scholarly journals Do we need to improve the reporting of evidence in tendinopathy management? A critical appraisal of systematic reviews with recommendations on strength of evidence assessment

2021 ◽  
Vol 7 (1) ◽  
pp. e000920
Author(s):  
Dimitris Challoumas ◽  
Neal L Millar
Keyword(s):  
Systematic Reviews ◽  
Assessment Tool ◽  
Data Extraction ◽  
Cochrane Collaboration ◽  
Mean Difference ◽  
Strength Of Evidence ◽  
The Mean ◽  
Randomised Controlled ◽  
Meta Analyses ◽  
The Cochrane Collaboration

ObjectiveTo critically appraise the quality of published systematic reviews (SRs) of randomised controlled trials (RCTs) in tendinopathy with regard to handling and reporting of results with special emphasis on strength of evidence assessment.Data sourcesMedline from inception to June 2020.Study eligibilityAll SRs of RCTs assessing the effectiveness of any intervention(s) on any location of tendinopathy.Data extraction and synthesisIncluded SRs were appraised with the use of a 12-item tool devised by the authors arising from the Preferred Reporting Items in Systematic Reviews and Meta-Analyses statement and other relevant guidance. Subgroup analyses were performed based on impact factor (IF) of publishing journals and date of publication.ResultsA total of 57 SRs were included published in 38 journals between 2006 and 2020. The most commonly used risk-of-bias (RoB) assessment tool and strength of evidence assessment tool were the Cochrane Collaboration RoB tool and the Cochrane Collaboration Back Review Group tool, respectively. The mean score on the appraisal tool was 46.5% (range 0%–100%). SRs published in higher IF journals (>4.7) were associated with a higher mean score than those in lower IF journals (mean difference 26.4%±8.8%, p=0.004). The mean score of the 10 most recently published SRs was similar to that of the first 10 published SRs (mean difference 8.3%±13.7%, p=0.54). Only 23 SRs (40%) used the results of their RoB assessment in data synthesis and more than half (n=30; 50%) did not assess the strength of evidence of their results. Only 12 SRs (21%) assessed their strength of evidence appropriately.ConclusionsIn light of the poor presentation of evidence identified by our review, we provide recommendations to increase transparency and reproducibility in future SRs.

scholarly journals Acupuncture for Tourette Syndrome: A Systematic Review

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Jinna Yu ◽  
Yongming Ye ◽  
Jun Liu ◽  
Yang Wang ◽  
Weina Peng ◽  
...  
Keyword(s):  
Tourette Syndrome ◽  
Western Medicine ◽  
Data Extraction ◽  
Cochrane Collaboration ◽  
Fixed Effect Model ◽  
Study Selection ◽  
Mean Differences ◽  
Randomised Controlled ◽  
Meta Analyses ◽  
The Cochrane Collaboration

Tourette syndrome (TS) is a neuropsychiatric disorder that affects both children and adults. We searched for randomised controlled trials (RCTs) using acupuncture to treat TS written in English or Chinese without restrictions on publication status. Study selection, data extraction, and assessment of study quality were conducted independently by two reviewers. Meta-analyses were performed using Review Manager (RevMan) 5.3 software from the Cochrane Collaboration. Data were combined with the fixed-effect model based on a heterogeneity test. Results were presented as risk ratios for dichotomous data and mean differences (MDs) for continuous data. This review included 7 RCTs with a total of 564 participants. The combined results showed that acupuncture may have better short-term effect than Western medicine for TS and that acupuncture may be an effective adjuvant therapy in improving the effect of Western medicine on TS, but the evidence is limited because of existing biases. Rigorous high-quality RCTs are needed to verify these findings.

Evidence-Based Practice: The Cochrane Collaboration, and Occupational Therapy

1998 ◽  
Vol 65 (3) ◽  
pp. 144-151 ◽  
Author(s):  
Robyn L. Hayes ◽  
John J. McGrath
Keyword(s):  
Systematic Reviews ◽  
Randomised Controlled Trials ◽  
Best Practice ◽  
Evidence Based Practice ◽  
Occupational Therapists ◽  
Cochrane Collaboration ◽  
Controlled Trials ◽  
Evidence Based ◽  
Randomised Controlled ◽  
The Cochrane Collaboration

This paper describes how occupational therapists can become involved in the Cochrane Collaboration — a well-developed tool for facilitating the involvement of health professionals and lay people in evidence-based practice. The Cochrane Collaboration is a growing international project intended to systematically locate, conduct systematic reviews (including metaanalyses) of, and disseminate information on all available randomised controlled trials of interventions in any area of health. In particular, occupational therapists can use the Cochrane Collaboration to become better informed about best practice and evaluate research in their areas of interest, and learn skills related to conducting randomised controlled trials, systematic reviews, and meta-analyses.

scholarly journals Which psychotherapy is effective in panic disorder? And which delivery formats are supported by the evidence? Study protocol for two systematic reviews and network meta-analyses

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e038909
Author(s):  
Davide Papola ◽  
Giovanni Ostuzzi ◽  
Chiara Gastaldon ◽  
Marianna Purgato ◽  
Cinzia Del Giovane ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Systematic Reviews ◽  
Data Extraction ◽  
Behavioural Therapy ◽  
Primary Data ◽  
Study Endpoint ◽  
Controlled Trials ◽  
Endpoint Data ◽  
Randomised Controlled ◽  
Meta Analyses

IntroductionPanic disorder is among the most prevalent anxiety diseases. Although psychotherapy is recommended as first-line treatment for panic disorder, little is known about the relative efficacy of different types of psychotherapies. Moreover, there is little evidence concerning the effectiveness of different formats of major psychotherapeutic types, such as cognitive–behavioural therapy (CBT). In this protocol, we present an overarching project consisting of two systematic reviews and network meta-analyses (NMA) to shed light on which psychotherapy (NMA-1), and specifically, which CBT delivery format (NMA-2) should be considered most effective for adults suffering from panic disorder with or without agoraphobia.Methods and analysesStarting from a common pool of data, we will conduct two systematic reviews and NMA of randomised controlled trials examining panic disorder. A comprehensive search will be performed in electronic databases MEDLINE, Embase, PsycINFO and the Cochrane Register of Controlled Trials—CENTRAL from database inception to 1 January 2021 to identify relevant studies. A systematic approach to searching, screening, reviewing and data extraction will be applied. Titles, abstract and—whenever necessary—full texts will be examined independently by at least two reviewers. The quality of the included studies will be assessed using the revised Cochrane risk of bias tool V.2. The primary efficacy outcome will be anxiety symptoms at study endpoint. The primary acceptability outcome will be all-cause discontinuation, as measured by the proportion of patients who had discontinued treatment for any reason at endpoint. Data will be pooled using a random-effects model. Pairwise and NMA will be conducted.Ethics and disseminationNo ethical approval is necessary for these two studies, as there will be no collection of primary data. The results will be disseminated through peer-reviewed publications and presentations at national and international conferences and meetings.

Evaluation of Industry Relationships Among Authors of Systematic Reviews and Meta-analyses Regarding Ménières Disease

2021 ◽  
pp. 000348942110518
Author(s):  
David Wenger ◽  
Ross Nowlin ◽  
Austin L. Johnson ◽  
Michael Anderson ◽  
Michael Weaver ◽  
...  
Keyword(s):  
High Risk ◽  
Systematic Reviews ◽  
Conflicts Of Interest ◽  
Cochrane Collaboration ◽  
Risk Of Bias ◽  
Inclusion Criteria ◽  
Disease Treatment ◽  
Bias Assessment ◽  
Meta Analyses ◽  
The Cochrane Collaboration

Objectives: To quantify the presence of conflicts of interest (COI) in SRs and MAs of Ménières disease treatment and identify any related secondary characteristics of these articles. Methods: A search was conducted on May 28, 2020 to search MEDLINE and Embase databases for SRs or MAs pertaining to Ménières disease published between September 1, 2016 and June 2, 2020. A risk of bias assessment was performed using the Cochrane Collaboration risk of bias assessment criteria. Results: A total of 13 systematic reviews conducted by 49 authors met the inclusion criteria. Of the 49 authors, 7 (14.3%) were found to have some form of COI. Of these 7 authors, 1 (14.3%) completely disclosed all COI within the SR, 1 (14.3%) disclosed one or more COI but were found to have an additional undisclosed COI, and 5 (71.4%) were found to have only undisclosed COI. One of 2 industry funded SRs (50%) had a high risk of bias, and 1 (50%) of the non-industry sponsored SRs were found to have a high risk of bias. Conclusions: Overall authors of SRs pertaining to Ménières disease appear to be properly disclosing COI at higher rates than other fields of medicine; however, further room for improvement has been noted.

Combining results from several studies: systematic reviews and meta-analyses

2017 ◽  
Author(s):  
Mark Elwood
Keyword(s):  
Systematic Reviews ◽  
Testing Effect ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Outcome Reporting Bias ◽  
Regression Methods ◽  
Inverse Variance ◽  
Funnel Plots ◽  
Meta Analyses ◽  
The Cochrane Collaboration

This chapter explains systematic reviews, the PRISMA format, and meta-analysis. It discusses publication bias, outcome reporting bias, funnel plots, the issue of false positive results in small studies, along with search strategies, electronic databases, PubMed, and the Cochrane collaboration. It discusses the assessment of quality, risks of bias, limitations of meta-analysis, heterogeneity testing, effect modification, and meta-regression methods. In part two, it explains statistical methods for meta-analyses are presented, including the Mantel-Haenszel and Peto methods for individual patient data, the inverse variance weighted method using final results, and random effects methods. Forest plots and tests of heterogeneity are explained.

scholarly journals Níveis plasmáticos do TNF-alfa em gestantes com infecção pelo Zika vírus (ZIKV) e sua relação com gravidade da síndrome congênita: revisão sistemática e metanálise

2021 ◽  
Vol 10 (10) ◽  
pp. e428101019080
Author(s):  
Emile Ivana Fernandes Santos Costa ◽  
Murilo de Jesus Porto ◽  
Danilo Ferreira de Sousa ◽  
Camila Alexandrina Viana Figueiredo ◽  
Valdirene Leão Carneiro
Keyword(s):  
Random Effects ◽  
Systematic Reviews ◽  
Zika Virus ◽  
Cochrane Collaboration ◽  
Random Effects Model ◽  
Virus Zika ◽  
Meta Analyses ◽  
The Cochrane Collaboration

O processo patológico ocasionado pelo vírus Zika (ZIKV), que é transmitida por mosquitos do gênero Aedes, apresenta distintos sinais e sintomas, havendo uma certa dificuldade em achados de biomarcadores genéticos, bioquímicos ou imunológicos, indicando alterações a nível de tecidos alvos. Assim, o estudo tem como objetivo verificar se o aumento da expressão ou dos níveis plasmáticos de TNF-alfa em gestantes com infecção pelo ZIKV estão associados com a ocorrência/gravidade da Síndrome Congênita. Como processo metodológico, trata-se de uma revisão sistemática da literatura, seguindo as recomendações do protocolo Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) para revisões sistemáticas e metanálise. Os estudos foram pesquisados nas fontes de dados Scielo, Pubmed, LILACS e Scopus, onde todas as análises foram realizadas pelo software REVMAN 5.4 (The Cochrane Collaboration, 2020). Devido à heterogeneidade desses estudos incluídos na metanálise, foi selecionado o modelo de efeitos aleatórios (random-effects model), sendo utilizados sete trabalhos. Os resultados e discussão indicam que os achados nos estudos indicados valores de I2 elevado (95%; p<0,01) para o desfecho, mostrando heterogeneidade considerável, os resultados demonstram que há uma elevação considerável da citocina TNF- alfa  na SCZ, sendo que o papel do TNF- alfa  tanto nas doenças infecciosas quanto nas inflamações agudas e crônicas, vem sendo cada vez mais descrito, para tentar entender melhor a dinâmica da resposta de defesa do organismo as partículas invasoras que o acometem. Quando a produção de citocinas pró-inflamatórias, ficando evidente a presença de níveis plasmáticos de TNF- alfa em gestantes com infecção pelo ZIKV como marcadores biológicos.

scholarly journals Effects of physical exercise during pregnancy on mothers’ and neonates’ health: a protocol for an umbrella review of systematic reviews and meta-analysis of randomised controlled trials

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030162
Author(s):  
Gema Sanabria-Martínez ◽  
Raquel Poyatos-León ◽  
Blanca Notario-Pacheco ◽  
Celia Álvarez-Bueno ◽  
Iván Cavero-Redondo ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Systematic Reviews ◽  
Fixed Effects ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Evaluation Framework ◽  
Controlled Trials ◽  
Randomised Controlled ◽  
Meta Analyses

IntroductionA growing interest has emerged on the effects of exercise during gestation. Several systematic reviews and meta-analyses have shown that prenatal exercise could reduce the mothers’ risk for some disorders. Despite this, evidence regarding the risk of caesarean section, birth weight or Apgar score at delivery is still controversial. Furthermore, practitioners are reluctant to recommend exercise to pregnant women suffering from some disorders, such as hypertension, pre-eclampsia or pregnant women with obesity. Moreover, the scarcity of studies addressing the risks and benefits of exercise at higher intensity prevent practitioners from recommending it at higher dosages. Umbrella reviews represent an appropriate design to elucidate the reasons behind the contradictory findings of previous systematic reviews.MethodsThis protocol was developed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols and the Cochrane Collaboration Handbook. Medline, EMBASE, Web of Science, Cochrane database of systematic reviews, Epistemonikos, Prospero register and SPORTDiscuss databases will be searched to identify systematic reviews, meta-analyses and randomised controlled trials that examine the effect of exercise on pregnancy outcomes from inception to August 2019. Searches will be conducted from September to November 2019.Statistical analysisMethodological quality will be evaluated using the AMSTAR 2 tool. The certainty of evidence and strength of recommendations for meta-analyses will be assessed by the Grading of Recommendations Assessment, Development and Evaluation framework. The summary effect sizes will be calculated through the use of random-effects and fixed-effects models. Heterogeneity among studies will be assessed using the I2statistic, and evidence of excess significance bias and evidence of small study effects will also be evaluated.Ethics and disseminationEthical approval will not be needed for this review protocol. The results will be disseminated to academic audiences by peer-reviewed publications. Furthermore, results will be disseminated to clinical audiences through professionals’ associations and social networks, and may influence guidelines developers in order to improve outcomes in mothers and offspring.PROSPERO registration numberCRD42019123410.

scholarly journals Sensory-Based Priming for Upper Extremity Hemiparesis After Stroke: A Scoping Review

2021 ◽  
pp. 153944922110326
Author(s):  
Mary E. Stoykov ◽  
Courtney Heidle ◽  
Shamshir Kang ◽  
Lisa Lodesky ◽  
Lindsay E. Maccary ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Motor Skills ◽  
Upper Limb ◽  
Scoping Review ◽  
Web Of Science ◽  
Motor Impairment ◽  
Cochrane Collaboration ◽  
Prisma Statement ◽  
Meta Analyses ◽  
The Cochrane Collaboration

Sensory priming is a technique to facilitate neuroplasticity and improve motor skills after injury. Common sensory priming modalities include peripheral nerve stimulation/somatosensory electrical stimulation (PNS/SES), transient functional deafferentation (TFD), and vibration. The aim of this study was to determine whether sensory priming with a motor intervention results in improved upper limb motor impairment or function after stroke. PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and EMBASE were the databases used to search the literature in July 2020. This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and recommendations for the Cochrane collaboration. In total, 30 studies were included in the analysis: three studies examined TFD, 16 examined PNS/SES, 10 studied vibration, and one combined the three stimulation techniques. Most studies reported significant improvements for participants receiving sensory priming. Given the low risk, it may be advantageous to use sensory-based priming prior to or concurrent with upper limb training after stroke.

scholarly journals Efficacy and safety of instantaneous wave-free ratio in patients undergoing coronary revascularisation: protocol for a systematic review

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017868
Author(s):  
Joey S.W. Kwong ◽  
Sheyu Li ◽  
Wan-Jie Gu ◽  
Hao Chen ◽  
Chao Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Coronary Revascularisation ◽  
Eligibility Criteria ◽  
Registration Number ◽  
Collection Form ◽  
Randomised Controlled ◽  
Meta Analyses

IntroductionEffective selection of coronary lesions for revascularisation is pivotal in the management of symptoms and adverse outcomes in patients with coronary artery disease. Recently, instantaneous ‘wave-free’ ratio (iFR) has been proposed as a new diagnostic index for assessing the severity of coronary stenoses without the need of pharmacological vasodilation. Evidence of the effectiveness of iFR-guided revascularisation is emerging and a systematic review is warranted.Methods and analysisThis is a protocol for a systematic review of randomised controlled trials and controlled observational studies. Electronic sources including MEDLINE via Ovid, Embase, Cochrane databases and ClinicalTrials.gov will be searched for potentially eligible studies investigating the effects of iFR-guided strategy in patients undergoing coronary revascularisation. Studies will be selected against transparent eligibility criteria and data will be extracted using a prestandardised data collection form by two independent authors. Risk of bias in included studies and overall quality of evidence will be assessed using validated methodological tools. Meta-analysis will be performed using the Review Manager software. Our systematic review will be performed according to the guidance from the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.Ethics and disseminationEthics approval is not required. Results of the systematic review will be disseminated as conference proceedings and peer-reviewed journal publication.Trial registration numberThis protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42017065460.

scholarly journals Relationship between hospital or surgeon volume and outcomes in joint arthroplasty: protocol for a suite of systematic reviews and dose–response meta-analyses

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e022797 ◽  
Author(s):  
Xiang-Dong Wu ◽  
Meng-Meng Liu ◽  
Ya-Ying Sun ◽  
Zhi-Hu Zhao ◽  
Quan Zhou ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Dose Response ◽  
Data Extraction ◽  
Meta Analysis ◽  
High Volume ◽  
Joint Arthroplasty ◽  
Surgeon Volume ◽  
Published Data ◽  
Records Management ◽  
Meta Analyses

IntroductionJoint arthroplasty is a particularly complex orthopaedic surgical procedure performed on joints, including the hip, knee, shoulder, ankle, elbow, wrist and even digit joints. Increasing evidence from volume–outcomes research supports the finding that patients undergoing joint arthroplasty in high-volume hospitals or by high-volume surgeons achieve better outcomes, and minimum case load requirements have been established in some areas. However, the relationships between hospital/surgeon volume and outcomes in patients undergoing arthroplasty are not fully understood. Furthermore, whether elective arthroplasty should be restricted to high-volume hospitals or surgeons remains in dispute, and little is known regarding where the thresholds should be set for different types of joint arthroplasties.Methods and analysesThis is a protocol for a suite of systematic reviews and dose–response meta-analyses, which will be amended and updated in conjunction with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. Electronic databases, including PubMed and Embase, will be searched for observational studies examining the relationship between the hospital or surgeon volume and clinical outcomes in adult patients undergoing primary or revision of joint arthroplasty. We will use records management software for study selection and a predefined standardised file for data extraction and management. Quality will be assessed using the Newcastle-Ottawa Scale, and the meta-analysis, subgroup analysis and sensitivity analysis will be performed using Stata statistical software. Once the volume–outcome relationships are established, we will examine the potential non-linear relationships between hospital/surgeon volume and outcomes and detect whether thresholds or turning points exist.Ethics and disseminationEthical approval is not required, because these studies are based on aggregated published data. The results of this suite of systematic reviews and meta-analyses will be submitted to peer-reviewed journals for publication.PROSPERO registration numberCRD42017056639.

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