Commentary: Systematic Review and Meta-Analysis of the Dose-Response and Risk Factors for Obliteration of Arteriovenous Malformations Following Radiosurgery: An Update Based on the Last 20 Years of Published Clinical Evidence

ABSTRACT BACKGROUND Intracranial arteriovenous malformation (AVM) is a congenital lesion that can potentially lead to devastating consequences if not treated. Many institutional cohort studies have reported on the outcomes after radiosurgery and factors associated with successful obliteration in the last few decades. OBJECTIVE To quantitatively assess the dose-response relationship and risk factors associated with AVM obliteration using a systematic review and meta-analysis approach. METHODS Data were extracted from reports published within the last 20 yr. The dose-response fit for obliteration as a function of marginal dose was performed using inverse-variance weighting. Risk factors for AVM obliteration were assessed by combining odds ratios from individual studies using inverse-variance weighting. RESULTS The logistic model fit showed a clear association between higher marginal dose and higher rates of obliteration. There appeared to be a difference in the steepness in dose-response when comparing studies with patients treated using Gamma Knife radiosurgery (Elekta), compared to linear accelerators (LINACs), and when stratifying studies based on the size of treated AVMs. In the risk-factor analysis, AVM obliteration rate decreases with larger AVM volume or AVM diameter, higher AVM score or Spetzler-Martin (SM) grade, and prior embolization, and increases with compact AVM nidus. No statistically significant associations were found between obliteration rate and age, sex, prior hemorrhage, prior aneurysm, and location eloquence. CONCLUSION A marginal dose above 18 Gy was generally associated with AVM obliteration rates greater than 60%, although lesion size, AVM score, SM grade, prior embolization, and nidus compactness all have significant impact on AVM obliteration rate.

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Incidence, risk factors and prognostic effect of imaging right ventricular involvement in patients with COVID-19: a dose–response analysis protocol for systematic review

BMJ Open ◽

10.1136/bmjopen-2021-049866 ◽

2021 ◽

Vol 11 (5) ◽

pp. e049866

Author(s):

Chenghui Zhou ◽

Baohui Lou ◽

Hui Li ◽

Xin Wang ◽

Hushan Ao ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Right Ventricular ◽

Dose Response ◽

Meta Analysis ◽

Adult Patients ◽

Sensitivity Analyses ◽

Prognostic Effect ◽

All Cause Mortality ◽

Incidence Risk

IntroductionEmerging evidence has shown that COVID-19 infection may result in right ventricular (RV) disturbance and be associated with adverse clinical outcomes. The aim of this meta-analysis is to summarise the incidence, risk factors and the prognostic effect of imaging RV involvement in adult patients with COVID-19.MethodsA systematical search will be performed in PubMed, EMBase, ISI Knowledge via Web of Science and preprint databases (MedRxiv and BioRxiv) (until October 2021) to identify all cohort studies in adult patients with COVID-19. The primary outcome will be the incidence of RV involvement (dysfunction and/or dilation) assessed by echocardiography, CT or MRI. Secondary outcomes will include the risk factors for RV involvement and their association with all-cause mortality during hospitalisation. Additional outcomes will include the RV global or free wall longitudinal strain (RV-GLS or RV-FWLS), tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC) and RV diameter. Univariable or multivariable meta-regression and subgroup analyses will be performed for the study design and patient characteristics (especially acute or chronic pulmonary embolism and pulmonary hypertension). Sensitivity analyses will be used to assess the robustness of our results by removing each included study at one time to obtain and evaluate the remaining overall estimates of RV involvement incidence and related risk factors, association with all-cause mortality, and other RV parameters (RV-GLS or RV-FWLS, TAPSE, S’, FAC and RV diameter). Both linear and cubic spline regression models will be used to explore the dose–response relationship between different categories (>2) of RV involvement and the risk of mortality (OR or HR).Ethics and disseminationThere was no need for ethics approval for the systematic review protocol according to the Institutional Review Board/Independent Ethics Committee of Fuwai Hospital. This meta-analysis will be disseminated through a peer-reviewed journal for publication.PROSPERO registration numberCRD42021231689.

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Correction to: Association of dietary inflammatory potential with cardiometabolic risk factors and diseases: a systematic review and dose–response meta-analysis of observational studies

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-020-00615-2 ◽

2020 ◽

Vol 12 (1) ◽

Author(s):

Zahra Aslani ◽

Omid Sadeghi ◽

Motahar Heidari-Beni ◽

Hoda Zahedi ◽

Fereshteh Baygi ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Dose Response ◽

Observational Studies ◽

Cardiometabolic Risk ◽

Meta Analysis ◽

Cardiometabolic Risk Factors

An amendment to this paper has been published and can be accessed via the original article.

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Cycling is associated with a lower incidence of cardiovascular diseases and death: Part 1 – systematic review of cohort studies with meta-analysis

British Journal of Sports Medicine ◽

10.1136/bjsports-2018-099099 ◽

2019 ◽

Vol 53 (14) ◽

pp. 870-878 ◽

Cited By ~ 6

Author(s):

Solveig Nordengen ◽

Lars Bo Andersen ◽

Ane K Solbraa ◽

Amund Riiser

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Systematic Review ◽

Dose Response ◽

Meta Analysis ◽

Effect Estimate ◽

Cvd Risk ◽

Eligibility Criteria ◽

Relative Risks ◽

Quantitative Studies

ObjectivesPhysical inactivity is a risk factor for cardiovascular disease (CVD). Cycling as a physical activity holds great potential to prevent CVD. We aimed to determine whether cycling reduces the risk of CVD and CVD risk factors and to investigate potential dose-response relationships.DesignSystematic review and meta-analysis of quantitative studies.Eligibility criteria for selecting studiesWe searched four databases (Web of Science, MEDLINE, SPORTDiscus and Scopus). All quantitative studies, published until August 2017, were included when a general population was investigated, cycling was assessed either in total or as a transportation mode, and CVD incidence, mortality or risk factors were reported. Studies were excluded when they reported continuous outcomes or when cycling and walking were combined in them. We pooled adjusted relative risks (RR) and OR. Heterogeneity was investigated using I.ResultsThe search yielded 5174 studies; 21 studies which included 1,069,034 individuals. We found a significantly lower association in combined CVD incidence, mortality and physiological risk factors with total effect estimate 0.78 (95% CI (CI): 0.74–0.82; P<0.001; I2=58%). Separate analyses for CVD incidence, mortality and risk factors showed estimates of RR 0.84 (CI, 0.80 to 0.88; P<0.001; I2=29%), RR 0.83 (CI, 0.76 to 0.90; P<0.001; I2=0%), and OR 0.75 (CI, 0.69 to 0.82; P<0.001; I2=66%), respectively. We found no dose-response relationship or sex-specific difference.ConclusionsAny form of cycling seems to be associated with lower CVD risk, and thus, we recommend cycling as a health-enhancing physical activity.Systematic review registrationProspero CRD42016052421.

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