
Community Dwelling ◽  
Individual Participant Data ◽  
Case Control Studies ◽  
Individual Participant ◽  
Design Case

Opportunistic screening for heart failure with natriuretic peptides in patients with atrial fibrillation: a meta-analysis of individual participant data of four screening studies

Heart ◽  
2018 ◽  
Vol 104 (15) ◽  
pp. 1236.1-1237 ◽  
Author(s):  
Sander van Doorn ◽  
Geert-Jan Geersing ◽  
Rogier F Kievit ◽  
Yvonne van Mourik ◽  
Loes C Bertens ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Natriuretic Peptide ◽  
Natriuretic Peptides ◽  
Meta Analysis ◽  
Diagnostic Value ◽  
Community Dwelling ◽  
Individual Participant Data ◽  
Cut Point ◽  
Individual Participant

ObjectiveHeart failure (HF) often coexists in atrial fibrillation (AF) but is frequently unrecognised due to overlapping symptomatology. Furthermore, AF can cause elevated natriuretic peptide levels, impairing its diagnostic value for HF detection. We aimed to assess the prevalence of previously unknown HF in community-dwelling patients with AF, and to determine the diagnostic value of the amino-terminal pro B-type natriuretic peptide (NTproBNP) for HF screening in patients with AF.MethodsIndividual participant data from four HF-screening studies in older community-dwelling persons were combined. Presence or absence of HF was in each study established by an expert panel following the criteria of the European Society of Cardiology. We performed a two-stage patient-level meta-analysis to calculate traditional diagnostic indices.ResultsOf the 1941 individuals included in the four studies, 196 (10.1%) had AF at baseline. HF was uncovered in 83 (43%) of these 196 patients with AF, versus 381 (19.7%) in those without AF at baseline. Median NTproBNP levels of patients with AF with and without HF were 744 pg/mL and 211 pg/mL, respectively. At the cut-point of 125 pg/mL, sensitivity was 93%, specificity 35%, and positive and negative predictive values 51% and 86%, respectively. Only 23% of all patients with AF had an NTproBNP level below the 125 pg/mL cut-point, with still a 13% prevalence of HF in this group.ConclusionsWith a prevalence of nearly 50%, unrecognised HF is common among community-dwelling patients with AF. Given the high prior change, natriuretic peptides are diagnostically not helpful, and straightforward echocardiography seems to be the preferred strategy for HF screening in patients with AF.

scholarly journals Could seasonal influenza vaccination influence COVID-19 risk?

2020 ◽  
Author(s):  
Philippe De wals ◽  
Maziar Divangahi
Keyword(s):  
Influenza Vaccination ◽  
Seasonal Influenza ◽  
Cross Sectional Study ◽  
Case Control ◽  
Influenza Vaccines ◽  
Case Control Studies ◽  
Cross Sectional ◽  
Viral Pathogen ◽  
Negative Case ◽  
Increased Risk

Background: With possible resurgence of the SARS-CoV-2 and low seasonal influenza virus circulation next winter, reviewing evidence on a possible interaction between influenza vaccination and COVID-19 risk is important. Objective: To review studies on the effect of influenza vaccines on non-influenza respiratory disease (NIRD). Methods: Using different search strategies, 18 relevant studies were identified and their strength, limitations and significance were assessed. Results: Analysis of 4 RCT datasets did not suggest increased NIRD risk in recipients of live-attenuated vaccines (LAIV) and results of a cohort study suggested short-term protection consistent with the hypothesis of trained immunity. One RCT, four cohort studies and one test-negative case-control suggested increased NIRD risk in recipients of inactivated influenza vaccines (IIV), whereas five test-negative case-control studies did not show an increased risk associated with a specific viral pathogen. Cross-protection against COVID-19 was suggested in one cross-sectional study on IIV but major biases could not be excluded. Results of four recent ecological studies on COVID-19 were challenging to interpret. Conclusions: Available data on LAIV are reassuring but not all those on IIV. A drastic reorientation of 2020-2021 influenza campaigns is probably not warranted but studies aiming to test COVID-19 risk modification among recipients of seasonal influenza vaccines should be planned and funded.

scholarly journals Retinal Changes in Schizophrenia: A Systematic Review and Meta-analysis Based on Individual Participant Data

2019 ◽  
Author(s):  
Charalampos T Kazakos ◽  
Vasilios Karageorgiou
Keyword(s):  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Fundus Photography ◽  
Current Evidence ◽  
Primary Study ◽  
Individual Participant Data ◽  
Case Control Studies ◽  
Fiber Layer ◽  
Functional Changes ◽  
Individual Participant

Abstract Background Retinal assessment has indicated the presence of neuronal loss in neurodegenerative disorders, but its role in schizophrenia remains unclear. We sought to synthesize the available evidence considering 3 noninvasive modalities: optical coherence tomography, electroretinography, and fundus photography, and examine their diagnostic accuracy based on unpublished individual participant data, when provided by the primary study authors. Methods We searched MEDLINE, SCOPUS, clinicaltrials.gov, PSYNDEX, Cochrane Controlled Register of Trials (CENTRAL), WHO International Clinical Trials Registry Platform, and Google Scholar, up to October 30, 2018. Authors were contacted and invited to share anonymized participant-level data. Aggregate data were pooled using random effects models. Diagnostic accuracy meta-analysis was based on multiple cutoffs logistic generalized linear mixed modeling. This study was registered with PROSPERO, number CRD42018109344. Results Pooled mean differences of peripapillary retinal nerve fiber layer thickness in micrometer between 694 eyes of 432 schizophrenia patients and 609 eyes of 358 controls, from 11 case-control studies, with corresponding 95% confidence intervals (CIs) by quadrant were the following: −4.55, 95% CI: −8.28, −0.82 (superior); −6.25, 95% CI: −9.46, −3.04 (inferior); −3.18, 95% CI: −5.04, −1.31 (nasal); and −2.7, 95% CI: −4.35, −1.04 (temporal). Diagnostic accuracy, based on 4 studies, was fair to poor, unaffected by age and sex; macular area measurements performed slightly better. Conclusion The notion of structural and functional changes in retinal integrity of patients with schizophrenia is supported with current evidence, but diagnostic accuracy is limited. The potential prognostic, theranostic, and preventive role of retinal evaluation remains to be examined.

scholarly journals Protective effect of influenza vaccination on cardiovascular diseases: a systematic review and meta-analysis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Moein Zangiabadian ◽  
Seyed Aria Nejadghaderi ◽  
Mehdi Mirsaeidi ◽  
Bahareh Hajikhani ◽  
Mehdi Goudarzi ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Influenza Vaccination ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Case Control ◽  
Cochrane Library ◽  
P Value ◽  
Case Control Studies ◽  
Mortality And Morbidity ◽  
Statistical Heterogeneity

AbstractCardiovascular diseases (CVDs) are among the leading causes of mortality and morbidity worldwide. There are many contrasting ideas on the effectiveness of influenza vaccination on CVDs. This study aimed to investigate the association between influenza vaccination and the risk of CVDs. We systematically searched all PubMed/Medline, EMBASE, and the Cochrane library entries up to November 2019 for studies of influenza vs. the CVDs outcomes. We conducted a random-effects meta‐analysis using the inverse variance method for pooled risk ratios (RR) or odds ratios (OR) and evaluated statistical heterogeneity using the I2 statistic. We identified 17 studies (6 randomized controlled trial [RCT], 5 cohorts, and 6 case–control) with a total of 180,043 cases and 276,898 control participants. The pooled RR of developing CVDs after influenza vaccination in RCT studies was 0.55 (95% CI 0.41–0.73), which was significant (P-value = 0.00). The pooled OR of decreasing CVDs after influenza vaccination in cohort studies was 0.89 (95% CI 0.77–1.04). The pooled OR of developing CVDs after influenza vaccination by pooling case–control studies was 0.70 (95% CI 0.57–0.86, (P-value = 0.00). All of these studies suggest decreased risks of CVDs with influenza vaccination. The current study does support the protective role of influenza vaccination on CVDs events. Health authorities may develop evidence-based preventive strategies to offer influenza vaccination in patients with CVDs.

scholarly journals Duration of Breastfeeding and Risk of SIDS: An Individual Participant Data Meta-analysis

2018 ◽  
pp. 127-136
Author(s):  
John M.D. Thompson ◽  
Kawai Tanabe ◽  
Rachel Y. Moon ◽  
Edwin A. Mitchell ◽  
Cliona McGarvey ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
Data Extraction ◽  
Meta Analysis ◽  
Case Control ◽  
Breastfeeding Duration ◽  
Sudden Infant ◽  
Case Control Studies ◽  
Individual Level ◽  
Individual Participant ◽  
Duration Of Breastfeeding

CONTEXT Sudden infant death syndrome (SIDS) is a leading cause of postneonatal infant mortality. Our previous meta-analyses showed that any breastfeeding is protective against SIDS with exclusive breastfeeding conferring a stronger effect. The duration of breastfeeding required to confer a protective effect is unknown. OBJECTIVE To assess the associations between breastfeeding duration and SIDS. DATA SOURCES Individual-level data from 8 case-control studies. STUDY SELECTION Case-control SIDS studies with breastfeeding data. DATA EXTRACTION Breastfeeding variables, demographic factors, and other potential confounders were identified. Individual-study and pooled analyses were performed. RESULTS A total of 2267 SIDS cases and 6837 control infants were included. In multivariable pooled analysis, breastfeeding for <2 months was not protective (adjusted odds ratio [aOR]: 0.91, 95% confidence interval [CI]: 0.68–1.22). Any breastfeeding ≥2 months was protective, with greater protection seen with increased duration (2–4 months: aOR: 0.60, 95% CI: 0.44– 0.82; 4–6 months: aOR: 0.40, 95% CI: 0.26–0.63; and >6 months: aOR: 0.36, 95% CI: 0.22– 0.61). Although exclusive breastfeeding for <2 months was not protective (aOR: 0.82, 95% CI: 0.59–1.14), longer periods were protective (2–4 months: aOR: 0.61, 95% CI: 0.42–0.87; 4–6 months: aOR: 0.46, 95% CI: 0.29–0.74). LIMITATIONS The variables collected in each study varied slightly, limiting our ability to include all studies in the analysis and control for all confounders. CONCLUSIONS Breastfeeding duration of at least 2 months was associated with half the risk of SIDS. Breastfeeding does not need to be exclusive to confer this protection.

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