scholarly journals Mindfulness-based interventions for teachers: A meta-analysis of the emerging evidence base.

2018 ◽  
Vol 33 (4) ◽  
pp. 501-511 ◽  
Author(s):  
David A. Klingbeil ◽  
Tyler L. Renshaw
Keyword(s):  
Meta Analysis ◽  
Evidence Base

scholarly journals Comparing the use of aggregate data and various methods of integrating individual patient data to network meta-analysis and its application to first-line ART

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Steve Kanters ◽  
Mohammad Ehsanul Karim ◽  
Kristian Thorlund ◽  
Aslam H. Anis ◽  
Michael Zoratti ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Evidence Base ◽  
Aggregate Data ◽  
World Health ◽  
Coefficient Estimates ◽  
Two Stage ◽  
Individual Patient Level ◽  
One Stage ◽  
Meta Regression ◽  
Empirical Priors

Abstract Background The 2018 World Health Organization HIV guidelines were based on the results of a network meta-analysis (NMA) of published trials. This study employed individual patient-level data (IPD) and aggregate data (AgD) and meta-regression methods to assess the evidence supporting the WHO recommendations and whether they needed any refinements. Methods Access to IPD from three trials was granted through ClinicalStudyDataRequest.com (CSDR). Seven modelling approaches were applied and compared: 1) Unadjusted AgD network meta-analysis (NMA) – the original analysis; 2) AgD-NMA with meta-regression; 3) Two-stage IPD-AgD NMA; 4) Unadjusted one-stage IPD-AgD NMA; 5) One-stage IPD-AgD NMA with meta-regression (one-stage approach); 6) Two-stage IPD-AgD NMA with empirical-priors (empirical-priors approach); 7) Hierarchical meta-regression IPD-AgD NMA (HMR approach). The first two were the models used previously. Models were compared with respect to effect estimates, changes in the effect estimates, coefficient estimates, DIC and model fit, rankings and between-study heterogeneity. Results IPD were available for 2160 patients, representing 6.5% of the evidence base and 3 of 24 edges. The aspect of the model affected by the choice of modeling appeared to differ across outcomes. HMR consistently generated larger intervals, often with credible intervals (CrI) containing the null value. Discontinuations due to adverse events and viral suppression at 96 weeks were the only two outcomes for which the unadjusted AgD NMA would not be selected. For the first, the selected model shifted the principal comparison of interest from an odds ratio of 0.28 (95% CrI: 10.17, 0.44) to 0.37 (95% CrI: 0.23, 0.58). Throughout all outcomes, the regression estimates differed substantially between AgD and IPD methods, with the latter being more often larger in magnitude and statistically significant. Conclusions Overall, the use of IPD often impacted the coefficient estimates, but not sufficiently as to necessitate altering the final recommendations of the 2018 WHO Guidelines. Future work should examine the features of a network where adjustments will have an impact, such as how much IPD is required in a given size of network.

Evaluating the effectiveness of interventions to reducing screen time in children: meta-analysis of randomized controlled trials

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Duygu Akçay ◽  
Nuray Barış
Keyword(s):  
Effect Size ◽  
Subgroup Analysis ◽  
Screen Time ◽  
Meta Analysis ◽  
Intervention Group ◽  
Evidence Base ◽  
Control Group ◽  
Content Type ◽  
Mean Differences ◽  
The Impact

Purpose The purpose of this paper is to evaluate the impact of interventions focused on reducing screen time in children. Design/methodology/approach Studies that aim to investigate the effects of interventions aimed at reducing the time spent in front of the screen (i.e. screen time). A Random-effects model was used to calculate the pooled standard mean differences. The outcome was to evaluate the screen time in children in the 0–18 age range. A subgroup analysis was performed to reveal the extent to which the overall effect size varied by subgroups (participant age, duration of intervention and follow). Findings For the outcome, the meta-analysis included 21 studies, and the standard difference in mean change in screen time in the intervention group compared with the control group was −0.16 (95% confidence interval [CI], −0.21 to −0.12) (p < 0.001). The effect size was found to be higher in long-term (=7 months) interventions and follow-ups (p < 0.05). Originality/value Subgroup analysis showed that a significant effect of screen time reduction was observed in studies in which the duration of intervention and follow-up was =7 months. As the evidence base grows, future researchers can contribute to these findings by conducting a more comprehensive analysis of effect modifiers and optimizing interventions to reduce screen time.

scholarly journals Prevalence and predictors of medication non-adherence among patients with multimorbidity: A systematic review protocol

2019 ◽  
Vol 2 ◽  
pp. 29
Author(s):  
Louise Foley ◽  
James Larkin ◽  
Richard Lombard-Vance ◽  
Andrew W. Murphy ◽  
Gerard J. Molloy
Keyword(s):  
Systematic Review ◽  
Full Text ◽  
Chronic Conditions ◽  
Data Extraction ◽  
Meta Analysis ◽  
Intervention Development ◽  
Evidence Base ◽  
Multiple Chronic Conditions ◽  
Review Protocol ◽  
Form Quality

Introduction: Patients with multimorbidity are expected to adhere to complex medication regimens in order to manage their multiple chronic conditions. It has been reported the likelihood of adherence decreases as patients are prescribed more medications. Much medication adherence research to date is dominated by a single-disease focus, which is at odds with the rising prevalence of multimorbidity and may artificially underestimate the complexity of managing chronic illness. This review aims to describe the prevalence of medication non-adherence among patients with multimorbidity, and to identify potential predictors of non-adherence in this population. Methods: A systematic review will be conducted and reported according to PRISMA guidelines. PubMed, EMBASE, CINAHL and PsycINFO will be searched using a predefined search strategy from 2009–2019. Quantitative studies will be considered eligible for review if prevalence of medication non-adherence among adults with two or more chronic conditions is reported. Studies will be included in the review if available in English full text. Titles and abstracts will be screened by single review, with 20% of screening cross-checked by a second reviewer. Full-text articles will be screened by two independent reviewers, noting reasons for exclusions. Data extraction will be performed using a predefined extraction form. Quality and risk of bias assessment will be conducted using criteria for observational studies outlined by Sanderson et al. (2007). A narrative synthesis and, if feasible, meta-analysis will be conducted. Discussion: By exploring medication non-adherence from a multimorbidity perspective, the review aims to inform an evidence base for intervention development which accounts for the rising prevalence of patients with multiple chronic conditions.  Study registration: The systematic review is prospectively registered in PROSPERO (CRD42019133849); registered on 12 June 2019.

scholarly journals An Evidence Base for School Health Policy during the COVID-19 Pandemic

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Saif Badran ◽  
Omran Musa ◽  
Somaya Al-maadeed ◽  
Egon Toft ◽  
Suhail Doi
Keyword(s):  
Dose Response ◽  
Case Fatality Rate ◽  
School Health ◽  
Meta Analysis ◽  
Case Fatality ◽  
Evidence Base ◽  
Mortality Data ◽  
Response Analysis ◽  
Fatality Rate ◽  
Epidemiological Characteristics

Objective: Children represent a small fraction of confirmed COVID-19 cases, with a low case fatality rate (CFR). In this paper, we lay out an evidence-based policy for reopening schools. Methods: We gathered age-specific COVID-19 case counts and identified mortality data for 14 countries. Dose-response meta-analysis was used to examine the relationship of the incremental case fatality rate (CFR) to age. In addition, an evidence-to-decision framework (EtD) was used to correlate the dose-response data with other epidemiological characteristics of COVID-19 in childhood. Results: In the dose-response analysis, we found that there was an almost negligible fatality below age 18. CFR rose little between ages 5 to 50 years. The confidence intervals were narrow, suggesting relative homogeneity across countries. Further data suggested decreased childhood transmission from respiratory droplets and a low viral load among children. Conclusions: Opening up schools and kindergartens is unlikely to impact COVID-19 case or mortality rates in both the child and adult populations. We outline a robust plan for schools that recommends that general principles not be micromanaged, with authority left to schools and monitored by public health authorities.

Research methods and evidence-based medicine

2018 ◽  
pp. 19-24
Author(s):  
Tim Colbourn
Keyword(s):  
Research Methods ◽  
Meta Analysis ◽  
Research Question ◽  
Secondary Data ◽  
Evidence Base ◽  
Primary Data ◽  
Key Points ◽  
Study Type ◽  
Based Medicine ◽  
And Child Health

This chapter provides an overview of research methods used to build the evidence base for global maternal and child health. It covers primary data collection, secondary data analysis, systematic reviews, and meta-analysis, and provides tips on how to interpret the scientific literature. This chapter should be read in conjunction with Chapters 1–3, Chapter 5 on economic evaluation, and Chapter 4 on converting research into policy to put the use of research evidence into context. The three key points from this chapter are: (1) you need to clearly define a research question before deciding what study type is best suited to answer it; (2) designing a research study involves detailed attention to practical details, including how groups are going to be defined; and (3) scientific studies are sometimes published with incorrect conclusions. Critically appraise each study, and define appropriate conclusions that are based on the data and methodology.

scholarly journals Benefits of Outdoor Sports for Society. A Systematic Literature Review and Reflections on Evidence

2019 ◽  
Vol 16 (6) ◽  
pp. 937 ◽  
Author(s):  
Barbara Eigenschenk ◽  
Andreas Thomann ◽  
Mike McClure ◽  
Larissa Davies ◽  
Maxine Gregory ◽  
...  
Keyword(s):  
Literature Review ◽  
Meta Analysis ◽  
Evidence Base ◽  
Long Term Effects ◽  
Outdoor Sports ◽  
Health And Wellbeing ◽  
The Social ◽  
Study Designs ◽  
Benefits And Costs

The combination of physical activity and being in nature is recognized as providing a range of significant benefits. The objective of this literature review was to compile an overview of the social benefits and costs associated with outdoor sports within the academic literature and to reflect on the quality of underlying evidence that supports the relationship. A systematic review was carried out with seven partners from different European countries, including Bulgaria, France, Germany, United Kingdom, Italy, Portugal, and Spain. From a total of 17,560 studies identified, 133 studies were selected with relevant data extracted to standardized forms. The selected studies have been analyzed with qualitative research methods. A meta-analysis could not be conducted due to the heterogeneity of the study designs and outcome measures. As a result, the review gives an overview of the social impacts associated with outdoor sports which have been clustered to six broad categories: physical health, mental health and wellbeing, education and lifelong learning, active citizenship, crime reduction, and anti-social behavior, as well as additional benefits. The review furthermore revealed gaps in the evidence base which are especially notable in the long-term effects that outdoor sports can have on personal and social development.

scholarly journals Epidemiology of Microsatellite Instability High (MSI-H) and Deficient Mismatch Repair (dMMR) in Solid Tumors: A Structured Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-17 ◽  
Author(s):  
Maria Lorenzi ◽  
Mayur Amonkar ◽  
Jacky Zhang ◽  
Shivani Mehta ◽  
Kai-Li Liaw
Keyword(s):  
Literature Review ◽  
Solid Tumors ◽  
English Language ◽  
Meta Analysis ◽  
Evidence Base ◽  
Published Data ◽  
Cancer Type ◽  
Pooled Prevalence ◽  
Tumor Types ◽  
Structured Literature Review

Background. Given limited data on the epidemiology of MSI-H and dMMR across solid tumors (except colorectal cancer (CRC)), the current study was designed to estimate their prevalence. Materials and Methods. A structured literature review identified English language publications that used immunohistochemistry (IHC) or polymerase chain replication (PCR) techniques. Publications were selected for all tumors except CRC using MEDLINE, EMBASE, and Cochrane databases and key congresses; CRC and pan-tumor genomic publications were selected through a targeted review. Meta-analysis was performed to estimate pooled prevalence of MSI-H/dMMR across all solid tumors and for selected tumor types. Where possible, prevalence within tumor types was estimated by disease stages. Results. Of 1,176 citations retrieved, 103 and 48 publications reported prevalence of MSI-H and dMMR, respectively. Five pan-tumor genomic studies supplemented the evidence base. Tumor types with at least 5 publications included gastric (n = 39), ovarian (n = 23), colorectal (n = 20), endometrial (n = 53), esophageal (n = 6), and renal cancer (n = 8). Overall MSI-H prevalence (with 95% CI) across 25 tumors was based on 90 papers (28,213 patients) and estimated at 14% (10%–19%). MSI-H prevalence among Stage 1/2 cancers was estimated at 15% (8%–23%); Stages 3 and 4 prevalence was estimated at 9% (3%–17%) and 3% (1%–7%), respectively. Overall, dMMR prevalence across 13 tumor types (based on 54 papers and 20,383 patients) was estimated at 16% (11%–22%). Endometrial cancer had the highest pooled MSI-H and dMMR prevalence (26% and 25% all stages, respectively). Conclusions. This is the first comprehensive attempt to report pooled prevalence estimates of MSI-H/dMMR across solid tumors based on published data. Prevalence determined by IHC and PCR was generally comparable, with some variations by cancer type. Late-stage prevalence was lower than that in earlier stages.

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