scholarly journals Support needs of carers making proxy healthcare decisions for people with dementia: a systematic review based on the Noblit and Hare meta-ethnographic synthesis of qualitative studies

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e052608
Author(s):  
Victoria Hodges ◽  
Catherine Hynes ◽  
Samuel Lassa ◽  
Caroline Mitchell
Keyword(s):  
Systematic Review ◽  
Data Extraction ◽  
Decision Makers ◽  
Support Needs ◽  
Healthcare Decision ◽  
Eligibility Criteria ◽  
People With Dementia ◽  
Registration Number ◽  
Legal Frameworks ◽  
Critical Appraisal Skills

BackgroundThere are 50 million dementia sufferers worldwide. Decisions about healthcare often need to be made when the person with dementia lacks capacity to do so.Understanding the support needs of carers acting as proxy healthcare decision-makers will be vital in improving the decision-making process for people with dementia and addressing the holistic needs of carers.ObjectiveThe objective of this study was to review the existing literature on the support needs of carers acting as proxy healthcare decision-makers for people with dementia.DesignA qualitative systematic review protocol was published on PROSPERO. The Critical Appraisal Skills Programme checklist was used to appraise study quality. A meta-ethnographic synthesis was performed to develop third-order constructs.Data sourcesA search was conducted using three online databases (MEDLINE, CINAHL and PsycINFO).Eligibility criteriaFifteen studies met the inclusion criteria: primary qualitative research involving carers of people with dementia who had been involved in making proxy healthcare decisions.Data extraction and synthesisTwo independent researchers conducted validity assessments for each paper selected for inclusion, and discrepancies were resolved by discussions with a third reviewer. Nvivo software was used and conceptual findings from study papers lead to interpretations of findings by the team.ResultsFrom the 15 papers included in the study, three main domains arose from the meta-ethnography; informational, practical and emotional. Informational support needs included information about dementia itself and the anticipated disease trajectory. Practical needs included continuity of care, person-centred care and the use of legal frameworks.Emotional support included recognising the guilt that healthcare decisions can provoke and the importance of providing guidance in an empathic manner.ConclusionsThis meta-ethnography highlights opportunities for healthcare professionals and policymakers to improve experiences of carers making proxy healthcare decisions for people with dementia.PROSPERO registration numberCRD42020124485.

scholarly journals What components of smoking cessation care during pregnancy are implemented by health providers? A systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e026037 ◽  
Author(s):  
Gillian Sandra Gould ◽  
Laura Twyman ◽  
Leah Stevenson ◽  
Gabrielle R Gribbin ◽  
Billie Bonevski ◽  
...  
Keyword(s):  
Systematic Review ◽  
Smoking Cessation ◽  
Data Extraction ◽  
Meta Analysis ◽  
Self Report ◽  
Health Providers ◽  
Eligibility Criteria ◽  
Reporting Practices ◽  
Registration Number ◽  
Meta Analyses

BackgroundPregnancy is an opportunity for health providers to support women to stop smoking.ObjectivesIdentify the pooled prevalence for health providers in providing components of smoking cessation care to women who smoke during pregnancy.DesignA systematic review synthesising original articles that reported on (1) prevalence of health providers’ performing the 5As (‘Ask’, ‘Advise’, ‘Assess’, ‘Assist’, ‘Arrange’), prescribing nicotine replacement therapy (NRT) and (2) factors associated with smoking cessation care.Data sourcesMEDLINE, EMBASE, CINAHL and PsycINFO databases searched using ‘smoking’, ‘pregnancy’ and ‘health provider practices’.Eligibility criteria for selecting studiesStudies included any design except interventions (self-report, audit, observed consultations and women’s reports), in English, with no date restriction, up to June 2017.ParticipantsHealth providers of any profession.Data extraction, appraisal and analysisData were extracted, then appraised with the Hawker tool. Meta-analyses pooled percentages for performing each of the 5As and prescribing NRT, using, for example, ‘often/always’ and ‘always/all’. Meta-regressions were performed of 5As for ‘often/always’.ResultsOf 3933 papers, 54 were included (n=29 225 participants): 33 for meta-analysis. Health providers included general practitioners, obstetricians, midwives and others from 10 countries. Pooled percentages of studies reporting practices ‘often/always’ were: ‘Ask’ (n=9) 91.6% (95% CI 88.2% to 95%); ‘Advise’ (n=7) 90% (95% CI 72.5% to 99.3%), ‘Assess’ (n=3) 79.2% (95% CI 76.5% to 81.8%), ‘Assist (cessation support)’ (n=5) 59.1% (95% CI 56% to 62.2%), ‘Arrange (referral)’ (n=6) 33.3% (95% CI 20.4% to 46.2%) and ‘prescribing NRT’ (n=6) 25.4% (95% CI 12.8% to 38%). Heterogeneity (I2) was 95.9%–99.1%. Meta-regressions for ‘Arrange’ were significant for year (p=0.013) and country (p=0.037).ConclusionsHealth providers ‘Ask’, ‘Advise’ and ‘Assess’ most pregnant women about smoking. ‘Assist’, ‘Arrange’ and ‘prescribing NRT’ are reported at lower rates: strategies to improve these should be considered.PROSPERO registration numberCRD42015029989.

scholarly journals Epidemiology of placenta previa accreta: a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031193 ◽  
Author(s):  
Eric Jauniaux ◽  
Lene Grønbeck ◽  
Catey Bunce ◽  
Jens Langhoff-Roos ◽  
Sally L Collins
Keyword(s):  
Systematic Review ◽  
Placenta Previa ◽  
Data Extraction ◽  
Meta Analysis ◽  
Eligibility Criteria ◽  
Registration Number ◽  
Newcastle Ottawa Scale ◽  
Placenta Accreta Spectrum ◽  
Obstetric Population ◽  
Ottawa Scale

ObjectiveTo estimate the prevalence and incidence of placenta previa complicated by placenta accreta spectrum (PAS) and to examine the different criteria being used for the diagnosis.DesignSystematic review and meta-analysis.Data sourcesPubMed, Google Scholar, ClinicalTrials.gov and MEDLINE were searched between August 1982 and September 2018.Eligibility criteriaStudies reporting on placenta previa complicated by PAS diagnosed in a defined obstetric population.Data extraction and synthesisTwo independent reviewers performed the data extraction using a predefined protocol and assessed the risk of bias using the Newcastle-Ottawa scale for observational studies, with difference agreed by consensus. The primary outcomes were overall prevalence of placenta previa, incidence of PAS according to the type of placenta previa and the reported clinical outcomes, including the number of peripartum hysterectomies and direct maternal mortality. The secondary outcomes included the criteria used for the prenatal ultrasound diagnosis of placenta previa and the criteria used to diagnose and grade PAS at birth.ResultsA total of 258 articles were reviewed and 13 retrospective and 7 prospective studies were included in the analysis, which reported on 587 women with placenta previa and PAS. The meta-analysis indicated a significant (p<0.001) heterogeneity between study estimates for the prevalence of placenta previa, the prevalence of placenta previa with PAS and the incidence of PAS in the placenta previa cohort. The median prevalence of placenta previa was 0.56% (IQR 0.39–1.24) whereas the median prevalence of placenta previa with PAS was 0.07% (IQR 0.05–0.16). The incidence of PAS in women with a placenta previa was 11.10% (IQR 7.65–17.35).ConclusionsThe high heterogeneity in qualitative and diagnostic data between studies emphasises the need to implement standardised protocols for the diagnoses of both placenta previa and PAS, including the type of placenta previa and grade of villous invasiveness.PROSPERO registration numberCRD42017068589

scholarly journals Prevalence of peritonitis and mortality in patients with ESKD treated with chronic peritoneal dialysis in Africa: a systematic review

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e039970
Author(s):  
Ikechi G Okpechi ◽  
Udeme Ekrikpo ◽  
Mothusi W Moloi ◽  
Jean Jacques Noubiap ◽  
Ugochi S Okpechi-Samuel ◽  
...  
Keyword(s):  
Systematic Review ◽  
Peritoneal Dialysis ◽  
Data Extraction ◽  
Chronic Peritoneal Dialysis ◽  
African Countries ◽  
Eligibility Criteria ◽  
Technique Survival ◽  
Median Proportion ◽  
Registration Number ◽  
End Stage

ObjectiveThe aim of this study was to report the prevalence of peritonitis and mortality in patients with end-stage kidney disease (ESKD) treated with chronic peritoneal dialysis (PD) in Africa.DesignSystematic review.SettingAfrica.ParticipantsPatients with ESKD in Africa.InterventionsPD in its varied forms.Primary and secondary outcomesPD-related peritonitis rate (primary outcome), time-to-discontinuation of PD, mortality.Data sourcesFour databases, including PubMed, Embase, Web of Science and Africa Journal Online were systematically searched from 1 January 1980 to 31 December 2019.Eligibility criteriaStudies conducted in Africa reporting peritonitis rate and mortality in patients treated with PD.Data extraction and synthesisTwo reviewers extracted and synthesised the data using Microsoft Excel. The quality of included data was also assessed.ResultsWe included 17 studies from seven African countries representing 1894 patients treated with PD. The overall median age was 41.4 years (IQR: 38.2–44.7) with a median time on PD of 18.0 months (17.0–22.6). An overall median peritonitis rate of 0.75 (0.56–2.20) episodes per patient-year (PPY) was observed and had declined with time; peritonitis rate was higher in paediatric studies than adult studies (1.78 (1.26–2.25) vs 0.63 (0.55–1.87) episodes PPY). The overall median proportion of deaths was 21.1% (16.2–25.8). Culture negative peritonitis was common in paediatric studies and studies that reported combined outcomes of continuous ambulatory PD and automated PD. Both 1-year and 2-year technique survival were low in all studies (83.6% and 53.0%, respectively) and were responsible for a high proportion of modality switch.ConclusionsOur study identifies that there is still high but declining peritonitis rates as well as low technique and patient survival in PD studies conducted in Africa. Sustained efforts should continue to mitigate factors associated with peritonitis in patients with ESKD treated with PD in Africa.PROSPERO registration numberCRD42017072966.

scholarly journals Acupuncture-related adverse events: systematic review and meta-analyses of prospective clinical studies

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e045961
Author(s):  
Petra Bäumler ◽  
Wenyue Zhang ◽  
Theresa Stübinger ◽  
Dominik Irnich
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Prospective Studies ◽  
Data Extraction ◽  
Eligibility Criteria ◽  
Serious Adverse Events ◽  
Related Risk ◽  
Registration Number ◽  
Meta Analyses ◽  
Medical Competence

ObjectiveOverview on risks of acupuncture-related adverse events (AEs).DesignSystematic review and meta-analyses of prospective studies.Data sourcesPubMed, Scopus and Embase from inception date to 15 September 2019.Eligibility criteria for selecting studiesProspective studies assessing AEs caused by needle acupuncture in humans as primary outcome published in English or German.Data extraction and synthesisTwo independent researchers selected articles, extracted the data and assessed study quality. Overall risks and risks for different AE categories were obtained from random effects meta-analyses.Main outcomesOverall risk of minor AEs and serious adverse events (SAEs) per patients and per treatments.ResultsA total of 7679 publications were identified. Twenty-two articles reporting on 21 studies were included. Meta-analyses suggest at least one AE occurring in 9.31% (95% CI 5.10% to 14.62%, 11 studies) of patients undergoing an acupuncture series and in 7.57% (95% CI 1.43% to 17.95%, 5 studies) of treatments. Summary risk estimates for SAEs were 1.01 (95% CI 0.23 to 2.33, 11 studies) per 10 000 patients and 7.98 (95% CI 1.39 to 20.00, 14 studies) per one million treatments, for AEs requiring treatment 1.14 (95% CI 0.00 to 7.37, 8 studies) per 1000 patients. Heterogeneity was substantial (I2 >80%). On average, 9.4 AEs occurred in 100 treatments. Half of the AEs were bleeding, pain or flare at the needle site that are argued to represent intended acupuncture reaction. AE definitions and assessments varied largely.ConclusionAcupuncture can be considered among the safer treatments in medicine. SAEs are rare, and the most common minor AEs are very mild. AEs requiring medical management are uncommon but necessitate medical competence to assure patient safety. Clinical and methodological heterogeneity call for standardised AE assessments tools, clear criteria for differentiating acupuncture-related AEs from therapeutically desired reactions, and identification of patient-related risk factors for AEs.PROSPERO registration numberCRD42020151930.

scholarly journals Characterization and Critical Appraisal of Physiotherapy Intervention Research in Nigeria: A Systematic Review

2021 ◽  
Author(s):  
Martins Nweke ◽  
Emeriewen Ejiroghene ◽  
Henrietta. O. Fawole ◽  
Mshunqane Nombeko
Keyword(s):  
Systematic Review ◽  
Clinical Research ◽  
Data Extraction ◽  
Controlled Trial ◽  
Eligibility Criteria ◽  
Intention To Treat ◽  
Clinical Innovation ◽  
Registration Number ◽  
Clinical Experiments ◽  
Treat Analysis

Abstract Objectives Clinical research is the bedrock of clinical innovation, education and practice. We characterized and critically appraised physiotherapy clinical research to avoid implementing misleading research findings into practice and to task the Nigerian physiotherapy societies on responsible conduct of clinical research. Methods This is a systematic review of articles published in English between 2009 and 2021. We searched Pubmed, Medline, Cumulative Index to Nursing and Allied Health Literature, Academic Search Complete, PsycINFO and African Journal Online, and reference lists of relevant articles. Data were selected and extracted according to predesigned eligibility criteria and using a standardized data extraction table. Where appropriate, the Pedro and Cochrane ROBINS1 were used to examine the risk of bias. Results Of the clinical experiments, the randomized controlled trial (RCT) was the most common design (87.5%). Musculoskeletal conditions (39.3%) were the most studied disorder. Most of the studies (76.8%) were of suboptimal quality. Interventions constituted exercise therapy (76.3%), manual therapy (8.5%) and electrotherapy (8.5%). More than half (67.8%) of the studies recorded medium to large effect sizes. A fair proportion (48.2%) of the studies had a confounding-by-indication bias. A few studies conducted normality tests (10.9%) and intention-to-treat analysis (37.5%). Discussion Of the clinical research, the volume of clinical experiments in the Nigeria Physiotherapy research community is small; notwithstanding, RCT is the most frequent clinical experiment. Physiotherapy interventions especially exercise appears effective, although incongruence between effect size and study quality limits inference. Sources of bias include absent/inadequate covariate analysis, blinding and intention-to-treat analysis approach. Registration: We registered the protocol with PROSPERO. The registration number: CRD42021228514.

scholarly journals Helping Babies Breathe and its effects on intrapartum-related stillbirths and neonatal mortality in low-resource settings: a systematic review

2019 ◽  
pp. archdischild-2018-316319 ◽  
Author(s):  
Jorien M D Versantvoort ◽  
Mirjam Y Kleinhout ◽  
Henrietta D L Ockhuijsen ◽  
Kitty Bloemenkamp ◽  
Willem B de Vries ◽  
...  
Keyword(s):  
Systematic Review ◽  
Neonatal Mortality ◽  
Data Extraction ◽  
Neonatal Resuscitation ◽  
Eligibility Criteria ◽  
Low Resource Settings ◽  
Low Resource ◽  
Helping Babies Breathe ◽  
Simulation Based ◽  
Registration Number

BackgroundAn important factor in worldwide neonatal mortality is the deficiency in neonatal resuscitation skills among trained professionals. ‘Helping Babies Breathe’ (HBB) is a simulation-based training course designed to train healthcare professionals in the initial steps of neonatal resuscitation in low-resource areas. The aim of this systematic review is to provide an overview of the available evidence regarding intrapartum-related stillbirths and neonatal mortality related to the HBB training and resuscitation method.Data sourcesCochrane, CINAHL, Embase, PubMed and Scopus.Study eligibility criteriaConducted in low-resource settings focusing on the effects of HBB on intrapartum-related stillbirths and neonatal mortality.Study appraisalIncluded studies were reviewed independently by two researchers in terms of methodological quality.Data extractionData were extracted by two independent reviewers and crosschecked by one additional reviewer.ResultsSeven studies were included in this systematic review; the selected studies included a total of 230.797 neonates. Significant decreases were found after the implementation of HBB in one of two studies describing perinatal mortality (n=25 108, rate ratio (RR) 0.75; p<0.001), four out of six studies related to intrapartum-related stillbirths (n=125.720, RR 0.31–0.76), in four out of five studies focusing on 1 day neonatal mortality (n=111.289, RR 0.37–0.67), and one out of three studies regarding 7 day neonatal mortality (n=4.390, RR 0.32). No changes were seen in late neonatal mortality after HBB training and resuscitation method.LimitationsIncluded studies in were predominantly of moderate quality, therefore no strong recommendations can be made.Conclusions and implications of key findingsDue to the heterogeneous quality of the studies, this systematic review showed moderate evidence for a decrease in intrapartum-related stillbirth and 1-day neonatal mortality rate after implementing the ‘Helping Babies Breathe’ training and resuscitation method. Further research is required to address the effects of simulation-based team training on morbidity and mortality beyond the initial neonatal period.PROSPERO registration numberCRD42018081141.

scholarly journals Apathy Measures in Older Adults and People with Dementia: A Systematic Review of Measurement Properties Using the COSMIN Methodology

2021 ◽  
pp. 1-13
Author(s):  
Clare Burgon ◽  
Sarah Elizabeth Goldberg ◽  
Veronika van der Wardt ◽  
Catherine Brewin ◽  
Rowan H. Harwood
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Rating Scale ◽  
Measurement Properties ◽  
Evaluation Procedure ◽  
Measurement Instruments ◽  
Health Measurement ◽  
Eligibility Criteria ◽  
People With Dementia ◽  
Patient Reported

<b><i>Background:</i></b> Apathy is highly prevalent in dementia and is also seen in mild cognitive impairment and the general population. Apathy contributes to failure to undertake daily activities and can lead to health problems or crises. It is therefore important to assess apathy. However, there is currently no gold standard measure of apathy. A comprehensive systematic review of the measurement properties of apathy scales is required. <b><i>Methods:</i></b> A systematic review was registered with PROSPERO (ID: CRD42018094390). MEDLINE, Embase, PsycINFO, and CINAHL were searched for studies that aimed to develop or assess the validity or reliability of an apathy scale in participants over 65 years, living in the community. A systematic review was conducted in line with the COnsensus-based Standards for the selection of health Measurement INstruments procedure for reviewing patient-reported outcome measures. The studies’ risk of bias was assessed, and all relevant measurement properties were assessed for quality. Results were pooled and rated using a modified Grading of Recommendations Assessment, Development, and Evaluation procedure. <b><i>Results:</i></b> Fifty-seven publications regarding 18 measures and 39 variations met the eligibility criteria. The methodological quality of individual studies ranged from inadequate to very good and measurement properties ranged from insufficient to sufficient. Similarly, the overall evidence for measurement properties ranged from very low to high quality. The Apathy Evaluation Scale (AES) and Lille Apathy Rating Scale (LARS) had sufficient content validity, reliability, construct validity, and where applicable, structural validity and internal consistency. <b><i>Conclusion:</i></b> Numerous scales are available to assess apathy, with varying psychometric properties. The AES and LARS are recommended for measuring apathy in older adults and people living with dementia. The apathy dimension of the commonly used Neuropsychiatric Inventory should be limited to screening for apathy.

scholarly journals Contrast extravasation and outcome of endovascular therapy in acute ischaemic stroke: a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e044917
Author(s):  
Tao Xu ◽  
You Wang ◽  
Jinxian Yuan ◽  
Yangmei Chen ◽  
Haiyan Luo
Keyword(s):  
Systematic Review ◽  
Ischaemic Stroke ◽  
Functional Outcome ◽  
Endovascular Therapy ◽  
Acute Ischaemic Stroke ◽  
Data Extraction ◽  
Meta Analysis ◽  
Poor Functional Outcome ◽  
Eligibility Criteria ◽  
Contrast Extravasation

ObjectiveContrast extravasation (CE) after endovascular therapy (EVT) is commonly present in acute ischaemic stroke (AIS) patients. Substantial uncertainties remain about the relationship between CE and the outcomes of EVT in patients with AIS. Therefore, we aimed to evaluate this association.DesignA systematic review and meta-analysis of published studies were performed.Data sourceWe systematically searched the Medline and Embase databases for relevant clinical studies. The last literature search in databases was performed in June 2020.Eligibility criteria for study selectionWe included studies exploring the associations between CE and the outcomes of EVT in patients with AIS undergoing EVT.Data extraction and synthesisTwo reviewers extracted relevant information and data from each article independently. We pooled ORs with CIs using a random-effects meta-analysis to calculate the associations between CE and outcomes of EVT. The magnitude of heterogeneity between estimates was quantified with the I2 statistic with 95% CIs.ResultsFifteen observational studies that enrolled 1897 patients were included. Patients with CE had higher risks of poor functional outcome at discharge (2.38, 95% CI 1.45 to 3.89 p=0.001; n=545) and poor functional outcome at 90 days (OR 2.16, 95% CI 1.20 to 3.90; n=1194). We found no association between CE and in-hospital mortality (OR 0.95, 95% CI 0.27 to 3.30; n=376) or 90-day mortality (OR 1.38, 95% CI 0.81 to 2.36; n=697) after EVT. Moreover, CE was associated with higher risks of post-EVT intracranial haemorrhage (ICH) (OR 6.68, 95% CI 3.51 to 12.70; n=1721) and symptomatic ICH (OR 3.26, 95% CI 1.97 to 5.40; n=1092).ConclusionsThis systematic review and meta-analysis indicates that in patients with AIS undergoing EVT, CE is associated with higher risks of unfavourable functional outcomes and ICH. Thus, we should pay more attention to CE in patients with AIS undergoing EVT.

scholarly journals Socioeconomic inequalities in primary-care and specialist physician visits: a systematic review

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Sara Lena Lueckmann ◽  
Jens Hoebel ◽  
Julia Roick ◽  
Jenny Markert ◽  
Jacob Spallek ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Primary Care Physicians ◽  
Web Of Science ◽  
Adult Population ◽  
Socioeconomic Inequalities ◽  
Eligibility Criteria ◽  
Physician Visits ◽  
General Adult Population ◽  
Registration Number

Abstract Background Utilization of primary-care and specialist physicians seems to be associated differently with socioeconomic status (SES). This review aims to summarize and compare the evidence on socioeconomic inequalities in consulting primary-care or specialist physicians in the general adult population in high-income countries. Methods We carried out a systematic search across the most relevant databases (Web of Science, Medline) and included all studies, published since 2004, reporting associations between SES and utilization of primary-care and/or specialist physicians. In total, 57 studies fulfilled the eligibility criteria. Results Many studies found socioeconomic inequalities in physician utilization, but inequalities were more pronounced in visiting specialists than primary-care physicians. The results of the studies varied strongly according to the operationalization of utilization, namely whether a physician was visited (probability) or how often a physician was visited (frequency). For probabilities of visiting primary-care physicians predominantly no association with SES was found, but frequencies of visits were higher in the most disadvantaged. The most disadvantaged often had lower probabilities of visiting specialists, but in many studies no link was found between the number of visits and SES. Conclusion This systematic review emphasizes that inequalities to the detriment of the most deprived is primarily a problem in the probability of visiting specialist physicians. Healthcare policy should focus first off on effective access to specialist physicians in order to tackle inequalities in healthcare. PROSPERO registration number CRD42019123222.

scholarly journals Antimicrobial Photodynamic Therapy and Dental Plaque: A Systematic Review of the Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
G. C. Santin ◽  
D. S. B. Oliveira ◽  
R. Galo ◽  
M. C. Borsatto ◽  
S. A. M. Corona
Keyword(s):  
Systematic Review ◽  
Photodynamic Therapy ◽  
Data Extraction ◽  
Antimicrobial Photodynamic Therapy ◽  
Review Of The Literature ◽  
Eligibility Criteria ◽  
Dental Biofilm ◽  
Quality Assessments

Background. The aim of this study was to perform a systematic review of the literature on the efficacy of antimicrobial photodynamic therapy (PDTa) on cariogenic dental biofilm.Types of Studies Reviewed. Studiesin vivo,in vitro, andin situwere included. Articles that did not address PDTa, those that did not involve cariogenic biofilm, those that used microorganisms in the plankton phase, and reviews were excluded. Data extraction and quality assessments were performed independently by two raters using a scale.Results. Two hundred forty articles were retrieved; only seventeen of them met the eligibility criteria and were analyzed in the present review. Considerable variability was found regarding the methodologies and application protocols for antimicrobial PDTa. Two articles reported unfavorable results.Practical Implications. The present systematic review does not allow drawing any concrete conclusions regarding the efficacy of antimicrobial PDTa, although this method seems to be a promising option.

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