P106 Robotic Roux-en-Y gastric bypass: A systematic review to examine reporting of a surgical innovation

Abstract Introduction Roux-en-Y gastric bypass (RYGB) is one of the most commonly performed bariatric procedures, and robotic methods are increasingly used. Perceived benefits of robotic surgery include improved visualisation and ergonomics, fewer complications, and shorter hospital stay. Rigorous processes that facilitate the safe transition of surgical innovations such as robotic RYGB into clinical practice are currently lacking. This may place patients at risk, and lead to research waste. The IDEAL Collaboration has produced guidance on the reporting of surgical innovations, but it is not known how robotic RYGB has been reported. This project aims to summarise technique description, governance arrangements and outcome reporting in robotic RYGB. Methods A systematic review is being conducted, using PRISMA guidance. A search of Embase, Ovid Medline, the Cochrane Library and Web of Science was performed to identify primary studies reporting outcomes of robotic RYGB. Data will be extracted on study characteristics, governance and ethical arrangements, descriptions of technique, and outcomes. The data will be evaluated in relation to IDEAL principles. Results The literature search yielded 1012 studies; 754 remained after de-duplication. Following screening by abstract, 229 full texts were screened. 67 studies will undergo extraction of data. A descriptive summary of the data will be presented, with a critique of the findings. Conclusion This study will summarise and appraise how robotic RYGB has been reported. This will contribute towards the development of a standardised and methodical process for the introduction of surgical innovation into clinical practice.

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P102 Reporting of innovations in surgery: a systematic review of robotic liver resections

BJS Open ◽

10.1093/bjsopen/zrab032.101 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

Author(s):

Sarah Biggs ◽

Keng Siang Lee ◽

Max Shah ◽

Tom Brankin-Frisby ◽

Tjun Wei Leow ◽

...

Keyword(s):

Systematic Review ◽

Descriptive Analysis ◽

Cochrane Library ◽

Research Reporting ◽

Liver Resections ◽

Surgical Access ◽

Ovid Medline ◽

Study Characteristics ◽

The Cochrane Library ◽

The Ideal

Abstract Introduction Liver resections are most commonly performed for either primary or secondary cancers. Consensus guidelines recommend that minor liver resections should be attempted laparoscopically, however this technique has limitations. These include difficulties with surgical access, ergonomics and visualization. Consequently, there has been increasing interest in innovative solutions such as robotic surgery. The IDEAL Collaboration has provided guidance for the reporting of surgical innovations, but it is not known how robotic liver resections have been reported. The aim of this study is to summarize technique descriptions and governance procedures, and understand which clinical outcomes have been reported. Methods A systematic review is being conducted in accordance with the PRISMA guideline. A search of Embase, Ovid Medline, the Cochrane Library and Web of Science was performed, using search concepts of “robotic” and “liver resection”. Articles will be screened to select primary research reporting outcomes of robotic liver resections. Data will be extracted on the reporting of study characteristics, governance and ethical arrangements, mitigations of harm, techniques and modifications, and outcomes. A descriptive summary of the data will be produced. The results will be critiqued in relation to guidance from the IDEAL Collaboration. Results The search returned 3063 articles, with 2385 remaining after de-duplication. An interim descriptive analysis of the data will be presented, summarizing how robotic liver resections have been reported. A critique of the available results in the context of IDEAL guidance will be provided. Conclusion This systematic review will describe how robotic liver resections have been reported as surgical innovations.

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Comparative Effectiveness and Harms of Intraoperative Transesophageal Echocardiography in Noncardiac Surgery: A Systematic Review

Seminars in Cardiothoracic and Vascular Anesthesia ◽

10.1177/1089253218756756 ◽

2018 ◽

Vol 22 (2) ◽

pp. 122-136 ◽

Cited By ~ 4

Author(s):

Ashraf Fayad ◽

Sasha Shillcutt ◽

Massimiliano Meineri ◽

Terrence D. Ruddy ◽

Mohammed Toseef Ansari

Keyword(s):

Systematic Review ◽

Transesophageal Echocardiography ◽

Comparative Effectiveness ◽

Noncardiac Surgery ◽

Cochrane Library ◽

Serious Adverse Events ◽

Ovid Medline ◽

Quantitative Synthesis ◽

The Cochrane Library ◽

Important Design

Intraoperative use of transesophageal echocardiography (TEE) has become commonplace in high-risk noncardiac surgeries but the balance of benefits and harms remains unclear. This systematic review investigated the comparative effectiveness and harms of intraoperative TEE in noncardiac surgery. We searched Ovid MEDLINE, PubMed, EMBASE, and the Cochrane Library from 1946 to March 2017. Two reviewers independently screened the literature for eligibility. Studies were assessed for the risk of selection bias, confounding, measurement bias, and reporting bias. Three comparative and 13 noncomparative studies were included. Intraoperative TEE was employed in a total of 1912 of 3837 patients. Studies had important design limitations. Data were not amenable to quantitative synthesis due to clinical and methodological diversity. Reported incidence of TEE complications ranged from 0% to 1.7% in patients undergoing various procedures (5 studies, 540 patients). No serious adverse events were observed for mixed surgeries (2 studies, 197 patients). Changes in surgical or medical management attributable to the use of TEE were noted in 17% to 81% of patients (7 studies, 558 patients). The only randomized trial of intraoperative TEE was grossly underpowered to detect meaningful differences in 30-day postoperative outcomes. There is lack of high-quality evidence of effectiveness and harms of intraoperative TEE in the management of non-cardiac surgeries. Evidence, however, indicates timely evaluation of cardiac function and structure, and hemodynamics. Future studies should be comparative evaluating confounder-adjusted impact on both intraoperative and 30-day postoperative clinical outcomes.

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LO072: Fever in the returning traveller: a systematic review and critical appraisal of existing clinical practice guidelines and approaches to returning travellers presenting with fever

CJEM ◽

10.1017/cem.2016.109 ◽

2016 ◽

Vol 18 (S1) ◽

pp. S54-S55

Author(s):

A. Collier ◽

J.J. Perry ◽

A. Nath

Keyword(s):

Systematic Review ◽

Clinical Practice ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Practice Guideline ◽

Critical Appraisal ◽

Clinical Information ◽

Final Analysis ◽

Cochrane Library ◽

The Cochrane Library

Introduction: Fever in the returning traveller is a common ED presentation; however approaches and level of comfort with tropical diseases vary widely. This project aimed to conduct a systematic review and critical appraisal of existing clinical practice guidelines and approaches, to guide an ED approach, in Canada, to fever in the returning traveller. Methods: A literature review was conducted of peer reviewed papers, national and international practice guidelines, and practice statements presenting approaches to fever in the returning traveller. A literature search was conducted using MEDLINE and Embase (1947-Dec 2014), with librarian assistance to optimize strategy. The databases of guideline clearing houses, CMA, PHAC, WHO, CDC, and the Cochrane library were searched, along with a google scholar search. References of included articles were hand searched. Article titles and abstracts were reviewed by the author for inclusion. Key elements of the guidelines and approaches were identified and grouped by theme and where appropriate, the quality of guidelines were assessed by two reviewers using the AGREEII tool. Results: The search returned 1598 titles. 72 full manuscripts were reviewed based on inclusion from title and abstract, with 24 manuscripts included for final analysis. Common elements suggested by the guidelines or approaches were identified and grouped within three themes (key historical features, physical exam findings, investigations). Most manuscripts presented tables of important clinical information, but limited guidance on how to approach diagnosis in a focused manner. When evaluated by AGREEII, only one guideline (D’Acremont et al) scored > 50% overall quality rating. Unlike other approaches, this guideline proposes a stepwise approach to diagnosis and treatment based on the presence of key exposures, signs/symptoms, and eosinophilia. Conclusion: The guideline by D’Acremont et al was identified as the most rigorous existing practice guideline. This guideline, combined with other elements identified by thematic review, forms the basis of a suggested ED approach to fever in the returning traveller, which will be further refined using the AGREEII model to propose a practice guideline for Canadian EDs.

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The Effect of Hysteroscopy on the Reproductive Outcomes of Infertile Women Without Intrauterine Pathologies: A Systematic Review and Meta-Analysis

10.20944/preprints202009.0649.v1 ◽

2020 ◽

Author(s):

Soo Yeon Yang ◽

Seon Heui Lee ◽

Seung-Joo Chon

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Cochrane Library ◽

Reproductive Outcomes ◽

Vitro Fertilization ◽

Infertile Women ◽

Ovid Medline ◽

Meta Analyses ◽

The Cochrane Library

(1) Background: The aim of this work was to systematically review existing studies on whether hysteroscopy improves the reproductive outcomes of women with infertility even in the absence of intrauterine pathologies when compared to women who did not receive a hysteroscopy. (2) Methods: We established the Participant-Intervention-Comparison-Outcome strategy and used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement to conduct a systematic review of 11 studies which were retrieved from 3 electronic databases: Ovid-Medline, Ovid-Embase, and the Cochrane Library. Two independent investigators extracted the data from the included studies and used the Cochrane risk-of-bias tool to assess their quality. (3) Results: The primary outcome measures were the clinical pregnancy rates (CPRs) and live birth rates (LBRs) in the in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles. Hysteroscopy in infertile women without intrauterine pathologies showed higher CPRs and LBRs than those in the same population who did not receive hysteroscopy in cases of recurrent implantation failure and IVF (odds ratio: 1.79 and 1.46, 95% confidence interval: 1.46-2.30 and 1.08-1.97 for CPR and LBR, respectively); however, the degree of significance was not as high for LBR. (4) Conclusions: Hysteroscopy before IVF/ICSI in infertile women without intrauterine pathologies may potentially be effective in improving the CPRs and LBRs in patients with RIF. Robust and high-quality randomized trials are warranted to confirm this finding.

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Smoking and Outcomes After Knee and Hip Arthroplasty: A Systematic Review

The Journal of Rheumatology ◽

10.3899/jrheum.101221 ◽

2011 ◽

Vol 38 (9) ◽

pp. 1824-1834 ◽

Cited By ~ 95

Author(s):

JASVINDER A. SINGH

Keyword(s):

Systematic Review ◽

Postoperative Complication ◽

Risk Ratio ◽

Hip Arthroplasty ◽

Cochrane Library ◽

Death Risk ◽

Ovid Medline ◽

Complication Risk ◽

The Cochrane Library ◽

Proquest Dissertation

Objective.Studies have suggested higher rates of perioperative and postoperative complications in smokers compared to nonsmokers. The objective of this systematic review was to assess the association of smoking and postoperative outcomes following total hip arthroplasty (THA) or total knee arthroplasty (TKA).Methods.A search of 6 databases (The Cochrane Library, Scopus, Proquest Dissertation abstracts, CINAHL, Ovid Medline, and Embase) was performed by a Cochrane librarian. All titles and abstracts were screened by 2 independent reviewers with expertise in performing systematic reviews. Studies were included if they were fully published reports that included smoking and any perioperative or postoperative clinical outcome in patients with TKA or THA.Results.A total of 21 studies were included for the review, of which 6 provided multivariable-adjusted analyses, 14 univariate analyses, and one statistical modeling. For most outcomes, results from 1–2 studies could be pooled. Current smokers were significantly more likely to have any postoperative complication (risk ratio 1.24, 95% CI 1.01 to 1.54) and death (risk ratio 1.63, 95% CI 1.06 to 2.51) compared to nonsmokers. Former smokers were significantly more likely to have any post-operative complication (risk ratio 1.32, 95% CI 1.05 to 1.66) and death (risk ratio 1.69, 95% CI 1.08 to 2.64) compared to nonsmokers.Conclusion.This systematic review found that smoking is associated with significantly higher risk of postoperative complication and mortality following TKA or THA. Studies examining longterm consequences of smoking on implant survival and complications are needed. Smoking cessation may improve outcomes after THA or TKA.

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Trends and Effectiveness of ICT Interventions for the Elderly to Reduce Loneliness: A Systematic Review

Healthcare ◽

10.3390/healthcare9030293 ◽

2021 ◽

Vol 9 (3) ◽

pp. 293

Author(s):

Hee Kyung Choi ◽

Seon Heui Lee

Keyword(s):

Systematic Review ◽

Social Participation ◽

Data Extraction ◽

Health And Safety ◽

The Elderly ◽

Development Trend ◽

Basic Knowledge ◽

Cochrane Library ◽

Ovid Medline ◽

The Cochrane Library

Elderly people are sensitive to loneliness, which may contribute to mental and physical health, serious illness, and increased mortality. This study investigates the development trend of information communication technology (ICT) interventions designed for the elderly to reduce loneliness and synthesize its effect. We searched relevant articles on 23 May 2020 using three databases: Ovid-Medline, Ovid-EMBASE, and the Cochrane library. Data extraction and quality assessment were independently performed by two authors. The development is changing from animal robots to online social platforms and from simple emotional support to a multifaceted system that promotes social participation, cognition, physical activity, and nutrition. Our systematic review reported that ICT interventions are being developed to alleviate loneliness and increase social participation. Our study revealed an increase in the use of ICT interventions among the elderly and a positive change in their attitude toward ICT interventions. ICT interventions in the field of nursing should continue to be developed in the future to meet social, health, and safety needs. In the context of coronavirus disease 2019 (COVID-19), ICT interventions are needed to respond effectively to the needs of the elderly. This study is expected to provide basic knowledge for the development of ICT interventions for the elderly.

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Different Treatments for Granulomatous Lobular Mastitis: A Systematic Review and Meta-Analysis

Breast Care ◽

10.1159/000501498 ◽

2019 ◽

Vol 15 (1) ◽

pp. 60-66 ◽

Cited By ~ 2

Author(s):

Xiaojia Ma ◽

Xiaoli Min ◽

Chang Yao

Keyword(s):

Systematic Review ◽

Complete Remission ◽

Meta Analysis ◽

Surgical Excision ◽

Cochrane Library ◽

Efficacy And Safety ◽

Abscess Drainage ◽

Significant Efficacy ◽

The Cochrane Library ◽

The Ideal

Objective: Granulomatous lobular mastitis (GLM) is infrequently diagnosed. This study aimed to evaluate the efficacy and safety of managements for GLM in the nonlactation period. Methods: Publications were retrieved from PubMed, EMBASE, and the Cochrane library on September 10, 2018. We pooled and compared the outcome parameters and complete remission (CR) rates between different treatments using a meta-analysis. Results: Twenty-one publications including 970 patients treated with surgical excision, steroids, abscess drainage, antibiotics, and observation were included. Surgery significantly improved CR rate compared with steroids (p = 0.0003). There was no difference in the CR rate in patients treated with surgery alone or combined with steroids (p = 0.28). Surgery showed borderline significant efficacy in the CR rate compared with antibiotics (p = 0.06) and abscess drainage (p = 0.06). No difference was observed in effectiveness between observation and surgical management in patients diagnosed with early GLM and mild symptoms. Conclusions: Although surgery was the ideal management for GLM, steroids and antibiotics might be ideal managements for GLM patients who are worried about surgical scars. Observation was an impressive alternative for patients with early GLM.

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The impact of institutional repositories: a systematic review

Journal of the Medical Library Association JMLA ◽

10.5195/jmla.2020.856 ◽

2020 ◽

Vol 108 (2) ◽

Author(s):

Michelle R. Demetres ◽

Diana Delgado ◽

Drew N. Wright

Keyword(s):

Systematic Review ◽

Information Science ◽

Positive Impact ◽

Citation Count ◽

Cochrane Library ◽

Institutional Repositories ◽

Scholarly Output ◽

Ovid Medline ◽

The Cochrane Library ◽

The Impact

Objective: Institutional repositories are platforms for presenting and publicizing scholarly output that might not be suitable to publish in a peer-reviewed journal or that must meet open access requirements. However, there are many challenges associated with their launch and up-keep. The objective of this systematic review was to define the impacts of institutional repositories (IRs) on an academic institution, thus justifying their implementation and/or maintenance.Methods: A comprehensive literature search was performed in the following databases: Ovid MEDLINE, Ovid EMBASE, the Cochrane Library (Wiley), ERIC (ProQuest), Web of Science (Core Collection), Scopus (Elsevier), and Library, Information Science & Technology Abstracts (EBSCO). A total of 6,593 citations were screened against predefined inclusion and exclusion criteria.Results: Thirteen included studies were divided into 3 areas of impact: citation count, exposure or presence, and administrative impact. Those focusing on citation count (n=5) and exposure or presence (n=7) demonstrated positive impacts of IRs on institutions and researchers. One study focusing on administrative benefit demonstrated the utility of IRs in automated population of ORCID profiles.Conclusion: Based on the available literature, IRs appear to have a positive impact on citation count, exposure or presence, and administrative burden. To draw stronger conclusions, more and higher-quality studies are needed.

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Characteristics of the Frequency-Following Response to Speech in Neonates and Potential Applicability in Clinical Practice: A Systematic Review

Journal of Speech Language and Hearing Research ◽

10.1044/2020_jslhr-19-00322 ◽

2020 ◽

Vol 63 (5) ◽

pp. 1618-1635

Author(s):

Céline Richard ◽

Mary Lauren Neel ◽

Arnaud Jeanvoine ◽

Sharon Mc Connell ◽

Alison Gehred ◽

...

Keyword(s):

Systematic Review ◽

Cochrane Library ◽

Neurodevelopmental Outcomes ◽

Frequency Following Response ◽

Ovid Medline ◽

Published Evidence ◽

Mesh Terms ◽

Potential Applicability ◽

Clinical Potential

Purpose We sought to critically analyze and evaluate published evidence regarding feasibility and clinical potential for predicting neurodevelopmental outcomes of the frequency-following responses (FFRs) to speech recordings in neonates (birth to 28 days). Method A systematic search of MeSH terms in the Cumulative Index to Nursing and Allied HealthLiterature, Embase, Google Scholar, Ovid Medline (R) and E-Pub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Web of Science, SCOPUS, COCHRANE Library, and ClinicalTrials.gov was performed. Manual review of all items identified in the search was performed by two independent reviewers. Articles were evaluated based on the level of methodological quality and evidence according to the RTI item bank. Results Seven articles met inclusion criteria. None of the included studies reported neurodevelopmental outcomes past 3 months of age. Quality of the evidence ranged from moderate to high. Protocol variations were frequent. Conclusions Based on this systematic review, the FFR to speech can capture both temporal and spectral acoustic features in neonates. It can accurately be recorded in a fast and easy manner at the infant's bedside. However, at this time, further studies are needed to identify and validate which FFR features could be incorporated as an addition to standard evaluation of infant sound processing evaluation in subcortico-cortical networks. This review identifies the need for further research focused on identifying specific features of the neonatal FFRs, those with predictive value for early childhood outcomes to help guide targeted early speech and hearing interventions.

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Efficacy of compression stockings in preventing post-thrombotic syndrome in patients with deep venous thrombosis: a systematic review and metaanalysis

VASA ◽

10.1024/0301-1526/a000508 ◽

2016 ◽

Vol 45 (2) ◽

pp. 141-147 ◽

Cited By ~ 7

Author(s):

Jakob Martin Burgstaller ◽

Johann Steurer ◽

Ulrike Held ◽

Beatrice Amann-Vesti

Keyword(s):

Systematic Review ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Cochrane Library ◽

Compression Stockings ◽

Post Thrombotic Syndrome ◽

Study Results ◽

Preventive Efficacy ◽

One Year ◽

The Cochrane Library

Abstract. Background: Here, we update an earlier systematic review on the preventive efficacy of active compression stockings in patients with diagnosed proximal deep venous thrombosis (DVT) by including the results of recently published trials. The aims are to synthesize the results of the original studies, and to identify details to explain heterogeneous results. Methods: We searched the Cochrane Library, PubMed, Scopus, and Medline for original studies that compared the preventive efficacy of active compression stockings with placebo or no compression stockings in patients with diagnosed proximal DVT. Only randomized controlled trials (RCTs) were included. Results: Five eligible RCTs with a total of 1393 patients (sample sizes ranged from 47 to 803 patients) were included. In three RCTs, patients started to wear compression stockings, placebo stockings or no stockings within the first three weeks after the diagnosis of DVT. The results of two RCTs indicate a statistically significant reduction in post-thrombotic syndrome (PTS) of 50% or more after two or more years. The result of one RCT shows no preventive effect of compression stockings at all. Due to the heterogeneity of the study results, we refrained from pooling the results of the RCTs. In a further RCT, randomization to groups with and without compression stockings took place six months after the diagnosis of DVT, and in another RCT, only patients with the absence of PTS one year after the diagnosis of DVT were analyzed. One RCT revealed a significant reduction in symptoms, whereas another RCT failed to show any benefit of using compression stockings. Conclusions: At this time, it does not seem to be justifiable to entirely abandon the recommendations regarding compression stockings to prevent PTS in patients with DVT. There is evidence favoring compression stockings, but there is also evidence showing no benefit of compression stockings.

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