Clinical preventive guidelines for school-aged children and adolescents in primary care: a protocol for a systematic review

IntroductionGuidelines for clinical preventive services targeting school-aged children and adolescents in primary care are limited, often inconsistent and difficult to apply in clinical contexts. This publication describes the protocol concerning a comprehensive systematic review that primarily aims to collect and synthesise available guidelines for prevention in primary care focused on school-aged children living in high-income regions. A second objective is to assess the quality of identified documents.Methods and analysisWe will search for reports providing clinical practice guidelines or consensus or expert opinion on preventive actions in paediatric primary care. We will use the WHO definition of prevention. We will focus on children aged 6–18 years living in the European region, the USA, Canada and Australia. We will search PubMed, Embase, Web of Science and Cochrane Library and guidelines-specific databases from 1 January 2010. We will also explore the grey literature using web search engines (Google and Google Scholar). We will finally obtain unpublished information through personal contact with national paediatric societies. We will summarise all identified documents as well as their potential methodological bias. We will further use the Appraisal of Guidelines Research and Evaluation Instrument, version II tool to critically appraise their quality.Ethics and disseminationOur findings will contribute to the identification of clinical preventive guidelines for which implementation in routine paediatric primary care should be considered. We intend to disseminate our results through publication in peer-reviewed journals and conference proceedings.PROSPERO registration numberCRD42020163184.

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Protocol for a systematic review of the incidence of infection in operative vs non-operative management of Seymour fractures in children and adolescents

10.21203/rs.3.rs-21070/v1 ◽

2020 ◽

Author(s):

Ailbhe Lynda Kiely ◽

Grant Switzer Nolan ◽

Lilli Cooper

Keyword(s):

Systematic Review ◽

Soft Tissue ◽

Children And Adolescents ◽

Grey Literature ◽

Operative Management ◽

Fracture Pattern ◽

Cochrane Library ◽

Non Union ◽

Fractures In Children ◽

Non Operative Management

Abstract Background Seymour fractures are open, displaced juxta-epiphyseal fractures of the distal phalanx, with an overlying nail bed laceration that occur in children and adolescents with an open physis. This fracture occurs rarely, but its potential consequences are clinically significant. Due to anatomical particulars and proximity to the growth plate, this open fracture may result in soft tissue infection and osteomyelitis, leading to growth arrest and persistent mallet deformity. At present, there is no consensus as to the optimal management of Seymour fractures. The objective of this study will be to systematically evaluate the existing evidence to establish whether operative or non-operative management of Seymore fractures is associated with a lower incidence of infection. Methods We designed and registered a study protocol for a systematic review of comparative and observational studies. A comprehensive literature search will be conducted (from 1966 to present) in MEDLINE, EMBASE, CINAHL, Cochrane Library and Google Scholar databases. Grey literature will be identified through searching Open Grey and dissertation databases using an exhaustive search strategy. All clinical studies examining the management of Seymour fractures in children & adolescents will be included, comparing operative and non-operative groups. Operative management will be defined as formal washout and soft tissue debridement prior to reduction, whether in the emergency department or operating theatre. Non-operative management refers to washout without surgical debridement. Primary outcome measures will be the incidence of superficial and deep infection. Secondary outcomes will include adverse events such mal-union, non-union, need for re-operation, physeal disturbance, nail dystrophy/atrophy. Two independent reviewers will screen all citations, full-text articles, and abstract data. Conflicts will be resolved through discussion. The study methodological quality (or bias) will be appraised using an appropriate tool. A narrative synthesis will be performed and if two or more studies with comparable design and reporting the same outcome are identified, data will be pooled for comparative analysis. Discussion This review will provide robust evidence for the management of Seymour fractures, based on a cumulation of existing studies. Due to the rarity of this fracture pattern, included studies are expected to be mainly observational and prone to bias; however, there is value in summarising the evidence, assessing its risk of bias and performing meta-analysis where possible to guide clinicians. Registration PROSPERO CRD42020153726

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Sensitivity of chest X-ray for detecting lung cancer in people presenting with symptoms: a systematic review

British Journal of General Practice ◽

10.3399/bjgp19x706853 ◽

2019 ◽

Vol 69 (689) ◽

pp. e827-e835 ◽

Cited By ~ 3

Author(s):

Stephen H Bradley ◽

Sarah Abraham ◽

Matthew EJ Callister ◽

Adam Grice ◽

William T Hamilton ◽

...

Keyword(s):

Lung Cancer ◽

Systematic Review ◽

Primary Care ◽

High Risk ◽

Grey Literature ◽

Primary Objective ◽

Risk Of Bias ◽

Cochrane Library ◽

X Ray ◽

Chest X Ray

BackgroundDespite increasing use of computed tomography (CT), chest X-ray remains the first-line investigation for suspected lung cancer in primary care in the UK. No systematic review evidence exists as to the sensitivity of chest X-ray for detecting lung cancer in people presenting with symptoms.AimTo estimate the sensitivity of chest X-ray for detecting lung cancer in symptomatic people.Design and settingA systematic review was conducted to determine the sensitivity of chest X-ray for the detection of lung cancer.MethodDatabases including MEDLINE, EMBASE, and the Cochrane Library were searched; a grey literature search was also performed.ResultsA total of 21 studies met the eligibility criteria. Almost all were of poor quality. Only one study had the diagnostic accuracy of chest X-ray as its primary objective. Most articles were case studies with a high risk of bias. Several were drawn from non-representative groups, for example, specific presentations, histological subtypes, or comorbidities. Only three studies had a low risk of bias. Two primary care studies reported sensitivities of 76.8% (95% confidence interval [CI] = 64.5 to 84.2%) and 79.3% (95% CI = 67.6 to 91.0%). One secondary care study reported a sensitivity of 79.7% (95% CI = 72.7 to 86.8%).ConclusionThough there is a paucity of evidence, the highest-quality studies suggest that the sensitivity of chest X-ray for symptomatic lung cancer is only 77% to 80%. GPs should consider if further investigation is necessary in high-risk patients who have had a negative chest X-ray.

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Mapping evidence on the effects of gender-affirming hormone therapy on the hard and soft tissues of the craniofacial complex in transgender people: a protocol for a scoping review

Systematic Reviews ◽

10.1186/s13643-021-01668-8 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

M. F. Van den Bosch ◽

C. M. Wiepjes ◽

M. Den Heijer ◽

L. J. Schoonmade ◽

R. E. G. Jonkman ◽

...

Keyword(s):

Systematic Review ◽

Scoping Review ◽

Soft Tissues ◽

Grey Literature ◽

Cochrane Library ◽

Sex Characteristics ◽

Transgender People ◽

Link Type ◽

Scoping Reviews ◽

Craniofacial Complex

Abstract Background Gender-affirming hormone (GAH) therapy aims to support the transition of transgender people to their gender identity. GAHs can induce changes in their secondary sex characteristics such as the development of breasts in transgender females and increased muscle mass in transgender males. The face and its surrounding tissues also have an important role in gender confirmation. The aim of this scoping review is to systematically map the available evidence in order to provide an overview of the effects of GAH therapy on the hard and soft tissues of the craniofacial complex in transgender people. Methods/design The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA) extension for Scoping Reviews was consulted for reporting this protocol. The methods were based on the Arksey and O’Malley’s framework and the Reviewer’s Manual of the Joanna Briggs Institute for conducting scoping reviews. Ten transgender people were involved in the development of the primary research question through short interviews. The eligibility criteria were defined for transgender people undergoing GAH therapy and for quantitative and qualitative outcomes on the hard and soft tissues of the craniofacial complex. Eligible sources of evidence include observational, experimental, qualitative, and mixed method studies. No exclusion criteria will be applied for the language of publication and the setting. To identify eligible sources of evidence, we will conduct searches from inception onwards in PubMed, Embase.com, the Cochrane Library, Web of Science Core Collection, Scopus, CINAHL, LIVIVO, and various grey literature sources such as Google Scholar. Two reviewers will independently select eligible studies in these information sources and will subsequently conduct data extraction. The same operators will chart, categorize, and summarize the extracted data. A narrative summary of findings will be conducted. Frequency counts of quantitative and qualitative data on items such as concepts, populations, interventions, and other characteristics of the eligible sources will be given. Where possible, these items will be mapped descriptively. Discussion We chose the scoping review over the systematic review approach, because the research questions are broad-spectrum and the literature is expected to be widely scattered. No systematic review has previously assessed this topic. Identifying knowledge gaps in this area and summarizing and disseminating research findings are important for a wide spectrum of stakeholders, in particular, for transgender people who want to undergo additional interventions such as plastic or orthognathic surgery or orthodontics. Systematic review registration This protocol was registered in the Open Science Framework: https://osf.io/e3qj6

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Medicines Related Problems (MRPs) Originating in Primary Care Settings in Older Adults - A Systematic Review

Journal of Pharmacy Practice ◽

10.1177/08971900211023638 ◽

2021 ◽

pp. 089719002110236

Author(s):

Rosetta Chinyere Ude-Okeleke ◽

Zoe Aslanpour ◽

Soraya Dhillon ◽

Nkiruka Umaru

Keyword(s):

Systematic Review ◽

Primary Care ◽

Library Science ◽

Cochrane Library ◽

Inclusion Criteria ◽

Data Bases ◽

Primary Care Settings ◽

Preventative Interventions ◽

Use Of Health Services

Background: As people age, they become increasingly vulnerable to the untoward effects of medicines due to changes in body systems. These may result in medicines related problems (MRPs) and consequent decline or deterioration in health. Aim: To identify MRPs, indicators of deterioration associated with these MRPs, and preventative interventions from the literature. Design and Setting: Systematic review of primary studies on MRPs originating in Primary Care in older people. Methods: Relevant studies published between 2001 and April 2018 were obtained from Medline (via PubMed), CINAHL, Embase, Psych Info, PASCAL, Scopus, Cochrane Library, Science Direct, and Zetoc. Falls, delirium, pressure ulcer, hospitalization, use of health services and death were agreed indicators of deterioration. The methodological quality of included studies was assessed using the Down and Black tool. Results: There were 1858 articles retrieved from the data bases. Out of these, 21 full text articles met inclusion criteria for the review. MRPs identified were medication error, potentially inappropriate medicines, adverse drug reaction and non-adherence. These were associated with indicators of deterioration. Interventions that involved doctors, pharmacists and patients in planning and implementation yielded benefits in halting MRPs. Conclusion: This Systematic review summarizes MRPs and associated indicators of deterioration. Appropriate interventions appeared to be effective against certain MRPs and their consequences. Further studies to explore deterioration presented in this systematic review is imperative.

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Factors associated with human visceral leishmaniasis cases during urban epidemics in Brazil: a systematic review

Parasitology ◽

10.1017/s0031182021000019 ◽

2021 ◽

pp. 1-9

Author(s):

Cleya da Silva Santana Cruz ◽

David Soeiro Barbosa ◽

Vinícius Cunha Oliveira ◽

Diogo Tavares Cardoso ◽

Nathália Sernizon Guimarães ◽

...

Keyword(s):

Systematic Review ◽

Visceral Leishmaniasis ◽

Urban Areas ◽

Grey Literature ◽

Cochrane Library ◽

Positive Correlation ◽

Individual Level ◽

Factors Associated ◽

The North ◽

Unified Health System

Abstract Visceral leishmaniasis (VL) is endemic in 70 countries and has been reported in 12 countries of Latin America, with over 90% of the cases reported in Brazil, where epidemics have occurred since 1980. The objective of this review is to describe the factors associated with the occurrence of VL epidemics in humans in urban areas. A systematic review was conducted according to the PRISMA-P guidelines. The databases PubMed (by Medline), Cochrane Library, Embase, Amed, LILACS and grey literature [Google Scholar and handsearch of the database of the Information System for Notifiable Diseases (SINAN) of Brazil's Unified Health System] were used. The protocol was registered under PROSPERO (CRD42019128998). Climatic, environmental factors and indicators of urban social structure were described as influencing the outbreaks in the North and Northeast regions. Gender and age characteristics were related to a greater chance of developing VL in the Central-West, Northeast and Southeast regions. Vector indicators showed a positive correlation with the incidence of VL in studies in the Northeast region. In the Southeast and Northeast regions, studies revealed the presence of dogs with positive correlation with VL. Knowledge gaps remain regarding the contribution to the increase in the risk factors described in ecological approaches, as no analysis was performed at the individual level, and it is still necessary to discuss the influence of other associated elements in epidemic episodes in the spread of VL.

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Sedentary behaviour among general practitioners: a systematic review

BMC Family Practice ◽

10.1186/s12875-020-01359-8 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Richard S. Mayne ◽

Nigel D. Hart ◽

Neil Heron

Keyword(s):

Systematic Review ◽

Sedentary Behaviour ◽

General Practitioners ◽

Sedentary Time ◽

Grey Literature ◽

Sitting Time ◽

Cochrane Library ◽

Cross Sectional ◽

The Cochrane Library ◽

Activity Questionnaire

Abstract Background Sedentary behaviour is when someone is awake, in a sitting, lying or reclining posture and is an independent risk factor for multiple causes of morbidity and mortality. A dose-response relationship has been demonstrated, whereby increasing sedentary time corresponds with increasing mortality rate. This study aimed to identify current levels of sedentary behaviour among General Practitioners (GPs), by examining and synthesising how sedentary behaviour has been measured in the primary care literature. Methods A systematic review was conducted to identify studies relating to levels of sedentary behaviour among GPs. Searches were performed using Medline®, Embase®, PscycINFO, Web of Science and the Cochrane Library, from inception of databases until January 2020, with a subsequent search of grey literature. Articles were assessed for quality and bias, with extraction of relevant data. Results The search criteria returned 1707 studies. Thirty four full texts were reviewed and 2 studies included in the final review. Both were cross-sectional surveys using self-reported estimation of sedentary time within the International Physical Activity Questionnaire (IPAQ). Keohane et al. examined GP trainees and GP trainers in Ireland. 60% reported spending in excess of 7 h sitting each day, 24% between 4 and 7 h, and 16% less than or equal to 4 h. Suija et al. examined female GPs in Estonia. The mean reported daily sitting time was 6 h and 36 min, with 56% sitting for over 6 h per day. Both studies were of satisfactory methodological quality but had a high risk of bias. Conclusion There is a paucity of research examining current levels of sedentary behaviour among GPs. Objective data is needed to determine GPs’ current levels of sedentary behaviour, particularly in light of the increase in remote consulting as a result of the COVID-19 pandemic.

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Computerized Clinical Decision Support Systems for Prescribing in Primary Care: Main Characteristics and Implementation Impact. Protocol of an Evidence and Gap Map.

10.21203/rs.3.rs-499725/v1 ◽

2021 ◽

Author(s):

Hector Acosta-Garcia ◽

Ingrid Ferrer-López ◽

Juan Ruano-Ruiz ◽

Bernardo Santos-Ramos ◽

Teresa Molina-López

Keyword(s):

Primary Care ◽

Decision Support ◽

Decision Support Systems ◽

Clinical Decision Support ◽

Literature Search ◽

Support Systems ◽

Grey Literature ◽

Clinical Decision Support Systems ◽

Clinical Decision ◽

Cochrane Library

Abstract Background Computerized clinical decision support systems are used by clinicians at the point-of-care to improve quality of healthcare processes (prescribing error prevention, adherence to clinical guidelines...) and clinical outcomes (preventive, therapeutic, and diagnostics). Attempts to summarize results of computerized clinical decision support systems to support prescription in primary care have been challenging, and most systematic reviews and meta-analyses failed due to an extremely high degree of heterogeneity present among the included primary studies. The aim of our study will be to synthesize the evidence, considering all methodological factors that could explain these differences, and to build an evidence and gap map to identify important remaining research questions. Methods A literature search will be conducted from January 2010 onwards in Medline, Embase, The Cochrane Library and Web of Science databases. Two reviewers will independently screen all citations, full-text and abstract data. The study methodological quality and risk of bias will be appraised using appropriate tools if applicable. A flow diagram with the screened studies will be presented, and all included studies will be displayed using interactive evidence and gap maps. Results will be reported in accordance with recommendations from The Campbell Collaboration on the development of evidence and gap maps. Discussion Evidence behind computerized clinical decision support systems to support prescription use in primary care, has so far been difficult to be synthesized. Evidence and gap maps represent an innovative approach that has emerged and is increasingly being used to address a broader research question, where multiple types of intervention and outcomes reported may be evaluated. Broad inclusion criteria have been chosen with regards to study designs, in order to collect all available information. Regarding the limitations we will only include English and Spanish language studies from the last 10 years, we will not perform a grey literature search, and we will not carry out a meta-analysis due to the predictable heterogeneity of available studies. Systematic Review registration: This study is registered in Open Science Framework https://bit.ly/2RqKrWp

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Relationship between exclusive breast feeding and cardiorespiratory fitness in children and adolescents: a protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-023223 ◽

2018 ◽

Vol 8 (10) ◽

pp. e023223 ◽

Cited By ~ 1

Author(s):

Carlos Berlanga-Macías ◽

Diana P. Pozuelo-Carrascosa ◽

Celia Álvarez-Bueno ◽

Jose Alberto Martínez-Hortelano ◽

Miriam Garrido-Miguel ◽

...

Keyword(s):

Systematic Review ◽

Quality Assessment ◽

Children And Adolescents ◽

Cardiorespiratory Fitness ◽

Breast Feeding ◽

Exclusive Breastfeeding ◽

Meta Analysis ◽

Cochrane Library ◽

Exclusive Breast Feeding

IntroductionBreast feeding has been considered important due to its short-term and long-term benefits on infant and maternal health. Regarding the long-term benefits, the influence of exclusive breastfeeding on cardiorespiratory fitness (CRF) during childhood and adolescence has been studied, although with controversial conclusions. This study protocol aims to provide a clear and standardised procedure for systematically reviewing the relationship between breast feeding, in terms of duration and exclusivity, and CRF in children and adolescents.Methods and analysisThis systematic review and meta-analysis protocol is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. A literature search will be conducted in MEDLINE, EMBASE, Web of Science and Cochrane Library. Observational studies regarding the association between breast feeding and CRF in children and adolescents written in English or Spanish will be included. A Critical Appraisal Checklist for Analytical Cross Sectional Studies and The Newcastle-Ottawa Quality Assessment Scale for longitudinal studies will be used for quality assessment of included studies. Standardised mean differences of CRF by exclusive breastfeeding categories will be calculated as the primary outcome. Subgroup analyses and meta-regression will be performed based on the sources of heterogeneity.Ethics and disseminationThis evidence-based systematic review will summarise the relevant information on the association of exclusive breast feeding and CRF in children and adolescents. The results will be disseminated by publication in a peer-reviewed journal. Given that the data used for this systematic review will be exclusively extracted from published studies, ethical approval will not be required.PROSPERO registration numberCRD42018082642.

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Validity of acute cardiovascular outcome diagnoses in European electronic health records: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2019-031373 ◽

2019 ◽

Vol 9 (10) ◽

pp. e031373 ◽

Cited By ~ 1

Author(s):

Jennifer Anne Davidson ◽

Amitava Banerjee ◽

Rutendo Muzambi ◽

Liam Smeeth ◽

Charlotte Warren-Gash

Keyword(s):

Systematic Review ◽

Electronic Health Records ◽

Predictive Value ◽

Grey Literature ◽

Cochrane Library ◽

Free Text ◽

Health Records ◽

Coronary Syndrome ◽

Validation Measure ◽

Electronic Health

IntroductionCardiovascular diseases (CVDs) are among the leading causes of death globally. Electronic health records (EHRs) provide a rich data source for research on CVD risk factors, treatments and outcomes. Researchers must be confident in the validity of diagnoses in EHRs, particularly when diagnosis definitions and use of EHRs change over time. Our systematic review provides an up-to-date appraisal of the validity of stroke, acute coronary syndrome (ACS) and heart failure (HF) diagnoses in European primary and secondary care EHRs.Methods and analysisWe will systematically review the published and grey literature to identify studies validating diagnoses of stroke, ACS and HF in European EHRs. MEDLINE, EMBASE, SCOPUS, Web of Science, Cochrane Library, OpenGrey and EThOS will be searched from the dates of inception to April 2019. A prespecified search strategy of subject headings and free-text terms in the title and abstract will be used. Two reviewers will independently screen titles and abstracts to identify eligible studies, followed by full-text review. We require studies to compare clinical codes with a suitable reference standard. Additionally, at least one validation measure (sensitivity, specificity, positive predictive value or negative predictive value) or raw data, for the calculation of a validation measure, is necessary. We will then extract data from the eligible studies using standardised tables and assess risk of bias in individual studies using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Data will be synthesised into a narrative format and heterogeneity assessed. Meta-analysis will be considered when a sufficient number of homogeneous studies are available. The overall quality of evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation tool.Ethics and disseminationThis is a systematic review, so it does not require ethical approval. Our results will be submitted for peer-review publication.PROSPERO registration numberCRD42019123898

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Internet of Things–Enabled Technologies for Weight Management in Children and Adolescents: Protocol for a Systematic Review

JMIR Research Protocols ◽

10.2196/16930 ◽

2020 ◽

Vol 9 (3) ◽

pp. e16930

Author(s):

Ching Lam ◽

Madison Milne-Ives ◽

Michelle Helena Van Velthoven ◽

Edward Meinert

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Childhood Obesity ◽

Internet Of Things ◽

Children And Adolescents ◽

Weight Management ◽

Health Care Services ◽

Grey Literature ◽

Medical Spending ◽

Google Search

Background Childhood obesity is a serious global issue, leading to increased medical spending on obesity-related diseases such as cardiovascular diseases and diabetes. There is a need for health care services that link health behavior to risk factors, such as diet and physical activity, and that provide better advice and feedback to users, which Internet of Things–enabled technologies could facilitate. Objective The objective of the systematic review will be to identify available Internet of Things–enabled technologies for weight management of children and adolescents (users younger than 18 years). It will also aim to understand the use, effectiveness, and feasibility of these technologies. Methods We will search the Medline, PubMed, Web of Science, Scopus, ProQuest Central, and IEEE Xplore Digital Library databases for studies published after 2010, using a combination of keywords and subject headings related to health activity tracking, youth, and Internet of Things. In addition, a Google search to identify grey literature will be conducted. Two authors will independently screen the titles and abstracts identified from the search and accept or reject the studies according to the study inclusion criteria. Any discrepancies will then be discussed and resolved. The quality of the included studies will be assessed using the Critical Appraisal Skills Programme (CASP) checklists. Data from included studies will be extracted into a predesigned form to identify the types of devices or apps, Internet of Things applications, and health outcomes related to weight management. Results A preliminary search on Medline returned 484 results. The publication of the final systematic review is expected in mid-2020. Conclusions The effectiveness and feasibility of physical activity trackers and consumer wearables for different patient groups have been well reviewed, but there are currently no published reviews that look into these technologies in the wider Internet of Things context. This review aims to address this gap by examining Internet of Things–enabled technologies that are designed for youth weight management and thus inform further research and clinical studies to reduce childhood obesity. International Registered Report Identifier (IRRID) PRR1-10.2196/16930

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