A Systematic Review of Practiced-Based Research of Complementary and Integrative Health Therapies as Provided for Pain Management in Clinical Settings: Recommendations for the Future and A Call to Action

Pain Medicine ◽  
2021 ◽  
Author(s):  
Natalie L Dyer ◽  
Jessica Surdam ◽  
Jeffery A Dusek
Keyword(s):  
Systematic Review ◽  
Rating Scale ◽  
Retention Rates ◽  
Future Research ◽  
Clinical Settings ◽  
Call To Action ◽  
Integrative Health ◽  
Positive Effects ◽  
Percent Improvement ◽  
Pain Outcomes

Abstract Objective The goal of this systematic review was to evaluate practice-based, real-world research of individualized complementary and integrative health (CIH) therapies for pain as provided in CIH outpatient clinics. Methods A systematic review was conducted using PubMed, Ovid, Cochrane, Web of Science, Scopus and Embase through Dec 2020. The study was listed in the PROSPERO database (CRD42020159193). Major categories of variables extracted included study details and demographics; interventions; and outcomes. Results The literature search yielded 3,316 records with 264 assessed for full text review. Of those, 23 studies (including ∼8,464 patients) were specific to pain conditions as a main outcome. Studies included chiropractic, acupuncture, multimodal individualized intervention/programs, physiotherapy, and anthroposophic medicine therapy. Retention rates ranged from 53% to 91%, with studies offering monetary incentives showing the highest retention. The 0–10 numerical rating scale was the most common pain questionnaire (n = 10, 43% of studies), with an average percent improvement across all studies and timepoints of 32% (range 18–60%). Conclusions Findings from this systematic review of practice-based, real-word research indicate that CIH therapies exert positive effects on various pain outcomes. Although all studies reported beneficial impacts on one or more pain outcomes, the heterogeneous nature of studies limits our overall understanding of CIH as provided in clinical settings. Accordingly, we present numerous recommendations to improve publication reporting and guide future research. Our call to action is future, practice-based CIH research is needed, but should be more expansive and in association with a CIH scientific society with academic and healthcare members.

scholarly journals Interventions to improve healthcare workers’ hand hygiene compliance: A systematic review of systematic reviews

2018 ◽  
Vol 39 (12) ◽  
pp. 1449-1456 ◽  
Author(s):  
Lesley Price ◽  
Jennifer MacDonald ◽  
Lucyna Gozdzielewska ◽  
Tracey Howe ◽  
Paul Flowers ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hand Hygiene ◽  
Systematic Reviews ◽  
Hand Hygiene Compliance ◽  
Educational Interventions ◽  
Risk Of Bias ◽  
Future Research ◽  
Monitoring Technology ◽  
Positive Effects ◽  
Hygiene Compliance

AbstractObjectiveTo synthesize the existing evidence base of systematic reviews of interventions to improve healthcare worker (HCW) hand hygiene compliance (HHC).MethodsPRISMA guidelines were followed, and 10 information sources were searched in September 2017, with no limits to language or date of publication, and papers were screened against inclusion criteria for relevance. Data were extracted and risk of bias was assessed.ResultsOverall, 19 systematic reviews (n=20 articles) were included. Only 1 article had a low risk of bias. Moreover, 15 systematic reviews showed positive effects of interventions on HCW HHC, whereas 3 reviews evaluating monitoring technology did not. Findings regarding whether multimodal rather than single interventions are preferable were inconclusive. Targeting social influence, attitude, self-efficacy, and intention were associated with greater effectiveness. No clear link emerged between how educational interventions were delivered and effectiveness.ConclusionsThis is the first systematic review of systematic reviews of interventions to improve HCW HHC. The evidence is sufficient to recommend the implementation of interventions to improve HCW HHC (except for monitoring technology), but it is insufficient to make specific recommendations regarding the content or how the content should be delivered. Future research should rigorously apply behavior change theory, and recommendations should be clearly described with respect to intervention content and how it is delivered. Such recommendations should be tested for longer terms using stronger study designs with clearly defined outcomes.

scholarly journals Azithromycin in patients with Covid-19; a systematic review and metanalysis

2021 ◽  
Author(s):  
Luis Ayerbe ◽  
Ivo Forgnone ◽  
Carlos Risco-Risco ◽  
Maria Perez-Pinar ◽  
Salma Ayis
Keyword(s):  
Systematic Review ◽  
Clinical Severity ◽  
Future Research ◽  
Controlled Trials ◽  
Clinical Settings ◽  
Cochrane Central Register ◽  
Random Effects Models ◽  
Central Register ◽  
Significant Difference ◽  
Observational Design

Background: Azithromycin (AZM) has been widely used in the management of Covid-19. However, the evidence on its actual effects remains disperse and difficult to apply in clinical settings. This systematic review and metanalysis summarizes the studies on the beneficial and adverse effect of AZM in patients with Covid-19. Methods: The PRISMA 2020 statement criteria were followed. Randomized controlled trials (RCTs) and observational studies comparing clinical outcomes of patients treated, and not treated, with AZM, indexed until the 5th of July 2021, were searched in PubMed, Embase, The Web of Science, Scopus, The Cochrane Central Register of Controlled Trials, and MedRXivs. We used Random-effects models to estimate pooled effect size from aggregate data. Results: The initial search produced 4950 results. Finally, 16 studies, five RCTs and 11 with an observational design, with a total of 22984 patients, were included. The metanalysis showed no difference in mortality for those treated, or not, with AZM, OR: 0.95 (0.79-1.13). There was also no significant difference for those treated, and not, with AZM in need for hospital admission or time to admission from ambulatory settings, clinical severity, need for intensive care, or adverse effects. Conclusions: These results presented in this review do not support the use of AZM in the management of Covid-19. They also show that any harm caused to the patient who received it is unlikely. Future research on treatment for patients with Covid-19 may need to focus on other drugs

Faces scales in paediatric pain assessment

2018 ◽  
Author(s):  
Alison Bliss
Keyword(s):  
Pain Intensity ◽  
Rating Scale ◽  
Critical Evaluation ◽  
Pain Scale ◽  
The Self ◽  
Self Report ◽  
Future Research ◽  
Clinical Settings ◽  
Pain Scales ◽  
Pain Rating Scale

The landmark paper discussed in this chapter is a systematic review assessing the commonly used faces pain scales employed to aid children in the self-report of their pain intensity. The review provides a critical evaluation of the Faces Pain Scale, the Faces Pain Scale-Revised (FPS-R), the Oucher pain scale, and the Wong–Baker Faces Pain Rating Scale (WBFPRS). The reviewers found that the psychometric properties of the FPS-R supported its superiority for use in research. Although they found that children, and many staff, expressed a preference for the WBFPRS, the reviewers had major concerns about this scale confounding pain intensity with affect. They also noted the paucity of research in younger children, and concluded that future research should not focus on developing more pain scales for paediatric use but on examining the appropriate application of existing scales in a wider range of clinical settings.

Systematic review of developmental care interventions in the neonatal intensive care unit since 2006

2018 ◽  
Vol 22 (2) ◽  
pp. 269-286 ◽  
Author(s):  
Sara Burke
Keyword(s):  
Systematic Review ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Future Research ◽  
Neurodevelopmental Outcomes ◽  
Developmental Care ◽  
Positive Effects

Intervention studies designed to improve neurodevelopmental outcomes of premature infants in the neonatal intensive care unit (NICU) were evaluated in this systematic review to analyze research methods, to illuminate the effectiveness of interventions, and to make recommendations for future research. Google Scholar, the Cumulative Index of Nursing and Applied Health Literature, PubMed, and Cochrane databases were investigated to identify experimental and quasi-experimental interventional studies in peer-reviewed journals. Each study was assessed in the areas of sample, design, interventional strategies, threats to validity, and outcomes. Nineteen articles were reviewed with a variety of clustered and individual strategies identified to improve neurodevelopmental outcomes of premature infants in the NICU. Developmental care in the NICU appears to have some positive effects on the neurodevelopment of preterm infants. However, there were a number of limitations identified that threaten the validity of the included studies. Going forward, components of developmental care should be operationalized more consistently, greater effort should be put into ensuring treatment fidelity, and electroencephalogram data should be collected in conjunction with behavioral outcome measures.

scholarly journals Using Mediation Analysis to Understand How Treatments for Paediatric Pain Work: A Systematic Review and Recommendations for Future Research

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 147
Author(s):  
Hayley B. Leake ◽  
G. Lorimer Moseley ◽  
Tasha R. Stanton ◽  
Lauren C. Heathcote ◽  
Joshua W. Pate ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Treatment Effect ◽  
Mediation Analysis ◽  
Future Research ◽  
Functional Abdominal Pain ◽  
Mediation Analyses ◽  
Intermediate Variable ◽  
Pain Outcomes ◽  
Irritable Bowel

Clinicians have an increasing number of evidence-based interventions to treat pain in youth. Mediation analysis offers a way of investigating how interventions work, by examining the extent to which an intermediate variable, or mediator, explains the effect of an intervention. This systematic review examined studies that used mediation analysis to investigate mechanisms of interventions on pain-relevant outcomes for youth (3–18 years) with acute or chronic pain, and provides recommendations for future mediation research in this field. We searched five electronic databases for clinical trials or observational longitudinal studies that included a comparison group and conducted mediation analyses of interventions on youth and assessed pain outcomes. We found six studies (N = 635), which included a total of 53 mediation models examining how interventions affect pain-relevant outcomes for youth. Five studies were secondary analyses of randomized controlled trials of psychological interventions for chronic pain; one was a longitudinal observational study of morphine for acute pain. The pain conditions studied were irritable bowel syndrome, functional abdominal pain, juvenile fibromyalgia, mixed chronic pain, and post-operative pain. Fourteen putative mediators were tested, of which three partially mediated treatment effect; seven did not significantly mediate treatment effect and four had mixed results. Methodological and reporting limitations were common. There are substantial gaps in the field with respect to investigating, and therefore understanding, how paediatric interventions work.

scholarly journals Are We Involving Patients in Shared Decision-Making in Young Adult Hip Surgery? A Systematic Review of Patient Engagement Initiatives in Hip Preservation

2020 ◽  
Vol 7 (6) ◽  
pp. 920-924
Author(s):  
Aaron Alokozai ◽  
David N Bernstein ◽  
Linsen T Samuel ◽  
Atul F Kamath
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Young Adults ◽  
Shared Decision Making ◽  
Patient Engagement ◽  
Decision Aids ◽  
Future Research ◽  
Shared Decision ◽  
Call To Action ◽  
Hip Disease

There are limited published studies on patient engagement, including shared decision-making, in adolescents and young adults with complex congenital or post-traumatic hip disorders. Despite the limited number of papers, we aim to clearly summarize what is currently available in the literature using a systematic review approach. We hope this serves as a call to action and catalyst for more work in this field. Future research must focus on awareness of what matters most to patients (values), and the development, implementation, and barriers to the use of decision aids and patient engagement optimization specific to hip disease in young adults.

scholarly journals The Association between Nursing Skill Mix and Mortality for Adult Medical and Surgical Patients: Protocol for a Systematic Review

2020 ◽  
Vol 17 (22) ◽  
pp. 8604
Author(s):  
Diana Kushemererwa ◽  
Jenny Davis ◽  
Nompilo Moyo ◽  
Sue Gilbert ◽  
Richard Gray
Keyword(s):  
Systematic Review ◽  
Patient Outcomes ◽  
Meta Analysis ◽  
Workforce Planning ◽  
Future Research ◽  
Clinical Settings ◽  
Inpatient Mortality ◽  
Skill Mix ◽  
Review Management ◽  
Full Text Screening

Skill mix refers to the number and educational experience of nurses working in clinical settings. Authors have used several measures to determine the skill mix, which includes nurse-to-patient ratio and the proportion of baccalaureate-prepared nurses. Observational studies have tested the association between nursing skill mix and patient outcomes (mortality). To date, this body of research has not been subject to systematic review or meta-analysis. The aim of this study is to systematically review and meta-analyse observational and experimental research that tests the association between nursing skill mix and patient mortality in medical and surgical settings. We will search four key electronic databases—MEDLINE [OVID], EMBASE [OVID], CINAHL [EBSCOhost], and ProQuest Central (five databases)—from inception. Title, abstract, and full-text screening will be undertaken independently by at least two researchers using COVIDENCE review management software. We will include studies where the authors report an association between nursing skill mix and outcomes in adult medical and surgical inpatients. Extracted data from included studies will consist measures of nursing skill mix and inpatient mortality outcomes. A meta-analysis will be undertaken if there are at least two studies with similar designs, exposures, and outcomes. The findings will inform future research and workforce planning in health systems internationally.

scholarly journals A systematic literature review of machine learning in online personal health data

2019 ◽  
Vol 26 (6) ◽  
pp. 561-576 ◽  
Author(s):  
Zhijun Yin ◽  
Lina M Sulieman ◽  
Bradley A Malin
Keyword(s):  
Machine Learning ◽  
Systematic Review ◽  
Future Research ◽  
Support Vector ◽  
Personal Health ◽  
Free Text ◽  
Clinical Settings ◽  
Gold Standard Dataset ◽  
Vector Machines ◽  
Health Related

Abstract Objective User-generated content (UGC) in online environments provides opportunities to learn an individual’s health status outside of clinical settings. However, the nature of UGC brings challenges in both data collecting and processing. The purpose of this study is to systematically review the effectiveness of applying machine learning (ML) methodologies to UGC for personal health investigations. Materials and Methods We searched PubMed, Web of Science, IEEE Library, ACM library, AAAI library, and the ACL anthology. We focused on research articles that were published in English and in peer-reviewed journals or conference proceedings between 2010 and 2018. Publications that applied ML to UGC with a focus on personal health were identified for further systematic review. Results We identified 103 eligible studies which we summarized with respect to 5 research categories, 3 data collection strategies, 3 gold standard dataset creation methods, and 4 types of features applied in ML models. Popular off-the-shelf ML models were logistic regression (n = 22), support vector machines (n = 18), naive Bayes (n = 17), ensemble learning (n = 12), and deep learning (n = 11). The most investigated problems were mental health (n = 39) and cancer (n = 15). Common health-related aspects extracted from UGC were treatment experience, sentiments and emotions, coping strategies, and social support. Conclusions The systematic review indicated that ML can be effectively applied to UGC in facilitating the description and inference of personal health. Future research needs to focus on mitigating bias introduced when building study cohorts, creating features from free text, improving clinical creditability of UGC, and model interpretability.

scholarly journals Gait parameters and characteristics associated with increased risk of falls in people with dementia: a systematic review

2018 ◽  
Vol 31 (9) ◽  
pp. 1287-1303 ◽  
Author(s):  
Shirin Modarresi ◽  
Alison Divine ◽  
Jessica A. Grahn ◽  
Tom J. Overend ◽  
Susan W. Hunter
Keyword(s):  
Systematic Review ◽  
Rating Scale ◽  
Future Research ◽  
Time Variability ◽  
Double Support ◽  
People With Dementia ◽  
Gait Parameters ◽  
Increased Risk ◽  
Double Support Time ◽  
Support Time

ABSTRACTBackground:People with dementia fall twice as often and have more serious fall-related injuries than healthy older adults. While gait impairment as a generic term is understood as a fall risk factor in this population, a clear elaboration of the specific components of gait that are associated with falls risk is needed for knowledge translation to clinical practice and the development of fall prevention strategies for people with dementia.Objective:To review gait parameters and characteristics associated with falls in people with dementia.Methods:Electronic databases CINAHL, EMBASE, MedLine, PsycINFO, and PubMed were searched (from inception to April 2017) to identify prospective cohort studies evaluating the association between gait and falls in people with dementia.Results:Increased double support time variability, use of mobility aids, walking outdoors, higher scores on the Unified Parkinson’s Disease Rating Scale, and lower average walking bouts were associated with elevated risk of any fall. Increased double support time and step length variability were associated with recurrent falls. The reviewed articles do not support using the Performance Oriented Mobility Assessment and the Timed Up-and-Go tests to predict any fall in this population. There is limited research on the use of dual-task gait assessments for predicting falls in people with dementia.Conclusion:This systematic review shows the specific spatiotemporal gait parameters and features that are associated with falls in people with dementia. Future research is recommended to focus on developing specialized treatment methods for these specific gait impairments in this patient population.

scholarly journals Policing Directions: A Systematic Review on the Efficacy of Quantitative Police Presence

2021 ◽  
Author(s):  
Philipp M. Dau ◽  
Christophe Vandeviver ◽  
Maite Dewinter ◽  
Frank Witlox ◽  
Tom Vander Beken
Keyword(s):  
Systematic Review ◽  
Fear Of Crime ◽  
Future Research ◽  
Calls For Service ◽  
Positive Effects ◽  
Traffic Regulation ◽  
Police Presence ◽  
Meta Analyses ◽  
High Degree ◽  
Degree Of Heterogeneity

This systematic review assesses the efficacy of quantitative police presence. The review also investigates concepts of police presence and differences between reported effects. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and protocols are used to systematically identify and review eligible studies on police presence. Further, quality assessment and findings synthesis are used to map limitations of current research as well as grounds for future avenues. The systematic search strategies yielded 49 studies focusing on testing the effects of police presence or evaluating its measurement. We find evidence that police presence has mostly positive effects on reducing crimes related to motor theft, property, violence, and guns. Police presence also reduces calls for service and improves traffic behaviour. Police presence focused on specific areas, times, and types of crime achieves maximum efficacy. The reviewed studies show a high degree of heterogeneity in reporting, which limits comparability of findings across studies. Research on police presence presents evidence for crime preventative effects of focused police actions. Police forces can be focused on certain areas, times, and types of crimes. We encourage future research to focus on police presence en route and its effects, including crime prevention, traffic regulation, and fear of crime.

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