Spontaneous brain microbleeds: systematic review, subgroup analyses and standards for study design and reporting

IntroductionType 2 diabetes is a global health priority. People with diabetes are more likely to experience mental health problems relative to people without diabetes. Diabetes guidelines recommend assessment of depression and diabetes distress during diabetes care. This systematic review will examine the effect of routinely assessing and addressing depression and diabetes distress using patient-reported outcome measures in improving outcomes among adults with type 2 diabetes.Methods and analysisMEDLINE, Embase, CINAHL Complete, PsycInfo, The Cochrane Library and Cochrane Central Register of Controlled Trials will be searched using a prespecified strategy using a prespecified Population, Intervention, Comparator, Outcomes, Setting and study design strategy. The date range of the search of all databases will be from inception to 3 August 2020. Randomised controlled trials, interrupted time-series studies, prospective and retrospective cohort studies, case–control studies and analytical cross-sectional studies published in peer-reviewed journals in the English language will be included. Two review authors will independently screen abstracts and full texts with disagreements resolved by a third reviewer, if required, using Covidence software. Two reviewers will undertake risk of bias assessment using checklists appropriate to study design. Data will be extracted using prespecified template. A narrative synthesis will be conducted, with a meta-analysis, if appropriate.Ethics and disseminationEthics approval is not required for this review of published studies. Presentation of results will follow the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidance. Findings will be disseminated via peer-reviewed publication and conference presentations.PROSPERO registration numberCRD42020200246.

Download Full-text

SARS-CoV-2 genome and antibodies in breastmilk: a systematic review and meta-analysis

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2020-321074 ◽

2021 ◽

pp. fetalneonatal-2020-321074

Author(s):

Faith Zhu ◽

Carlos Zozaya ◽

Qi Zhou ◽

Charmaine De Castro ◽

Prakesh S Shah

Keyword(s):

Systematic Review ◽

Outcome Measures ◽

Study Design ◽

Web Of Science ◽

Meta Analysis ◽

Respiratory Support ◽

Common Finding ◽

Rt Pcr

ObjectiveTo systematically review and meta-analyse the rate of SARS-CoV-2 genome identification and the presence of SARS-CoV-2 antibodies in breastmilk of mothers with COVID-19.DesignA systematic review of studies published between January 2019 and October 2020 without study design or language restrictions.SettingData sourced from Ovid Embase Classic+Embase, PubMed, Web of Science, Scopus, relevant bibliographies and the John Hopkins University COVID-19 database.PatientsMothers with confirmed COVID-19 and breastmilk tested for SARS-CoV-2 by RT-PCR or for anti-SARS-CoV-2 antibodies.Main outcome measuresPresence of SARS-CoV-2 genome and antibodies in breastmilk.ResultsWe included 50 articles. Twelve out of 183 women from 48 studies were positive for SARS-CoV-2 genome in their breastmilk (pooled proportion 5% (95% CI 2% to 15%; I2=48%)). Six infants (50%) of these 12 mothers tested positive for SARS-CoV-2, with one requiring respiratory support. Sixty-one out of 89 women from 10 studies had anti-SARS-CoV-2 antibody in their breastmilk (pooled proportion 83% (95% CI 32% to 98%; I2=88%)). The predominant antibody detected was IgA.ConclusionsSARS-CoV-2 genome presence in breastmilk is uncommon and is associated with mild symptoms in infants. Anti-SARS-CoV-2 antibodies may be a more common finding. Considering the low proportion of SARS-CoV-2 genome detected in breastmilk and its lower virulence, mothers with COVID-19 should be supported to breastfeed.

Download Full-text

Sarcopenia Is Associated with Mortality in Adults: A Systematic Review and Meta-Analysis

Gerontology ◽

10.1159/000517099 ◽

2021 ◽

pp. 1-16

Author(s):

Jane Xu ◽

Ching S. Wan ◽

Kiriakos Ktoris ◽

Esmee M. Reijnierse ◽

Andrea B. Maier

Keyword(s):

Systematic Review ◽

Working Group ◽

Meta Analysis ◽

Nursing Home Residents ◽

Community Dwelling ◽

Risk Of Mortality ◽

European Working ◽

Subgroup Analyses ◽

Meta Analyses

Background: Sarcopenia can predispose individuals to falls, fractures, hospitalization, and mortality. The prevalence of sarcopenia depends on the population studied and the definition used for the diagnosis. Objective: This systematic review and meta-analysis aimed to investigate the association between sarcopenia and mortality and if it is dependent on the population and sarcopenia definition. Methods: A systematic search was conducted in MEDLINE, EMBASE, and Cochrane from 1 January 2010 to 6 April 2020 for articles relating to sarcopenia and mortality. Articles were included if they met the following criteria – cohorts with a mean or median age ≥18 years and either of the following sarcopenia definitions: Asian Working Group for Sarcopenia (AWGS and AWGS2019), European Working Group on Sarcopenia in Older People (EWGSOP and EWGSOP2), Foundation for the National Institutes of Health (FNIH), International Working Group for Sarcopenia (IWGS), or Sarcopenia Definition and Outcomes Consortium (SDOC). Hazard ratios (HR) and odds ratios (OR) were pooled separately in meta-analyses using a random-effects model, stratified by population (community-dwelling adults, outpatients, inpatients, and nursing home residents). Subgroup analyses were performed for sarcopenia definition and follow-up period. Results: Out of 3,025 articles, 57 articles were included in the systematic review and 56 in the meta-analysis (42,108 participants, mean age of 49.4 ± 11.7 to 86.6 ± 1.0 years, 40.3% females). Overall, sarcopenia was associated with a significantly higher risk of mortality (HR: 2.00 [95% CI: 1.71, 2.34]; OR: 2.35 [95% CI: 1.64, 3.37]), which was independent of population, sarcopenia definition, and follow-up period in subgroup analyses. Conclusions: Sarcopenia is associated with a significantly higher risk of mortality, independent of population and sarcopenia definition, which highlights the need for screening and early diagnosis in all populations.

Download Full-text

The impact of study design on schizophrenia incidence estimates: A systematic review of Northern European studies 2008–2019

Schizophrenia Research ◽

10.1016/j.schres.2021.03.017 ◽

2021 ◽

Vol 231 ◽

pp. 134-141

Author(s):

Simon J. Hogerzeil ◽

Hans W. Hoek ◽

Albert M. van Hemert

Keyword(s):

Systematic Review ◽

Study Design ◽

European Studies ◽

Northern European ◽

The Impact

Download Full-text

Systematic Reviews are Rarely Used to Inform Study Design - a Systematic Review and Meta-analysis

Journal of Clinical Epidemiology ◽

10.1016/j.jclinepi.2022.01.007 ◽

2022 ◽

Author(s):

Birgitte Nørgaard ◽

Eva Draborg ◽

Jane Andreasen ◽

Carsten Bogh Juhl ◽

Jennifer Yost ◽

...

Keyword(s):

Systematic Review ◽

Study Design ◽

Systematic Reviews ◽

Meta Analysis

Download Full-text

Diagnostic accuracy of the Geriatric Depression Scale-30, Geriatric Depression Scale-15, Geriatric Depression Scale-5 and Geriatric Depression Scale-4 for detecting major depression: protocol for a systematic review and individual participant data meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-026598 ◽

2018 ◽

Vol 8 (12) ◽

pp. e026598 ◽

Cited By ~ 3

Author(s):

Andrea Benedetti ◽

Yin Wu ◽

Brooke Levis ◽

Machelle Wilchesky ◽

Jill Boruff ◽

...

Keyword(s):

Systematic Review ◽

Major Depression ◽

Diagnostic Accuracy ◽

Meta Analysis ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Individual Participant Data ◽

Geriatric Depression ◽

Subgroup Analyses ◽

Individual Participant

IntroductionThe 30-item Geriatric Depression Scale (GDS-30) and the shorter GDS-15, GDS-5 and GDS-4 are recommended as depression screening tools for elderly individuals. Existing meta-analyses on the diagnostic accuracy of the GDS have not been able to conduct subgroup analyses, have included patients already identified as depressed who would not be screened in practice and have not accounted for possible bias due to selective reporting of results from only better-performing cut-offs in primary studies. Individual participant data meta-analysis (IPDMA), which involves a standard systematic review, then a synthesis of individual participant data, rather than summary results, could address these limitations. The objective of our IPDMA is to generate accuracy estimates to detect major depression for all possible cut-offs of each version of the GDS among studies using different reference standards, separately and among participant subgroups based on age, sex, dementia diagnosis and care settings. In addition, we will use a modelling approach to generate individual participant probabilities for major depression based on GDS scores (rather than a dichotomous cut-off) and participant characteristics (eg, sex, age, dementia status, care setting).Methods and analysisIndividual participant data comparing GDS scores to a major depression diagnosis based on a validated structured or semistructured diagnostic interview will be sought via a systematic review. Data sources will include Medline, Medline In-Process & Other Non-Indexed Citations, PsycINFO and Web of Science. Bivariate random-effects models will be used to estimate diagnostic accuracy parameters for each cut-off of the different versions of the GDS. Prespecified subgroup analyses will be conducted. Risk of bias will be assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool.Ethics and disseminationThe findings of this study will be of interest to stakeholders involved in research, clinical practice and policy.PROSPERO registration numberCRD42018104329.

Download Full-text

Return to Sport After Ankle Syndesmotic Injury: A Systematic Review

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738118816282 ◽

2018 ◽

Vol 11 (2) ◽

pp. 116-122 ◽

Cited By ~ 1

Author(s):

Seline Y. Vancolen ◽

Ibrahim Nadeem ◽

Nolan S. Horner ◽

Herman Johal ◽

Bashar Alolabi ◽

...

Keyword(s):

Systematic Review ◽

Study Design ◽

Return To Sport ◽

Nonoperative Treatment ◽

High Rate ◽

Rate Of Return ◽

Syndesmotic Injury ◽

Level Of Evidence ◽

Treatment Groups ◽

Pertinent Data

Context: Ankle syndesmotic injuries present a significant challenge for athletes due to prolonged disability and recovery periods. The optimal management of these injuries and rates of return to sport in athletes remains unclear. Objective: The purpose of this study was to evaluate return to sport for athletes after ankle syndesmotic injuries. Data Source: The electronic databases MEDLINE, EMBASE, and PubMed were searched for relevant studies from database inception to January 15, 2017, and pertinent data were abstracted. Study Selection: Only studies reporting return-to-sport rates after ankle syndesmotic injuries were included. Study Design: Systematic review. Level of Evidence: Level 4. Data Extraction: Two reviewers extracted data from the included studies, which were stored in a standardized collection form (Microsoft Excel). Recorded data included demographics (eg, author, year of publication, study design), descriptive statistics (eg, patient age, percentage male, number of athletes, sample size), and outcomes (eg, time to return to sport, proportion of those who returned to sport, the self-reported questionnaire the Olerud-Molander Ankle Score). Results: A total of 10 studies and 312 patients with ankle syndesmotic injuries were included in this systematic review. The rate of return to preinjury or any injury level of sport after ankle syndesmotic injuries was 93.8% ± 1.2% and 97.6% ± 1.5%, respectively, for the corresponding 7 and 3 studies that reported this characteristic. The mean time to return to sport was 46.4 days (range, 15.4-70 days), with 55.2 ± 15.8 and 41.7 ± 9.8 days for operative and nonoperative management, respectively. Conclusion: This systematic review found a high rate of return to any as well as preinjury level of sport after ankle syndesmotic injury in both operative and nonoperative treatment groups. However, further high-level studies are required to compare operative and nonoperative treatment groups associated with return to sport after ankle syndesmotic injury.

Download Full-text

The influence of study characteristics on reporting of subgroup analyses in randomised controlled trials: systematic review

BMJ ◽

10.1136/bmj.d1569 ◽

2011 ◽

Vol 342 (mar28 1) ◽

pp. d1569-d1569 ◽

Cited By ~ 53

Author(s):

X. Sun ◽

M. Briel ◽

J. W. Busse ◽

J. J. You ◽

E. A. Akl ◽

...

Keyword(s):

Systematic Review ◽

Randomised Controlled Trials ◽

Controlled Trials ◽

Subgroup Analyses ◽

Study Characteristics ◽

Randomised Controlled

Download Full-text

Association Between Glucocorticoids Treatment and Viral Clearance Delay in Patients with COVID-19: A Systematic Review and Meta-Analysis

10.21203/rs.3.rs-138544/v1 ◽

2021 ◽

Author(s):

Jianbo Li ◽

Xuelian Liao ◽

Yue Zhou ◽

Luping Wang ◽

Hang Yang ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Severity Of Illness ◽

Viral Clearance ◽

Cochrane Library ◽

High Dose ◽

Hazard Ratios ◽

Subgroup Analyses ◽

High Doses ◽

Critical Ill

Abstract BackgroundEvidence of glucocorticoids on viral clearance delay of COVID-19 patients is not clear. MethodsIn this systematic review and meta-analysis, we searched studies on Medline, Embase, EBSCO, ScienceDirect, Web of Science, Cochrane Library, and ClinicalTrials.gov from 2002 to December 2, 2020. We mainly pooled the adjusted hazard ratios (HRs), mean difference (MD) or risk ratios (RRs) of viral clearance delay and did subgroup analyses by doses and the severity of illness.ResultsOne trial and 38 observational studies, with a total of 7119 patients, were identified. Glucocorticoids treatment was associated with delayed viral clearance in COVID-19 (Adjusted HR 1.71, 95% CI 1.51 to 1.94, I2=22%, PI 1.45 to 2.01), based on moderate-quality evidence. In subgroup analyses, risk of viral clearance delay was significantly higher among COVID-19 patients being mild or moderate ill (adjusted HR 1.94, 95% CI 1.39 to 2.70, I2=52%; MD 2.59, 95% CI 1.21 to 3.97, I2=24%), but not in those of being severe or critical ill (adjusted HR 1.85, 95% CI 1.05 to 3.26; MD 0.22, 95% CI -1.85 to 2.29, I2=56%); taking high doses (adjusted HR 1.49, 95% CI 1.03 to 2.15; unadjusted RR 1.47, 95% CI 1.12 to 1.94) rather taking low doses (adjusted HR 1.39, 95% CI 0.93 to 2.08; unadjusted RR 1.33, 95% CI 1.00 to 1.77) or pulse (unadjusted RR 1.85, 95% CI 0.66 to 5.19).ConclusionsGlucocorticoids treatment delayed viral clearance in COVID-19 patients of being mild or moderate ill or taking a high dose, rather in those of being severe or critical ill or taking low dose or pulse.

Download Full-text