Observing time effect of SSRIs on suicide risk and suicide-related behaviour: a network meta-analysis protocol

IntroductionSuicide is a serious problem worldwide and 90% cases are associated with pre-existing or underlying mental illness. As a common treatment for depressive symptoms that suicidal people may receive, selective serotonin reuptake inhibitors (SSRIs) have been linked to a possible increase in suicide rates. Studies focusing on SSRIs and suicide have produced inconsistent results, suggesting that use of SSRIs decreases, increases, has no effect on suicide rates, or that the effect of SSRIs on suicide is age-dependent. This protocol of network meta-analysis aims to precisely evaluate the time effects of SSRIs by observing weekly changes of suicidality in the first 2 months of the treatment, and consequently, to explore whether the effect of the SSRIs on suicide varies depending on the stages of the treatment; if so, we will identify the turning point.Methods and analysisWe will search in the following databases: PubMed, Web of science, China National Knowledge Infrastructure and Wanfang Data, from dates of inception to 9 July 2021, with language restricted to English and Chinese. Studies focusing on the time effect of SSRIs on suicide will be retrieved. Then, the study selection process will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline, and the quality assessment will be conducted with Cochrane Collaboration’s tool. Two researchers will work independently on data extraction using a standardised data extraction spreadsheet. Any disagreement between two researchers will be discussed and determined by a third researcher.Ethics and disseminationThis work does not require ethics approval as it will be based on published studies. This review will be published in peer-reviewed journals.PROSPERO registration numberCRD42021244779.

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Aromatherapy for Symptom Relief in Patients with Burn: A Systematic Review and Meta-Analysis

Medicina ◽

10.3390/medicina58010001 ◽

2021 ◽

Vol 58 (1) ◽

pp. 1

Author(s):

Hye Won Lee ◽

Lin Ang ◽

Jung Tae Kim ◽

Myeong Soo Lee

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Meta Analysis ◽

Symptom Relief ◽

Routine Care ◽

Risk Of Bias ◽

Review Author ◽

Beneficial Effects ◽

Study Selection ◽

Meta Analyses

Background and Objectives: This review aimed to provide an updated review of evidence regarding the effects of aromatherapy in relieving symptoms of burn injuries, focusing on pain and physiological distress. Materials and Methods: Fifteen databases (including five English databases, four Korean medical databases, and four Iranian databases) and trial registries were searched for studies published between their dates of inception and July 2021. Two review authors individually performed study selection, data extraction, and risk of bias assessment, and any discrepancies were solved by a third review author. Results: Eight RCTs met our inclusion criteria and were analyzed in this updated systematic review. Our meta-analyses revealed that inhaled aromatherapy plus routine care showed beneficial effects in relieving pain after dressing, as compared to placebo plus routine care (p < 0.00001) and routine care alone (p = 0.02). Additionally, inhaled aromatherapy plus routine care (p < 0.00001) and aromatherapy massage plus routine care (p < 0.0001) also showed superior effects in calming anxiety, as compared to routine care alone. None of the included studies reported on AEs. Overall, the risk of bias across the studies was concerning. Conclusions: This updated review and synthesis of the studies had brought a more detailed understanding of the potential application of aromatherapy for easing the pain and anxiety of burn patients.

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Ultrasound imaging versus palpation method for diagnostic lumbar puncture in neonates and infants: a systematic review and meta-analysis

BMJ Paediatrics Open ◽

10.1136/bmjpo-2018-000412 ◽

2019 ◽

Vol 3 (1) ◽

pp. e000412 ◽

Cited By ~ 4

Author(s):

Abiola Olowoyeye ◽

Opeyemi Fadahunsi ◽

Jerome Okudo ◽

Oluwakare Opaneye ◽

Charles Okwundu

Keyword(s):

Lumbar Puncture ◽

Ultrasound Imaging ◽

Risk Ratio ◽

Ultrasound Guidance ◽

Data Extraction ◽

Meta Analysis ◽

Study Selection ◽

Registration Number ◽

Diagnostic Lumbar Puncture ◽

Neonates And Infants

ImportanceLumbar puncture (LP) failure rates vary and can be as high as 65%. Ultrasound guidance could increase the success of performing LP.ObjectiveTo summarise the evidence on the use of ultrasound guidance versus palpation method for LP.Data sourcesWe searched computerised databases and published indexes, registries and references identified from bibliographies of pertinent articles without any language restrictions to find studies that compared ultrasound guidance to palpation method for performing an LP.Study selectionStudies were included if they were randomised or quasirandomised trials in neonates and infants that compared ultrasound guidance with palpation method for performing an LP.Data extraction and synthesisStandardised data collection tool was used for data extraction, and two reviewers independently assessed the quality of the studiesMain outcome(s) and measure(s)The primary outcome was the risk of LP failure, while the risk of traumatic tap, needle redirections/reinsertions and procedure durations were secondary outcomesResultsData from four studies and 308 participants is included in the analysis. Ultrasound imaging reduced the risk of LP failure, risk ratio of 0.58 (95% CI 0.15 to 2.28), but it was not statistically significant (p=0.44). Ultrasound imaging significantly reduced the risk of a traumatic tap risk ratio of 0.33 (95% CI 0.13 to 0.82) and p=0.02. The included studies had low to moderate quality; the studies differed based on mean age and with variability on outcome definition.Conclusions and relevanceThis meta-analysis suggests that ultrasound imaging has no effect in increasing lumbar success but is beneficial in reducing the risk of traumatic taps in neonates and infants.Trial registration numberCRD42017055800.

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Methods used to meta-analyse results from interrupted time series studies: A methodological systematic review protocol

F1000Research ◽

10.12688/f1000research.22226.2 ◽

2020 ◽

Vol 9 ◽

pp. 110

Author(s):

Elizabeth Korevaar ◽

Amalia Karahalios ◽

Andrew B. Forbes ◽

Simon L. Turner ◽

Steve McDonald ◽

...

Keyword(s):

Public Health ◽

Time Series ◽

Systematic Reviews ◽

Data Extraction ◽

Meta Analysis ◽

Interrupted Time Series ◽

Analysis Methods ◽

Study Selection ◽

The Individual ◽

Meta Analyses

Background: Systematic reviews are used to inform healthcare decision making. In reviews that aim to examine the effects of organisational, policy change or public health interventions, or exposures, evidence from interrupted time series (ITS) studies may be included. A core component of many systematic reviews is meta-analysis, which is the statistical synthesis of results across studies. There is currently a lack of guidance informing the choice of meta-analysis methods for combining results from ITS studies, and there have been no studies examining the meta-analysis methods used in practice. This study therefore aims to describe current meta-analysis methods used in a cohort of reviews of ITS studies. Methods: We will identify the 100 most recent reviews (published between 1 January 2000 and 11 October 2019) that include meta-analyses of ITS studies from a search of eight electronic databases covering several disciplines (public health, psychology, education, economics). Study selection will be undertaken independently by two authors. Data extraction will be undertaken by one author, and for a random sample of the reviews, two authors. From eligible reviews we will extract details at the review level including discipline, type of interruption and any tools used to assess the risk of bias / methodological quality of included ITS studies; at the meta-analytic level we will extract type of outcome, effect measure(s), meta-analytic methods, and any methods used to re-analyse the individual ITS studies. Descriptive statistics will be used to summarise the data. Conclusions: This review will describe the methods used to meta-analyse results from ITS studies. Results from this review will inform future methods research examining how different meta-analysis methods perform, and ultimately, the development of guidance.

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

BMJ Open ◽

10.1136/bmjopen-2018-026037 ◽

2019 ◽

Vol 9 (8) ◽

pp. e026037 ◽

Cited By ~ 2

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.

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Non-adherence to immunosuppressants following renal transplantation: a protocol for a systematic review

BMJ Open ◽

10.1136/bmjopen-2016-015411 ◽

2017 ◽

Vol 7 (9) ◽

pp. e015411 ◽

Cited By ~ 6

Author(s):

Abigail Hucker ◽

Frances Bunn ◽

Lewis Carpenter ◽

Christopher Lawrence ◽

Ken Farrington ◽

...

Keyword(s):

Systematic Review ◽

Renal Transplant ◽

Data Extraction ◽

Meta Analysis ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Data Extraction Form ◽

Registration Number ◽

Meta Analyses ◽

The Impact

IntroductionAdherence to immunosuppressant medication is essential for renal transplant recipients. This review aims to summarise what is known about non-adherence, with a view to providing comprehensive evidence to inform strategies aimed at advancing adherent behaviour.Methods and analysisA systematic review of quantitative studies that report adherence to immunosuppressants in adult (over 18 years) renal transplant recipients. The review will follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines; study quality will be assessed using the Downs and Black checklist. Systematic searches will be completed across relevant databases. Two reviewers will independently extract data using a predefined data extraction form. We will summarise the operationalisation of adherence across studies and use narrative synthesis to identify factors associated with non-adherence. A meta-analysis will be conducted if there is sufficient homogeneity, and available data, across studies to estimate the prevalence of non-adherence in renal transplant recipients. Heterogeneity will be assessed using the I2test. Survival analysis will be conducted to estimate hazard ratios to explore the impact of non-adherence on graft survival, graft failure and patient survival.Ethics and disseminationFindings will be published in a peer-reviewed journal and disseminated at conferences for professionals and researchers. Review outcomes will help support clinical practice by highlighting the extent of non-adherence among adults, and in doing so, signpost the need for suitable intervention.Trial registration numberPROSPERO registration number (CRD42016038751).

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Quality of meta-analyses of non-opioid, pharmacological, perioperative interventions for chronic postsurgical pain: a systematic review

Regional Anesthesia and Pain Medicine ◽

10.1136/rapm-2021-102981 ◽

2022 ◽

pp. rapm-2021-102981

Author(s):

Rachel H McGregor ◽

Freda M Warner ◽

Lukas D Linde ◽

Jacquelyn J Cragg ◽

Jill A Osborn ◽

...

Keyword(s):

Systematic Reviews ◽

Data Extraction ◽

Meta Analysis ◽

Measurement Tool ◽

Critical Element ◽

Postsurgical Pain ◽

Chronic Postsurgical Pain ◽

Registration Number ◽

Meta Analyses

BackgroundIn an attempt to aggregate observations from clinical trials, several meta-analyses have been published examining the effectiveness of systemic, non-opioid, pharmacological interventions to reduce the incidence of chronic postsurgical pain.ObjectiveTo inform the design and reporting of future studies, the purpose of our study was to examine the quality of these meta-analyses.Evidence reviewWe conducted an electronic literature search in Embase, MEDLINE, and the Cochrane Database of Systematic Reviews. Published meta-analyses, from the years 2010 to 2020, examining the effect of perioperative, systemic, non-opioid pharmacological treatments on the incidence of chronic postsurgical pain in adult patients were identified. Data extraction focused on methodological details. Meta-analysis quality was assessed using the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) critical appraisal tool.FindingsOur search yielded 17 published studies conducting 58 meta-analyses for gabapentinoids (gabapentin and pregabalin), ketamine, lidocaine, non-steroidal anti-inflammatory drugs, and mexiletine. According to AMSTAR 2, 88.2% of studies (or 15/17) were low or critically low in quality. The most common critical element missing was an analysis of publication bias. Trends indicated an improvement in quality over time and association with journal impact factor.ConclusionsWith few individual trials adequately powered to detect treatment effects, meta-analyses play a crucial role in informing the perioperative management of chronic postsurgical pain. In light of this inherent value and despite a number of attempts, high-quality meta-analyses are still needed.PROSPERO registration numberCRD42021230941.

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Incidence and Risk Factors of Relapse After Elective Electrical Cardioversion for Atrial Fibrillation: a Protocol for Systematic Review and Meta-analysis

10.21203/rs.3.rs-129186/v1 ◽

2020 ◽

Author(s):

Mazou Temgoua ◽

Jerome Boombhi ◽

Joel Noutakdie Tochie ◽

Clovis Nkoke ◽

Cedric Tsinda ◽

...

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Systematic Review ◽

Data Extraction ◽

Meta Analysis ◽

Hemodynamic Instability ◽

Electrical Cardioversion ◽

Study Selection ◽

Registration Number ◽

Existing Data

Abstract BackgroundAtrial Fibrillation (AF) is the most frequent cardiac arrhythmia and it is associated with life-threatening complications such as hemodynamic instability and thromboembolic events. Electrical cardioversion remains its mainstay of treatment and can be performed either urgently or electively. Relapse after electrical cardioversion has been reported by several primary studies with divergent results, but no detailed summary exists for a critical appraisal of its global incidence and risk factors.Therefore, we propose the first systematic review and meta-analysis to synthesize the existing data on the global incidence and risk factors of relapse after electrical cardioversion for AF.MethodsWe will include case-control and cohort studies reporting on the incidence and risk factors of relapse after electrical cardioversion for atrial fibrillation. Electronic databases including PubMed, Embase, WHO Global Health Library and Web of Science will be searched for relevant records published between January 01, 2000, and December 15, 2020. Pairs of independents reviewers will perform study selection and data extraction, as well as an assessment of the methodological quality of included studies. Appropriate meta-analysis will then be used to pool studies judged to be clinically homogenous. Egger’s test and funnel plots will be used to detect publication bias. Findings will be reported and compared by the human development level of countries. ResultsThis systematic review and meta-analysis to synthesize the existing data on the global incidence and risk factors of relapse after electrical cardioversion for AFConclusionThis review is expected to provide relevant data to help in evaluating the burden and risk factors of relapse after electrical cardioversion for atrial fibrillation. The overall findings of this research will be published in a peer-reviewed journal. Systematic Review RegistrationThe protocol has been registered in Prospero with this registration number: CRD42020209301

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

BMJ Open ◽

10.1136/bmjopen-2021-056270 ◽

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.

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Prior surgical uterine evacuation of pregnancy and infertility: protocol for systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-034837 ◽

2020 ◽

Vol 10 (7) ◽

pp. e034837

Author(s):

Pengcheng Tu ◽

Kaiyan Pei

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Meta Analysis ◽

Published Data ◽

Inverse Variance ◽

Increased Risk ◽

Registration Number ◽

Meta Analyses ◽

Classification Tool ◽

Dissemination Of Results

IntroductionPrior surgical uterine evacuation is associated with an increased risk of infertility. However, findings are inconsistent, highlighting the need for a clear consensus on the effect of prior surgical uterine evacuation on the risk of infertility. Therefore, the aim of this systematic review and meta-analysis is to summarise the available evidence examining the association between prior surgical uterine evacuation and the risk of infertility.Methods and analysisA systematic search of electronic databases (ie, PubMed, Scopus, ClinicalTrials.gov, EMBASE and ScienceDirect) will be conducted since their inception until October 2019 with no limit for language using a detailed prespecified search strategy. Both the authors will independently screen titles and abstracts and select full-text articles, perform data extraction and appraise the quality of included studies using a bias classification tool. Meta-analyses will be performed to calculate the overall pooled estimates using the generic inverse variance method. This systematic review and meta-analysis will follow the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines.Ethics and disseminationGiven that this is a protocol based on published data, there is no requirement for ethics approval. It is anticipated that the dissemination of results will be reported according to the PRISMA statement. The results will be published in peer-reviewed journals and presented at scientific conferences.PROSPERO registration numberCRD42019117266.

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