scholarly journals Role of diffusional kurtosis imaging in grading of brain gliomas: a protocol for systematic review and meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e025123 ◽  
Author(s):  
Gehad Abdalla ◽  
Eser Sanverdi ◽  
Pedro M Machado ◽  
Joey S W Kwong ◽  
Jasmina Panovska-Griffiths ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Brain Tumours ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Histopathological Analysis ◽  
Low Grade ◽  
Diffusional Kurtosis Imaging ◽  
Non Invasive ◽  
Statistical Heterogeneity

IntroductionCentral nervous system (CNS) gliomas are the most common primary intra-axial brain tumours and pose variable treatment response according to their grade, therefore, precise staging is mandatory. Histopathological analysis of surgical tumour samples is still deemed as the state-of-the-art staging technique for gliomas due to the moderate specificity of the available non-invasive imaging modalities. A recently evolved analysis of the tissue water diffusion properties, known as diffusional kurtosis imaging (DKI), is a dimensionless metric, which quantifies water molecules’ degree of non-Gaussian diffusion, hence reflects tissue microenvironment’s complexity by means of non-invasive diffusion-weighted MRI acquisitions. The objective of this systematic review and meta-analysis is to explore the performance of DKI in the presurgical grading of gliomas, both regarding the differentiation between high-grade and low-grade gliomas as well as the discrimination between gliomas and other intra-axial brain tumours.Methods and analysisWe will search PubMed, Medline via Ovid, Embase and Scopus in July 2018 for research studies published between January 1990 and June 2018 with no language restrictions, which have reported on the performance of DKI in diagnosing CNS gliomas. Robust inclusion/exclusion criteria will be applied for selection of eligible articles. Two authors will separately perform quality assessment according to the quality assessment of diagnostic accuracy studies-2 tool. Data will be extracted in a predesigned spreadsheet. A meta-analysis will be held using a random-effects model if substantial statistical heterogeneity is expected. The heterogeneity of studies will be evaluated, and sensitivity analyses will be conducted according to individual study quality.Ethics and disseminationThis work will be based on published studies; hence, it does not require institutional review board approval or ethics clearance. The results will be published in peer-reviewed journals.PROSPERO registration numberCRD42018099192.

scholarly journals Interventional radiology versus operative management for splenic injuries: a study protocol for a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e028172
Author(s):  
Masahiro Kashiura ◽  
Noritaka Yada ◽  
Kazuma Yamakawa
Keyword(s):  
Systematic Review ◽  
Interventional Radiology ◽  
Meta Analysis ◽  
Operative Management ◽  
Sensitivity Analyses ◽  
Definitive Treatment ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Statistical Heterogeneity ◽  
Non Operative Management

IntroductionOver the past decades, the treatment for blunt splenic injuries has shifted from operative to non-operative management. Interventional radiology such as splenic arterial embolisation generally increases the success rate of non-operative management. However, the type of intervention, such as the first definitive treatment for haemostasis (interventional radiology or surgery) in blunt splenic injuries is unclear. Therefore, we aim to clarify whether interventional radiology improves mortality in patients with blunt splenic trauma compared with operative management by conducting a systematic review and meta-analysis.Methods and analysisWe will search the following electronic bibliographic databases to retrieve relevant articles for the literature review: Medline, Embase and the Cochrane Central Register of Controlled Trials. We will include controlled trials and observational studies published until September 2018. We will screen search results, assess the study population, extract data and assess the risk of bias. Two review authors will extract data independently, and discrepancies will be identified and resolved through a discussion with a third author where necessary. Data from eligible studies will be pooled using a random-effects meta-analysis. Statistical heterogeneity will be assessed by using the Mantel-Haenszel χ² test and the I² statistic, and any observed heterogeneity will be quantified using the I² statistic. We will conduct sensitivity analyses according to several factors relevant for the heterogeneity.Ethics and disseminationOur study does not require ethical approval as it is based on the findings of previously published articles. This systematic review will provide guidance on selecting a method for haemostasis of splenic injuries and may also identify knowledge gaps that could direct further research in the field. Results will be disseminated through publication in a peer-reviewed journal and presentations at relevant conferences.PROSPERO registration numberCRD42018108304.

Occupational lifting and adverse pregnancy outcome: a systematic review and meta-analysis

2020 ◽  
Vol 77 (7) ◽  
pp. 496-505 ◽  
Author(s):  
Agathe Croteau
Keyword(s):  
Systematic Review ◽  
Pregnancy Outcome ◽  
Adverse Pregnancy Outcome ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Strength Of Evidence ◽  
Statistical Heterogeneity ◽  
Exposure Levels ◽  
Adverse Pregnancy ◽  
Explicit Criteria

This systematic review was conducted to help clarify the effect of lifting at work on pregnancy outcome, by focusing on specific exposure categories. A search in Medline and Embase identified 51 articles reporting association of spontaneous abortion (SA), preterm delivery (PTD) or small-for-gestational-age (SGA) infant with exposure to occupational lifting. A global validity score was assigned to each study and six potential sources of bias were considered in sensitivity analyses. For each exposure–outcome combination, a summary risk estimate (RE) was obtained from all studies and from a subset of studies with high validity score, this latter summary RE was selected as a final result. Statistical heterogeneity was measured with I2 and Q tests and the possibility of a publication bias was also assessed. For each meta-analysis, the strength of evidence was established from explicit criteria. Heavy (or ≥10 kg) loads often (or ≥10x/day) lifted were associated with increased risks of SA (summary RE=1.31, 95% CI 1.17 to 1.47) and PTD (summary RE=1.24, 95% CI 1.07 to 1.43), with good strength of evidence. No association was identified with SGA, nor with lower exposure levels and SA or PTD. These results are reassuring for lower levels of exposure; however, observed associations can guide health professionals’ recommendations aimed at the prevention of SA and PTD for pregnant women who frequently lift (or ≥10x/day) heavy (or ≥10 kg) loads at work.Résumé

scholarly journals BIOM-12. CIRCULATING TUMOR DNA IN ADULTS WITH GLIOMA: A SYSTEMATIC REVIEW AND META-ANALYSIS OF BIOMARKER SENSITIVITY

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii3-ii4
Author(s):  
James McMahon ◽  
Matthew Studer ◽  
Bryan Ulrich ◽  
Gustavo Pradilla
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Circulating Tumor Dna ◽  
Low Grade ◽  
High Grade ◽  
Who Grade ◽  
Targeted Next Generation Sequencing ◽  
Non Invasive ◽  
Performance Statistics ◽  
Tumor Dna

Abstract BACKGROUND Circulating tumor DNA (ctDNA) has emerged as a promising non-invasive biomarker to capture tumor genetics in patients with primary brain tumors. Research into its clinical utility, however, has not been standardized, as performance statistics of ctDNA remain undefined and optimal ctDNA assay and biospecimen sources for its evaluation have not been conclusively identified. We sought to determine a pooled sensitivity of the detection ctDNA in both CSF in plasma when compared to detecting the same mutant DNA in tumor tissue of gliomas. We then sought to compare ctDNA sensitivity between these two reservoirs, as well as between individual WHO grades of glioma. METHODS Following PRISMA guidelines, systematic review and meta-analysis was performed using published studies that assessed circulating tumor DNA in either plasma or CSF among adult patients with histopathology-confirmed glioma. Weighting of individual studies was conducted to reach an overall pooled sensitivity of ctDNA detection in both CSF and plasma. Chi-squared tests of independence were performed to compare overall sensitivity of ctDNA in CSF versus plasma, as well as to estimate the sensitivity of ctDNA for each WHO grade of glioma. RESULTS The overall reported sensitivity of ctDNA in CSF was found to be 77.4%, significantly higher than the 38.8% sensitivity in plasma (p< 0.0001). Sensitivity was significantly higher for high grade (82.8%) than low grade (60.5%) tumors in CSF (p=0.0023), and sensitivity was found to sequentially increase with increasing WHO grade. Qualitative analysis revealed evidence of greater sensitivity among single-allele PCR or small targeted next generation sequencing (NGS) panels, and increased sensitivity among larger tumors and those in proximity to cisternal or ventricular CSF. CONCLUSION Circulating tumor DNA is potentially a highly sensitive non-invasive biomarker among adults with gliomas. To maximize its sensitivity, CSF should be studied with targeted genetic analysis platforms, particularly in suspected high-grade gliomas.

Reference Ranges for Vermis Biometry on Prenatal Ultrasound: Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Joshua I Rosenbloom ◽  
Lauren H. Yaeger ◽  
Shay Porat
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Large Sample Size ◽  
Reference Ranges ◽  
Maternal Characteristics ◽  
Anteroposterior Diameter ◽  
Normal Ranges ◽  
Statistical Heterogeneity

Abstract Purpose To conduct a systematic review and meta-analysis of published nomograms for fetal vermis biometry. Materials and Methods A structured literature search was conducted to identify studies that reported normal measurements of the fetal vermis. A customized quality assessment tool was used to review the selected articles. Random effects meta-analysis was used to calculate normal ranges for vermian craniocaudal diameter, anteroposterior diameter, and surface area. Results A total of 21 studies were included for qualitative review and 3 studies were included for quantitative synthesis. The 3 included articles comprised a total of 10 910 measurements from gestational ages 17–35 weeks. The quality assessment demonstrated that there was generally poor reporting regarding maternal characteristics and neonatal outcomes. Except for one article with a large sample size, the mean number of fetuses per week of gestational age was 15.9, with the lowest number being 5. There was significant statistical heterogeneity. Non-visualization rates ranged from 0–35.4 %. The craniocaudal diameter (reported in 3 articles) increased from a mean of 7.90 mm (95 % confidence interval [CI] 7.42, 8.38) at 17 weeks to 21.90 mm (95 % CI 20.63, 23.16) at 35 weeks gestation. The anteroposterior diameter (reported in 2 articles) increased from 6.30 mm (95 % CI 5.42, 7.18) at 17 weeks to 15.85 (95 %CI 15.49, 16.21) at 32 weeks. Conclusion Reference ranges for vermis biometry across gestation based on meta-analysis of existing references are provided. However, because many of the underlying studies suffered from significant methodological issues, the ranges should be used with caution.

C-Reactive Protein for Prediction or Early Detection of Pre-Eclampsia: A Systematic Review

2021 ◽  
pp. 1-14
Author(s):  
Rola Hamadeh ◽  
Amani Mohsen ◽  
Firas Kobeissy ◽  
Ali Karouni ◽  
Hikmat Akoum
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Meta Analysis ◽  
Significant Risk ◽  
Positive Association ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Statistical Heterogeneity

<b><i>Objective:</i></b> Pre-eclampsia (PE) is a serious disease of pregnancy and one of the major causes of morbidity and mortality for both the mother and baby. This systematic review aims to detect the role of high-sensitivity C-reactive protein (CRP) in the detection of PE. <b><i>Methods:</i></b> Thirty-four articles published between 2001 and 2019 were included in this review. The articles were extracted from OVID Medline and Embase. The study designs of these articles are randomized controlled, cohort, case-control, and cross-sectional studies evaluating CRP as a marker to predict or early diagnose PE. The quality assessment of these articles is made by the modified Quality Assessment of Diagnostic Accuracy Studies 2 tool. Meta-analysis was not done because of clinical and statistical heterogeneity. <b><i>Results:</i></b> A positive association between CRP levels and the development of PE was confirmed in 18 studies. This positive effect was addressed in patients with normal BMI (&#x3c;25 kg/m<sup>2</sup>) in 3 studies and in overweight patients in 2 studies. One study addressed this positive association in patients with a BMI ranging between 28 and 31 kg/m<sup>2</sup>. Three studies determined a cutoff level of CRP above which a significant risk of PE development should be suspected. These levels ranged between 7 and 15 mg/L. <b><i>Conclusion:</i></b> CRP is a promising cost-effective biomarker that may be used in the prediction of PE. A CRP level higher than 15 mg/L may suggest initiation of low-dose aspirin in low-risk pregnancies.

scholarly journals Ultrasound for Breast Cancer Detection Globally: A Systematic Review and Meta-Analysis

2019 ◽  
pp. 1-17 ◽  
Author(s):  
Rupali Sood ◽  
Anne F. Rositch ◽  
Delaram Shakoor ◽  
Emily Ambinder ◽  
Kara-Lee Pool ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Quality Assessment ◽  
Meta Analysis ◽  
High Sensitivity ◽  
Sensitivity Analyses ◽  
Bias Analysis ◽  
Middle Income ◽  
Bias Level ◽  
Handheld Ultrasound

PURPOSE Mammography is not always available or feasible. The purpose of this systematic review and meta-analysis is to assess the diagnostic performance of ultrasound as a primary tool for early detection of breast cancer. MATERIALS AND METHODS For this systematic review and meta-analysis, we comprehensively searched PubMed and SCOPUS to identify articles from January 2000 to December 2018 that included data on the performance of ultrasound for detection of breast cancer. Studies evaluating portable, handheld ultrasound as an independent detection modality for breast cancer were included. Quality assessment and bias analysis were performed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Sensitivity analyses and meta-regression were used to explore heterogeneity. The study protocol has been registered with the international prospective register of systematic reviews (PROSPERO identifier: CRD42019127752). RESULTS Of the 526 identified studies, 26 were eligible for inclusion. Ultrasound had an overall pooled sensitivity and specificity of 80.1% (95% CI, 72.2% to 86.3%) and 88.4% (95% CI, 79.8% to 93.6%), respectively. When only low- and middle-income country data were considered, ultrasound maintained a diagnostic sensitivity of 89.2% and specificity of 99.1%. Meta-analysis of the included studies revealed heterogeneity. The high sensitivity of ultrasound for the detection of breast cancer was not statistically significantly different in subgroup analyses on the basis of mean age, risk, symptoms, study design, bias level, and study setting. CONCLUSION Given the increasing burden of breast cancer and infeasibility of mammography in certain settings, we believe these results support the potential use of ultrasound as an effective primary detection tool for breast cancer, which may be beneficial in low-resource settings where mammography is unavailable.

Abstract 10508: Variation in Community and Emergency Medical Systems Processes for Out-of-Hospital Cardiac Arrest During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Yoshio Masuda ◽  
Seth E Teoh ◽  
Darren J Tan ◽  
Marcus E Ong ◽  
Andrew F Ho ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Arrest ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Bibliographic Databases ◽  
Medical Systems ◽  
Process Measures ◽  
Emergency Medical ◽  
Statistical Heterogeneity ◽  
Chain Of Survival

Introduction: Bystander cardiopulmonary resuscitation (B-CPR) with early defibrillation and immediate emergency medical services (EMS) care significantly increases a victim's chance of survival from out-of-hospital sudden cardiac arrest (OHCA). Few studies have assessed the overall effect of the COVID-19 pandemic on the prehospital chain of survival. Objectives: We sought to quantify the effect of the COVID-19 pandemic on prehospital processes including B-CPR, bystander defibrillation, community characteristics, and EMS process measures. We hypothesized that B-CPR rates would decrease and OHCA occurring in the home would increase during the pandemic. Methods: We conducted a systematic review and meta-analysis of studies identified through 05/03/2021. We examined 5 bibliographic databases and searched terms including cardiac arrest, OHCA, and COVID-19. Data were abstracted and independently coded. Subgroup analysis and meta-regression analysis were performed. Our primary outcome was B-CPR; our secondary outcomes were community processes and EMS characteristics. Results: The original search yielded 966 articles; 20 articles were included in our analysis. Studies originated from 10 different countries and were retrospective in study design. There was no difference in B-CPR rates during COVID-19 compared to Pre-COVID-19 (OR: 0.94 (0.80-1.11), p=0.46). Patients had a 1.38 (1.11-1.71) higher likelihood of having an OHCA at home during COVID-19 compared to Pre-COVID-19 (p=0.01). Receipt of bystander defibrillation was significantly lower during COVID-19 compared to Pre-COVID-19 (OR: 0.65 (0.48-0.88), p=0.01). There was a significant increase in EMS call to arrival time during COVID-19 compared to Pre-COVID-19 (Mean difference in minutes= 0.27 (0.13-0.40), p<0.01). Statistical heterogeneity was moderate-to-high; findings were robust to sensitivity analyses with no publication bias detected. Conclusion: B-CPR rates remained unchanged during the pandemic, while OHCA in the home increased. Bystander defibrillation decreased, while EMS response time increased during the pandemic. These findings may inform future public programing, particularly to consider interventions to improve the prehospital chain of survival.

scholarly journals Role of diffusional kurtosis imaging in grading of brain gliomas: A diagnostic test accuracy systematic review and meta-analysis

2019 ◽  
Vol 21 (Supplement_4) ◽  
pp. iv12-iv12
Author(s):  
Gehad Abdalla ◽  
Eser Sanverdi ◽  
Pedro M Machado ◽  
Joey S W Kwong ◽  
Jasmina Panovska-Griffiths ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Test Accuracy ◽  
Low Grade ◽  
Moderate Degree ◽  
Diffusional Kurtosis Imaging ◽  
Low Grade Gliomas ◽  
Effect Model

Abstract Aim and objectives We aim to illustrate the diagnostic performance of diffusional kurtosis imaging (DKI) in the diagnosis of gliomas. Methods and materials A review protocol was developed according to the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P), registered in the international prospective register of systematic reviews, PROSPERO and published. Literature search in 4 databases was performed using the keywords “glioma” and “diffusional kurtosis”.After applying a robust inclusion/exclusion criteria, included articles were independently evaluated according to the QUADAS-2 tool.Data extraction was done in a pre-designed pro forma.Reported sensitivities and specificities were used to construct 2x2 tables and paired forest plots using the Review Manager (RevMan®) software.Random-effect model was pursued using the hierarchical summary receiver operator characteristics. Results Initially, 216 hits were retrieved. Considering duplicates and inclusion criteria; 23 articles were eligible for full-text reading. Ultimately, 19 studies were deemed to be eligible for final inclusion. Quality assessment revealed 9 studies with low risk of bias in the 4 domains. Using a bivariate random-effect model for data synthesis; summary ROC curve showed pooled area under the curve (AUC) of 0.92 and estimated sensitivity of 0.87 (95% CI: 0.78 - 0.92) in high/low grade gliomas’ differentiation.A mean difference in Mean Kurtosis (MK) value between HGG and LGG of 0.22 [95% CI: 0.25 - 0.19] was illustrated (p value = 0.0014) and a moderate degree of heterogeneity (I²= 73.8%). Conclusion DKI shows good diagnostic accuracy in high/low grade gliomas’ differentiation; which might qualify it to be part of the routine clinical practice, however; further evidence is deemed for technique standardization.

scholarly journals The Association Between Periodontitis and Erectile Dysfunction: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 15 (3) ◽  
pp. 155798832110072
Author(s):  
Fathima Farook ◽  
Azzam Al Meshrafi ◽  
Nuzaim Mohamed Nizam ◽  
Abdulsalam Al Shammari
Keyword(s):  
Systematic Review ◽  
Erectile Dysfunction ◽  
Quality Assessment ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Increased Risk ◽  
Statistical Heterogeneity ◽  
High Degree

The objective of this study is to investigate the association between periodontitis (PD) and erectile dysfunction (ED). A systematic review and meta-analysis on data was extracted and conducted according to PRISMA. Relevant articles were selected from a literature search using MEDLINE, EMBASE, Scopus, Web of Science and CENTRAL from inception until August 2, 2020. Both randomized and nonrandomized controlled studies were included. Case reports, case series, nonsystematic reviews and trials published as abstract were excluded. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were used to estimate the association between PD and the risk of ED. The meta-analysis was conducted with RevMan 5.3. Methodological quality assessment was carried out using the Newcastle-Ottawa Quality Assessment Scale and the quality of evidence was assessed using the GRADE approach. Six articles (215008 subjects) were included for analysis. Of the participants, 38,675 cases were compared to 1,76,333 healthy controls. Based on the random effects model, periodontitis was associated with an increased risk of ED (OR = 2.56, 95% CI: 1.70–3.85) as compared with the non-periodontitis individuals. The findings were statistically significant with a p < .0001. The statistical heterogeneity was high across all studies ( I2 = 98%, p < .00001). Estimates of total effects were generally consistent with the sensitivity and subgroup analyses. Within the limits of the available evidence, our review and meta-analysis showed that a significant association exists between the PD and ED. The results should be interpreted with caution due to high degree of inconsistency across all the studies.

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