Burn scar assessment: A systematic review of objective scar assessment tools

During the COVID-19 pandemic, healthcare workers (HCWs) have been subject to increased workload while also exposed to many psychosocial stressors. In a systematic review we analyze the impact that the pandemic has had on HCWs mental state and associated risk factors. Most studies reported high levels of depression and anxiety among HCWs worldwide, however, due to a wide range of assessment tools, cut-off scores, and number of frontline participants in the studies, results were difficult to compare. Our study is based on two online surveys of 2195 HCWs from different regions of Russia during spring and autumn epidemic outbreaks revealed the rates of anxiety, stress, depression, emotional exhaustion and depersonalization and perceived stress as 32.3%, 31.1%, 45.5%, 74.2%, 37.7% ,67.8%, respectively. Moreover, 2.4% of HCWs reported suicidal thoughts. The most common risk factors include: female gender, nurse as an occupation, younger age, working for over 6 months, chronic diseases, smoking, high working demands, lack of personal protective equipment, low salary, lack of social support, isolation from families, the fear of relatives getting infected. These results demonstrate the need for urgent supportive programs for HCWs fighting COVID-19 that fall into higher risk factors groups.

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Diagnostic value of transcranial ultrasonography for selecting subjects with large vessel occlusion: a systematic review

The Ultrasound Journal ◽

10.1186/s13089-019-0143-6 ◽

2019 ◽

Vol 11 (1) ◽

Cited By ~ 1

Author(s):

Daria Antipova ◽

Leila Eadie ◽

Ashish Stephen Macaden ◽

Philip Wilson

Keyword(s):

Systematic Review ◽

Diagnostic Accuracy ◽

Acute Stroke ◽

Clinical Assessment ◽

Assessment Tools ◽

Large Vessel ◽

Cochrane Library ◽

Direct Transfer ◽

Large Vessel Occlusion ◽

Vessel Occlusion

Abstract Introduction A number of pre-hospital clinical assessment tools have been developed to triage subjects with acute stroke due to large vessel occlusion (LVO) to a specialised endovascular centre, but their false negative rates remain high leading to inappropriate and costly emergency transfers. Transcranial ultrasonography may represent a valuable pre-hospital tool for selecting patients with LVO who could benefit from rapid transfer to a dedicated centre. Methods Diagnostic accuracy of transcranial ultrasonography in acute stroke was subjected to systematic review. Medline, Embase, PubMed, Scopus, and The Cochrane Library were searched. Published articles reporting diagnostic accuracy of transcranial ultrasonography in comparison to a reference imaging method were selected. Studies reporting estimates of diagnostic accuracy were included in the meta-analysis. Results Twenty-seven published articles were selected for the systematic review. Transcranial Doppler findings, such as absent or diminished blood flow signal in a major cerebral artery and asymmetry index ≥ 21% were shown to be suggestive of LVO. It demonstrated sensitivity ranging from 68 to 100% and specificity of 78–99% for detecting acute steno-occlusive lesions. Area under the receiver operating characteristics curve was 0.91. Transcranial ultrasonography can also detect haemorrhagic foci, however, its application is largely restricted by lesion location. Conclusions Transcranial ultrasonography might potentially be used for the selection of subjects with acute LVO, to help streamline patient care and allow direct transfer to specialised endovascular centres. It can also assist in detecting haemorrhagic lesions in some cases, however, its applicability here is largely restricted. Additional research should optimize the scanning technique. Further work is required to demonstrate whether this diagnostic approach, possibly combined with clinical assessment, could be used at the pre-hospital stage to justify direct transfer to a regional thrombectomy centre in suitable cases.

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162 An Examination of Scar Modelling and Assessment Methods for the Evaluation of Scar Treatments

British Journal of Surgery ◽

10.1093/bjs/znab134.005 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

R Mistry

Keyword(s):

Assessment Tools ◽

Randomised Control Trial ◽

Silicone Gel ◽

Scar Assessment ◽

Significant Difference ◽

Gel Treatment ◽

Current Assessment ◽

Set Up ◽

Silicone Gel Sheeting

Abstract Introduction Scarring is the final common pathway for healing within the skin. Scars can be itchy, painful, tight, and disfiguring. Despite advances in surgery there is currently no reliably effective treatment for reducing or preventing scarring. The primary aim of this research is to assess the currently available models for scarring and evaluate/further develop the utility of current assessment tools, in an effort to design a pilot randomised control trial (RCT) for silicone gel treatment of scars. Method A systematic review of scar models in humans and animals. Examination of currently used subjective and objective scar assessment tools in a plastic surgery scar clinic. A retrospective cohort study assessing long-term scar outcomes in paediatric burn patients. Results Limitations and drawbacks of many existing methods to assess scar treatments were found. No statistically significant difference in long-term scarring outcomes was found between paediatric burns patients treated surgically versus conservatively. A RCT for silicone gel sheeting in the treatment of scars was set up and successful in recruitment. Conclusions Here, we have demonstrated difficulties in establishing a scientific scar treatment model; and created a pilot study that will help to provide high-quality evidence for the efficacy of silicone gel sheeting as a treatment for scars.

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POS0716 FACTORS ASSOCIATED WITH FERTILITY OUTCOMES IN WOMEN WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A SYSTEMATIC REVIEW

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.937 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 607.2-608

Author(s):

S. Giambalvo ◽

C. Garaffoni ◽

E. Silvagni ◽

F. Furini ◽

M. Govoni ◽

...

Keyword(s):

Systematic Review ◽

Systemic Lupus Erythematosus ◽

Quality Assessment ◽

Lupus Erythematosus ◽

Ovarian Failure ◽

Assessment Tools ◽

Study Quality ◽

Systemic Lupus ◽

Factors Associated ◽

Study Quality Assessment

Background:Fertility is thought to be not reduced in women affected by systemic lupus erythematosus (SLE), however disease-related factors, psychosocial effects of chronic disease as well as medication exposure might impair gonadal function.Objectives:The aim of this systematic review was to explore clinical, hormonal, serological, instrumental and management factors associated with fertility outcomes in women of childbearing age with SLE.Methods:This systematic review was conducted following the Preferred Reporting Items for systematic reviews and Meta-analysis (PRISMA) statement. All articles available in English, published from 1972 to 15th August 2020 in Pubmed, EMBASE, Scopus and Cochrane Library. Study selection and data collection were performed by two independent reviewers. All data were extracted using a standardized template. Risk of bias of the included studies was assessed by using the NIH risk-of-bias tool [1].Results:Of 788 abstracts, we included in the review 45 studies of which 1 systematic literature reviews, 16 cross-sectional studies, 15 cohort studies, 12 observational studies and 1 case-series study, with a total of 4656 patients. The mean age was 33.5 ± 5.4 years, while the mean disease duration was 97.4 ± 65.2 months. Figure 1 illustrates the quality of the included studies. Definitions of fertility/premature ovarian failure (POF) adopted in the studies varied in terms of the number of months of amenorrhea considered. Most studies did not use a hormonally based definition of fertility. Clinical factors associated with the development of POF were older age at the time initiation of therapy and older age at the onset of SLE disease. Cyclophosphamide exposure (CYC) and its cumulative dose influenced gonadal function in SLE women, leading to amenorrhoea and ovarian failure, as reported in 19 studies. Mycophenolate, azathioprine, calcineurin inhibitors and steroids seem to be associated with a lower risk of ovarian failure compared to CYC. 3 studies demonstrated that POF was more frequent in patients treated with CYC not receiving gonadotropin-releasing hormone analogues (GnRH) in comparison to those co-treated with GnRH. 11 studies evaluated the impact of damage and disease activity on ovarian reserve in patients with SLE with conflicting evidence. Finally, 18 studies investigated exposure to hormonal and serological factors able to influence fertility outcomes; among others nor Anti-Müllerian Hormone, neither anti-corpus luteum antibodies were associated with POF.Conclusion:The role of disease activity on fertility in SLE patients is contradictory. Regarding management factors associated with fertility in SLE women of childbearing age, the strongest evidence is about the treatment with CYC and its cumulative dose. Hormonal and serological factors did not impact on fertility outcome but might be used as a surrogate of fertility, especially after treatment with disease-specific drugs.References:[1]Study Quality Assessment Tools NIH. https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools.[2]Andreoli L. et al. EULAR recommendations for women’s health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome. Ann Rheum Dis. 2017; 76: 476–485.Disclosure of Interests:None declared

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Complications following volar locking plate fixation for distal radial fractures: a systematic review

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193413511936 ◽

2013 ◽

Vol 39 (7) ◽

pp. 745-754 ◽

Cited By ~ 46

Author(s):

A. Bentohami ◽

K. de Burlet ◽

N. de Korte ◽

M. P. J. van den Bekerom ◽

J. C. Goslings ◽

...

Keyword(s):

Systematic Review ◽

Quality Assessment ◽

Locking Plate ◽

Assessment Tool ◽

Plate Fixation ◽

Assessment Tools ◽

Volar Locking Plate ◽

Locking Plate Fixation ◽

Distal Radial Fractures ◽

Level Of Evidence

The purpose of this systematic review is to assess the prevalence of complications following volar locking plate fixation of distal radial fractures. A computer-based search was carried out using EMBASE and PUBMED/MEDLINE. Only prospective comparative and prospective cohort studies that presented data concerning complications after treatment of distal radial fractures with a volar locking plate in human adults with a minimal follow-up of 6 months were included. Two quality assessment tools were used to assess the methodological quality of the studies (level of evidence rating according to the Oxford Centre of Evidence Based Medicine and the modified version of the Cochrane Bone, Joint and Muscle Trauma Group’s former quality assessment tool). Thirty three studies were eligible for final assessment. Most complications were problems with nerve and tendon function as well as complex regional pain syndrome. With an overall complication rate of 16.5%, most of which were ‘minor’ complications and low rates of nonunion and malunion, volar locking plate fixation can be considered a reasonably safe treatment option for patients with distal radial fractures.

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Monitoring the ability to deliver care in low- and middle-income countries: a systematic review of health facility assessment tools

Health Policy and Planning ◽

10.1093/heapol/czu043 ◽

2014 ◽

Vol 30 (5) ◽

pp. 675-686 ◽

Cited By ~ 22

Author(s):

J. W. Nickerson ◽

O. Adams ◽

A. Attaran ◽

J. Hatcher-Roberts ◽

P. Tugwell

Keyword(s):

Systematic Review ◽

Health Facility ◽

Assessment Tools ◽

Middle Income ◽

Middle Income Countries ◽

Facility Assessment ◽

Low And Middle Income

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A Systematic Review of the Current State and Validity of Digital Assessment Tools for Psychiatry (Preprint)

10.2196/preprints.32824 ◽

2021 ◽

Author(s):

Nayra Anna Martin-Key ◽

Benedetta Spadaro ◽

Erin Funnell ◽

Eleanor Jane Barker ◽

Thea Sofie Schei ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Depressive Disorder ◽

Diagnostic Accuracy ◽

Mental Healthcare ◽

Risk Of Bias ◽

Assessment Tools ◽

Cochrane Library ◽

Digital Assessment ◽

Current State

BACKGROUND Given the role digital technologies are likely to play in the future of mental healthcare, there is a need for a comprehensive appraisal of the current state and validity (i.e., screening/diagnostic accuracy) of digital mental health assessments. OBJECTIVE To explore the current state and validity of question-and-answer-based digital tools for diagnosing and screening psychiatric conditions in adults. METHODS This systematic review was based on the Population, Intervention, Comparison, and Outcome (PICO) framework and was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, Embase, Cochrane Library, ASSIA, Web of Science Core Collection, CINAHL, and PsycINFO were systematically searched for articles published between 2005 and 2020. A descriptive evaluation of the study characteristics and digital solutions and a quantitative appraisal of the screening/diagnostic accuracy of the included tools was conducted. Risk of bias and applicability were assessed using the Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) guidelines. RESULTS A total of 25 studies met the inclusion criteria, with the most frequently evaluated conditions encompassing generalized anxiety disorder (GAD), major depressive disorder (MDD), and any depressive disorder. The majority of the studies employed digitized versions of existing pen-and-paper questionnaires, with findings revealing poor to excellent screening/diagnostic accuracy (sensitivity = 0.36-1.00, specificity = 0.37-1.00, AUC = 0.57-0.98) and a high risk of bias for most of the included studies. CONCLUSIONS The current state of the field of digital mental health tools is in its early stages and high-quality evidence is lacking. INTERNATIONAL REGISTERED REPORT RR2-10.2196/25382

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Hearing Loss Treatment in Older Adults With Cognitive Impairment: A Systematic Review

Journal of Speech Language and Hearing Research ◽

10.1044/2018_jslhr-h-18-0077 ◽

2018 ◽

Vol 61 (10) ◽

pp. 2589-2603 ◽

Cited By ~ 9

Author(s):

Sara K. Mamo ◽

Nicholas S. Reed ◽

Carrie Price ◽

Dona Occhipinti ◽

Alexandra Pletnikova ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Hearing Loss ◽

Cognitive Impairment ◽

Hearing Aids ◽

Controlled Trial ◽

Controlled Vocabulary ◽

Assessment Tools ◽

Cochrane Library ◽

Full Text Review

Purpose The purpose of this systematic review was to assess studies of treating hearing loss in older adults with cognitive impairment. Of interest to this review is identifying clinical adaptations that may be used to tailor hearing loss treatment to older adults with cognitive impairment in order to better serve this vulnerable population. Method A systematic search with controlled vocabulary and key word terms was applied to PubMed, the Cochrane Library, Embase, CINAHL, and PsycINFO. Search concepts included terms related to hearing loss and cognitive impairment. The overall search resulted in 4,945 unique references, 50 of which were eligible for full-text review and 13 of which were included in the final review. Included manuscripts were categorized according to the American Speech-Language-Hearing Association's levels of evidence and the National Institutes of Health Quality Assessment Tools. Results Only 1 study implemented a randomized controlled trial design to assess cognitive function and behavioral symptoms after treatment with hearing aids. Other quasiexperimental studies evaluated dementia-related symptoms and/or auditory function after treating hearing loss in pre/post research designs. Finally, evidence from case studies suggested that hearing loss treatment is feasible, reduces stressful communication for caregivers, and improves dementia-related behavior problems. Conclusion Based on the systematic review, evidence suggests that treating hearing loss in persons with cognitive impairment can have benefits to communication and quality of life. Because of the quasi- and nonexperimental nature of most of the evidence found in this review, further studies are necessary to understand the effect of treatment in the context of a variable and progressive disease.

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