Do Immediate Postoperative Radiographs Change Patient Management After Fracture Fixation? A Systematic Review

2018 ◽  
Vol 32 (5) ◽  
pp. 211-215 ◽  
Author(s):  
Tammie Teo ◽  
Emily Schaeffer ◽  
Anthony Cooper ◽  
Kishore Mulpuri
Keyword(s):  
Systematic Review ◽  
Fracture Fixation ◽  
Patient Management

scholarly journals A systematic review and meta-analysis of complications in conversion arthroplasty methods for failed intertrochanteric fracture fixation

2019 ◽  
Vol 10 (2) ◽  
pp. 282-285
Author(s):  
Daniel B. Dix ◽  
Ibukunoluwa B. Araoye ◽  
Jackson R. Staggers ◽  
Chee P. Lin ◽  
Ashish B. Shah ◽  
...  
Keyword(s):  
Systematic Review ◽  
Fracture Fixation ◽  
Intertrochanteric Fracture ◽  
Meta Analysis

Variability in the Reporting Terminology of Adverse Events and Complications in Ankle Fracture Fixation: A Systematic Review

2019 ◽  
Vol 41 (2) ◽  
pp. 170-176
Author(s):  
Stefan A. St George ◽  
Hooman Sadr ◽  
Chayanin Angthong ◽  
Murray Penner ◽  
Peter Salat ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Fracture Fixation ◽  
Ankle Fracture ◽  
Soft Tissue Injuries ◽  
Classification Systems ◽  
Level Of Evidence ◽  
Implant Complications ◽  
Frequency Of Use ◽  
Standardized Reporting

Background: Classification systems for the reporting of surgical complications have been developed and adapted for many surgical subspecialties. The purpose of this systematic review was to examine the variability and frequency of reporting terms used to describe adverse events and complications in ankle fracture fixation. We hypothesized that the terminology used would be highly variable and inconsistent, corroborating previous results that have suggested a need for standardized reporting terminology in orthopedics. Methods: Ankle fracture outcome studies meeting predetermined inclusion and exclusion criteria were selected for analysis by 2 independent observers. Terms used to define adverse events and complications were identified and recorded. Discrepancies were resolved by consensus with the aid of a third observer. All terms were then compiled and assessed for variability and frequency of use throughout the studies involved. Reporting terminology was subsequently grouped into 10 categories. Results: In the 48 studies analyzed, 301 distinct terms were utilized to describe complications or adverse events. Of these terms, 74.4% (224/301) were found in a single study each. Only 1 term, “infection,” was present in 50% of studies, and only 19 of 301 terms (6.3%) were used in at least 10% of papers. The category that was most frequently reported was “infection,” with 89.6% of studies reporting on this type of adverse event using 25 distinct terms. Other categories were “wound healing complications” (72.9% of papers, 38 terms), “bone/joint complications” (66.7% of papers, 35 terms), “hardware/implant complications” (56.3% of papers, 47 terms), “revision” (56.3% of papers, 35 terms), “cartilage/soft tissue injuries” (45.8% of papers, 31 terms), “reduction/alignment issues” (45.8% of papers, 29 terms), “medical complications” (43.8% of papers, 32 terms), “pain” (29.2% of papers, 16 terms), and “other complications” (20.8% of papers, 13 terms). There was a 78.6% interobserver agreement in the identification of terms across the 48 studies included. Conclusion: The reporting terminology utilized to describe complications and adverse events in ankle fracture fixation was found to be highly variable and inconsistent. This variability prevents accurate reporting of complications and adverse events and makes the analysis of potential outcomes difficult. The development of standardized reporting terminology in orthopedics would be instrumental in addressing these challenges and allow for more accurate and consistent outcome reporting. Level of Evidence: Level III; systematic review of Level III studies and above.

scholarly journals Artificial Intelligence Techniques: Analysis, Application, and Outcome in Dentistry—A Systematic Review

2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Naseer Ahmed ◽  
Maria Shakoor Abbasi ◽  
Filza Zuberi ◽  
Warisha Qamar ◽  
Mohamad Syahrizal Bin Halim ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Systematic Review ◽  
Full Text ◽  
Patient Management ◽  
English Language ◽  
Clinical Performance ◽  
Research Question ◽  
Time Saving ◽  
Artificial Intelligence Techniques ◽  
Clinical Scenarios

Objective. The objective of this systematic review was to investigate the quality and outcome of studies into artificial intelligence techniques, analysis, and effect in dentistry. Materials and Methods. Using the MeSH keywords: artificial intelligence (AI), dentistry, AI in dentistry, neural networks and dentistry, machine learning, AI dental imaging, and AI treatment recommendations and dentistry. Two investigators performed an electronic search in 5 databases: PubMed/MEDLINE (National Library of Medicine), Scopus (Elsevier), ScienceDirect databases (Elsevier), Web of Science (Clarivate Analytics), and the Cochrane Collaboration (Wiley). The English language articles reporting on AI in different dental specialties were screened for eligibility. Thirty-two full-text articles were selected and systematically analyzed according to a predefined inclusion criterion. These articles were analyzed as per a specific research question, and the relevant data based on article general characteristics, study and control groups, assessment methods, outcomes, and quality assessment were extracted. Results. The initial search identified 175 articles related to AI in dentistry based on the title and abstracts. The full text of 38 articles was assessed for eligibility to exclude studies not fulfilling the inclusion criteria. Six articles not related to AI in dentistry were excluded. Thirty-two articles were included in the systematic review. It was revealed that AI provides accurate patient management, dental diagnosis, prediction, and decision making. Artificial intelligence appeared as a reliable modality to enhance future implications in the various fields of dentistry, i.e., diagnostic dentistry, patient management, head and neck cancer, restorative dentistry, prosthetic dental sciences, orthodontics, radiology, and periodontics. Conclusion. The included studies describe that AI is a reliable tool to make dental care smooth, better, time-saving, and economical for practitioners. AI benefits them in fulfilling patient demand and expectations. The dentists can use AI to ensure quality treatment, better oral health care outcome, and achieve precision. AI can help to predict failures in clinical scenarios and depict reliable solutions. However, AI is increasing the scope of state-of-the-art models in dentistry but is still under development. Further studies are required to assess the clinical performance of AI techniques in dentistry.

scholarly journals Effectiveness of tests to detect the presence of SARS-CoV-2 virus, and antibodies to SARS-CoV-2, to inform COVID-19 diagnosis: a rapid systematic review

2020 ◽  
pp. bmjebm-2020-111511 ◽  
Author(s):  
David Jarrom ◽  
Lauren Elston ◽  
Jennifer Washington ◽  
Matthew Prettyjohns ◽  
Kimberley Cann ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Patient Management ◽  
Sampling Methods ◽  
Clinical Effectiveness ◽  
Antibody Detection ◽  
Test Accuracy ◽  
Reference Standard ◽  
Published Evidence ◽  
Subsequent Patient

ObjectivesWe undertook a rapid systematic review with the aim of identifying evidence that could be used to answer the following research questions: (1) What is the clinical effectiveness of tests that detect the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to inform COVID-19 diagnosis? (2) What is the clinical effectiveness of tests that detect the presence of antibodies to the SARS-CoV-2 virus to inform COVID-19 diagnosis?Design and settingSystematic review and meta-analysis of studies of diagnostic test accuracy. We systematically searched for all published evidence on the effectiveness of tests for the presence of SARS-CoV-2 virus, or antibodies to SARS-CoV-2, up to 4 May 2020, and assessed relevant studies for risks of bias using the QUADAS-2 framework.Main outcome measuresMeasures of diagnostic accuracy (sensitivity, specificity, positive/negative predictive value) were the main outcomes of interest. We also included studies that reported influence of testing on subsequent patient management, and that reported virus/antibody detection rates where these facilitated comparisons of testing in different settings, different populations or using different sampling methods.Results38 studies on SARS-CoV-2 virus testing and 25 studies on SARS-CoV-2 antibody testing were identified. We identified high or unclear risks of bias in the majority of studies, most commonly as a result of unclear methods of patient selection and test conduct, or because of the use of a reference standard that may not definitively diagnose COVID-19. The majority were in hospital settings, in patients with confirmed or suspected COVID-19 infection. Pooled analysis of 16 studies (3818 patients) estimated a sensitivity of 87.8% (95% CI 81.5% to 92.2%) for an initial reverse-transcriptase PCR test. For antibody tests, 10 studies reported diagnostic accuracy outcomes: sensitivity ranged from 18.4% to 96.1% and specificity 88.9% to 100%. However, the lack of a true reference standard for SARS-CoV-2 diagnosis makes it challenging to assess the true diagnostic accuracy of these tests. Eighteen studies reporting different sampling methods suggest that for virus tests, the type of sample obtained/type of tissue sampled could influence test accuracy. Finally, we searched for, but did not identify, any evidence on how any test influences subsequent patient management.ConclusionsEvidence is rapidly emerging on the effectiveness of tests for COVID-19 diagnosis and management, but important uncertainties about their effectiveness and most appropriate application remain. Estimates of diagnostic accuracy should be interpreted bearing in mind the absence of a definitive reference standard to diagnose or rule out COVID-19 infection. More evidence is needed about the effectiveness of testing outside of hospital settings and in mild or asymptomatic cases. Implementation of public health strategies centred on COVID-19 testing provides opportunities to explore these important areas of research.

scholarly journals Oligomeric Enteral Nutrition in Undernutrition, due to Oncology Treatment-Related Diarrhea. Systematic Review and Proposal of An Algorithm of Action

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1888 ◽  
Author(s):  
Sanz-Paris ◽  
Martinez-García ◽  
Martinez-Trufero ◽  
Lambea-Sorrosal ◽  
Calvo-Gracia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Enteral Nutrition ◽  
Patient Management ◽  
Nutritional Assessment ◽  
Dietary Recommendations ◽  
Medium Chain Triglycerides ◽  
Nutritional Treatment ◽  
Oncological Patients ◽  
Oncology Treatment ◽  
Therapeutic Possibilities

Oncology treatment-related diarrhea and malnutrition appear together in oncological patients because of the disease itself, or the treatments that are administered for it. Therefore it is essential to carry out a nutritional treatment. Enteral nutrition formulas, containing peptides and medium chain triglycerides, can facilitate absorption in cases of malabsorption. There are few references to the use of enteral nutrition in the clinical society guidelines of patient management with oncology treatment-related diarrhea (OTRD). A bibliographic review of the studies with oligomeric enteral nutrition in OTRD found only nine studies with chemotherapy (all with the same oligomeric formula in which oral mucositis improves, while the rest of the outcomes show different results), and eight studies with radiotherapy (with different products and very heterogeneous results). We hereby present our action algorithm to supplement the diet of OTRD patients with an oligomeric enteral nutrition formula. The first step is the nutritional assessment, followed by the assessment of the functional capacity of the patient’s intestine. With these two aspects evaluated, the therapeutic possibilities available vary in degrees of complexity: These will range from the usual dietary recommendations, to supplementation with oral oligomeric enteral nutrition, along with complete enteral nutrition with oligomeric formula, and up to potentially total parenteral nutrition.

scholarly journals Definition of infection after fracture fixation: A systematic review of randomized controlled trials to evaluate current practice

Injury ◽  
2018 ◽  
Vol 49 (3) ◽  
pp. 497-504 ◽  
Author(s):  
WJ. Metsemakers ◽  
K. Kortram ◽  
M. Morgenstern ◽  
T.F. Moriarty ◽  
I. Meex ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Fracture Fixation ◽  
Current Practice ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Definition Of

Systematic review of the impact of endoscopic ultrasound on the management of patients with esophageal cancer

2008 ◽  
Vol 24 (01) ◽  
pp. 25-35 ◽  
Author(s):  
Suzanne M. Dyer ◽  
Dane B. Levison ◽  
Robert Y. Chen ◽  
Sarah J. Lord ◽  
Stephen Blamey
Keyword(s):  
Systematic Review ◽  
Esophageal Cancer ◽  
Endoscopic Ultrasound ◽  
Patient Management ◽  
Patient Survival ◽  
Cancer Staging ◽  
Therapeutic Impact ◽  
Impact Studies ◽  
The Impact

Objectives:Although endoscopic ultrasound (EUS) staging of esophageal cancer is established in clinical practice, high-quality evidence about its impact on patient outcomes is not available. This study aims to determine the impact of EUS for esophageal cancer staging on patient management and survival.Methods:A systematic review was conducted using Medline, PreMedline, Embase, and The Cochrane Library. Included studies were (i) comparative studies reporting survival following EUS esophageal cancer staging, (ii) therapeutic impact studies reporting change in patient management following EUS. The quality of included studies was critically appraised.Results:One systematic review, five studies reporting therapeutic impact, and two studies reporting patient survival were identified. The design and quality of the therapeutic impact studies varied widely. Management changed in 24–29 percent of patients following EUS staging of esophageal cancer (two studies). No studies provided data on the avoidance of surgery for this indication. One retrospective cohort study with historical control found EUS staging of esophageal cancer improved patient survival; a second study with similar design limitations did not find a survival benefit for EUS staging in patients undergoing resection. These studies had a high potential for bias, limiting the value of these findings.Conclusions:Two studies provided evidence of a change in patient management following EUS for staging esophageal cancer, a higher level of evidence for a clinical benefit than can be obtained from accuracy studies alone. This evidence contributed to a recommendation for public funding of EUS in staging esophageal cancer in Australia.

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