scholarly journals Fit, Female or Fifty - is cardiac rehabilitation fit for purpose? A systematic review and meta-analysis with meta-regression

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Smith ◽  
JJ Orchard ◽  
A La Gerche ◽  
R Gallagher ◽  
J Fitzpatrick
Keyword(s):  
Systematic Review ◽  
Cardiac Surgery ◽  
Cardiac Rehabilitation ◽  
Exercise Prescription ◽  
Meta Analysis ◽  
Epidemiological Data ◽  
Study Groups ◽  
Normative Values ◽  
Gender And Age ◽  
Meta Regression

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cardiac rehabilitation (CR) is a multi-disciplinary, evidence-based intervention, aimed to address modifiable risk factors for coronary artery disease. It is recommended worldwide for patients following myocardial infarction (MI), Percutaneous Coronary Intervention (PCI) and cardiac surgery. A growing body of evidence points towards a lack of uptake in CR in females and younger people. Purpose To examine the effectiveness of contemporary CR programs and assess whether they cater for all patients regardless of age, gender and prior level of fitness, via systematic review, meta-analysis and meta-regression. Methods MEDLINE was examined for studies involving exercise prescription or CR following MI, PCI and cardiac surgery from January 2010 to May 2020. RCTs and cohort studies of ≥10 patients were included for programs delivering phase II or III CR. Primary outcome measures were peakVO2max, 6-minute walk test (6MWT) and Metabolic Equivalent of Task (METs). Data were extracted using random effects meta-analysis. Epidemiological data were analysed for age, proportion of males to females and prior level of fitness. Baseline level of fitness was assessed by peakVO2max, 6MWT and METs values on entry into CR programs. Meta-regression was then used to determine change in fitness and the influence of age or gender. Results Thirty-three of the 713 studies (13 RCT, 20 cohort) were eligible and included in the review. Participants had a mean age of 60.0 years and 6/49 (12%) of study groups had a mean age <55 years. Male participants comprised 81.9% of those who completed CR and 41/58 (71%) participants were below average for cardiorespiratory fitness (CRF) when compared to normative values for those aged 60-69 years on entering CR. CRF improved in all study groups by the end of CR programs (mean improvement in peakVO2 3.3mL/kg/min, 6MWT 90.8m and METs 1.7). Meta-regression analysis showed that males were more likely to have an increase in 6MWT distance compared to females (mean difference 3.16m (95% CI 0.44-5.89). However, gender and age did not independently affect peakVO2max or METs. Conclusion CR following MI, PCI or cardiac surgery improved mean CRF in all study groups. While males were more likely to show an improvement in 6MWT there was no appreciable difference in effect in other outcomes after controlling for age or gender differences. Females, younger people and those of average or above CRF appear to be under-represented in data and attendance at cardiac rehabilitation. Given that CR outcomes are equal across gender and age, more effort should be made to encourage female and younger patients to attend. A ‘Precision Medicine’ model of exercise prescription may assist in this aim.

scholarly journals Pre-print full manuscript

2018 ◽  
Author(s):  
Hannah Jongsma ◽  
Caitlin Turner ◽  
James Bowes Kirkbride ◽  
Peter Jones
Keyword(s):  
Systematic Review ◽  
Affective Disorders ◽  
Psychotic Disorders ◽  
Meta Analysis ◽  
Personal Characteristics ◽  
Epidemiological Data ◽  
Original Research ◽  
Meta Regression ◽  
Study Designs ◽  
First Contact

BackgroundThe last comprehensive international systematic review of the incidence of psychotic disorders was published in 2004. New epidemiological data, from different settings, now permit a broader understanding of global variation. We synthesized this literature to examine variation by demographic characteristics and study methodology.MethodsWe followed PRISMA guidelines and registered our systematic review on PROSPERO (ID: CRD42018086800). We searched PubMed, Embase, Web of Science, PsychInfo and bibliographies, and directly contacted authors, to obtain citations of original research published between 2002 and 2017 on incidence of non-organic adult-onset psychotic disorder. Quality of yield was assessed. Data were evaluated using univariable random-effects meta-analysis, and meta-regression. ResultsFrom 56,721 records, 177 met inclusion criteria. The pooled incidence of all psychotic disorders was 26.6 (95% confidence interval [CI]:22.0-31.7) per 100,000 person-years. Pooled incidence of non-affective disorders was 18.7 (95%CI:14.8-23.7) per 100,000 person-years, and 4.6 (95%CI:3.1-6.8) for affective psychotic disorders. Heterogeneity was high (I2≥99.0%). Men were at higher risk of all psychotic disorders (incidence rate ratio [IRR]: 1.44, 95%CI:1.27-1.62) and non-affective disorders (IRR:1.60, 95%CI:1.44-1.87), but not of affective psychotic disorders (IRR:0.87, 95%CI:0.75-1.00). Ethnic minorities were also at excess risk of all psychotic disorders (IRR:1.75, 95%CI:1.53-2.00), including non-affective disorders (IRR:1.71, 95%CI:1.40-2.09). Meta-regression revealed that population registers reported higher rates of non-affective disorders (IRR:9.64, 95%CI:2.72-31.82), schizophrenia (IRR:2.51, 95%CI:1.24-5.21) and bipolar disorder (IRR:4.53, 95%CI:2.41-8.51) than first contact study designs. DiscussionThere is marked variation in incidence of psychotic disorders by personal characteristics and place. Some geographical variation could be partially explained by differences in case ascertainment methods.

Systematic review and meta-analysis of Altruistic and Game-playing Love

2020 ◽  
Author(s):  
Hossein Dabiriyan Tehrani ◽  
Sara Yamini
Keyword(s):  
Systematic Review ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Game Playing ◽  
Love Styles ◽  
Collectivistic Culture ◽  
Meta Regression ◽  
Collectivistic Cultures ◽  
The Relationship

This systematic review aimed to find attitudes toward Altruistic and Game-playing love styles across individualistic and collectivistic cultures. Addressing major moderators concerning Altruistic and Game-playing love styles are the secondary objectives of this review. This review included 102 articles comprising samples from 37 countries (N = 41997). The findings of this meta-analysis show that there is a collectivistic and individualistic difference in Game-playing but not in the Altruistic love style. Collectivistic and individualistic cultures, on average, demonstrate the same perception concerning the Altruistic love style, whereas collectivistic culture shows the Game-playing love style more strongly. To explain the role of moderators in key measures, the subgroup analysis and meta-regression show that both Game-playing and Altruistic love styles decline by increasing the length of the relationship. Likewise, having children affects these love styles such that the Altruistic love style is improved, and the Game-playing love style is reduced by the presence of children in families.

scholarly journals Correction: Hill, A.; et al. Effects of Vitamin C on Organ Function in Cardiac Surgery Patients: A Systematic Review and Meta-Analysis. Nutrients 2019, 11, 2103

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3910
Author(s):  
Aileen Hill ◽  
Kai Clasen ◽  
Sebastian Wendt ◽  
Ádám Majoros ◽  
Christian Stoppe ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Surgery ◽  
Vitamin C ◽  
Meta Analysis ◽  
Organ Function

The authors thank the readers for pointing out the issues [...]

scholarly journals Effect modification of the association between comorbidities and severe course of COVID-19 disease by age of study participants: a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Nathalie Verónica Fernández Villalobos ◽  
Jördis Jennifer Ott ◽  
Carolina Judith Klett-Tammen ◽  
Annabelle Bockey ◽  
Patrizio Vanella ◽  
...  
Keyword(s):  
Systematic Review ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Icu Admission ◽  
Vaccination Strategies ◽  
Relative Risks ◽  
Quantitative Synthesis ◽  
Meta Regression ◽  
Behavioural Factors ◽  
Study Participants

Abstract Background Comprehensive evidence synthesis on the associations between comorbidities and behavioural factors with hospitalisation, intensive care unit (ICU) admission, and death due to COVID-19 is required for deriving national and international recommendations on primary targets for non-pharmacological interventions (NPI) and vaccination strategies. Methods We performed a rapid systematic review and meta-analysis on studies and publicly accessible data to quantify associations between predisposing health conditions, demographics, behavioural factors on the one hand and hospitalisation, ICU admission, and death from COVID-19 on the other hand. We provide ranges of reported and calculated effect estimates and pooled relative risks derived from a meta-analysis and meta-regression. Results Seventy-five studies were included in qualitative and 74 in quantitative synthesis, with study populations ranging from 19 to 44,672 COVID-19 cases. The risk of dying from COVID-19 was significantly associated with cerebrovascular [pooled relative risk (RR) 2.7 (95% CI 1.7–4.1)] and cardiovascular [RR 3.2 (CI 2.3–4.5)] diseases, hypertension [RR 2.6 (CI 2.0–3.4)], and renal disease [RR 2.5 (CI 1.8–3.4)], with high heterogeneity in pooled estimates, partly but not solely explained by age of study participants. For some comorbidities, our meta-regression showed a decrease in effect on the severity of disease with a higher median age of the study population. Compared to death, associations between several comorbidities and hospitalisation and ICU admission were less pronounced. Conclusions We obtained robust estimates on the magnitude of risk for COVID-19 hospitalisation, ICU admission, and death associated with comorbidities, demographic, and behavioural risk factors and show that these estimates are modified by age of study participants. This interaction is an important finding to be kept in mind for current vaccination strategies and for the protection of individuals with high risk for a severe COVID-19 course.

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