scholarly journals Outcomes of hyperglycaemia in pregnancy in Africa: systematic review study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e040921
Author(s):  
Ezekiel Musa ◽  
Tawanda Chivese ◽  
Mahmoud Werfalli ◽  
Mushi Matjila ◽  
Shane A Norris ◽  
...  
Keyword(s):  
Systematic Review ◽  
Narrative Analysis ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Published Data ◽  
Metabolic Complication ◽  
Ethical Approval ◽  
Registration Number ◽  
Meta Analyses ◽  
In Pregnancy

IntroductionThe prevalence of diabetes mellitus globally has increased considerably over the past decades with a resultant increase in the incidence of diabetes-complicated pregnancies. Hyperglycaemia in pregnancy is the most common metabolic complication encountered during pregnancy and is associated with adverse maternal and fetal outcomes. This systematic review aims to examine maternal, fetal, neonatal, childhood and long-term maternal outcomes of hyperglycaemia in pregnancy in Africa.Methods and analysisA systematic review of all studies that investigated hyperglycaemia in pregnancy outcomes, carried out in Africa from 1998 to 2019. A comprehensive search of all published articles indexed in PubMed-MEDLINE, Cochrane Library, Scopus, CINAHL (EBSCOhost), Embase and Web of Science databases will be performed. Studies will be screened for eligibility by title, abstract and full text in duplicate by two independent reviewers. For data where meta-analysis is not possible, narrative analysis will be carried out using themes from data. For data where meta-analysis is possible, random effects meta-analysis will be conducted. This systematic review will be reported according to the Meta-analyses of Observational Studies in Epidemiology.Ethics and disseminationEthical approval is not required for this study considering this is a systematic review protocol that uses only published data. The findings of this study will be disseminated through peer-reviewed publications and conference presentations.PROSPERO registration numberCRD42020184573.

Simultaneous compared to interval administration of mifepristone and misoprostol for medical abortion up to 10+0 weeks' gestation: a systematic review with meta-analyses

2020 ◽  
pp. bmjsrh-2019-200448
Author(s):  
Mia Schmidt-Hansen ◽  
Jonathan Lord ◽  
Elise Hasler ◽  
Sharon Cameron
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Medical Abortion ◽  
Cochrane Library ◽  
Published Data ◽  
Study Results ◽  
Randomised Controlled ◽  
Meta Analyses

BackgroundMedical abortion with mifepristone and misoprostol usually involves an interval of 36–48 hours between administering these drugs; however, it is possible that the clinical efficacy at early gestations may be maintained when the drugs are taken simultaneously. The objective of this systematic review was to determine the safety and effectiveness of simultaneous compared with interval administration of mifepristone and misoprostol for abortion up to 10+0 weeks’ gestation.MethodsWe searched Embase Classic, Embase; Ovid MEDLINE(R) including Daily, and Epub Ahead-of-Print, In-Process & Other Non-Indexed Citations; and Cochrane Library on 11 December 2019. We included randomised controlled trials (RCTs), published in English from 1985, comparing simultaneous to interval administration of mifepristone and misoprostol for early abortion. Risk of bias was assessed using the Cochrane Collaboration checklist for RCTs. Meta-analysis of risk ratios (RRs) using the Mantel-Haenszel method were performed. The quality of the evidence was assessed using GRADE.ResultsMeta-analyses of three RCTs (n=1280) showed no differences in ‘ongoing pregnancy’ (RR 1.78, 95% CI 0.38 to 8.36), ‘haemorrhage requiring transfusion or ≥500 mL blood loss’ (RR 0.11, 95% CI 0.01 to 2.03) and ‘incomplete abortion with the need for surgical intervention’ (RR 1.30, 95% CI 0.76 to 2.25) between the interventions. Individual study results showed no difference in patient satisfaction, or ‘need for repeat misoprostol’, although ‘time to onset of bleeding or cramping’ was longer after simultaneous than interval administration. The quality of evidence was very low to moderate.ConclusionThe published data support the use of simultaneous mifepristone and misoprostol for medical abortion up to 9+0 weeks in women who prefer this method of administration.

scholarly journals Epidemiology of Cutaneous T-Cell Lymphomas: A Systematic Review and Meta-Analysis of 16,953 Patients

Cancers ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 2921
Author(s):  
Gabor Dobos ◽  
Anne Pohrt ◽  
Caroline Ram-Wolff ◽  
Céleste Lebbé ◽  
Jean-David Bouaziz ◽  
...  
Keyword(s):  
Systematic Review ◽  
T Cell ◽  
Meta Analysis ◽  
Global Perspective ◽  
Cochrane Library ◽  
Asian Populations ◽  
T Cell Lymphomas ◽  
Cutaneous Lymphomas ◽  
Registration Number ◽  
Meta Analyses

Cutaneous T-cell lymphomas (CTCL) are a heterogenous group of rare diseases. Many studies have reported on local epidemiology or geographic clustering, however we lack information from a global perspective. A systematic review and meta-analysis was conducted in Medline and the Cochrane Library based on a previously registered protocol and according to the preferred reporting of items for systematic reviews and meta-analyses (PRISMA). We selected publications that enrolled at least 100 patients with primary cutaneous lymphomas according to the current classifications. The relative frequencies (proportions) of subtypes were compared between studies and geographic regions in a meta-analysis. In total, 26 studies met our inclusion criteria, reporting on altogether 16,953 patients. Within primary cutaneous lymphomas, CTCL appeared to be 15% more frequent in Asian populations. Mycosis fungoides (MF) accounted for 62% of CTCL, with an important heterogeneity in frequencies between studies and continents. The proportion of Sézary syndrome (SS) was 3%, stable worldwide. Rare CTCL, such as NK/T-cell lymphoma or subcutaneous panniculitis-like lymphoma, were more frequent in Asian studies. This global meta-analysis of CTCL confirmed the predominance of CTCL among primary cutaneous lymphomas (83% on average) in the three analyzed continents, most of which were MF cases. It revealed the same proportions of SS across continents, and the heterogeneity of MF frequencies, suggesting the possible role of environmental factors in the pathophysiology of the latter. Registration number: CRD42020148295 (PROSPERO).

scholarly journals Global epidemiology of acute generalised peritonitis: a protocol for a systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e034326
Author(s):  
Joel Noutakdie Tochie ◽  
Ndip Valirie Agbor ◽  
Tianyi Tianyi Frank Leonel ◽  
Aime Mbonda ◽  
Desmond Aji Abang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Fatality Rate ◽  
Data Extraction ◽  
Meta Analysis ◽  
Case Fatality ◽  
Published Data ◽  
Fatality Rate ◽  
Global Epidemiology ◽  
Ethical Approval ◽  
Registration Number

IntroductionGlobally, acute generalised peritonitis (AGP) is a common medical and surgical emergency which is a major contributor to non-trauma deaths despite improvements in diagnosis and surgical and intensive care management. In order to determine the global burden of AGP, geared at tailoring key interventions to curb its morbidity and mortality, we proposed this first ever systematic review and meta-analysis to estimate the contemporary prevalence, and to determine the most frequent AGP and the case fatality rate of AGP, at the global scene.Methods and analysisWe intend to searchAfricanJournalsOnline, Americana em Ciências da Saúde, Citation index, EMBASE, Global Index Medicus, Literatura Latino Africa Index Medicus, Medline and Scientific Electronic Library Online databases from 1 January 2009 to 31 July 2019 to identify studies that reported the prevalence, types of AGP, and case fatality rate of AGP in the global population without any language restrictions. Study selection, data extraction and risk of bias assessment will be conducted independently at each level by a pair of independent investigators. Random-effects meta-analysis will be used to pool studies judged to be clinically homogeneous. The presence of heterogeneity will be evaluated using the χ² test on Cochrane’s Q statistic and quantified with the I² statistics. Publication bias will be evaluated statistically and visually using the Egger’s test and funnel plots, respectively. Findings will be reported and compared by countries, WHO regions and globally.Ethics and disseminationSince this study will be based on published data, it does will not require an ethical approval. The findings will be published in a scientific peer-reviewed journal. They will also be presented at scientific conferences and to relevant public health actors.PROSPERO registration numberCRD42019143331.

Impact of trainee involvement in esophagectomy on clinical outcomes: a narrative systematic review of the literature

2019 ◽  
Vol 32 (10) ◽  
pp. 1-8
Author(s):  
P Prasad ◽  
M Navidi ◽  
A Immanuel ◽  
S M Griffin OBE ◽  
A W Phillips
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Neoadjuvant Treatment ◽  
Length Of Hospital Stay ◽  
High Volume ◽  
Cochrane Library ◽  
Published Data ◽  
Meta Analyses ◽  
The Impact

SUMMARY Changes in the structure of surgical training have affected trainees’ operative experience. Performing an esophagectomy is being increasingly viewed as a complex technical skill attained after completion of the routine training pathway. This systematic review aimed to identify all studies analyzing the impact of trainee involvement in esophagectomy on clinical outcomes. A search of the major reference databases (Cochrane Library, MEDLINE, EMBASE) was performed with no time limits up to the date of the search (November 2017). Results were screened in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and study quality assessed using the MINORS (Methodological Index for Non-Randomized Studies) criteria. Four studies that included a total of 42 trainees and 16 consultants were identified, which assessed trainee involvement in open esophagogastric resectional surgery. A total of 1109 patients underwent upper gastrointestinal procedures, of whom 904 patients underwent an esophagectomy. Preoperative characteristics, histology, neoadjuvant treatment, and overall length of hospital stay were comparable between groups. One study found higher rates of anastomotic leaks in procedures primarily performed by trainees as compared to consultants (P < 0.01)—this did not affect overall morbidity or survival; however, overall anastomotic leak rates from the published data were 10.4% (trainee) versus 6.3% (trainer) (P = 0.10). A meta-analysis could not be performed due to the heterogeneity of data. The median MINORS score for the included studies was 13 (range 11–15). This study demonstrates that training can be achieved with excellent results in high-volume centers. This has important implications on the consent process and training delivered, as patients wish to be aware of the risks involved with surgery and can be reassured that appropriately supervised trainee involvement will not adversely affect outcomes.

scholarly journals Accuracy of potential diagnostic indicators for coeliac disease: a systematic review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e038994
Author(s):  
Martha Maria Christine Elwenspoek ◽  
Joni Jackson ◽  
Sarah Dawson ◽  
Hazel Everitt ◽  
Peter Gillett ◽  
...  
Keyword(s):  
Systematic Review ◽  
Coeliac Disease ◽  
Prediction Models ◽  
Data Extraction ◽  
Meta Analysis ◽  
Case Finding ◽  
Endoscopic Biopsy ◽  
Cochrane Library ◽  
Ethical Approval ◽  
Registration Number

IntroductionCoeliac disease (CD) is a systemic immune-mediated disorder triggered by gluten in genetically predisposed individuals. CD is diagnosed using a combination of serology tests and endoscopic biopsy of the small intestine. However, because of non-specific symptoms and heterogeneous clinical presentation, diagnosing CD is challenging. Early detection of CD through improved case-finding strategies can improve the response to a gluten-free diet, patients’ quality of life and potentially reduce the risk of complications. However, there is a lack of consensus in which groups may benefit from active case-finding.Methods and analysisWe will perform a systematic review to determine the accuracy of diagnostic indicators (such as symptoms and risk factors) for CD in adults and children, and thus can help identify patients who should be offered CD testing. MEDLINE, Embase, Cochrane Library and Web of Science will be searched from 1997 until 2020. Screening will be performed in duplicate. Data extraction will be performed by one and checked by a second reviewer. Disagreements will be resolved through discussion or referral to a third reviewer. We will produce a narrative summary of identified prediction models. Studies, where 2×2 data can be extracted or reconstructed, will be treated as diagnostic accuracy studies, that is, the diagnostic indicators are the index tests and CD serology and/or biopsy is the reference standard. For each diagnostic indicator, we will perform a bivariate random-effects meta-analysis of the sensitivity and specificity.Ethics and disseminationResults will be reported in peer-reviewed journals, academic and public presentations and social media. We will convene an implementation panel to advise on the optimum strategy for enhanced dissemination. We will discuss findings with Coeliac UK to help with dissemination to patients. Ethical approval is not applicable, as this is a systematic review and no research participants will be involved.PROSPERO registration numberCRD42020170766.

scholarly journals Does pain influence force steadiness? A protocol for a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e042525
Author(s):  
Michail Arvanitidis ◽  
Deborah Falla ◽  
Andy Sanderson ◽  
Eduardo Martinez-Valdes
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Grey Literature ◽  
Force Steadiness ◽  
Assessment Development ◽  
Ethical Approval ◽  
Registration Number ◽  
Meta Analyses

IntroductionPerforming contractions with minimum force fluctuations is essential for everyday life as reduced force steadiness impacts on the precision of voluntary movements and functional ability. Several studies have investigated the effect of experimental or clinical musculoskeletal pain on force steadiness but with conflicting findings. The aim of this systematic review is to summarise the current literature to determine whether pain, whether it be clinical or experimental, influences force steadiness.Methods and analysisThis protocol for a systematic review was informed and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols and the Cochrane Handbook for Systematic Reviews of Interventions. Key databases will be searched from inception to 31 August 2020, including MEDLINE, EMBASE, PubMed, CINAHL Plus, ZETOC and Web of Science. Grey literature and key journals will be also reviewed. Risk of bias will be assessed with the Newcastle-Ottawa tool, and the quality of the cumulative evidence assessed with the Grading of Recommendations, Assessment, Development and Evaluation guidelines. If homogeneity exists between groups of studies, meta-analysis will be conducted. Otherwise, a narrative synthesis approach and a vote-counting method will be used, while the results will be presented as net increases or decreases of force steadiness.Ethics and disseminationThe findings will be presented at conferences and the review will be also submitted for publication in a refereed journal. No ethical approval was required.PROSPERO registration numberCRD42020196479

scholarly journals The utility of Ki-67 as a prognostic biomarker in pulmonary neuroendocrine tumours: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e031531 ◽  
Author(s):  
Salma Naheed ◽  
Chloe Holden ◽  
Lulu Tanno ◽  
Eleanor Jaynes ◽  
Judith Cave ◽  
...  
Keyword(s):  
Systematic Review ◽  
Neuroendocrine Tumours ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Ki 67 ◽  
Ethical Approval ◽  
Registration Number ◽  
Academic Review ◽  
Reliable Marker ◽  
The Cochrane Library

IntroductionThe omission of the immunohistochemical proliferation marker Ki-67 labelling index (henceforth, simply Ki-67) from the 2015 WHO classification system of pulmonary neuroendocrine tumours (Lung-NETs) as a prognostic and grading criterion remains controversial. This systematic review along with meta-analysis will be conducted to assess the prognostic/grading utility of Ki-67 in Lung-NETs.MethodsThis systematic review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A systematic search of MEDLINE Ovid, Embase, Scopus and the Cochrane Library will be performed from the inception of each database to 28 February 2019 for studies investigating any role of Ki-67 in Lung-NETs. Only full papers published in English detailing survival outcomes and HRs according to Ki-67 will be included. The primary endpoint will be establishing whether Ki-67 is a reliable marker in determining prognosis and thus assessing grade of Lung-NETs patients.Ethics and disseminationEthical approval will not be required as this is an academic review of published literature. Findings will be disseminated through the preparation of a manuscript for publication in a peer-reviewed journal as well as presentation at national and international conferences.PROSPERO registration numberCRD42018093389

scholarly journals Effectiveness, Uses and Safety of Granulocyte Colony Stimulating Factor biosimilars: a protocol for systematic review and meta-analysis

2021 ◽  
Author(s):  
Chi-kadibia Theophilus Ukoma ◽  
Emmanuel Okechukwu Nna ◽  
Helen Chioma Okoye ◽  
Augustine Nwakuche Duru ◽  
Samuel Osobuchi Ngene ◽  
...  
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Reference Product ◽  
Meta Analysis ◽  
Severe Neutropenia ◽  
Cochrane Library ◽  
Published Data ◽  
Mesh Terms ◽  
Statistical Heterogeneity ◽  
Registration Number

Abstract Background Granulocyte Colony-stimulating factors (G-CSF) biosimilars are recombinant biologics that are similar to a reference product, neupogen, a 175 amino acid recombinant human G-CSF. Characteristically, biosimilars are produced from living cells as high molecular weight, heterogenous compounds that are highly immunogenic. They are primarily used to treat febrile and severe neutropenia in oncology patients as well as mobilize peripheral stem cells in transplant donors. However, as biosimilars are produced by biological processes rather than chemical synthesis, their comparable effectiveness and safety are very paramount to clinical uses. We aimed to produce a protocol for consistent and accurate systematic review and meta-analysis of G-CSF biosimilars.Methods We developed a search strategy using MeSH terms, key words and entry terms to search 9 databases: PubMed, AJOL, Embase, Google Scholar, Scopus, Cochrane Library, CINAHL, Web of Science and ResearchGate. Only randomized controlled trials retreivable in the English language will be included in this study. The primary measurable outcomes in this study are uses, effectiveness and safety of G-CSF biosimilars. Identified primary studies will be screened, deduplicated and selected based on study design, inclusion/exclusion criteria and outcome measures using DistillerSR software. Studies will be assessed for methodological, clinical and statistical heterogeneity. Extractable data items for effectiveness measure are: i) proportion of patients with 50% increase in absolute neutrophil count within 3–7 days; ii) resolution of fever within 3–7 days, iii) resolution of intra-oral mucosa ulcers within 7–10 days and iv) resoluton of difficulty in swallowing within 7–10 days. Measures of safety are i) proportion of patients with immunologic reactions, ii) any other documented adverse events. Quality scores and risk of bias for individual studies will be reported. Funnel Plots will be used for assessing publication bias in selected studies. Effect size, variance, SE and % CI and heterogeneity tests will be reported on forest plots using the CMA software version 3. Subgroup analysis and meta-regression will also be included using secondary outcomes as moderators and explanatory variables. The systematic review and meta-analysis will be reported according to PRISMA 2015 Statement.Discussion Ethical approval will not be required since this study will be based on published data. G-CSF biosimilars will be compared with the reference product, neupogen (filgrastin). The uses, effectiveness and safety of the biosimilars will be discussed. The study will also examine short and long acting biosimilars and compare their overall effectiveness. The strength of evidence from this study will be assessed using the NIH Quality assessment for systematic review and meta-analysis.Trial Registration Number The study is registered with PROSPERO, with registration number CRD42021232375

scholarly journals Effect of leisure-time physical activity in controlling hypertension: a systematic review and meta-analysis protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e056270
Author(s):  
Md Shariful Islam ◽  
Md Golam Rabbani ◽  
Ammatul Fardousi ◽  
Monaemul Islam Sizear ◽  
KM Saif-Ur-Rahman
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Leisure Time ◽  
Leisure Time Physical Activity ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Ethical Approval ◽  
Registration Number ◽  
Meta Analyses

IntroductionHypertension is a major risk factor for cardiovascular diseases. In 2015, over 1.13 billion individuals worldwide had hypertension. Globally, it results in 10.8 million deaths every year. Around half of the individuals do not continue treatment with medicine to control blood pressure. Physical activity, a non-pharmacological option of treatment, reduces blood pressure. We aim in this research to examine the effect of leisure-time physical activity in controlling blood pressure.Methods and analysisWe will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses to conduct this study. We will perform a systematic search in Medline/PubMed, Embase, Scopus, Web of Science, Physical Education Index (ProQuest) and CENTRAL (the Cochrane Library). Both experimental and observational studies will be included. The study population would be people with hypertension. Two reviewers will perform screening of the articles, bias assessment and data extraction independently. We will use the Joanna Briggs Institute Critical Appraisal Tools to assess the risk of bias. We will conduct a meta-analysis if it is applicable.Ethics and disseminationThe results will be published in peer-reviewed journals and presented at relevant scientific seminars and conferences. Ethical approval is not applicable.PROSPERO registration numberCRD42021260751.

scholarly journals Corticosteroids Treatment for Patients With Coronavirus Disease-2019 (COVID-19) With Different Disease Severity: a Systematic Review and Meta-analysis Protocol

2021 ◽  
Author(s):  
Shaofei Lou ◽  
Kaizhuang Huang ◽  
Jiao Jiang ◽  
Ningjun Li
Keyword(s):  
Systematic Review ◽  
Disease Severity ◽  
Oxygen Therapy ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Antiviral Agents ◽  
Adverse Outcomes ◽  
Cochrane Library ◽  
Registration Number ◽  
Meta Analyses

Abstract Introduction: As the coronavirus disease 2019 (COVID-19) pandemic progresses, identifying effective antiviral agents to treat the COVID-19 is of most urgency. Efficacy and safety of corticosteroids in patients with COVID-19 still are debated. Because high-quality randomized clinical trials (RCTs) on the use of corticosteroids for patients with COVID-19 recently were published recently, we aim to conduct a systematic review and meta-analysis of RCTs on corticosteroids therapy in patients with different disease severity to ascertain the effect on survival. Methods: We will undertake a comprehensive literature search among PubMed, EMBASE, Cochrane Library, medRxiv, and bioRxiv from their inception onwards to identify relevant RCTs. Two reviewers will independently extract data and conduct risk of bias assessments. The primary outcome is all-cause mortality, mortality of mechanically ventilated patients and patients who did not receive oxygen therapy. Secondary outcomes include need for mechanical ventilation or oxygen therapy and incidence of adverse outcomes. Heterogeneity of the estimates across studies will be assessed. Outcomes will be analyzed to pooled risk ratio and pertinent 95% confidence interval. A subgroup analysis will be conducted by disease severity to explore the source of heterogeneity. The systematic review and meta-analysis will be presented according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses. Discussion: This systematic review will provide an overview of the current state of evidence concerning the effect of corticosteroids on survival of patients with COVID-19 depended on the disease severity. Also, this systematic review will show the limitations and strengths of the studies available in the literature, as well as recommendations for future avenues of research will be given. PROSPERO registration number: CRD42020227740.

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