scholarly journals Diversity or disarray? A systematic review of decision-making capacity for treatment and research in schizophrenia and other non-affective psychoses

2017 ◽  
Vol 47 (11) ◽  
pp. 1906-1922 ◽  
Author(s):  
B. W. J. Spencer ◽  
G. Shields ◽  
T. Gergel ◽  
M. Hotopf ◽  
G. S. Owen
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Wide Spectrum ◽  
Meta Analysis ◽  
Research Participation ◽  
Demographic Factors ◽  
Neurocognitive Deficits ◽  
Ovid Medline ◽  
Decision Making Capacity ◽  
Socio Demographic Factors

BackgroundValid consent for treatment or research participation requires that an individual has decision-making capacity (DMC), which is the ability to make a specific decision. There is evidence that the psychopathology of schizophrenia can compromise DMC. The objective of this review was to examine the presence or absence of DMC in schizophrenia and the socio-demographic/psychopathological factors associated.MethodsWe searched three databases Embase, Ovid MEDLINE(R), and PsycINFO for studies reporting data on the proportion of DMC for treatment and research (DMC-T and DMC-R), and/or socio-demographic/psychopathological associations with ability to make such decisions, in people with schizophrenia and related illnesses.ResultsA total of 40 studies were identified. While high levels of heterogeneity limited direct comparison, meta-analysis of inpatient data showed that DMC-T was present in 48% of people. Insight was strongly associated with DMC-T. Neurocognitive deficits were strongly associated with lack of DMC-R and to a lesser extent DMC-T. With the exception of years of education, there was no evidence for an association with socio-demographic factors.ConclusionsInsight and neurocognitive deficits are most closely associated with DMC in schizophrenia. The lack of an association with socio-demographic factors dispels common misperceptions regarding DMC and characteristics such as age. Although our results reveal a wide spectrum of DMC-T and DMC-R in schizophrenia, this could be partly due to the complexity of the DMC construct and the heterogeneity of existing studies. To facilitate systematic review research, there is a need for improvement within research study design and increased consistency of concepts and tools.

scholarly journals Systematic review and meta-analysis of factors that help or hinder treatment decision-making capacity in psychosis

2017 ◽  
Vol 211 (4) ◽  
pp. 205-215 ◽  
Author(s):  
Amanda Larkin ◽  
Paul Hutton
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Current Knowledge ◽  
Meta Analysis ◽  
Treatment Decision ◽  
Psychotic Symptoms ◽  
Related Factors ◽  
Treatment Decision Making ◽  
Effective Strategies ◽  
Decision Making Capacity

BackgroundThe evidence on factors that may influence treatment decisional capacity (‘capacity’) in psychosis has yet to be comprehensively synthesised, which limits the development of effective strategies to improve or support it.AimsTo determine the direction, magnitude and reliability of the relationship between capacity in psychosis and a range of clinical, demographic and treatment-related factors, thus providing a thorough synthesis of current knowledge.MethodWe conducted a systematic review, meta-analytical and narrative synthesis of factors that help or hinder treatment decision-making capacity in psychosis, assessing the direction, magnitude, significance and reliability of reported associations.ResultsWe identified 23 relevant studies (n= 1823). Psychotic symptoms had small, moderate and strong associations with appreciation, understanding and reasoning respectively. Both verbal cognitive functioning and duration of education had small to moderate correlations with understanding and reasoning. Better capacity was also associated with better insight, better metacognitive ability, higher anxiety and lower perceived coercion. No linear relationship with depression was observed. Interventions linked to improved capacity over time were in-patient care, information simplification, shared decision-making and metacognitive training.ConclusionsAlthough much is known about the role of symptoms and other clinical variables, effective and acceptable psychological interventions to support capacity in this group are lacking.

scholarly journals Death Anxiety Associated With Coronavirus (COVID-19) Disease: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 003022282110505
Author(s):  
Safiye Özgüç ◽  
Emine Kaplan Serin ◽  
Derya Tanriverdi
Keyword(s):  
Systematic Review ◽  
Death Anxiety ◽  
Meta Analysis ◽  
Demographic Factors ◽  
Human Existence ◽  
The World ◽  
Socio Demographic Factors

Death anxiety is a feeling that exists since birth, continues throughout life, lies at the root of all fears, and develops after the awareness that people will no longer exist and that they can lose themselves and the world. It is associated with death-induced anxiety with many features of the COVID-19 pandemic, which can be seen as a threat to human existence. In this study, it is aimed to compile studies on death anxiety associated with coronavirus disease, list the general characteristics of these studies through descriptive summaries, and combine findings on the level of death anxiety associated with coronavirus disease through meta-analysis. The findings of this study suggest that COVID-19 pandemic process and is affected by socio-demographic factors such as fear of COVID-19, gender, and occupation. As a result of this study, it was determined that death anxiety was relatively high during the COVID-19 pandemic process.

A systematic review and meta-analysis of effectiveness of decision aids for vaccination decision-making

Vaccine ◽  
2021 ◽  
Author(s):  
Cassandra Vujovich-Dunn ◽  
Jessica Kaufman ◽  
Catherine King ◽  
S. Rachel Skinner ◽  
Handan Wand ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Meta Analysis ◽  
Decision Aids ◽  
Vaccination Decision

Focal Concerns and Police Decision Making in Sexual Assault Cases: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 152483802199128
Author(s):  
David S. Lapsey ◽  
Bradley A. Campbell ◽  
Bryant T. Plumlee
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Sexual Assault ◽  
Meta Analysis ◽  
The United States ◽  
Empirical Literature ◽  
Campbell Collaboration ◽  
Focal Concerns ◽  
Police Decision Making ◽  
The Impact

Sexual assault and case attrition at the arrest stage are serious problems in the United States. Focal concerns have increasingly been used to explain police decision making in sexual assault cases. Because of the popularity of the focal concerns perspective and potential to inform evidence-based training, a systematic review and meta-analysis are needed to condense the literature. In this study, we assess the overall strength of the relationship between focal concerns variables and police decisions to arrest in cases of sexual assault. Our assessment of the effects of focal concerns variables on arrest decision making in sexual assault cases followed the systematic review protocols provided by the Campbell Collaboration of Systematic Reviews. Specifically, we used the Campbell Collaboration recommendations to search empirical literature and used meta-analysis to evaluate the size, direction, and strength of the impact of focal concerns variables on arrest decisions. Our search strategy detected 14 eligible studies and 79 effect sizes. The meta-analysis found several robust and statistically significant correlates of arrest. In fact, each focal concerns concept produced at least one robust arrest correlate. Overall, focal concerns offers a strong approach for explaining police decisions in sexual assault cases. Although practical concerns and resource constraints produced the strongest arrest correlates, results show the importance of additional case characteristics in officers’ decision to arrest.

scholarly journals A systematic review and meta-analysis of treatment-related toxicities of curative and palliative radiation therapy in non-small cell lung cancer

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
M. Or ◽  
B. Liu ◽  
J. Lam ◽  
S. Vinod ◽  
W. Xuan ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Decision Making ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Meta Analysis ◽  
Small Cell ◽  
Small Cell Lung ◽  
Cardiac Events ◽  
Grade 3

AbstractTreatment-related toxicity is an important component in non-small cell lung cancer (NSCLC) management decision-making. Our aim was to evaluate and compare the toxicity rates of curative and palliative radiotherapy with and without chemotherapy. This meta-analysis provides better quantitative estimates of the toxicities compared to individual trials. A systematic review of randomised trials with > 50 unresectable NSCLC patients, treated with curative or palliative conventional radiotherapy (RT) with or without chemotherapy. Data was extracted for oesophagitis, pneumonitis, cardiac events, pulmonary fibrosis, myelopathy and neutropenia by any grade, grade ≥ 3 and treatment-related deaths. Mantel–Haenszel fixed-effect method was used to obtain pooled risk ratio. Forty-nine trials with 8609 evaluable patients were included. There was significantly less grade ≥ 3 acute oesophagitis (6.4 vs 22.2%, p < 0.0001) and any grade oesophagitis (70.4 vs 79.0%, p = 0.04) for sequential CRT compared to concurrent CRT, with no difference in pneumonitis (grade ≥ 3 or any grade), neutropenia (grade ≥ 3), cardiac events (grade ≥ 3) or treatment-related deaths. Although the rate of toxicity increased with intensification of treatment with RT, the only significant difference between treatment regimens was the rate of oesophagitis between the use of concurrent and sequential CRT. This can aid clinicians in radiotherapy decision making for NSCLC.

Decision-making capacity for research participation among individuals in the CATIE schizophrenia trial

2005 ◽  
Vol 80 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Scott Stroup ◽  
Paul Appelbaum ◽  
Marvin Swartz ◽  
Mukesh Patel ◽  
Sonia Davis ◽  
...  
Keyword(s):  
Decision Making ◽  
Research Participation ◽  
Decision Making Capacity

scholarly journals Biotic Supplements for Renal Patients: A Systematic Review and Meta-Analysis

Nutrients ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 1224 ◽  
Author(s):  
Anna Pisano ◽  
Graziella D’Arrigo ◽  
Giuseppe Coppolino ◽  
Davide Bolignano
Keyword(s):  
Systematic Review ◽  
Large Scale ◽  
Meta Analysis ◽  
Outcome Data ◽  
Reactive Protein ◽  
Surrogate Outcomes ◽  
Ovid Medline ◽  
Primary Endpoints ◽  
Intestinal Dysbiosis ◽  
Secondary Endpoints

Intestinal dysbiosis is highly pervasive among chronic kidney disease (CKD) patients and may play a key role in disease progression and complications. We performed a systematic review and meta-analysis to evaluate effects of biotic supplements on a large series of outcomes in renal patients. Ovid-MEDLINE, PubMed and CENTRAL databases were searched for randomized controlled trials (RCTs) comparing any biotic (pre-, pro- or synbiotics) to standard therapy or placebo. Primary endpoints were change in renal function and cardiovascular events; secondary endpoints were change in proteinuria/albuminuria, inflammation, uremic toxins, quality of life and nutritional status. Seventeen eligible studies (701 participants) were reviewed. Biotics treatment did not modify estimated glomerular filtration rate (eGFR) (mean difference (MD) 0.34 mL/min/1.73 m2; 95% CI −0.19, 0.86), serum creatinine (MD −0.13 mg/dL; 95% confidence interval (CI) −0.32, 0.07), C-reactive protein (MD 0.75 mg/dL; 95% CI −1.54, 3.03) and urea (standardized MD (SMD) −0.02; 95% CI −0.25, 0.20) as compared to control. Outcome data on the other endpoints of interest were lacking, sparse or in an unsuitable format to be analyzed collectively. According to the currently available evidence, there is no conclusive rationale for recommending biotic supplements for improving outcomes in renal patients. Large-scale, well-designed and adequately powered studies focusing on hard rather than surrogate outcomes are still awaited.

Safety of Cochlear Implantation in Children 12 Months or Younger: Systematic Review and Meta-analysis

2022 ◽  
pp. 019459982110677
Author(s):  
Firas Sbeih ◽  
Malek H. Bouzaher ◽  
Swathi Appachi ◽  
Seth Schwartz ◽  
Michael S. Cohen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cochlear Implants ◽  
Cochlear Implantation ◽  
Meta Analysis ◽  
Cochrane Central Register ◽  
Ovid Medline ◽  
Central Register ◽  
Data Source ◽  
Anesthetic Complications ◽  
Full Text Screening

Objective To systematically review the literature to determine safety of cochlear implantation in pediatric patients 12 months and younger. Data Source Ovid MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched from inception to March 20, 2021. Review Methods Studies that involved patients 12 months and younger with report of intraoperative or postoperative complication outcomes were included. Studies selected were reviewed for complications, explants, readmissions, and prolonged hospitalizations. Two independent reviewers screened all studies that were selected for the systematic review and meta-analysis. All studies included were assessed for quality and risk of bias. Results The literature search yielded 269 studies, of which 53 studies underwent full-text screening, and 18 studies were selected for the systematic review and meta-analysis. A total of 449 patients and 625 cochlear implants were assessed. Across all included studies, major complications were noted in 3.1% of patients (95% CI, 0.8-7.1) and 2.3% of cochlear implantations (95% CI, 0.6-5.2), whereas minor complications were noted in 2.4% of patients (95% CI, 0.4-6.0) and 1.8% of cochlear implantations (95% CI, 0.4-4.3). There were no anesthetic complications reported across all included studies. Conclusion The results of this systematic review and meta-analysis suggest that cochlear implantation in patients 12 months and younger is safe with similar rates of complications to older cohorts.

scholarly journals How does decisional capacity evolve with normal cognitive aging: systematic review of the literature

2019 ◽  
Vol 11 (1) ◽  
pp. 117-129 ◽  
Author(s):  
Thomas Tannou ◽  
Séverine Koeberlé ◽  
Régis Aubry ◽  
Emmanuel Haffen
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Processing Speed ◽  
Cognitive Aging ◽  
Social Issues ◽  
Meta Analysis ◽  
Decisional Capacity ◽  
Literature Reviews ◽  
Decision Making Processes ◽  
Motivation Profiles

Abstract Purpose Aging is associated with increased needs related to complex decisions, particularly in medical and social issues. However, the complexity of decision-making involves many neurological functions and structures which are potentially altered by cognitive aging. Methodology A systematic review was conducted in accordance with PRISMA guidelines to examine changes in decision-making occurring in normal cognitive aging. The keywords “decision making” and “normal aging” were used to find the clinical studies and literature reviews focused on these changes. Results A total of 97 articles were considered in the review, and ultimately 40 articles were selected, including 30 studies and 10 literature reviews. The data from these studies were of uneven quality and too disparate to allow meta-analysis according to PRISMA criteria. Nevertheless, a key result of the analysis is the decrease of processing speed with aging. In ambiguous decision-making situations, the alteration of the ventromedial system is associated with changes in motivation profiles. These changes can be compensated by experience. However, difficulties arise for older adults in the case of one-off decisions, which are very common in the medical or medico-social domains. Conclusions Cognitive aging is associated with a slowdown in processing speed of decision-making, especially in ambiguous situations. However, decision-making processes which are based on experience and cases in which sufficient time is available are less affected by aging. These results highlight the relativity of decision-making capacities in cognitive aging.

Prevalence of Mycoplasma genitalium by anatomical site in men who have sex with men: a systematic review and meta-analysis

2020 ◽  
Vol 96 (8) ◽  
pp. 563-570
Author(s):  
Rosie L Latimer ◽  
Hannah S Shilling ◽  
Lenka A Vodstrcil ◽  
Dorothy A Machalek ◽  
Christopher K Fairley ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Mycoplasma Genitalium ◽  
Nucleic Acid Amplification ◽  
Hiv Positive ◽  
Published Data ◽  
Anatomical Site ◽  
Ovid Medline ◽  
Registration Number ◽  
Sex With Men

ObjectiveTo systematically review and appraise published data, to determine the prevalence of Mycoplasma genitalium (MG) in men who have sex with men (MSM) tested at each anatomical site, that is, at the urethra, rectum and/or pharynx.DesignSystematic review and meta-analysis.Data sourcesOvid Medline, PubMed, Embase were searched for articles from 1st January 1981 (the year MG was first identified) to 1st June 2018.Review methodsStudies were eligible for inclusion if they reported MG prevalence in MSM tested at the urethra, rectum and/or pharynx, in at least 50 MSM, using nucleic acid amplification testing. Data were extracted by anatomical site, symptom and HIV status. Summary estimates (95% CIs) were calculated using random-effects meta-analysis. Subgroup analyses were performed to assess heterogeneity between studies.ResultsForty-six studies met inclusion criteria, with 34 reporting estimates of MG prevalence at the urethra (13 753 samples), 25 at the rectum (8629 samples) and 7 at the pharynx (1871 samples). MG prevalence was 5.0% (95% CI 3.5 to 6.8; I2=94.0) at the urethra; 6.2% (95% CI 4.6 to 8.1; I2=88.1) at the rectum and 1.0% (95% CI 0.0 to 5.1; I2=96.0) at the pharynx. The prevalence of MG was significantly higher at urethral and rectal sites in symptomatic versus asymptomatic MSM (7.1% vs 2.2%, p<0.001; and 16.1% vs 7.5%, p=0.039, respectively). MG prevalence at the urethra was significantly higher in HIV-positive compared with HIV-negative MSM (7.0% vs 3.4%, p=0.006).ConclusionMG was common in MSM, particularly at urethral and rectal sites (5% to 6%). MG was more commonly detected in symptomatic men at both sites, and more common in HIV-positive men at the urethra. MG was uncommonly detected in the pharynx. Site-specific estimates are similar to those for chlamydia and will be helpful in informing testing practices in MSM.PROSPERO registration numberCRD42017058326.

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