scholarly journals When applying GRADE, how do we decide the target of certainty of evidence rating?

2021 ◽  
pp. ebmental-2020-300170
Author(s):  
Linan Zeng ◽  
Romina Brignardello-Petersen ◽  
Gordon Guyatt
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Working Group ◽  
Health Technology ◽  
Assessment Development ◽  
True Effect ◽  
Evidence Rating

The Grades of Recommendation, Assessment, Development and Evaluation’ (GRADE) offers a widely adopted, transparent and structured process for developing and presenting summaries of evidence, including the certainty of evidence, for systematic reviews and recommendations in healthcare. GRADE defined certainty of evidence as ‘the extent of our confidence that the estimates of the effect are correct (in the context of systematic review), or are adequate to support a particular decision or recommendation (in the context of guideline)’. Realising the incoherence in the conceptualisation, the GRADE working group re-clarified the certainty of evidence as ‘the certainty that a true effect lies on one side of a specified threshold, or within a chosen range’. Following the new concept, in the context of both systematic reviews and health technology assessments, it is desirable for GRADE users to specify the thresholds and clarify of which effect they are certain. To help GRADE users apply GRADE in accordance with the new conceptualisation, GRADE defines three levels of contextualisation: minimally, partially and fully contextualised approaches, and provides possible thresholds for each level of contextualisation. In this article, we will use a hypothetic systematic review to illustrate the application of the minimally and partially contextualised approaches, and discuss the application of a fully contextualised approach in deciding how we are rating our certainty (i.e.target of the rating of certainty of evidence).

Parent–Infant Interventions to Promote Parental Sensitivity During NICU Hospitalization: Systematic Review and Meta-Analysis

2021 ◽  
pp. 105381512199192
Author(s):  
Andréane Lavallée ◽  
Gwenaëlle De Clifford-Faugère ◽  
Ariane Ballard ◽  
Marilyn Aita
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Standard Care ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Parental Sensitivity ◽  
Assessment Development ◽  
Implementation Failure ◽  
Meta Analyses

This systematic review and meta-analysis examined the effectiveness of parent–infant interventions for parents of preterm infants on parental sensitivity compared to standard care or active comparators. This review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO; registration ID: CRD42016047083). Database searches were performed from inception to 2020 to identify eligible randomized controlled trials. Two review authors independently selected studies, extracted data, and assessed the risk of bias using the Cochrane risk of bias assessment tool and quality of evidence using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) guidelines. A total of 19 studies ( n = 2,111 participants) were included and 14 were suitable to be pooled in our primary outcome meta-analysis. Results show no significant effect of parent–infant interventions over standard care or basic educational programs, on parental sensitivity. Results may not necessarily be due to the ineffectiveness of the interventions but rather due to implementation failure or high risk of bias of included studies.

scholarly journals Does pain influence force steadiness? A protocol for a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e042525
Author(s):  
Michail Arvanitidis ◽  
Deborah Falla ◽  
Andy Sanderson ◽  
Eduardo Martinez-Valdes
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Grey Literature ◽  
Force Steadiness ◽  
Assessment Development ◽  
Ethical Approval ◽  
Registration Number ◽  
Meta Analyses

IntroductionPerforming contractions with minimum force fluctuations is essential for everyday life as reduced force steadiness impacts on the precision of voluntary movements and functional ability. Several studies have investigated the effect of experimental or clinical musculoskeletal pain on force steadiness but with conflicting findings. The aim of this systematic review is to summarise the current literature to determine whether pain, whether it be clinical or experimental, influences force steadiness.Methods and analysisThis protocol for a systematic review was informed and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols and the Cochrane Handbook for Systematic Reviews of Interventions. Key databases will be searched from inception to 31 August 2020, including MEDLINE, EMBASE, PubMed, CINAHL Plus, ZETOC and Web of Science. Grey literature and key journals will be also reviewed. Risk of bias will be assessed with the Newcastle-Ottawa tool, and the quality of the cumulative evidence assessed with the Grading of Recommendations, Assessment, Development and Evaluation guidelines. If homogeneity exists between groups of studies, meta-analysis will be conducted. Otherwise, a narrative synthesis approach and a vote-counting method will be used, while the results will be presented as net increases or decreases of force steadiness.Ethics and disseminationThe findings will be presented at conferences and the review will be also submitted for publication in a refereed journal. No ethical approval was required.PROSPERO registration numberCRD42020196479

scholarly journals Effect of Probiotic, Prebiotic, or Synbiotic Supplement on Children, Adolescents, or Infants: A Protocol of an Umbrella Review

2021 ◽  
Author(s):  
Shunlian 付顺链 Fu ◽  
Qian Zhou ◽  
Lijun Yuan ◽  
Zi-nan Li ◽  
Qiu Chen
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Data Extraction ◽  
Random Effect ◽  
Control Group ◽  
Measurement Tool ◽  
Umbrella Review ◽  
Qualitative Comparison ◽  
Assessment Development ◽  
Meta Analyses

Abstract Background: Many systematic reviews and meta-analyses have studied the association between probiotics, prebiotics, or synbiotics and children, adolescents, or Infants. With the promotion of probiotics, prebiotics, or synbiotics in our life and medical practice, more and more attention has been paid to them. Therefore, it is necessary to make a systematic summary of them. When the information was obtained in the identified systematic review, it will be compared with a control group that do not use probiotics, prebiotics, or synbiotics. In addition, our aim is to assess the quality of the included systematic reviews.Methods: We will conduct a comprehensive systematic search by summarizing systematic reviews of randomized controlled trials which have studied effect of probiotic, prebiotic, or synbiotic supplement on children, adolescents, or Infants. Four electronic databases (Embase, PubMed, Medline, and Cochrane Database of Systematic Reviews) will be searched. Two reviewers will independently screen the retrieved papers. Two reviewers will independently extract the data by reference to the JBI Data Extraction Form for Review for Systematic Reviews and Research Syntheses. We will also assess methodological quality and assessment of certainty in the findings by A Measurement Tool to Assess Systematic Review version 2 (AMSTAR-2) and the GRADE (Grading of Recommendations Assessment, Development and Evaluation). We will calculate the corrected covered area (CCA). We will recalculate the summary effect and 95% CIs by using fixed-effect or random-effect models.Discussion: Through quantitative and qualitative comparison by conducting an umbrella review, we hope our results will service better for future clinical practice.Systematic review registration: This protocol have finished the registration in the International Prospective Register of Systematic Reviews (PROSPERO) (registration number: CRD42021244923).

scholarly journals Elimination and Reduction of Harmful Substances in Cigarette Smoke, Using Nanomaterials: Study Protocol for a Systematic Review

2021 ◽  
Author(s):  
Mohammad Hossein Chalak ◽  
Soqrat Omari Shekaftik ◽  
Hossein Jafari ◽  
Hamid Reza Ghaffari ◽  
Sakineh Dadipoor ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cigarette Smoke ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Evaluation Methodology ◽  
Toxic Substances ◽  
Assessment Development ◽  
Effective Interventions ◽  
Harmful Substances ◽  
Meta Analyses

Abstract Background Cigarette smoke is an aerosol containing more than thousands of chemical compounds, several of which are carcinogens and toxic. Many efforts have been made to use nanomaterials (NMs) to remove and filter toxic substances in cigarette smoke. Due to the characteristics of MLs and their selectivity to different compounds, NMs have a high potential for practical application in reducing harmful compounds in cigarette smoke. The objective of this systematic review is to collect, combine, and analyze the basic intervention research on NMs for removal and reduction of harmful substances in cigarette smoke. This systematic review will determine the most important factors and expected characterizations for the development or commercialization of a new filters. Finally, we will review the challenges of using NMs-based interventions. Methods This protocol is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-P protocol and Cochrane methodology. The inclusion/exclusion criteria are determined based on PICOTS (Population, Intervention, Comparator, Outcome, Time, Study Design) Framework. The Comprehensive literature searches will be conducted in international databases such as PubMed, Scopus, Science Direct and 3Iranian database, including SID, Iranmedex and Magiran. The quality of the papers and the risk of bias will be assessed using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) methodology. The results will be presented in the text as well as in a table and figure based on the SWiM guidelines (Synthesis Without Meta-analysis). the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and guidelines will be tracked to certify a robustness and reproducibility of the process. Discussion A comprehensive analysis of the studies conducted in this field can identify research needs, examine the current and expected situation, provide the necessary parameters for research and development of new filters and ultimately determine the effective priorities for further effective interventions.

scholarly journals Systematic review protocol on Bacillus Calmette-Guerin (BCG) revaccination and protection against tuberculosis

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e027033 ◽  
Author(s):  
Phetole Walter Mahasha ◽  
Duduzile Edith Ndwandwe ◽  
Edison Johannes Mavundza ◽  
Muki Shey ◽  
Charles Shey Wiysonge
Keyword(s):  
Systematic Review ◽  
Mycobacterium Tuberculosis ◽  
Cause Of Death ◽  
Systematic Reviews ◽  
Evaluation Method ◽  
Infectious Agent ◽  
Cochrane Central Register ◽  
Recent Trial ◽  
Assessment Development ◽  
Ethical Approval

IntroductionTuberculosis (TB) is a disease caused byMycobacterium tuberculosis(M.TB) and other species of the Mycobacterium tuberculosis complex. Globally, TB is ranked as the ninth leading cause of death and the leading cause of death from a single infectious agent. The bacille Calmette-Guerin (BCG) vaccine has been used globally since 1921 for the prevention of TB in humans, and was derived from an attenuated strain ofMycobacterium bovis. Evidence from previous randomised trials show that the efficacy of primary BCG vaccination against pulmonary TB ranged from no protection to very high protection. In addition, some studies suggest a benefit of BCG revaccination. For example, a recent trial conducted in South Africa showed that BCG revaccination of adolescents could reduce the risk of TB infection by half. However, we are not aware of any recent systematic reviews of the effects of BCG revaccination. Thus, the need for this systematic review of the effects of BCG revaccination on protection against TB infection and disease.Method and analysisWe will search PubMed, the Cochrane Central Register of Controlled Trials, EMBASE, WHO International Clinical Trials Registry Platform and reference lists of relevant publications for potentially eligible studies. We will screen search outputs, select eligible studies, extract data and assess risk of bias in duplicate. Discrepancies will be resolved by discussion and consensus or arbitration. We will use the Grading of Recommendations Assessment, Development and Evaluation method to assess the certainty of the evidence. The planned systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO) in August 2018.Ethics and disseminationPublicly available data will be used, hence no formal ethical approval will be required for this review. The findings of the review will be disseminated through conference presentations and publication in an open-access peer-reviewed journal.PROSPERO registration numberCRD42018105916

OP96 Assessing Impact Of UK Health Technology Assessment Programme Trials

2019 ◽  
Vol 35 (S1) ◽  
pp. 24-24
Author(s):  
Christopher Carroll ◽  
Andy Tattersall
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Health Technology ◽  
Controlled Trials ◽  
Citation Data ◽  
Cochrane Systematic Review ◽  
Cochrane Reviews ◽  
Guidance Documents ◽  
Meta Analyses

IntroductionCitation analysis is a standard tool for measuring the impact and influence of scientific work. One purpose behind controlled trials is to answer clinical and policy questions and to contribute directly or indirectly (contributing to systematic review and meta-analyses) to the production of practice guidance. The citation of trials within systematic reviews and policy or guidance documents therefore represents an authentic and meaningful measure of impact.MethodsAll 136 randomized controlled trials published by the United Kingdom (UK) Health Technology Assessment (HTA) programme in a 10-year period (2006-2015) were identified. Web of Science citation index was used to collect citation data relating to each trial. Altmetrics were used to identify additional policy and guidance documents. Citation data were collected and tabulated, and descriptive statistics produced. Additional data were collected for principal ‘spin-off’ publications.ResultsEighty-eight percent of trials were cited by at least one Cochrane or non-Cochrane systematic review or meta-analysis; 37 percent by at least one Cochrane review (90 Cochrane reviews in total); 85 percent by at least one non-Cochrane systematic review or meta-analysis (365 in total). Forty-four percent of trials were cited by at least one unique piece of published policy or guidance. Mean number of review citations per published trial: 25.30; mean number of systematic reviews/meta-analyses per trial: 3.34; mean number of guidance documents per trial: 0.85. Trial investigators published the primary clinical outcome data in 27 additional peer-reviewed journal articles, generating citations in a further 66 unique reviews and 22 unique guidance documents.ConclusionsBased on the payback model, this sample of 136 UK HTA trials represent meaningful impact: 88 percent of trials were cited in systematic reviews and 44 percent in guidance documents. Chronological data indicate that there might be a sizeable time-lag between publication and impact, especially for policy documents and Cochrane reviews.

The Clinical Utility and Assessment of Renal Biomarkers in Acute Kidney Injury After Abdominal Endovascular Aneurysm Repair. A Systematic Review

2020 ◽  
Vol 25 (44) ◽  
pp. 4695-4701 ◽  
Author(s):  
Georgios Karaolanis ◽  
Zachary F. Williams ◽  
Chris Bakoyiannis ◽  
Dimitrios Hadjis ◽  
Mitchell W. Cox ◽  
...  
Keyword(s):  
Systematic Review ◽  
Acute Kidney Injury ◽  
Systematic Reviews ◽  
Clinical Utility ◽  
Binding Protein ◽  
Endovascular Aneurysm Repair ◽  
Kidney Injury ◽  
Aortic Aneurysms ◽  
Renal Biomarkers ◽  
Aneurysm Repair

: The widespread adoption of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAA) is due to the obvious advantages of the procedure compared to the traditional open repair. However, these advantages have to be weighed against the increased risk of renal dysfunction with EVAR. The evaluation of the perioperative renal function after EVAR has been hampered by the lack of sensitive and specific biochemical markers of acute kidney injury (AKI). The purpose of this study was to summarize all novel renal biomarkers and to evaluate their clinical utility for the assessment of the kidney function after EVAR. A systematic review of the current literature, as the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines, was performed to identify relevant studies with novel renal biomarkers and EVAR. Pubmed and Scopus databases were systemically searched. Studies reporting on thoracic endovascular aortic repair (TEVAR), case reports, case series, letters to the editor, and systematic reviews were excluded. Neutrophil-Gelatinase-Associated Lipocalin, Cystatin C, Liver-type fatty-acid-binding protein were the most common among the eligible studies while Interleukin-18, Retinol binding protein, N-acetyle-b-D-glucosaminidase and microalbumin have a sparse appearance in the literature. These biomarkers have been assessed in plasma as well as urine samples with each sample material having its own advantages and drawbacks. Which of these biomarkers has the most potential for assessing postoperative renal failure after EVAR, remains to be proved. The few studies presented in the literature show the potential clinical utility of these biomarkers, but larger studies with longer follow-up are required to determine the precise relationship between these biomarkers and postoperative acute kidney injury.

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