scholarly journals Comparative effectiveness of exercise training program in patients with heart failure: protocol for a systematic review of randomised controlled trials and network meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043160
Author(s):  
Min Gao ◽  
Yangxi Huang ◽  
Qianyi Wang ◽  
Zejuan Gu ◽  
Guozhen Sun
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Comparative Effectiveness ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Exercise Interventions ◽  
Exercise Rehabilitation ◽  
Randomised Controlled

IntroductionHeart failure (HF) is an end-stage of numerous heart diseases including hypertension, coronary heart disease and arrhythmia, in which the heart is unable to perform its circulatory function with sufficient efficiency due to structural or functional dysfunction (systolic or diastolic alterations). Strategies such as exercise rehabilitation may improve cardiac function, exercise capacity and health-related quality of life and reduce anxiety and depression in patients with HF. However, the relative effectiveness as well as the hierarchy of exercise interventions have not been well established, although various exercise options are available. Therefore, this protocol proposes to conduct a network meta-analysis (NMA) aiming to compare the effectiveness of different types of exercise training in patients with HF.Methods and analysisPubMed, Embase and the Cochrane Library will be searched from inception to March 2021 for relevant randomised controlled trials. Other resources, such as Google Scholar and Clinical Trials.gov will also be considered. Studies assessing exercise rehabilitation in patients with HF will be selected. Two independent reviewers will identify eligible trials. The PEDro risk of bias assessment tool will be used to assess the quality of the included studies. Bayesian NMA will be used when possible to determine the comparative effectiveness of the different exercise interventions. The mean ranks and surface will estimate the ranking probabilities for the optimal intervention of various treatments under the cumulative ranking curve. Subgroup, sensitivity and meta-regression will be conducted to explain the included studies’ heterogeneity if possible. We will also use the Grading of Recommendations, Assessment, Development, and Evaluation system to assess the strength of evidence.Ethics and disseminationThis systematic review and NMA will synthesise evidence on the effectiveness of the different exercises in patients with HF. The results will be submitted to a peer-reviewed journal. No ethical approval will be required because the data used for the review will be exclusively extracted from published studies.PROSPERO registration numberCRD42020165870.

scholarly journals Effect of Uric Acid-Lowering Agents on Patients With Heart Failure: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

2021 ◽  
Vol 8 ◽  
Author(s):  
Hongxuan Xu ◽  
Yunqing Liu ◽  
Lingbing Meng ◽  
Li Wang ◽  
Deping Liu
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Uric Acid ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Controlled Trials ◽  
Heart Failure Patients ◽  
All Cause Mortality ◽  
Randomised Controlled

Background: Elevated serum uric acid (SUA) level is considered an independent predictor of all-cause mortality and the combined endpoint of death or readmission in cardiovascular disease patients. However, the causal relationship between uric acid-lowering therapies (ULTs) and heart failure is still controversial.Design: Meta-analyses were performed to systematically compile available evidence to determine the overall effect of ULTs on heart failure patients.Method: We conducted this systematic review following the PRISMA statement guidelines. Databases were searched to identify randomised controlled trials related to the influence of a ULT intervention in people with heart failure. Data extracted from the included studies were subjected to a meta-analysis to compare the effects of ULTs to a control.Results: Pooled analysis of left ventricular ejection fraction (LEVF) showed an insignificant result towards the ULT group (MD, 1.63%; 95%CI, −1.61 to 4.88; p = 0.32; three studies). Pooled analysis of the 6-Minute Walk Test (6MWT) showed an insignificant result towards the ULT group (MD, 4.59; 95%CI, −12.683 to 22.00; p = 0.61; four studies). Pooled analysis of BNP/NT-pro-BNP led to a nearly statistically significant result towards the ULT group (SMD, −0.30; 95%CI, −0.64 to 0.04; p = 0.08; five studies). Pooled analysis of all-cause mortality and cardiovascular death between ULTs (all XOIs) and placebo did not show a significant difference (RR, 1.26; 95% CI, 0.74 to 2.15, p = 0.39).Conclusion: ULTs did not improve LVEF, BNP/NT-pro-BNP, 6MWT, all-cause mortality, and CV death in heart failure patients. UA may just be a risk marker of heart failure.

scholarly journals The effect of eHealth-based falls prevention programmes on balance in people aged 65 years and over living in the community: protocol for a systematic review of randomised controlled trials

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e031200
Author(s):  
Meghan Ambrens ◽  
Anne Tiedemann ◽  
Kim Delbaere ◽  
Stephanie Alley ◽  
Corneel Vandelanotte
Keyword(s):  
Systematic Review ◽  
Fall Prevention ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Community Dwelling ◽  
Controlled Trials ◽  
Exercise Interventions ◽  
Prevention Interventions ◽  
Randomised Controlled ◽  
Community Dwellers

IntroductionBetween 20% and 28% of community-dwelling older people experience a fall each year. Falls can result in significant personal and socioeconomic costs, and are the leading cause of admission to hospital for an older person in Australia. Exercise interventions that target balance are the most effective for preventing falls in community-dwellers; however, greater accessibility of effective programmes is needed. As technology has become more accessible, its use as a tool for supporting and promoting health and well-being of individuals has been explored. Little is known about the effectiveness of eHealth technologies to deliver fall prevention interventions. This protocol describes a systematic review with meta-analysis that aims to evaluate the effect of eHealth fall prevention interventions compared with usual care control on balance in people aged 65 years and older living in the community.Methods and analysisWe will perform a systematic search of the following electronic databases: MEDLINE, CINAHL Complete, Embase and PsychINFO and citation search of Scopus, Web of Science, PubMed Central, Cochrane Database Central and PEDro for randomised controlled trials that use an eHealth technology to deliver a fall prevention intervention to community-dwellers aged ≥65 years, that are published in English, and include a balance outcome (primary outcome). The screening and selection of articles for review will be undertaken by two independent reviewers. The PEDro scale and Grading of Recommendations, Assessment, Development and Evaluations will be used to assess study quality. The results will be synthesised descriptively, and if sufficient data are available and the studies are not overly heterogeneous, a meta-analysis will be conducted using the random effects model.Ethics and disseminationAs this will be a systematic review, without involvement of human participants, there will be no requirement for ethical approval. The results of this systematic review will be disseminated through peer-reviewed publications, conference presentations and dissemination to policymakers and consumers to maximise health impact.PROSPERO registration numberCRD42018115098.

scholarly journals Exercise for premenstrual syndrome: a systematic review and meta-analysis of randomised controlled trials

BJGP Open ◽  
2020 ◽  
Vol 4 (3) ◽  
pp. bjgpopen20X101032 ◽  
Author(s):  
Emma Pearce ◽  
Kate Jolly ◽  
Laura L Jones ◽  
Gemma Matthewman ◽  
Mandana Zanganeh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Premenstrual Syndrome ◽  
Randomised Controlled Trials ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Current Evidence ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Exercise Interventions ◽  
Randomised Controlled

BackgroundExercise is recommended as a treatment for premenstrual syndrome (PMS) in clinical guidelines, but this is currently based on poor-quality trial evidence.AimTo systematically review the evidence for the effectiveness of exercise as a treatment for PMS.Design & settingThis systematic review searched eight major databases, including MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL), and two trial registries from inception until April 2019.MethodRandomised controlled trials (RCTs) comparing exercise interventions of a minimum of 8-weeks duration with non-exercise comparator groups in women with PMS were included. Mean change scores for any continuous PMS outcome measure were extracted from eligible trials and standardised mean differences (SMDs) were calculated where possible. Random-effects meta-analysis of the effect of exercise on global PMS symptoms was the primary outcome. Secondary analyses examined the effects of exercise on predetermined clusters of psychological, physical, and behavioural symptoms.ResultsA total of 436 non-duplicate returns were screened, with 15 RCTs eligible for inclusion (n = 717). Seven trials contributed data to the primary outcome meta-analysis (n = 265); participants randomised to an exercise intervention reported reduced global PMS symptom scores (SMD = -1.08; 95% confidence interval [CI] = -1.88 to -0.29) versus comparator, but with substantial heterogeneity (I2 = 87%). Secondary results for psychological (SMD = -1.67; 95% CI = -2.38 to -0.96), physical (SMD = -1.62; 95% CI = -2.41 to -0.83) and behavioural (SMD = -1.94; 95% CI = -2.45 to -1.44) symptom groupings displayed similar findings. Most trials (87%) were considered at high risk of bias.ConclusionBased on current evidence, exercise may be an effective treatment for PMS, but some uncertainty remains.

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