Ensuring that the outcome domains proposed for use in burns research are relevant to adult burn patients: a systematic review of qualitative research evidence

Abstract Background There have been several attempts to define core outcome domains for use in research focused on adult burns. Some have been based in expert opinion, whilst others have used primary qualitative research to understand patients’ perspectives on outcomes. To date there has not been a systematic review of qualitative research in burns to identify a comprehensive list of patient-centred outcome domains. We therefore conducted a systematic review of qualitative research studies in adult burns. Methods We searched multiple databases for English-language, peer-reviewed, qualitative research papers. We used search strategies devised using the SPIDER tool for qualitative synthesis. Our review utilized an iterative three-step approach: (1) outcome-focused coding; (2) development of descriptive accounts of outcome-relevant issues; and (3) revisiting studies and the broader theoretical literature in order to frame the review findings. Results Forty-one articles were included. We categorized papers according to their primary focus. The category with the most papers was adaptation to life following burn injury (n = 13). We defined 19 outcome domains across the 41 articles: (1) sense of self; (2) emotional and psychological morbidity; (3) sensory; (4) scarring and scar characteristics; (5) impact on relationships; (6) mobility and range of joint motion; (7) work; (8) activities of daily living and self-care; (9) treatment burden; (10) engagement in activities; (11) wound healing and infection; (12) other physical manifestations; (13) financial impact; (14) impact on spouses and family members; (15) analgesia and side effects; (16) cognitive skills; (17) length of hospital stay; (18) access to healthcare; and (19) speech and communication. We suggest that sense of self is a core concern for patients that, to date, has not been clearly conceptualized in the burns outcome domain literature. Conclusions This outcome domain framework identifies domains that are not covered in previous attempts to outline core outcome domains for adult burn research. It does so with reference to existing theoretical perspectives from the sociology and psychology of medicine. We propose that this framework can be used as a basis to ensure that outcome assessment is patient-centred. Sense of self requires further consideration as a core outcome domain.

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Associations of Sedentary Time with Heart Rate and Heart Rate Variability in Adults: A Systematic Review and Meta-Analysis of Observational Studies

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168508 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8508

Author(s):

Abdullah Bandar Alansare ◽

Lauren C. Bates ◽

Lee Stoner ◽

Christopher E. Kline ◽

Elizabeth Nagle ◽

...

Keyword(s):

Systematic Review ◽

Heart Rate ◽

English Language ◽

Sedentary Time ◽

Meta Analysis ◽

Qualitative Synthesis ◽

Cross Sectional ◽

Inverse Variance ◽

Observational Design ◽

Substantial Heterogeneity

Purpose: To evaluate if sedentary time (ST) is associated with heart rate (HR) and variability (HRV) in adults. Methods: We systematically searched PubMed and Google Scholar through June 2020. Inclusion criteria were observational design, humans, adults, English language, ST as the exposure, resting HR/HRV as the outcome, and (meta-analysis only) availability of the quantitative association with variability. After qualitative synthesis, meta-analysis used inverse variance heterogeneity models to estimate pooled associations. Results: Thirteen and eight articles met the criteria for the systematic review and meta-analysis, respectively. All studies were cross-sectional and few used gold standard ST or HRV assessment methodology. The qualitative synthesis suggested no associations between ST and HR/HRV. The meta-analysis found a significant association between ST and HR (β = 0.24 bpm per hour ST; CI: 0.10, 0.37) that was stronger in males (β = 0.36 bpm per hour ST; CI: 0.19, 0.53). Pooled associations between ST and HRV indices were non-significant (p > 0.05). Substantial heterogeneity was detected. Conclusions: The limited available evidence suggests an unfavorable but not clinically meaningful association between ST and HR, but no association with HRV. Future longitudinal studies assessing ST with thigh-based monitoring and HRV with electrocardiogram are needed.

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A systematic review of endoscopic versus open treatment of craniosynostosis. Part 2: the nonsagittal single sutures

Journal of Neurosurgery Pediatrics ◽

10.3171/2018.4.peds17730 ◽

2018 ◽

Vol 22 (4) ◽

pp. 361-368 ◽

Cited By ~ 9

Author(s):

Han Yan ◽

Taylor J. Abel ◽

Naif M. Alotaibi ◽

Melanie Anderson ◽

Toba N. Niazi ◽

...

Keyword(s):

Systematic Review ◽

Blood Loss ◽

Assessment Tool ◽

Operating Time ◽

Length Of Hospital Stay ◽

Transfusion Rate ◽

Cochrane Central Register ◽

Qualitative Synthesis ◽

Endoscopic Techniques ◽

Single Suture

OBJECTIVEDespite increasing adoption of endoscopic techniques for repair of nonsagittal single-suture craniosynostosis, the efficacy and safety of the procedure relative to established open approaches are unknown. In this systematic review the authors aimed to directly compare open surgical and endoscope-assisted techniques for the treatment of metopic, unilateral coronal, and lambdoid craniosynostosis, with an emphasis on quantitative reported outcomes.METHODSA literature search was performed in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant articles were identified from 3 electronic databases (MEDLINE, EMBASE, and CENTRAL [Cochrane Central Register of Controlled Trials]) from their inception to August 2017. The quality of methodology and bias risk were assessed using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies.RESULTSOf 316 screened records, 7 studies were included in a qualitative synthesis of the evidence, of which none were eligible for meta-analysis. These reported on 111 unique patients with metopic, 65 with unilateral coronal, and 12 with lambdoid craniosynostosis. For all suture types, 100 (53%) children underwent endoscope-assisted craniosynostosis surgery and 32 (47%) patients underwent open repair. These studies all suggest that blood loss, transfusion rate, operating time, and length of hospital stay were superior for endoscopically treated children. Although potentially comparable or better cosmetic outcomes are reported, the paucity of evidence and considerable variability in outcomes preclude meaningful conclusions.CONCLUSIONSLimited data comparing open and endoscopic treatments for metopic, unilateral coronal, and lambdoid synostosis suggest a benefit for endoscopic techniques with respect to blood loss, transfusion, length of stay, and operating time. This report highlights shortcomings in evidence and gaps in knowledge regarding endoscopic repair of nonsagittal single-suture craniosynostosis, emphasizing the need for further matched-control studies.

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Understanding patients’ experiences of the wish to hasten death: an updated and expanded systematic review and meta-ethnography

BMJ Open ◽

10.1136/bmjopen-2017-016659 ◽

2017 ◽

Vol 7 (9) ◽

pp. e016659 ◽

Cited By ~ 32

Author(s):

Andrea Rodríguez-Prat ◽

Albert Balaguer ◽

Andrew Booth ◽

Cristina Monforte-Royo

Keyword(s):

Systematic Review ◽

Meaning In Life ◽

Assisted Suicide ◽

Advanced Disease ◽

Sense Of Self ◽

Free Text ◽

Qualitative Synthesis ◽

Care Plans ◽

Wish To Hasten Death ◽

Life Threatening

ObjectivesPatients with advanced disease sometimes express a wish to hasten death (WTHD). In 2012, we published a systematic review and meta-ethnography of qualitative studies examining the experience and meaning of this phenomenon. Since then, new studies eligible for inclusion have been reported, including in Europe, a region not previously featured, and specifically in countries with different legal frameworks for euthanasia and assisted suicide. The aim of the present study was to update our previous review by including new research and to conduct a new analysis of available data on this topic.SettingEligible studies originated from Australia, Canada, China, Germany, The Netherlands, Switzerland, Thailand and USA.ParticipantsStudies of patients with life-threatening conditions that had expressed the WTHD.DesignThe search strategy combined subject terms with free-text searching of PubMed MEDLINE, Web of Science, CINAHL and PsycInfo. The qualitative synthesis followed the methodology described by Noblit and Hare, using the ‘adding to and revising the original’ model for updating a meta-ethnography, proposed by Franceet al. Quality assessment was done using the Critical Appraisal Skills Programme checklist.Results14 studies involving 255 participants with life-threatening illnesses were identified. Five themes emerged from the analysis: suffering (overarching theme), reasons for and meanings and functions of the WTHD and the experience of a timeline towards dying and death. In the context of advanced disease, the WTHD emerges as a reaction to physical, psychological, social and existential suffering, all of which impacts on the patient’s sense of self, of dignity and meaning in life.ConclusionsThe WTHD can hold different meanings for each individual—serving functions other than to communicate a genuine wish to die. Understanding the reasons for, and meanings and functions of, the WTHD is crucial for drawing up and implementing care plans to meet the needs of individual patients.

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New-Onset and Relapsed Kidney Histopathology Following COVID-19 Vaccination: A Systematic Review

Vaccines ◽

10.3390/vaccines9111252 ◽

2021 ◽

Vol 9 (11) ◽

pp. 1252

Author(s):

Henry H. L. Wu ◽

Philip A. Kalra ◽

Rajkumar Chinnadurai

Keyword(s):

Systematic Review ◽

English Language ◽

Published Data ◽

Scleroderma Renal Crisis ◽

Qualitative Synthesis ◽

Vaccination Programs ◽

Relapsed Disease ◽

Meta Analyses ◽

New Onset

Introduction: The introduction of COVID-19 vaccination programs has become an integral part of the major strategy to reduce COVID-19 numbers worldwide. New-onset and relapsed kidney histopathology have been reported following COVID-19 vaccination, sparking debate on whether there are causal associations. How these vaccines achieve an immune response to COVID-19 and the mechanism that this triggers kidney pathology remains unestablished. We describe the results of a systematic review for new-onset and relapsed kidney histopathology following COVID-19 vaccination. Methods: A systematic literature search of published data up until 31 August 2021 was completed through the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guideline. Research articles reporting new onset or relapsed kidney histopathology in adult patients (>18 years) following COVID-19 vaccination were included for qualitative review. Only full-text articles published in the English language were selected for review. Results: Forty-eight cases from thirty-six articles were included in the qualitative synthesis of this systematic review. Minimal change disease (19 cases) was the most frequent pathology observed, followed by IgA nephropathy (14 cases) and vasculitis (10 cases). Other cases include relapse of membranous nephropathy, acute rejection of kidney transplant, relapse of IgG4 nephritis, new-onset renal thrombotic microangiopathy, and scleroderma renal crisis following COVID-19 vaccination. There was no mortality reported in any of the included cases. Patients in all but one case largely recovered and did not require long-term renal replacement therapy. Conclusion: This systematic review provides insight into the relationship between various kidney pathologies that may have followed COVID-19 vaccination. Despite these reported cases, the protective benefits offered by COVID-19 vaccination far outweigh its risks. It would be recommended to consider early biopsy to identify histopathology amongst patients presenting with symptoms relating to new-onset kidney disease following vaccination and to monitor symptoms for those with potential relapsed disease.

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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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How People Forgive: A Systematic Review of Nurse-Authored Qualitative Research

Journal of Holistic Nursing ◽

10.1177/0898010119828080 ◽

2019 ◽

Vol 38 (2) ◽

pp. 233-251 ◽

Cited By ~ 2

Author(s):

Ann Gentry Recine ◽

Louis Recine ◽

Tenzin Paldon

Keyword(s):

Systematic Review ◽

Qualitative Research ◽

English Language ◽

The Body ◽

Nursing Interventions ◽

Holistic Nursing ◽

Nursing Knowledge ◽

The People ◽

Letting Go ◽

Research Questions

Purpose: The aim of this systematic review of qualitative forgiveness studies by nurse authors is to contribute to the body of holistic nursing knowledge by discovering answers to the following research questions: (a) where/how does a person get the power to forgive? and (b) what are the people who forgive like? Method: We conducted a systematic search of the English language, peer-reviewed literature for nurse-authored, primary qualitative research that answered our research questions. A total of 188 potential studies were found, and 11 studies met the inclusion criteria. Results: Study participants used interpersonal, intrapersonal, and transpersonal sources of power to forgive, including prayer, meditation, and support from family, friends, and nurses. The findings also revealed the cognitive, emotional, and spiritual traits of forgiving people, including being faith oriented, empathetic, and understanding the meaning of forgiveness as letting go of negative emotions. The findings confirm activities listed under “Forgiveness Facilitation” (2018) in Nursing Interventions Classification (NIC) and suggest additions. Conclusion: This literature review adds to nursing knowledge by synthesizing the findings of the review in a way that provides guidance to nurses to help facilitate forgiveness with patients who want that.

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Completeness of reporting in Indian qualitative public health research: a systematic review of 20 years of literature

Journal of Public Health ◽

10.1093/pubmed/fdy122 ◽

2018 ◽

Vol 41 (2) ◽

pp. 405-411 ◽

Cited By ~ 1

Author(s):

Myron Anthony Godinho ◽

Nachiket Gudi ◽

Maja Milkowska ◽

Shruti Murthy ◽

Ajay Bailey ◽

...

Keyword(s):

Public Health ◽

Systematic Review ◽

Qualitative Research ◽

Health Research ◽

English Language ◽

Public Health Research ◽

Descriptive Statistics ◽

Search Results ◽

Time Periods ◽

Completeness Of Reporting

Abstract Background This study reviewed the completeness of reporting in Indian qualitative public health research (QPHR) studies using the ‘Consolidated Criteria for Reporting Qualitative Research’ (COREQ) checklist. Methods Search results from five electronic databases were screened by two independent reviewers. We included English-language, primary QPHR studies from India, which were assessed for their compliance with the COREQ checklist. Each COREQ item was noted as either reported or unreported. Descriptive statistics for the number of COREQ items reported by each study, and the number of studies that reported each COREQ item were reported, as were the items reported in each year, and in pre- and post-COREQ time periods. Results Of 537 citations, 246 articles were included. Trends demonstrated an increasing number of Indian QPHR studies being published annually, and an overall increase in reporting completeness since 1997. Only two COREQ items were reported in all studies. 52.4% of articles reported between 16 and 21 items, corresponding to 43–57% of items being reported. Six items were reported in fewer than 10% of studies. COREQ domain 1 was least frequently reported. Conclusions Despite improving trends, the reporting of QPHR in India is incomplete. Authors and journals should ensure adherence to reporting guidelines.

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Ceftolozane-Tazobactam Combination Therapy Compared to Ceftolozane-Tazobactam Monotherapy for the Treatment of Severe Infections: A Systematic Review and Meta-Analysis

Antibiotics ◽

10.3390/antibiotics10010079 ◽

2021 ◽

Vol 10 (1) ◽

pp. 79

Author(s):

Marco Fiore ◽

Antonio Corrente ◽

Maria Caterina Pace ◽

Aniello Alfieri ◽

Vittorio Simeon ◽

...

Keyword(s):

Systematic Review ◽

Combination Therapy ◽

Clinical Improvement ◽

English Language ◽

Meta Analysis ◽

Control Group ◽

Qualitative Synthesis ◽

All Cause Mortality ◽

Severe Infections ◽

Microbiological Cure

Ceftolozane-tazobactam (C/T) is a combination of an advanced-generation cephalosporin (ceftolozane) with a β-lactamase inhibitor (tazobactam). It is approved for the treatment of complicated urinary-tract/intra-abdominal infections and hospital-acquired/ventilator-associated pneumonia. This systematic review and meta-analysis (registered prospectively on PROSPERO, no. CRD42019134099, on 20 January 2020) aimed to evaluate the effectiveness of C/T combination therapy compared to C/T monotherapy for the treatment of severe infections and to describe the prevalence of microorganisms in the included studies. We retrieved literature from PubMed, EMBASE, and CENTRAL, until 26 November 2020. Eligible studies were both randomised trials and nonrandomised studies with a control group, published in the English language and peer-reviewed journals. The primary outcome was all-cause mortality; secondary outcomes were (i) clinical improvement and (ii) microbiological cure. Eight nonrandomised studies were included in the qualitative synthesis: Seven retrospective cohort studies and one case-control study. The meta-analysis of the four studies evaluating all-cause mortality (in total 148 patients: 87 patients treated with C/T alone and 61 patients treated with C/T combination therapy) showed a significant reduction of mortality in patients receiving C/T combination therapy, OR: 0.31, 95% CI: 0.10–0.97, p = 0.045. Conversely, the meta-analysis of the studies evaluating clinical improvement and microbiological cure showed no differences in C/T combination therapy compared to C/T monotherapy. The most consistent data come from the analysis of the clinical improvement, n = 391 patients, OR: 0.97, 95% CI: 0.54–1.74, p = 0.909. In 238 of the 391 patients included (60.8%), C/T was used for the treatment of infections caused by Pseudomonas aeruginosa.

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How Suppressed Anger Can Become an Illness: A Qualitative Systematic Review of the Experiences and Perspectives of Hwabyung Patients in Korea

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.637029 ◽

2021 ◽

Vol 12 ◽

Author(s):

Hyo-Weon Suh ◽

Ki-Beom Lee ◽

Sun-Yong Chung ◽

Minjung Park ◽

Bo-Hyoung Jang ◽

...

Keyword(s):

Systematic Review ◽

Qualitative Research ◽

Information Service ◽

Anger Expression ◽

Physical Symptoms ◽

Emotional Dysregulation ◽

Integrated System ◽

Medical Database ◽

Emotional Symptoms ◽

Qualitative Synthesis

Background: In the clinical field, anger has generally been studied in terms of aggressive behavior. However, in Asians, anger suppression is more common than anger expression. Hwabyung is a culture-related anger syndrome in Korea and is known to occur due to the continued repression of anger. Investigating Hwabyung should lead to a better understanding of the multiple dimensions of anger. To explore Hwabyung patients' experiences and perspectives, a meta-aggregation approach was used to conduct a systematic review and a qualitative synthesis.Methods: A systematic search was conducted in MEDLINE/PubMed, EMBASE, Allied and Complementary Medicine Database (AMED), Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycARTICLES, and four Korean databases [Korean Medical Database (KMbase), Korean Studies Information Service System (KISS), National Digital Science Library (NDSL), and Oriental Medicine Advanced Searching Integrated System (OASIS)] in September 2020. Studies were included if they collected and analyzed qualitative data from Hwabyung patients. Qualitative research findings on the experiences and perspectives of Hwabyung patients in Korea were critically appraised and synthesized using the Joanna Briggs Institute methodology.Results: Seven eligible studies were included. The findings from those studies (i.e., theme or subtheme of qualitative research) were aggregated into categories (a group of similar findings) and synthesized findings (a group of categorized findings). Ultimately, 116 findings were aggregated into 15 categories. Finally, four synthesized findings were derived from the 15 categories: (i) anger arousal, (ii) blame, (iii) uncontrollable physical and emotional symptoms, and (iv) compromise and temporary coping.Conclusions: Patients with Hwabyung experience chronic anger through the complex cognitive processes involved in blame. Hwabyung negatively affects patients' physical, psychological, and social functions. Because Hwabyung patients feel as if they are losing control, due to emotional dysregulation and physical symptoms, professional support should be provided to facilitate their coping strategies. Further studies on Hwabyung can serve as a new model of pathological anger.

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Learning curves in robot-assisted spine surgery: a systematic review and proposal of application to residency curricula

Neurosurgical FOCUS ◽

10.3171/2021.10.focus21496 ◽

2022 ◽

Vol 52 (1) ◽

pp. E3

Keyword(s):

Systematic Review ◽

Learning Curve ◽

English Language ◽

Operative Time ◽

Case Series ◽

Clinical Results ◽

Learning Curves ◽

Primary Data ◽

Qualitative Synthesis ◽

Half Decade

OBJECTIVE Spine robots have seen increased utilization over the past half decade with the introduction of multiple new systems. Market research expects this expansion to continue over the next half decade at an annual rate of 20%. However, because of the novelty of these devices, there is limited literature on their learning curves and how they should be integrated into residency curricula. With the present review, the authors aimed to address these two points. METHODS A systematic review of the published English-language literature on PubMed, Ovid, Scopus, and Web of Science was conducted to identify studies describing the learning curve in spine robotics. Included articles described clinical results in patients using one of the following endpoints: operative time, screw placement time, fluoroscopy usage, and instrumentation accuracy. Systems examined included the Mazor series, the ExcelsiusGPS, and the TiRobot. Learning curves were reported in a qualitative synthesis, given as the mean improvement in the endpoint per case performed or screw placed where possible. All studies were level IV case series with a high risk of reporting bias. RESULTS Of 1579 unique articles, 97 underwent full-text review and 21 met the inclusion and exclusion criteria; 62 articles were excluded for not presenting primary data for one of the above-described endpoints. Of the 21 articles, 18 noted the presence of a learning curve in spine robots, which ranged from 3 to 30 cases or 15 to 62 screws. Only 12 articles performed regressions of one of the endpoints (most commonly operative time) as a function of screws placed or cases performed. Among these, increasing experience was associated with a 0.24- to 4.6-minute decrease in operative time per case performed. All but one series described the experience of attending surgeons, not residents. CONCLUSIONS Most studies of learning curves with spine robots have found them to be present, with the most common threshold being 20 to 30 cases performed. Unfortunately, all available evidence is level IV data, limited to case series. Given the ability of residency to allow trainees to safely perform these cases under the supervision of experienced senior surgeons, it is argued that a curriculum should be developed for senior-level residents specializing in spine comprising a minimum of 30 performed cases.

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