scholarly journals Women’s leadership in academic medicine: a systematic review of extent, condition and interventions

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e032232 ◽  
Author(s):  
Lulu Alwazzan ◽  
Samiah S Al-Angari
Keyword(s):  
Systematic Review ◽  
Leadership Development ◽  
Academic Medicine ◽  
Medical Schools ◽  
Women's Leadership ◽  
Research Quality ◽  
Cochrane Library ◽  
Cross Sectional ◽  
Quantitative Studies ◽  
The Impact

ObjectivesBecause culture reflects leadership, the making of diverse and inclusive medical schools begins with diversity among leaders. The inclusion of women leaders remains elusive, warranting a systematic exploration of scholarship in this area. We ask: (1) What is the extent of women’s leadership in academic medicine? (2) What factors influence women’s leadership? (3) What is the impact of leadership development programmes?DesignSystematic review.Data sourcesA systematic search of six online databases (OvidMEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Library and ERIC) from the earliest date available to April 2018 was conducted. Bridging searches were conducted from April 2018 until October 2019.Eligibility criteria(1) Peer-reviewed; (2) English; (3) Quantitative studies (prospective and retrospective cohort, cross-sectional and preintervention/postintervention); evaluating (4) The extent of women’s leadership at departmental, college and graduate programme levels; (5) Factors influencing women’s leadership; (6) Leadership development programmes. Quantitative studies that explored women’s leadership in journal editorial boards and professional societies and qualitative study designs were excluded.Data extraction and synthesisTwo reviewers screened retrieved data of abstracts and full-texts for eligibility, assessment and extracted study-level data independently. The included studies were objectively appraised using the Medical Education Research Quality Study Instrument with an inter-rater reliability of (κ=0.93).ResultsOf 4024 records retrieved, 40 studies met the inclusion criteria. The extent of women’s leadership was determined through gender distribution of leadership positions. Women’s leadership emergence was hindered by institutional requirements such as research productivity and educational credentials, while women’s enactment of leadership was hindered by lack of policy implementation. Leadership development programmes had a positive influence on women’s individual enactment of leadership and on medical schools’ cultures.ConclusionsScholarship on women’s leadership inadvertently produced institute-centric rather than women-centric research. More robust contextualised scholarship is needed to provide practical-recommendations; drawing on existing conceptual frameworks and using more rigorous research methods.

scholarly journals Prevalence of delirium, depression, anxiety, and post-traumatic stress disorder among COVID-19 patients: protocol for a living systematic review

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Jiyuan Shi ◽  
Ya Gao ◽  
Liang Zhao ◽  
Yuanyuan Li ◽  
Meili Yan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Virus Disease ◽  
Cochrane Library ◽  
Post Traumatic Stress ◽  
Cross Sectional ◽  
Post Traumatic ◽  
The Impact

Abstract Background Previous studies on the impact of corona virus disease 2019 (COVID-19) on the mental health of the patients has been limited by the lack of relevant data. With the rapid and sustained growth of the publications on COVID-19 research, we will perform a living systematic review (LSR) to provide comprehensive and continuously updated data to explore the prevalence of delirium, depression, anxiety, and post-traumatic stress disorder (PTSD) among COVID-19 patients. Methods We will perform a comprehensive search of the following databases: Cochrane Library, PubMed, Web of Science, EMBASE, and Chinese Biomedicine Literature to identify relevant studies. We will include peer-reviewed cross-sectional studies published in English and Chinese. Two reviewers will independently assess the methodological quality of included studies using the Joanna Briggs Institute Prevalence Critical Appraisal tool and perform data extraction. In the absence of clinical heterogeneity, the prevalence estimates with a 95% confidence interval (CI) of delirium, depression, anxiety, and post-traumatic stress disorder (PTSD) will be calculated by using random-effects model to minimize the effect of between-study heterogeneity separately. The literature searches will be updated every 3 months. We will perform meta-analysis if any new eligible studies or data are obtained. We will resubmit an updated review when there were relevant changes in the results, i.e., when outcomes became statistically significant (or not statistically significant anymore) or when heterogeneity became substantial (or not substantial anymore). Discussion This LSR will provide an in-depth and up-to-date summary of whether the common neuropsychiatric conditions observed in patients hospitalized for severe acute respiratory syndrome (SARS-CoV) and Middle East respiratory syndrome (MERS) are also prevalent in a different stage of COVID-19 patients. Systematic review registration PROSPERO CRD42020196610

scholarly journals Prevalence of delirium, depression, anxiety, and post-traumatic stress disorder among COVID-19 patients: protocol for a living systematic review

2020 ◽  
Author(s):  
Jiyuan Shi ◽  
Ya Gao ◽  
Liang Zhao ◽  
Yuanyuan Li ◽  
Meili Yan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Virus Disease ◽  
Cochrane Library ◽  
Post Traumatic Stress ◽  
Cross Sectional ◽  
Post Traumatic ◽  
The Impact

Abstract Background Previous studies on the impact of corona virus disease 2019 (COVID-19) on the mental health of the patients has been limited by the lack of relevant data. With the rapid and sustained growth of the publications on COVID-19 research, we will perform a living systematic review (LSR) to provide comprehensive and continuously updated data to explore the prevalence of delirium, depression, anxiety, and post-traumatic stress disorder (PTSD) among COVID-19 patients.Methods We will perform a comprehensive search of the following databases: Cochrane Library, PubMed, Web of Science, Embase, and Chinese Biomedicine Literature to identify relevant studies. We will include peer-reviewed cross-sectional studies published in English and Chinese. Two reviewers will independently assess the methodological quality of included studies using the Joanna Briggs Institute Prevalence Critical Appraisal tool and perform data extraction. In the absence of clinical heterogeneity, the prevalence estimates with a 95% confidence interval (CI) of delirium, depression, anxiety, and post-traumatic stress disorder (PTSD) will be calculated by using random-effects model to minimize the effect of between-study heterogeneity separately. The literature searches will be updated every three months. We will perform meta-analysis if any new eligible studies or data are obtained. We will resubmit an updated review when there were relevant changes in the results, i.e. when outcomes became statistically significant (or not statistically significant anymore) or when heterogeneity became substantial (or not substantial anymore).Discussion This LSR will provide an in-depth and up-to-date summary of whether the common neuropsychiatric conditions observed in patients hospitalized for severe acute respiratory syndrome (SARS-CoV) and Middle East respiratory syndrome (MERS) are also prevalent in a different stage of COVID-19 patients.Systematic review registrationPROSPERO CRD42020196610

scholarly journals Estimate of false-positive breast cancer diagnoses from accuracy studies: a systematic review

2017 ◽  
Vol 70 (4) ◽  
pp. 282-294 ◽  
Author(s):  
Nereo Segnan ◽  
Silvia Minozzi ◽  
Antonio Ponti ◽  
Cristina Bellisario ◽  
Sara Balduzzi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
False Positive ◽  
Surgical Excision ◽  
Cochrane Library ◽  
Needle Core Biopsy ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
The Impact ◽  
Positive Breast Cancer

BackgroundFalse-positive histological diagnoses have the same consequences of overdiagnosis in terms of unnecessary treatment. The aim of this systematic review is to assess their frequency at needle core biopsy (CB) and/or surgical excision of the breast.MethodsPubMed, Embase, Cochrane Library were systematically searched up to 30 October 2015. Eligibility criteria: cross-sectional studies assessing diagnostic accuracy of CB compared with surgical excision; studies assessing reproducibility of pathologists reading the same slides. Outcomes: false-positive rates; Misclassification of Benign as Malignant (MBM) histological diagnosis; K statistic. Independent reviewers extracted data and assessed quality using an adapted QUADAS-2 tool.ResultsSixteen studies assessed CB false-positive rates. In 10 studies (41 989 screen-detected lesions), the range of false-positive rates was 0%–7.1%. Twenty-seven studies assessed pathologists' reproducibility. Studies with consecutive, random or stratified samples of all the specimens: at CB the MBM range was 0.25%–2.4% (K values 0.83–0.98); at surgical excision, it was 0.67%–1.2% (K values 0.86–0.94). Studies with enriched samples: the MBM range was 1.4%–6.2% (K values 0.57–0.86). Studies of cases selected for second opinion: the MBM range was 0.29%–12.2% (K values 0.48 and 0.50).ConclusionsHigh heterogeneity of the included studies precluded formal pooling estimates. When considering studies of higher sample size or methodological quality, false-positive rates and MBM are around 1%. The impact of false-positive histological diagnoses of breast cancer on unnecessary treatment, as well as that of overdiagnosis, is not negligible and is of importance in clinical practice.

scholarly journals Conflict of Interest Policies at Medical Schools and Teaching Hospitals: A Systematic Review of Cross-sectional Studies

2021 ◽  
Author(s):  
Alice Fabbri ◽  
Kristine Rasmussen Hone ◽  
Asbjørn Hróbjartsson ◽  
Andreas Lundh
Keyword(s):  
Systematic Review ◽  
Medical Schools ◽  
High Income ◽  
Educational Quality ◽  
Assessment Tools ◽  
Teaching Hospitals ◽  
Cross Sectional ◽  
European Institutions ◽  
Cross Sectional Studies ◽  
The Impact

Background: This systematic review aims to estimate the proportion of medical schools and teaching hospitals with conflicts of interest (COI) policies for health research and education, to describe the provisions included in the policies and their impact on research outputs and educational quality or content. Methods: Experimental and observational studies reporting at least one of the above mentioned aims were included irrespective of language, publication type or geographical setting. MEDLINE, Scopus, Embase and the Cochrane Methodology Register were searched from inception to March 2020. Methodological study quality was assessed using an amended version of the Joanna Briggs Institute’s checklist for prevalence studies. Results: Twenty-two cross-sectional studies were included; all were conducted in high-income countries. Of these, 20 studies estimated the prevalence of COI policies, which ranged from 5% to 100% (median: 85%). Twenty studies assessed the provisions included in COI policies with different assessment methods. Of these, nine analysed the strength of the content of medical schools’ COI policies using various assessment tools that looked at a range of policy domains. The mean standardised summary score of policy strength ranged from 2% to 73% (median: 30%), with a low score indicating a weak policy. North American institutions more frequently had COI policies and their content was rated as stronger than policies from European institutions. None of the included studies assessed the impact of COI policies on research outputs or educational quality or content. Conclusion: Prevalence of COI policies at medical schools and teaching hospitals varied greatly in high-income countries. No studies estimated the prevalence of policies in low to middle-income countries. The content of COI policies varied widely and while most European institutions ranked poorly, in North America more medical schools had strong policies. No studies were identified on impact of COI policies on research outputs and educational quality or content.

scholarly journals The Effect of Social Media Use on Depression in Adolescents: A Systematic Review and Meta-analysis

2021 ◽  
Vol 24 (1) ◽  
pp. 2-23
Author(s):  
Mina Vesal ◽  
◽  
Changiz Rahimi ◽  
Keyword(s):  
Systematic Review ◽  
Social Media ◽  
Media Use ◽  
Meta Analysis ◽  
Ethical Considerations ◽  
Social Media Use ◽  
Cross Sectional ◽  
Moderating Variables ◽  
Quantitative Studies ◽  
The Impact

Background and Aim: Concerns are increasingly raised about the impact of social media use on depression in adolescents. This article aimed to summarize and synthesize quantitative studies addressing the association between social media and depression in adolescents. Methods & Materials: This systematic review and meta-analysis included studies on the impact of the internet and social media use on depression in adolescents using Persian and English databases. In total, 15 studies met the inclusion criteria and were included in the analysis. Ethical Considerations: All ethical principles are considered in this article. Results: The obtained data revealed a slight (0.18) statistically significant correlation (P<0.000) between social media use and depression in adolescents. However, this relationship was complex and associated with multiple psychosocial, behavioral, and individual factors, necessitating further investigation of mediating and moderating variables. Notably, most explored studies were cross-sectional; thus, they failed to infer the causal relationship between social media use and depression. In Iran, research has only investigated internet dependence. Further research is required in this area. Conclusion: Overall, the mechanism of the impact of social media on depression should be further investigated through qualitative and longitudinal studies.

The impact of exogenous nitric oxide during cardiopulmonary bypass for cardiac surgery

Perfusion ◽  
2021 ◽  
pp. 026765912110148
Author(s):  
Joseph Mc Loughlin ◽  
Lorraine Browne ◽  
John Hinchion
Keyword(s):  
Nitric Oxide ◽  
Systematic Review ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Troponin I ◽  
Length Of Hospital Stay ◽  
Cochrane Library ◽  
High Quality Research ◽  
Low Cardiac Output Syndrome ◽  
The Impact

Objectives: Cardiac surgery using cardiopulmonary bypass frequently provokes a systemic inflammatory response syndrome. This can lead to the development of low cardiac output syndrome (LCOS). Both of these can affect morbidity and mortality. This study is a systematic review of the impact of gaseous nitric oxide (gNO), delivered via the cardiopulmonary bypass (CPB) circuit during cardiac surgery, on post-operative outcomes. It aims to summarise the evidence available, to assess the effectiveness of gNO via the CPB circuit on outcomes, and highlight areas of further research needed to develop this hypothesis. Methods: A comprehensive search of Pubmed, Embase, Web of Science and the Cochrane Library was performed in May 2020. Only randomised control trials (RCTs) were considered. Results: Three studies were identified with a total of 274 patients. There was variation in the outcomes measures used across the studies. These studies demonstrate there is evidence that this intervention may contribute towards cardioprotection. Significant reductions in cardiac troponin I (cTnI) levels and lower vasoactive inotrope scores were seen in intervention groups. A high degree of heterogeneity between the studies exists. Meta-analysis of the duration of mechanical ventilation, length of ICU stay and length of hospital stay showed no significant differences. Conclusion: This systematic review explored the findings of three pilot RCTs. Overall the hypothesis that NO delivered via the CPB circuit can provide cardioprotection has been supported by this study. There remains a significant gap in the evidence, further high-quality research is required in both the adult and paediatric populations.

scholarly journals Is the use of contraceptives associated with periodontal diseases? A systematic review and meta-analyses

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Micaele Maria Lopes Castro ◽  
Maria Karolina Martins Ferreira ◽  
Iasmin Encaua Essashika Prazeres ◽  
Paula Beatriz de Oliveira Nunes ◽  
Marcela Baraúna Magno ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quantitative Analysis ◽  
Periodontal Diseases ◽  
Hormonal Contraceptive ◽  
Cochrane Library ◽  
Hormonal Contraceptives ◽  
Clinical Parameters ◽  
Significant Difference ◽  
Meta Analyses ◽  
The Impact

Abstract Background Previous studies indicated an impact of hormonal contraceptive use on oral health. This systematic review aimed to investigate the evidence supporting the impact of the use of hormonal contraceptives and periodontal diseases. Methods This study is based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and based on the PECO acrostic. Inclusion criteria comprised observational studies including women (P), which evaluated hormonal contraceptive users (E) and hormonal contraceptive non-users (C), to verify the association between this hormonal therapy and the periodontal diseases (O). Searches were performed on 5 databases: PubMed, Scopus, Web of Science, Cochrane Library, LILACS and grey literature (OpenGrey and Google Scholar). After the selection process, the included studies were evaluated qualitatively. Moreover, quantitative data were analyzed in two meta-analyses for clinical attachment loss (CAL) and probing depth (PD). Finally, the level of certainty was measured with the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) tool between periodontal clinical parameters. Results 18 articles were eligible for the qualitative synthesis and 7 of them were selected for quantitative analysis. Hence, 15 of the eligible articles reported an association between the use of hormonal contraceptives and severity of periodontal disease. However, 6 articles demonstrated high risk of bias and were excluded from quantitative synthesis. The meta-analysis showed a statistically significant difference for CAL (MD 0.24 [0.09, 0.40]; p = 0.002), but in PD (MD 0.05 [− 0.05, 0.15]; p = 0.33) such difference was not identified. A very low level of evidence was found between the clinical parameters. Conclusions The use of hormonal contraceptives may be associated to severity of periodontal diseases. However, the quantitative analysis points to an inconclusive outcome due to the high level of heterogeneity. The association is biologically plausible, however additional studies are warranted to better elucidate the clinical significance of this possible association.

scholarly journals Variation in performance on common content items at UK medical schools

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
David Hope ◽  
David Kluth ◽  
Matthew Homer ◽  
Avril Dewar ◽  
Richard Fuller ◽  
...  
Keyword(s):  
Undergraduate Students ◽  
Standard Setting ◽  
Medical Schools ◽  
Cross Sectional Study ◽  
Pass Rates ◽  
Cross Sectional ◽  
Study Results ◽  
Institutional Differences ◽  
Common Content ◽  
The Impact

Abstract Background Due to differing assessment systems across UK medical schools, making meaningful cross-school comparisons on undergraduate students’ performance in knowledge tests is difficult. Ahead of the introduction of a national licensing assessment in the UK, we evaluate schools’ performances on a shared pool of “common content” knowledge test items to compare candidates at different schools and evaluate whether they would pass under different standard setting regimes. Such information can then help develop a cross-school consensus on standard setting shared content. Methods We undertook a cross-sectional study in the academic sessions 2016-17 and 2017-18. Sixty “best of five” multiple choice ‘common content’ items were delivered each year, with five used in both years. In 2016-17 30 (of 31 eligible) medical schools undertook a mean of 52.6 items with 7,177 participants. In 2017-18 the same 30 medical schools undertook a mean of 52.8 items with 7,165 participants, creating a full sample of 14,342 medical students sitting common content prior to graduation. Using mean scores, we compared performance across items and carried out a “like-for-like” comparison of schools who used the same set of items then modelled the impact of different passing standards on these schools. Results Schools varied substantially on candidate total score. Schools differed in their performance with large (Cohen’s d around 1) effects. A passing standard that would see 5 % of candidates at high scoring schools fail left low-scoring schools with fail rates of up to 40 %, whereas a passing standard that would see 5 % of candidates at low scoring schools fail would see virtually no candidates from high scoring schools fail. Conclusions Candidates at different schools exhibited significant differences in scores in two separate sittings. Performance varied by enough that standards that produce realistic fail rates in one medical school may produce substantially different pass rates in other medical schools – despite identical content and the candidates being governed by the same regulator. Regardless of which hypothetical standards are “correct” as judged by experts, large institutional differences in pass rates must be explored and understood by medical educators before shared standards are applied. The study results can assist cross-school groups in developing a consensus on standard setting future licensing assessment.

Impact of Treatment for Nasal Cavity Disorders on Sleep Quality: Systematic Review and Meta-analysis

2021 ◽  
pp. 019459982110295
Author(s):  
Jacob Fried ◽  
Erick Yuen ◽  
Kathy Zhang ◽  
Andraia Li ◽  
Nicholas R. Rowan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sleep Quality ◽  
Nasal Obstruction ◽  
Meta Analysis ◽  
Mean Difference ◽  
Cochrane Library ◽  
Life Questionnaire ◽  
Subjective Sleep Quality ◽  
Subjective Sleep ◽  
The Impact

Objective To determine the impact of treatment for patients with nasal obstruction secondary to allergic rhinitis (AR) and nasal septal deviation (NSD) on sleep quality. Data Sources Primary studies were identified though PubMed, Scopus, Cochrane Library, and Web of Science. Review Methods A systematic review was performed by querying databases for articles published through August 2020. Studies were included that reported on objective sleep parameters (apnea-hypopnea index) and sinonasal and sleep-specific patient-reported outcome measures: Rhinoconjunctivitis Quality of Life Questionnaire, Nasal Obstruction Symptom Evaluation, Epworth Sleepiness Scale (EpSS), and Pittsburgh Sleep Quality Index (PSQI). Results The database search yielded 1414 unique articles, of which 28 AR and 7 NSD studies were utilized for meta-analysis. A total of 9037 patients (8515 with AR, 522 with NSD) were identified with a mean age of 35.0 years (35.3 for AR, 34.0 for NSD). Treatment for AR and NSD significantly improved subjective sleep quality. For AR, the EpSS mean difference was −1.5 (95% CI, –2.4 to –0.5; P = .002) and for the PSQI, –1.7 (95% CI, –2.1 to –1.2; P < .00001). For NSD, the EpSS mean difference was −3.2 (95% CI, –4.2 to –2.2; P < .00001) and for the PSQI, –3.4 (95% CI, –6.1 to –0.6; P = .02). Conclusion Subjective sleep quality significantly improved following treatment for AR and NSD. There were insufficient data to demonstrate that objective metrics of sleep quality similarly improved.

scholarly journals Efficacy of hydrofibre dressing following total joint arthroplasty: a meta-analysis of randomised controlled trials

2021 ◽  
pp. 112070002110126
Author(s):  
Raman Mundi ◽  
Harman Chaudhry ◽  
Seper Ekhtiari ◽  
Prabjit Ajrawat ◽  
Daniel M Tushinski ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Joint Arthroplasty ◽  
Meta Analysis ◽  
Joint Infection ◽  
The United States ◽  
Joint Arthroplasty ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Observable Effect ◽  
The Impact

Introduction: In the United States, over 1,000,000 total joint arthroplasty (TJA) surgeries are performed annually and has been forecasted that this number will exceed 4,000,000 by the year 2030. Many different types of dressing exist for use in TJA surgery, and it is unclear if any of the newer, hydrofibre dressings are superior to traditional dressings at reducing rates of infections or improving wound healing. Thus, the aim of this systematic review and meta-analysis was to assess the impact of hydrofiber dressings on reducing complications. Methods: A systematic review and meta-analysis was performed using the online databases MEDLINE and the Cochrane Library. Randomized controlled trials (RCTs) comparing hydrofibre dressings to a standard dressing were included. Summary measures are reported as odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs). Our primary outcome was prosthetic joint infection (PJI). Secondary outcomes included blisters, dressing changes and wound irritation. Results: 5 RCTs were included. Hydrofibre dressing had no observable effect on PJI or wound irritation (OR 0.53; 95% CI, 0.14–1.98; p = 0.35). Hydrofibre dressings reduced the rate of blisters (OR 0.36; 95% CI, 0.14–0.90; p = 0.03) and number of dressing changes (MD -1.89; 95% CI, -2.68 to -1.11). Conclusions: In conclusion, evidence suggests hydrofibre dressings have no observable effect on PJI and wound irritation. Evidence for reduction in blisters and number of dressings is modest given wide CIs and biased trial methodologies. Use of hydrofibre dressings should be considered inconclusive for mitigating major complications in light of current best evidence.

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