Effect of prone position on respiratory parameters, intubation and death rate in COVID-19 patients: systematic review and meta-analysis

AbstractProne position (PP) is known to improve oxygenation and reduce mortality in COVID-19 patients. This systematic review and meta-analysis aimed to determine the effects of PP on respiratory parameters and outcomes. PubMed, EMBASE, ProQuest, SCOPUS, Web of Sciences, Cochrane library, and Google Scholar were searched up to 1st January 2021. Twenty-eight studies were included. The Cochran's Q-test and I2 statistic were assessed heterogeneity, the random-effects model was estimated the pooled mean difference (PMD), and a meta-regression method has utilized the factors affecting heterogeneity between studies. PMD with 95% confidence interval (CI) of PaO2/FIO2 Ratio in before–after design, quasi-experimental design and in overall was 55.74, 56.38, and 56.20 mmHg. These values for Spo2 (Sao2) were 3.38, 17.03, and 7.58. PP in COVID-19 patients lead to significantly decrease of the Paco2 (PMD: − 8.69; 95% CI − 14.69 to − 2.69 mmHg) but significantly increase the PaO2 (PMD: 37.74; 95% CI 7.16–68.33 mmHg). PP has no significant effect on the respiratory rate. Based on meta-regression, the study design has a significant effect on the heterogeneity of Spo2 (Sao2) (Coefficient: 12.80; p < 0.001). No significant associations were observed for other respiratory parameters with sample size and study design. The pooled estimate for death rate and intubation rates were 19.03 (8.19–32.61) and 30.68 (21.39–40.75). The prone positioning was associated with improved oxygenation parameters and reduced mortality and intubation rate in COVID-19 related respiratory failure.

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Sex-Based Differences in the Incidence of Sports-Related Concussion: Systematic Review and Meta-analysis

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738119877186 ◽

2019 ◽

Vol 11 (6) ◽

pp. 486-491 ◽

Cited By ~ 5

Author(s):

Jennifer Cheng ◽

Brittany Ammerman ◽

Kristen Santiago ◽

Bridget Jivanelli ◽

Emerald Lin ◽

...

Keyword(s):

Systematic Review ◽

Study Design ◽

Rate Ratio ◽

Meta Analysis ◽

Incidence Rates ◽

Ice Hockey ◽

Cochrane Library ◽

Eligibility Criteria ◽

Level Of Evidence ◽

Meta Regression

Context: The incidence of sports-related concussion in females has been increasing in recent years. Objective: To conduct a meta-analysis on sex-based differences in concussion incidence in various sports and to determine the effects of study design (retrospective vs prospective), setting (competition vs practice), and population (university and above vs high school and below) via a meta-regression. Data Sources: PubMed (Medline), EMBASE, and Cochrane Library databases were searched from January 2000 to January 2018. Study Selection: Studies reporting sports-related concussion incidence data for both males and females (age ≥10 years) were included. Study Design: Systematic review with meta-analysis and meta-regression. Level of Evidence: Level 4. Methods: The rate ratio was calculated as the concussion rate in females/males. Data were pooled using the DerSimonian-Laird random-effects model. Results: Thirty-eight studies met the eligibility criteria and were included in the meta-analysis. Soccer and basketball demonstrated significantly higher incidence of concussions in females compared with males (rate ratio [95% CI], 1.76 [1.43-2.16] and 1.99 [1.56-2.54], respectively; P < 0.01). Sex-based differences in concussion incidence rates for baseball/softball, ice hockey, lacrosse, swimming/diving, and track and field were not statistically significant. In the meta-regression analysis, there were no significant effects on the rate ratio when evaluating study design, setting, and population. Conclusion: Concussion incidence rates were significantly higher in females than in males for soccer and basketball.

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The prevalence of diabetes in Afghanistan: a systematic review and meta-analysis

BMC Public Health ◽

10.1186/s12889-021-10993-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sohail Akhtar ◽

Jamal Abdul Nasir ◽

Amara Javed ◽

Mariyam Saleem ◽

Sundas Sajjad ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Methodological Quality ◽

Meta Analysis ◽

Population Based ◽

Included Study ◽

Cochrane Library ◽

Or Education ◽

Meta Regression

Abstract Background The aim of this paper is to investigate the prevalence of diabetes and its associated risk factors in Afghanistan through a systematic review and meta–analysis. Methods A comprehensive literature search was conducted using EMBASE, PubMed, Web of Sciences, Google Scholar and the Cochrane library, carried out from inception to April 312,020, without language restriction. Meta–analysis was performed using DerSimonian and Laird random-effects models with inverse variance weighting. The existence of publication bias was initially assessed by visual inspection of a funnel plot and then tested by the Egger regression test. Subgroup analyses and meta-regression were used to explore potential sources of heterogeneity. This systematic review was reported by following the PRISMA guidelines and the methodological quality of each included study was evaluated using the STROBE guidelines. Results Out of 64 potentially relevant studies, only 06 studies fulfilled the inclusion criteria and were considered for meta-analysis. The pooled prevalence of diabetes in the general population based on population-based studies were 12.13% (95% CI: 8.86–16.24%), based on a pooled sample of 7071 individuals. Results of univariate meta-regression analysis revealed that the prevalence of diabetes increased with mean age, hypertension and obesity. There was no significant association between sex (male vs female), smoking, the methodological quality of included articles or education (illiterate vs literate) and the prevalence of diabetes. Conclusions This meta-analysis reports the 12.13% prevalence of diabetes in Afghanistan,with the highest prevalence in Kandahar and the lowest in Balkh province. The main risk factors include increasing age, obesity and hypertension. Community-based care and preventive training programmes are recommended. Trial registration This review was registered on PROSPERO (registration number CRD42020172624).

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Daily sodium consumption and CVD mortality in the general population: systematic review and meta-analysis of prospective studies

Public Health Nutrition ◽

10.1017/s1368980014000949 ◽

2014 ◽

Vol 18 (4) ◽

pp. 695-704 ◽

Cited By ~ 37

Author(s):

Rosana Poggio ◽

Laura Gutierrez ◽

María G Matta ◽

Natalia Elorriaga ◽

Vilma Irazola ◽

...

Keyword(s):

Systematic Review ◽

Relative Risk ◽

General Population ◽

Prospective Studies ◽

Meta Analysis ◽

Cochrane Library ◽

Random Effects Models ◽

Meta Regression ◽

Cvd Mortality

AbstractObjectiveThe purpose of the present study was to determine whether elevated dietary Na intake could be associated with CVD mortality.DesignWe performed a systematic review and meta-analysis of prospective studies representing the general population. The adjusted relative risks and their 95 % confidence intervals were pooled by the inverse variance method using random-effects models. Heterogeneity, publication bias, subgroup and meta-regression analyses were performed.SettingsMEDLINE (since 1973), Embase (since 1975), the Cochrane Library (since 1976), ISI Web of Science, Google Scholar (until September 2013) and secondary referencing were searched for inclusion in the study.SubjectEleven prospective studies with 229 785 participants and average follow-up period of 13·37 years (range 5·5–19 years).ResultsHigher Na intake was significantly associated with higher CVD mortality (relative risk=1·12; 95 % CI 1·06, 1·19). In the sensitivity analysis, the exclusion of studies with important relative weights did not significantly affect the results (relative risk=1·08; 95 % CI 1·01, 1·15). The meta-regression analysis showed that for every increase of 10 mmol/d in Na intake, CVD mortality increased significantly by 1 % (P=0·016). Age, hypertensive status and length of follow-up were also associated with increased CVD mortality.ConclusionsHigher Na intake was associated with higher CVD mortality in the general population; this result suggests a reduction in Na intake to prevent CVD mortality from any cause.

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Intelligence Quotient Outcome Following Epilepsy Surgery in Pediatric Age – A Systematic Review and Meta-Analysis

Journal of Psychiatry & Mental Disorders ◽

10.26420/jpsychiatrymentaldisord.2021.1049 ◽

2021 ◽

Vol 6 (4) ◽

Author(s):

Alferes AR ◽

◽

Oliveiros B ◽

Pereira C ◽

◽

...

Keyword(s):

Systematic Review ◽

Intelligence Quotient ◽

Meta Analysis ◽

Full Scale ◽

Cochrane Library ◽

Pediatric Epilepsy ◽

Pediatric Age ◽

Meta Regression ◽

The Cochrane Library ◽

Intelligence Development

There is a deep-rooted correlation between refractory epilepsy in pediatric age and intelligence development. However, little is known about whether surgical procedures used in pediatric epilepsy treatment can affect Intelligence Quotient (IQ) or not. Factors that might influence postoperative IQ are also a matter of study in several articles. To tackle these issues, a systematic review with meta-analysis was conducted with the terms “epilepsy”, “epileptic”, “surgery”, “surgical”, “Wechsler Scale” and “intelligence tests” in PubMed, the Cochrane Library, EMBASE and Clinical Trials.gov. A descriptive data synthesis was carried out to address each of the objectives and then a metaanalysis using a random effects model was conducted. A meta-regression was performed to ascertain possible factors that could influence postoperative IQ. The meta-analysis of the studies included found a mean difference between postoperative and preoperative full-scale IQ values of 1.014 standardized points (p < 0.001). Among all the articles regarding curative surgeries, only three reported an overall significant improvement in IQ after surgery. Regarding palliative procedures, both studies with anterior corpus callosotomy reported a significant improvement in full-scale IQ values two years after surgery. The meta-regression performed did not find any predictors of change in full-scale IQ.

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The Effectiveness of Telemedicine Solutions for the Management of Type 2 Diabetes: A Systematic Review, Meta-Analysis, and Meta-Regression

Journal of Diabetes Science and Technology ◽

10.1177/19322968211064633 ◽

2021 ◽

pp. 193229682110646

Author(s):

Stine Hangaard ◽

Sisse H. Laursen ◽

Jonas D. Andersen ◽

Thomas Kronborg ◽

Peter Vestergaard ◽

...

Keyword(s):

Systematic Review ◽

Type 2 Diabetes ◽

Systematic Reviews ◽

Meta Analysis ◽

Cochrane Library ◽

Controlled Trials ◽

Sufficient Information ◽

Meta Regression ◽

Meta Analyses

Background: Previous systematic reviews have aimed to clarify the effect of telemedicine on diabetes. However, such reviews often have a narrow focus, which calls for a more comprehensive systematic review within the field. Hence, the objective of the present systematic review, meta-analysis, and meta-regression is to evaluate the effectiveness of telemedicine solutions versus any comparator without the use of telemedicine on diabetes-related outcomes among adult patients with type 2 diabetes (T2D). Methods: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We considered telemedicine randomized controlled trials (RCT) including adults (≥18 years) diagnosed with T2D. Change in glycated hemoglobin (HbA1c, %) was the primary outcome. PubMed, EMBASE, and the Cochrane Library Central Register of Controlled Trials (CENTRAL) were searched on October 14, 2020. An overall treatment effect was estimated using a meta-analysis performed on the pool of included studies based on the mean difference (MD). The revised Cochrane risk-of-bias tool was applied and the certainty of evidence was graded using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Results: The final sample of papers included a total of 246, of which 168 had sufficient information to calculate the effect of HbA1c%. The results favored telemedicine, with an MD of −0.415% (95% confidence interval [CI] = −0.482% to −0.348%). The heterogeneity was great (I2 = 93.05%). A monitoring component gave rise to the higher effects of telemedicine. Conclusions: In conclusion, telemedicine may serve as a valuable supplement to usual care for patients with T2D. The inclusion of a telemonitoring component seems to increase the effect of telemedicine.

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Low-to-Moderate-Intensity Resistance Exercise Effectively Improves Arterial Stiffness in Adults: Evidence From Systematic Review, Meta-Analysis, and Meta-Regression Analysis

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.738489 ◽

2021 ◽

Vol 8 ◽

Author(s):

Yong Zhang ◽

Ya-Jun Zhang ◽

Weibing Ye ◽

Mallikarjuna Korivi

Keyword(s):

Systematic Review ◽

Arterial Stiffness ◽

Resistance Exercise ◽

High Intensity ◽

Meta Analysis ◽

Moderate Intensity ◽

Cochrane Library ◽

Middle Aged ◽

Meta Regression ◽

Middle Aged Adults

Background/Purpose: Resistance exercise (RE) is known to improve cardiovascular health, but the role of RE variables on arterial stiffness is inconclusive. In this systematic review and meta-analysis, we investigated the influence of RE and its intensities on arterial stiffness measured as pulse wave velocity (PWV) in young and middle-aged adults.Methods: Web of Science, PubMed/MEDLINE, Scopus, EMBASE, Cochrane Library, ScienceDirect, CINAHL, Wiley Online Library, and Google Scholar were searched for relevant studies. RE trials that reported PWV data, and compared with respective controls were included. The Cochrane Collaboration tool was used to assess the risk of bias.Results: Data were synthesized from a total of 20 studies, involving 981 participants from control (n = 462) and exercise (n = 519) trials. The test for overall effect (pooled outcome) showed RE intervention had no effect on arterial stiffness (SMD = −0.09; 95% CI: −0.32, 0.13; P = 0.42), but risk of heterogeneity (I2) was 64%. Meta-regression results revealed a significant correlation (P = 0.042) between RE intensity and PWV changes. Consequently, the trials were subgrouped into high-intensity and low-to-moderate-intensity to identify the effective RE intensity. Subgroup analysis showed that low-to-moderate-intensity significantly decreased PWV (SMD = −0.34; 95% CI: −0.51, −0.17; P < 0.0001), while high-intensity had no effect (SMD = 0.24; 95% CI: −0.18, 0.67; P = 0.26). When trials separated into young and middle-aged, low-to-moderate-intensity notably decreased PWV in young (SMD = −0.41; 95% CI: −0.77, −0.04; P = 0.03) and middle-aged adults (SMD = −0.32; 95% CI: −0.51, −0.14; P = 0.0007), whereas high-intensity had no effect in both age groups.Conclusions: Our findings demonstrated that RE intensity is the key variable in improving arterial stiffness. Low-to-moderate-intensity can prescribe as an effective non-pharmacological strategy to treat cardiovascular complications in young and middle-aged adults.

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Prevalence of musculoskeletal disorders among perioperative nurses: a systematic review and meta-analysis

10.21203/rs.3.rs-74075/v1 ◽

2020 ◽

Author(s):

Marco Clari ◽

Alessandro Godono ◽

Giacomo Garzaro ◽

Gianluca Voglino ◽

Maria Rosaria Gualano ◽

...

Keyword(s):

Systematic Review ◽

Musculoskeletal Disorders ◽

Health Care Professionals ◽

Meta Analysis ◽

Personal Characteristics ◽

Cochrane Library ◽

Perioperative Nurses ◽

Work Related ◽

Meta Regression ◽

Event Rates

Abstract Background To evaluate the prevalence of work-related musculoskeletal disorders (WRMSDs) in perioperative nurses and to explore their association with personal characteristics. Methods Medline, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, Cochrane Library and Joanna Briggs Institute Database were systematically searched. A meta-analysis calculating event rates, and relative 95% Confidence Intervals (CI) was performed for each musculoskeletal district. The contribution of perioperative nurses’ gender, age, and BMI was assessed trough a meta-regression. Results Twenty-two studies, considering 3405 perioperative nurses, were included in the systematic review. The highest prevalence of WRMSDs was found for the lower-back (61%; 95% CI 0.52–0.70), followed by shoulder (45%; 95% CI 0.38–0.53), waist (45%; 95% CI 0.34–0.57), knee (45%; 95% CI 0.32–0.54), neck (39%; 95% CI 0.27–0.52), upper-back (34%; 95% CI 0.24–0.46), ankle-feet (33%; 95% CI 0.18–0.51), hand-wrist (29%; 95% CI 0.19–0.41), and elbow (18%; 95% CI 0.11–0.27). Meta-regression showed that gender, age, and BMI were not significant predictors of low-back disorders (p = 0.69; R2 = 0). Conclusions WRMSDs represent a high prevalence issue among perioperative nurses. Perioperative nurses, in general, are steadily exposed to both physical and temporal risk factors. Several interventions may be adopted to reduce the burden of WRMSDs, including ergonomic education and physical rehabilitation. Our data could be used in future studies as a reference to assess the risk of WRMSDs in other health-care professionals’ population.

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The global and regional prevalence of hepatitis C and B co-infections among prisoners living with HIV: a systematic review and meta-analysis

Infectious Diseases of Poverty ◽

10.1186/s40249-021-00876-7 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Hasan Ahmadi Gharaei ◽

Mohammad Fararouei ◽

Ali Mirzazadeh ◽

Golnaz Sharifnia ◽

Marzieh Rohani-Rasaf ◽

...

Keyword(s):

Systematic Review ◽

Hepatitis C ◽

Meta Analysis ◽

Cochrane Library ◽

Hiv Positive ◽

High Risk Population ◽

Drug Injection ◽

East Mediterranean ◽

Meta Regression ◽

Living With Hiv

Abstract Background Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are common among individuals with human immune deficiency virus (HIV) infection worldwide. In this study, we did a systematic review and meta-analysis of the published literature to estimate the global and regional prevalence of HCV, HBV and HIV coinfections among HIV-positive prisoners. Methods We searched PubMed via MEDLINE, Embase, the Cochrane Library, SCOPUS, and Web of science (ISI) to identify studies that reported the prevalence of HBV and HCV among prisoners living with HIV. We used an eight-item checklist for critically appraisal studies of prevalence/incidence of a health problem to assess the quality of publications in the included 48 cross-sectional and 4 cohort studies. We used random-effect models and meta-regression for the meta-analysis of the results of the included studies. Results The number of the included studies were 50 for HCV-HIV, and 23 for HBV-HIV co-infections. The pooled prevalence rates of the coinfections were 12% [95% confidence interval (CI) 9.0–16.0] for HBV-HIV and 62% (95% CI 53.0–71.0) for HCV-HIV. Among HIV-positive prisoners who reported drug injection, the prevalence of HBV increased to 15% (95% CI 5.0–23.0), and the HCV prevalence increased to 78% (95% CI 51.0–100). The prevalence of HBV-HIV coinfection among prisoners ranged from 3% in the East Mediterranean region to 27% in the American region. Also, the prevalence of HCV-HIV coinfections among prisoners ranged from 6% in Europe to 98% in the East Mediterranean regions. Conclusions Our findings suggested that the high prevalence of HBV and HCV co-infection among HIV-positive prisoners, particularly among those with a history of drug injection, varies significantly across the globe. The results of Meta-regression analysis showed a sliding increase in the prevalence of the studied co-infections among prisoners over the past decades, rising a call for better screening and treatment programs targeting this high-risk population. To prevent the above coinfections among prisoners, aimed public health services (e.g. harm reduction via access to clean needles), human rights, equity, and ethics are to be seriously delivered or practiced in prisons. Protocol registration number: CRD42018115707 (in the PROSPERO international). Graphic abstract

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Current status of accurate prognostic awareness in advanced/terminally ill cancer patients: Systematic review and meta-regression analysis

Palliative Medicine ◽

10.1177/0269216316663976 ◽

2016 ◽

Vol 31 (5) ◽

pp. 406-418 ◽

Cited By ~ 41

Author(s):

Chen Hsiu Chen ◽

Su Ching Kuo ◽

Siew Tzuh Tang

Keyword(s):

Systematic Review ◽

Cancer Patients ◽

Meta Analysis ◽

Assessment Method ◽

Current Status ◽

Cochrane Library ◽

Terminal Cancer ◽

Prognostic Information ◽

Terminal Cancer Patients ◽

Meta Regression

Background: No systematic meta-analysis is available on the prevalence of cancer patients’ accurate prognostic awareness and differences in accurate prognostic awareness by publication year, region, assessment method, and service received. Aim: To examine the prevalence of advanced/terminal cancer patients’ accurate prognostic awareness and differences in accurate prognostic awareness by publication year, region, assessment method, and service received. Design: Systematic review and meta-analysis. Methods: MEDLINE, Embase, The Cochrane Library, CINAHL, and PsycINFO were systematically searched on accurate prognostic awareness in adult patients with advanced/terminal cancer (1990–2014). Pooled prevalences were calculated for accurate prognostic awareness by a random-effects model. Differences in weighted estimates of accurate prognostic awareness were compared by meta-regression. Results: In total, 34 articles were retrieved for systematic review and meta-analysis. At best, only about half of advanced/terminal cancer patients accurately understood their prognosis (49.1%; 95% confidence interval: 42.7%–55.5%; range: 5.4%–85.7%). Accurate prognostic awareness was independent of service received and publication year, but highest in Australia, followed by East Asia, North America, and southern Europe and the United Kingdom (67.7%, 60.7%, 52.8%, and 36.0%, respectively; p = 0.019). Accurate prognostic awareness was higher by clinician assessment than by patient report (63.2% vs 44.5%, p < 0.001). Conclusion: Less than half of advanced/terminal cancer patients accurately understood their prognosis, with significant variations by region and assessment method. Healthcare professionals should thoroughly assess advanced/terminal cancer patients’ preferences for prognostic information and engage them in prognostic discussion early in the cancer trajectory, thus facilitating their accurate prognostic awareness and the quality of end-of-life care decision-making.

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The prevalence of type 2 diabetes in Afghanistan: a systematic review and meta-analysis

10.21203/rs.3.rs-30152/v1 ◽

2020 ◽

Author(s):

Sohail Akhtar ◽

Jamal Abdul Nasir ◽

Amara Javed ◽

Mariyam Saleem ◽

Sundas Sajjad ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Methodological Quality ◽

Meta Analysis ◽

Population Based ◽

Included Study ◽

Cochrane Library ◽

Or Education ◽

Meta Regression

Abstract Background The aim of this paper is to investigate the prevalence of diabetes and its associated risk factors in Afghanistan through a systematic review and meta–analysis. Methods A comprehensive literature search was conducted using EMBASE, PubMed, Web of Sciences, Google Scholar and the Cochrane library, carried out from inception to April 31 2020, without language restriction. Meta–analysis was performed using DerSimonian and Laird random-effects models with inverse variance weighting. The existence of publication bias was initially assessed by visual inspection of a funnel plot and then tested by the Egger regression test. Subgroup analyses and meta-regression were used to explore potential sources of heterogeneity. This systematic review was reported by following the PRISMA guidelines and the methodological quality of each included study was evaluated using the STROBE guidelines. Results Out of 64 potentially relevant studies, only 10 studies fulfilled the inclusion criteria and were considered for meta-analysis. The pooled prevalence of diabetes in the general population based on population-based studies were 12.14% (95% CI: 10.06–14.39%), based on a pooled sample of 11,699 individuals. Results of univariate meta-regression analysis revealed that the prevalence of diabetes increased with mean age, hypertension and obesity. There was no significant association between sex (male vs female), smoking, the methodological quality of included articles or education (illiterate vs literate) and the prevalence of diabetes. Conclusions This meta-analysis reports a relatively high prevalence of diabetes in Afghanistan, with the highest prevalence in Kandahar and the lowest in Balkh province. The main risk factors include increasing age, obesity and hypertension. Community-based care and preventive training programmes are recommended. Trial registration: This review was registered on PROSPERO (registration number CRD42020172624).

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