Esophageal defect repair by artificial scaffolds: a systematic review of experimental studies and proportional meta-analysis

2020 ◽  
Author(s):  
Dimitrios Schizas ◽  
Maximos Frountzas ◽  
Emmanouil Sgouromallis ◽  
Eleftherios Spartalis ◽  
Konstantinos S Mylonas ◽  
...  
Keyword(s):  
Tissue Engineering ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Survival Rates ◽  
Experimental Studies ◽  
Esophageal Replacement ◽  
Measurement Tool ◽  
Cochrane Central Register ◽  
Graft Stenosis ◽  
Meta Analyses

Abstract Background The traditional technique of gastrointestinal reconstruction of the esophagus after esophagectomy presents plenty of complications. Hence, tissue engineering has been introduced as an effective artificial alternative with potentially fewer complications. Three types of esophageal scaffolds have been used in experimental studies so far. The aim of our meta-analysis is to present the postoperative outcomes after esophageal replacement with artificial scaffolds and the investigation of possible factors that affect these outcomes. Methods The present proportional meta-analysis was designed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and A MeaSurement Tool to Assess systematic Reviews guidelines. We searched Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials CENTRAL, and Google Scholar databases from inception until February 2020. Results Overall, 32 studies were included that recruited 587 animals. The pooled morbidity after esophageal scaffold implantation was 53.4% (95% CI = 36.6–70.0%). The pooled survival interval was 111.1 days (95% CI = 65.5–156.8 days). Graft stenosis (46%), postoperative dysphagia (15%), and anastomotic leak (12%) were the most common complications after esophageal scaffold implantation. Animals that underwent an implantation of an artificial scaffold in the thoracic part of their esophagus presented higher survival rates than animals that underwent scaffold implantation in the cervical or abdominal part of their esophagus (P < 0.001 and P = 0.011, respectively). Conclusion Tissue engineering seems to offer an effective alternative for the repair of esophageal defects in animal models. Nevertheless, issues like graft stenosis and lack of motility of the esophageal scaffolds need to be addressed in future experimental studies before scaffolds can be tested in human trials.

Combined heart and liver transplantation: an updated systematic review

2021 ◽  
Author(s):  
M Frountzas ◽  
N Karampetsou ◽  
C Nikolaou ◽  
D Schizas ◽  
D Tsapralis ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Survival Rates ◽  
Fresh Frozen Plasma ◽  
Ventilation Rate ◽  
Measurement Tool ◽  
Cochrane Central Register ◽  
Strict Adherence ◽  
Fresh Frozen

Introduction Combined heart and liver transplantation (CHLT) is one of the most complex procedures of surgery that has been implemented in the last 35 years. The aim of our meta-analysis was to investigate the safety and efficacy of CHLT. Materials The meta-analysis was designed according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) and AMSTAR (A MeaSurement Tool to Assess systematic Reviews) recommendations. A literature search was conducted up to April 2020 using the MEDLINE,® SCOPUS,® ClinicalTrials.gov, Embase™, Cochrane Central Register of Controlled Trials and Google Scholar™ databases. Results Our meta-analysis included 16 studies with 860 patients. The mortality rate following CHLT was 14.1%. One and five-year survival rates were 85.3% and 71.4% while the heart and liver rejection rates were 6.1% and 9.1% respectively. The hospital stay was 25.8 days and the intensive care unit stay was 9.9 days. Pooled values were also calculated for cardiopulmonary bypass duration, units of transfused red blood cells and fresh frozen plasma, postoperative infection rate, mechanical ventilation rate and follow-up duration. Conclusions Despite its complexity, CHLT is a safe and effective procedure for the management of lethal diseases that lead to progressive heart and/or liver failure. Nevertheless, there must be strict adherence to the indications for surgery, and future studies should compare CHLT with isolated cardiac and hepatic transplantations.

P14.71 An assessment of the reporting and methodological quality of meningioma systematic reviews and meta-analyses

2021 ◽  
Vol 23 (Supplement_2) ◽  
pp. ii51-ii52
Author(s):  
A M George ◽  
S Gupta ◽  
S M Keshwara ◽  
M A Mustafa ◽  
C S Gillespie ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Neurofibromatosis Type ◽  
Risk Of Bias ◽  
Measurement Tool ◽  
High Quality ◽  
Meta Analyses

Abstract BACKGROUND Systematic reviews and meta-analyses constitute the highest level of research evidence and for a disease with limited clinical trial activity, are often relied upon to help inform clinical practice. This review of reviews evaluates both the reporting & methodological quality of meningioma evidence syntheses. MATERIAL AND METHODS Potentially eligible meningioma reviews published between 1st January 1990 and 31st December 2020 were identified from eight electronic databases. Inclusion required the study to meet the Cochrane guideline definition of a systematic review or meta-analysis. Reviews concerning neurofibromatosis type 2, spinal and pediatric meningiomas were excluded. The reporting and methodological quality of articles were assessed against the following modified guidelines: Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), A MeaSurement Tool to Assess Systematic Reviews (AMSTAR2) and the Risk of Bias in Systematic Reviews (ROBIS) guidelines. RESULTS 117 systematic reviews were identified, 57 of which included meta-analysis (48.7%). The number of meningioma systematic reviews published each year has increased with 63 studies (53.9%) published between 01/2018 and 12/2020. A median of 17 studies (IQR 9–29) were included per review. Impact factor of journals publishing a systematic review with or without a meta-analysis was similar (median 2.3 vs 1.8, P=0.397). The mean PRISMA scores for systematic reviews with a meta-analysis was 21.11 (SD 4.1, 78% adherence) and without was 13.89 (SD 3.4, 63% adherence). Twenty-nine systematic reviews with meta-analysis (51%) and 11 without meta-analysis (18%) achieved greater than 80% adherence to PRISMA recommendations. Methodological quality assessment using AMSTAR2 revealed one study (0.9%) as high quality whilst 111 (94.8%) studies were graded as critically low. One hundred and two articles (87.2%) did not utilize a comprehensive search strategy as defined by the AMSTAR2 tool. Ninety-nine studies (84.6%) obtained a high level of concern for potential bias as per the ROBIS assessment. One hundred and eight articles (92.3%) failed to present information that a protocol had been established prior to study commencement and 76 articles (65.0%) did not conduct a risk of bias assessment. Across the three tools, domains relating to the establishment of a protocol prior to review commencement and conducting appropriate risk of bias assessments were frequently low scoring. CONCLUSION Overall reporting and methodological quality of meningioma systematic reviews was sub-optimal. Established critical appraisal tools and reporting guidelines should be utilized a priori to assist in producing high-quality systematic reviews.

scholarly journals Scoping review of COVID-19-related systematic reviews and meta-analyses: can we really have confidence in their results?

2021 ◽  
pp. postgradmedj-2020-139392
Author(s):  
Rachel Wurth ◽  
Michelle Hajdenberg ◽  
Francisco J Barrera ◽  
Skand Shekhar ◽  
Caroline E Copacino ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Scoping Review ◽  
Meta Analysis ◽  
Internal Validity ◽  
Reporting Quality ◽  
Measurement Tool ◽  
Literature Search Strategy ◽  
Definition Of ◽  
Meta Analyses

AimThe aim of this study was to systematically appraise the quality of a sample of COVID-19-related systematic reviews (SRs) and discuss internal validity threats affecting the COVID-19 body of evidence.DesignWe conducted a scoping review of the literature. SRs with or without meta-analysis (MA) that evaluated clinical data, outcomes or treatments for patients with COVID-19 were included.Main outcome measuresWe extracted quality characteristics guided by A Measurement Tool to Assess Systematic Reviews-2 to calculate a qualitative score. Complementary evaluation of the most prominent published limitations affecting the COVID-19 body of evidence was performed.ResultsA total of 63 SRs were included. The majority were judged as a critically low methodological quality. Most of the studies were not guided by a pre-established protocol (39, 62%). More than half (39, 62%) failed to address risk of bias when interpreting their results. A comprehensive literature search strategy was reported in most SRs (54, 86%). Appropriate use of statistical methods was evident in nearly all SRs with MAs (39, 95%). Only 16 (33%) studies recognised heterogeneity in the definition of severe COVID-19 as a limitation of the study, and 15 (24%) recognised repeated patient populations as a limitation.ConclusionThe methodological and reporting quality of current COVID-19 SR is far from optimal. In addition, most of the current SRs fail to address relevant threats to their internal validity, including repeated patients and heterogeneity in the definition of severe COVID-19. Adherence to proper study design and peer-review practices must remain to mitigate current limitations.

scholarly journals The Efficacy of Moxibustion and Acupuncture Therapy for Ankylosing Spondylitis: A Protocol for an Overview of Systematic Reviews and Meta-analyses

2020 ◽  
Author(s):  
Jun Chen ◽  
Jun Xiong ◽  
Lunbin Lu ◽  
Siyuan Zhu ◽  
Zhiying Zhong ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Systematic Reviews ◽  
Activity Index ◽  
Meta Analysis ◽  
Relevant Literature ◽  
Complementary Therapy ◽  
Biomedical Literature ◽  
Cochrane Central Register ◽  
Meta Analyses ◽  
Methodological Guidelines

Abstract Background:Ankylosing Spondylitis (AS) is a complex and progressive autoimmune inflammatory disease with a worldwide prevalence ranging up to 0.9%. Several systematic reviews and meta-analyses of traditional Chinese medicine alternative therapies, such as acupuncture or moxibustion, have demonstrated the effectiveness of moxibustion and acupuncture in the treatment of ankylosing spondylitis. However, there is no relevant literature to comprehensively evaluate the evidence.The purpose of this overview is to synthesize and evaluate the reliability of evidence generated in the systematic review (SR) and meta-analysis of moxibustion and acupuncture as a primary or complementary therapy for patients with ankylosing spondylitis.Methods:PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure[CNKI], Chinese VIP Information, Wanfang Database, and Chinese Biomedical Literature Database[CBM] were searched for systematic reviews and Meta-analysis that review the efficacy of acupuncture or moxibustion as the primary treatment for patients with Ankylosing Spondylitis. The literature published before August 2020 will be selected. Additionally, the relevant SRs and Meta-analyses that unpublished or ongoing will be searched in PROSPERO and INPLASY. The methodological guidelines for overviews will be used to reviews and extract data by two reviewers, and their will do it independently.Methodology quality will be analyzed by the AMSTAR-2 and the risk of bias by POBIS. For the included studies, we will adopt the following results as primary evaluation indicators: effective rate, Visual Analogue Scale (VAS) and Bath AS Disease Activity Index (BASDAI). Reviewers will assess the certainty of evidence by Grading of Recommendations Assessment, Development and Evaluation(GRADE).Results: The results will be published in a peer-reviewed journal. Conclusion: This overview will provide comprehensive evidence of moxibustion and acupuncture for patients with Ankylosing Spondylitis. Registration number: INPLASY202080035

scholarly journals Buteyko method for people with asthma: a protocol for a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e049213
Author(s):  
Karla Morganna Pereira Pinto de Mendonça ◽  
Sean Collins ◽  
Tácito ZM Santos ◽  
Gabriela Chaves ◽  
Sarah Leite ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Secondary Data ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Plain Language ◽  
Randomised Controlled ◽  
Meta Analyses

IntroductionButeyko method is recommended as a non-pharmacological treatment for people with asthma. Although the worldwide interest in the Buteyko method, there is a paucity of studies gathering evidence to support its use. Therefore, we aim to conduct a systematic review and meta-analysis to assess the effects of the Buteyko method in children and adults with asthma.Methods and analysisWe will search on Cochrane Central Register of Controlled Trials, MEDLINE, Embase, US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov and WHO International Clinical Trials Registry Platform for studies focusing on the Buteyko method for children and adults with asthma. The searches will be carried out in September 2021 from database’s inception to the present. We will include randomised controlled trials comparing Buteyko method alone with asthma education or inactive control intervention. There will be no restriction on language. Primary outcomes include quality of life, asthma symptoms and adverse events/side effects. Two review authors will independently screen the studies for inclusion and extract data. We will assess the quality of the included studies using the ‘Risk of Bias’ tool. The certainty of the evidence will be assessed using the GRADE approach. Data synthesis will be conducted using Review Manager software. Reporting of the review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance and the Cochrane Handbook for Systematic Reviews of Interventions.Ethics and disseminationThis study will assess and provide evidence for the use of the Buteyko method in people with asthma. We will analyse secondary data and this does not require ethics approval. The findings will be published in peer-reviewed journals, at relevant conferences and will be shared in plain language in social media. Moreover, the findings of this review could guide the direction of healthcare practice and research.PROSPERO registration numberCRD42020193132.

scholarly journals The Effectiveness of Acupuncture and Moxibustion for Rheumatoid Arthritis: A Protocol of an Overview of Systematic Reviews and Meta-analysis

2020 ◽  
Author(s):  
Genhua Tang ◽  
Jun Xiong ◽  
Siyuan Zhu ◽  
Zhiying Zhong ◽  
Jun Chen ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Scientific Journal ◽  
Joint Damage ◽  
Biomedical Literature ◽  
Cochrane Central Register ◽  
China National Knowledge Infrastructure ◽  
Acupuncture And Moxibustion ◽  
Meta Analyses

Abstract Background: Rheumatoid Arthritis(RA) is a common chronic disease with an annual incidence of 25 per 10000 of the population, which will result in severe joint damage,disability and death. It is strongly supported by systematic reviews (SRs) as part of the treatment of these patients. However, the evidence has not been methodically integrated. This overview aims to describe,synthesize,evaluate the reliability of evidence come from current systematic reviews of acupuncture and moxibustion therapy for RA.Methods: We will search for SRs and meta-analyses from Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, PubMed, MEDLINE, Wan-Fang Databases,China National Knowledge Infrastructure (CNKI), Citation Information by National Institute of Informatics, Chinese Biomedical Literature Database(CBM),Chinese Scientific Journal Database(VIP Database). Additionally, we will search for the ongoing, unpublished, or recently completed SRs on the PROSPERO database. Two reviewers will assess those SRs, select data independently. Any disagreement will be resolved through discussion or arbitrated by the third author if necessary. The overview of SRs and meta-analysis will be reportedaccording to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA)statement.Results: The results in this study will be published in a peer-reviewed journal.Conclusion: The conclusion of our study expects to provide extensive evidence from multiple meta-analysis and systematic reviews for patients with RA.INPLASY registration number:INPLASY202080031.

scholarly journals Effect of Resin Infiltration on Enamel: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 (3) ◽  
pp. 48
Author(s):  
Madalena Soveral ◽  
Vanessa Machado ◽  
João Botelho ◽  
José João Mendes ◽  
Cristina Manso
Keyword(s):  
Bond Strength ◽  
Penetration Depth ◽  
Shear Bond Strength ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Cochrane Central Register ◽  
Resin Infiltration ◽  
Central Register ◽  
Intact Surface ◽  
Meta Analyses

Subsurface enamel demineralization beneath an intact surface layer or white spots lesions (WSL) can and should be treated with non-invasive procedures to impede the development of a cavitated lesion. We aim to analyze if infiltrative resin improves enamel roughness, microhardness, shear bond strength, and penetration depth. MEDLINE [via Pubmed], Cochrane Central Register of Controlled Trials, Embase, Web of Science, Scholar, and LILACS were searched until May 2021. Methodological quality was assessed using the Joanna Briggs Institute Clinical Appraisal Checklist for Experimental Studies. Pairwise ratio of means (ROM) meta-analyses were carried out to compare the enamel properties after treatment with infiltrative resin on sound enamel and WSLs. From a total of 1604 articles, 48 studies were included. Enamel surface roughness decreased 35% in sound enamel (95%CI: 0.49–0.85, I2 = 98.2%) and 54% in WSLs (95%CI: 0.29–0.74, I2 = 98.5%). Microhardness reduced 24% in sound enamel (95%CI: 0.73–0.80, I2 = 99.1%) and increased by 68% in WSLs (95%CI: 1.51; 1.86, I2 = 99.8%). Shear bond strength reduced of 25% in sound enamel (95%CI: 0.60; 0.95, I2 = 96.9%) and increased by 89% in WSLs (95%CI: 1.28–2.79, I2 = 99.8%). Penetration depth was 65.39% of the WSLs (95%CI: 56.11–74.66, I2 = 100%). Infiltrative resins effectively promote evident changes in enamel properties in sound and WSLs. Future studies with long-term follow-ups are necessary to corroborate these results from experimental studies.

scholarly journals The differential efficacy of systemic therapy: a protocol for a systematic review and meta-analysis

2021 ◽  
Author(s):  
Niels Braus ◽  
Rebecca von Oepen ◽  
Nina Immel ◽  
Johanna Wichmann ◽  
Christian Frankman ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Systemic Therapy ◽  
Literature Search ◽  
Meta Analysis ◽  
Social Systems ◽  
Future Research ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
System Functioning ◽  
Meta Analyses

Abstract Background: Systemic therapy is a widespread evidence-based psychotherapy approach. Its main goal revolves around the concept of viewing mental symptoms within the context of social systems (e.g., families, couples). Systematic reviews and meta-analyses have confirmed that systemic therapy significantly reduces symptom severity of DSM- or ICD-diagnosed patients. This meta-analysis aims to investigate the differential efficacy of systemic therapy, taking into account moderators (e.g., allegiance, adherence) and outcomes (system functioning) not considered in previous meta-analytical investigations.Methods: To conduct a comprehensive literature search, we will optimize search strategies from previous systematic reviews on systemic therapy. The search strategy presented in this protocol has improved the precision and sensitivity by using an iterative validation and optimization process. We will conduct the literature search in multiple electronic databases (PsycInfo, Pubmed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL)). We will include all randomized controlled trials that report quantitative outcomes for symptom change and/or system functioning. For the calculations, we will conduct a Bayesian meta-analysis for the outcomes based on a random-effects model, a Bayesian meta-regression for the moderators, and Bayesian subgroup analysis for disorder-specific differences.Discussion: Understanding the differential efficacy of systemic therapy is essential for the conceptualization, performance, and analysis of future research and therapeutic practice. This meta-analysis faces potential limitations associated with the definition of systemic therapy, as well as methodological problems in systemic therapy research.

Quality of meta-analyses of non-opioid, pharmacological, perioperative interventions for chronic postsurgical pain: a systematic review

2022 ◽  
pp. rapm-2021-102981
Author(s):  
Rachel H McGregor ◽  
Freda M Warner ◽  
Lukas D Linde ◽  
Jacquelyn J Cragg ◽  
Jill A Osborn ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Data Extraction ◽  
Meta Analysis ◽  
Measurement Tool ◽  
Critical Element ◽  
Postsurgical Pain ◽  
Chronic Postsurgical Pain ◽  
Registration Number ◽  
Meta Analyses

BackgroundIn an attempt to aggregate observations from clinical trials, several meta-analyses have been published examining the effectiveness of systemic, non-opioid, pharmacological interventions to reduce the incidence of chronic postsurgical pain.ObjectiveTo inform the design and reporting of future studies, the purpose of our study was to examine the quality of these meta-analyses.Evidence reviewWe conducted an electronic literature search in Embase, MEDLINE, and the Cochrane Database of Systematic Reviews. Published meta-analyses, from the years 2010 to 2020, examining the effect of perioperative, systemic, non-opioid pharmacological treatments on the incidence of chronic postsurgical pain in adult patients were identified. Data extraction focused on methodological details. Meta-analysis quality was assessed using the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) critical appraisal tool.FindingsOur search yielded 17 published studies conducting 58 meta-analyses for gabapentinoids (gabapentin and pregabalin), ketamine, lidocaine, non-steroidal anti-inflammatory drugs, and mexiletine. According to AMSTAR 2, 88.2% of studies (or 15/17) were low or critically low in quality. The most common critical element missing was an analysis of publication bias. Trends indicated an improvement in quality over time and association with journal impact factor.ConclusionsWith few individual trials adequately powered to detect treatment effects, meta-analyses play a crucial role in informing the perioperative management of chronic postsurgical pain. In light of this inherent value and despite a number of attempts, high-quality meta-analyses are still needed.PROSPERO registration numberCRD42021230941.

scholarly journals Evidence-based umbrella review of cognitive effects of prefrontal tDCS

2020 ◽  
Author(s):  
Luis C Farhat ◽  
Andre F Carvalho ◽  
Marco Solmi ◽  
Andre R Brunoni
Keyword(s):  
Systematic Reviews ◽  
Meta Analysis ◽  
Measurement Tool ◽  
Affective Neuroscience ◽  
Umbrella Review ◽  
Quality Of Evidence ◽  
Neuroscience Research ◽  
Cochrane Database ◽  
Meta Analyses

Abstract Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique, which has been increasingly used as an investigational tool in neuroscience. In social and affective neuroscience research, the prefrontal cortex has been primarily targeted, since this brain region is critically involved in complex psychobiological processes subserving both ‘hot’ and ‘cold’ domains. Although several studies have suggested that prefrontal tDCS can enhance neuropsychological outcomes, meta-analyses have reported conflicting results. Therefore, we aimed to assess the available evidence by performing an umbrella review of meta-analyses. We evaluated the effects of prefrontal active vs sham tDCS on different domains of cognition among healthy and neuropsychiatric individuals. A MeaSurement Tool to Assess Systematic Reviews 2 was employed to evaluate the quality of meta-analyses, and the GRADE system was employed to grade the quality of evidence of every comparison from each meta-analysis. PubMed/MEDLINE, PsycINFO and the Cochrane Database of Systematic Reviews were searched, and 11 meta-analyses were included resulting in 55 comparisons. Only 16 comparisons reported significant effects favoring tDCS, but 13 of them had either very low or low quality of evidence. Of the remaining 39 comparisons which reported non-significant effects, 38 had either very low or low quality of evidence. Meta-analyses were rated as having critically low and low quality. Among several reasons to explain these findings, the lack of consensus and reproducibility in tDCS research is discussed.

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