Discrepancies in self-reported financial conflicts of interest disclosures by physicians: a systematic review

BackgroundThere is a high prevalence of financial conflicts of interest (COI) between physicians and industry.ObjectivesTo conduct a systematic review with meta-analysis examining the completeness of self-reported financial COI disclosures by physicians, and identify factors associated with non-disclosure.Data sourcesMEDLINE, Embase and PsycINFO were searched for eligible studies up to April 2020 and supplemented with material identified in the references and citing articles.Data extraction and synthesisData were independently abstracted by two authors. Data synthesis was performed via systematic review of eligible studies and random-effects meta-analysis.Main outcomes and measuresThe proportion of discrepancies between physician self-reported disclosures and objective payment data was the main outcome. The proportion of discrepant funds and factors associated with non-disclosure were also examined.Results40 studies were included. The pooled proportion of COI discrepancies at the article level was 81% (range: 54%–98%; 95% CI 72% to 89%), 79% at the payment level (range: 71%–89%; 95% CI 67% to 89%), 93% at the authorship level (range: 71%–100%; 95% CI 79% to 100%) and 66% at the author level (range: 8%–99%; 95% CI 48% to 78%). The proportion of funds discrepant was 33% (range: 2%–77%; 95% CI 12% to 58%). There was high heterogeneity between studies across all five analyses (I2=94%–99%). Most undisclosed COI were related to food and beverage, or travel and lodging. While the most common explanation for failure to disclose was perceived irrelevance, a median of 45% of non-disclosed payments were directly or indirectly related to the work. A smaller monetary amount was the most common factor associated with nondisclosure.ConclusionsPhysician self-reports of financial COI are highly discrepant with objective data sources reporting payments from industry. Stronger policies are required to reduce reliance on physician self-reporting of financial COI and address non-compliance.

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Prevalence of suicidal behavior in young university students: A systematic review with meta-analysis

Revista Latino-Americana de Enfermagem ◽

10.1590/1518-8345.5320.3495 ◽

2021 ◽

Vol 29 ◽

Author(s):

Marília de Oliveira Crispim ◽

Cândida Maria Rodrigues dos Santos ◽

Iracema da Silva Frazão ◽

Cecília Maria Farias de Queiroz Frazão ◽

Rossana Carla Rameh de Albuquerque ◽

...

Keyword(s):

Systematic Review ◽

Suicidal Ideation ◽

University Students ◽

Suicidal Behavior ◽

Attempted Suicide ◽

Data Extraction ◽

Meta Analysis ◽

Cross Sectional ◽

High Prevalence ◽

Theses And Dissertations

Objective: to identify the prevalence of suicidal behavior in young university students. Method: a systematic review with meta-analysis of cross-sectional studies based on the Joanna Briggs Institute proposal, and carried out in the PubMed, Web of Science, Scopus, PsycINFO and LILACS databases and in the Brazilian Digital Library of Theses and Dissertations, with no language or year restrictions. A total of 2,942 publications were identified. Selection, data extraction and methodological evaluation of the studies were performed by two independent researchers. The meta-analysis was performed considering the random effects model. Results: eleven articles were included in this review. The prevalence variation for suicidal ideation was from 9.7% to 58.3% and, for attempted suicide, it was from 0.7% to 14.7%. The meta-analysis showed a 27.1% prevalence for suicidal ideation in life, 14.1% for ideation in the last year, and 3.1% for attempted suicide in life. Conclusion: the high prevalence of suicidal behavior, even with the considerable heterogeneity of the studies, raises the need to implement interventions aimed at preventing suicide and promoting mental health, especially in the academic environment.

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Factors Associated with Disease Severity and Mortality among Patients with Coronavirus Disease 2019: A Systematic Review and Meta-Analysis

10.1101/2020.08.07.20166868 ◽

2020 ◽

Author(s):

Vignesh Chidambaram ◽

Nyan Lynn Tun ◽

Waqas Haque ◽

Marie Gilbert Majella ◽

Ranjith Kumar Sivakumar ◽

...

Keyword(s):

Systematic Review ◽

Disease Severity ◽

English Language ◽

Clinical Decision Making ◽

Clinical Laboratory ◽

Data Extraction ◽

Meta Analysis ◽

Severe Disease ◽

Factors Associated ◽

Risk Of Mortality

Background: Understanding the factors associated with disease severity and mortality in Coronavirus disease (COVID19) is imperative to effectively triage patients. We performed a systematic review to determine the demographic, clinical, laboratory and radiological factors associated with severity and mortality in COVID-19. Methods: We searched PubMed, Embase and WHO database for English language articles from inception until May 8, 2020. We included Observational studies with direct comparison of clinical characteristics between a) patients who died and those who survived or b) patients with severe disease and those without severe disease. Data extraction and quality assessment were performed by two authors independently. Results: Among 15680 articles from the literature search, 109 articles were included in the analysis. The risk of mortality was higher in patients with increasing age, male gender (RR 1.45; 95%CI 1.23,1.71), dyspnea (RR 2.55; 95%CI 1.88,2.46), diabetes (RR 1.59; 95%CI 1.41,1.78), hypertension (RR 1.90; 95%CI 1.69,2.15). Congestive heart failure (OR 4.76; 95%CI 1.34,16.97), hilar lymphadenopathy (OR 8.34; 95%CI 2.57,27.08), bilateral lung involvement (OR 4.86; 95%CI 3.19,7.39) and reticular pattern (OR 5.54; 95%CI 1.24,24.67) were associated with severe disease. Clinically relevant cut-offs for leukocytosis(>10.0 x109/L), lymphopenia(< 1.1 x109/L), elevated C-reactive protein(>100mg/L), LDH(>250U/L) and D-dimer(>1mg/L) had higher odds of severe disease and greater risk of mortality. Conclusion: Knowledge of the factors associated of disease severity and mortality identified in our study may assist in clinical decision-making and critical-care resource allocation for patients with COVID-19.

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“Subtherapeutic concentrations of first-line antitubercular agents in pediatric patients and its association with tuberculosis treatment outcome: protocol for a systematic review and meta-analysis”

10.1101/2020.05.19.20107177 ◽

2020 ◽

Author(s):

Jorge Chachaima-Mar ◽

Diana Sánchez-Velazco ◽

Cesar Ugarte-Gil

Keyword(s):

Systematic Review ◽

Pediatric Patients ◽

Conflicts Of Interest ◽

Data Extraction ◽

Meta Analysis ◽

Serum Levels ◽

Reference Ranges ◽

Antitubercular Agents ◽

First Line ◽

Antitubercular Drugs

AbstractPediatric tuberculosis is a neglected disease that is receiving more attention lately. Some studies found that serum levels of first line antituberculosis drugs do not reach reference concentrations in children. However, these reference ranges were validated in an adult sample. Thus, we do not know if subtherapeutic concentrations of antitubercular agents in children are associated with negative outcomes.ObjectiveTo estimate the association between subtherapeutic concentrations of first-line antitubercular drugs with clinical outcomes of treatment.MethodsWe propose to do a systematic review and meta-analysis. In order to do so, we will perform an electronic search in Medline, SCOPUS, Web of Science and Global Index Medicus. There will be no restriction of language nor date of publication. First, we will screen titles and abstracts; then we will screen through the full text of the article. Both phases will be done by 2 independent authors. Data extraction will be performed using a data abstraction form by two independent authors. The quality of the studies will be checked with standardized tools according to the design of the study, and will also be performed by duplicate. We will present the main characteristics of each included study through tables. The heterogeneity between studies will be assessed through the I2 statistic. If appropriate, we will use the random-effects model to calculate the pooled estimate. We will evaluate the publication bias through visual inspection of the funnel plot and Egger’s test. Pre-arranged subgroup and sensitivity analysis will be performed.ResultsWe will publish the results of this systematic review in a peer-reviewed journal.ConclusionsThis systematic review will provide up-to-date evidence regarding serum concentration in pediatric patients and its association with outcomes. With the analysis we plan, we will offer important recommendations regarding the dosage of the first line antitubercular agents in children, and the modifications that may be needed.Conflicts of interestAll the authors declare to have no conflict of interest.FundingThis study did not receive funding from the public, commercial or not-for-profit sectors.

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Effect of Therapeutic Aquatic Exercise on Symptoms and Function Associated With Lower Limb Osteoarthritis: Systematic Review With Meta-Analysis

Physical Therapy ◽

10.2522/ptj.20130417 ◽

2014 ◽

Vol 94 (10) ◽

pp. 1383-1395 ◽

Cited By ~ 43

Author(s):

Benjamin Waller ◽

Anna Ogonowska-Slodownik ◽

Manuel Vitor ◽

Johan Lambeck ◽

Daniel Daly ◽

...

Keyword(s):

Systematic Review ◽

Lower Limb ◽

Data Extraction ◽

Meta Analysis ◽

Small Sample ◽

Data Sources ◽

Aquatic Exercise ◽

Control Group ◽

Management Options ◽

And Function

BackgroundCurrent management of osteoarthritis (OA) focuses on pain control and maintaining physical function through pharmacological, nonpharmacological, and surgical treatments. Exercise, including therapeutic aquatic exercise (TAE), is considered one of the most important management options. Nevertheless, there is no up-to-date systematic review describing the effect of TAE on symptoms and function associated with lower limb OA.PurposeThe purpose of this study was to conduct a systematic review with meta-analysis to determine the effect of TAE on symptoms and function associated with lower limb OA.Data SourcesThe data sources used in this study were: MEDLINE, PubMed, EMBASE, CINAHL, PEDro, and SPORTDiscus.Study SelectionAll studies selected for review were randomized controlled trials with an aquatic exercise group and a nontreatment control group. In total, 11 studies fulfilled the inclusion criteria and were included in the synthesis and meta-analysis.Data ExtractionData were extracted and checked for accuracy by 3 independent reviewers.Data SynthesisStandardized mean difference (SMD) with 95% confidence interval (95% CI) was calculated for all outcomes. The meta-analysis showed a significant TAE effect on pain (SMD=0.26 [95% CI=0.11, 0.41]), self-reported function (SMD=0.30 [95% CI=0.18, 0.43]), and physical functioning (SMD=0.22 [95% CI=0.07, 0.38]). Additionally, a significant effect was seen on stiffness (SMD=0.20 [95% CI=0.03, 0.36]) and quality of life (SMD=0.24 [95% CI=0.04, 0.45]).LimitationsHeterogeneity of outcome measures and small sample sizes for many of the included trials imply that conclusions based on these results should be made with caution.ConclusionsThe results indicate that TAE is effective in managing symptoms associated with lower limb OA.

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Adherence to clinical practice guidelines (CPGs) for the treatment of cancers in Australia and the factors associated with adherence: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2021-050912 ◽

2021 ◽

Vol 11 (9) ◽

pp. e050912

Author(s):

Mia Bierbaum ◽

Frances Rapport ◽

Gaston Arnolda ◽

Yvonne Tran ◽

Bróna Nic Giolla Easpaig ◽

...

Keyword(s):

Systematic Review ◽

Clinical Practice ◽

Cancer Treatment ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Data Extraction ◽

Meta Analysis ◽

Survival Rates ◽

Implementation Strategies ◽

Factors Associated

IntroductionClinical practice guidelines (CPGs) synthesise the latest evidence to support clinical and patient decision-making. CPG adherent care is associated with improved patient survival outcomes; however, adherence rates are low across some cancer streams in Australia. Greater understanding of specific barriers to cancer treatment CPG adherence is warranted to inform future implementation strategies.This paper presents the protocol for a systematic review that aims to determine cancer treatment CPG adherence rates in Australia across a variety of common cancers, and to identify any factors associated with adherence to those CPGs, as well as any associations between CPG adherence and patient outcomes.Methods and analysisFive databases will be searched, Ovid Medline, PsychInfo, Embase, Scopus and Web of Science, for eligible studies evaluating adherence rates to cancer treatment CPGs in Australia. A team of reviewers will screen the abstracts in pairs according to predetermined inclusion criteria and then review the full text of eligible studies. All included studies will be assessed for quality and risk of bias. Data will be extracted using a predefined data extraction template. The frequency or rate of adherence to CPGs, factors associated with adherence to those CPGs and any reported patient outcome rates (eg, relative risk ratios or 5-year survival rates) associated with adherence to CPGs will be described. If applicable, a pooled estimate of the rate of adherence will be calculated by conducting a random-effects meta-analysis. The systematic review will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Ethics and disseminationEthics approval will not be required, as this review will present anonymised data from other published studies. Results from this study will form part of a doctoral dissertation (MB), will be published in a journal, presented at conferences, and other academic presentations.PROSPERO registration numberCRD42020222962.

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Factors associated with disease severity and mortality among patients with COVID-19: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0241541 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0241541 ◽

Cited By ~ 1

Author(s):

Vignesh Chidambaram ◽

Nyan Lynn Tun ◽

Waqas Z. Haque ◽

Marie Gilbert Majella ◽

Ranjith Kumar Sivakumar ◽

...

Keyword(s):

Systematic Review ◽

Disease Severity ◽

English Language ◽

Clinical Decision Making ◽

Clinical Laboratory ◽

Data Extraction ◽

Meta Analysis ◽

Severe Disease ◽

Factors Associated ◽

Risk Of Mortality

Background Understanding the factors associated with disease severity and mortality in Coronavirus disease (COVID-19) is imperative to effectively triage patients. We performed a systematic review to determine the demographic, clinical, laboratory and radiological factors associated with severity and mortality in COVID-19. Methods We searched PubMed, Embase and WHO database for English language articles from inception until May 8, 2020. We included Observational studies with direct comparison of clinical characteristics between a) patients who died and those who survived or b) patients with severe disease and those without severe disease. Data extraction and quality assessment were performed by two authors independently. Results Among 15680 articles from the literature search, 109 articles were included in the analysis. The risk of mortality was higher in patients with increasing age, male gender (RR 1.45, 95%CI 1.23–1.71), dyspnea (RR 2.55, 95%CI 1.88–2.46), diabetes (RR 1.59, 95%CI 1.41–1.78), hypertension (RR 1.90, 95%CI 1.69–2.15). Congestive heart failure (OR 4.76, 95%CI 1.34–16.97), hilar lymphadenopathy (OR 8.34, 95%CI 2.57–27.08), bilateral lung involvement (OR 4.86, 95%CI 3.19–7.39) and reticular pattern (OR 5.54, 95%CI 1.24–24.67) were associated with severe disease. Clinically relevant cut-offs for leukocytosis(>10.0 x109/L), lymphopenia(< 1.1 x109/L), elevated C-reactive protein(>100mg/L), LDH(>250U/L) and D-dimer(>1mg/L) had higher odds of severe disease and greater risk of mortality. Conclusion Knowledge of the factors associated of disease severity and mortality identified in our study may assist in clinical decision-making and critical-care resource allocation for patients with COVID-19.

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Sedentary behaviour levels in adults with an intellectual disability: a systematic review and meta-analysis

HRB Open Research ◽

10.12688/hrbopenres.13326.1 ◽

2021 ◽

Vol 4 ◽

pp. 69

Author(s):

Louise Lynch ◽

Mary McCarron ◽

Philip McCallion ◽

Eilish Burke

Keyword(s):

Systematic Review ◽

Intellectual Disability ◽

Sedentary Behaviour ◽

Screen Time ◽

Data Extraction ◽

Meta Analysis ◽

Grey Literature ◽

Extraction Process ◽

Assessment Tools ◽

High Prevalence

Background: Sedentary behaviour (SB), which is characterised by low levels of energy expenditure, has been linked to increased cardio-metabolic risks, obesity and mortality, as well as cancer risk. No firm guidelines are established on safe levels of SB. Adults with an intellectual disability (ID) have poorer health than their counterparts in the general population with higher rates of multi-morbidity, inactivity, and obesity. The reasons for this health disparity are unclear however it is known that SB and overall inactivity contribute to poorer health. There is no clear picture of the levels of SB among individuals with ID therefore SB levels in this vulnerable population need to be examined. The aim of this systematic review is to investigate the prevalence of sedentary behaviour in adults with an ID. Methods: The PRISMA-P framework was applied to identify high quality articles. An extensive search was carried out in four databases and grey literature sources . In total, 1,972 articles were retrieved of which 48 articles went forward for full review after duplicate removal and screening by title and abstract. The National Institute of Health’s quality assessment tools were used to assess article quality. Two reviewers independently assessed each article. An excel spreadsheet was created to guide the data extraction process. The final review included 25 articles. A meta-analysis was completed using REVMAN. Results: Different SB assessment types were identified in studies. These included steps, time, questionnaires, and screen time. Studies were heterogeneous. Observed daily steps per individual ranged from 44 to above 30,000, with an average of approximately 6,500 steps. Mean daily time spent in SBs was more than 60% of available time, with observed screen time of more than 3 hours. Conclusion: There is a high prevalence of SB in adults with an intellectual disability. [Registration no: Index CRD42020177225].

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