scholarly journals O-195 The impact of the COVID-19 outbreak on psychological distress due to the cancellation of ART. A systematic review and meta-analysis

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Z Donarelli ◽  
G Lo Coco ◽  
S Gullo ◽  
V Oieni ◽  
A Volpes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Psychological Distress ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Infertile Couples ◽  
The Impact ◽  
Infertile Patients

Abstract Study question Is there evidence that infertile patients have been more likely to experience distress during the COVID-19 outbreak with the consequent interruption of treatment plans? Summary answer High levels of psychological distress among infertile patients have been found during the COVID-19 pandemic, greater than that reported in the general population. What is known already Preliminary research on the negative consequences of the COVID-19 outbreak on mental health evidenced heightened levels of anxiety, depression and post-traumatic stress in some clinical populations as well as in community samples. However, little is known about the impact of COVID-19 on psychological distress of infertile patients who have been forced to suspend infertility treatment and postpone parenthood goals during the pandemic. The aim of this meta-analytic review is to summarize extant literature on the prevalence of psychological distress symptoms in infertile patients during the COVID-19 pandemic. Study design, size, duration A systematic review and meta-analysis were conducted following the PRISMA guidelines on PsycInfo, PubMed, Embase, Web of Science, MedRxiv from March 2020 to mid-December 2020. Study inclusion criteria were specified according to the PICOS guideline. All naturalistic or RCT studies published in 2020 that examined infertility as the primary diagnosis and had a quantitative measurement of distress, were eligible. The primary outcomes were symptoms of psychological distress and secondary outcomes were indicators of psychological health. Participants/materials, setting, methods The database search identified 144 papers. Two reviewers independently screened potential studies by title and abstracts based on the inclusion criteria. The full texts were then screened for eligibility. The Newcastle-Ottawa Scale was used to judge the methodological quality of the studies. In order to estimate the pooled prevalence of distress, Odds Ratios with 95% Confidence Interval were calculated as the effect size by using a random-effects model. Heterogeneity was tested using I2 statistics. Main results and the role of chance Fourteen studies met the inclusion criteria and were summarized for the systematic review (N = 6473). Only six studies did not include males although, in the surveys, females made up 92% of the total sample. Ten studies adopted a cross-sectional study design. 100% gathered data through an online survey. Nine studies showed a high risk of bias, and five had a moderate risk. Review results showed that 56,4% of patients wished to resume treatment; participants were mostly worried about the delay in treatment because of their age (>35 years) or diminished ovarian reserve, or money constraints and low education level. Only five studies examined the role of protective factors such as social support, coping, optimism trait and intolerance of uncertainty. Nine studies were included for meta-analysis. The prevalence of psychological distress was 0.58 (95% CI 0.32÷0.84). The pooled point estimates of prevalence for anxiety (N = 6) were 0.56 (95% CI 0.24÷0.88), whereas the prevalence for depression (N = 5) was 0.46 (95% CI 0.15÷0.77). There was significant heterogeneity among studies to estimate the prevalence (I² ranging from 99% to 100%). Limitations, reasons for caution Results are preliminary, given the small number of studies and their cross-sectional data. The risk of bias was high or moderate across studies. Wider implications of the findings Infertile couples reported high levels of distress due to cancellation of their diagnostic procedures or treatment; they would benefit from information, appropriate support and advice from healthcare professionals, with an important role in maintaining the wishes of infertile couples to continue their parenthood goals. Trial registration number not applicable

The impact of bereavement support on psychological distress in family members: a systematic review and meta-analysis

2021 ◽  
Vol 23 (2) ◽  
pp. 225-233
Author(s):  
*Louise I Rait ◽  
◽  
*Nikki Y Yeo ◽  
*Equal first authors ◽  
Yasmine Ali Abdelhamid ◽  
...  
Keyword(s):  
Systematic Review ◽  
Psychological Distress ◽  
Meta Analysis ◽  
Family Members ◽  
Risk Of Bias ◽  
Bereavement Support ◽  
Impact Of Event Scale ◽  
Event Scale ◽  
Bereaved Family ◽  
The Impact

BACKGROUND: Persistent psychological distress occurs frequently in family members of patients who die in an intensive care unit (ICU). OBJECTIVE: To determine the effectiveness of bereavement interventions in reducing persisting psychological distress in bereaved family members after death in an adult ICU. DESIGN: Systematic review and meta-analysis of studies that assessed the effect of bereavement interventions on persisting psychological distress in bereaved family members of ICU patients. DATA SOURCES: MEDLINE and APA Psycinfo databases were searched until April 2020. REVIEW METHODS: Two of us independently screened titles and abstracts of identified studies, and then completed full text evaluation of selected studies. We assessed risk of bias using version 2 of the Cochrane risk-of-bias tool for randomised trials and the Newcastle-Ottawa Scale, which is designed to assess the quality of non-randomised studies in meta-analyses. We also used random effects meta-analysis to assess the effect of various interventions on total Hospital Anxiety and Depression Scale (HADS) scores. RESULTS: From 664 citations, five studies were included — three multicentre randomised clinical trials and two single centre observational studies. Three studies tested the intervention of written bereavement support materials and two studies used narration of family members' experiences in the ICU. All studies reported HADS scores. Scores for Impact of Event Scale, Impact of Event Scale–Revised and Inventory of Complicated Grief were measured in some but not all studies. There was no effect of an intervention on HADS scores (weighted mean difference, −0.79 [95% confidence interval, −3.81 to 2.23]; Ι2 = 65.8%). CONCLUSIONS: Owing to limited data, and clinical and statistical heterogeneity, there is considerable uncertainty regarding whether bereavement support strategies reduce, increase or have no effect on psychological distress in bereaved family members.

scholarly journals The Role of Circulating Lycopene in Low-Grade Chronic Inflammation: A Systematic Review of the Literature

Molecules ◽  
2020 ◽  
Vol 25 (19) ◽  
pp. 4378
Author(s):  
Hidde P. van Steenwijk ◽  
Aalt Bast ◽  
Alie de Boer
Keyword(s):  
Systematic Review ◽  
Chronic Inflammation ◽  
Intervention Studies ◽  
Low Grade ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Markers Of Inflammation ◽  
The Impact ◽  
Low Grade Inflammation

Background and aims: In recent years, it has become clear that low-grade chronic inflammation is involved in the onset and progression of many non-communicable diseases. Many studies have investigated the association between inflammation and lycopene, however, results have been inconsistent. This systematic review aims to determine the impact of circulating lycopene on inflammation and to investigate the effect of consuming tomato products and/or lycopene supplements on markers of inflammation. Methods: Eligible studies, published before March 2020, were identified from PubMed, EBSCOhost and ScienceDirect. Human studies published in English, that evaluated the effect of circulating lycopene in relation to inflammation biomarkers were screened and included. Studies assessing lycopene intake or general intake of carotenoids/antioxidants without measuring circulating lycopene, as well as those not reporting inflammation biomarkers as outcomes, were excluded. Results: Out of 80 publications identified and screened, 35 met the inclusion criteria. Results from 18 cross-sectional studies suggest that lycopene levels are adversely affected during inflammation and homeostatic imbalance. Most of the 17 included intervention studies reported increased circulating lycopene levels after tomato/lycopene supplementation, but almost no changes in inflammation biomarkers were observed. Conclusions: There is little evidence that increasing tomato intake or lycopene supplementation diminuates this inflammation. However, depletion of lycopene may be one of the first signs of low-grade inflammation. The available data thereby imply that it is beneficial to consume lycopene-rich foods occasionally to stay healthy and keep circulating lycopene at a basal level.

P–004 Effect of varicocelectomy on sperm DNA fragmentation rates in infertile men with clinical varicocele: a systematic review and meta-analysis

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
F Tenori. Lir. Neto ◽  
M Roque ◽  
S Esteves
Keyword(s):  
Systematic Review ◽  
Surgical Technique ◽  
Dna Fragmentation ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Sperm Dna Fragmentation ◽  
Inclusion Criteria ◽  
Infertile Men ◽  
Sperm Dna ◽  
The Impact

Abstract Study question Does varicocelectomy improve sperm DNA quality in men with infertility and clinically detected varicoceles? Summary answer Varicocelectomy reduces sperm DNA fragmentation (SDF) rates in infertile men with clinical varicocele. What is known already Varicocele has been linked to male infertility through various non-mutually exclusive mechanisms, including an increase in reactive oxygen species (ROS) production that may lead to sperm DNA damage. Damage to sperm DNA may result in longer time-to-pregnancy, unexplained infertility, recurrent pregnancy loss, and failed intrauterine insemination or in vitro fertilization/intracytoplasmic sperm injection. Therefore, interventions aimed at decreasing SDF rates, including varicocele repair, have been explored to improve fertility and pregnancy outcomes potentially, either by natural conception or using medically assisted reproduction. Study design, size, duration Systematic review and meta-analysis Participants/materials, setting, methods We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our systematic search included PubMed/Medline, EMBASE, Scielo, and Google Scholar to identify all relevant studies written in English and published from inception until October 2020. Inclusion criteria were studies comparing SDF rates before and after varicocelectomy in infertile men with clinical varicocele. Articles were included if the following SDF assays were utilized: SCSA, TUNEL, SCD test, or alkaline Comet. Main results and the role of chance Thirteen studies fulfilled the inclusion criteria and were selected for the analysis. The estimated weighted mean difference of SDF rates after varicocelectomy was –6.58% (13 studies, 95% CI –8.33%, –4.84%; I2=90% p < 0.0001). Subgroup analysis revealed a significant decrease in SDF rates using SCSA (eight studies, WMD –6.80%, 95% CI –9.31%, –4.28%; I2=89%, p < 0.0001), and TUNEL (three studies, WMD –4.86%, 95% CI –7.38%, –2.34%; I2=89%, p < 0.0001). The test for subgroup difference revealed that pooled results were conservative using the above SDF assays. Comet and SCD tests were used in only one study each; thus, a meta-analysis was not applicable. The studies were further categorized by the surgical technique (microsurgical versus non-microsurgical). This subgroup analysis showed a significant decrease in SDF rates using microsurgical technique (10 studies, WMD –6.70%, 95% CI –9.04%, –4.37%; I2=91%, p < 0.0001). After varicocelectomy, SDF rates were also decreased when non-microsurgical approaches were used, albeit the effect was not statistically significant (2 studies, WMD –6.84%, 95% CI –10.05%, 1.38%; I2=86%) (Figure 3). The heterogeneity was not materially affected by performing analyses by the above subgroups, suggesting that the SDF assay and surgical technique do not explain the inconsistency in the treatment effect across primary studies. Limitations, reasons for caution There were no randomized controlled trials comparing varicocelectomy to placebo for alleviating SDF levels. Heterogeneity was high, which may be explained by the low number of included studies. Pregnancy data are not available in most studies, thus the impact of reduced SDF after varicocelectomy on pregnancy rates unclear. Wider implications of the findings: Our study indicates a positive association between varicocelectomy and reduced postoperative SDF rates in men with clinical varicocele and infertility, independentetly of the assays used to measure SDF. These findings may help counsel and manage infertile men with varicocele and high SDF levels. Trial registration number Not applicable

scholarly journals The relationship between Internet use and self-concept clarity: A systematic review and meta-analysis

2021 ◽  
Vol 15 (2) ◽  
Author(s):  
Cristina Elena Petre
Keyword(s):  
Systematic Review ◽  
Internet Use ◽  
Meta Analysis ◽  
Self Concept ◽  
The Internet ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Self Evaluation ◽  
Cross Sectional Design ◽  
The Relationship

There are three hypotheses regarding the relationship between Self-Concept Clarity (SCC) and Internet use. It was argued that Internet use: 1) decreases SCC, 2) increases SCC, 3) does not relate with SCC. The present study, in the form of a systematic and meta-analytic synthesis, aimed to explore: a) the extent empirical evidence can support each hypothesis; b) how Internet use-SCC relationship was addressed across studies; c) the intensity of the Internet use –SCC relationship; d) potential moderators. Twenty-one studies (N = 8,910) met the inclusion criteria for the systematic review (i.e., being quantitative, written in English, concerned with Internet use -SCC relationship) and 11 studies (N = 3,298) met the additional criteria for meta-analysis (i.e., being correlational, using self-evaluation instruments, quantifying general Internet use and including the information needed to calculate the meta-analysis specific indicators). Results emphasized that all three hypotheses are plausible, as distinct dimensions of Internet use related differently with SCC. However, the conclusions were limited by the extensive use of cross-sectional design. For general Internet use and SCC relationship the overall effect was -0.350, p < .01. Some moderators were significant: cultural background, Internet operationalization, age homogeneity, participants rewarding. This paper outlines the complexity of SCC – Internet relationship and underlines some of the gaps that should be further addressed. Implications and limits of the study (e.g., publication bias, excluded outcomes in the meta-analysis or possible omission of moderators) are discussed.

scholarly journals The Effect of Anakinra in Hospitalized Patients with COVID-19: An Updated Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (19) ◽  
pp. 4462
Author(s):  
Konstantinos G. Kyriakoulis ◽  
Anastasios Kollias ◽  
Garyphallia Poulakou ◽  
Ioannis G. Kyriakoulis ◽  
Ioannis P. Trontzas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Interleukin 1 ◽  
Severe Pneumonia ◽  
Hospitalized Patients ◽  
Current Evidence ◽  
Adjusted Risk ◽  
Risk Of Death ◽  
The Impact

The role of immunomodulatory agents in the treatment of hospitalized patients with COVID-19 has been of increasing interest. Anakinra, an interleukin-1 inhibitor, has been shown to offer significant clinical benefits in patients with COVID-19 and hyperinflammation. An updated systematic review and meta-analysis regarding the impact of anakinra on the outcomes of hospitalized patients with COVID-19 was conducted. Studies, randomized or non-randomized with adjustment for confounders, reporting on the adjusted risk of death in patients treated with anakinra versus those not treated with anakinra were deemed eligible. A search was performed in PubMed/EMBASE databases, as well as in relevant websites, until 1 August 2021. The meta-analysis of six studies that fulfilled the inclusion criteria (n = 1553 patients with moderate to severe pneumonia, weighted age 64 years, men 66%, treated with anakinra 50%, intubated 3%) showed a pooled hazard ratio for death in patients treated with anakinra at 0.47 (95% confidence intervals 0.34, 0.65). A meta-regression analysis did not reveal any significant associations between the mean age, percentage of males, mean baseline C-reactive protein levels, mean time of administration since symptoms onset among the included studies and the hazard ratios for death. All studies were considered as low risk of bias. The current evidence, although derived mainly from observational studies, supports a beneficial role of anakinra in the treatment of selected patients with COVID-19.

scholarly journals Overuse and underuse of cardiovascular diagnostic and therapeutic procedures for community-dwelling adults: a protocol for a systematic review

2021 ◽  
Vol 4 ◽  
pp. 99
Author(s):  
Dominic Quinn ◽  
David Byrne ◽  
Tom Fahey ◽  
Rose Anne Kenny ◽  
Christine McGarrigle ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Artery Bypass ◽  
Cost Effective ◽  
Risk Of Bias ◽  
Community Dwelling ◽  
Cochrane Library ◽  
Healthcare Intervention ◽  
Cross Sectional ◽  
International Guidelines

Background: Potentially inappropriate care can result from overuse or underuse of treatments, tests, or procedures. Overuse is defined as the use of health services with no clear benefit to the recipient or where harms outweigh benefits and/or costs of care. Underuse is defined as failure to deliver an effective and cost-effective healthcare intervention. Cardiovascular procedures such as coronary artery bypass grafting, carotid endarterectomy, coronary angiography, and coronary angioplasty (with/without stenting) are potentially both underused and overused. This systematic review aims to identify rates of potential overuse and underuse of these cardiovascular procedures and explore any associated patient or healthcare system factors. Methods: A systematic review and meta-analysis will be conducted in accordance with the PRISMA guidelines. A systematic search of MEDLINE (via Ovid), Embase, Cumulative Index to Nursing and Allied Health Literature and the Cochrane library will be conducted using a predefined search strategy.  Eligible studies for inclusion will examine rates of overuse and underuse of cardiovascular procedures, measured against national/international guidelines, for adults aged ≥18 years. Primary observational studies including cross-sectional and cohort studies will be included. Titles, abstracts, and full texts will be screened for inclusion by two reviewers. Data will be extracted using a standardised form. Risk of bias for all included studies will be assessed using a modified version of the Hoy risk of bias tool. Where adequate data exists, and if statistically appropriate, meta-analyses will be conducted. If statistical pooling of the data is not possible, the findings will be narratively summarised focusing on the review’s objectives. Conclusion: This systematic review will examine overuse and underuse of cardiovascular procedures for adults.  The results will help inform policy makers, researchers, patients, and clinicians in the appropriate use of these procedures, in line with international guidelines. Registration: This protocol has been submitted for registration on PROSPERO (CRD42021239041).

scholarly journals Prevalence of smoking in adults with spinal cord stimulators: a systematic review and meta-analysis

2020 ◽  
Vol 45 (3) ◽  
pp. 214-218
Author(s):  
W Michael Hooten ◽  
Rajat N Moman ◽  
Jodie Dvorkin ◽  
E Morgan Pollard ◽  
Robalee Wonderman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Smoking Status ◽  
Meta Analysis ◽  
Vascular Diseases ◽  
Risk Of Bias ◽  
Future Research ◽  
Cross Sectional ◽  
Prevalence Studies ◽  
Pooled Prevalence

BackgroundSmoking adversely impacts pain-related outcomes of spinal cord stimulation (SCS). However, the proportion of SCS patients at risk of worse outcomes is limited by an incomplete knowledge of smoking prevalence in this population. Thus, the primary aim of this systematic review is to determine the prevalence of smoking in adults with chronic pain treated with SCS.MethodsA comprehensive search of databases from 1 January 1980 to 3 January 2019 was conducted. Eligible study designs included (1) randomized trials; (2) prospective and retrospective cohort studies; and (3) cross-sectional studies. The risk of bias was assessed using a tool specifically developed for prevalence studies. A total of 1619 records were screened, 19 studies met inclusion criteria, and the total number of participants was 10 838.ResultsThirteen studies had low or moderate risk of bias, and six had a high risk of bias. All 19 studies reported smoking status and the pooled prevalence was 38% (95% CI 30% to 47%). The pooled prevalence in 6 studies of peripheral vascular diseases was 56% (95% CI 42% to 69%), the pooled prevalence of smoking in 11 studies of lumbar spine diagnoses was 28% (95% CI 20% to 36%) and the pooled prevalence in 2 studies of refractory angina was 44% (95% CI 31% to 58%).ConclusionsThe estimated prevalence of smoking in SCS patients is 2.5 times greater than the general population. Future research should focus on development, testing and deployment of tailored smoking cessation treatments for SCS patients.

scholarly journals Effect of dose administration aids on adherence to self-administered medications: a systematic review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e030536
Author(s):  
Kanika Chaudhri ◽  
Madeleine Kearney ◽  
Richard O Day ◽  
Anthony Rodgers ◽  
Emily Atkins
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Meta Analysis ◽  
Study Participant ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
Dose Administration ◽  
Common Solution ◽  
The Impact

IntroductionForgetting to take a medication is the most common reason for non-adherence to self-administered medication. Dose administration aids (DAAs) are a simple and common solution to improve unintentional non-adherence for oral tablets. DAAs can be in the form of compartmentalised pill boxes, automated medication dispensing devices, blister packs and sachets packets. This protocol aims to outline the methods that will be used in a systematic review of the current literature to assess the impact of DAAs on adherence to medications and health outcomes.Methods and analysisRandomised controlled trials will be identified through electronic searches in databases including EMBASE, MEDLINE, CINAHL and the Cochrane Library, from the beginning of each database until January 2020. Two reviewers will independently screen studies and extract data using the standardised forms. Data extracted will include general study information, characteristics of the study, participant characteristics, intervention characteristics and outcomes. Primary outcome is to assess the effects of DAAs on medication adherence. Secondary outcome is to evaluate the changes in health outcomes. The risk of bias will be ascertained by two reviewers in parallel using The Cochrane Risk of Bias Tool. A meta-analysis will be performed if data are homogenous.Ethics and disseminationEthics approval will not be required for this study. The results of the review described within this protocol will be disseminated through publication in a peer-reviewed journal and relevant conference presentations.PROSPERO registration numberCRD42018096087

scholarly journals Considering the methodological limitations in the evidence base of antidepressants for depression: a reanalysis of a network meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e024886 ◽  
Author(s):  
Klaus Munkholm ◽  
Asger Sand Paludan-Müller ◽  
Kim Boesen
Keyword(s):  
Systematic Review ◽  
Clinical Study ◽  
Effect Size ◽  
Meta Analysis ◽  
Evidence Base ◽  
Risk Of Bias ◽  
Depression Symptom ◽  
Meta Analyses ◽  
The Impact ◽  
Clinical Study Reports

ObjectivesTo investigate whether the conclusion of a recent systematic review and network meta-analysis (Ciprianiet al) that antidepressants are more efficacious than placebo for adult depression was supported by the evidence.DesignReanalysis of a systematic review, with meta-analyses.Data sources522 trials (116 477 participants) as reported in the systematic review by Ciprianiet aland clinical study reports for 19 of these trials.AnalysisWe used the Cochrane Handbook’s risk of bias tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to evaluate the risk of bias and the certainty of evidence, respectively. The impact of several study characteristics and publication status was estimated using pairwise subgroup meta-analyses.ResultsSeveral methodological limitations in the evidence base of antidepressants were either unrecognised or underestimated in the systematic review by Ciprianiet al. The effect size for antidepressants versus placebo on investigator-rated depression symptom scales was higher in trials with a ‘placebo run-in’ study design compared with trials without a placebo run-in design (p=0.05). The effect size of antidepressants was higher in published trials compared with unpublished trials (p<0.0001). The outcome data reported by Ciprianiet aldiffered from the clinical study reports in 12 (63%) of 19 trials. The certainty of the evidence for the placebo-controlled comparisons should be very low according to GRADE due to a high risk of bias, indirectness of the evidence and publication bias. The mean difference between antidepressants and placebo on the 17-item Hamilton depression rating scale (range 0–52 points) was 1.97 points (95% CI 1.74 to 2.21).ConclusionsThe evidence does not support definitive conclusions regarding the benefits of antidepressants for depression in adults. It is unclear whether antidepressants are more efficacious than placebo.

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