Incidence of neonatal necrotising enterocolitis in high-income countries: a systematic review

2018 ◽  
Vol 103 (2) ◽  
pp. F182-F189 ◽  
Author(s):  
Cheryl Battersby ◽  
Tharsika Santhalingam ◽  
Kate Costeloe ◽  
Neena Modi
Keyword(s):  
Systematic Review ◽  
Birth Weight ◽  
Final Analysis ◽  
Case Definition ◽  
Necrotising Enterocolitis ◽  
High Income ◽  
Future Research ◽  
Control And Prevention ◽  
Registration Number ◽  
Neonatal Necrotising Enterocolitis

ObjectiveTo conduct a systematic review of neonatal necrotising enterocolitis (NEC) rates in high-income countries published in peer-reviewed journals.MethodsWe searched MEDLINE, Embase and PubMed databases for observational studies published in peer-reviewed journals. We selected studies reporting national, regional or multicentre rates of NEC in 34 Organisation for Economic Co-operation and Development countries. Two investigators independently screened studies against predetermined criteria. For included studies, we extracted country, year of publication in peer-reviewed journal, study time period, study population inclusion and exclusion criteria, case definition, gestation or birth weight-specific NEC and mortality rates.ResultsOf the 1888 references identified, 120 full manuscripts were reviewed, 33 studies met inclusion criteria, 14 studies with the most recent data from 12 countries were included in the final analysis. We identified an almost fourfold difference, from 2% to 7%, in the rate of NEC among babies born <32 weeks’ gestation and an almost fivefold difference, from 5% to 22%, among those with a birth weight <1000 g but few studies covered the entire at-risk population. The most commonly applied definition was Bell’s stage ≥2, which was used in seven studies. Other definitions included Bell’s stage 1–3, definitions from the Centers for Disease Control and Prevention, International Classification for Diseases and combinations of clinical and radiological signs as specified by study authors.ConclusionThe reasons for international variation in NEC incidence are an important area for future research. Reliable inferences require clarity in defining population coverage and consistency in the case definition applied.PROSPERO International prospective register of systematic reviews registration numberCRD42015030046.

scholarly journals Assessing the indirect effects of COVID-19 on healthcare delivery, utilization and health outcomes: a scoping review

2021 ◽  
Author(s):  
Charlotte M Roy ◽  
E Brennan Bollman ◽  
Laura M Carson ◽  
Alexander J Northrop ◽  
Elizabeth F Jackson ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Health Effects ◽  
Scoping Review ◽  
Cardiovascular Health ◽  
Healthcare Delivery ◽  
Final Analysis ◽  
High Income ◽  
Future Research ◽  
Published Data ◽  
Local Health

Abstract Background The COVID-19 pandemic and global efforts to contain its spread, such as stay-at-home orders and transportation shutdowns, have created new barriers to accessing healthcare, resulting in changes in service delivery and utilization globally. The purpose of this study is to provide an overview of the literature published thus far on the indirect health effects of COVID-19 and to explore the data sources and methodologies being used to assess indirect health effects. Methods A scoping review of peer-reviewed literature using three search engines was performed. Results One hundred and seventy studies were included in the final analysis. Nearly half (46.5%) of included studies focused on cardiovascular health outcomes. The main methodologies used were observational analytic and surveys. Data were drawn from individual health facilities, multicentre networks, regional registries, and national health information systems. Most studies were conducted in high-income countries with only 35.4% of studies representing low- and middle-income countries (LMICs). Conclusion Healthcare utilization for non-COVID-19 conditions has decreased almost universally, across both high- and lower-income countries. The pandemic’s impact on non-COVID-19 health outcomes, particularly for chronic diseases, may take years to fully manifest and should be a topic of ongoing study. Future research should be tied to system improvement and the promotion of health equity, with researchers identifying potentially actionable findings for national, regional and local health leadership. Public health professionals must also seek to address the disparity in published data from LMICs as compared with high-income countries.

scholarly journals Predictors of discharge destination from acute care in patients with traumatic brain injury

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e016694 ◽  
Author(s):  
Sareh Zarshenas ◽  
Laetitia Tam ◽  
Angela Colantonio ◽  
Seyed Mohammad Alavinia ◽  
Nora Cullen
Keyword(s):  
Systematic Review ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Acute Care ◽  
English Language ◽  
Healthcare Providers ◽  
Trial Registration ◽  
Future Research ◽  
Reference List ◽  
Registration Number

IntroductionMany studies have assessed the predictors of morbidity/mortality of patients with traumatic brain injury (TBI) in acute care. However, with the increasing rate of survival after TBI, more attention has been given to discharge destinations from acute care as an important measure of clinical priorities. This study describes the design of a systematic review compiling and synthesising studies on the prognostic factors of discharge settings from acute care in patients with TBI.Methods and analysisThis systematic review will be conducted on peer-reviewed studies using seven databases including Medline/Medline in-Process, Embase, Cochrane Database of Systematic Reviews, Cochrane CENTRAL, PsycINFO, CINAHL and Supplemental PubMed. The reference list of selected articles and Google Scholar will also be reviewed to determine other relevant articles. This study will include all English language observational studies that focus on adult patients with TBI in acute care settings. The quality of articles will be assessed by the Quality in Prognostic Studies tool.Ethics and disseminationThe results of this review will provide evidence that may guide healthcare providers in making more informed and timely discharge decisions to the next level of care for patient with TBI. Also, this study will provide valuable information to address the gaps in knowledge for future research.Trial registration numberTrial registration number (PROSPERO) is CRD42016033046.

scholarly journals A systematic review of the characteristics and needs of older prisoners

2020 ◽  
Vol 10 (4) ◽  
pp. 253-276
Author(s):  
Dean Wilkinson ◽  
Laura Caulfield
Keyword(s):  
Systematic Review ◽  
Older People ◽  
Selection Process ◽  
Final Analysis ◽  
Evidence Base ◽  
Future Research ◽  
Care Needs ◽  
Content Type ◽  
Older Prisoners ◽  
Search And Selection

Purpose The purpose of this paper is to review and understand what the existing evidence base concludes about the needs of this population. The older prisoner population is growing faster than the older general population and placing a strain on prisons. Much of the existing literature focusses on the health-care needs of, or in-prison initiatives for, older prisoners. Typically, these are responsive and lacking an evidence-based understanding of the characteristics and needs of this group. Design/methodology/approach This paper presents a systematic review of the existing literature on the needs and characteristics of older people in contact with the criminal justice system. After a thorough search and selection process, 21 papers, from 2002 onwards, were included in the final analysis. The review process was structured through (People, Intervention/Exposure, Comparison, Outcome) and reported using (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Findings The contradictions within the existing evidence base make it difficult to reach firm conclusions about the needs and characteristics of older prisoners. What is clear from the existing research are the relatively high levels of need. There is also some consensus that where older people commit homicide, the victim is likely to be an intimate partner. Overall, there is a need for consistent recording and reporting of characteristics and demographics and more systematic study design. Originality/value This paper has highlighted the key findings and limitations in the existing literature. Future research should make use of secondary official data sources to provide a clearer understanding of the characteristics of this group, their routes to prison, their needs and challenges they present.

scholarly journals Radiology artificial intelligence, a systematic evaluation of methods (RAISE): a systematic review protocol

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Brendan Kelly ◽  
Conor Judge ◽  
Stephanie M. Bollard ◽  
Simon M. Clifford ◽  
Gerard M. Healy ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Systematic Review ◽  
Data Extraction ◽  
Meta Analysis ◽  
Group Analysis ◽  
Cochrane Collaboration ◽  
Systematic Evaluation ◽  
Future Research ◽  
Ethical Approval ◽  
Registration Number

Abstract Introduction There has been a recent explosion of research into the field of artificial intelligence as applied to clinical radiology with the advent of highly accurate computer vision technology. These studies, however, vary significantly in design and quality. While recent guidelines have been established to advise on ethics, data management and the potential directions of future research, systematic reviews of the entire field are lacking. We aim to investigate the use of artificial intelligence as applied to radiology, to identify the clinical questions being asked, which methodological approaches are applied to these questions and trends in use over time. Methods and analysis We will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and by the Cochrane Collaboration Handbook. We will perform a literature search through MEDLINE (Pubmed), and EMBASE, a detailed data extraction of trial characteristics and a narrative synthesis of the data. There will be no language restrictions. We will take a task-centred approach rather than focusing on modality or clinical subspecialty. Sub-group analysis will be performed by segmentation tasks, identification tasks, classification tasks, pegression/prediction tasks as well as a sub-analysis for paediatric patients. Ethics and dissemination Ethical approval will not be required for this study, as data will be obtained from publicly available clinical trials. We will disseminate our results in a peer-reviewed publication. Registration number PROSPERO: CRD42020154790

scholarly journals Endotracheal intubation to reduce aspiration events in acutely comatose patients: a systematic review

2020 ◽  
Vol 28 (1) ◽  
Author(s):  
Daniele Orso ◽  
Luigi Vetrugno ◽  
Nicola Federici ◽  
Natascia D’Andrea ◽  
Tiziana Bove
Keyword(s):  
Systematic Review ◽  
Care Setting ◽  
Retrospective Studies ◽  
Final Analysis ◽  
Hospital Environment ◽  
Cochrane Library ◽  
Trauma Population ◽  
Registration Number ◽  
Gcs Score ◽  
Risk Of Aspiration

Abstract Background It is customary to believe that a patient with a Glasgow Coma Scale (GCS) score less than or equal to 8 should be intubated to avoid aspiration. We conducted a systematic review to establish if patients with GCS ≤ 8 for trauma or non-traumatic emergencies and treated in the acute care setting (e.g., Emergency Department or Pre-hospital environment) should be intubated to avoid aspiration or aspiration pneumonia/pneumonitis, and consequently, reduce mortality. Methods We searched six databases, Pubmed, Embase, Scopus, SpringerLink, Cochrane Library, and Ovid Emcare, from April 15th to October 14th, 2020, for studies involving low GCS score patients of whom the risk of aspiration and related complications was assessed. Results Thirteen studies were included in the final analysis (7 on non-traumatic population, 4 on trauma population, 1 pediatric and 1 adult mixed case studies). For the non-traumatic cases, two prospective studies and one retrospective study found no difference in aspiration risk between intubated and non-intubated patients. Two retrospective studies reported a reduction in the risk of aspiration in the intubated patient group. For traumatic cases, the study that considered the risk of aspiration did not show any differences between the two groups. A study on adult mixed cases found no difference in the incidence of aspiration among intubated and non-intubated patients. A study on pediatric patients found increased mortality for intubated versus non-intubated non-traumatic patients with a low GCS score. Conclusion Whether intubation results in a reduction in the incidence of aspiration events and whether these are more frequent in patients with low GCS scores are not yet established. The paucity of evidence on this topic makes clinical trials justifiable and necessary. Trial registration Prospero registration number: CRD42020136987.

scholarly journals The differential impact of pediatric COVID-19 between high-income countries and low- and middle-income countries: A systematic review of fatality and ICU admission in children worldwide

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0246326
Author(s):  
Taito Kitano ◽  
Mao Kitano ◽  
Carsten Krueger ◽  
Hassan Jamal ◽  
Hatem Al Rawahi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pediatric Population ◽  
Case Fatality ◽  
High Income ◽  
Regional Variability ◽  
Middle Income ◽  
Icu Admission ◽  
Middle Income Countries ◽  
Registration Number ◽  
Low And Middle Income

Background The overall global impact of COVID-19 in children and regional variability in pediatric outcomes are presently unknown. Methods To evaluate the magnitude of global COVID-19 death and intensive care unit (ICU) admission in children aged 0–19 years, a systematic review was conducted for articles and national reports as of December 7, 2020. This systematic review is registered with PROSPERO (registration number: CRD42020179696). Results We reviewed 16,027 articles as well as 225 national reports from 216 countries. Among the 3,788 global pediatric COVID-19 deaths, 3,394 (91.5%) deaths were reported from low- and middle-income countries (LMIC), while 83.5% of pediatric population from all included countries were from LMIC. The pediatric deaths/1,000,000 children and case fatality rate (CFR) were significantly higher in LMIC than in high-income countries (HIC) (2.77 in LMIC vs 1.32 in HIC; p < 0.001 and 0.24% in LMIC vs 0.01% in HIC; p < 0.001, respectively). The ICU admission/1,000,000 children was 18.80 and 1.48 in HIC and LMIC, respectively (p < 0.001). The highest deaths/1,000,000 children and CFR were in infants < 1 year old (10.03 and 0.58% in the world, 5.39 and 0.07% in HIC and 10.98 and 1.30% in LMIC, respectively). Conclusions The study highlights that there may be a larger impact of pediatric COVID-19 fatality in LMICs compared to HICs.

scholarly journals Differences in outcomes of mandatory motorcycle helmet legislation by country income level: A systematic review and meta-analysis

PLoS Medicine ◽  
2021 ◽  
Vol 18 (9) ◽  
pp. e1003795
Author(s):  
Jacob R. Lepard ◽  
Riccardo Spagiari ◽  
Jacquelyn Corley ◽  
Ernest J. Barthélemy ◽  
Eliana Kim ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Road Traffic ◽  
Meta Analysis ◽  
Final Analysis ◽  
High Income ◽  
Total Study Population ◽  
Motorcycle Helmet ◽  
Significant Difference ◽  
Helmet Laws

Background The recent Lancet Commission on Legal Determinants of Global Health argues that governance can provide the framework for achieving sustainable development goals. Even though over 90% of fatal road traffic injuries occur in low- and middle-income countries (LMICs) primarily affecting motorcyclists, the utility of helmet laws outside of high-income settings has not been well characterized. We sought to evaluate the differences in outcomes of mandatory motorcycle helmet legislation and determine whether these varied across country income levels. Methods and findings A systematic review and meta-analysis were completed using the PRISMA checklist. A search for relevant articles was conducted using the PubMed, Embase, and Web of Science databases from January 1, 1990 to August 8, 2021. Studies were included if they evaluated helmet usage, mortality from motorcycle crash, or traumatic brain injury (TBI) incidence, with and without enactment of a mandatory helmet law as the intervention. The Newcastle–Ottawa Scale (NOS) was used to rate study quality and funnel plots, and Begg’s and Egger’s tests were used to assess for small study bias. Pooled odds ratios (ORs) and their 95% confidence intervals (CIs) were stratified by high-income countries (HICs) versus LMICs using the random-effects model. Twenty-five articles were included in the final analysis encompassing a total study population of 31,949,418 people. There were 17 retrospective cohort studies, 2 prospective cohort studies, 1 case–control study, and 5 pre–post design studies. There were 16 studies from HICs and 9 from LMICs. The median NOS score was 6 with a range of 4 to 9. All studies demonstrated higher odds of helmet usage after implementation of helmet law; however, the results were statistically significantly greater in HICs (OR: 53.5; 95% CI: 28.4; 100.7) than in LMICs (OR: 4.82; 95% CI: 3.58; 6.49), p-value comparing both strata < 0.0001. There were significantly lower odds of motorcycle fatalities after enactment of helmet legislation (OR: 0.71; 95% CI: 0.61; 0.83) with no significant difference by income classification, p-value: 0.27. Odds of TBI were statistically significantly lower in HICs (OR: 0.61, 95% CI 0.54 to 0.69) than in LMICs (0.79, 95% CI 0.72 to 0.86) after enactment of law (p-value: 0.0001). Limitations of this study include variability in the methodologies and data sources in the studies included in the meta-analysis as well as the lack of available literature from the lowest income countries or from the African WHO region, in which helmet laws are least commonly present. Conclusions In this study, we observed that mandatory helmet laws had substantial public health benefits in all income contexts, but some outcomes were diminished in LMIC settings where additional measures such as public education and law enforcement might play critical roles.

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