Reference Ranges for Vermis Biometry on Prenatal Ultrasound: Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Joshua I Rosenbloom ◽  
Lauren H. Yaeger ◽  
Shay Porat
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Large Sample Size ◽  
Reference Ranges ◽  
Maternal Characteristics ◽  
Anteroposterior Diameter ◽  
Normal Ranges ◽  
Statistical Heterogeneity

Abstract Purpose To conduct a systematic review and meta-analysis of published nomograms for fetal vermis biometry. Materials and Methods A structured literature search was conducted to identify studies that reported normal measurements of the fetal vermis. A customized quality assessment tool was used to review the selected articles. Random effects meta-analysis was used to calculate normal ranges for vermian craniocaudal diameter, anteroposterior diameter, and surface area. Results A total of 21 studies were included for qualitative review and 3 studies were included for quantitative synthesis. The 3 included articles comprised a total of 10 910 measurements from gestational ages 17–35 weeks. The quality assessment demonstrated that there was generally poor reporting regarding maternal characteristics and neonatal outcomes. Except for one article with a large sample size, the mean number of fetuses per week of gestational age was 15.9, with the lowest number being 5. There was significant statistical heterogeneity. Non-visualization rates ranged from 0–35.4 %. The craniocaudal diameter (reported in 3 articles) increased from a mean of 7.90 mm (95 % confidence interval [CI] 7.42, 8.38) at 17 weeks to 21.90 mm (95 % CI 20.63, 23.16) at 35 weeks gestation. The anteroposterior diameter (reported in 2 articles) increased from 6.30 mm (95 % CI 5.42, 7.18) at 17 weeks to 15.85 (95 %CI 15.49, 16.21) at 32 weeks. Conclusion Reference ranges for vermis biometry across gestation based on meta-analysis of existing references are provided. However, because many of the underlying studies suffered from significant methodological issues, the ranges should be used with caution.

scholarly journals Prevalence and risk factors for food allergy in older people: protocol for a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e029633 ◽  
Author(s):  
Inês Laia-Dias ◽  
Carlos Lozoya-Ibáñez ◽  
Isabel Skypala ◽  
Jorge M R Gama ◽  
Ulugbek Nurmatov ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Food Allergy ◽  
Older People ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Clinical Manifestations ◽  
Cochrane Library ◽  
Older Individuals ◽  
Statistical Heterogeneity

IntroductionStudies suggest that the prevalence of food allergy may be increasing worldwide. Results regarding the prevalence and features of adverse food reactions older people have, however, scarcely been analysed in the literature. Thus, the objective of the present systematic review will be to describe the prevalence of food allergy in older individuals, its risk factors, clinical features, as well as the most frequently and commonly involved foods.Methods and analysisWe will conduct a systematic review and meta-analysis of the incidence, prevalence and risk factors for food allergy in older individuals. We will search international electronic databases including MEDLINE, EMBASE, Cochrane Library, CINAHL, AMED and ISI Web of Science for published, unpublished and ongoing studies from 1980 toJanuary 2019. There will be no restriction on the language or geography of publication. We will use the critical appraisal skills programme quality assessment tool to appraise the methodological quality of included studies. A descriptive summary with data tables will be elaborated, and if deemed clinically relevant and statistically adequate, meta-analysis using random-effects modelling will be carried out, given the expected clinical, methodological and statistical heterogeneity of studies. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist will guide reporting of the systematic review.Ethics and disseminationSince this systematic review will be solely based on published and retrievable literature, no ethics approval will be obtained. This study will allow us to draw up-to-date estimates of the prevalence of adverse food reactions in older individuals, worldwide, besides allowing the identification of its major risk factors, clinical manifestations and predominant foods responsible for such reactions. A multidisciplinary team has been assembled for this systematic review and will participate in relevant dissemination activities, namely reports, publications and presentations.PROSPERO registration numberCRD42018102140

scholarly journals Compliance with spectacle use in children with refractive errors- a systematic review and meta-analysis

2020 ◽  
Author(s):  
Nonita Dhirar ◽  
Sankalp Dudeja ◽  
Mona Duggal ◽  
Parul Chawla Gupta ◽  
Nishant Jaiswal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sensitivity Analysis ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Poor Quality ◽  
Primary Objective ◽  
Refractive Errors ◽  
Cross Sectional ◽  
Care Services ◽  
Statistical Heterogeneity

Abstract Background Primary objective of this review was to measure compliance with spectacle use in children with refractive errors. Secondary objective was to understand the reasons for non-compliance.Methods The databases searched were Ovid, EMBASE, CINAHL and Pubmed. All studies up to March, 2018 were included. The search terms were- ((((((Compliance [Title/Abstract]) OR Adherence[Title/Abstract]) OR Compliant[Title/Abstract]) OR Adherent[Title/Abstract])) AND (((Spectacle[Title/Abstract]) OR Spectacles[Title/Abstract]) OR Eye Glasses[Title/Abstract])) AND ((((Child[Title/Abstract]) OR Children[Title/Abstract]) OR Adolescent[Title/Abstract]) OR Adolescents[Title/Abstract]). Two researchers independently searched the databases and initial screening obtained 33 articles. The PRISMA guidelines were followed for conducting and writing the systematic review. Two reviewers assessed data quality independently using the Quality Assessment tool for systematic reviews of observational studies (QATSO). Poor quality studies were those, which had a score of less than 33% on the QATSO tool. Sensitivity analysis was done to determine if poor quality studies effected compliance. Galbraith plot was used to investigate statistical heterogeneity amongst studies. A random effects model was used to pool compliance.Results Twenty-three studies were included in the review, of which 20 were included in the quantitative analysis. All the studies were cross sectional. The overall compliance with spectacle use was 40.14% (95% CI- 32.78-47.50). The compliance varied from 9.84% (95% CI=2.36-17.31) to 78.57% (95% CI=68.96-88.18). The compliance derived in sensitivity analysis was 40.09%. Reasons for non-compliance were broken/lost spectacles, forgetfulness, and parental disapproval.Conclusion Appropriate remedial measures such as health education and strengthening vision care services will be required to address poor compliance with spectacle use among children.

scholarly journals Role of diffusional kurtosis imaging in grading of brain gliomas: a protocol for systematic review and meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e025123 ◽  
Author(s):  
Gehad Abdalla ◽  
Eser Sanverdi ◽  
Pedro M Machado ◽  
Joey S W Kwong ◽  
Jasmina Panovska-Griffiths ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Brain Tumours ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Histopathological Analysis ◽  
Low Grade ◽  
Diffusional Kurtosis Imaging ◽  
Non Invasive ◽  
Statistical Heterogeneity

IntroductionCentral nervous system (CNS) gliomas are the most common primary intra-axial brain tumours and pose variable treatment response according to their grade, therefore, precise staging is mandatory. Histopathological analysis of surgical tumour samples is still deemed as the state-of-the-art staging technique for gliomas due to the moderate specificity of the available non-invasive imaging modalities. A recently evolved analysis of the tissue water diffusion properties, known as diffusional kurtosis imaging (DKI), is a dimensionless metric, which quantifies water molecules’ degree of non-Gaussian diffusion, hence reflects tissue microenvironment’s complexity by means of non-invasive diffusion-weighted MRI acquisitions. The objective of this systematic review and meta-analysis is to explore the performance of DKI in the presurgical grading of gliomas, both regarding the differentiation between high-grade and low-grade gliomas as well as the discrimination between gliomas and other intra-axial brain tumours.Methods and analysisWe will search PubMed, Medline via Ovid, Embase and Scopus in July 2018 for research studies published between January 1990 and June 2018 with no language restrictions, which have reported on the performance of DKI in diagnosing CNS gliomas. Robust inclusion/exclusion criteria will be applied for selection of eligible articles. Two authors will separately perform quality assessment according to the quality assessment of diagnostic accuracy studies-2 tool. Data will be extracted in a predesigned spreadsheet. A meta-analysis will be held using a random-effects model if substantial statistical heterogeneity is expected. The heterogeneity of studies will be evaluated, and sensitivity analyses will be conducted according to individual study quality.Ethics and disseminationThis work will be based on published studies; hence, it does not require institutional review board approval or ethics clearance. The results will be published in peer-reviewed journals.PROSPERO registration numberCRD42018099192.

C-Reactive Protein for Prediction or Early Detection of Pre-Eclampsia: A Systematic Review

2021 ◽  
pp. 1-14
Author(s):  
Rola Hamadeh ◽  
Amani Mohsen ◽  
Firas Kobeissy ◽  
Ali Karouni ◽  
Hikmat Akoum
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Meta Analysis ◽  
Significant Risk ◽  
Positive Association ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Statistical Heterogeneity

<b><i>Objective:</i></b> Pre-eclampsia (PE) is a serious disease of pregnancy and one of the major causes of morbidity and mortality for both the mother and baby. This systematic review aims to detect the role of high-sensitivity C-reactive protein (CRP) in the detection of PE. <b><i>Methods:</i></b> Thirty-four articles published between 2001 and 2019 were included in this review. The articles were extracted from OVID Medline and Embase. The study designs of these articles are randomized controlled, cohort, case-control, and cross-sectional studies evaluating CRP as a marker to predict or early diagnose PE. The quality assessment of these articles is made by the modified Quality Assessment of Diagnostic Accuracy Studies 2 tool. Meta-analysis was not done because of clinical and statistical heterogeneity. <b><i>Results:</i></b> A positive association between CRP levels and the development of PE was confirmed in 18 studies. This positive effect was addressed in patients with normal BMI (&#x3c;25 kg/m<sup>2</sup>) in 3 studies and in overweight patients in 2 studies. One study addressed this positive association in patients with a BMI ranging between 28 and 31 kg/m<sup>2</sup>. Three studies determined a cutoff level of CRP above which a significant risk of PE development should be suspected. These levels ranged between 7 and 15 mg/L. <b><i>Conclusion:</i></b> CRP is a promising cost-effective biomarker that may be used in the prediction of PE. A CRP level higher than 15 mg/L may suggest initiation of low-dose aspirin in low-risk pregnancies.

scholarly journals Compliance with spectacle use in children with refractive errors- a systematic review and meta-analysis

2019 ◽  
Author(s):  
Nonita Dhirar ◽  
Sankalp Dudeja ◽  
Mona Duggal ◽  
Parul Chawla Gupta ◽  
Nishant Jaiswal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sensitivity Analysis ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Poor Quality ◽  
Primary Objective ◽  
Refractive Errors ◽  
Cross Sectional ◽  
Care Services ◽  
Statistical Heterogeneity

Abstract Background Primary objective of this review was to measure compliance with spectacle use in children with refractive errors. Secondary objective was to understand the reasons for non-compliance.Methods The databases searched were Ovid, EMBASE, CINAHL and Pubmed. All studies up to March, 2018 were included. The search terms were- ((((((Compliance [Title/Abstract]) OR Adherence[Title/Abstract]) OR Compliant[Title/Abstract]) OR Adherent[Title/Abstract])) AND (((Spectacle[Title/Abstract]) OR Spectacles[Title/Abstract]) OR Eye Glasses[Title/Abstract])) AND ((((Child[Title/Abstract]) OR Children[Title/Abstract]) OR Adolescent[Title/Abstract]) OR Adolescents[Title/Abstract]). Two researchers independently searched the databases and initial screening obtained 33 articles. The PRISMA guidelines were followed for conducting and writing the systematic review. Two reviewers assessed data quality independently using the Quality Assessment tool for systematic reviews of observational studies (QATSO). Poor quality studies were those, which had a score of less than 33% on the QATSO tool. Sensitivity analysis was done to determine if poor quality studies effected compliance. Galbraith plot was used to investigate statistical heterogeneity amongst studies. A random effects model was used to pool compliance.Results Twenty-three studies were included in the review, of which 20 were included in the quantitative analysis. All the studies were cross sectional. The overall compliance with spectacle use was 40.14% (95% CI- 32.78-47.50). The compliance varied from 9.84% (95% CI=2.36-17.31) to 78.57% (95% CI=68.96-88.18). The compliance derived in sensitivity analysis was 40.09%. Reasons for non-compliance were broken/lost spectacles, forgetfulness, and parental disapproval.Conclusion Appropriate remedial measures such as health education and strengthening vision care services will be required to address poor compliance with spectacle use among children.

scholarly journals The Prevalence of Asthma among Iranian Children and Adolescent: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Neda Rahimian ◽  
Mohammad Aghajanpour ◽  
Leila Jouybari ◽  
Pedram Ataee ◽  
Asadollah Fathollahpour ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Children And Adolescents ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Scientific Information ◽  
Current Status ◽  
Asthma Prevalence ◽  
Cross Sectional ◽  
Iranian Children

Background. Asthma is an important reason for hospitalization in children aged under five years. Information about the current status of asthma in Iranian children can help the Iranian health sector plan carefully and prevent asthma incidence by educating the families. The present systematic review and meta-analysis is aimed at estimating asthma prevalence in Iranian children and adolescents. Method. Data were found using keywords such as prevalence, epidemiology, asthma, adolescent, children, pediatrics, Iran in Web of Science, Scopus, PubMed, Cochrane, and Embase databases. Three national databases, including Magiran, Barakat Pharmed Co (Iran medex), and Scientific Information Databank (SID) were searched until 1 October 2020. Cross-sectional and original studies were included in the study, and then, quality assessment was done using the National Institutes of Health’s Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. A pooled estimated prevalence of asthma was calculated using Der Simonian-Laird random model. Egger’s test was used to evaluate publication bias. The data were analyzed using the STATA software version 16. Results. 30 studies were selected and investigated. The prevalence of asthma in children and adolescents was 6% and 8%, and the prevalence in boys and girls was 9% and 8%, respectively. Among the asthma symptoms, wheezing had the most prevalence (17% in children and 19% in adolescents) and sleep disturbance had the lowest prevalence (6% in children and 6% in adolescents). Conclusion. The prevalence of asthma in Iranian children and adolescents is lower than in the world. Existing strategies should be pursued followed. Also, guidelines for asthma control and prevention should be considered in the future.

scholarly journals Clinical Anatomy of the Anterior Meniscofemoral Ligament of Humphrey: An Original MRI Study, Meta-analysis, and Systematic Review

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712097319
Author(s):  
Przemysław A. Pękala ◽  
Mateusz A. Rosa ◽  
Dominik P. Łazarz ◽  
Jakub R. Pękala ◽  
Adam Baginski ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Assessment Tool ◽  
Cruciate Ligament ◽  
Meta Analysis ◽  
Lateral Meniscus ◽  
Lower Limbs ◽  
Clinical Anatomy ◽  
Significant Heterogeneity ◽  
Meniscofemoral Ligament

Background: The anterior meniscofemoral ligament (aMFL) of Humphrey is an anatomically variable fibrous band of connective tissue that attaches between the lateral aspect of the medial femoral condyle and posterior horn of the lateral meniscus, running posterior to the anterior cruciate ligament and anterior to the posterior cruciate ligament (PCL). The presence of an intact aMFL may contribute to stabilization of the lateral compartment of the knee joint. Purpose: The original magnetic resonance imaging (MRI) arm of this study aimed to assess the aMFL incidence among Polish patients. The goal of the systematic review and meta-analysis was to review the literature discussing the clinical anatomy of the aMFL and provide data on its prevalence. It was hypothesized that significant heterogeneity exists within the published literature. Study Design: Cross-sectional study and systematic review; Level of evidence, 3. Methods: A retrospective investigation was performed on the MRI scans of 100 knees (52 right, 48 left) of Polish patients. Scans were randomly selected from a database of MRI examinations performed in 2019. For the meta-analysis, major online databases were queried for data on the aMFL, and 2 authors independently assessed and extracted data from all included studies. A quality assessment of the included articles was performed using the Anatomical Quality Assessment tool. Results: In the MRI arm of this study, the aMFL was found in 62 of the 100 lower limbs. The meta-analysis included 41 studies with a total of 4220 limbs. The aMFL was present in 55.5% (95% CI, 45.5%-65.3%) of cases. Arthroscopic studies yielded the highest prevalence (82.3% [95% CI, 36.6%-100.0%]); of MRI studies, the highest prevalence was at 3.0-T strength (51.0% [95% CI, 13.3%-88.2%]). Conclusion: Significant variability in the prevalence of the aMFL was found in the literature. More emphasis should be placed on the clinical relevance of injuries to the aMFL because of its significant role in the function of the knee. It is important to be aware that, because of the anatomy of the aMFL, the ligament can also function to support a torn PCL.

scholarly journals Trends of blood pressure and heart rate in normal pregnancies: a systematic review and meta-analysis

BMC Medicine ◽  
2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Lise Loerup ◽  
Rebecca M. Pullon ◽  
Jacqueline Birks ◽  
Susannah Fleming ◽  
Lucy H. Mackillop ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Pregnant Women ◽  
Diastolic Blood Pressure ◽  
Meta Analysis ◽  
Blood Pressure Measurement ◽  
Reference Ranges ◽  
Normal Ranges

Abstract Background Current reference ranges for blood pressure and heart rate throughout pregnancy have a poor evidence base. Methods This is a systematic review and meta-analysis. We included studies measuring blood pressure or heart rate from healthy pregnant women within defined gestational periods of 16 weeks or less. We analysed systolic blood pressure, diastolic blood pressure and heart rate by gestational age. We assessed effects of measurement year and method. Results We included 39 studies undertaken in 1967–2017, containing 124,349 systolic measurements from 36,239 women, 124,291 diastolic measurements from 36,181 women and 10,948 heart rate measurements from 8317 women. Mean (95% CI) systolic blood pressure was lowest at 10 weeks gestation, 110.4 (108.5, 112.3) mmHg, rising to 116.0 (113.6, 118.4) mmHg at 40 weeks, mean (95% CI) change 5.6 (4.0, 7.2) mmHg. Mean (95% CI) diastolic blood pressure was lowest at 21 weeks gestation, 65.9 (64.2, 67.7) mmHg; rising to 72.8 (71.0, 74.6) mmHg at 40 weeks, mean (95% CI) change 6.9 (6.2, 7.5) mmHg. Mean (95% CI) heart rate rose from 79.3 (75.5, 83.1) beats/min at 10 weeks to 86.9 (82.2, 91.6) beats/min at 40 weeks gestation, mean (95% CI) change 7.6 (1.8, 13.4) beats/min. Studies using manual measurement reported higher diastolic blood pressures than studies using automated measurement, mean (95 CI) difference 4.9 (0.8, 8.9) mmHg. Diastolic blood pressure increased by 0.26 (95% CI 0.10–0.43) mmHg/year. Including only higher-quality studies had little effect on findings, with heterogeneity remaining high (I2 statistic > 50%). Conclusions Significant gestational blood pressure and heart rate changes occur that should be taken into account when assessing pregnant women. Commonly taught substantial decreases in blood pressure mid-pregnancy were not seen and heart rate increases were lower than previously thought. Manual and automated blood pressure measurement cannot be used interchangeably. Increases in diastolic blood pressure over the last half-century and differences between published studies show contemporary data are required to define current normal ranges. Study registration PROSPERO CRD42014009673

scholarly journals Effectiveness of Traditional Chinese Exercise for Symptoms of Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 17 (21) ◽  
pp. 7873
Author(s):  
Ruojin Li ◽  
Hongwei Chen ◽  
Jiahao Feng ◽  
Ying Xiao ◽  
Haoyang Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Knee Osteoarthritis ◽  
Physical Function ◽  
Case Reports ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Control Group ◽  
Large Sample Size ◽  
Statistical Heterogeneity

Background: Growing evidences have advocated the potential benefits of traditional Chinese exercise (TCE) on symptomatic improvement of knee osteoarthritis (KOA). However, most of them have been derived from cross-sectional studies or case reports; the effectiveness of TCE therapies has not been fully assessed with a randomized control trial (RCT). In order to evaluate the combined clinical effectiveness of TCE for KOA, we conducted a systematic review and meta-analysis on the existing RCTs on KOA. Methods: A systematic search was performed in four electronic databases: PubMed, Web of Science, Cochrane Library, and EMBASE from the time of their inception to February 2020. All eligible RCTs were included in which TCE was utilized for treating KOA as compared to a control group. Two reviewers independently extracted the data and evaluated the risk of bias following the Cochrane Risk of Bias Tool for RCT. The symptoms of KOA evaluated by the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) were regarded as the primary outcomes in this study. Each outcome measure was pooled by a standardized mean difference (SMD) with 95% confidence intervals (CI). A meta-analysis was applied with a random or fixed effect model for the collected data to calculate the summary SMD with 95% CI based on different statistical heterogeneity. In addition, subgroup analyses were used to investigate heterogeneity and sensitivity analysis was carried out for the results of the meta-analysis. Egger’s test and the funnel plots were used to examine the potential bias in the RCTs. Results: A total of 14 RCTs involving 815 patients with KOA were included. Compared with a control group; the synthesized data of TCE showed a significant improvement in WOMAC/KOOS pain score (SMD = −0.61; 95% CI: −0.86 to −0.37; p < 0.001), stiffness score (SMD = −0.75; 95% CI: −1.09 to −0.41; p < 0.001), and physical function score (SMD = −0.67; 95% CI: −0.82 to −0.53; p < 0.001). Conclusions: Our meta-analysis suggested that TCE may be effective in alleviating pain; relieving stiffness and improving the physical function for patients with KOA. Yet; given the methodological limitations of included RCTs in this meta-analysis; more high-quality RCTs with large sample size and long-term intervention are required to further confirm the effectiveness and underlying mechanisms of TCE for treating KOA.

scholarly journals Postnatal Outcome and Associated Anomalies of Prenatally Diagnosed Right Aortic Arch with Concomitant Right Ductal Arch: A Systematic Review and Meta-Analysis

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 831
Author(s):  
Paolo Ivo Cavoretto ◽  
Alexandros Sotiriadis ◽  
Serena Girardelli ◽  
Silvia Spinillo ◽  
Massimo Candiani ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Aortic Arch ◽  
Assessment Tool ◽  
Chromosomal Abnormalities ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Case Series ◽  
Right Aortic Arch

Right aortic arch presents a reported incidence of 0.1% of the general population; the aim of our study was to evaluate the risk of associated intracardiac (ICA), extracardiac (ECA), or chromosomal abnormalities in fetuses with right aortic arch (RAA) and concomitant right ductal arch (RDA). A systematic review of the literature selected 18 studies including 60 cases of RAA/RDA. A meta-analysis with a random effect model calculated for each outcome the pooled crude proportion of associated abnormal outcomes in cases of RAA/RDA and the pooled proportions and odds ratios in RAA with LDA or RDA. Quality assessment of the included studies was achieved using the NIH quality assessment tool for case series studies. RAA/RDA presents risk of associated conotruncal CHDs of about 30% and risk of 22q11 microdeletion in the region of 1%. Two-thirds of 22q11 microdeletions had concomitant thymic hypoplasia and no other chromosomal defects were described. Risks for ICA, ECA, 22q11 microdeletion, and aberrant left subclavian artery are not substantially different in RAA with right or left arterial duct. RAA increases the risk of associated cardiac defects regardless of laterality of the ductal arch. In isolated RDA/RAA cases, absolute risks of extracardiac associated problems or surgery are rather low, we would therefore recommend reassurance, particularly when the thymus and karyotype are normal.

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