Evolution of Qualitative Synthesis within Systematic Reviews

Abstract Introduction: Motor function is essential in our daily lives, one of the most common impairments caused by stroke is loss of functional movement. Over 70% of stroke survivors have motor or other neurological functional disabilities. However, rehabilitation of motor function suffered from a stroke can be rather difficult due to the complexity of organs and systems related to motor function, as well as the neural system that supported motor function. In particularly, previous evidence for the effectiveness of physiotherapy, a commonly prescribed intervention method for people with stroke, that recover motor function in people following a stroke is varied and limited in the chronic rehabilitation phase and therefore has never been reviewed systematically. With the progress of study in neurology and the development of novel tools for rehabilitation, results from more and more clinical trials are now available, thus here justifying conducting a systematic review. Methods and analysis: This systematic review protocol is developed in accordance with the methodology recommended by the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols, as well as the Cochrane handbook for systematic reviews of interventions. Relevant studies will be identified by searching the databases. We will perform searches for relevant studies in databases, including PubMed, Embase, CINAHL, and Web of Science, Physiotherapy Evidence Database and Cochrane Library databases. The reference lists of included articles and reviews will be searched manually. The date range parameters used in searching all databases will be restricted between January 2001 and January 2021. Randomized controlled trials (RCTs) published will be included. The language used in the articles included was restricted to English. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation system from the Cochrane Handbook for Systematic Reviews of Interventions) approach will be used to systematically appraise the quality of methodology. We will assess the risk of bias of the RCTs included using the Cochrane Collaboration’s tool and provide a qualitative synthesis. After that, we will consider conducting a meta-analysis if the final data across outcomes shows sufficient homogeneity. Ethics and dissemination: No ethical approval is needed as the proposed study does not involve the collection of primary data, and the results of this review will be disseminated via peer-reviewed publications and conference presentations. Trial registration number: CRD42021267069.

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The impact of digital interventions on antimicrobial stewardship in hospitals: A qualitative synthesis of systematic reviews (Preprint)

10.2196/preprints.27959 ◽

2021 ◽

Author(s):

Bethany A Van Dort ◽

Jonathan Penm ◽

Angus Ritchie ◽

Melissa T Baysari

Keyword(s):

Systematic Reviews ◽

Antimicrobial Stewardship ◽

Digital Health ◽

Hospital Setting ◽

Antimicrobial Use ◽

Qualitative Synthesis ◽

Large Variability ◽

Antimicrobial Prescribing ◽

Digital Interventions ◽

The Impact

BACKGROUND Antimicrobial stewardship (AMS) programs aim to optimize antimicrobial use by utilizing a suite of coordinated strategies. With the increased use of health information technology in hospitals, AMS processes that were traditionally paper-based are becoming computerized and streamlined. A number of reviews on digital interventions supporting AMS have been performed, so we performed a review of reviews to consolidate findings OBJECTIVE To provide a systematic overview and synthesis of evidence on the effectiveness of digital interventions to improve antimicrobial prescribing and monitoring in hospitals. METHODS Databases: Medline, Embase, Scopus, CINAHL and the Cochrane Database of Systematic Reviews were searched from 2010 onwards. Papers were eligible if they included studies that examined the effectiveness of digital health interventions related to antimicrobial prescribing and monitoring, in an inpatient hospital setting. Papers were excluded if they did not include a clearly defined search strategy, if they were limited to a pediatric setting, or they were not in English. RESULTS Seven systematic reviews were included for data extraction. Five reviews were of moderate quality and two of low quality. A large number of digital interventions were evaluated, with a strong focus on clinical decision support. There was a large variability in outcome measures used. Six reviews reported that digital interventions reduced antimicrobial use and improved antimicrobial appropriateness. The impact of digital interventions on clinical outcomes was inconsistent. CONCLUSIONS The results of this review indicate digital interventions, regardless of type, reduce antimicrobial use and improve antimicrobial appropriateness in hospitals. We recommend hospitals consider implementing one or more digital interventions to facilitate AMS programs.

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Use of Augmented Reality in Reconstructive Microsurgery: A Systematic Review and Development of the Augmented Reality Microsurgery Score

Journal of Reconstructive Microsurgery ◽

10.1055/s-0039-3401832 ◽

2019 ◽

Vol 36 (04) ◽

pp. 261-270

Author(s):

Yasser Al Omran ◽

Ali Abdall-Razak ◽

Catrin Sohrabi ◽

Tiffanie-Marie Borg ◽

Hayat Nadama ◽

...

Keyword(s):

Systematic Review ◽

Augmented Reality ◽

Systematic Reviews ◽

Real World ◽

Digital Information ◽

Inclusion Criteria ◽

Qualitative Synthesis ◽

Reconstructive Microsurgery ◽

User Access ◽

Meta Analyses

Abstract Background Augmented reality (AR) uses a set of technologies that overlays digital information into the real world, giving the user access to both digital and real-world environments in congruity. AR may be specifically fruitful in reconstructive microsurgery due to the dynamic nature of surgeries performed and the small structures encountered in these operations. The aim of this study was to conduct a high-quality preferred reporting items for systematic reviews and meta-analyses (PRISMA) and assessment of multiple systematic reviews 2 (AMSTAR 2) compliant systematic review evaluating the use of AR in reconstructive microsurgery. Methods A systematic literature search of Medline, EMBASE, and Web of Science databases was performed using appropriate search terms to identify all applications of AR in reconstructive microsurgery from inception to December 2018. Articles that did not meet the objectives of the study were excluded. A qualitative synthesis was performed of those articles that met the inclusion criteria. Results A total of 686 articles were identified from title and abstract review. Five studies met the inclusion criteria. Three of the studies used head-mounted displays, one study used a display monitor, and one study demonstrated AR using spatial navigation technology. The augmented reality microsurgery score was developed and applied to each of the AR technologies and scores ranged from 8 to 12. Conclusion Although higher quality studies reviewing the use of AR in reconstructive microsurgery is needed, the feasibility of AR in reconstructive microsurgery has been demonstrated across different subspecialties of plastic surgery. AR applications, that are reproducible, user-friendly, and have clear benefit to the surgeon and patient, have the greatest potential utility. Further research is required to validate its use and overcome the barriers to its implementation.

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Intrinsic Kidney Pathology Following COVID-19 Infection in Children and Adolescents: A Systematic Review

Children ◽

10.3390/children9010003 ◽

2021 ◽

Vol 9 (1) ◽

pp. 3

Author(s):

Henry H. L. Wu ◽

Mohan Shenoy ◽

Philip A. Kalra ◽

Rajkumar Chinnadurai

Keyword(s):

Systematic Review ◽

Children And Adolescents ◽

Systematic Reviews ◽

English Language ◽

Published Data ◽

Antibody Testing ◽

Qualitative Synthesis ◽

Vaccination Programs ◽

Kidney Pathology ◽

Necrotizing Glomerulonephritis

Introduction: COVID-19 infections resulting in pathological kidney manifestations have frequently been reported in adults since the onset of the global COVID-19 pandemic in December 2019. Gradually, there have been an increased number of COVID-19-associated intrinsic kidney pathologies in children and adolescents reported as well. The pathophysiological mechanisms between COVID-19 and the onset of kidney pathology are not fully known in children; it remains a challenge to distinguish between intrinsic kidney pathologies that were caused directly by COVID-19 viral invasion, and cases which occurred as a result of multisystem inflammatory syndrome due to the infection. This challenge is made more difficult in children, due to the ethical limitations of performing kidney biopsies to reach a biopsy-proven diagnosis. Although previous systematic reviews have summarized the various pathological kidney manifestations that have occurred in adults following acute COVID-19 infection, such reviews have not yet been published for children and adolescents. We describe the results of a systematic review for intrinsic kidney pathology following COVID-19 infection in children and adolescents. Methods: A systematic literature search of published data up until 31 October was completed through the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. Research articles reporting new-onset or relapsed intrinsic kidney pathology in children or adolescents (≤18 years) following acute COVID-19 infection were included for qualitative review. COVID-19 infection status was defined by a positive result from a RT-PCR, or nuclear antibody testing. Only full-text articles published in the English language were selected for review. Results: Twenty-nine cases from fifteen articles were included in the qualitative synthesis of this systematic review. Nephrotic syndrome, as an umbrella condition, appeared as the most frequently observed presentation (20 cases) with disease remission noted in all cases with steroid treatment. Other cases included numerous glomerulonephritides, such as acute necrotizing glomerulonephritis, MPO vasculitis and collapsing glomerulopathy, and thrombotic microangiopathies, such as aHUS. For patients with transplanted kidneys, T-cell-mediated rejection and mild tubular interstitial infiltration were noted following testing positive for COVID-19. There were no mortalities reported in any of the included cases, although two patients remained dialysis dependent at hospital discharge. Conclusion: This systematic review highlights the various intrinsic pathological kidney manifestations in children and adolescents as a result of acute COVID-19 infection. The clinical timeline and presentation of these cases support the mechanistic hypothesis between COVID-19 infection and the onset of intrinsic kidney pathologies within this context. The progressive introduction of vaccination programs for children and adolescents may hopefully reduce the severity of COVID-19-associated illnesses, and pathological kidney manifestations in this population.

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Effectiveness of feeding supplementation in preterm infants: an overview of systematic reviews

BMC Pediatrics ◽

10.1186/s12887-021-03052-w ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Keqin Liu ◽

Jiaxin Tao ◽

Jixin Yang ◽

Yufeng Li ◽

Yanwei Su ◽

...

Keyword(s):

Health Outcomes ◽

Preterm Infants ◽

Systematic Reviews ◽

Methodological Quality ◽

Data Extraction ◽

Cochrane Library ◽

Qualitative Synthesis ◽

Term Infants ◽

Online Library

Abstract Background Preterm infants have higher nutrition needs than term infants. The effectiveness of various feeding supplementation was assessed by the improvement of health outcomes in single specific systematic reviews (SRs). The aim of this review was to comprehensively describe the effectiveness of feeding supplementation in promoting health outcomes of preterm infants. Methods A literature search was conducted in the PUBMED, EMBASE, Science Direct, Cochrane library, Web of Science, and Wiley online library. SRs selection followed clear inclusion and exclusion criteria. Pairs of reviewers independently applied the criteria to both titles/abstracts and full texts. Screening and data extraction were performed by using the advanced tables. The methodological quality of SRs and the quality of the evidence were carried out according to the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) tool and the Grades of Recommendation, Assessment, Development, and Evaluation guidelines (GRADE) respectively. A qualitative synthesis of evidence is presented. Results Seventeen SRs were included in the review. Fifteen kinds of feeding supplementation were reported in the SRs. In preterm infants, the effectiveness of feeding supplementation in addition to regular breast-feeding was mainly shown in six aspects: physical health, neurodevelopment, biochemical outcomes, other health outcomes, morbidity and all-cause mortality. And the effectiveness of the interventions on health outcomes in preterm infants was found by most systematic reviews. The methodological quality of all the included SRs was high, and most of the evidences was of low or very low quality. Conclusions Our results will allow a better understanding of the feeding supplementation in preterm infants. Although the feeling supplements may improve the health outcomes of in preterm infants, the existing evidence is uncertain. Therefore, the clinical use of these supplements should be considered cautiously and more well-designed RCTs are still needed to further address the unsolved problems of the included SRs.

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Measuring the experience of remote home workers: A scoping review

10.31234/osf.io/8szwx ◽

2021 ◽

Author(s):

Stefano Federici ◽

Maria Laura De Filippis ◽

Maria Laura Mele ◽

Simone Borsci ◽

Marco Bracalenti ◽

...

Keyword(s):

Systematic Reviews ◽

Scoping Review ◽

Sociotechnical Systems ◽

Qualitative Synthesis ◽

Working From Home ◽

Scoping Reviews ◽

Exchange Information ◽

Meta Analyses ◽

Home Workers ◽

Careful Design

Introduction: Working from home (WFH) remotely is a modality of working that requires the careful design of systems of rules and tools to enable people to exchange information and perform actions. WFH is expected to expand after the COVID-19 pandemic, and how best to reliably assess and compare the experience of workers with different (sociotechnical) systems of WFH is central to the diffusion of acceptable modalities of remote working. However, the concept of experience and how it can be measured in the domain in WFH is yet to be clearly characterized.Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology for scoping reviews, we systematically map the approaches used by researchers to assess WFH, identify which aspects are usually investigated, and examine how such aspects are usually measured in terms of questions and tools. Literature is collected using Scopus and Web of Science.Results: Thirty-four records out of 323 focusing either on validating a scale, presenting theoretically the experience of workers or testing this empirically are included in the qualitative synthesis. The results highlight a lack of unified terminology and tools, with assessments of workers’ experience mainly characterized by survey approaches and qualitative questions. Conclusion: Clustering together the most investigated aspects in the literature and reviewing how these aspects are assessed, we propose a list of 10 relevant overarching dimensions and attempt to define workers’ experience in the domain of WFH remotely. This definition can be used as a tool by researchers aiming to assess the experience of workers in order to inform the design or redesign of the sociotechnical systems that enable WFH.

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Hospital-induced Delirium among Medical Older Adults: Evaluating the Veracity of Prognostic Models

Innovation in Aging ◽

10.1093/geroni/igab046.3608 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 1016-1017

Author(s):

Urszula Snigurska ◽

Ragnhildur Bjarnadottir ◽

Robert Lucero

Keyword(s):

Older Adults ◽

Statistical Analysis ◽

Data Collection ◽

Older Adult ◽

Systematic Reviews ◽

Adult Population ◽

Risk Of Bias ◽

Prognostic Models ◽

Qualitative Synthesis ◽

Older Adult Population

Abstract Several prognostic models have been developed and validated for delirium prediction among older adults. However, model development and validation studies need to be evaluated for risk of bias to establish the veracity of the prognostic models. This is a critical step before they can be implemented in clinical practice. Multiple systematic reviews have evaluated prognostic models of hospital-induced delirium. However, none of the existing systematic reviews evaluated the validity of models for non-surgical, medical hospitalized older adults. We conducted a scoping review to evaluate the validity of existing prognostic models of hospital-induced delirium in medical older adults. CINAHL, PsycINFO, PubMed, and Web of Science were searched for original studies. The database search yielded 4,312 records. Five studies were included in the qualitative synthesis. All the studies claimed to have developed valid prognostic models. However, the risk of bias assessment revealed that existing prognostic models of hospital-induced delirium in medical older adults are at a high risk of bias. Collectively, the statistical analysis was the greatest source of bias. Notably, while we have seen a proliferation of prognostic models for use in the surgical older adult population, efforts at developing prognostic models in the medical older adult population seem to have declined since the early 1990s. Newer methods of data collection, such as data mining of electronic health records, and statistical analysis, such as machine learning, have shown promise in accurate prediction of hospital-induced delirium while overcoming many challenges associated with manual data collection and traditional statistical analyses.

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A systematic review of evidence for cannabis and cannabinoids as adjuvant therapy in palliative and supportive oncology care.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.12091 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. 12091-12091

Author(s):

Sebastian Jugl ◽

Shailina Keshwani ◽

Lauren Adkins ◽

Coy D. Heldermon ◽

Almut Winterstein ◽

...

Keyword(s):

United States ◽

Systematic Review ◽

Cancer Patients ◽

Systematic Reviews ◽

Meta Analysis ◽

The United States ◽

Nausea And Vomiting ◽

Medical Cannabis ◽

Qualitative Synthesis ◽

Oncology Care

12091 Background: Medical cannabis use is increasing significantly in the United States as states reduce restrictions. However, ambiguity concerning the evidence for medical cannabis efficacy and safety, especially in the field of oncology, is persistent. Clinicians therefore face challenges in examining benefits and risks of medical cannabis as adjuvant treatment for cancer patients. This study identifies and evaluates the most recent available evidence for the efficacy of cannabis and cannabinoids as adjuvant in supportive and/or palliative use in patients with cancer. Methods: Electronic databases searched included PubMed, Embase, Web of Science, and Cochrane Library to identify studies published following the latest available systematic review, between July 2016 through October 2019. Studies conducted outside the United States, studies not evaluating cannabis or cannabinoids in Oncology care, and preclinical studies were excluded. Findings were organized in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) framework. Lastly, qualitative synthesis was used to generate summary statements about the role of cannabis and cannabinoids as adjuvant in supportive and/or palliative cancer care. Results: We screened 2,267 articles and included 96 studies in our qualitative synthesis. Among those were 2 RCT’s (1 completed), 6 Systematic reviews with Meta-analysis, 4 Systematic reviews without Meta-analysis, 71 other types of reviews and 13 observational studies. The most frequently reported outcomes assessed were efficacy of cannabis and cannabinoids for: pain (40 of 96; 17 indicating improvement), nausea and vomiting (26 of 96; 20 indicating improvement), cachexia (22 of 96; 2 indicating improvement), and utilization patterns of cannabis and/or cannabinoids among cancer patients (8 of 96). Conclusions: Latest available prevalence estimates indicate that a significant proportion of patients in the United States with cancer use cannabis and/or cannabinoids (18.3-40.0%). There is substantial evidence for the effectiveness of cannabis and cannabinoids in treating cancer-related pain; specifically, oromucosal THC/CBD spray. There is conclusive evidence for the effectiveness of cannabis and cannabinoids in relieving chemotherapy-induced nausea and vomiting; specifically, oral THC. There is inconclusive evidence regarding the effectiveness of cannabis and cannabinoids in treating cancer-related cachexia.

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Complementary therapy in palliative care: A synthesis of qualitative and quantitative systematic reviews

Palliative Medicine ◽

10.1177/0269216320942450 ◽

2020 ◽

Vol 34 (10) ◽

pp. 1332-1339

Author(s):

Megan Armstrong ◽

Nuriye Kupeli ◽

Kate Flemming ◽

Patrick Stone ◽

Susie Wilkinson ◽

...

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

Systematic Reviews ◽

Complementary Therapies ◽

Complementary Therapy ◽

Qualitative Studies ◽

Perceived Benefits ◽

Qualitative Synthesis ◽

Qualitative And Quantitative

Background: Interventions delivered in palliative care are complex and their evaluation through qualitative and quantitative research can lead to contrasting results. In a systematic review of trials, the effectiveness results of complementary therapies in palliative care were inconclusive; however, our qualitative synthesis showed participants perceived them to be beneficial. Aim: Use a novel methodology to synthesise evidence from qualitative and quantitative systematic reviews on complementary therapy in palliative care to explore the following: (1) If interventions delivered in trials reflect how participants in qualitative studies report they are delivered in real-life settings and (2) whether quality of life measures used in trials capture perceived benefits that are reported in qualitative studies. Methods: Two matrix tables were formulated. In one, key components in delivery of the complementary therapy from the qualitative synthesis which are as follows: (1) relationship with therapist, (2) comfortable environment, (3) choices (e.g. area of massage) and (4) frequent sessions, were plotted against intervention description, to explore matches and mismatches. In the other, items included in quality of life scales were compared with perceived benefits of complementary therapy. Results: None of the trials included all four key delivery components. The five quality of life scales used in the trials failed to capture the range of perceived benefits from the complementary therapies and many included inappropriate or redundant items. Conclusions: By integrating qualitative and quantitative review data, we determined the reasons trials may be inconclusive. This methodological exemplar provides a framework for understanding complexity in outcomes across trials and a direction for future research.

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Detection of Fusobaterium nucleatum in feces and colorectal mucosa as a risk factor for colorectal cancer: a systematic review and meta-analysis

Systematic Reviews ◽

10.1186/s13643-020-01526-z ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Amal Idrissi Janati ◽

Igor Karp ◽

Claudie Laprise ◽

Hisham Sabri ◽

Elham Emami

Keyword(s):

Colorectal Cancer ◽

Systematic Review ◽

Systematic Reviews ◽

Meta Analysis ◽

Positive Association ◽

Fusobacterium Nucleatum ◽

Relevant Information ◽

Colorectal Carcinogenesis ◽

Qualitative Synthesis ◽

Tissue Samples

Abstract Background Colorectal cancer (CRC) is a major cause of cancer deaths worldwide. Accumulating evidence suggests a potentially important role of colorectal infection with Fusobacterium nucleatum (F. nucleatum) in colorectal carcinogenesis. We conducted a systematic review, including both a qualitative synthesis and a meta-analysis, to synthesize the evidence from the epidemiological literature on the association between F. nucleatum detection in the colon/rectum and CRC. Methods A systematic literature search of Ovid MEDLINE(R), Embase, Web of Science Core Collection, EBM Reviews—Cochrane Database of Systematic Reviews, and CINAHL Plus with Full Text was conducted using earliest inclusive dates up to 4 October 2020. Eligible studies were original, comparative observational studies that reported results on colorectal F. nucleatum detection and CRC. Two independent reviewers extracted the relevant information. Odds ratio (OR) estimates were pooled across studies using the random effects model. Newcastle-Ottawa scale was used to critically appraise study quality. Results Twenty-four studies were included in the systematic review, of which 12 were included in the meta-analysis. Studies investigated F. nucleatum in feces, colorectal tissue samples, or both. In most studies included in the systematic review, the load of F. nucleatum was higher, on average, in specimens from CRC patients than in those from CRC-free controls. Meta-analysis showed a positive association between F. nucleatum detection in colorectal specimens and CRC (OR = 8.3; 95% confidence interval (95% CI) 5.2 to 13.0). Conclusions The results of this systematic review suggest that F. nucleatum in the colon/rectum is associated with CRC. Systematic review registration This systematic review protocol has been registered with the International Prospective Register of Systematic Reviews (PROSPERO) on July 10, 2018 (registration number CRD42018095866).

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