scholarly journals Smartphone Interventions Effect in Pediatric Subjects on the Day of Surgery: A Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Li Li ◽  
Jianping Ma ◽  
Dan Ma ◽  
Xiaokang Zhou
Keyword(s):  
Random Effects ◽  
Standard Care ◽  
Literature Search ◽  
Meta Analysis ◽  
Continuous Method ◽  
Mean Difference ◽  
Random Effects Model ◽  
Systematic Literature Search ◽  
Oral Midazolam ◽  
The Mean

Background: A meta-analysis was performed to evaluate the effect of smartphone interventions on the anxiety of the pediatric subjects at induction on the day of surgery compared to oral midazolam or standard care as control.Methods: A systematic literature search up to June 2021 was performed and nine studies selected 785 pediatric subjects on the day of surgery at the start of the study; 390 of them were using smartphone interventions, 192 were control, and 203 were using oral midazolam. They were reporting relationships between the effects of smartphone interventions on the anxiety of the pediatric subjects at induction on the day of surgery compared to oral midazolam or control. The mean difference (MD) with its 95% CIs was calculated to assess the effect of smartphone interventions on the anxiety of the pediatric subjects at induction on the day of surgery compared to oral midazolam or control using the continuous method with a fixed or a random-effects model.Results: Smartphone interventions in pediatric subjects were significantly related to lower anxiety at induction on the day of surgery (MD, −19.74; 95% CI, −29.87 to −9.61, p < 0.001) compared to control and significantly related to lower anxiety at induction on the day of surgery (MD, −7.81; 95% CI, −14.49 to −1.14, p = 0.02) compared to oral midazolam.Conclusion: Smartphone interventions in pediatric subjects on the day of surgery may have lower anxiety at induction compared to control and oral midazolam. Further studies are needed to confirm these findings.

scholarly journals Comparison of coated meshes for intraperitoneal placement in animal studies: a systematic review and meta-analysis

Hernia ◽  
2019 ◽  
Vol 24 (6) ◽  
pp. 1253-1261 ◽  
Author(s):  
H. Liu ◽  
S. van Steensel ◽  
M. Gielen ◽  
T. Vercoulen ◽  
J. Melenhorst ◽  
...  
Keyword(s):  
Systematic Review ◽  
Random Effects ◽  
Fixed Effects ◽  
Animal Studies ◽  
Meta Analysis ◽  
Adhesion Formation ◽  
Mean Difference ◽  
Random Effects Model ◽  
Fixed Effects Model

Abstract Purpose Laparoscopic intraperitoneal onlay mesh in hernia repair can result in adhesions leading to intestinal obstruction and fistulation. The aim of this systematic review is to compare the effects of mesh coatings reducing the tissue-to-mesh adhesion in animal studies. Methods Pubmed and Embase were systematically searched. Animal experiments comparing intraperitoneally placed meshes with coatings were eligible for inclusion. Only studies with comparable follow-up, measurements, and species were included for data pooling and subsequent meta-analysis. Results A total of 131 articles met inclusion criteria, with four studies integrated into one comparison and five studies integrated into another comparison. Compared to uncoated polypropylene (PP) mesh, PP mesh coated with hyaluronic acid/carboxymethyl cellulose (HA/CMC) showed significantly reduced adhesion formation at follow-up of 4 weeks measured with adhesion score of extent (random effects model, mean difference,−  0.96, 95% CI − 1.32 to − 0.61, P < 0.001, I2 = 23%; fixed effects model, mean difference,− 0.94, 95% CI − 1.25 to − 0.63, P < 0.001, I2 = 23%). Compared to PP mesh, polyester mesh coated with collagen (PC mesh) showed no significant difference at follow-up of 4 weeks regarding percentage of adhesion-area on a mesh, using random effects model (mean difference − 11.69, 95% CI − 44.14 to 20.76, P = 0.48, I2 = 92%). However, this result differed using fixed effects model (mean difference − 25.55, 95% CI − 33.70 to − 7.40, P < 0.001, I2 = 92%). Conclusion HA/CMC coating reduces adhesion formation to PP mesh effectively at a follow-up of 4 weeks, while the anti-adhesive properties of PC mesh are inclusive comparing all study data.

scholarly journals Meta-analysis of rare binary events in treatment groups with unequal variability

2017 ◽  
Vol 28 (1) ◽  
pp. 263-274 ◽  
Author(s):  
Lie Li ◽  
Xinlei Wang
Keyword(s):  
Random Effects ◽  
Mean Squared Error ◽  
Meta Analysis ◽  
Random Effects Model ◽  
Treatment Groups ◽  
Continuity Correction ◽  
Large Samples ◽  
Squared Error ◽  
The Mean ◽  
Simple Average

Meta-analysis has been widely used to synthesize information from related studies to achieve reliable findings. However, in studies of rare events, the event counts are often low or even zero, and so standard meta-analysis methods such as fixed-effect models with continuity correction may cause substantial bias in estimation. Recently, Bhaumik et al. developed a simple average estimator for the overall treatment effect based on a random effects model. They proved that the simple average method with the continuity correction factor 0.5 (SA_0.5) is the least biased for large samples and showed via simulation that it has superior performance when compared with other commonly used estimators. However, the random effects models used in previous work are restrictive because they all assume that the variability in the treatment group is equal to or always greater than that in the control group. Under a general framework that explicitly allows treatment groups with unequal variability but assumes no direction, we prove that SA_0.5 is still the least biased for large samples. Meanwhile, to account for a trade-off between the bias and variance in estimation, we consider the mean squared error to assess estimation efficiency and show that SA_0.5 fails to minimize the mean squared error. Under a new random effects model that accommodates groups with unequal variability, we thoroughly compare the performance of various methods for both large and small samples via simulation and draw conclusions about when to use which method in terms of bias, mean squared error, type I error, and confidence interval coverage. A data example of rosiglitazone meta-analysis is used to provide further comparison.

scholarly journals Impact of Resistance Therapy on Motor Function in Children with Cerebral Palsy: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 16 (22) ◽  
pp. 4513 ◽  
Author(s):  
Luisa Collado-Garrido ◽  
Paula Parás-Bravo ◽  
Pilar Calvo-Martín ◽  
Miguel Santibáñez-Margüello
Keyword(s):  
Clinical Trials ◽  
Cerebral Palsy ◽  
Motor Function ◽  
Random Effects ◽  
Meta Analysis ◽  
Scientific Information ◽  
Mean Difference ◽  
Random Effects Model ◽  
Controlled Clinical Trials ◽  
The Impact

Cerebral palsy is one of the main causes of disability in childhood. Resistance therapy shows benefits in increasing strength and gait in these patients, but its impact on motor function is not yet clear. The objective was to analyze the impact of resistance therapy on the improvement in the motor function using a review and meta-analysis. A comprehensive literature research was conducted in Medline (PubMed), Institute for Scientific Information (ISI) Web of Knowledge, and Physiotherapy Evidence Database (PEDro) in relation to clinical trials in which resistance therapy was used and motor function was assessed. Twelve controlled clinical trials and three non-controlled clinical trials (only one intervention arm) studies were identified. In terms of pre–post difference, the overall intra-group effect was in favor of resistance therapy intervention: standardized mean difference (SMD) = 0.37, 95% confidence interval (CI) = 0.21 to 0.52, p < 0.001 (random-effects model), with moderate heterogeneity (I2 = 59.82%). SMDs were also positive by restricting to each of the analyzed scales: SMD = 0.37, 1.33, 0.10, and 0.36 for Gross Motor Function Measure (GMFM), Lateral Step Up (LSU), Time Up and Go (TUG), and Mobility Questionnaire (MobQue) scales, respectively. Regarding the difference between groups, the results showed a high heterogeneity (I2 < 99%), with the mean difference (MD) also favorable for the GMFM scale: MD = 1.73, 95% CI = 0.81 to 2.64, p < 0.001 (random-effects model). Our results support a positive impact of resistance therapy on motor function. Further studies should delve into the clinical relevance of these results.

scholarly journals A meta-analysis of outcomes and complications of magnetic resonance–guided focused ultrasound in the treatment of essential tremor

2018 ◽  
Vol 44 (2) ◽  
pp. E4 ◽  
Author(s):  
Nasser Mohammed ◽  
Devi Patra ◽  
Anil Nanda
Keyword(s):  
Quality Of Life ◽  
Magnetic Resonance ◽  
Essential Tremor ◽  
Random Effects ◽  
Focused Ultrasound ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Random Effects Model ◽  
The Mean

OBJECTIVEMagnetic resonance–guided focused ultrasound (MRgFUS) is a novel technique that uses high-intensity focused ultrasound to achieve target ablation. Like a lens focusing the sun’s rays, the ultrasound waves are focused to generate heat. This therapy combines the noninvasiveness of Gamma Knife thalamotomy and the real-time ablation of deep brain stimulation with acceptable complication rates. The aim of this study was to analyze the overall outcomes and complications of MRgFUS in the treatment of essential tremor (ET).METHODSA meta-analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was made by searching PubMed, Cochrane library database, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Patients with the diagnosis of ET who were treated with MRgFUS were included in the study. The change in the Clinical Rating Scale for Tremor (CRST) score after treatment was analyzed. The improvement in disability was assessed with the Quality of Life in Essential Tremor Questionnaire (QUEST) score. The pooled data were analyzed by the DerSimonian-Laird random-effects model. Tests for bias and heterogeneity were performed.RESULTSNine studies with 160 patients who had ET were included in the meta-analysis. The ventral intermediate nucleus was the target in 8 of the studies. The cerebellothalamic tract was targeted in 1 study. There was 1 randomized controlled trial, 6 studies were retrospective, and 2 were prospective. The mean number of sonications given in various studies ranged from 11 ± 3.2 to 22.5 ± 7.5 (mean ± SD). The maximum delivered energy ranged from 10,320 ± 4537 to 14,497 ± 6695 Joules. The mean of peak temperature reached ranged from 53°C ± 2.3°C to 62.0°C ± 2.5°C. On meta-analysis with the random-effects model, the pooled percentage improvements in the CRST Total, CRST Part A, CRST Part C, and QUEST scores were 62.2%, 62.4%, 69.1%, and 46.5%, respectively. Dizziness was the most common in-procedure complication, occurring in 43.4%, followed by nausea and vomiting in 26.85% (pooled percentage). At 3 months, ataxia was the most common complication, occurring in 32.8%, followed by paresthesias in 25.1% of the patients. At 12 months posttreatment, the ataxia had significantly recovered and paresthesias became the most common persisting complication, at 15.3%.CONCLUSIONSThe MRgFUS therapy for ET significantly improves the CRST scores and improves the quality of life in patients with ET, with an acceptable complication rate. Therapy with MRgFUS is a promising frontier in functional neurosurgery.

scholarly journals Evaluation of SARS-CoV-2 clearance period in patients with COVID-19: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Yasutaka Okita ◽  
Takayoshi Morita ◽  
Atsushi Kumanogoh
Keyword(s):  
Systematic Review ◽  
Random Effects ◽  
Selection Criteria ◽  
Web Of Science ◽  
Meta Analysis ◽  
Random Effects Model ◽  
Viral Shedding ◽  
The Mean

Abstract Background: There is insufficient consensus on the viral shedding period in each background of patients with coronavirus disease 2019 (COVID-19).Methods: We conducted a comprehensive systematic review and meta-analysis according to the PRISMA guidelines. PubMed and Web of Science were searched for original studies reporting the viral shedding period in patients with COVID-19. A random effects model was used to calculate the mean number of days from the onset. Subanalysis was performed focusing on age, sex, severity, locality, and treatment.Results Of 55 studies identified, 12 met the selection criteria. The viral shedding period tended to be longer in sputum (19.03 days) than in nasopharynx (14.58 days). The viral shedding period in nasopharynx tended to be longer in severe patients (23.65 days) than in nonsevere patients (12.67 days). It also tended to be longer in patients treated with steroid (21.24 days) than in patients treated without steroid (12.20 days). This period tended to be longer in Asia (16.07 days) than in Europe (12.57 days). Age, sex, and anti-viral drugs did not affect the viral shedding period.Conclusions Severity, steroid usage, and locality may affect the viral shedding period.

A Systematic Review and Meta-Analysis of the Relation Between Engagement and Achievement in Early Childhood Research

2021 ◽  
pp. 027112142110327
Author(s):  
Esther R. Lindström ◽  
Jason C. Chow ◽  
Kathleen N. Zimmerman ◽  
Hongyang Zhao ◽  
Elise Settanni ◽  
...  
Keyword(s):  
Early Childhood ◽  
Academic Engagement ◽  
Literature Search ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Data Sets ◽  
Systematic Literature Search ◽  
Random Effects Models ◽  
Unique Data ◽  
Early Childhood Research

Engagement in early childhood has been linked with later achievement, but the relation between these variables and how they are measured in early childhood requires examination. We estimated the overall association between academic engagement and achievement in children prior to kindergarten entry. Our systematic literature search yielded 13,521 reports for structured eligibility screening; from this pool of studies, we identified 21 unique data sets, with 199 effect sizes for analysis. We coded eligible studies, extracted effect sizes, accounted for effect size dependency, and used random-effects models to synthesize findings. The overall correlation between academic engagement and achievement was r = .24 (range: −.08 to −.71), and moderator analyses did not significantly predict the relation between the two constructs. This study aligns with previous research on this topic and examines issues related to these measures, their constraints, and applications as they pertain to early childhood research.

scholarly journals Gunshot Wounds to the Lumbosacral Spine: Systematic Review and Meta-Analysis

2021 ◽  
pp. 219256822110308
Author(s):  
Andrew Platt ◽  
Mostafa H. El Dafrawy ◽  
Michael J. Lee ◽  
Martin H. Herman ◽  
Edwin Ramos
Keyword(s):  
Systematic Review ◽  
Random Effects ◽  
Surgical Intervention ◽  
Meta Analysis ◽  
Gunshot Wounds ◽  
Operative Management ◽  
Operative Intervention ◽  
Lumbosacral Spine ◽  
Random Effects Model ◽  
Significant Difference

Study Design: Systematic review and meta-analysis. Objectives: Indications for surgical decompression of gunshot wounds to the lumbosacral spine are controversial and based on limited data. Methods: A systematic review of literature was conducted to identify studies that directly compare neurologic outcomes following operative and non-operative management of gunshot wounds to the lumbosacral spine. Studies were evaluated for degree of neurologic improvement, complications, and antibiotic usage. An odds ratio and 95% confidence interval were calculated for dichotomous outcomes which were then pooled by random-effects model meta-analysis. Results: Five studies were included that met inclusion criteria. The total rate of neurologic improvement was 72.3% following surgical intervention and 61.7% following non-operative intervention. A random-effects model meta-analysis was carried out which failed to show a statistically significant difference in the rate of neurologic improvement between surgical and non-operative intervention (OR 1.07; 95% CI 0.45, 2.53; P = 0.88). In civilian only studies, a random-effects model meta-analysis failed to show a statistically significant difference in the rate of neurologic improvement between surgical and non-operative intervention (OR 0.75; 95% CI 0.21, 2.72; P = 0.66). Meta-analysis further failed to show a statistically significant difference in the rate of neurologic improvement between patients with either complete (OR 4.13; 95% CI 0.55, 30.80; P = 0.17) or incomplete (OR 0.38; 95% CI 0.10, 1.52; P = 0.17) neurologic injuries who underwent surgical and non-operative intervention. There were no significant differences in the number of infections and other complications between patients who underwent surgical and non-operative intervention. Conclusions: There were no statistically significant differences in the rate of neurologic improvement between those who underwent surgical or non-operative intervention. Further research is necessary to determine if surgical intervention for gunshot wounds to the lumbosacral spine, including in the case of retained bullet within the spinal canal, is efficacious.

scholarly journals Autism Spectrum Disorder and Clinical High Risk for Psychosis: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Julio Vaquerizo-Serrano ◽  
Gonzalo Salazar de Pablo ◽  
Jatinder Singh ◽  
Paramala Santosh
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Literature Search ◽  
Meta Analysis ◽  
Autism Spectrum ◽  
Clinical High Risk ◽  
Psychotic Experiences ◽  
Attenuated Psychosis Syndrome ◽  
The Mean ◽  
Spectrum Disorders

AbstractPsychotic experiences can occur in autism spectrum disorders (ASD). Some of the ASD individuals with these experiences may fulfil Clinical High-Risk for Psychosis (CHR-P) criteria. A systematic literature search was performed to review the information on ASD and CHR-P. A meta-analysis of the proportion of CHR-P in ASD was conducted. The systematic review included 13 studies. The mean age of ASD individuals across the included studies was 11.09 years. The Attenuated Psychosis Syndrome subgroup was the most frequently reported. Four studies were meta-analysed, showing that 11.6% of CHR-P individuals have an ASD diagnosis. Symptoms of prodromal psychosis may be present in individuals with ASD. The transition from CHR-P to psychosis is not affected by ASD.

Intralymphatic immunotherapy for allergic rhinitis: A systematic review and meta-analysis

2021 ◽  
Vol 42 (4) ◽  
pp. 283-292 ◽  
Author(s):  
Michael T. Werner ◽  
John V. Bosso
Keyword(s):  
Systematic Review ◽  
Allergic Rhinitis ◽  
Adverse Event ◽  
Skin Prick Testing ◽  
Meta Analysis ◽  
Mean Difference ◽  
Random Effects Model ◽  
Nasal Provocation ◽  
Intralymphatic Immunotherapy ◽  
Standardized Mean Difference

Background: Only a fraction of patients with allergic rhinitis receive allergen-specific immunotherapy (AIT). AIT is most commonly delivered subcutaneously in a series of injections over 3‐5 years. Common obstacles to completing this therapy include cost and inconvenience. Intralymphatic immunotherapy (ILIT) has been proposed as a faster alternative, which requires as few as three injections spaced 4 weeks apart. Objective: This systematic review and meta-analysis evaluated the current evidence that supports the use of ILIT for allergic rhinitis. Methods: Clinical trials were identified in the published literature by using an electronic search strategy and were evaluated by using a risk of bias tool. Treatment outcome (symptom scores, medication scores, and combined symptom and medication scores) and provocation testing results (nasal provocation and skin-prick testing) were included in a meta-analysis of standardized mean difference with subgrouping by using a random-effects model. Overall adverse event rates were tabulated, and overall risk ratios were calculated by using a random-effects model. Results: We identified 17 clinical trials that met eligibility criteria. The standardized mean difference of ILIT on the symptom and medication score was ‐0.72 (95% confidence interval [CI], ‐0.98 to ‐0.46; p < 0.0001) (n = 10). The standardized mean difference of ILIT on nasal provocation and skin-prick testing was ‐1.00 (95% CI, ‐1.38 to ‐0.61; p < 0.0001) (n = 7) and ‐0.73 (95% CI, ‐0.99 to ‐0.47; p < 0.0001) (n = 7), respectively. No statistically significant heterogeneity was detected. The overall adverse event rate was 39.5% for ILIT and 23.5% for placebo. Also, 98.4% of adverse events were mild. Conclusion: Our meta-analysis demonstrated that ILIT was safe, conferred desensitization to seasonal and nonseasonal allergens, alleviated allergic rhinitis symptoms, and reduced medication use. A larger randomized, double-blind, placebo controlled trial will be necessary for wider adaptation of this form of AIT.

P–022 Improvement in sperm concentration and motility after oral antioxidant supplementation in infertile men with varicocele who have not undergone surgical repair: systematic review and meta-analys

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
P Ioannidou ◽  
J Bosdou ◽  
D Papanikolaou ◽  
D Goulis ◽  
A Lambropoulos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Folic Acid ◽  
Random Effects ◽  
Surgical Repair ◽  
Meta Analysis ◽  
Sperm Concentration ◽  
Random Effects Model ◽  
Antioxidant Supplementation ◽  
Infertile Men ◽  
Single Study

Abstract Study question Does oral antioxidant supplementation improve sperm quality in infertile men with varicocele who have not undergone surgical repair? Summary answer Oral antioxidant supplementation improves sperm concentration and motility in infertile men with varicocele who have not undergone surgical repair. What is known already: Benefit from oral antioxidant supplementation has been shown in infertile men with varicocele following surgical repair. Similarly, oral antioxidant supplementation has been suggested in infertile men with varicocele who have not undergone surgical repair. However, its effect currently remains controversial. Study design, size, duration A literature search was performed until January 2021 aiming to identify prospective studies evaluating the use of oral antioxidant supplementation alone or in combination in men with varicocele who have not undergone surgical repair. Participants/materials, setting, methods Seven prospective studies were identified, published between 1987 and 2018, including 278 infertile men with varicocele who had not undergone surgical repair. The number of patients included ranged from 20 to 65. Sperm analysis, evaluating sperm concentration, motility and morphology was performed in these studies before and after oral antioxidant supplementation. Meta-analysis of weighted data was performed using random effects model. Results are reported as weighted mean difference (WMD) with 95% confidence interval (CI). Main results and the role of chance Seven studies were included in the systematic review. Oral antioxidant supplementation was performed by a combination of pentoxifylline, zinc and folic acid (single study), a combination of l-carnitine, fumarate, acetyl-l-carnitine, fructose, CoQ, vitamin C, zinc, folic acid and vitamin B12 (single study), a combination of L-Carnitine, vitamin C, coenzyme Q10, vitamin E, vitamin B9, vitamin B12, zinc , and selenium, l-carnitine (single study), or sole treatment with acetyl-l-carnitine (single study), L-Carnitine (single study), Coenzyme Q10 (single study) or zinc sulfate (single study). For the purpose of meta-analysis, the effect of oral antioxidant supplementation was evaluated after three months of treatment. Oral antioxidant supplementation significantly increased sperm concentration (WMD +5.65x106/ml 95% CI: +1.11 to + 10.12 p = 0.01, random effects model) and motility (WMD +4.30%, 95% CI: +0.86 to + 7.74 p = 0.01, random effects model) in infertile men with varicocele who had not undergone surgical repair. On the other hand, no significance difference was observed in sperm morphology (WMD +3.9%, 95% CI: –0.16 to + 8.04 p = 0.06, random effects model) and volume (WMD +0.53ml, 95% CI: 0.0 to + 1.0 p = 0.052, random effects model). Limitations, reasons for caution The number of relevant trials and that of patients included is small to allow for solid conclusions to be drawn. Moreover, although different oral antioxidants have been administered in infertile who had not undergone surgical repair, subgroup analysis was not feasible. Wider implications of the findings: Currently, limited evidence supports the use of oral antioxidants in the treatment of men with varicocele, who have not undergone surgical repair. Although the benefit in sperm concentration and motility appears to be modest, it might be important regarding achievement of pregnancy in these men. Trial registration number Not applicable

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