Assessing Randomised Clinical Trials of Cognitive and Exposure Therapies for Gambling Disorders: A Systematic Review

2013 ◽  
Vol 30 (3) ◽  
pp. 139-158 ◽  
Author(s):  
David P. Smith ◽  
Kirsten I. Dunn ◽  
Peter W. Harvey ◽  
Malcolm W. Battersby ◽  
Rene G. Pols
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Adverse Outcomes ◽  
Randomised Clinical Trials ◽  
Current Evidence ◽  
Cochrane Library ◽  
Behaviour Therapy ◽  
Gambling Disorders ◽  
Cognitive Behaviour ◽  
Current Evidence Base

Aims:Problem or pathological gambling is associated with significant disruption to the individual, family and community with a range of adverse outcomes, including legal, financial and mental health impairment. It occurs more frequently in younger populations, and comorbid conditions are common. Cognitive–behaviour therapy (CBT) is the most empirically established class of treatments for problematic gambling. This article reports on a systematic review and evaluation of randomised clinical trials (RCTs) concerning two core techniques of CBT: cognitive and behavioural (exposure-based) therapies.Methods:PsycINFO, MEDLINE and the Cochrane library were searched from database inception to December 2012. The CONsolidated Standards Of Reporting Trials (CONSORT) for non-pharmacological treatments was used to evaluate each study.Results:The initial search identified 104 references. After two screening phases, seven RCTs evaluating either cognitive (n= 3), exposure (n= 3) or both (n= 1) interventions remained. The studies were published between 1983 and 2003 and conducted across Australia, Canada, and Spain. On average, approximately 31% of CONSORT items were rated as ‘absent’ for each study and more than 52% rated as ‘present with some limitations’. For all studies, 70.83% of items rated as ‘absent’ were in the methods section.Conclusions:The findings from this review of randomised clinical trials involving cognitive and exposure-based treatments for gambling disorders show that the current evidence base is limited. Trials with low risk of bias are needed to be reported before recommendations are given on their effectiveness and clinicians can appraise their potential utility with confidence.

scholarly journals Efficacy of dialectical behavior therapy for adolescent self-harm and suicidal ideation: a systematic review and meta-analysis

2021 ◽  
pp. 1-11
Author(s):  
Oswald D. Kothgassner ◽  
Andreas Goreis ◽  
Kealagh Robinson ◽  
Mercedes M. Huscsava ◽  
Christian Schmahl ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Suicidal Ideation ◽  
Dialectical Behavior Therapy ◽  
Meta Analysis ◽  
Adolescent Psychopathology ◽  
Cochrane Library ◽  
Behaviour Therapy ◽  
Clinical Consequences ◽  
Self Harm

Abstract Background Given the widespread nature and clinical consequences of self-harm and suicidal ideation among adolescents, establishing the efficacy of developmentally appropriate treatments that reduce both self-harm and suicidal ideation in the context of broader adolescent psychopathology is critical. Methods We conducted a systematic review and meta-analysis of the Dialectical Behaviour Therapy for Adolescents (DBT-A) literature on treating self-injury in adolescents (12–19 years). We searched for eligible trials and treatment evaluations published prior to July 2020 in MEDLINE/PubMed, Scopus, Google Scholar, EMBASE, and the Cochrane Library databases for clinical trials. Twenty-one studies were identified [five randomized-controlled trials (RCTs), three controlled clinical trials (CCTs), and 13 pre-post evaluations]. We extracted data for predefined primary (self-harm, suicidal ideation) and secondary outcomes (borderline personality symptoms; BPD) and calculated treatment effects for RCTs/CCTs and pre-post evaluations. This meta-analysis was pre-registered with OSF: osf.io/v83e7. Results Overall, the studies comprised 1673 adolescents. Compared to control groups, DBT-A showed small to moderate effects for reducing self-harm (g = −0.44; 95% CI −0.81 to −0.07) and suicidal ideation (g = −0.31, 95% CI −0.52 to −0.09). Pre-post evaluations suggested large effects for all outcomes (self-harm: g = −0.98, 95% CI −1.15 to −0.81; suicidal ideation: g = −1.16, 95% CI −1.51 to −0.80; BPD symptoms: g = −0.97, 95% CI −1.31 to −0.63). Conclusions DBT-A appears to be a valuable treatment in reducing both adolescent self-harm and suicidal ideation. However, evidence that DBT-A reduces BPD symptoms was only found in pre-post evaluations.

scholarly journals Vasoactive agents in acute mesenteric ischaemia in critical care.  A systematic review

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 453
Author(s):  
Christopher A Brennan ◽  
Peter Osei-Bonsu ◽  
Rachael Eimear McClenaghan ◽  
Ahmed Nassar ◽  
Patrice Forget ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Critical Care ◽  
Randomised Clinical Trials ◽  
Current Evidence ◽  
Mesenteric Ischaemia ◽  
Vasoactive Agents ◽  
Acute Mesenteric Ischaemia ◽  
Ovid Medline ◽  
Randomised Controlled

Background: Acute mesenteric ischaemia (AMI) is a surgical emergency which has an associated high mortality.  The mainstay of active treatment includes early surgical intervention, with resection of non-viable bowel, and revascularisation of the ischaemic bowel where possible. Due to the physiological insult of AMI however, perioperative care often involves critical care and the use of vasoactive agents to optimise end organ perfusion. A number of these vasoactive agents are currently available with varied mechanism of action and effects on splanchnic blood flow. However, specific guidance on which is the optimal vasoactive drug to use in these settings is limited. This systematic review aimed to evaluate the current evidence comparing vasoactive drugs in AMI. Methods: A systematic search of Ovid Medline, Ovid Embase, Cochrane CENTRAL and the Cochrane Database of Systematic Review was performed on the 5th of November 2020 to identify randomised clinical trials comparing different vasoactive agents in AMI on outcomes including mortality. The search was performed through the Royal College of Surgeons of England (RCSEng) search support library. Results were analysed using the Rayyan platform, and independently screened by four investigators. Results: 614 distinct papers were identified. After screening, there were no randomised clinical trials meeting the inclusion criteria. Conclusions: This review identifies a gap in literature, and therefore recommends an investigation into current practice and clinician preference in relation to vasoactive agents in AMI. Multicentre randomised controlled trials comparing these medications on clinical outcomes will therefore be required to address this question.

scholarly journals Systematic review of Swedish snus for smoking cessation based on primary subject data from randomised clinical trials

2013 ◽  
Vol 8 (1) ◽  
pp. 33-44 ◽  
Author(s):  
L. E. Rutqvist ◽  
J. S. Fry ◽  
P. N. Lee
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Smoking Cessation ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Randomised Clinical Trials ◽  
Cochrane Library ◽  
Population Surveys ◽  
The Us ◽  
Swedish Snus

Introduction: The ability of Swedish snus to serve as a smoking cessation aid has been documented in several observational, population surveys from Scandinavia, but randomised clinical trials provide more reliable information on efficacy. Aims: To perform a systematic review and meta-analysis of randomised clinical trials of Swedish snus as an aid to smoking cessation. Methods: Literature searches were conducted in MedLine, Cochrane Library, and Embase to identify relevant clinical trials. The primary outcome was defined as biologically confirmed smoking cessation during around six months. Meta-analyses based on primary subject data tested for effect of allocated treatment as well as selected baseline characteristics. Results: There were two relevant clinical trials, one conducted at five sites in the US (n = 250), the other at two sites in Serbia (n = 319). Based on the primary outcome, success was higher in the treated group in both Serbia (5.7% vs 1.9%) and the US (4.0% vs 1.6%). Meta-analysis estimated the relative success rate at 2.83 (95% CI 1.03–7.75), which was of borderline significance (exact p = 0.06, chi-squared p = 0.03). For smoking cessation in the last 4 weeks of each study, rates were 12.4% for snus and 6.6% for placebo (RR 1.86, 95% CI 1.09-3.18). Efficacy of snus was not clearly related to any baseline characteristic. Conclusions: Swedish snus increased quit rates similarly in US and Serbia. These results confirm and extend previous information based on observational population surveys.

A critical evaluation of the role of cognitive behaviour therapy in children and adolescents with depression

2009 ◽  
Vol 2 (2) ◽  
pp. 83-91 ◽  
Author(s):  
Maura Delaney
Keyword(s):  
Children And Adolescents ◽  
Cognitive Behaviour Therapy ◽  
Depressive Disorders ◽  
Critical Evaluation ◽  
Evidence Base ◽  
Current Evidence ◽  
Behaviour Therapy ◽  
Treatment Of Depression ◽  
Cognitive Behaviour ◽  
Current Evidence Base

AbstractDepressive disorders are relatively common in adolescents although less so in younger children. They accrue significant morbidity and frequent long-term sequelae as well as increased suicide risk in sufferers. Evidence-based treatment of depression in children and adolescents is the subject of intense investigation and debate. This article reviews the current evidence base for cognitive behaviour therapy in this group and makes recommendations for further areas of research.

Cognitive Behaviour Therapy for Psychosis: Current Evidence and Future Directions

2008 ◽  
Vol 36 (6) ◽  
pp. 705-712 ◽  
Author(s):  
Craig Steel
Keyword(s):  
Evidence Base ◽  
Behavioural Therapy ◽  
Current Evidence ◽  
Behaviour Therapy ◽  
Theoretical Understanding ◽  
Future Directions ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour ◽  
Current Evidence Base ◽  
Cognitive Behavioural Interventions

AbstractThe past decade has seen considerable growth in the evidence base of cognitive behavioural therapy for psychosis. Consistent reports of moderate effect sizes have led to such interventions being recommended as part of routine clinical practice. Most of this evidence is based on a generic form of CBT for psychosis applied to a heterogeneous group. An increase in the effectiveness of cognitive behavioural interventions may require new protocols. Such therapeutic developments should be based on the theoretical understanding of the psychological processes associated with specific forms of psychotic presentation. The current evidence base of CBT for psychosis is reviewed, and barriers that have held back the development of this research are discussed.

scholarly journals Tooth-Bone-Borne Vs. Bone-Borne Palatal Expanders: A Systematic Review

2021 ◽  
Vol 2 ◽  
Author(s):  
Yomna M. Yacout ◽  
Mohamed G. Hassan ◽  
Nadia M. El-Harouni ◽  
Hanan A. Ismail ◽  
Abbas R. Zaher
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Selection Criteria ◽  
Randomized Clinical Trials ◽  
Reference Lists ◽  
Web Of Science ◽  
Research Question ◽  
Current Evidence ◽  
Cochrane Library ◽  
Hand Search

The aim of this review was to evaluate the current evidence regarding post-treatment effects of tooth-bone-borne vs. bone-borne expanders. A search was conducted in MEDLINE via PubMed, Web of Science, Scopus, Cochrane Library, Google Scholar, and Open Gray; in addition to a hand search in reference lists of selected articles and creating a search alert in electronic databases. Selection criteria included randomized and prospective clinical trials comparing post-expansion skeletal and/or dento-alveolar effects of tooth-bone-borne expanders to those of bone-borne expanders. Following study retrieval and selection, relevant data was extracted, and risk of bias was assessed using the revised RoB 2 tool for randomized clinical trials. After examining 10 full text articles, one randomized clinical trial was finally included. The study compared the dento-alveolar effects of tooth-bone-borne and bone-borne expanders, following expansion and after 6 months, using digital dental casts. Using the RoB 2 tool, the study was judged overall to show some concerns. A definitive conclusion could not be drawn from this systematic review due to the scarcity of clinical trials tackling the research question. A need for future well-conducted research was highlighted in this review.

scholarly journals The Use of Augmented and Mixed Reality Technology to Improve Surgical Outcomes: a Systematic Review Protocol

2020 ◽  
Author(s):  
Edward Bollen ◽  
Joshua Solomon ◽  
Matthew Stubbs ◽  
Benjamin Langridge ◽  
Peter E. Butler
Keyword(s):  
Systematic Review ◽  
Augmented Reality ◽  
Real World ◽  
Surgical Outcomes ◽  
Mixed Reality ◽  
Current Evidence ◽  
Cochrane Library ◽  
Future Research ◽  
The Real ◽  
Current Evidence Base

Abstract BackgroundThe use of mixed and augmented reality in surgery is a novel and rapidly developing field. Augmented reality is a technology which overlays virtual images on to the real world and is supported by a variety of platforms. Mixed reality is a newer technology, which, in contrast, allows the user to interact with virtual objects projected onto the real world. These technologies have been employed in a range of surgical contexts and specialities and have generated significant public interest, however, the evidence supporting their proposed benefits is unclear. This systematic review aims to critically appraise the intraoperative use of mixed and augmented reality technologies to improve surgical outcomes and provide directions for future research. Methods This systematic review will follow the PRISMA guidelines and search the MEDLINE, EMBASE, the Cochrane Library electronic databases. All clinical studies reporting empirical data on the intraoperative use of augmented or mixed reality technologies will be eligible for inclusion. Identified studies will be screened for inclusion by three authors in parallel, with a fourth author resolving any discrepancies. Risk of bias will be assessed in accordance with Cochrane Handbook for Systematic Reviews of Interventions guidance. The quality of evidence for each outcome will be assessed using the GRADE approach.DiscussionThis will be the first systematic review performed with a specific focus on the use of mixed reality in surgery. If augmented and mixed reality are to become established tools in surgery, it is necessary to understand their use cases, advantages, limitations and cost-effectiveness. This is a young but rapidly evolving field; this synthesis of the current evidence base will provide direction for future research and development.Systematic Review RegistrationPROSPERO CRD42020205892

scholarly journals Vasoactive agents in acute mesenteric ischaemia in critical care.  A systematic review

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 453
Author(s):  
Christopher A Brennan ◽  
Peter Osei-Bonsu ◽  
Rachael Eimear McClenaghan ◽  
Ahmed Nassar ◽  
Patrice Forget ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Critical Care ◽  
Randomised Clinical Trials ◽  
Current Evidence ◽  
Mesenteric Ischaemia ◽  
Vasoactive Agents ◽  
Acute Mesenteric Ischaemia ◽  
Ovid Medline ◽  
Randomised Controlled

Background: Acute mesenteric ischaemia (AMI) is a surgical emergency which has an associated high mortality.  The mainstay of active treatment includes early surgical intervention, with resection of non-viable bowel, and revascularisation of the ischaemic bowel where possible. Due to the physiological insult of AMI however, perioperative care often involves critical care and the use of vasoactive agents to optimise end organ perfusion. A number of these vasoactive agents are currently available with varied mechanism of action and effects on splanchnic blood flow. However, specific guidance on which is the optimal vasoactive drug to use in these settings is limited. This systematic review aimed to evaluate the current evidence comparing vasoactive drugs in AMI. Methods: A systematic search of Ovid Medline, Ovid Embase, Cochrane CENTRAL and the Cochrane Database of Systematic Review was performed on the 5th of November 2020 to identify randomised clinical trials comparing different vasoactive agents in AMI on outcomes including mortality. The search was performed through the Royal College of Surgeons of England (RCSEng) search support library. Results were analysed using the Rayyan platform, and independently screened by four investigators. Results: 614 distinct papers were identified. After screening, there were no randomised clinical trials meeting the inclusion criteria. Conclusions: This review identifies a gap in literature, and therefore recommends an investigation into current practice and clinician preference in relation to vasoactive agents in AMI. Multicentre randomised controlled trials comparing these medications on clinical outcomes will therefore be required to address this question.

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