Meta-Analysis of Sensorimotor Gating Deficits in Patients With Schizophrenia Evaluated by Prepulse Inhibition Test

Abstracts Prepulse inhibition (PPI) of startle is an operational measure of sensorimotor gating that is often impaired in patients with schizophrenia. Despite the large number of studies, there is considerable variation in PPI outcomes reported. We conducted a systematic review and meta-analysis investigating PPI impairment in patients with schizophrenia compared with healthy control subjects, and examined possible explanations for the variation in results between studies. Major databases were screened for observational studies comparing healthy subjects and patients with schizophrenia for the prepulse and pulse intervals of 60 and 120 ms as primary outcomes, ie, PPI-60 and PPI-120. Standardized mean difference (SMD) and 95% confidence intervals (CI) were extracted and pooled using random effects models. We then estimated the mean effect size of these measures with random effects meta-analyses and evaluated potential PPI heterogeneity moderators, using sensitivity analysis and meta-regressions. Sixty-seven primary studies were identified, with 3685 healthy and 4290 patients with schizophrenia. The schizophrenia group showed reduction in sensorimotor gating for both PPI-60 (SMD = −0.50, 95% CI = [−0.61, −0.39]) and PPI-120 (SMD = −0.44, 95% CI = [−0.54, −0.33]). The sensitivity and meta-regression analysis showed that sample size, gender proportion, imbalance for gender, source of control group, and study continent were sources of heterogeneity (P < .05) for both PPI-60 and PPI-120 outcomes. Our findings confirm a global sensorimotor gating deficit in schizophrenia patients, with overall moderate effect size for PPI-60 and PPI-120. Methodological consistency should decrease the high level of heterogeneity of PPI results between studies.

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Abstract WP196: Selective Serotonin Reuptake Inhibitors (SSRI) for Depression and Functional Recovery After Stroke: A Meta-Analysis

Stroke ◽

10.1161/str.51.suppl_1.wp196 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Thirumalaivasan Dhasakeerthi ◽

Muhammad Ishfaq ◽

Balaji Krishnaiah ◽

Andrei Alexandrov ◽

Georgios Tsivgoulis

Keyword(s):

Functional Recovery ◽

Selective Serotonin Reuptake Inhibitors ◽

Meta Analysis ◽

Potential Effect ◽

Control Group ◽

Random Effects Models ◽

Post Stroke Depression ◽

Meta Analyses ◽

And Function ◽

Ssri Treatment

Background: Post-stroke depression is common and it impedes rehabilitation and function recovery after stroke, and numerous trials evaluated SSRI’s for depression prophylaxis. The objective of this study is to assess the use of SSRI for prevention of poststroke depression and the potential effect on functional recovery after stroke. Methods: We searched electronic databases up to July 2019 for randomized controlled trials of SSRI’s for patients with stroke versus placebo. We calculated pooled odds ratios and 95% CIs by using random-effects models. The primary end points were depression and good functional outcome (modified Rankin Scale score of 0-2) at 90 days post-randomization. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Twelve randomized control trials assessing 4,887 patients have been included in the meta-analysis. SSRI treatment after stroke decreased the odds of depression compared to control group (OR = 0.48, 95% CI - 0.30 to 0.78, p=0.003). There was no heterogeneity between the trials (Cochran’s Q statistic 4.623, df 5; P = .337, I 2 =5.626%). The proportion of subjects who achieved mRS 0-2 at 90 days was similar between SSRI and control groups (OR= 3.471, 95% CI - 0.59 to 20.38, p=0.168). Conclusion: SSRI treatment for the stroke patients reduces the incidence of depression but it does not increase the odds of good functional recovery.

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Prognostic Role of Matrix Metalloproteinases in Cervical Cancer: A Meta-Analysis

Cancer Control ◽

10.1177/10732748211033743 ◽

2021 ◽

Vol 28 ◽

pp. 107327482110337

Author(s):

Weiwei Chen ◽

Shenjiao Huang ◽

Kun Shi ◽

Lisha Yi ◽

Yaqiong Liu ◽

...

Keyword(s):

Cervical Cancer ◽

Matrix Metalloproteinases ◽

Random Effects ◽

Fixed Effects ◽

Prognostic Value ◽

Meta Analysis ◽

Free Survival ◽

Random Effects Models ◽

Registration Number ◽

Meta Analyses

Objective Studies have published the association between the expression of matrix metalloproteinases (MMPs) and the outcome of cervical cancer. However, the prognostic value in cervical cancer remains controversial. This meta-analysis was conducted to evaluate the prognostic functions of MMP expression in cervical cancer. Methods A comprehensive search of PubMed, Embase, and Web of Science databases was conducted to identify the eligible studies according to defined selection and excluding criteria and analyzed according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Fixed and random effects models were evaluated through the hazard ratios (HRs) and 95% confidence intervals (CIs) to estimate the overall survival (OS), recurrence-free survival (RFS), and progress-free survival (PFS). Results A total of 18 eligible studies including 1967 patients were analyzed for prognostic value. Totally 16 selected studies including 21 tests were relevant to the cervical cancer OS, 4 studies focused on RFS, and 1 study on PFS. The combined pooled HRs and 95% CIs of OS were calculated with random-effects models (HR = 1.64, 95% CI = 1.01–2.65, P = .000). In the subgroup analysis for OS, there was no heterogeneity in MMP-2 (I2 = .0%, P = .880), MMP-1 (I2 = .0%, P = .587), and MMP-14 (I2 = 28.3%, P = .248). In MMP-7 and MMP-9, the heterogeneities were obvious (I2 = 99.2% ( P = .000) and I2 = 77.9% ( P = .000), respectively). The pooled HRs and 95% CIs of RFS were calculated with fixed-effects models (HR = 2.22, 95% CI = 1.38–3.58, P = .001) and PFS (HR = 2.29, 95% CI = 1.14–4.58, P = .035). Conclusions The results indicated that MMP overexpression was associated with shorter OS and RFS in cervical cancer patients. It suggested that MMP overexpression might be a poor prognostic marker in cervical cancer. Research Registry Registration Number: reviewregistry 1159.

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Detecting and correcting for publication bias in meta-analysis – A truncated normal distribution approach

Statistical Methods in Medical Research ◽

10.1177/0962280216684671 ◽

2016 ◽

Vol 27 (9) ◽

pp. 2722-2741 ◽

Cited By ~ 4

Author(s):

Qiaohao Zhu ◽

KC Carriere

Keyword(s):

Normal Distribution ◽

Publication Bias ◽

Random Effects ◽

Effect Size ◽

Meta Analysis ◽

Truncated Normal Distribution ◽

Random Effects Models ◽

Funnel Plot ◽

Fixed And Random Effects ◽

Truncated Normal

Publication bias can significantly limit the validity of meta-analysis when trying to draw conclusion about a research question from independent studies. Most research on detection and correction for publication bias in meta-analysis focus mainly on funnel plot-based methodologies or selection models. In this paper, we formulate publication bias as a truncated distribution problem, and propose new parametric solutions. We develop methodologies of estimating the underlying overall effect size and the severity of publication bias. We distinguish the two major situations, in which publication bias may be induced by: (1) small effect size or (2) large p-value. We consider both fixed and random effects models, and derive estimators for the overall mean and the truncation proportion. These estimators will be obtained using maximum likelihood estimation and method of moments under fixed- and random-effects models, respectively. We carried out extensive simulation studies to evaluate the performance of our methodology, and to compare with the non-parametric Trim and Fill method based on funnel plot. We find that our methods based on truncated normal distribution perform consistently well, both in detecting and correcting publication bias under various situations.

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Triclosan-Coated Sutures Reduce the Risk of Surgical Site Infections: A Systematic Review and Meta-analysis

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2014.22 ◽

2015 ◽

Vol 36 (2) ◽

pp. 169-179 ◽

Cited By ~ 24

Author(s):

Anucha Apisarnthanarak ◽

Nalini Singh ◽

Aila Nica Bandong ◽

Gilbert Madriaga

Keyword(s):

Systematic Review ◽

Abdominal Surgery ◽

Random Effects ◽

Meta Analysis ◽

Surgical Site Infections ◽

Sensitivity Analyses ◽

Publication Type ◽

Random Effects Models ◽

Meta Regression ◽

Meta Analyses

OBJECTIVETo analyze available evidence on the effectiveness of triclosan-coated sutures (TCSs) in reducing the risk of surgical site infection (SSI).DESIGNSystematic review and meta-analysis.METHODSA systematic search of both randomized (RCTs) and nonrandomized (non-RCT) studies was performed on PubMed Medline, OVID, EMBASE, and SCOPUS, without restrictions in language and publication type. Random-effects models were utilized and pooled estimates were reported as the relative risk (RR) ratio with 95% confidence interval (CI). Tests for heterogeneity as well as meta-regression, subgroup, and sensitivity analyses were performed.RESULTSA total of 29 studies (22 RCTs, 7 non-RCTs) were included in the meta-analysis. The overall RR of acquiring an SSI was 0.65 (95% CI: 0.55–0.77; I2=42.4%, P=.01) in favor of TCS use. The pooled RR was particularly lower for the abdominal surgery group (RR: 0.56; 95% CI: 0.41–0.77) and was robust to sensitivity analysis. Meta-regression analysis revealed that study design, in part, may explain heterogeneity (P=.03). The pooled RR subgroup meta-analyses for randomized controlled trials (RCTs) and non-RCTs were 0.74 (95% CI: 0.61–0.89) and 0.53 (95% CI: 0.42–0.66), respectively, both of which favored the use of TCSs.CONCLUSIONThe random-effects meta-analysis based on RCTs suggests that TCSs reduced the risk of SSI by 26% among patients undergoing surgery. This effect was particularly evident among those who underwent abdominal surgery.Infect Control Hosp Epidemiol 2015;36(2): 1–11

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Prediction intervals for random-effects meta-analysis: A confidence distribution approach

Statistical Methods in Medical Research ◽

10.1177/0962280218773520 ◽

2018 ◽

Vol 28 (6) ◽

pp. 1689-1702 ◽

Cited By ~ 8

Author(s):

Kengo Nagashima ◽

Hisashi Noma ◽

Toshi A Furukawa

Keyword(s):

Random Effects ◽

Prediction Interval ◽

Meta Analysis ◽

Prediction Intervals ◽

Point Estimate ◽

Random Effects Models ◽

Confidence Distribution ◽

Large Sample Approximation ◽

Sample Approximation ◽

Meta Analyses

Prediction intervals are commonly used in meta-analysis with random-effects models. One widely used method, the Higgins–Thompson–Spiegelhalter prediction interval, replaces the heterogeneity parameter with its point estimate, but its validity strongly depends on a large sample approximation. This is a weakness in meta-analyses with few studies. We propose an alternative based on bootstrap and show by simulations that its coverage is close to the nominal level, unlike the Higgins–Thompson–Spiegelhalter method and its extensions. The proposed method was applied in three meta-analyses.

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Improving the accuracy of likelihood-based inference in meta-analysis and meta-regression

Biometrika ◽

10.1093/biomet/asx001 ◽

2017 ◽

Vol 104 (2) ◽

pp. 489-496 ◽

Cited By ~ 6

Author(s):

I. Kosmidis ◽

A. Guolo ◽

C. Varin

Keyword(s):

Random Effects ◽

Effect Size ◽

Variance Component ◽

General Framework ◽

Meta Analysis ◽

Asymptotic Bias ◽

Likelihood Estimator ◽

Random Effects Models ◽

The Mean ◽

Meta Regression

Summary Random-effects models are frequently used to synthesize information from different studies in meta-analysis. While likelihood-based inference is attractive both in terms of limiting properties and of implementation, its application in random-effects meta-analysis may result in misleading conclusions, especially when the number of studies is small to moderate. The current paper shows how methodology that reduces the asymptotic bias of the maximum likelihood estimator of the variance component can also substantially improve inference about the mean effect size. The results are derived for the more general framework of random-effects meta-regression, which allows the mean effect size to vary with study-specific covariates.

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Efficacy of Corticosteroids in Patients with SARS, MERS and COVID-19: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm9082392 ◽

2020 ◽

Vol 9 (8) ◽

pp. 2392 ◽

Cited By ~ 1

Author(s):

Keum Hwa Lee ◽

Sojung Yoon ◽

Gwang Hun Jeong ◽

Jong Yeob Kim ◽

Young Joo Han ◽

...

Keyword(s):

Systematic Review ◽

Random Effects ◽

Meta Analysis ◽

Random Effect Model ◽

Control Group ◽

Random Effects Model ◽

Number Of Patients ◽

Significant Difference ◽

Meta Analyses ◽

Coronavirus Infections

(1) Background: The use of corticosteroids in critical coronavirus infections, including severe acute respiratory syndrome (SARS), Middle East Respiratory Syndrome (MERS), or Coronavirus disease 2019 (COVID-19), has been controversial. However, a meta-analysis on the efficacy of steroids in treating these coronavirus infections is lacking. (2) Purpose: We assessed a methodological criticism on the quality of previous published meta-analyses and the risk of misleading conclusions with important therapeutic consequences. We also examined the evidence of the efficacy of corticosteroids in reducing mortality in SARS, MERS and COVID-19. (3) Methods: PubMed, MEDLINE, Embase, and Web of Science were used to identify studies published until 25 April 2020, that reported associations between steroid use and mortality in treating SARS/MERS/COVID-19. Two investigators screened and extracted data independently. Searches were restricted to studies on humans, and articles that did not report the exact number of patients in each group or data on mortality were excluded. We calculated odds ratios (ORs) or hazard ratios (HRs) under the fixed- and random-effect model. (4) Results: Eight articles (4051 patients) were eligible for inclusion. Among these selected studies, 3416 patients were diagnosed with SARS, 360 patients with MERS, and 275 with COVID-19; 60.3% patients were administered steroids. The meta-analyses including all studies showed no differences overall in terms of mortality (OR 1.152, 95% CI 0.631–2.101 in the random effects model, p = 0.645). However, this conclusion might be biased, because, in some studies, the patients in the steroid group had more severe symptoms than those in the control group. In contrast, when the meta-analysis was performed restricting only to studies that used appropriate adjustment (e.g., time, disease severity), there was a significant difference between the two groups (HR 0.378, 95% CI 0.221–0.646 in the random effects model, p < 0.0001). Although there was no difference in mortality when steroids were used in severe cases, there was a difference among the group with more underlying diseases (OR 3.133, 95% CI 1.670–5.877, p < 0.001). (5) Conclusions: To our knowledge, this study is the first comprehensive systematic review and meta-analysis providing the most accurate evidence on the effect of steroids in coronavirus infections. If not contraindicated, and in the absence of side effects, the use of steroids should be considered in coronavirus infection including COVID-19.

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Stereotactic radiosurgery for non-functioning pituitary adenomas: meta-analysis and International Stereotactic Radiosurgery Society practice opinion

Neuro-Oncology ◽

10.1093/neuonc/noz225 ◽

2019 ◽

Vol 22 (3) ◽

pp. 318-332 ◽

Cited By ~ 4

Author(s):

Rupesh Kotecha ◽

Arjun Sahgal ◽

Muni Rubens ◽

Antonio De Salles ◽

Laura Fariselli ◽

...

Keyword(s):

Systematic Review ◽

Stereotactic Radiosurgery ◽

Random Effects ◽

Local Control ◽

Pituitary Adenomas ◽

Meta Analysis ◽

Random Effects Models ◽

Review Reports ◽

Meta Analyses ◽

Non Functioning Pituitary Adenomas

Abstract Background This systematic review reports on outcomes and toxicities following stereotactic radiosurgery (SRS) for non-functioning pituitary adenomas (NFAs) and presents consensus opinions regarding appropriate patient management. Methods Using the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, a systematic review was performed from articles of ≥10 patients with NFAs published prior to May 2018 from the Medline database using the key words “radiosurgery” and “pituitary” and/or “adenoma.” Weighted random effects models were used to calculate pooled outcome estimates. Results Of the 678 abstracts reviewed, 35 full-text articles were included describing the outcomes of 2671 patients treated between 1971 and 2017 with either single fraction SRS or hypofractionated stereotactic radiotherapy (HSRT). All studies were retrospective (level IV evidence). SRS was used in 27 studies (median dose: 15 Gy, range: 5–35 Gy) and HSRT in 8 studies (median total dose: 21 Gy, range: 12–25 Gy, delivered in 3–5 fractions). The 5-year random effects local control estimate after SRS was 94% (95% CI: 93.0–96.0%) and 97.0% (95% CI: 93.0–98.0%) after HSRT. The 10-year local control random effects estimate after SRS was 83.0% (95% CI: 77.0–88.0%). Post-SRS hypopituitarism was the most common treatment-related toxicity observed, with a random effects estimate of 21.0% (95% CI: 15.0–27.0%), whereas visual dysfunction or other cranial nerve injuries were uncommon (range: 0–7%). Conclusions SRS is an effective and safe treatment for patients with NFAs. Encouraging short-term data support HSRT for select patients, and mature outcomes are needed before definitive recommendations can be made. Clinical practice opinions were developed on behalf of the International Stereotactic Radiosurgery Society (ISRS).

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The Effects of Physical Education on Motor Competence in Children and Adolescents: A Systematic Review and Meta-Analysis

Sports ◽

10.3390/sports8060088 ◽

2020 ◽

Vol 8 (6) ◽

pp. 88 ◽

Cited By ~ 2

Author(s):

Håvard Lorås

Keyword(s):

Physical Education ◽

Children And Adolescents ◽

Motor Skills ◽

Effect Size ◽

Meta Analysis ◽

Control Groups ◽

Motor Competence ◽

Random Effects Models ◽

Health Related ◽

Meta Analyses

Appropriate levels of motor competence are an integrated part of individuals’ health-related fitness, and physical education is proposed as an important context for developing a broad range of motor skills. The aim of the current study was to apply meta-analyses to assess the effectiveness of curriculum-based physical education on the development of the overall motor competence of children and adolescents. Studies were located by searching seven databases and included according to predefined criteria. Random effects models using the standardized effect size (Hedges’ g) were used to aggregate results, including an examination of heterogeneity and inconsistency. The meta-analysis included 20 studies, and a total of 38 effect sizes were calculated. A statistically significant improvement in motor competence following curriculum-based physical education compared to active control groups was observed in children and adolescents (g = −0.69, 95% CI −0.91 to −0.46, n = 23). Participants’ ages, total time for physical education intervention, and type of motor competence assessment did not appear to be statistically significant moderators of effect size. Physical education with various curricula can, therefore, increase overall motor competence in children and adolescents.

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Combined Effects of Aerobic Exercise and Diet on Lipids and Lipoproteins in Overweight and Obese Adults: A Meta-Analysis

Journal of Obesity ◽

10.1155/2012/985902 ◽

2012 ◽

Vol 2012 ◽

pp. 1-16 ◽

Cited By ~ 11

Author(s):

George A. Kelley ◽

Kristi S. Kelley ◽

Susan Roberts ◽

William Haskell

Keyword(s):

Aerobic Exercise ◽

Random Effects ◽

Effect Size ◽

Meta Analysis ◽

Combined Effects ◽

Obese Adults ◽

Men And Women ◽

Random Effects Models ◽

Multiple Groups ◽

Lipids And Lipoproteins

This study used the aggregate data meta-analytic approach to determine the combined effects of aerobic exercise and diet on lipids and lipoproteins in overweight and obese adults. Twelve studies representing 859 men and women (443 intervention, 416 control) were included. Using random-effects models, statistically significant, intervention minus control reductions were found for TC (−12.8 mg/dL, 95% CI, −19.9 to −5.7), TC : HDL-C (−0.5 mg/dL, 95% CI, −0.8 to −0.1), LDL-C (−6.8 mg/dL, 95% CI, −11.8 to −1.8), and TG (−13.1 mg/dL, 95% CI, −21.2 to −5.0) but not HDL-C (−0.4 mg/dL, 95% CI, −2.3 to 1.6). Results remained robust when adjusted for publication bias, deleting each study from the model once, and collapsing results for multiple groups from the same study into one effect size. These findings suggest that concurrent aerobic exercise and diet improve TC, LDL-C, TC : HDL-C, and TG, but not HDL-C, in overweight and obese adults.

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