Correction of Thumb Duplication: A Systematic Review of Surgical Techniques

AbstractSurgical intervention for thumb duplication can be divided into three categories: simple excision of the accessory thumb, excision of the accessory thumb with reconstruction from available “spare parts,” and combining the two thumbs into one, as described by Bilhaut. This prospectively PROSPERO registered systematic review evaluates the overall, aesthetic and functional outcomes for the latter two options (reconstruction from spare parts vs. combining two thumbs into one), aiming to facilitate evidence-based decision making when addressing thumb duplication and direct future research. The review was performed in accordance with the Cochrane Handbook of Systematic Reviews and PRISMA statement. Embase, PubMed, Medline, and Cochrane databases were systematically searched. Studies offering comparisons of techniques were included. Risk of bias was assessed using the Risk of Bias In Non-randomized Studies—of Intervention tool. The quality of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation. Ten retrospective observational studies were included. Data did not consistently allow analysis by procedure type. Four studies reported similar overall outcomes between techniques, while two specifically reported poor overall outcomes for the Bilhaut procedure. Two studies reported comparatively worse aesthetic outcomes for the Bilhaut procedure with four studies reporting comparatively improved functional outcomes for this procedure. Overall, interpretation of outcomes was challenging with no patient-reported outcome measures used. The quality of the evidence was universally “very low” due to all studies being at risk of methodological bias. Based on the available evidence, surgical techniques for thumb duplication correction appear comparable regarding overall outcome. There is limited evidence suggesting reconstruction with spare parts offers superior aesthetic outcomes at the expense of stability. The level of evidence is III.

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Nocturnal digital surveillance in aged populations and its effects on health, welfare and social care provision: a systematic review

BMC Health Services Research ◽

10.1186/s12913-021-06624-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Matt X. Richardson ◽

Maria Ehn ◽

Sara Landerdahl Stridsberg ◽

Ken Redekop ◽

Sarah Wamala-Andersson

Keyword(s):

Systematic Review ◽

Standard Care ◽

Social Care ◽

Grey Literature ◽

Care Quality ◽

Risk Of Bias ◽

Future Research ◽

Care Provision ◽

Digital Surveillance

Abstract Background Nocturnal digital surveillance technologies are being widely implemented as interventions for remotely monitoring elderly populations, and often replace person-based surveillance. Such interventions are often placed in care institutions or in the home, and monitored by qualified personnel or relatives, enabling more rapid and/or frequent assessment of the individual’s need for assistance than through on-location visits. This systematic review summarized the effects of these surveillance technologies on health, welfare and social care provision outcomes in populations ≥ 50 years, compared to standard care. Method Primary studies published 2005–2020 that assessed these technologies were identified in 11 databases of peer-reviewed literature and numerous grey literature sources. Initial screening, full-text screening, and citation searching steps yielded the studies included in the review. The Risk of Bias and ROBINS-I tools were used for quality assessment of the included studies. Result Five studies out of 744 identified records met inclusion criteria. Health-related outcomes (e.g. accidents, 2 studies) and social care outcomes (e.g. staff burden, 4 studies) did not differ between interventions and standard care. Quality of life and affect showed improvement (1 study each), as did economic outcomes (1 study). The quality of studies was low however, with all studies possessing a high to critical risk of bias. Conclusions We found little evidence for the benefit of nocturnal digital surveillance interventions as compared to standard care in several key outcomes. Higher quality intervention studies should be prioritized in future research to provide more reliable evidence.

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Psychometric properties of the Jefferson Scale of Empathy: a COSMIN systematic review protocol

Systematic Reviews ◽

10.1186/s13643-019-1240-0 ◽

2019 ◽

Vol 8 (1) ◽

Cited By ~ 1

Author(s):

Brett Williams ◽

Bronwyn Beovich

Keyword(s):

Systematic Review ◽

Psychometric Properties ◽

Methodological Quality ◽

Grey Literature ◽

Risk Of Bias ◽

Measurement Properties ◽

Future Research ◽

Health Measurement ◽

Jefferson Scale Of Empathy

Abstract Background Empathy is an important characteristic to possess for healthcare professionals. It has been found to improve communication between professionals and patients and to improve clinical health outcomes. The Jefferson Scale of Empathy (JSE) was developed to measure this quality and has been used extensively, and psychometrically appraised, with a variety of cohorts and in different cultural environments. However, no study has been undertaken to systematically examine the methodological quality of studies which have assessed psychometric factors of the JSE. This systematic review will examine the quality of published papers that have reported on psychometric factors of the JSE. Methods A systematic review of studies which report on the psychometric properties of the JSE will be conducted. We will use a predefined search strategy to identify studies meeting the following eligibility criteria: original data is reported on for at least one of the psychometric measurement properties described in the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist, examines the JSE in a healthcare cohort (using the student, physician or health profession versions of the JSE), and is published from January 2001 and in the English language. Conference abstracts, editorials and grey literature will be excluded. Six electronic databases (Medline, EMBASE, PsychInfo, PubMed, Web of Science and CINAHL) will be systematically searched for articles meeting these criteria and studies will be assessed for eligibility by two review authors. The methodological quality of included papers will be examined using the COSMIN Risk of Bias checklist. Discussion A narrative description of the findings will be presented along with summary tables. Recommendations for use of the JSE with various cohorts and circumstances will be offered which may inform future research in this field. Systematic review registration PROSPERO CRD42018111412

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Articular Cartilage Defects of the Glenohumeral Joint: A Systematic Review of Treatment Options and Outcomes

Cartilage ◽

10.1177/1947603519870858 ◽

2019 ◽

pp. 194760351987085 ◽

Cited By ~ 2

Author(s):

Anthony Fiegen ◽

Devin P. Leland ◽

Christopher D. Bernard ◽

Aaron J. Krych ◽

Jonathan D. Barlow ◽

...

Keyword(s):

Systematic Review ◽

Patient Reported Outcomes ◽

Glenohumeral Joint ◽

Meta Analysis ◽

Treatment Options ◽

Surgical Techniques ◽

Cartilage Defects ◽

Imaging Findings ◽

Level Of Evidence ◽

Patient Reported

Objective To report radiographic and magnetic resonance imaging findings, patient-reported outcomes, and complications and/or reoperations following nonarthroplasty surgical intervention for focal glenohumeral cartilage defects. Design A literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Patients were included if they possessed a chondral defect of the humeral head, glenoid, or both, which had been treated with a joint preserving nonarthroplasty procedure. Risk of bias assessment was performed using the Methodological Index for Non-Randomized Studies scoring system. Study demographics, surgical technique, imaging findings, patient-reported outcomes, complications, failures, and reoperations were collected. Results Fourteen studies with 98 patients (100 shoulders) met the inclusion criteria. Patient ages ranged from 7 to 74 years. The nonarthroplasty surgical techniques utilized included microfracture (67 shoulders), osteochondral transplantation (28 shoulders), chondrocyte transplantation (4 shoulders), and internal fixation (1 shoulder). The rates of radiographic union and progression of osteoarthritis ranged between 90% to 100% and 57% to 100%, respectively. Visual analog scores ranged from 0 to 1.9 at final follow-up. Mean postoperative ASES (American Shoulder and Elbow Surgeons) shoulder scores ranged from 75.8-100. Mean postoperative CSS (Constant Shoulder Score) scores ranged from 83.3-94. Mean postoperative SSV (Subjective Shoulder Value) ranged from 70% to 99%. Failure and reoperation rates ranged between 0% to 35% and 0% to 30%, respectively, with the most common reoperation being conversion to prosthetic arthroplasty. Conclusions In this systematic review, nonarthroplasty surgical techniques demonstrated acceptable rates of radiographic healing, improved patient reported outcomes, minimal complications, and low rates of failure or reoperation. Joint preserving techniques are likely viable options to prolong function of the native shoulder and provide short- to midterm pain relief in young and highly active patients. Level of Evidence Level IV.

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A Systematic Review and Meta-Analysis to Assess Patient-Reported Outcomes after Lung Cancer Surgery

The Scientific World JOURNAL ◽

10.1155/2013/789625 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 13

Author(s):

Sayf Gazala ◽

Jean-Sébastien Pelletier ◽

Dale Storie ◽

Jeffrey A. Johnson ◽

Demetrios J. Kutsogiannis ◽

...

Keyword(s):

Lung Cancer ◽

Systematic Review ◽

Patient Reported Outcomes ◽

Meta Analysis ◽

Lung Cancer Surgery ◽

Risk Of Bias ◽

Patient Reported ◽

Related Quality ◽

Health Related

The main objective of this review was to systematically review, assess, and report on the studies that have assessed health related quality of life (HRQOL) after VATS and thoracotomy for resection of lung cancer. We performed a systematic review of six databases. The Downs and Black tool was used to assess the risk of bias. Five studies were included. In general, patients undergoing VATS have a better HRQOL when compared to thoracotomy; however, there was a high risk of bias in the included studies. The consistent use of a lung cancer specific questionnaire for measuring HRQOL after surgery is encouraged.

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Ionizing Radiation Protein Biomarkers in Normal Tissue and Their Correlation to Radiosensitivity: Protocol for a Systematic Review

Journal of Personalized Medicine ◽

10.3390/jpm11010003 ◽

2020 ◽

Vol 11 (1) ◽

pp. 3

Author(s):

Anne Dietz ◽

Maria Gomolka ◽

Simone Moertl ◽

Prabal Subedi

Keyword(s):

Systematic Review ◽

Ionizing Radiation ◽

Normal Tissue ◽

Health Assessment ◽

Risk Of Bias ◽

Level Of Evidence ◽

Human Normal Tissue

Background: Radiosensitivity is a significantly enhanced reaction of cells, tissues, organs or organisms to ionizing radiation (IR). During radiotherapy, surrounding normal tissue radiosensitivity often limits the radiation dose that can be applied to the tumour, resulting in suboptimal tumour control or adverse effects on the life quality of survivors. Predicting radiosensitivity is a component of personalized medicine, which will help medical professionals allocate radiation therapy decisions for effective tumour treatment. So far, there are no reviews of the current literature that explore the relationship between proteomic changes after IR exposure and normal tissue radiosensitivity systematically. Objectives: The main objective of this protocol is to specify the search and evaluation strategy for a forthcoming systematic review (SR) dealing with the effects of in vivo and in vitro IR exposure on the proteome of human normal tissue with focus on radiosensitivity. Methods: The SR framework has been developed following the guidelines established in the National Toxicology Program/Office of Health Assessment and Translation (NTP/OHAT) Handbook for Conducting a Literature-Based Health Assessment, which provides a standardised methodology to implement the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to environmental health assessments. The protocol will be registered in PROSPERO, an open source protocol registration system, to guarantee transparency. Eligibility criteria: Only experimental studies, in vivo and in vitro, investigating effects of ionizing radiation on the proteome of human normal tissue correlated with radio sensitivity will be included. Eligible studies will include English peer reviewed articles with publication dates from 2011–2020 which are sources of primary data. Information sources: The search strings will be applied to the scientific literature databases PubMed and Web of Science. The reference lists of included studies will also be manually searched. Data extraction and results: Data will be extracted according to a pre-defined modality and compiled in a narrative report following guidelines presented as a “Synthesis without Meta-analyses” method. Risk of bias: The risk of bias will be assessed based on the NTP/OHAT risk of bias rating tool for human and animal studies (OHAT 2019). Level of evidence rating: A comprehensive assessment of the quality of evidence for both in vivo and in vitro studies will be followed, by assigning a confidence rating to the literature. This is followed by translation into a rating on the level of evidence (high, moderate, low, or inadequate) regarding the research question. Registration: PROSPERO Submission ID 220064.

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Surgery for Shoulder Osteoarthritis: A Cochrane Systematic Review

The Journal of Rheumatology ◽

10.3899/jrheum.101008 ◽

2011 ◽

Vol 38 (4) ◽

pp. 598-605 ◽

Cited By ~ 39

Author(s):

JASVINDER A. SINGH ◽

JOHN SPERLING ◽

RACHELLE BUCHBINDER ◽

KELLY McMAKEN

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Relative Risk ◽

Short Form ◽

Surgical Techniques ◽

Mean Difference ◽

Cochrane Systematic Review ◽

Shoulder Osteoarthritis ◽

Patient Reported

Objective.To determine the benefits and harm of surgery for shoulder osteoarthritis (OA).Methods.We performed a Cochrane Systematic Review of clinical trials of adults with shoulder OA, comparing surgical techniques [total shoulder arthroplasty (TSA), hemiarthroplasty, implant types, and fixation] to placebo, sham surgery, nonsurgical modalities, and no treatment. We also reviewed trials that compared various surgical techniques, reporting patient-reported outcomes (pain, function, quality of life, etc.) or revision rates. We calculated the risk ratio for categorical outcomes and mean differences for continuous outcomes with 95% CI.Results.There were no controlled trials of surgery versus placebo or nonsurgical interventions. Seven studies with 238 patients were included. Two studies compared TSA to hemiarthroplasty (n = 88). Significantly worse scores on the 0–100 American Shoulder and Elbow Surgeons scale (mean difference, −10.05 at 24–34 mo; 95% CI −18.97 to −1.13; p = 0.03) and a nonsignificant trend toward higher revision rate in hemiarthroplasty compared to TSA (relative risk 6.18; 95% CI 0.77 to 49.52; p = 0.09) were noted. With 1 study providing data (n = 41), no differences were noted between groups for pain scores (mean difference 7.8; 95% CI −5.33 to 20.93), quality of life on Medical Outcomes Study Short-Form 36 physical component summary (mean difference 0.80; 95% CI −6.63 to −8.23), and adverse events (relative risk 1.2; 95% CI 0.4 to 3.8).Conclusion.TSA was associated with better shoulder function, with no other demonstrable clinical benefits compared to hemiarthroplasty. More studies are needed to compare clinical outcomes between them and comparing shoulder surgery to sham, placebo, and other nonsurgical treatment options.

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Surgical Results of Chronic Distal Biceps Ruptures: A Systematic Review

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211065772 ◽

2022 ◽

Vol 10 (1) ◽

pp. 232596712110657

Author(s):

Arpun Bajwa ◽

Maciej J.K. Simon ◽

Jordan M. Leith ◽

Farhad O. Moola ◽

Thomas J. Goetz ◽

...

Keyword(s):

Systematic Review ◽

Surgical Management ◽

Functional Outcomes ◽

Biceps Tendon ◽

Surgical Techniques ◽

Elbow Flexion ◽

Level Of Evidence ◽

Arm Pain ◽

Distal Biceps ◽

Cochrane Database

Background: Distal biceps tendon tears can cause weakness and fatigue with activities requiring elbow flexion and supination. Surgical management of chronic tears (>21 days) is not well described in the literature. Purpose: To determine the clinical outcomes of chronic distal biceps repairs and reconstructions. Study Design: Systematic review; Level of evidence, 4. Methods: We performed a search of Medline (PubMed and Ovid), EMBASE, CINAHL physical therapy, Cochrane Database of Systematic Reviews and Central Register of Controlled Trials, and PubMed Central from inception until September 29, 2020, to identify articles on chronic distal biceps ruptures. The inclusion criteria were studies with at least 1 outcome measure and 10 patients with chronic distal biceps ruptures treated surgically. The quality of the included studies was assessed with the methodological index for nonrandomized studies (MINORS) score. Functional outcomes and complications were reviewed. Results: A total of 12 studies were included after systematic database screenings. The MINORS scores ranged from 5 to 19. There were a total of 1704 distal biceps ruptures, of which 1270 were acute and 434 were chronic. Average follow-up time was 12 months to 5.1 years. Single-incision (n = 3), 2-incision (n = 2), or both (n = 6) surgical techniques were used in these studies. Four studies described the use of autografts, and 4 articles used allografts in the chronic repair. Range of motion, function, and strength outcomes were similar when compared with the contralateral arm. Pain was reduced to minimal levels. Main postoperative complications were of paresthesia (specifically to the lateral antebrachial cutaneous nerve), which were temporary in 69.1% of cases. Conclusion: The results of this review indicate that surgical management of chronic distal biceps ruptures demonstrates improvement in outcomes including pain reduction and functional ability. Although there may be a slightly higher immediate complication rate, the functional outcomes remain comparable with those seen in the patient population with acute distal biceps.

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Systematic Review of Patient-Reported Outcomes following Surgical Treatment of Lymphedema

Cancers ◽

10.3390/cancers12030565 ◽

2020 ◽

Vol 12 (3) ◽

pp. 565 ◽

Cited By ~ 5

Author(s):

Michelle Coriddi ◽

Joseph Dayan ◽

Nikhil Sobti ◽

David Nash ◽

Johanna Goldberg ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Surgical Treatment ◽

Patient Reported Outcomes ◽

Short Form ◽

Future Research ◽

Secondary Lymphedema ◽

Patient Reported ◽

Life Impact

Introduction: Analysis of quality of life (QOL) outcomes is an important aspect of lymphedema treatment since this disease can substantially impact QOL in affected individuals. There are a growing number of studies reporting patient-reported outcomes (PROMs) for patients with lymphedema. The purpose of this study was to conduct a systematic review of outcomes and utilization of PROMs following surgical treatment of lymphedema. Methods: A literature search of four databases was performed up to and including March, 2019. Studies included reported on QOL outcomes after physiologic procedures, defined as either lymphovenous bypass (LVB) or vascularized lymph node transplant (VLNT), to treat upper and/or lower extremity primary or secondary lymphedema. Results: In total, 850 studies were screened—of which, 32 studies were included in this review. Lymphovenous bypass was the surgical intervention in 16 studies, VLNT in 11 studies, and both in 5 studies. Of the 32 total studies, 16 used validated survey tools. The most commonly used PROM was the lymph quality of life measure for limb lymphedema (LYMQOL) (12 studies). In the remaining four studies, the upper limb lymphedema 27 scale (ULL27), the short form 36 questionnaire (SF-36), the lymphedema functioning, disability and health questionnaire (Lymph-ICF), and lymphedema life impact scale (LLIS) were each used once. QOL improvement following surgical treatment was noted in all studies. Conclusions: Physiologic surgical treatment of lymphedema results in improved QOL outcomes in most patients. The use of validated PROM tools is increasing but there is no current consensus on use. Future research to evaluate the psychometric properties of PROMs in lymphedema is needed to guide the development and use of lymphedema-specific tools.

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Multi-disciplinary palliative care is effective in people with symptomatic heart failure: A systematic review and narrative synthesis

Palliative Medicine ◽

10.1177/0269216319859148 ◽

2019 ◽

Vol 33 (8) ◽

pp. 1003-1016 ◽

Cited By ~ 12

Author(s):

Sushma Datla ◽

Cornelia Antonia Verberkt ◽

Angela Hoye ◽

Daisy J.A. Janssen ◽

Miriam J Johnson

Keyword(s):

Heart Failure ◽

Systematic Review ◽

Palliative Care ◽

Grey Literature ◽

Risk Of Bias ◽

Future Research ◽

Narrative Synthesis ◽

Symptomatic Heart Failure ◽

Evaluation Phase ◽

Patient Reported

Background: Despite recommendations, people with heart failure have poor access to palliative care. Aim: To identify the evidence in relation to palliative care for people with symptomatic heart failure. Design: Systematic review and narrative synthesis. (PROSPERO CRD42016029911) Data sources: Databases (Medline, Cochrane database, CINAHL, PsycINFO, HMIC, CareSearch Grey Literature), reference lists and citations were searched and experts contacted. Two independent reviewers screened titles and abstracts and retrieved papers against inclusion criteria. Data were extracted from included papers and studies were critically assessed using a risk of bias tool according to design. Results: Thirteen interventional and 10 observational studies were included. Studies were heterogeneous in terms of population, intervention, comparator, outcomes and design rendering combination inappropriate. The evaluation phase studies, with lower risk of bias, using a multi-disciplinary specialist palliative care intervention showed statistically significant benefit for patient-reported outcomes (symptom burden, depression, functional status, quality of life), resource use and costs of care. Benefit was not seen in studies with a single component/discipline intervention or with higher risk of bias. Possible contamination in some studies may have caused under-estimation of effect and missing data may have introduced bias. There was no apparent effect on survival. Conclusion: Overall, the results support the use of multi-disciplinary palliative care in people with advanced heart failure but trials do not identify who would benefit most from specialist palliative referral. There are no sufficiently robust multi-centre evaluation phase trials to provide generalisable findings. Use of common population, intervention and outcomes in future research would allow meta-analysis.

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Duration of Cast Immobilization in Distal Radial Fractures: A Systematic Review

Journal of Wrist Surgery ◽

10.1055/s-0039-1683433 ◽

2019 ◽

Vol 08 (05) ◽

pp. 430-438 ◽

Cited By ~ 1

Author(s):

Eva A.K. van Delft ◽

Tamara G. van Gelder ◽

Ralph de Vries ◽

Jefrey Vermeulen ◽

Frank W. Bloemers

Keyword(s):

Systematic Review ◽

Nonoperative Treatment ◽

Outcome Data ◽

Cochrane Library ◽

Future Research ◽

Cast Immobilization ◽

Distal Radial Fractures ◽

Level Of Evidence ◽

Homogeneous Groups ◽

Patient Reported

Objective The duration of immobilization in distal radial fractures is disputed in the current literature. There are still no long-term superior outcomes of operative treatment in comparison to nonoperative treatment. A systematic review was initiated to assess the clinical controversy on the duration of the immobilization period for nonoperatively treated distal radial fractures. Materials and Methods A comprehensive search was performed in the PubMed, Embase, and Wiley/Cochrane Library databases and a manual reference check of the identified systematic reviews and meta-analyses was executed. Eligible studies were randomized controlled trials that compared two periods of immobilization, with reported functional, patient-reported, and radiological outcomes. Two reviewers independently agreed on eligibility, and assessed methodological quality and extracted outcome data. Results The initial search yielded 3.384 studies. Twelve trials, with 1063 patients, were included in this systematic review. Grip strength and patient-reported outcome were better in patients treated by a shorter period of immobilization. There was no difference in pain, range of motion, or radiological outcome between different periods of immobilization. Owing to heterogeneity of studies, data were unsuitable for pooling. Conclusion Included studies showed that there might be a preference for a shorter period of immobilization in nonoperatively treated distal radius fractures. Therefore, shortening the period of immobilization in distal radial fractures to a maximum of three weeks should be considered. Future research should include homogeneous groups of patients to draw valid conclusions on the appropriate period of immobilization for nonoperatively treated distal radial fractures. Level of Evidence This is a Level II study. Systematic Review Registration Number PROSPERO 2018 CRD42018085524.

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