A systematic review of reported outcomes and outcome measures in randomized controlled trials on apical prolapse surgery

Introduction. Regional anesthesia is a rapidly growing subspecialty. There are few published meta-analyses exploring pain outcome measures utilised in regional anesthesia randomized controlled trials (RCTs), which may be due to heterogeneity in outcomes assessed. This systematic review explores postoperative pain outcomes utilised in regional anesthesia RCTs. Methods. A literature search was performed using three databases (Medline, Embase, and CINAHL). Regional anesthesia RCTs with postoperative pain as a primary outcome were included if written in English and published in one of the top 20 impact factor journals between 2005 and 2017. Study quality was assessed using the Cochrane Collaboration’s tool for assessing risk of bias. Results. From the 31 included articles, 15 different outcome measures in total were used to assess postoperative pain. The most commonly (16/31) used outcome measures were verbal numerical grading of pain out of 10, total opioid consumption, and visual analogue scale 10 cm (VAS). The need for analgesia was used as an outcome measure where studies did not use a pain rating score. Ten studies reported pain scores on activity and 27/31 studies utilised ≥2 pain outcomes. Time of measurement of pain score also varied with a total of 51 different time points used in total. Conclusion. Analysis of the articles demonstrated heterogeneity and inconsistency in choice of pain outcome and time of measurement within regional anesthesia studies. Identification of these pain outcomes utilised can help to create a definitive list of core outcomes, which may guide future researchers when designing such studies.

Download Full-text

Supportive care interventions for people with cancer assisted by digital technology: A systematic review (Preprint)

10.2196/preprints.24722 ◽

2020 ◽

Author(s):

Michael Marthick ◽

Deborah McGregor ◽

Jennier A. Alison ◽

Birinder Cheema ◽

Haryana Dhillon ◽

...

Keyword(s):

Systematic Review ◽

Supportive Care ◽

Randomized Controlled Trials ◽

Outcome Measures ◽

Cancer Care ◽

Digital Health ◽

Health Interventions ◽

Controlled Trials ◽

Supportive Cancer Care ◽

Randomized Controlled

BACKGROUND While relatively new, digital health interventions are demonstrating rapid growth due to their ability to facilitate access and overcome issues of location, time, health status, and most recently, the impact of a major pandemic. With the increased uptake of digital technologies, digital health has the potential to improve the provision of supportive cancer care. OBJECTIVE The purpose of this systematic review was to evaluate digital health interventions in supportive cancer care. METHODS Published literature between 2000 and 2020 was systematically searched in Medline, PubMed, Embase, PsycINFO, Cochrane Central Register of Controlled Trials and Scopus. Eligible publications were randomized controlled trials (RCTs) of clinician led digital health interventions to support adult cancer patients. Included interventions were determined by applying a digital health conceptual model. Studies were appraised for quality using the revised Cochrane risk of bias tool. RESULTS Twenty randomized controlled trials met the inclusion criteria for analysis. Interventions varied by duration, frequency, degree of technology use and applied outcome measures. Interventions targeting a single tumour stream, predominantly breast cancer, and studies involving the implementation of remote symptom monitoring dominated results. In most studies the digital intervention resulted in significant positive outcomes in patient reported symptoms, levels of fatigue and pain, health-related quality of life, functional capacity, and/or depression levels compared to control. CONCLUSIONS Digital health interventions are helpful and effective for the supportive care of patients with cancer. There is a need for higher quality research. Future endeavours could focus on use of valid, standardised outcome measures, maintenance of methodological rigour, and strategies to improve patient and health professional engagement in the design and delivery of supportive digital health interventions. CLINICALTRIAL

Download Full-text

Psychometric Properties of Parent–Child (0–5 years) Interaction Outcome Measures as Used in Randomized Controlled Trials of Parent Programs: A Systematic Review

Clinical Child and Family Psychology Review ◽

10.1007/s10567-019-00275-3 ◽

2019 ◽

Vol 22 (2) ◽

pp. 253-271 ◽

Cited By ~ 7

Author(s):

Nicole Gridley ◽

Sarah Blower ◽

Abby Dunn ◽

Tracey Bywater ◽

Karen Whittaker ◽

...

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Psychometric Properties ◽

Outcome Measures ◽

Controlled Trials ◽

Randomized Controlled ◽

Parent Child

Download Full-text

Physiotherapy as an Initial Treatment Option for Femoroacetabular Impingement: A Systematic Review of the Literature and Meta-analysis of 5 Randomized Controlled Trials

The American Journal of Sports Medicine ◽

10.1177/0363546519882668 ◽

2019 ◽

Vol 48 (8) ◽

pp. 2042-2050 ◽

Cited By ~ 1

Author(s):

Graeme Hoit ◽

Daniel B. Whelan ◽

Tim Dwyer ◽

Prabjit Ajrawat ◽

Jaskarndip Chahal

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Outcome Measures ◽

Femoroacetabular Impingement ◽

Meta Analysis ◽

Hip Pain ◽

Cochrane Library ◽

Controlled Trials ◽

Randomized Controlled

Background: Femoroacetabular impingement is a common and debilitating source of hip pain in young adults. Although physiotherapy is used as a mainstay of nonoperative care for femoroacetabular impingement, the evidence regarding different physiotherapy practices is poorly understood. Purpose: To collect and synthesize the best available evidence and arrive at a summary estimate of treatment effect for the utility of physiotherapy in the management of femoroacetabular impingement. Study Design: Meta-analysis. Methods: A systematic review was performed on February 2, 2019, of PubMed, EMBASE, and Cochrane Library databases using “femoroacetabular impingement OR hip pain” and “physiotherapy OR nonoperative management” and their synonyms as search terms. Central treatment themes were identified across protocols, and pooled analyses were conducted to assess for differences in patient-reported outcome measures across these themes. Results: A total of 5 randomized controlled trials met our inclusion criteria. The studies included 124 patients with a mean age of 35 years, of whom 24% were male. The average follow-up was 9.4 weeks (range, 6-12 weeks), and the follow-up rate across all participants was 86%. Among these 5 studies, 4 studies used a physiotherapy protocol that focused on core strengthening versus no core strengthening, 4 studies compared active strengthening versus passive modalities, and 3 studies compared supervised versus unsupervised physiotherapy. Pooled analysis across all studies demonstrated improved outcomes in the treatment groups compared with the controls (standardized mean difference [SMD], 0.76; 95% CI, 0.38-1.13; P < .0001). Core strengthening (SMD, 0.82; 95% CI, 0.39-1.26; P = .0002), active physiotherapy (SMD, 0.70; 95% CI, 0.29-1.10; P = .0008), and supervised physiotherapy (SMD, 0.58; 95% CI, 0.14-1.03; P = .01) were found to result in statistically significant improvements in functional outcomes compared with no core strengthening, passive modalities, and unsupervised care, respectively. Conclusion: Supervised physiotherapy programs focusing on active strengthening and core strengthening are more effective than unsupervised, passive, and non–core focused programs. Future studies with longer term follow-up and validated femoroacetabular impingement specific outcome measures are required to determine prognostic factors for success with nonoperative care as well as to determine the ideal patient profile and structured rehabilitation protocol.

Download Full-text