Two decades of digital interventions for anxiety disorders: a systematic review and meta-analysis of treatment effectiveness

2021 ◽  
pp. 1-13
Author(s):  
Darin Pauley ◽  
Pim Cuijpers ◽  
Davide Papola ◽  
Clara Miguel ◽  
Eirini Karyotaki
Keyword(s):  
Systematic Review ◽  
Anxiety Disorder ◽  
Confidence Interval ◽  
Anxiety Disorders ◽  
Effect Size ◽  
Meta Analysis ◽  
Bibliographic Databases ◽  
Wait List ◽  
Digital Interventions ◽  
Significant Difference

Abstract Background Digital interventions for anxiety disorders are a promising solution to address barriers to evidence-based treatment access. Precise and powerful estimates of digital intervention effectiveness for anxiety disorders are necessary for further adoption in practice. The present systematic review and meta-analysis examined the effectiveness of digital interventions across all anxiety disorders and specific to each disorder v. wait-list and care-as-usual controls. Methods A systematic search of bibliographic databases identified 15 030 abstracts from inception to 1 January 2020. Forty-seven randomized controlled trials (53 comparisons; 4958 participants) contributed to the meta-analysis. Subgroup analyses were conducted by an anxiety disorder, risk of bias, treatment support, recruitment, location and treatment adherence. Results A large, pooled effect size of g = 0.80 [95% Confidence Interval: 0.68–0.93] was found in favor of digital interventions. Moderate to large pooled effect sizes favoring digital interventions were found for generalized anxiety disorder (g = 0.62), mixed anxiety samples (g = 0.68), panic disorder with or without agoraphobia (g = 1.08) and social anxiety disorder (g = 0.76) subgroups. No subgroups were significantly different or related to the pooled effect size. Notably, the effects of guided interventions (g = 0.84) and unguided interventions (g = 0.64) were not significantly different. Supplemental analysis comparing digital and face-to-face interventions (9 comparisons; 683 participants) found no significant difference in effect [g = 0.14 favoring digital interventions; Confidence Interval: −0.01 to 0.30]. Conclusion The precise and powerful estimates found further justify the application of digital interventions for anxiety disorders in place of wait-list or usual care.

Mindfulness-Based Interventions for Youth With Anxiety: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 29 (2) ◽  
pp. 195-205 ◽  
Author(s):  
Debra S. Borquist-Conlon ◽  
Brandy R. Maynard ◽  
Kristen Esposito Brendel ◽  
Anne S. J. Farina
Keyword(s):  
Systematic Review ◽  
Anxiety Disorder ◽  
Confidence Interval ◽  
Anxiety Disorders ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Risk Of Bias ◽  
Quasi Experimental ◽  
Disorder Risk

Purpose: To examine the effects on anxiety of mindfulness-based interventions (MBIs) among youth with anxiety disorders. Method: Systematic review and meta-analytic procedures were employed to synthesize experimental and quasi-experimental studies authored between 1980 and 2015. Results: The search yielded five studies from five countries reporting results for a total of 188 youth between the ages of 5 and 18 (mean age 13.26) who met criteria for an anxiety disorder. Risk of bias varied across studies. Meta-analytic results suggest a moderate and significant effect ( g = .62; 95% confidence interval = [0.20, 1.04], p = .004). Heterogeneity was moderate ( I2 = 47.22) and not statistically significant ( Q = 7.58, df = 4, p = .11), thus moderator analyses were not warranted. Discussion: The findings of this review suggest that MBIs for the treatment of anxiety in youth with anxiety disorders are effective.

scholarly journals Anemia and iron metabolism in COVID-19: a systematic review and meta-analysis

2020 ◽  
Vol 35 (8) ◽  
pp. 763-773 ◽  
Author(s):  
Petek Eylul Taneri ◽  
Sergio Alejandro Gómez-Ochoa ◽  
Erand Llanaj ◽  
Peter Francis Raguindin ◽  
Lyda Z. Rojas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Iron Metabolism ◽  
Binding Capacity ◽  
Ferritin Level ◽  
Meta Analysis ◽  
Older Age ◽  
Bibliographic Databases ◽  
Distribution Width ◽  
Significant Difference ◽  
The Impact

Abstract Iron metabolism and anemia may play an important role in multiple organ dysfunction syndrome in Coronavirus disease 2019 (COVID-19). We conducted a systematic review and meta-analysis to evaluate biomarkers of anemia and iron metabolism (hemoglobin, ferritin, transferrin, soluble transferrin receptor, hepcidin, haptoglobin, unsaturated iron-binding capacity, erythropoietin, free erythrocyte protoporphyrine, and erythrocyte indices) in patients diagnosed with COVID-19, and explored their prognostic value. Six bibliographic databases were searched up to August 3rd 2020. We included 189 unique studies, with data from 57,563 COVID-19 patients. Pooled mean hemoglobin and ferritin levels in COVID-19 patients across all ages were 129.7 g/L (95% Confidence Interval (CI), 128.51; 130.88) and 777.33 ng/mL (95% CI, 701.33; 852.77), respectively. Hemoglobin levels were lower with older age, higher percentage of subjects with diabetes, hypertension and overall comorbidities, and admitted to intensive care. Ferritin level increased with older age, increasing proportion of hypertensive study participants, and increasing proportion of mortality. Compared to moderate cases, severe COVID-19 cases had lower hemoglobin [weighted mean difference (WMD), − 4.08 g/L (95% CI − 5.12; − 3.05)] and red blood cell count [WMD, − 0.16 × 1012 /L (95% CI − 0.31; − 0.014)], and higher ferritin [WMD, − 473.25 ng/mL (95% CI 382.52; 563.98)] and red cell distribution width [WMD, 1.82% (95% CI 0.10; 3.55)]. A significant difference in mean ferritin levels of 606.37 ng/mL (95% CI 461.86; 750.88) was found between survivors and non-survivors, but not in hemoglobin levels. Future studies should explore the impact of iron metabolism and anemia in the pathophysiology, prognosis, and treatment of COVID-19.

Systematic Review and Meta-Analysis of Anxiety and Depression in Youth With Epilepsy

2020 ◽  
Vol 45 (2) ◽  
pp. 133-144 ◽  
Author(s):  
Amelia J Scott ◽  
Louise Sharpe ◽  
Max Loomes ◽  
Milena Gandy
Keyword(s):  
Systematic Review ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Depressive Disorders ◽  
Meta Analysis ◽  
Control Sample ◽  
Separation Anxiety Disorder ◽  
Anxiety And Depression ◽  
Healthy Controls ◽  
Pooled Prevalence

Abstract Objective The aim of this systematic review and meta-analysis was to provide an estimate of the prevalence of anxiety and depressive disorders in youth with epilepsy (YWE). It also aimed to calculate the overall magnitude of observed differences in anxiety and depressive symptoms reported by YWE compared with healthy controls and investigate whether any factors moderated anxiety and depression outcomes in YWE. Methods Following prospective registration, electronic databases were searched up until October 2018. Studies were included if they reported on the rate of anxiety or depression in samples of YWE, and/or if they used valid measures of anxious or depressive symptomatology in YWE compared with a healthy control sample. Results Twenty-three studies met inclusion criteria. The overall pooled prevalence of anxiety disorders in YWE was 18.9% (95% confidence interval [CI] 12.0%–28.5%), and for depression the pooled prevalence was 13.5% (95% CI 8.8%–20.2%). In samples of YWE compared with healthy controls, significantly higher anxiety (d = 0.57, 95% CI 0.32–0.83, p < .000) and depressive (d = 0.42, 95% CI 0.16–0.68, p < .000) symptomatology was reported. Conclusions YWE report anxiety and depressive disorders and symptoms to a significantly higher degree than youth without epilepsy. There is also evidence that certain anxiety disorders (e.g. generalized anxiety disorder, separation anxiety disorder) are particularly elevated, perhaps reflecting the unique impact of epilepsy on youth psychopathology. Research is needed to understand the risk factors associated with anxiety and depressive disorders in epilepsy, and better understand how these symptoms change across development.

scholarly journals Accuracy of Wristband Fitbit Models in Assessing Sleep: Systematic Review and Meta-Analysis (Preprint)

2019 ◽  
Author(s):  
Shahab Haghayegh ◽  
Sepideh Khoshnevis ◽  
Michael H Smolensky ◽  
Kenneth R Diller ◽  
Richard J Castriotta
Keyword(s):  
Systematic Review ◽  
Effect Size ◽  
Meta Analysis ◽  
Body Movement ◽  
Sleep Onset ◽  
Sleep Stages ◽  
Sleep Staging ◽  
Exclusion Criteria ◽  
Significant Difference ◽  
Sleep Parameters

BACKGROUND Wearable sleep monitors are of high interest to consumers and researchers because of their ability to provide estimation of sleep patterns in free-living conditions in a cost-efficient way. OBJECTIVE We conducted a systematic review of publications reporting on the performance of wristband <italic>Fitbit</italic> models in assessing sleep parameters and stages. METHODS In adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we comprehensively searched the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane, Embase, MEDLINE, PubMed, PsycINFO, and Web of Science databases using the keyword <italic>Fitbit</italic> to identify relevant publications meeting predefined inclusion and exclusion criteria. RESULTS The search yielded 3085 candidate articles. After eliminating duplicates and in compliance with inclusion and exclusion criteria, 22 articles qualified for systematic review, with 8 providing quantitative data for meta-analysis. In reference to polysomnography (PSG), nonsleep-staging <italic>Fitbit</italic> models tended to overestimate total sleep time (TST; range from approximately 7 to 67 mins; effect size=-0.51, <italic>P</italic>&lt;.001; heterogenicity: I<sup>2</sup>=8.8%, <italic>P</italic>=.36) and sleep efficiency (SE; range from approximately 2% to 15%; effect size=-0.74, <italic>P</italic>&lt;.001; heterogenicity: I<sup>2</sup>=24.0%, <italic>P</italic>=.25), and underestimate wake after sleep onset (WASO; range from approximately 6 to 44 mins; effect size=0.60, <italic>P</italic>&lt;.001; heterogenicity: I<sup>2</sup>=0%, <italic>P</italic>=.92) and there was no significant difference in sleep onset latency (SOL; <italic>P</italic>=.37; heterogenicity: I<sup>2</sup>=0%, <italic>P</italic>=.92). In reference to PSG, nonsleep-staging <italic>Fitbit</italic> models correctly identified sleep epochs with accuracy values between 0.81 and 0.91, sensitivity values between 0.87 and 0.99, and specificity values between 0.10 and 0.52. Recent-generation <italic>Fitbit</italic> models that collectively utilize heart rate variability and body movement to assess sleep stages performed better than early-generation nonsleep-staging ones that utilize only body movement. Sleep-staging <italic>Fitbit</italic> models, in comparison to PSG, showed no significant difference in measured values of WASO (<italic>P</italic>=.25; heterogenicity: I<sup>2</sup>=0%, <italic>P</italic>=.92), TST (<italic>P</italic>=.29; heterogenicity: I<sup>2</sup>=0%, <italic>P</italic>=.98), and SE (<italic>P</italic>=.19) but they underestimated SOL (<italic>P</italic>=.03; heterogenicity: I<sup>2</sup>=0%, <italic>P</italic>=.66). Sleep-staging <italic>Fitbit</italic> models showed higher sensitivity (0.95-0.96) and specificity (0.58-0.69) values in detecting sleep epochs than nonsleep-staging models and those reported in the literature for regular wrist actigraphy. CONCLUSIONS Sleep-staging <italic>Fitbit</italic> models showed promising performance, especially in differentiating wake from sleep. However, although these models are a convenient and economical means for consumers to obtain gross estimates of sleep parameters and time spent in sleep stages, they are of limited specificity and are not a substitute for PSG.

scholarly journals The Effects of Including Aerobic Exercise in the Treatment Protocol of Concussions: A Systemic Review and Meta-analysis

2019 ◽  
Vol 7 (4) ◽  
pp. 33
Author(s):  
Sofie De Wandel ◽  
Tracey Sulak ◽  
Darryn S. Willoughby
Keyword(s):  
Physical Activity ◽  
Confidence Interval ◽  
Aerobic Exercise ◽  
Children And Adolescents ◽  
Effect Size ◽  
Meta Analysis ◽  
Risk Difference ◽  
Systemic Review ◽  
Significant Difference ◽  
The Mean

Background of Study: More research studies are being completed advocating for the use of exercise as an intervention and form of treatment for concussions. However, exercise can include many forms of physical activity, intensities, and durations. This systemic review and meta-analysis focused on the use of aerobic exercise, such as cycling or walking, as an intervention and form of treatment for children and young adults suffering from a concussion. Objective: The purpose of this systematic review and meta-analysis was to determine if the addition of aerobic exercise to an individual concussion treatment makes a significant difference when compared to treatments using flexibility as a form of physical activity or traditional methods of treatment following guidelines from the 2016 Berlin Consensus Statement on Concussion in Sport. Method: The search conducted for articles generated 472 studies. Out of these, 5 studies were selected based from the inclusion criteria. Results: Aerobic exercise was shown to significantly decrease the absolute risk difference for the development of prolonged post-concussion symptoms in children and adolescents with concussions when compared to those who reported no physical activity. The mean risk difference for the independent variable (IV) was -0.12 with a 95% confidence interval was reported to be -0.17 to -0.07 and an effect size of Z = 4.94 (P < 0.00001). Aerobic exercise was also shown to have an effect on the change in post-concussion symptom scale scores. The mean IV difference was 8.7 with a 95% confidence interval of 2.05 to 14.35 and an effect size of Z=3.02 (p=0.003). Conclusion: In conclusion, while there is evidence that aerobic exercise is beneficial for children and adolescents with a concussion, more studies need to be completed focusing on this age group and the effects of aerobic exercise on concussion recovery.

scholarly journals Systematic Review and Meta-Analysis of the Efficacy of Appropriate Empiric Antibiotic Therapy for Sepsis

2010 ◽  
Vol 54 (11) ◽  
pp. 4851-4863 ◽  
Author(s):  
Mical Paul ◽  
Vered Shani ◽  
Eli Muchtar ◽  
Galia Kariv ◽  
Eyal Robenshtok ◽  
...  
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Antibiotic Treatment ◽  
Effect Size ◽  
Observational Studies ◽  
Meta Analysis ◽  
Empiric Antibiotic Therapy ◽  
Clinical Variable ◽  
Empirical Antibiotic Treatment ◽  
All Cause Mortality

ABSTRACT Quantifying the benefit of early antibiotic treatment is crucial for decision making and can be assessed only in observational studies. We performed a systematic review of prospective studies reporting the effect of appropriate empirical antibiotic treatment on all-cause mortality among adult inpatients with sepsis. Two reviewers independently extracted data. Risk of bias was assessed using the Newcastle-Ottawa score. We calculated unadjusted odds ratios (ORs) with 95% confidence intervals for each study and extracted adjusted ORs, with variance, methods, and covariates being used for adjustment. ORs were pooled using random-effects meta-analysis. We examined the effects of methodological and clinical confounders on results through subgroup analysis or mixed-effect meta-regression. Seventy studies were included, of which 48 provided an adjusted OR for inappropriate empirical antibiotic treatment. Inappropriate empirical antibiotic treatment was associated with significantly higher mortality in the unadjusted and adjusted comparisons, with considerable heterogeneity occurring in both analyses (I 2 > 70%). Study design, time of mortality assessment, the reporting methods of the multivariable models, and the covariates used for adjustment were significantly associated with effect size. Septic shock was the only clinical variable significantly affecting results (it was associated with higher ORs). Studies adjusting for background conditions and sepsis severity reported a pooled adjusted OR of 1.60 (95% confidence interval = 1.37 to 1.86; 26 studies; number needed to treat to prevent one fatal outcome, 10 patients [95% confidence interval = 8 to 15]; I 2 = 46.3%) given 34% mortality with inappropriate empirical treatment. Appropriate empirical antibiotic treatment is associated with a significant reduction in all-cause mortality. However, the methods used in the observational studies significantly affect the effect size reported. Methods of observational studies assessing the effects of antibiotic treatment should be improved and standardized.

Comparing effectiveness of fat burners and thermogenic supplements to diet and exercise for weight loss and cardiometabolic health: Systematic review and meta-analysis

2021 ◽  
pp. 026010602098236
Author(s):  
James E Clark ◽  
Sarah Welch
Keyword(s):  
Systematic Review ◽  
Weight Loss ◽  
Confidence Interval ◽  
Dietary Supplements ◽  
Body Mass ◽  
Effect Size ◽  
Meta Analysis ◽  
Cardiometabolic Health ◽  
Chi Square ◽  
Diet And Exercise

Background: Those who are overfat face an onslaught of advice for losing weight, including using dietary supplements that purport to have fat burning capabilities to achieve a reduced body mass, fat mass and improvement in cardiometabolic health in combination with exercise or diet and exercise regimens. Aim: To examine long-term effectiveness of supplements for both weight loss and improvements in cardiometabolic health for these individuals. Methods: A PRISMA methods of systematic review was conducted from August 2018 through January 2019 using Medline, PubChem, PubMed, EBOSCO CINHAL and SPORTDiscus, and Google Scholar yielding 23,441 returns of which 21 studies (duration greater than 8 weeks with participant populations of BMI greater than 24.9) were included for meta-analysis. Meta-analysis examined pooled effect size and 95% confidence interval for: body mass, fat mass, fat-free mass, total cholesterol, high-density lipoproteins, low-density lipoproteins, resting metabolic rate. Intra-study effect sizes were compared with previously reported results for diet or diet and exercise in a 2x2 chi-square analysis for the number of studies that induced effects greater than or less than the effect size. Results: There is a general trend to show effectiveness (effect size greater than 0.00) for obtaining beneficial changes from use of thermogenic dietary supplements, yet the 95% confidence interval for effect size crossed 0.00 (indicating no benefit). Chi-square comparison to exercise, or combination of diet and exercise, indicates that responses induced from weight-loss supplements were less effective than what is obtained from utilizing exercise, or diet and exercise, without additional weight-loss supplements. Conclusion: There appears to be limited benefit that may be derived from the inclusion of thermogenic dietary supplements to reduce body mass and improve cardiometabolic health for individuals who are overfat.

scholarly journals How effective are digital interventions in increasing flu vaccination amongst pregnant women? A systematic review protocol

2020 ◽  
Author(s):  
Jo Parsons ◽  
Helen Atherton
Keyword(s):  
Systematic Review ◽  
Pregnant Women ◽  
Meta Analysis ◽  
Bibliographic Databases ◽  
Flu Vaccination ◽  
Digital Interventions ◽  
Increased Risk ◽  
Study Country ◽  
Randomised Controlled ◽  
The Uk

Abstract Background Pregnant women and their unborn babies are at increased risk of complications as a result of flu, yet uptake of the flu vaccination in the UK remains low. Digital interventions have proven effectiveness in changing health behaviour, but their effectiveness in increasing flu vaccination amongst pregnant women has not been examined. This protocol details the design and methodology of a systematic review and meta-analysis, examining the effectiveness of digital interventions in increasing flu vaccination amongst pregnant women. Methods Bibliographic databases will be searched using appropriate search terms related to vaccination, pregnancy and flu. Randomised, non-randomised, quasi randomised controlled trials and other quantitative study designs will be eligible for inclusion, and studies will present the rate of flu vaccination amongst pregnant women of digital interventions compared to non-digital interventions, or usual care. No date or study country restrictions will be put on included studies, but studies will be published in English. Discussion This is the first known systematic review to examine the effectiveness of digital interventions in increasing the rate of flu vaccination amongst pregnant women. This review has the potential to inform whether digital interventions are an appropriate and successful method of increasing flu vaccination amongst pregnant women, and to determine which mode of digital intervention is most effective. Registration This systematic review is registered on the international prospective register of systematic reviews (PROSPERO). Registration number to follow.

scholarly journals Efficacy of Transparent vs. Pressure Dressing in Prevention of Post-Cardiac Catheterization Pain, Discomfort and Hematoma: A Systematic Review and Meta-analysis of RCTs

2021 ◽  
Vol 10 (2) ◽  
pp. 103-110
Author(s):  
Suresh K Sharma ◽  
Kalpana Thakur ◽  
Shiv K Mudgal ◽  
Barun Kumar
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Cardiac Catheterization ◽  
Odds Ratio ◽  
English Language ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Significant Difference ◽  
Pressure Dressing

ABSTRACT Introduction: There is lack consensus on superiority of transparent vs. pressure dressing for prevention of post-cardiac catheterization pain, discomfort and hematoma. Therefore, we conducted this systematic review and meta-analysis of available RCTs on this subject. Methods: We performed a systematic search of RCTs published between in 2000-2019 in English language using databases including PubMed Medline, EMBASE, CINAHL, Cochrane Library, ERMED Journals, Clinical trials database, DELNET, Google Scholar and Discovery Search. Studies conducted on adult patients with femoral dressing after cardiac catheterization measuring pain, discomfort, hematoma as intended outcomes have been included. Data extraction, critical appraisal, assessment of risk bias was done and decisions on quality were made on mutual consensus. Mantel-Haenszel (MH) and odds ratio for dichotomous variables was calculated by Review Manager 5.3 software. Results: Out of all identified studies, only 5 studies comprising 664 patients fulfilled the inclusion criteria and met the quality assessment. Incidence of discomfort (25, 333) were significantly less in transparent dressing group as compared to pressure dressing group (149, 331); odds ratio 0.10, 95% confidence interval [CI] 0.06-0.15; I2 = 0%, P= 0.00. Four studies reported significantly lower number of pain cases in transparent dressing (17, 203) as compared to pressure dressing (57, 201); odds ratio 0.13, 95% confidence interval [CI] 0.03-0.59; I2 = 47%, P= 0.01). However, incidence of hematoma did not reveal any significant difference between two groups. Conclusion: Transparent dressing is a better option in patients with femoral/groin dressing after cardiac catheterization as it is more effective in prevention of pain and discomfort.

scholarly journals How effective are digital interventions in increasing flu vaccination amongst pregnant women? A systematic review protocol

2020 ◽  
Author(s):  
Jo Parsons ◽  
Helen Atherton
Keyword(s):  
Systematic Review ◽  
Pregnant Women ◽  
Meta Analysis ◽  
Bibliographic Databases ◽  
Flu Vaccination ◽  
Digital Interventions ◽  
Increased Risk ◽  
Study Country ◽  
Randomised Controlled ◽  
The Uk

Abstract Background: Pregnant women and their unborn babies are at increased risk of complications as a result of flu, yet uptake of the flu vaccination in the UK remains low. Digital interventions have proven effectiveness in changing health behaviour, but their effectiveness in increasing flu vaccination amongst pregnant women has not been examined. This protocol details the design and methodology of a systematic review and meta-analysis, examining the effectiveness of digital interventions in increasing flu vaccination amongst pregnant women.Methods: Bibliographic databases will be searched using appropriate search terms related to vaccination, pregnancy and flu. Randomised, non-randomised, quasi randomised controlled trials and other quantitative study designs will be eligible for inclusion, and studies will present the rate of flu vaccination amongst pregnant women of digital interventions compared to non-digital interventions, or usual care. No date or study country restrictions will be put on included studies, but studies will be published in English. Discussion: This is the first known systematic review to examine the effectiveness of digital interventions in increasing the rate of flu vaccination amongst pregnant women. This review has the potential to inform whether digital interventions are an appropriate and successful method of increasing flu vaccination amongst pregnant women, and to determine which mode of digital intervention is most effective.Registration: This systematic review is registered on the international prospective register of systematic reviews (PROSPERO). Registration number: INSERT NUMBER.

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