377. Diabetes as a prognostic factor for mortality in Coronavirus Disease 19 (COVID-19): a systematic review and meta-analysis comprising 18,506 patients

Abstract Background Diabetes Mellitus is one of the leading causes of morbidity and mortality in the world. Infectious diseases are more common and associated with worse outcomes among diabetics. Diabetes is considered a predictor of morbidity in patients with COVID-19. Methods Medline, Embase, Google Scholar, and medRxiv were systematically reviewed up to May 10th, 2020 for observational studies on diabetic adult populations hospitalized for COVID-19 and that assessed possible correlation between diabetes and mortality. A meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Heterogeneity among trials for each outcome was assessed with the I-squared test. Values < 25% indicated low, 25 to 70% moderate, and > 70% high heterogeneity. Egger test and funnel plots were used to assess for publication bias. Results Fourteen observational studies (12 retrospective and 2 prospective) met the prespecified criteria for inclusion in the analysis, including 18,506 patients (43% women): 3,713 diabetics (DM group) and 14,793 non-diabetics (no-DM group). The mean or median age was above 60 years in 12 studies. DM group had a higher risk of death compared to the no-DM group, heterogeneity was significant (OR: 1.65; 95% CI: 1.35–1.96; I2 77.4%). Sensitivity analysis for US studies only also revealed a higher chance of death among the DM group (OR: 1.34; 95% CI: 1.04–1.85; I2 73.7%). Conclusion In conclusion, death was 65% more likely among diabetic inpatients compared to non-diabetics. Further studies are needed to assess whether this association is independent or not, and to investigate to role of glucose control prior or during the disease. Disclosures All Authors: No reported disclosures

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Atrial Fibrillation and Diabetes Mellitus: the Control of Thromboembolic Risk

Kardiologiia ◽

10.18087/cardio.2020.7.n1146 ◽

2020 ◽

Vol 60 (7) ◽

pp. 108-114

Author(s):

A. G. Obrezan ◽

N. V. Kulikov

Keyword(s):

Diabetes Mellitus ◽

Atrial Fibrillation ◽

Meta Analysis ◽

Oral Anticoagulants ◽

Factor Xa ◽

Diabetic Patients ◽

Thromboembolic Risk ◽

Patients With Diabetes ◽

Meta Analyses

Atrial fibrillation is one of the most common concomitant diseases in patients with diabetes mellitus (DM). Meta-analyses of multiple studies have shown that the risk of AF is higher for diabetic patients with impaired glucose homeostasis than for patients without DM. Patients with AF and DM were younger, more frequently had arterial hypertension, chronic kidney disease, heart failure, and ischemic heart disease, and stroke and were characterized with a more severe course of AF. The article discusses possible mechanisms of the mutually aggravating effects of DM and AF, scales for evaluating the risk of bleeding (CHADS2, CHA2DS2‑VASc, HAS-BLED), and the role of anticoagulants. A meta-analysis of 16 randomized clinical studies, including 9 874 patients, has demonstrated the efficacy of oral anticoagulants in prevention of stroke with an overall decrease in the relative risk by 62 % compared to placebo (95% confidence interval, from 48 to 72 ). For prevention of complications in patients with AF and DM, current antithrombotic therapies can be used, specifically the oral factor Xa inhibitor, rivaroxaban, which is the best studied in patients with AF and DM and represents a possible alternative to warfarin in such patients.

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The alchemy of confirmation bias transmutes expectations into bilingual advantages: A tale of two new meta-analyses

Quarterly Journal of Experimental Psychology ◽

10.1177/1747021819900098 ◽

2020 ◽

Vol 73 (8) ◽

pp. 1290-1299 ◽

Cited By ~ 3

Author(s):

Kenneth R Paap ◽

Lauren Mason ◽

Brandon Zimiga ◽

Yocelyne Ayala-Silva ◽

Matthew Frost

Keyword(s):

Meta Analysis ◽

Confirmation Bias ◽

Effect Sizes ◽

Bilingual Advantage ◽

Search Terms ◽

Colour Word ◽

Funnel Plots ◽

The Mean ◽

Meta Analyses ◽

Clear Support

Five recent meta-analyses of the bilingual advantage in executive functioning hypothesis have converged on the outcome that the mean effect size is very small and that the incidence of statistically significant bilingual advantages is very low (about 15% of all comparisons). Those analyses that used the PET-PEESE method to correct for publication bias show mean effect sizes that are not different from zero and sometimes negative. In contrast, van den Noort and colleagues provide a sixth review of 46 studies published before October 31, 2018, that appears to produce a very different outcome, namely that more than half the studies yield clear support for the bilingual advantage hypothesis. We show that the deviance is due in part to search terms that yielded far fewer relevant studies, but more importantly to a subjective method of evaluating the results of each study that enables confirmation biases on the part of study authors and meta-analysts to substantially distort the objective pattern of results. A seventh meta-analysis, by Armstrong and colleagues, reports significant bilingual advantages of g = 0.48 for 32 samples using Simon and Stroop colour–word interference tasks that tested older adults. However, all effects were entered into the funnel plots as positive even though many were negative (bilingual disadvantages). This and other striking anomalies are consistent with the view that confirmation bias can suspend critical judgement and promulgate errors. Meta-analyses that use preregistration and a many-labs collaboration can better control for both publication and experimenter biases.

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Cardio-Cerebrovascular Disease is Associated With Severity and Mortality of COVID-19: A Systematic Review and Meta-Analysis

Biological Research For Nursing ◽

10.1177/1099800420951984 ◽

2020 ◽

pp. 109980042095198 ◽

Cited By ~ 1

Author(s):

Jia-Ning Yu ◽

Bing-Bing Wu ◽

Jie Yang ◽

Xiao-Ling Lei ◽

Wang-Qin Shen

Keyword(s):

Diabetes Mellitus ◽

Cerebrovascular Disease ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Severe Illness ◽

Significant Relation ◽

Effect Model ◽

The World ◽

Funnel Plots

At present, COVID-19 is raging all over the world. Many comorbidities, such as diabetes mellitus (OR = 2.67, 95% CI = 1.91–3.74) and hypertension (OR = 2.3, 95% CI = 1.76–3.00), have been shown to worsen the patient’s condition. However, whether cardio-cerebrovascular disease will affect COVID-19 remains unclear. In this meta-analysis, we collected studies from PubMed, Wed of Science and CNKI (Chinese) to July 25, which reported COVID-19 patients with and without cardio-cerebrovascular disease as well as their severity and mortality. The random-effect model meta-analysis was used to analyze them and get overall odds ratios (OR) with 95% CIs. Funnel plots and the Begg’s and Egger’s test were used to assess publication bias. Thirty-one studies with 23,632 patients were finally included in the meta-analysis. The results showed an OR of 3.004 (95% CI = 2.097–4.303) for COVID-19 severity and an OR of 5.587 (95% CI = 2.810–11.112) for COVID-19 mortality. Compared with cardiovascular disease, the subgroup analysis indicated that cerebrovascular disease was more likely to increase the severity (OR = 3.400, 95% CI = 1.569–7.368) and mortality (OR = 23.477, 95% CI = 3.050–180.735) of COVID-19. Therefore, it can be inferred that cardio-cerebrovascular disease is associated with an increase in the risk of severe illness and death among COVID-19 patients. This meta-analysis showed that cardio-cerebrovascular disease has a significant relation with severe and death outcomes of COVID-19. Nurses should pay special attention to COVID-19 patients with the cardio-cerebrovascular disease.

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Power-Enhanced Funnel Plots for Meta-Analysis

Zeitschrift für Psychologie ◽

10.1027/2151-2604/a000392 ◽

2020 ◽

Vol 228 (1) ◽

pp. 43-49 ◽

Cited By ~ 1

Author(s):

Michael Kossmeier ◽

Ulrich S. Tran ◽

Martin Voracek

Keyword(s):

Statistical Power ◽

Meta Analysis ◽

Relevant Information ◽

Selective Reporting ◽

Graphical Display ◽

Funnel Plot ◽

Evidential Value ◽

Graphical Displays ◽

Funnel Plots ◽

Meta Analyses

Abstract. Currently, dedicated graphical displays to depict study-level statistical power in the context of meta-analysis are unavailable. Here, we introduce the sunset (power-enhanced) funnel plot to visualize this relevant information for assessing the credibility, or evidential value, of a set of studies. The sunset funnel plot highlights the statistical power of primary studies to detect an underlying true effect of interest in the well-known funnel display with color-coded power regions and a second power axis. This graphical display allows meta-analysts to incorporate power considerations into classic funnel plot assessments of small-study effects. Nominally significant, but low-powered, studies might be seen as less credible and as more likely being affected by selective reporting. We exemplify the application of the sunset funnel plot with two published meta-analyses from medicine and psychology. Software to create this variation of the funnel plot is provided via a tailored R function. In conclusion, the sunset (power-enhanced) funnel plot is a novel and useful graphical display to critically examine and to present study-level power in the context of meta-analysis.

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The GSTM1 and GSTT1 Null Genotypes Increase the Risk for Type 2 Diabetes Mellitus and the Subsequent Development of Diabetic Complications: A Meta-analysis

Current Diabetes Reviews ◽

10.2174/1573399814666171215120228 ◽

2018 ◽

Vol 15 (1) ◽

pp. 31-43 ◽

Cited By ~ 6

Author(s):

Sayantan Nath ◽

Sambuddha Das ◽

Aditi Bhowmik ◽

Sankar Kumar Ghosh ◽

Yashmin Choudhury

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Meta Analysis ◽

Subsequent Development ◽

Asian Population ◽

Gstm1 Null Genotype ◽

Increased Risk

Background:Studies pertaining to association of GSTM1 and GSTT1 null genotypes with risk of T2DM and its complications were often inconclusive, thus spurring the present study.Methods:Meta-analysis of 25 studies for evaluating the role of GSTM1/GSTT1 null polymorphisms in determining the risk for T2DM and 17 studies for evaluating the role of GSTM1/GSTT1 null polymorphisms in development of T2DM related complications were conducted.Results:Our study revealed an association between GSTM1 and GSTT1 null polymorphism with T2DM (GSTM1; OR=1.37;95% CI =1.10-1.70 and GSTT1; OR=1.29;95% CI =1.04-1.61) with an amplified risk of 2.02 fold for combined GSTM1-GSTT1 null genotypes. Furthermore, the GSTT1 null (OR=1.56;95%CI=1.38-1.77) and combined GSTM1-GSTT1 null genotypes (OR=1.91;95%CI=1.25- 2.94) increased the risk for development of T2DM related complications, but not the GSTM1 null genotype. Stratified analyses based on ethnicity revealed GSTM1 and GSTT1 null genotypes increase the risk for T2DM in both Caucasians and Asians, with Asians showing much higher risk of T2DM complications than Caucasians for the same. </P><P> Discussion: GSTM1, GSTT1 and combined GSTM1-GSTT1 null polymorphism may be associated with increased risk for T2DM; while GSTT1 and combined GSTM1-GSTT1 null polymorphism may increase the risk of subsequent development of T2DM complications with Asian population carrying an amplified risk for the polymorphism.Conclusion:Thus GSTM1 and GSTT1 null genotypes increases the risk for Type 2 diabetes mellitus alone, in combination or with regards to ethnicity.

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Association between circulating neuregulin4 levels and diabetes mellitus: A meta-analysis of observational studies

PLoS ONE ◽

10.1371/journal.pone.0225705 ◽

2019 ◽

Vol 14 (12) ◽

pp. e0225705

Author(s):

Yao Wang ◽

Shuai Huang ◽

Pei Yu

Keyword(s):

Diabetes Mellitus ◽

Observational Studies ◽

Meta Analysis

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Osteoarthritis, mobility-related comorbidities and mortality: an overview of meta-analyses

Therapeutic Advances in Musculoskeletal Disease ◽

10.1177/1759720x20981219 ◽

2020 ◽

Vol 12 ◽

pp. 1759720X2098121

Author(s):

Gustavo Constantino de Campos ◽

Raman Mundi ◽

Craig Whittington ◽

Marie-Josée Toutounji ◽

Wilson Ngai ◽

...

Keyword(s):

Diabetes Mellitus ◽

Odds Ratio ◽

Meta Analysis ◽

Inclusion Criteria ◽

Increased Risk ◽

All Cause Mortality ◽

Ischemic Attack ◽

Meta Analyses ◽

The Relationship ◽

Related Mortality

Aims: The objective of this review was to examine the relationship between osteoarthritis (OA) and mobility-related comorbidities, specifically diabetes mellitus (DM) and cardiovascular disease (CVD). It also investigated the relationship between OA and mortality. Methods: An overview of meta-analyses was conducted by performing two targeted searches from inception to June 2020. The association between OA and (i) DM or CVD ( via PubMed and Embase); and (ii) mortality ( via PubMed) was investigated. Meta-analyses were selected if they included studies that examined adults with OA at any site and reported associations between OA and DM, CVD, or mortality. Evidence was synthesized qualitatively. Results: Six meta-analyses met inclusion criteria. One meta-analysis of 20 studies demonstrated a statistically significant association between OA and DM, with pooled odds ratio of 1.41 (95% confidence interval: 1.21, 1.65; n = 1,040,175 patients). One meta-analysis of 15 studies demonstrated significantly increased risk of CVD among OA patients, with a pooled risk ratio of 1.24 (1.12, 1.37, n = 358,944 patients). Stratified by type of CVD, OA was shown to be associated with increased heart failure (HF) and ischemic heart disease (IHD) and reduced transient ischemic attack (TIA). There was no association reported for stroke or myocardial infarction (MI). Three meta-analyses did not find a significant association between OA (any site) and all-cause mortality. However, OA was found to be significantly associated with cardiovascular-related death across two meta-analyses. Conclusion: The identified meta-analyses reported significantly increased risk of both DM and CVD (particularly, HF and IHD) among OA patients. It was not possible to confirm consistent directional or causal relationships. OA was found to be associated with increased mortality, but mostly in relation to CVD-related mortality, suggesting that further study is warranted in this area.

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Role of diet in osteoporosis incidence: Umbrella review of meta-analyses of prospective observational studies

Critical Reviews in Food Science and Nutrition ◽

10.1080/10408398.2021.1989374 ◽

2021 ◽

pp. 1-10

Author(s):

Weili Feng ◽

Xiaoping Wang ◽

Daoqiang Huang ◽

Anqi Lu

Keyword(s):

Observational Studies ◽

Umbrella Review ◽

Meta Analyses

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Arthrodesis of First Metatarsophalangeal Joint by Plate and Screws for Treatment of Hallux Rigidus (Systematic Review and Meta-Analysis)

QJM ◽

10.1093/qjmed/hcab104.016 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Ossama Abdelraoof El Shazly ◽

Mohamed Mokhtar Abdellah ◽

Mostafa Abdelnabee Abouzaid

Keyword(s):

Systematic Review ◽

Observational Studies ◽

Plate Fixation ◽

Meta Analysis ◽

Metatarsophalangeal Joint ◽

Hallux Rigidus ◽

Superficial Infection ◽

First Metatarsophalangeal Joint ◽

Non Union ◽

Meta Analyses

Abstract Background With continued loss of dorsiflexion of the 1st MTP, degenerative changes occur within the joint with severe restriction of movement and increase in pain, which leads to the condition known as hallux rigidus. The amount of dorsiflexion may be reduced to 0-10 degrees with pain on both active and passive motion. Objectives Systematically reviewing available evidence from published articles to assess the effectiveness of arthrodesis of first metatarsophalangeal joint by plate and screws in hallux rigidus. The assessment also would encompass safety, side effects, and complications of this mode of treatment. Materials and Methods We performed this systematic review and meta-analysis in accordance to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) statement. PRISMA and MOOSE are reporting checklists for Authors, Editors, and Reviewers of Meta-analyses of interventional and observational studies. According to International committee of medical journal association (ICJME), reviewers must report their findings according to each of the items listed in those checklists. Results Previous results for arthrodesis have been favourable with a union rate of almost 96%. In the present systematic review and meta-analysis, the overall effect estimates showed that the union rates after plate and screw arthrodesis for 1st MTPJ was 96.2% (95% CI 94 – 98.4%). In addition, the overall effect estimates showed that the non-union rates after plate and screw arthrodesis for 1st MTPJ was 4.2% (95% CI 2.4 – 6.1%). Moreover, the overall effect estimates showed that the satisfaction rates after plate and screw arthrodesis for 1st MTPJ was 94.5% (95% CI 90 – 99%). In the present study, the overall effect estimates showed that the overall complications rate after plate and screw arthrodesis for 1st MTPJ was 7.2% (95% CI 2.5 – 12%). The overall effect estimates showed that the malunion rates after plate and screw arthrodesis for 1st MTPJ was 2.7% (95% CI 0 – 6.4%). Additionally, the overall effect estimates showed that the hardware removal and superficial infection rates after plate and screw arthrodesis for 1st MTPJ were 2% and 2.9%, respectively. Conclusion Our analysis showed that plate and screws fixation is effective techniques that can be used for first MTPJ arthrodesis in patients with hallux rigidus. We found that the screw and plate fixation has a significantly lower rate of nonunion compared with the screw alone, as reported by the literature. However, owing to the small group sizes and methodologic shortcomings, we were unable to identify the clinically superior fixation technique for first MTPJ arthrodesis arthrodesis.

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