What factors must be considered in ‘return to school’ following concussion and what strategies or accommodations should be followed? A systematic review

ObjectiveTo evaluate the evidence regarding (1) factors affecting return to school (RTS) and (2) strategies/accommodations for RTS following a sport-related concussion (SRC) in children and adolescents.DesignA systematic review of original studies specifically addressing RTS following concussion in the paediatric and sporting context.Data sourcesMEDLINE (Ovid), Embase (Ovid), PsycInfo (Ovid) electronic databases and the grey literature OpenGrey, ClinicalTrials.gov and Google Advanced.Eligibility criteriaStudies were included if they were original research on RTS following SRC in children aged 5–18 years published in English between 1985 and 2017.ResultsA total of 180 articles were identified; 17 articles met inclusion criteria. Several factors should be considered for RTS after concussion, including: symptomatology; rest following injury; age/grade; and course load. On RTS after concussion, 17%–73% of students were provided academic accommodations or experienced difficulty with RTS. Students were more likely to obtain academic accommodations in schools with a concussion policy if they had a medical RTS letter and had regular medical follow-up after concussion.ConclusionsSchools should have a concussion policy and offer individualised academic accommodations to students recovering from SRC on RTS; a medical letter should be provided to facilitate provision/receipt of academic accommodations; students should have early, regular medical follow-up following SRC to help with RTS and monitor recovery; students may require temporary absence from school after SRC; clinicians should assess risk factors/modifiers that may prolong recovery and require more intensive academic accommodations.PROSPERO registration numberCRD42016039184.

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Effectiveness of return to activity and return to school protocols for children postconcussion: a systematic review

BMJ Open Sport & Exercise Medicine ◽

10.1136/bmjsem-2019-000667 ◽

2020 ◽

Vol 6 (1) ◽

pp. e000667 ◽

Cited By ~ 2

Author(s):

Carol DeMatteo ◽

E Dimitra Bednar ◽

Sarah Randall ◽

Katie Falla

Keyword(s):

Systematic Review ◽

Paediatric Population ◽

Acute Stage ◽

Current Data ◽

Return To School ◽

Original Research ◽

Reference List ◽

Eligibility Criteria ◽

Outcomes For Children ◽

Return To Activity

ObjectiveTo determine the effects of following return to activity (RTA) and return to school (RTS) protocols on clinical outcomes for children with concussion. The 12 subquestions of this review focus on the effectiveness of protocols, guidelines and recommendations, and the evidence supporting content of the protocols including rest, exercise and school accommodations.DesignSystematic review.Data sourcesPubMed, MEDLINE, EMBASE, CINAHL, ERIC and manual reference list check.Eligibility criteria for selecting studiesStudies were included if they evaluated RTA or RTS protocols in children aged 5–18 years with a concussion or if they reported a rigorous study design that provided evidence for the recommendations. Included studies were original research or systematic reviews. Articles were excluded if they did not report on their methodology or included participants with significant neurological comorbidities.ResultsThe literature search retrieved 198 non-duplicate articles and a total of 13 articles were included in this review. Despite the adoption of several RTS and RTA protocols in clinical practice there is little evidence to determine their efficacy in the paediatric population.SummaryThe current data support the recommendation that children in the acute stage postconcussion should undergo 1–2 days physical and cognitive rest as they initiate graduated RTA/RTS protocols. Prolonged rest may increase reported symptoms and time to recovery. Further interventional studies are needed to evaluate the effectiveness of RTA/RTS protocols in youth with concussion.

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Increasing physical activity by four legs rather than two: systematic review of dog-facilitated physical activity interventions

British Journal of Sports Medicine ◽

10.1136/bjsports-2019-101156 ◽

2020 ◽

Vol 54 (20) ◽

pp. 1202-1207 ◽

Cited By ~ 2

Author(s):

Ryan E Rhodes ◽

Maria Baranova ◽

Hayley Christian ◽

Carri Westgarth

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Behaviour Change ◽

Controlled Trial ◽

Grey Literature ◽

Future Research ◽

Behaviour Change Techniques ◽

Eligibility Criteria ◽

Dog Owners

ObjectivesRegular walking is a critical target of physical activity (PA) promotion, and dog walking is a feasible PA intervention for a large segment of the population. The purpose of this paper was to review PA interventions that have involved canine interactions and to evaluate their effectiveness. A secondary aim of this review was to highlight the populations, settings, designs and intervention components that have been applied so as to inform future research.DesignSystematic review.Data sourcesWe carried out literature searches to August 2019 using six common databases.Eligibility criteriaStudies included published papers in peer-reviewed journals and grey literature (theses and dissertations) in the English language that included any PA behaviour change design (ie, randomised controlled trial, quasi-experimental) that focused on canine-related intervention. We grouped findings by population, setting, medium, research design and quality, theory and behaviour change techniques applied.ResultsThe initial search yielded 25 010 publications which were reduced to 13 independent studies of medium and high risks of bias after screening for eligibility criteria. The approaches to intervene on PA were varied and included loaner dogs, new dog owners and the promotion of walking among established dog owners. Findings were consistent in showing that canine-assisted interventions do increase PA (82% of the studies had changes favouring the canine-facilitated intervention). Exploratory subanalyses showed that specific study characteristics and methods may have moderated the effects. Compared with studies with longer follow-up periods, studies with shorter follow-up favoured behaviour changes of the canine intervention over the control condition.ConclusionCanine-based PA interventions appear effective, but future research should move beyond feasibility and proof of concept studies to increase rigour, quality and generalisability of findings.

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Cell-based therapies for COVID-19: A living, systematic review

Medwave ◽

10.5867/medwave.2020.11.8078 ◽

2020 ◽

Vol 20 (11) ◽

pp. e8078-e8078

Author(s):

Gabriel Rada ◽

Javiera Corbalán ◽

Patricio Rojas

Keyword(s):

Systematic Review ◽

Randomized Trials ◽

Grey Literature ◽

Cochrane Central Register ◽

Eligibility Criteria ◽

Web Based ◽

Central Register ◽

Registration Number ◽

Near Future

Objective This living, systematic review aims to provide a timely, rigorous, and continuously updated summary of the available evidence on the role of cell-based therapies in the treatment of patients with COVID-19. Data sources We conducted searches in PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), grey literature, and in a centralized repository in L·OVE (Living OVerview of Evidence). L·OVE is a platform that maps PICO questions to evidence from the Epistemonikos database. In response to the COVID-19 emergency, L·OVE was adapted to expand the range of evidence it covers and customized to group all COVID-19 evidence in one place. All the searches covered the period until 23 April 2020 (one day before submission). Eligibility criteria for selecting studies and methods We adapted an already published standard protocol for multiple parallel systematic reviews to the specificities of this question. We searched for randomized trials evaluating the effectiveness and safety of cell-based therapies versus placebo or no treatment in patients with COVID-19. Anticipating the lack of randomized trials directly addressing this question, we also searched for trials evaluating other coronavirus infections, such as MERS-CoV and SARS-CoV, and nonrandomized studies in COVID-19. Two reviewers independently screened each study for eligibility. A living, web-based version of this review will be openly available during the COVID-19 pandemic. We will resubmit this review to a peer-reviewed journal every time the conclusions change or whenever there are substantial updates. Results We screened 1 043 records, but no study was considered eligible. We identified 61 ongoing studies, including 39 randomized trials evaluating different types of cell-based therapies in COVID-19. Conclusions We did not find any studies that met our inclusion criteria, and hence there is no evidence to support or refute the use of cell-based therapies for treating patients with COVID-19. A substantial number of ongoing studies should provide valuable evidence to inform researchers and decision-makers in the near future. PROSPERO Registration number CRD42020179711

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Assessment of patient-reported outcomes after polytrauma – instruments and methods: a systematic review

BMJ Open ◽

10.1136/bmjopen-2021-050168 ◽

2021 ◽

Vol 11 (12) ◽

pp. e050168

Author(s):

Michaela Ritschel ◽

Silke Kuske ◽

Irmela Gnass ◽

Silke Andrich ◽

Kai Moschinski ◽

...

Keyword(s):

Systematic Review ◽

Social Participation ◽

Patient Reported Outcomes ◽

Injury Severity ◽

Short Form ◽

Data Extraction ◽

Grey Literature ◽

Eligibility Criteria ◽

Patient Reported

ObjectivesWe (1) collected instruments that assess health-related quality of life (HRQoL), activities of daily living (ADL) and social participation during follow-up after polytrauma, (2) described their use and (3) investigated other relevant patient-reported outcomes (PROs) assessed in the studies.DesignSystematic Review using the Preferred Reporting Items for Systematic Review and Meta-Analysis guideline.Data sourcesMEDLINE, Embase, CINAHL, PsycINFO, CENTRAL, as well as the trials registers ClinicalTrials.gov and WHO ICTRP were searched from January 2005 to April 2018.Eligibility criteriaAll original empirical research published in English or German including PROs of patients aged 18–75 years with an Injury Severity Score≥16 and/or an Abbreviated Injury Scale≥3. Studies with defined injuries or diseases (e.g. low-energy injuries) and some text types (e.g. grey literature and books) were excluded. Systematic reviews and meta-analyses were excluded, but references screened for appropriate studies.Data extraction and synthesisData extraction, narrative content analysis and a critical appraisal (e.g. UK National Institute for Health and Care Excellence) were performed by two reviewers independently.ResultsThe search yielded 3496 hits; 54 publications were included. Predominantly, HRQoL was assessed, with Short Form-36 Health Survey applied most frequently. ADL and (social) participation were rarely assessed. The methods most used were postal surveys and single assessments of PROs, with a follow-up period of one to one and a half years. Other relevant PRO areas reported were function, mental disorders and pain.ConclusionsThere is a large variation in the assessment of PROs after polytrauma, impairing comparability of outcomes. First efforts to standardise the collection of PROs have been initiated, but require further harmonisation between central players. Additional knowledge on rarely reported PRO areas (e.g. (social) participation, social networks) may lead to their consideration in health services provision.PROSPERO registration numberCRD42017060825.

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Cell-based therapies for COVID-19: A living systematic review

10.1101/2020.04.24.20078667 ◽

2020 ◽

Author(s):

Gabriel Rada ◽

Javiera Corbalán ◽

Patricio Rojas

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Grey Literature ◽

Cochrane Central Register ◽

Randomised Trials ◽

Eligibility Criteria ◽

Open Platform ◽

Link Type ◽

Central Register ◽

Registration Number

ABSTRACT Objective This living systematic review aims to provide a timely, rigorous and continuously updated summary of the available evidence on the role of cell-based therapies in the treatment of patients with COVID-19. Data sources We conducted searches in PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), grey literature and in a centralised repository in L-OVE (Living OVerview of Evidence). L-OVE is a platform that maps PICO questions to evidence from Epistemonikos database. In response to the COVID-19 emergency, L-OVE was adapted to expand the range of evidence it covers and customised to group all COVID-19 evidence in one place. All the searches covered the period until April 23, 2020 (one day before submission). Eligibility criteria for selecting studies and methods We adapted an already published common protocol for multiple parallel systematic reviews to the specificities of this question. We searched for randomised trials evaluating the effect of cell-based therapies versus placebo or no treatment in patients with COVID-19. Anticipating the lack of randomised trials directly addressing this question, we also searched for trials evaluating other coronavirus infections, such as MERS-CoV and SARS-CoV, and non-randomised studies in COVID-19. Two reviewers independently screened each study for eligibility. A living, web-based version of this review will be openly available during the COVID-19 pandemic. We will resubmit it every time the conclusions change or whenever there are substantial updates. Results We screened 1,043 records but no study was considered eligible. We identified 61 ongoing studies, including 39 randomised trials evaluating different types of cell-based therapies in COVID-19. Conclusions We did not find any studies that met our inclusion criteria and hence there is no evidence to support or refute the use of cell-based therapies in the treatment of patients with COVID-19. A substantial number of ongoing studies should provide valuable evidence to inform researchers and decision makers in the near future. PROSPERO Registration number CRD42020179711 Box 1 Linked resources in this Living Systematic Review Common protocol Common protocol for the systematic reviews and overviews of systematic reviews being conducted by the COVID-19 L·OVE Working Group. Available here Living review Web version of this systematic review, presented in a ‘living systematic review format’. This means it is continuously updated as soon as new evidence emerges. Available here Living OVerview of Evidence - L·OVE An open platform that uses artificial intelligence and a broad network of contributors to identify all of the evidence relevant to this and other healthcare questions, including those related to COVID-19. Available here

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Biomarkers predictive of treatment response in psoriasis and psoriatic arthritis: a systematic review

Therapeutic Advances in Musculoskeletal Disease ◽

10.1177/1759720x211014010 ◽

2021 ◽

Vol 13 ◽

pp. 1759720X2110140

Author(s):

Conor Magee ◽

Hannah Jethwa ◽

Oliver M. FitzGerald ◽

Deepak R. Jadon

Keyword(s):

Systematic Review ◽

Psoriatic Arthritis ◽

Treatment Response ◽

Unmet Need ◽

Response To Treatment ◽

Cochrane Library ◽

Original Research ◽

Eligibility Criteria ◽

Psoriatic Disease ◽

Subsequent Response

Aims: The ability to predict response to treatment remains a key unmet need in psoriatic disease. We conducted a systematic review of studies relating to biomarkers associated with response to treatment in either psoriasis vulgaris (PsV) or psoriatic arthritis (PsA). Methods: A search was conducted in PubMed, Embase and the Cochrane library from their inception to 2 September 2020, and conference proceedings from four major rheumatology conferences. Original research articles studying pre-treatment biomarker levels associated with subsequent response to pharmacologic treatment in either PsV or PsA were included. Results: A total of 765 articles were retrieved and after review, 44 articles (22 relating to PsV and 22 to PsA) met the systematic review’s eligibility criteria. One study examined the response to methotrexate, one the response to tofacitinib and all the other studies to biologic disease-modifying antirheumatic drugs (DMARDs). Whilst several studies examined the HLA-C*06 allele in PsV, the results were conflicting. Interleukin (IL)-12 serum levels and polymorphisms in the IL-12B gene show promise as biomarkers of treatment response in PsV. Most, but not all, studies found that higher baseline levels of C-reactive protein (CRP) were associated with a better clinical response to treatment in patients with PsA. Conclusion: Several studies have identified biomarkers associated with subsequent response to treatment in psoriatic disease. However, due to the different types of biomarkers, treatments and outcome measures used, firm conclusions cannot be drawn. Further validation is needed before any of these biomarkers translate to clinical practice.

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Sexual health and COVID-19: protocol for a scoping review

Systematic Reviews ◽

10.1186/s13643-021-01591-y ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Navin Kumar ◽

Kamila Janmohamed ◽

Kate Nyhan ◽

Laura Forastiere ◽

Wei-Hong Zhang ◽

...

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Sexual Health ◽

Scoping Review ◽

Current Knowledge ◽

Grey Literature ◽

Well Being ◽

World Health ◽

Original Research ◽

Scoping Reviews

Abstract Background Global responses to the COVID-19 pandemic have exposed and exacerbated existing socioeconomic and health inequities that disproportionately affect the sexual health and well-being of many populations, including people of color, ethnic minority groups, women, and sexual and gender minority populations. Although there have been several reviews published on COVID-19 and health disparities across various populations, none has focused on sexual health. We plan to conduct a scoping review that seeks to fill several of the gaps in the current knowledge of sexual health in the COVID-19 era. Methods A scoping review focusing on sexual health and COVID-19 will be conducted. We will search (from January 2020 onwards) CINAHL, Africa-Wide Information, Web of Science Core Collection, Embase, Gender Studies Database, Gender Watch, Global Health, WHO Global Literature on Coronavirus Disease Database, WHO Global Index Medicus, PsycINFO, MEDLINE, and Sociological Abstracts. Grey literature will be identified using Disaster Lit, Google Scholar, governmental websites, and clinical trials registries (e.g., ClinicalTrial.gov, World Health Organization, International Clinical Trials Registry Platform, and International Standard Randomized Controlled Trial Number Registry). Study selection will conform to the Joanna Briggs Institute Reviewers’ Manual 2015 Methodology for JBI Scoping Reviews. Only English language, original studies will be considered for inclusion. Two reviewers will independently screen all citations, full-text articles, and abstract data. A narrative summary of findings will be conducted. Data analysis will involve quantitative (e.g., frequencies) and qualitative (e.g., content and thematic analysis) methods. Discussion Original research is urgently needed to mitigate the risks of COVID-19 on sexual health. The planned scoping review will help to address this gap. Systematic review registrations Systematic Review Registration: Open Science Framework osf/io/PRX8E

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Socioeconomic inequalities in primary-care and specialist physician visits: a systematic review

International Journal for Equity in Health ◽

10.1186/s12939-020-01375-1 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Sara Lena Lueckmann ◽

Jens Hoebel ◽

Julia Roick ◽

Jenny Markert ◽

Jacob Spallek ◽

...

Keyword(s):

Systematic Review ◽

Primary Care ◽

Primary Care Physicians ◽

Web Of Science ◽

Adult Population ◽

Socioeconomic Inequalities ◽

Eligibility Criteria ◽

Physician Visits ◽

General Adult Population ◽

Registration Number

Abstract Background Utilization of primary-care and specialist physicians seems to be associated differently with socioeconomic status (SES). This review aims to summarize and compare the evidence on socioeconomic inequalities in consulting primary-care or specialist physicians in the general adult population in high-income countries. Methods We carried out a systematic search across the most relevant databases (Web of Science, Medline) and included all studies, published since 2004, reporting associations between SES and utilization of primary-care and/or specialist physicians. In total, 57 studies fulfilled the eligibility criteria. Results Many studies found socioeconomic inequalities in physician utilization, but inequalities were more pronounced in visiting specialists than primary-care physicians. The results of the studies varied strongly according to the operationalization of utilization, namely whether a physician was visited (probability) or how often a physician was visited (frequency). For probabilities of visiting primary-care physicians predominantly no association with SES was found, but frequencies of visits were higher in the most disadvantaged. The most disadvantaged often had lower probabilities of visiting specialists, but in many studies no link was found between the number of visits and SES. Conclusion This systematic review emphasizes that inequalities to the detriment of the most deprived is primarily a problem in the probability of visiting specialist physicians. Healthcare policy should focus first off on effective access to specialist physicians in order to tackle inequalities in healthcare. PROSPERO registration number CRD42019123222.

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Efficacy and safety of instantaneous wave-free ratio in patients undergoing coronary revascularisation: protocol for a systematic review

BMJ Open ◽

10.1136/bmjopen-2017-017868 ◽

2017 ◽

Vol 7 (9) ◽

pp. e017868

Author(s):

Joey S.W. Kwong ◽

Sheyu Li ◽

Wan-Jie Gu ◽

Hao Chen ◽

Chao Zhang ◽

...

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Meta Analysis ◽

Adverse Outcomes ◽

Coronary Revascularisation ◽

Eligibility Criteria ◽

Registration Number ◽

Collection Form ◽

Randomised Controlled ◽

Meta Analyses

IntroductionEffective selection of coronary lesions for revascularisation is pivotal in the management of symptoms and adverse outcomes in patients with coronary artery disease. Recently, instantaneous ‘wave-free’ ratio (iFR) has been proposed as a new diagnostic index for assessing the severity of coronary stenoses without the need of pharmacological vasodilation. Evidence of the effectiveness of iFR-guided revascularisation is emerging and a systematic review is warranted.Methods and analysisThis is a protocol for a systematic review of randomised controlled trials and controlled observational studies. Electronic sources including MEDLINE via Ovid, Embase, Cochrane databases and ClinicalTrials.gov will be searched for potentially eligible studies investigating the effects of iFR-guided strategy in patients undergoing coronary revascularisation. Studies will be selected against transparent eligibility criteria and data will be extracted using a prestandardised data collection form by two independent authors. Risk of bias in included studies and overall quality of evidence will be assessed using validated methodological tools. Meta-analysis will be performed using the Review Manager software. Our systematic review will be performed according to the guidance from the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.Ethics and disseminationEthics approval is not required. Results of the systematic review will be disseminated as conference proceedings and peer-reviewed journal publication.Trial registration numberThis protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42017065460.

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Technology Acceptance in Healthcare: A Systematic Review

Applied Sciences ◽

10.3390/app112210537 ◽

2021 ◽

Vol 11 (22) ◽

pp. 10537

Author(s):

Adi A. AlQudah ◽

Mostafa Al-Emran ◽

Khaled Shaalan

Keyword(s):

Systematic Review ◽

Technology Acceptance ◽

Large Scale ◽

Empirical Studies ◽

Influential Factors ◽

Full Potential ◽

Eligibility Criteria ◽

Factors Affecting ◽

The Usa ◽

Healthcare Technologies

Understanding the factors affecting the use of healthcare technologies is a crucial topic that has been extensively studied, specifically during the last decade. These factors were studied using different technology acceptance models and theories. However, a systematic review that offers extensive understanding into what affects healthcare technologies and services and covers distinctive trends in large-scale research remains lacking. Therefore, this review aims to systematically review the articles published on technology acceptance in healthcare. From a yield of 1768 studies collected, 142 empirical studies have met the eligibility criteria and were extensively analyzed. The key findings confirmed that TAM and UTAUT are the most prevailing models in explaining what affects the acceptance of various healthcare technologies through different user groups, settings, and countries. Apart from the core constructs of TAM and UTAUT, the results showed that anxiety, computer self-efficacy, innovativeness, and trust are the most influential factors affecting various healthcare technologies. The results also revealed that Taiwan and the USA are leading the research of technology acceptance in healthcare, with a remarkable increase in studies focusing on telemedicine and electronic medical records solutions. This review is believed to enhance our understanding through a number of theoretical contributions and practical implications by unveiling the full potential of technology acceptance in healthcare and opening the door for further research opportunities.

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