scholarly journals Relative infectiousness of asymptomatic SARS-CoV-2 infected persons compared with symptomatic individuals: a rapid scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e042354
Author(s):  
David McEvoy ◽  
Conor McAloon ◽  
Aine Collins ◽  
Kevin Hunt ◽  
Francis Butler ◽  
...  
Keyword(s):  
Scoping Review ◽  
Quantitative Measure ◽  
Contact Tracing ◽  
Cochrane Library ◽  
International Studies ◽  
Screening Process ◽  
Modelling Studies ◽  
Asymptomatic Individuals ◽  
Definition Of ◽  
The Cochrane Library

ObjectivesThe aim of this study was to determine the relative infectiousness of asymptomatic SARS-CoV-2 infected persons compared with symptomatic individuals based on a scoping review of available literature.DesignRapid scoping review of peer-reviewed literature from 1 January to 5 December 2020 using the LitCovid database and the Cochrane library.SettingInternational studies on the infectiousness of individuals infected with SARS-CoV-2.ParticipantsStudies were selected for inclusion if they defined asymptomatics as a separate cohort distinct from presymptomatics and if they provided a quantitative measure of the infectiousness of asymptomatics relative to symptomatics.Primary outcome measuresPCR result (PCR studies), the rate of infection (mathematical modelling studies) and secondary attack rate (contact tracing studies) - in each case from asymptomatic in comparison with symptomatic individuals.ResultsThere are only a limited number of published studies that report estimates of relative infectiousness of asymptomatic compared with symptomatic individuals. 12 studies were included after the screening process. Significant differences exist in the definition of infectiousness. PCR studies in general show no difference in shedding levels between symptomatic and asymptomatic individuals; however, the number of study subjects is generally limited. Two modelling studies estimate relative infectiousness to be 0.43 and 0.57, but both of these were more reflective of the infectiousness of undocumented rather than asymptomatic cases. The results from contact tracing studies include estimates of relative infectiousness of 0, but with insufficient evidence to conclude that it is significantly different from 1.ConclusionsThere is considerable heterogeneity in estimates of relative infectiousness highlighting the need for further investigation of this important parameter. It is not possible to provide any conclusive estimate of relative infectiousness, as the estimates from the reviewed studies varied between 0 and 1.

scholarly journals The relative infectiousness of asymptomatic SARS-CoV-2 infected persons compared with symptomatic individuals: A rapid scoping review.

2020 ◽  
Author(s):  
David Mc Evoy ◽  
Conor G McAloon ◽  
Aine B Collins ◽  
Kevin Hunt ◽  
Francis Butler ◽  
...  
Keyword(s):  
Scoping Review ◽  
Statistical Power ◽  
Quantitative Measure ◽  
Relative Number ◽  
Evidence Base ◽  
Contact Tracing ◽  
International Studies ◽  
Primary Case ◽  
Viral Shedding ◽  
Modelling Studies

Objectives: The aim of this study was to conduct a scoping review of estimates of the relative infectiousness of asymptomatic persons infected with SARS-CoV-2 compared with symptomatic individuals. Design: Rapid scoping review of literature available until 8th April 2020. Setting: International studies on the infectiousness of individuals infected with SARS-CoV-2 Participants: Studies were selected for inclusion if they defined asymptomatics as a separate cohort distinct from pre-symptomatics and if they provided a quantitative measure of the infectiousness of asymptomatics relative to symptomatics. Primary outcome measures: The relative number of secondary cases produced by an average primary case, the relative probability of transmitting infection upon contact, and the degree of viral shedding. Results: Very few studies reported estimates of relative infectiousness of asymptomatic compared with symptomatic individuals. Significant differences exist in the definition of infectiousness. Viral shedding studies in general show no difference in shedding levels between symptomatic and asymptomatic individuals but are likely to be impacted by insufficient statistical power. Two contact tracing studies provided estimates of 0.7 and 1.0, but differences in approach and definition preclude comparison across the two studies. Finally, two modelling studies suggest a relative infectiousness of around 0.5 but one of these was more reflective of the infectiousness of undocumented rather than asymptomatic cases. Importantly, one contact tracing study showing a very low level of infectiousness of asymptomatic was not included in the analysis at this point due difficulties interpreting the reported findings. Conclusions: The present study highlights the need for additional studies in this area as a matter of urgency. For the purpose of epidemiological modelling, we cautiously suggest that at present, asymptomatics could be considered to have a degree of infectiousness which is about 0.40-0.70 that of symptomatics. However, it must be stressed that this suggestion comes from a very low evidence base and that estimates exist that are close to zero and close to 1.

scholarly journals Addressing barriers to the conduct and application of research in complementary and alternative medicine: a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yasamin Veziari ◽  
Saravana Kumar ◽  
Matthew Leach
Keyword(s):  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Scoping Review ◽  
Data Extraction ◽  
Grey Literature ◽  
Evidence Base ◽  
Cochrane Library ◽  
Educational Strategies ◽  
The Cochrane Library ◽  
Complementary And Alternative

Abstract Background Over the past few decades, the popularity of complementary and alternative medicine (CAM) has grown considerably and along with it, scrutiny regarding its evidence base. While this is to be expected, and is in line with other health disciplines, research in CAM is confronted by numerous obstacles. This scoping review aims to identify and report the strategies implemented to address barriers to the conduct and application of research in CAM. Methods The scoping review was undertaken using the Arksey and O’Malley framework. The search was conducted using MEDLINE, EMBASE, EMCARE, ERIC, Scopus, Web of Science, The Cochrane Library, JBI and the grey literature. Two reviewers independently screened the records, following which data extraction was completed for the included studies. Descriptive synthesis was used to summarise the data. Results Of the 7945 records identified, 15 studies met the inclusion criteria. Using the oBSTACLES instrument as a framework, the included studies reported diverse strategies to address barriers to the conduct and application of research in CAM. All included studies reported the use of educational strategies and collaborative initiatives with CAM stakeholders, including targeted funding, to address a range of barriers. Conclusions While the importance of addressing barriers to the conduct and application of research in CAM has been recognised, to date, much of the focus has been limited to initiatives originating from a handful of jurisdictions, for a small group of CAM disciplines, and addressing few barriers. Myriad barriers continue to persist, which will require concerted effort and collaboration across a range of CAM stakeholders and across multiple sectors. Further research can contribute to the evidence base on how best to address these barriers to promote the conduct and application of research in CAM.

scholarly journals Scoping review protocol: the use of telemedicine in providing opioid agonist treatment and related psychosocial supports

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040556
Author(s):  
Des Crowley ◽  
Robyn Homeniuk ◽  
Ide Delargy
Keyword(s):  
Scoping Review ◽  
Psychosocial Support ◽  
Descriptive Analysis ◽  
Cochrane Library ◽  
Opioid Use ◽  
Opioid Agonist ◽  
Opioid Agonist Treatment ◽  
Search Terms ◽  
Medical Librarian ◽  
The Cochrane Library

IntroductionThe global opioid-related disease burden is significant. Opioid agonist treatment (OAT) can be effective in reducing illicit opioid use and fatal overdose, and improving multiple health and social outcomes. Despite evidence for its effectiveness, there are significant deficits in OAT globally. COVID-19 has required rapid adaptation of remote models of healthcare. Telemedicine is not used routinely in OAT, and little is known about the current levels of use and effectiveness. The objective of this review is to describe models of telemedicine and their efficacy.Methods and analysisThis scoping review uses the review methodology described by Arksey and O’Malley and adapted by Levac et al. The search strategy developed by the medical librarian at the Irish College of General Practitioners in conjunction with the research team will involve five databases (PubMed, EMBASE, the Cochrane Library, PsycInfo and OpenGrey) and the hand searching of reference lists. A limited initial search of two databases will be completed to refine search terms, followed by a second comprehensive search using newly refined search terms of all databases and finally hand searching references of included studies. To be included, studies must report on remote ways of providing OAT (including assessment, induction and monitoring) or related psychosocial support; be published in English after 2010. Two researchers will independently screen titles, abstracts and full-text articles considered for inclusion. Data will be extracted onto an agreed template and will undergo a descriptive analysis of the contextual or process-oriented data and simple quantitative analysis using descriptive statistics.Ethics and disseminationResearch ethics approval is not required for this scoping review. The results of this scoping review will inform the development of a national remote model of OAT. The results will be published in peer-reviewed journals and presented at relevant conferences.

Problems and Barriers related to the Use of Digital Health Applications: A Scoping Review Protocol (Preprint)

2021 ◽  
Author(s):  
Godwin Denk Giebel ◽  
Christian Speckemeier ◽  
Carina Abels ◽  
Kirstin Börchers ◽  
Jürgen Wasem ◽  
...  
Keyword(s):  
Scoping Review ◽  
Digital Health ◽  
Health Care Systems ◽  
Grey Literature ◽  
Screening Process ◽  
Care Systems ◽  
Research Findings ◽  
Review Protocol ◽  
Definition Of ◽  
Health Applications

BACKGROUND Usage of digital health applications (DHA) is increasing internationally. More and more regulatory bodies develop regulations and guidelines to enable an evidence-based and safe use. In Germany, DHA fulfilling predefined criteria (Digitale Gesundheitsanwendungen (="DiGA")) can be prescribed and are reimbursable by the German statutory health insurance scheme. Due to the increasing distribution of DHA problems and barriers should receive special attention. OBJECTIVE This study aims to identify relevant problems and barriers related to the use of DHA fulfilling the criteria of DiGA. The research done in this area will be mapped and research findings will be summarized. METHODS Conduct of the scoping review will follow published methodological frameworks and PRISMA-Scr criteria. Electronic databases (MEDLINE, EMBASE, and PsycINFO), reference lists of relevant articles and grey literature sources will be searched. Two reviewers will assess eligibility of articles by a two-stage (title/abstract and full-text) screening process. Only problems and barriers related to DHA fulfilling the criteria of DiGA are included for this research. RESULTS This scoping review serves to give an overview about the available evidence and to identify research gaps with regards to problems and barriers related to DiGA. Results are planned to be submitted to an indexed, peer-reviewed journal in the fourth quarter of 2021. CONCLUSIONS This is the first review identifying problems and barriers specifically to the use of the German definition of DiGA. Nevertheless, our findings can presumably be applied to other contexts and health care systems as well.

scholarly journals SURG-16. SUPRATOTAL VERSUS GROSS TOTAL RESECTION OF GLIOBLASTOMA: A SYSTEMATIC REVIEW

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi243-vi243
Author(s):  
Christina Jackson ◽  
John Choi ◽  
Carrie Price ◽  
Chetan Bettegowda ◽  
Michael Lim ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Gross Total Resection ◽  
Cochrane Library ◽  
Study Quality ◽  
Total Resection ◽  
Significant Difference ◽  
Definition Of ◽  
Supratotal Resection ◽  
The Cochrane Library

Abstract INTRODUCTION Due to the infiltrative nature of glioblastoma(GBM) outside of the contrast enhancing region in the peritumoral zone, there is increasing movement to perform supratotal resections (SpTR) by extending the edge of resection beyond the contrast enhancing portion of the tumor. However, there is currently no consensus on the potential survival benefit of SpTR in GBM as compared to gross total resection (GTR). METHODS Therefore, we performed a systematic review using PRISMA guidelines and performed a comprehensive literature search on Pubmed, EMBASE, The Cochrane Library, Web of Science, Scopus, and ClinicalTrials.gov, from inception to August 16, 2018, to identify articles comparing overall survival (OS) after SpTR versus GTR. Furthermore, we assessed study quality using the Oxford Centre for Evidence-Based Medicine guidelines. RESULTS We identified 8902 unique citations, of which 11 articles and 2 abstracts met study inclusion criteria. 925 patients underwent SpTR out of a total of 2137 patients. 9 of the 13 studies demonstrated improved survival with SpTR compared to GTR (median improvement in OS of 10.5 months), with no significant difference in post-operative complication rate. Conversely, one abstract found worsened outcomes with SpTR compared to GTR (median decrease in OS of 4 months). However, overall study quality was poor, with 12 of the 13 studies of level IV evidence and one study of level IIIb evidence. We were unable to perform a meta-analysis due to significant clinical and methodological heterogeneity amongst the studies (e.g. differences in adjuvant therapy and lack of standardization of definition of supratotal resection). CONCLUSIONS Our systematic review indicates that SpTR may be associated with improved OS compared to GTR for GBM. However, this is limited by poor study quality and significant clinical and methodological heterogeneity amongst the studies. There is need for prospective clinical trials to further establish standardized guidelines for SpTR in GBM.

scholarly journals Comparison of platelet reactivity between prasugrel and ticagrelor in patients with acute coronary syndrome: a meta-analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mingxiang Wen ◽  
Yaqi Li ◽  
Xiang Qu ◽  
Yanyan Zhu ◽  
Lingfang Tian ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Platelet Reactivity ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Reactivity Index ◽  
Cochrane Library ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Definition Of ◽  
The Cochrane Library

Abstract Background This meta-analysis aimed to compare the effects of prasugrel and ticagrelor on high (HTPR) and low on-treatment platelet reactivity (LTPR) in patients with acute coronary syndrome (ACS). Methods Eligible studies were retrieved from PubMed, Embase, and the Cochrane Library. HTPR and LTPR were evaluated on the basis of the vasodilator-stimulated phosphoprotein platelet reactivity index (VASP-PRI) and P2Y12 reaction units (PRUs). HTPR and LTPR were analyzed using risk ratios (RRs) and their 95% confidence intervals (CIs). Weighted mean difference (WMD) and 95% CI were used to calculate the pooled effect size of platelet reactivity (PR). Results Fourteen eligible studies were obtained, which included 2629 patients treated with ticagrelor (n = 1340) and prasugrel (n = 1289). The pooled results showed that the prasugrel-treated patients had higher platelet reactivity than the ticagrelor-treated patients (PRU: WMD = − 32.26; 95% CI: − 56.48 to − 8.76; P < 0.01; VASP-PRI: WMD = − 9.61; 95% CI: − 14.63 to − 4.60; P = 0.002). No significant difference in HTPR based on PRU was identified between the ticagrelor and prasugrel groups (P = 0.71), whereas a lower HTPR based on VASP-PRI was found in the ticagrelor-treated patients than in the prasugrel-treated patients (RR = 0.30; 95% CI: 0.12–0.75; P = 0.010). In addition, the results showed a lower LTPR was observed in the prasugrel group than in the ticagrelor group (RR = 1.40; 95% CI: 1.08–1.81; P = 0.01). Conclusions Prasugrel might enable higher platelet reactivity than ticagrelor. Ticagrelor could lead to a decrease in HTPR and increase in LTPR. However, this result was only obtained in pooled observational studies. Several uncertainties such as the nondeterminancy of the effectiveness of ticagrelor estimated using VASP-PRI or the definition of HTPR (a high or modifiable risk factor) might have affected our results.

scholarly journals Preoperative education in patients undergoing foot and ankle surgery: A scoping review protocol

2021 ◽  
Author(s):  
Laura Vergara-Merino ◽  
María Jesús Lira ◽  
Camila Micaela Escobar Liquitay ◽  
Nicolás Gonzales ◽  
Sergio Morales
Keyword(s):  
Scoping Review ◽  
Ethics Committee ◽  
Cochrane Library ◽  
Foot And Ankle ◽  
Preoperative Education ◽  
Eligibility Criteria ◽  
Ankle Surgery ◽  
Review Protocol ◽  
The Cochrane Library ◽  
Clinical Trials Registry

Objective: We aim to identify and to describe all the available evidence addressing preoperative education on patients undergoing any foot and ankle surgery.Design: This is the protocol for a scoping review of the literature.Data sources: We will perform electronic searches on Pubmed/MEDLINE, EMBASE, CINAHL, LILACS, ERIC, Scopus, The Cochrane library, clinicaltrials.gov and the International Clinical Trials Registry Platform. We will broad this search by conducting a cross-citation search in Google Scholar of all included studies and by checking their references. Eligibility criteria and methods: We will include any study addressing preoperative education on patients undergoing a foot and ankle surgery, without regard to their design or language. Two independent authors will select the studies and extract the data. We will extract data concerning the characteristics of each study, their participants, and data about the preoperative education they evaluated.Ethics: No ethics committee approval is required.

scholarly journals How we teach children with asthma to use their inhaler: A scoping review protocol

2020 ◽  
Author(s):  
Patrick McCrossan ◽  
Orla Mallon ◽  
Michael Shields ◽  
Dara O'Donoghue
Keyword(s):  
Scoping Review ◽  
Open Science ◽  
Cochrane Library ◽  
Future Research ◽  
Inhaler Technique ◽  
Case Control Studies ◽  
Children With Asthma ◽  
Science Framework ◽  
Randomised Controlled ◽  
The Cochrane Library

Abstract Background One reason that asthma remains poorly controlled in children is poor inhaler technique. Current guidelines recommend checking inhaler technique at each clinical visit. However, they do not specify how best to train children to mastery of correct inhaler technique. Currently many children are simply shown how to use inhalers (brief intervention) which results in less than 50% with correct inhaler technique. The aim of this scoping review is to explore published literature on teaching methods used to train children to master correct inhaler technique. Methods This scoping review will follow the Arksey and O'Malley framework and the Joanna Briggs Institute guidelines. We will search (from inception onwards): MEDLINE, Embase, Scopus, Web of Science, CINAHL and the Cochrane library. We will include quantitative studies, (e.g. randomised controlled trials, cohort studies and case-control studies), published from the year 1956 to present, on teaching the skill of inhaler technique to children with asthma. Two reviewers will complete all screening and data abstraction independently. Data will be extracted onto a data charting table to create a descriptive summary of the results. Data will then be synthesised with descriptive statistics and visual mapping.Discussion This scoping review will provide a broad overview of currently used educational methods to improve inhaler technique in children with asthma. The analysis will allow us to refine future research in this area by focusing on the most effective methods and optimising them. Systematic review registration: Open Science Framework (osf.io/n7kcw).

Genetic variants and susceptibility to severe COVID-19: a scoping review protocol (Preprint)

2021 ◽  
Author(s):  
Estephania Candelo ◽  
Juan David Gutiérrez-Medina ◽  
Andrés Gempeler ◽  
Lorena Diaz-Ordoñez ◽  
Harry Pachajoa
Keyword(s):  
Scoping Review ◽  
Genetic Variants ◽  
Association Studies ◽  
Library Science ◽  
Google Scholar ◽  
Cochrane Library ◽  
Genome Wide Association Studies ◽  
Gene Variants ◽  
Antibody Diversity ◽  
The Cochrane Library

BACKGROUND Coronavirus disease 19 (COVID-19), the disease caused by the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is already responsible for more than four and a half million deaths worldwide. With a unique pathophysiology related to respiratory failure due to interstitial pneumonia and acute respiratory distress syndrome, severe COVID-19 is qualitatively different from moderate disease. Since genetics play a crucial role in susceptibility to viral infection and propensity to develop harmful inflammatory conditions, genetic heterogeneity promotes the question of whether gene variants might influence COVID-19 outcomes. The identification of genetic variants associated with severe courses of COVID-19 is a promising option for the improvement of prognostic tools, contemplation of new therapeutic targets and the development of patient’s clinical risk stratification. OBJECTIVE We aim to perform a scoping review to assess the extent of the literature regarding the gene variants that could be associated with COVID-19 severity. METHODS The proposed scoping review will be conducted in accordance with the methodology from the Joanna Briggs Institute’s Scoping Review Network.12 The search strategy will focus on published studies without discriminating in date or language. A multiple-database search (MEDLINE, LILACS, The Cochrane Library, Science Direct, Google Scholar and OpenGrey) will be done performing the following strategy: ((("COVID-19"[Mesh] OR "SARS-CoV-2"[Mesh]) AND ("Polymorphism, Genetic"[Mesh] OR "Mutation"[Mesh] OR "Antibody Diversity"[Mesh] OR "Antigenic Variation"[Mesh]) AND ("Severity of Illness Index"[Mesh] OR "Death"[Mesh] OR "Critical Care"[Mesh] OR "Critical Illness"[Mesh] OR (severity))). This scoping review will consider observational studies and genome-wide association studies (GWAS) without discriminating in date or language. Additionally, systematic reviews that meet the inclusion criteria will also be considered. Data will be extracted from papers included in the scoping review by two independent reviewers using an already existent data extraction tool. RESULTS The conducted search was performed on February 16th in MEDLINE, LILACS, The Cochrane Library, Science Direct, Google Scholar and OpenGrey retrieved a total of 2190 results. Completion of the review is expected in late 2021. CONCLUSIONS This scoping review will be the first to map the extent of information regarding the genetic variants associated to the severity of COVID-19. The data gathered by this investigation could lead to biomarkers of severity in COVID-19 and the stratification of patients according to their genetic risk of disease severity.

scholarly journals Effective therapeutic interventions for Australian adolescents using alcohol and/or other drugs: a scoping review

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Jennifer Martin ◽  
Marg Liddell ◽  
Susan Roberts ◽  
Emily Greenwood
Keyword(s):  
Scoping Review ◽  
Grey Literature ◽  
Evidence Base ◽  
Therapeutic Interventions ◽  
Cochrane Library ◽  
Literature Searches ◽  
Scoping Literature Review ◽  
Ebsco Host ◽  
The Cochrane Library ◽  
Alcohol And Other Drugs

Abstract Background There are a variety of residential and community service models of therapeutic interventions for people using substances. The focus of much of the currently available research is on adult populations with relatively little known about effective therapeutic interventions for adolescents. The aim of this paper is to identify the most effective therapeutic interventions for Australian adolescents using substances by conducting a systematic scoping literature review. Methods We followed the PRISMA guidelines to conduct a systematic scoping review that included searches of nine electronic databases (EMBASE, MEDLINE, EBSCO Host, APA PsycNet, SocIndex, Social Science Abstracts, Proquest Central Informit) and grey literature searches of government department and alcohol and other drugs peak body and service provider websites, Google Scholar and the Cochrane library. Results A total of 21 studies were identified. These studies included biological, psychological, social and technological therapeutic interventions targeted at different population groups and different substances. The review findings are limited and should considered with caution due to the inability to disaggregate the combinations of interventions provided and the low quality of most of the studies included. Conclusions This scoping review highlights the paucity of quality research on effective therapeutic interventions for Australian adolescents using substances. This is primarily due to the available studies not controlling for all of the therapeutic interventions provided. While there is an evidence-base for some of these interventions, others such as encounter groups and journaling require further and more substantive research for use with adolescents. This is necessary to enable informed service design and delivery decision-making and fiscal accountability.

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