scholarly journals Right versus left thoracic approach oesophagectomy for oesophageal cancer: a systematic review and meta-analysis protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e030157
Author(s):  
Tianci Chai ◽  
Zhimin Shen ◽  
Sui Chen ◽  
Yuhan Lin ◽  
Zhenyang Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Oesophageal Cancer ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Malignant Tumours ◽  
Central Register ◽  
Registration Number ◽  
Thoracic Approach ◽  
Randomised Controlled

IntroductionOesophageal cancer is one of the most common malignant tumours and has been identified as one of the leading causes of cancer death worldwide. Surgery is considered to be the optimal treatment for patients with resectable oesophageal cancer. Oesophagectomy for oesophageal cancer can significantly extend the survival period of patients and provide a potential opportunity for a cure. However, there is still controversy regarding which thoracic approach (right or left) during oesophagectomy for oesophageal cancer can lead to better surgical outcomes globally. This systematic review and meta-analysis will be performed to determine which thoracic approach during oesophagectomy will achieve longer patient survival and will be more beneficial for patients.Methods and analysisWe will search PubMed, Web of Science, Embase, Cancerlit, the Cochrane Central Register of Controlled Trials and Google Scholar databases for relevant clinical trials published in any language before 1 October 2019. Randomised controlled trials (RCTs), quasi-RCTs, propensity score-matched comparative studies and prospective cohort studies of interest, published or unpublished, that meet the inclusion criteria will be included. Subgroup analysis of the type of operation, tumour pathological stage and ethnicity will be performed.PROSPERO registration numberCRD42019124133.Ethics and disseminationBecause this study will be based on published or unpublished records and studies, there is no need for ethics approval. The results of the study will be published in a peer-reviewed journal.

scholarly journals Self-care interventions in stroke survivor–caregiver dyads: a protocol for systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e051860
Author(s):  
Wenna Wang ◽  
Beilei Lin ◽  
Yongxia Mei ◽  
Zhenxiang Zhang ◽  
Bing Zhou
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Self Care ◽  
Stroke Survivor ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Systematic Assessment ◽  
Ethical Approval ◽  
Registration Number ◽  
Randomised Controlled

IntroductionStroke is known as one of the leading causes of mortality and disability worldwide. Self-care plays a significant role in improving the quality of life, self-efficacy and many other outcomes of stroke survivors. However, it is a dyadic phenomenon where patient self-care and the caregiver contribution to self-care are inter-related in terms of predictors and outcomes. Currently, there is still no systematic assessment conducted to examine the overall effectiveness of self-care interventions carried out in stroke survivor–caregiver dyads and explore the effect on stroke survivor and/or caregiver outcomes.MethodsWe plan to conduct a systematic review and meta-analysis of the evidence regarding the self-care interventions carried out in stroke survivor–caregiver dyads. We will undertake a systematic search of multiple databases including PubMed, Web of Science, CINAHL, PsycINFO, EMBASE, Cochrane Central Register of Controlled Trials and four Chinese databases (CNKI, CBM, WANFANG and VIP) from inception to July 2021 for the purpose of collecting the relevant articles. The eligible studies are defined as those original researches, written in English or Chinese, on self-care interventions in stroke survivor–caregiver dyad samples. Two independent researchers will be deployed to identify the eligible trials according to the selection criteria and extract the relevant data. The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols checklist has been used for this protocol. We will use the Cochrane Risk for Bias tool to assess the risk of bias for randomised controlled trials.Ethics and disseminationIn our review, any identifiable patient data will be excluded, which removes the need for ethical approval and participant consent. The final results of our study will be published in an open-access peer-reviewed journal, and abstract will be presented at suitable national/international conferences.PROSPERO registration numberCRD42021239824.

scholarly journals Efficacy of pharmacological therapies for the treatment of opioid-induced constipation: systematic review and network meta-analysis

Gut ◽  
2018 ◽  
Vol 68 (3) ◽  
pp. 434-444 ◽  
Author(s):  
Pavit Luthra ◽  
Nicholas E Burr ◽  
Darren M Brenner ◽  
Alexander C Ford
Keyword(s):  
Systematic Review ◽  
Current Knowledge ◽  
Meta Analysis ◽  
Response To Therapy ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Primary Analysis ◽  
Central Register ◽  
Bowel Movements ◽  
Randomised Controlled

ObjectiveOpioids are increasingly prescribed in the West and have deleterious GI consequences. Pharmacological therapies to treat opioid-induced constipation (OIC) are available, but their relative efficacy is unclear. We performed a systematic review and network meta-analysis to address this deficit in current knowledge.DesignWe searched MEDLINE, EMBASE, EMBASE Classic and the Cochrane central register of controlled trials through to December 2017 to identify randomised controlled trials (RCTs) of pharmacological therapies in the treatment of adults with OIC. Trials had to report a dichotomous assessment of overall response to therapy, and data were pooled using a random effects model. Efficacy and safety of pharmacological therapies was reported as a pooled relative risk (RR) with 95% CIs to summarise the effect of each comparison tested and ranked treatments according to their P-score.ResultsTwenty-seven eligible RCTs of pharmacological therapies, containing 9149 patients, were identified. In our primary analysis, using failure to achieve an average of ≥3 bowel movements (BMs) per week with an increase of ≥1 BM per week over baseline or an average of ≥3 BMs per week, to define non-response, the network meta-analysis ranked naloxone first in terms of efficacy (RR=0.65; 95% CI 0.52 to 0.80, P-score=0.84), and it was also the safest drug. When non-response to therapy was defined using failure to achieve an average of ≥3 BMs per week, with an increase of ≥1 BM per week over baseline, naldemedinewas ranked first (RR=0.66; 95% CI 0.56 to 0.77, P score=0.91) and alvimopan second (RR=0.74; 95% CI 0.57 to 0.94, P-score=0.71).ConclusionIn network meta-analysis, naloxone and naldemedine appear to be the most efficacious treatments for OIC. Naloxone was the safest of these agents.

scholarly journals Acknowledging the gap: a systematic review of micronutrient supplementation in infants under six months of age

2020 ◽  
Vol 5 ◽  
pp. 238
Author(s):  
Isabella Stelle ◽  
Sruthi Venkatesan ◽  
Karen Edmond ◽  
Sophie E Moore
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Micronutrient Supplementation ◽  
Micronutrient Deficiencies ◽  
Term Infants ◽  
Middle Income ◽  
Central Register ◽  
Randomised Controlled

Background: Micronutrient deficiencies remain common worldwide, but the consequences to growth and development in early infancy (under six months of age) are not fully understood. We present a systematic review of micronutrient interventions in term infants under six months of age, with a specific focus on iron supplementation. Methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid) and Embase (Ovid) from January 1980 through December 2019. Interventions included iron or multiple micronutrients (MMNs). Results: Of 11,109 records identified, 32 publications from 23 trials were included (18 iron and five MMN supplementation trials). All 23 trials evaluated the effect of supplementation on biochemical outcomes, ten reported on growth, 14 on morbidity and/or mortality and six on neuro-behavioural development. Low- and middle- income countries made up 88% (21/24) of the total trial locations. Meta-analysis was not possible due to extensive heterogeneity in both exposure and outcome measures.  However, these trials indicated that infants less than six months of age benefit biochemically from early supplementation with iron, but the effect of additional nutrients or MMNs, along with the impacts on growth, morbidity and/or mortality, and neuro-behavioural outcomes remain unclear. Conclusions: Infants less than six months of age appear to benefit biochemically from micronutrient supplementation. However, well-powered randomised controlled trials are required to determine whether routine supplementation with iron or MMNs containing iron should commence before six months of life in exclusively breast-fed infants in low-resource settings.

scholarly journals Effects of advanced life support versus basic life support on the mortality rates of patients with trauma in prehospital settings: a study protocol for a systematic review and meta-analysis

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e016912 ◽  
Author(s):  
Yutaka Kondo ◽  
Tatsuma Fukuda ◽  
Ryo Uchimido ◽  
Toru Hifumi ◽  
Kei Hayashida
Keyword(s):  
Systematic Review ◽  
Basic Life Support ◽  
Life Support ◽  
Meta Analysis ◽  
Advanced Life Support ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Evaluation Approach ◽  
Registration Number ◽  
Randomised Controlled

IntroductionAdvanced life support (ALS) is thought to be associated with improved survival in prehospital trauma care when compared with basic life support (BLS). However, evidence on the benefits of prehospital ALS for patients with trauma is controversial. Therefore, we aim to clarify if ALS improves mortality in patients with trauma when compared with BLS by conducting a systematic review and meta-analysis of the recent literature.Methods and analysisWe will perform searches in PubMed, Embase and the Cochrane Central Register of Controlled Trials for published observational studies, controlled before-and-after studies, randomised controlled trials and other controlled trials conducted in humans and published until March 2017. We will screen search results, assess study selection, extract data and assess the risk of bias in duplicate; disagreements will be resolved through discussions. Data from clinically homogeneous studies will be pooled using a random-effects meta-analysis, heterogeneity of effects will be assessed using the χ2test of homogeneity, and any observed heterogeneity will be quantified using the I2statistic. Last, the Grading of Recommendations Assessment, Development and Evaluation approach will be used to rate the quality of the evidence.Ethics and disseminationOur study does not require ethical approval as it is based on findings of previously published articles. Results will be disseminated through publication in a peer-reviewed journal, presentations at relevant conferences and publications for patient information.Trial registration numberPROSPERO (International Prospective Register of Systematic Reviews) registration number CRD42017054389.

Functional cortical changes associated with shoulder instability – a systematic review

2021 ◽  
pp. 175857322110190
Author(s):  
Morissa F Livett ◽  
Deborah Williams ◽  
Hayley Potter ◽  
Melinda Cairns
Keyword(s):  
Systematic Review ◽  
Joint Instability ◽  
Glenohumeral Joint ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Cortical Function ◽  
High Quality Research ◽  
Central Register ◽  
Rehabilitative Measures ◽  
Randomised Controlled

Background Glenohumeral joint instability is associated with structural deficits and/or alterations in sensory and motor processing; however, a proportion of patients with glenohumeral joint instability fail to respond to surgical and rehabilitative measures. This systematic review aimed to establish if functional cortical changes occur in patients with glenohumeral joint instability. Methods AMED, CINAHL, Cochrane Central Register of Controlled Trials, Embase, Medline, PEDro, Pubmed, PsychINFO and Scopus were searched from inception to 17 March 2021. Randomised controlled trials and non-randomised trials were included and quality was appraised using the Downs and Black tool. Results One thousand two hundred seventy-nine records were identified of which five were included in the review. All studies showed altered cortical function when comparing instability patients with healthy controls and included areas associated with higher cortical functions. Discussion The findings of this systematic review offer some insight as to why interventions addressing peripheral pathoanatomical factors in patients with glenohumeral joint instability may fail in some cases due to functional cortical changes. However, data are of moderate to high risk of bias. Further high-quality research is required to ascertain the degree of functional cortical changes associated with the type and duration of glenohumeral joint instability.

scholarly journals Fluid resuscitation in paediatric burns: how do we get it right? A systematic review of the evidence

2018 ◽  
Vol 104 (3) ◽  
pp. 280-285 ◽  
Author(s):  
Christopher Stutchfield ◽  
Anna Davies ◽  
Amber Young
Keyword(s):  
Systematic Review ◽  
Fluid Resuscitation ◽  
Primary Data ◽  
Controlled Trials ◽  
Burn Shock ◽  
Cochrane Central Register ◽  
Study Protocols ◽  
Central Register ◽  
Affect Patient Outcome ◽  
Randomised Controlled

BackgroundOptimal fluid resuscitation in children with major burns is crucial to prevent or minimise burn shock and prevent complications of over-resuscitation.ObjectivesTo identify studies using endpoints to guide fluid resuscitation in children with burns, review the range of reported endpoint targets and assess whether there is evidence that targeted endpoints impact on outcome.DesignSystematic review.MethodsMedline, Embase, Cinahl and the Cochrane Central Register of Controlled Trials databases were searched with no restrictions on study design or date. Search terms combined burns, fluid resuscitation, endpoints, goal-directed therapy and related synonyms. Studies reporting primary data regarding children with burns (<16 years) and targeting fluid resuscitation endpoints were included. Data were extracted using a proforma and the results were narratively reviewed.ResultsFollowing screening of 777 unique references, 7 studies fulfilled the inclusion criteria. Four studies were exclusively paediatric. Six studies used urine output (UO) as the primary endpoint. Of these, one set a minimum UO threshold, while the remainder targeted a range from 0.5–1.0 mL/kg/hour to 2–3 mL/kg/hour. No studies compared different UO targets. Heterogeneous study protocols and outcomes precluded comparison between the UO targets. One study targeted invasive haemodynamic variables, but this did not significantly affect patient outcome.ConclusionsFew studies have researched resuscitation endpoints for children with burns. Those that have done so have investigated heterogeneous endpoints and endpoint targets. There is a need for future randomised controlled trials to identify optimal endpoints with which to target fluid resuscitation in children with burns.

scholarly journals Efficacy of pharmacological therapies in patients with IBS with diarrhoea or mixed stool pattern: systematic review and network meta-analysis

Gut ◽  
2019 ◽  
Vol 69 (1) ◽  
pp. 74-82 ◽  
Author(s):  
Christopher J Black ◽  
Nicholas E Burr ◽  
Michael Camilleri ◽  
David L Earnest ◽  
Eamonn MM Quigley ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Meta Analysis ◽  
Composite Endpoint ◽  
Response To Therapy ◽  
Stool Consistency ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Once Daily ◽  
Central Register ◽  
Randomised Controlled

ObjectiveOver half of patients with IBS have either diarrhoea (IBS-D) or a mixed stool pattern (IBS-M). The relative efficacy of licenced pharmacological therapies is unclear in the absence of head-to-head trials. We conducted a network meta-analysis to resolve this uncertainty.DesignWe searched MEDLINE, Embase, Embase Classic, the Cochrane central register of controlled trials, and Clinicaltrials.gov through January 2019 to identify randomised controlled trials (RCTs) assessing the efficacy of licenced pharmacological therapies (alosetron, eluxadoline, ramosetron and rifaximin) in adults with IBS-D or IBS-M. Trials included in the analysis reported a dichotomous assessment of overall response to therapy, and data were pooled using a random effects model. Efficacy and safety of all pharmacological therapies were reported as a pooled relative risk with 95% CIs to summarise the effect of each comparison tested. Treatments were ranked according to their p score.ResultsWe identified 18 eligible RCTs (seven alosetron, five ramosetron, two rifaximin and four eluxadoline), containing 9844 patients. All were superior to placebo for the treatment of IBS-D or IBS-M at 12 weeks, according to the Food and Drug Administration (FDA)-recommended endpoint for trials in IBS. Alosetron 1 mg twice daily was ranked first for efficacy, based on the FDA-recommended composite endpoint of improvement in both abdominal pain and stool consistency, effect on global symptoms of IBS and effect on stool consistency. Ramosetron 2.5µg once daily was ranked first for effect on abdominal pain. Total numbers of adverse events were significantly greater with alosetron 1 mg twice daily and ramosetron 2.5µg once daily, compared with placebo. Rifaximin 550 mg three times daily ranked first for safety. Constipation was significantly more common with all drugs, except rifaximin 550 mg three times daily.ConclusionIn a network meta-analysis of RCTs of pharmacological therapies for IBS-D and IBS-M, we found all drugs to be superior to placebo, but alosetron and ramosetron appeared to be the most effective.

scholarly journals Should Finasteride Be Routinely Given Preoperatively for TURP?

ISRN Urology ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
O. M. Aboumarzouk ◽  
M. Z. Aslam ◽  
A. Wedderburn ◽  
K. Turner ◽  
O. Hughes ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Postoperative Bleeding ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Vascular Endothelial ◽  
Central Register ◽  
Language Restriction ◽  
Randomised Controlled ◽  
Endothelial Growth Factor

Objective. The aim of the review was to compare the use of finasteride to placebo in patients undergoing TURP procedures. Material & Methods. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1966–November 2011), EMBASE (1980–November 2011), CINAHL, Clinicaltrials.gov, Google Scholar, reference lists of articles, and abstracts from conference proceedings without language restriction for studies comparing finasteride to placebo patients needing TURPs. Results. Four randomised controlled trials were included comparing finasteride to a placebo. A meta-analysis was not conducted due to the disparity present in the results between the studies. Three of the studies found that finasteride could reduce either intra- or postoperative bleeding after TURP. One study found finasteride to significantly lower the microvessel density (MVD) and vascular endothelial growth factor (VEGF). None of the studies reported any long-term complications related to either the medication or the procedure. Conclusion. finasteride reduces bleeding either during or after TURP.

scholarly journals Lowering blood pressure after acute intracerebral haemorrhage: protocol for a systematic review and meta-analysis using individual patient data from randomised controlled trials participating in the Blood Pressure in Acute Stroke Collaboration (BASC)

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e030121 ◽  
Author(s):  
Tom J Moullaali ◽  
Xia Wang ◽  
Lisa J Woodhouse ◽  
Zhe Kang Law ◽  
Candice Delcourt ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Acute Stroke ◽  
Intracerebral Haemorrhage ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Patient Data ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Randomised Controlled

IntroductionConflicting results from multiple randomised trials indicate that the methods and effects of blood pressure (BP) reduction after acute intracerebral haemorrhage (ICH) are complex. The Blood pressure in Acute Stroke Collaboration is an international collaboration, which aims to determine the optimal management of BP after acute stroke including ICH.Methods and analysisA systematic review will be undertaken according to the Preferred Reporting Items for Systematic review and Meta-Analysis of Individual Participant Data (IPD) guideline. A search of Cochrane Central Register of Controlled Trials, EMBASE and MEDLINE from inception will be conducted to identify randomised controlled trials of BP management in adults with acute spontaneous (non-traumatic) ICH enrolled within the first 7 days of symptom onset. Authors of studies that meet the inclusion criteria will be invited to share their IPD. The primary outcome will be functional outcome according to the modified Rankin Scale. Safety outcomes will be early neurological deterioration, symptomatic hypotension and serious adverse events. Secondary outcomes will include death and neuroradiological and haemodynamic variables. Meta-analyses of pooled IPD using the intention-to-treat dataset of included trials, including subgroup analyses to assess modification of the effects of BP lowering by time to treatment, treatment strategy and patient’s demographic, clinical and prestroke neuroradiological characteristics.Ethics and disseminationNo new patient data will be collected nor is there any deviation from the original purposes of each study where ethical approvals were granted; therefore, further ethical approval is not required. Results will be reported in international peer-reviewed journals.PROSPERO registration numberCRD42019141136.

scholarly journals Effectiveness of complex multiple-risk lifestyle interventions in reducing symptoms of depression: a study protocol for a systematic review and meta-analysis of randomised controlled trials

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e026842 ◽  
Author(s):  
Irene Gómez-Gómez ◽  
Emma Motrico ◽  
Patricia Moreno-Peral ◽  
Alina Rigabert ◽  
Sonia Conejo-Cerón ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Depression Symptoms ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Lifestyle Interventions ◽  
Symptoms Of Depression ◽  
Multiple Risk ◽  
Randomised Controlled

IntroductionMany studies have explored the impact of lifestyle interventions on depression. However, little is known about the effectiveness of complex multiple-risk lifestyle interventions in reducing symptoms of depression. Our objective is to assess the effectiveness of complex multiple-risk lifestyle interventions in reducing depressive symptoms in the adult population by the acquisition of at least two healthy habits—healthy diet, physical activity and/or smoking cessation. For such purpose, a systematic review and meta-analysis of randomised controlled trials will be conducted.Method and analysisMEDLINE (through Ovid and PubMed), Scopus, Cochrane Central Register of Controlled Trials, Web of Science, PsycINFO, OpenGrey Register (System for Information on Grey Literature in Europe) and the International Clinical Trials Registry Platform will be searched for relevant articles. Additionally, a supplementary manual search will be performed using lists of references, references to expert authors and other systematic reviews and/or meta-analyses. Study selection, data extraction (target habits, country, target populations, conditions and statistical data to name a few) and assessment of the risk of bias will be performed separately by two independent researchers. The primary outcome measure will be the reduction of depression symptoms, as measured by validated instruments. We will calculate pooled standardised mean differences and 95% CIs using random-effect models. Heterogeneity, sensitivity and publication bias will be assessed, and sub-group analysis will be performed. Heterogeneity will be explored by random-effects meta-regression analysis.Ethics and disseminationEthical approval is not required for this study. The results of this systematic review and meta-analysis will be presented in relevant conferences and published in a peer-review journal. The findings of this study could have important clinical and scientific implications for the improvement of symptoms of depression.PROSPERO registration numberCRD42018100253; Pre-results.

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