scholarly journals Obesity and Periodontal Disease: A Narrative Review on Current Evidence and Putative Molecular Links

2019 ◽  
Vol 13 (1) ◽  
pp. 526-536
Author(s):  
Federica Di Spirito ◽  
Ludovico Sbordone ◽  
Vincenzo Pilone ◽  
Francesco D’Ambrosio
Keyword(s):  
Periodontal Disease ◽  
Systematic Reviews ◽  
Literature Search ◽  
Meta Analysis ◽  
Indirect Evidence ◽  
Positive Association ◽  
Current Evidence ◽  
Screening Process ◽  
Clinical Criteria ◽  
Comparison Of The Results

Background: Obesity represents one of the main health problems worldwide and is considered a risk factor for several diseases, including periodontitis, which is a microbially-associated inflammatory disease affecting the tooth-supporting structures. Objective: The aim of this review was to report the current direct and indirect evidence concerning the possible association between obesity and periodontitis and their putative molecular links. Methods: A literature search was conducted between January 1999 and September 2019, in PubMed/MEDLINE and Science Direct databases, using pertinent keyword combined by Boolean operators. Through a multi-step screening process (literature search; articles title and abstract evaluation and full-text reading), studies fitting inclusion/exclusion criteria were considered for the review. Results: 35 studies were included in the present review (17 observational studies; 7 systematic reviews; 11 systematic reviews with meta-analysis), focusing on the direct and indirect evidence of the possible association between obesity and periodontitis and their potential etiopathogenic molecular links Conclusion: Although the majority of the studies reported a positive association between obesity and periodontitis, the heterogeneity of the classification criteria and of the clinical parameters employed in the studies for both obesity and periodontitis evaluation, complicated the comparison of the results, thus considered inconclusive. Although several putative molecular pathogenic links between obesity and periodontitis have been highlighted, further studies, with longer follow-ups and with homogeneous clinical criteria, are needed to better understand the putative relation between obesity and periodontal disease.

scholarly journals Conditional power of antidepressant network meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lisa Holper
Keyword(s):  
Meta Analysis ◽  
Indirect Evidence ◽  
Dropout Rate ◽  
Conclusive Evidence ◽  
Effect Sizes ◽  
Current Evidence ◽  
Hamilton Depression Scale ◽  
Conditional Power ◽  
Sample Sizes ◽  
Antidepressant Treatments

Abstract Background Conditional power of network meta-analysis (NMA) can support the planning of randomized controlled trials (RCTs) assessing medical interventions. Conditional power is the probability that updating existing inconclusive evidence in NMA with additional trial(s) will result in conclusive evidence, given assumptions regarding trial design, anticipated effect sizes, or event probabilities. Methods The present work aimed to estimate conditional power for potential future trials on antidepressant treatments. Existing evidence was based on a published network of 502 RCTs conducted between 1979-2018 assessing acute antidepressant treatment in major depressive disorder (MDD). Primary outcomes were efficacy in terms of the symptom change on the Hamilton Depression Scale (HAMD) and tolerability in terms of the dropout rate due to adverse events. The network compares 21 antidepressants consisting of 231 relative treatment comparisons, 164 (efficacy) and 127 (tolerability) of which are currently assumed to have inconclusive evidence. Results Required sample sizes to achieve new conclusive evidence with at least 80% conditional power were estimated to range between N = 894 - 4190 (efficacy) and N = 521 - 1246 (tolerability). Otherwise, sample sizes ranging between N = 49 - 485 (efficacy) and N = 40 - 320 (tolerability) may require stopping for futility based on a boundary at 20% conditional power. Optimizing trial designs by considering multiple trials that contribute both direct and indirect evidence, anticipating alternative effect sizes or alternative event probabilities, may increase conditional power but required sample sizes remain high. Antidepressants having the greatest conditional power associated with smallest required sample sizes were identified as those on which current evidence is low, i.e., clomipramine, levomilnacipran, milnacipran, nefazodone, and vilazodone, with respect to both outcomes. Conclusions The present results suggest that conditional power to achieve new conclusive evidence in ongoing or future trials on antidepressant treatments is low. Limiting the use of the presented conditional power analysis are primarily due to the estimated large sample sizes which would be required in future trials as well as due to the well-known small effect sizes in antidepressant treatments. These findings may inform researchers and decision-makers regarding the clinical relevance and justification of research in ongoing or future antidepressant RCTs in MDD.

Remotely Delivered Monitoring and Management of Diabetes-Related Foot Disease: An Overview of Systematic Reviews

2021 ◽  
pp. 193229682110124
Author(s):  
Aaron Drovandi ◽  
Shannon Wong ◽  
Leonard Seng ◽  
Benjamin Crowley ◽  
Chanika Alahakoon ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Systematic Reviews ◽  
Urban Areas ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Limb Amputation ◽  
Current Evidence ◽  
Or Management ◽  
Foot Disease ◽  
Poor Reporting

Background: Diabetes-related foot disease (DFD) management requires input from multiple healthcare professionals, and has worse outcomes for people living in remote localities by comparison to urban areas. Remotely delivered healthcare may reduce this disparity. This overview summarizes current evidence on the effectiveness, stakeholder perceptions, and cost-effectiveness of remotely delivered healthcare for DFD. Methods: A search of 5 databases was conducted to identify systematic reviews published between January 2000 and June 2020. Eligible reviews were those evaluating remotely delivered monitoring or management of patients at risk of or with active DFD, or clinicians managing these patients. Risk of bias was assessed using the AMSTAR-2 tool. Results: Eight reviews were eligible for inclusion, including 88 primary studies and 8509 participants, of which 36 studies involving 4357 participants evaluated remotely delivered monitoring or management of DFD. Only one review had a low risk of bias, with most reviews demonstrating limited search strategies and poor reporting of participants. Evidence on effectiveness was mixed, with meta-analyses demonstrating long-term ulcer healing and mortality were not significantly different between telehealth and standard care groups, although the lower-limb amputation rate was significantly decreased in one meta-analysis. Perceptions of telehealth by patients and clinicians were generally positive, whilst acknowledging limitations relating to access and use. Cost-effectiveness data were limited, with poor reporting preventing clear conclusions. Conclusions: Remotely delivered healthcare of DFD is well received by patients and clinicians, but its effectiveness is unclear. High quality trials are needed to evaluate the risks and benefits of remotely delivered DFD management.

scholarly journals Generic Patient-Reported Outcomes and Outcome Measures: A Systematic Review Study Protocol

2021 ◽  
Author(s):  
Yuki Seidler ◽  
Erika Mosor ◽  
Margaret R Andrews ◽  
Carolina Watson ◽  
Nick Bott ◽  
...  
Keyword(s):  
Systematic Review ◽  
Outcome Measures ◽  
Systematic Reviews ◽  
Patient Reported Outcomes ◽  
Outcome Measurement ◽  
Meta Analysis ◽  
Patient Reported Outcome ◽  
Cochrane Library ◽  
Screening Process ◽  
Patient Reported

Background: Patient-reported outcomes (PROs) are an essential part of health outcome measurement and vital to patient-centricity and valued-based care. Several international consortia have developed core outcome sets and many of them include PROs. PROs are measured by patient-reported outcome measures (PROMs). PROs and PROMs can be generic or specific to certain diseases or conditions. While the characteristics of generic PROs and PROMs are well recognised as widely relevant and applicable across different domains, diseases and conditions, there is a lack of knowledge on the types of PROs measured by generic PROMs. We also do not know in which disease areas generic PROs and PROMs are commonly used. To date, there has been no systematic review solely focusing on generic PROMs, what they measure and their areas of application. Objectives: This systematic review will identify core PROs measured by generic PROMs used in adult populations and the areas in which they are applied. Methods: We will conduct a systematic review of reviews. The screening process and the reporting will comply with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) 2020 Statement. We will use four databases, Medline [PubMed], CINHAL [Ebsco], Cochrane [Cochrane Library], and PsycINFO [Ovid], and reports from international consortia. Inclusion criteria are systematic reviews, meta-analysis or patient-reported outcome sets developed by international consortia reporting on generic PROMs in adult populations. Articles primarily focusing on patient-reported experience measures (PREMs), children or adolescents, or those not written in English will be excluded. Risk of bias will be assessed by checking if the included articles comply with established guidelines for systematic reviews such as the PRISMA statement. We will extract generic PROMs and PROs measured by these PROMs, and the areas applied from the selected articles and reports. Extracted data and information will be quantitatively and qualitatively synthesised without statistical interference. The quality of the synthesised evidences will be assessed by clarifying the strengths, limitations and possible biases in our review.

scholarly journals Management of haemorrhoids: protocol of an umbrella review of systematic reviews and meta-analyses

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e035287
Author(s):  
Min Chen ◽  
Tai-Chun Tang ◽  
Tao-Hong He ◽  
Yong-Jun Du ◽  
Di Qin ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Meta Analysis ◽  
Random Effect Model ◽  
Current Evidence ◽  
Cochrane Library ◽  
Final Report ◽  
Umbrella Review ◽  
Effect Model ◽  
Meta Analyses ◽  
The Impact

IntroductionThe prevalence of haemorrhoidal diseases was high in general population, and many treatments are proposed for the management of haemorrhoids. The treatments include conservative and surgical interventions; the credibility and strength of current evidence of their effectiveness are not comprehensively evaluated. We aim to evaluate the credibility of systematic reviews and meta-analyses that assess the effectiveness of the treatments for haemorrhoidal diseases through an umbrella review.Methods and analysisWe will search Ovid Medline, Embase, Cochrane library and Web of Science from inception to March 2020 without any language restriction. We will include meta-analyses that examine the effectiveness of treatments in the management of haemorrhoids. Two reviewers will independently screen the titles and abstracts of retrieved articles, and they will extract data from the included meta-analyses. For each meta-analysis, we will estimate the effect size of a treatment through the random-effect model and the fixed-effect model, and we will evaluate between-study heterogeneity (Cochrane’s Q and I2statistics) and small-study effect (Egger’s test); we will also estimate the evidence of excess significance bias. Evidence of each treatment will be graded according to prespecified criteria. Methodological quality of each meta-analysis will be evaluated by using Assessment of Multiple Systematic Reviews 2. The corrected cover area method will be used to assess the impact of overlap in reviews on the findings of the umbrella review.Ethics and disseminationWe will present the results of the umbrella review at conferences and publish the final report in a peer-reviewed journal. The umbrella review does not require ethical approval.PROSPERO registration numberCRD42019140702.

Systematic Reviews and Meta-analyses

2018 ◽  
Vol 157 (04) ◽  
pp. 392-399
Author(s):  
Sebastian Scheidt ◽  
Patrick Vavken ◽  
Cornelius Jacobs ◽  
Sebastian Koob ◽  
Davide Cucchi ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Scientific Knowledge ◽  
Literature Search ◽  
Meta Analysis ◽  
Review Article ◽  
Systematic Literature Search ◽  
Meta Analyses

AbstractThe rising number of medical publications makes it difficult to keep up-to-date on scientific knowledge. In recent years, reviews in the form of narrative or systematic publications and meta-analyses have increased. These can only be interpreted and evaluated if the reader understands the techniques used. This review article describes the differences between narrative and systematic reviews, together with the characteristics of meta-analysis, and discusses their interpretation. The concept of systematic reviews and meta-analysis includes a systematic literature search and summary, together with an appraisal of the quality of the publications. Systematic reviews are often considered to be original studies due to their structure and ability to reduce bias.

scholarly journals Oral Microbiome Response to Powered vs Manual Toothbrush: Protocol for a Systematic Review & Meta-Analysis

2020 ◽  
Author(s):  
Abanoub Riad ◽  
Jitka Klugarova ◽  
Veronika Chuchmova ◽  
Simona Slezakova ◽  
Andrea Pokorna ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Oral Microbiome ◽  
Primary Data ◽  
Cochrane Library ◽  
Process Data ◽  
Post Intervention ◽  
Screening Process ◽  
Study Results

Abstract Background: Subclinical changes in response to different types of toothbrushes represent a challenging knowledge gap in the context of self-administered oral hygiene regimes; therefore, this systematic review will be the first to evaluate the oral microbiome response to powered versus manual toothbrushes.Methods: We will conduct a systematic review using the Cochrane Handbook’s guidelines and will adhere to a standardized reporting format: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive search strategy will be conducted in the following databases for published studies: Ovid MEDLINE(R), EMBASE, Cochrane Library, Web of Science, Scopus, ProQuest Central, ProQuest Dissertations Theses Global, Bibliographia Medica Cechoslovaca, and Dentistry Oral Sciences Source. Following a two-level screening process, data including the full reference, objectives, target population, description of the intervention and control intervention, outcome measures, design, length of the post-intervention follow-up period, and the study results will be extracted, synthesized, and reported. Risk of bias and quality of the studies will also be assessed.Discussion: No primary data collection will be undertaken; therefore, no formal ethical assessment is required. The results of this systematic review and meta-analysis will be published in a peer-reviewed journal.Registration: The protocol has been registered with the PROSPERO International Prospective Register of Systematic Reviews (CRD42020153557) since April 28th, 2020.

scholarly journals Screening Tools as a Predictor of Injury in Gymnastics: Systematic Literature Review

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Ross Armstrong ◽  
Nicola Relph
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Evidence Base ◽  
Screening Tools ◽  
Screening Process ◽  
Acute Injuries ◽  
Movement Screening ◽  
High Level

Abstract Background Gymnastics requires a high level of physical ability and technical skill which utilises short sets of athleticism and artistry to perform complex and intense movements which can overload musculoskeletal tissues and result in acute injuries which can develop into chronic injuries. The aim of this systematic literature review was to investigate which screening tools predict injury in gymnasts and encompasses all genres, levels and ages. Methods An electronic search of seven databases from their inception until March 2021 was conducted. The databases were the Allied and Complementary Medicine Database, CINAHL, eBook Collection (EBSCOhost), MEDLINE, Cochrane Database of Systematic Reviews, SPORTDiscus and PEDro (the Physiotherapy Evidence Base). A combination of the following search terms was used: (1) Gymnastics AND injury AND Screening, (2) Screening AND Gymnastics and (3) Musculoskeletal AND Screening AND Gymnastics. These terms were searched in all text, abstract, title and subject terms. Studies were assessed using a 20-point scoring tool. Results The mean methodological quality score was 13.1 points (range 10–17 points). Range of motion, anthropometric and postural measurements, hypermobility, clinical diagnostic tests, movement screening tools, muscle strength, power and endurance were reported in the included studies. Some evidence existed for screening measurement of height and mass as taller and heavier gymnasts might be more susceptible to injury; however, the different methodologies utilised and lack of acknowledgment of confounding variables limit the clinical relevance of these findings. Conclusions Height and mass should be recorded during the screening process. A lack of heterogeneity in study methodology prevented a meta-analysis. Studies were limited by a lack of prospective injury design, poor injury definition, self-reporting of injury and only 2 studies reported reliability of screening tools. Further research is required to determine the role of injury screening in gymnastics. Registration: The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) with the registration number CRD42020218339.

Prophylactic human papillomavirus vaccination to prevent recurrence of cervical intraepithelial neoplasia: a meta-analysis

2020 ◽  
Vol 30 (6) ◽  
pp. 777-782 ◽  
Author(s):  
Helena C Bartels ◽  
James Postle ◽  
Ailin C Rogers ◽  
Donal Brennan
Keyword(s):  
Human Papillomavirus ◽  
Surgical Treatment ◽  
Cervical Intraepithelial Neoplasia ◽  
Systematic Reviews ◽  
Literature Search ◽  
Meta Analysis ◽  
Hpv Vaccination ◽  
Intraepithelial Neoplasia ◽  
Number Needed To Treat ◽  
Risk Of Recurrence

ObjectiveThe aim of this systematic review and meta-analysis was to review evidence supporting the use of prophylactic human papillomavirus (HPV) vaccines to influence the risk of recurrence of cervical intraepithelial neoplasia after surgical treatment.MethodsA systematic literature search was performed for publications reporting risk of recurrence of cervical intraepithelial neoplasia after surgical treatment in patients receiving HPV vaccination (either in the prophylactic or adjuvant setting). Comprehensive searches of six electronic databases (MEDLINE, Embase, Web of Science, PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and references of identified studies) from their inceptions were performed (English language only), and hand search reference lists were performed. Two independent reviewers applied inclusion and exclusion criteria to select manuscripts, with differences discussed and agreed by consensus. The literature search was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results were reported as mean differences or pooled odds ratios (OR) with 95% confidence intervals (95% CI).ResultsA total of 5744 citations were reviewed; 5 studies comprising 2912 patients were selected for the analysis. There were 1338 patients in the vaccinated group and 1574 in the placebo or unvaccinated group. The incidence of histologically confirmed cervical intraepithelial neoplasia 2+ was reduced in the vaccinated compared to the unvaccinated group (OR 0.34, 95% CI 0.21–0.54, p=< 0.00001). The number needed to treat to prevent one recurrence was 27. Both pre-treatment vaccination (OR 0.40, 95% CI 0.21–0.78, p=0.007, number needed to treat – 37) and adjuvant vaccination (OR 0.28, 95% CI 0.14–0.56, p=0.0003, number needed to treat – 30) reduced recurrence rates.ConclusionProphylactic or adjuvant HPV vaccination reduces the risk of recurrent cervical intraepithelial neoplasia 2+. These data support further investigation of its role as an adjuvant to surgical treatment.

scholarly journals Compliance of systematic reviews in veterinary journals with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) literature search reporting guidelines

2017 ◽  
Vol 105 (3) ◽  
Author(s):  
Lorraine C. Toews
Keyword(s):  
Systematic Reviews ◽  
Literature Search ◽  
Meta Analysis ◽  
Grey Literature ◽  
Primary Objective ◽  
Search Process ◽  
Validity And Reliability ◽  
Journal Editors ◽  
Meta Analyses ◽  
Accurate Reporting

Objective: Complete, accurate reporting of systematic reviews facilitates assessment of how well reviews have been conducted. The primary objective of this study was to examine compliance of systematic reviews in veterinary journals with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines for literature search reporting and to examine the completeness, bias, and reproducibility of the searches in these reviews from what was reported. The second objective was to examine reporting of the credentials and contributions of those involved in the search process.Methods: A sample of systematic reviews or meta-analyses published in veterinary journals between 2011 and 2015 was obtained by searching PubMed. Reporting in the full text of each review was checked against certain PRISMA checklist items.Results: Over one-third of reviews (37%) did not search the CAB Abstracts database, and 9% of reviews searched only 1 database. Over two-thirds of reviews (65%) did not report any search for grey literature or stated they excluded grey literature. The majority of reviews (95%) did not report a reproducible search strategy.Conclusions: Most reviews had significant deficiencies in reporting the search process that raise questions about how these searches were conducted and ultimately cast serious doubts on the validity and reliability of reviews based on a potentially biased and incomplete body of literature. These deficiencies also highlight the need for veterinary journal editors and publishers to be more rigorous in requiring adherence to PRISMA guidelines and to encourage veterinary researchers to include librarians or information specialists on systematic review teams to improve the quality and reporting of searches.

scholarly journals Intake of Unprocessed and Processed Meat and the Association with Cardiovascular Disease: An Overview of Systematic Reviews

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3303
Author(s):  
Marianne Uhre Jakobsen ◽  
Anette Bysted ◽  
Heddie Mejborn ◽  
Anders Stockmarr ◽  
Ellen Trolle
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Studies ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Positive Association ◽  
Red Meat ◽  
Processed Meat ◽  
Overview Of Systematic Reviews ◽  
Meta Analyses

We conducted an overview of systematic reviews to summarize reviews of cohort studies on intake of unprocessed and processed meat and the risk of cardiovascular disease (CVD), coronary heart disease (CHD), and stroke. Systematic reviews of cohort studies published between January 2010 and August 2020 were identified through a systematic literature search in PubMed, Embase, and Web of Science. The quality of how each review was conducted was assessed and the overall confidence in the results of each review was rated using AMSTAR 2. The quality of evidence of each meta-analysis was graded using NutriGrade. Three reviews were included, with meta-analyses of unprocessed red meat and CVD (n = 1) and stroke (n = 2); unprocessed poultry and stroke (n = 1); and processed meat and CVD (n = 1), CHD (n = 1), and stroke (n = 3). The overall confidence in the results of each review was rated as critically low. The meta-evidence was graded moderate for a positive association between unprocessed red meat and stroke and moderate for a positive association between processed meat and CHD and stroke. For other associations the meta-evidence was graded as low or very low. In conclusion, the associations between unprocessed and processed meat with CVD and major subtypes of CVD have not been extensively investigated.

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