scholarly journals Systematic review and meta-analysis: does colonic mural thickening on CT correlate with endoscopic findings at colonoscopy?

2018 ◽  
Vol 9 (4) ◽  
pp. 278-284 ◽  
Author(s):  
Subashini Chandrapalan ◽  
Faraz Tahir ◽  
Peter Kimani ◽  
Rakesh Sinha ◽  
Ramesh Arasaradnam
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Positive Predictive Value ◽  
Search Strategy ◽  
Meta Analysis ◽  
Small Sample ◽  
Limiting Factors ◽  
Endoscopic Findings ◽  
Registration Number ◽  
Small Sample Sizes

BackgroundColonic mural thickening (MT) is often reported on standard CT examinations of the abdomen and pelvis. It often presents a dilemma for the clinician on whether any further evaluation is needed, especially in the absence of any set guidelines.ObjectiveTo evaluate the significance of colonic MT and to assess its correlation with colonoscopy.MethodsThe search strategy was initially developed in Medline and adapted for use in Embase, Medline, NHS Evidence and TRIP. Studies were included if they had reported colonic MT and subsequent colonoscopy in adults.ResultsA total of 9 cohort studies examining 1252 patients were selected having undergone both CT and colonoscopy. Of the 1252 patients with MT, 950 had an abnormal colonoscopy. In the presence of MT, the pooled positive predictive value (PPV) of having any abnormal findings at colonoscopy was 0.73 (95% CI 0.60 to 0.84). The pooled PPV for colorectal cancer, in the presence of MT reporting suspicion of cancer, was 0.63 (95% CI 0.49 to 0.75), and MT suggestive of inflammation confirmed at colonoscopy was 0.97.ConclusionThe probability of having an abnormal colonoscopy in the presence of MT identified on CT is high, especially for inflammation. Asymptomatic cancers may also be detected; hence, further endoscopic confirmation is reasonable when a finding of MT is demonstrated on CT examinations. Small sample sizes of the available studies and lack of data on the description of MT detected are the main limiting factors in this review.Trial registration numberCRD42016039378.

scholarly journals Utility of the methylated SEPT9 test for the early detection of colorectal cancer: a systematic review and meta-analysis of diagnostic test accuracy

2020 ◽  
Vol 7 (1) ◽  
pp. e000355 ◽  
Author(s):  
Rohit Hariharan ◽  
Mark Jenkins
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Early Detection ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Diagnostic Test ◽  
Predictive Value ◽  
Meta Analysis ◽  
Test Accuracy ◽  
Sensitivity Specificity

BackgroundCirculating tumour DNA from colorectal cancer (CRC) is a biomarker for early detection of the disease and therefore potentially useful for screening. One such biomarker is the methylated SEPT9 (mSEPT9) gene, which occurs during CRC tumourigenesis. This systematic review and meta-analysis aims to establish the sensitivity, specificity and accuracy of mSEPT9 tests for the early diagnosis of CRC.MethodsA systematic search of the relevant literature was conducted using Medline and Embase databases. Data were extracted from the eligible studies and analysed to estimate pooled sensitivity, specificity and diagnostic test accuracy.ResultsBased on 19 studies, the pooled estimates (and 95% CIs) for mSEPT9 to detect CRC were: sensitivity 69% (62–75); specificity 92% (89–95); positive likelihood ratio 9.1 (6.1–13.8); negative likelihood ratio 0.34 (0.27–0.42); diagnostic OR 27 (15–48) and area under the curve 0.89 (0.86–0.91). The test has a positive predictive value of 2.6% and negative predictive value of 99.9% in an average risk population (0.3% CRC prevalence), and 9.5% (positive predictive value) and 99.6% (negative predictive value) in a high-risk population (1.2% CRC prevalence).ConclusionThe mSEPT9 test has high specificity and moderate sensitivity for CRC and is therefore a potential alternative screening method for those declining faecal immunochemical test for occult blood (FIT) or other screening modalities. However, it is limited by its poor diagnostic performance for precancerous lesions (advanced adenomas and polyps) and its relatively high costs, and little is known about its acceptability to those declining to use the FIT.

Prevalence of tuberculosis, brucellosis and trypanosomiasis in cattle in Tanzania: a systematic review and meta-analysis

2016 ◽  
Vol 17 (1) ◽  
pp. 16-27 ◽  
Author(s):  
Silvia Alonso ◽  
Ian Dohoo ◽  
Johanna Lindahl ◽  
Cristobal Verdugo ◽  
Isaiah Akuku ◽  
...  
Keyword(s):  
Systematic Review ◽  
Production Systems ◽  
Strong Predictor ◽  
Meta Analysis ◽  
Small Sample ◽  
Skin Tests ◽  
Prevalence Studies ◽  
Prevalence Estimates ◽  
Using Data ◽  
Small Sample Sizes

AbstractA meta-analysis was performed to derive prevalence estimates for Brucella spp., Mycobacterium spp. and Trypanosoma spp. in cattle in Tanzania using data derived from a systematic review of zoonotic hazards in cattle production systems. Articles published before 2012 reporting prevalence and considered at least moderate in quality were included in the analysis. Results showed high heterogeneity between studies, with wide ranges in the reported prevalence: Brucella (0.3–60.8%), Mycobacterium (0.1–13.2%) and Trypanosoma (0.82–33.3%). Overall meta-analytic mean prevalence estimates were 8.2% (95% CI 6.5–10.2), 1.28% (95% CI 0.35–4.58) and 10.3% (95% CI 6.20–16.70) respectively, for Brucella spp., Mycobacterium spp. and Trypanosoma spp. Time and region were predictors of variability of Brucella spp. prevalence, while diagnostic test was a strong predictor of Mycobacterium spp. prevalence, with higher prevalence estimates given by skin tests compared with post-mortem inspection. None of the studied factors were associated with prevalence of Trypanosoma spp. The small sample sizes, range of study locations, study designs and diagnostics used, contributed to high variability among prevalence estimates. Larger and more robust prevalence studies are needed to adequately support risk assessment and management of animal and public health threats.

scholarly journals Looking for crumbs in the obesity forest: anti-obesity interventions in the Mexican population. History, and systematic review with Meta-Analysis

2021 ◽  
Author(s):  
Esperanza M. Garcia-Oropesa ◽  
Yoscelina E. Martinez-Lopez ◽  
Sonia Maria Ruiz-Cejudo ◽  
Jose Dario Martinez-Ezquerro ◽  
Alvaro Diaz-Badillo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Waist Circumference ◽  
Behavioral Interventions ◽  
Meta Analysis ◽  
Small Sample ◽  
Population History ◽  
Sample Sizes ◽  
Obesity And Diabetes ◽  
Small Sample Sizes

Mexicans and Mexican Americans share culture, genetic background, and predisposition for chronic complications associated with obesity and diabetes making imperative efficacious treatments and prevention. Obesity has been treated for centuries focused-on weight loss while other treatments on associated conditions like gout, diabetes (T2D), and hypertriglyceridemia. To date, there is no systematic review that synthetize the origin of obesity clinics in Mexico and the efforts to investigate treatments for obesity tested by randomized clinical trials (RCT). We conducted systematic searches in Pubmed, Scopus, and Web of Science to retrieve anti-obesity RCT through 2019 and without inferior temporal limit. The systematic review included RCT of anti-obesity treatments in the Mexican adult population, including alternative medicine, pharmacological, nutritional, behavioral, and surgical interventions reporting biometric outcomes such as BMI, weight, waist circumference, triglycerides, glucose, among others. Studies with at least three months of treatment were included in the meta-analysis. We found 634 entries, after removal of duplicates and screening the studies based on eligibility criteria, we analyzed 43, and 2 multinational-collaborative studies. Most of the national studies have small sample sizes, and the studied strategies do not have replications in the population. The nutrition/behavioral interventions were difficult to blind, and most studies have medium to high risk of bias. Nutritional/behavioral interventions and medications showed effects on BMI, waist circumference, and blood pressure. Simple measures like plain water instead of sweet beverages decrease triglycerides and systolic blood pressure. Participants with obesity and hypertension can have benefic effects with antioxidants, and treatment with insulin increase weight in those with T2D. The study of obesity in Mexico has been on-going for more than four decades, but the interest on RCT just increased until this millennium, but with small sample sizes and lack of replication. The interventions affect different metabolic syndrome components, which should be analyzed in detail with the population living on the U.S.-Mexico border; therefore, bi-national collaboration is desirable to disentangle the cultural effects on this population's treatment response.

Effectiveness of Outdoor Exercise Parks on Health Outcomes in Older Adults—A Mixed-Methods Systematic Review and Meta-Analysis

2020 ◽  
pp. 1-13
Author(s):  
Yoke Leng Ng ◽  
Keith D. Hill ◽  
Pazit Levinger ◽  
Elissa Burton
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Older Adults ◽  
Meta Analysis ◽  
Small Sample ◽  
Activity Levels ◽  
Single Leg Stance ◽  
Small Sample Sizes ◽  
Meta Analyses

The objective of this systematic review was to examine the effectiveness of outdoor exercise park equipment on physical activity levels, physical function, psychosocial outcomes, and quality of life of older adults living in the community and to evaluate the evidence of older adults’ use of outdoor exercise park equipment. A search strategy was conducted from seven databases. Nine articles met the inclusion criteria. The study quality results were varied. Meta-analyses were undertaken for two physical performance tests: 30-s chair stand test and single-leg stance. The meta-analysis results were not statistically significant. It was not possible to conclude whether exercise parks were effective at improving levels of physical activity. The review shows that older adults value the benefits of health and social interaction from the use of exercise parks. Findings should be interpreted with caution due to the small sample sizes and the limited number of studies.

scholarly journals Human Papillomavirus in Sinonasal Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

Cancers ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 45
Author(s):  
Kim J. W. Chang Sing Pang ◽  
Taha Mur ◽  
Louise Collins ◽  
Sowmya R. Rao ◽  
Daniel L. Faden
Keyword(s):  
Systematic Review ◽  
Human Papillomavirus ◽  
Squamous Cell ◽  
Meta Analysis ◽  
Small Sample ◽  
Squamous Cell Carcinomas ◽  
Causative Role ◽  
Sample Sizes ◽  
Geographic Regions ◽  
Small Sample Sizes

Human papillomavirus (HPV) drives tumorigenesis in a subset of oropharyngeal squamous cell carcinomas (OPSCC) and is increasing in prevalence across the world. Mounting evidence suggests HPV is also involved in a subset of sinonasal squamous cell carcinomas (SNSCC), yet small sample sizes and variability of HPV detection techniques in existing literature hinder definitive conclusions. A systematic review was performed by searching literature through March 29th 2020 using PubMed, Embase, and Web of Science Core Collection databases. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed by two authors independently. A meta-analysis was performed using the random-effects model. Sixty studies (n = 1449) were eligible for statistical analysis estimating an overall HPV prevalence of 25.5% (95% CI 20.7–31.0). When stratified by HPV detection method, prevalence with multiple substrate testing (20.5%, 95% CI 14.5–28.2) was lower than with single substrate testing (31.7%, 95% CI 23.6–41.1), highest in high-exposure anatomic subsites (nasal cavity and ethmoids) (37.6%, 95% CI 26.5–50.2) vs. low-exposure (15.1%, 95% CI 7.3–28.6) and highest in high HPV+ OPSCC prevalence geographic regions (North America) (30.9%, 95% CI 21.9–41.5) vs. low (Africa) (13.1, 95% CI 6.5–24.5)). While small sample sizes and variability in data cloud firm conclusions, here, we provide a new reference point prevalence for HPV in SNSCC along with orthogonal data supporting a causative role for virally driven tumorigenesis, including that HPV is more commonly found in sinonasal subsites with increased exposure to refluxed oropharyngeal secretions and in geographic regions where HPV+ OPSCC is more prevalent.

Thymidylate Synthase Expression and Prognosis in Colorectal Cancer: A Systematic Review and Meta-Analysis

2004 ◽  
Vol 22 (3) ◽  
pp. 529-536 ◽  
Author(s):  
Sanjay Popat ◽  
Athena Matakidou ◽  
Richard S. Houlston
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Thymidylate Synthase ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Progression Free Survival ◽  
Small Sample ◽  
Sample Sizes ◽  
Free Survival ◽  
Small Sample Sizes

Purpose A number of studies have investigated the relationship between thymidylate synthase (TS) expression and survival in colorectal cancer (CRC) patients. Although most have reported poorer overall and progression-free survival with high TS expression, estimates of the hazard ratio (HR) between studies differ wildly. To derive a more precise estimate of the prognostic significance of TS expression, we have reviewed published studies and carried out a meta-analysis. Materials and Methods Twenty studies stratifying overall survival and/or progression-free survival in CRC patients by TS expression status were eligible for analysis. The principal outcome measure was the HR. Data from these studies were pooled using standard meta-analysis techniques. Results Thirteen studies investigated outcome in a total of 887 cases with advanced CRC, and seven studies investigated outcome in a total of 2,610 patients with localized CRC. A number of methods were used both to assess TS expression and to assign TS status. Sample sizes varied greatly, small sample sizes being a feature of the advanced disease studies. The combined HR estimate for overall survival (OS) was 1.74 (95% CI, 1.34 to 2.26) and 1.35 (95% CI, 1.07 to 1.80) in the advanced and adjuvant settings, respectively, but there was evidence of heterogeneity and possible publication bias. Conclusion Tumors expressing high levels of TS appeared to have a poorer OS compared with tumors expressing low levels. Additional studies with consistent methodology are needed to define the precise prognostic value of TS.

scholarly journals Comparison of Weightlifting, Traditional Resistance Training and Plyometrics on Strength, Power and Speed: A Systematic Review with Meta-Analysis

2022 ◽  
Author(s):  
Stephanie J. Morris ◽  
Jon L. Oliver ◽  
Jason S. Pedley ◽  
G. Gregory Haff ◽  
Rhodri S. Lloyd
Keyword(s):  
Systematic Review ◽  
Resistance Training ◽  
Meta Analysis ◽  
Small Sample ◽  
Training Methods ◽  
Plyometric Training ◽  
Jump Performance ◽  
Sprint Speed ◽  
Traditional Resistance Training ◽  
Small Sample Sizes

Abstract Background Weightlifting training (WLT) is commonly used to improve strength, power and speed in athletes. However, to date, WLT studies have either not compared training effects against those of other training methods, or been limited by small sample sizes, which are issues that can be resolved by pooling studies in a meta-analysis. Therefore, the objective of this systematic review with meta-analysis was to evaluate the effects of WLT compared with traditional resistance training (TRT), plyometric training (PLYO) and/or control (CON) on strength, power and speed. Methods The systematic review included peer-reviewed articles that employed a WLT intervention, a comparison group (i.e. TRT, PLYO, CON), and a measure of strength, power and/or speed. Means and standard deviations of outcomes were converted to Hedges’ g effect sizes using an inverse variance random-effects model to generate a weighted mean effect size (ES). Results Sixteen studies were included in the analysis, comprising 427 participants. Data indicated that when compared with TRT, WLT resulted in greater improvements in weightlifting load lifted (4 studies, p = 0.02, g = 1.35; 95% CI 0.20–2.51) and countermovement jump (CMJ) height (9 studies, p = 0.00, g = 0.95; 95% CI 0.04–1.87). There was also a large effect in terms of linear sprint speed (4 studies, p = 0.13, g = 1.04; 95% CI − 0.03 to 2.39) and change of direction speed (CODS) (2 studies, p = 0.36, g = 1.21; 95% CI − 1.41 to 3.83); however, this was not significant. Interpretation of these findings should acknowledge the high heterogeneity across the included studies and potential risk of bias. WLT and PLYO resulted in similar improvements in speed, power and strength as demonstrated by negligible to moderate, non-significant effects in favour of WLT for improvements in linear sprint speed (4 studies, p = 0.35, g = 0.20; 95% CI − 0.23 to 0.63), CODS (3 studies, p = 0.52, g = 0.17; 95% CI − 0.35 to 0.68), CMJ (6 studies, p = 0.09, g = 0.31; 95% CI − 0.05 to 0.67), squat jump performance (5 studies, p = 0.08, g = 0.34; 95% CI − 0.04 to 0.73) and strength (4 studies, p = 0.20, g = 0.69; 95% CI − 0.37 to 1.75). Conclusion Overall, these findings support the notion that if the training goal is to improve strength, power and speed, supplementary weightlifting training may be advantageous for athletic development. Whilst WLT and PLYO may result in similar improvements, WLT can elicit additional benefits above that of TRT, resulting in greater improvements in weightlifting and jumping performance.

scholarly journals Sex Differences in the Association Between Obesity and Hypertension: A Systematic Review

2021 ◽  
pp. 2-3
Author(s):  
Ava Oliaei
Keyword(s):  
Systematic Review ◽  
Sex Differences ◽  
Meta Analysis ◽  
Small Sample ◽  
Obese Women ◽  
Life Years ◽  
Health Related ◽  
The Difference ◽  
Small Sample Sizes ◽  
Meta Analyses

Introduction: Obesity is associated with multiple health-related complications, which together can decrease quality of life, disability-adjusted life years and life expectancy.1 Systematic reviews and meta-analyses have demonstrated that sex can influence the association between obesity and health complications, such as rheumatoid arthritis and many types of cancer.2-4 However, no systematic review or meta-analysis has been conducted to review the effect of sex on the association between obesity and hypertension, thus far. Knowing whether or not sex influences this relationship can help tailor the prevention, prediction, and care of this condition towards each sex.    Objectives: To evaluate current studies on the association between sex, obesity, and hypertension, so as to obtain an overall estimate of the effect of sex on the prevalence of hypertension in obese individuals.     Methods: A systematic search of EMBASE, MEDLINE, and PubMed was conducted. Search terms, such as “obesity,” “sex differences,” and “hypertension,” were used to filter results. After reviewing 406 articles, eight articles were included.    Results: Four articles showed that obese women were at a greater risk of developing hypertension than obese men.5-8 Conversely, the results of two studies found that obese men are at a greater risk of developing hypertension.9,10 The remaining two studies showed that the difference between the sexes was insignificant.11,12     Discussion/Limitations: Stronger evidence shows that obese women are at a greater risk of developing hypertension than obese men. The two studies that had contradictory conclusions had small sample sizes relative to the other studies. Additionally, the two studies that concluded that both sexes are at a similar risk highlighted that most other studies have determined that obese women are at a greater risk and that their limitations may have caused this discrepancy. Limitations of this review include the limited ethnicity of participants and the use of BMI to classify obesity, which can sometimes lead to misclassification due to varying muscle to fat ratios. These factors limit the generalizability of the results.     Conclusion: Obese women are seemingly at a greater risk of developing hypertension than obese men. However, this conclusion remains statistically inconclusive. Therefore, it would be beneficial to complete a meta-analysis in order to conclusively determine which sex is statistically more at risk of developing hypertension, when obese.  

A Comparative Effectiveness Systematic Review and Meta-Analysis of Drugs for the Prophylaxis of Junctional Ectopic Tachycardia

2021 ◽  
Vol 17 ◽  
Author(s):  
Brian Mendel ◽  
Christianto ◽  
Moira Setiawan ◽  
Radityo Prakoso ◽  
Sisca Natalia Siagian
Keyword(s):  
Systematic Review ◽  
Risk Ratio ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Meta Analysis ◽  
Congenital Heart Surgery ◽  
Small Sample ◽  
Junctional Ectopic Tachycardia ◽  
Drug Of Choice ◽  
Small Sample Sizes

Background: Junctional ectopic tachycardia (JET) is an arrhythmia originating from the AV junction, which may occur following congenital heart surgery, especially when the intervention is near the atrioventricular junction. Objective: The aim of this systematic review and meta-analysis is to compare the effectiveness of amiodarone, dexmedetomidine and magnesium in preventing JET following congenital heart surgery. Methods: This meta-analysis was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement, where 11 electronic databases were searched from date of inception to August 2020. The incidence of JET was calculated with the relative risk of 95% confidence interval (CI). Quality assessment of the included studies was assessed using the Consolidated Standards of Reporting Trials (CONSORT) 2010 statement. Results: Eleven studies met the predetermined inclusion criteria and were included in this meta-analysis. Amiodarone, dexmedetomidine and magnesium significantly reduced the incidence of postoperative JET [Amiodarone: risk ratio 0.34; I2= 0%; Z=3.66 (P=0.0002); 95% CI 0.19-0.60. Dexmedetomidine: risk ratio 0.34; I2= 0%; Z=4.77 (P<0.00001); 95% CI 0.21-0.52. Magnesium: risk ratio 0.50; I2= 24%; Z=5.08 (P<0.00001); 95% CI 0.39-0.66]. Conclusion: All three drugs show promise in reducing the incidence of JET. Our systematic review found that dexmedetomidine is better in reducing the length of ICU stays as well as mortality. In addition, dexmedetomidine also has the least pronounced side effects among the three. However, it should be noted that this conclusion was derived from studies with small sample sizes. Therefore, dexmedetomidine may be considered as the drug of choice for preventing JET.

scholarly journals Pharmacopuncture in Korea: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2016 ◽  
Vol 2016 ◽  
pp. 1-19 ◽  
Author(s):  
Jimin Park ◽  
Hyangsook Lee ◽  
Byung-Cheul Shin ◽  
Myeong Soo Lee ◽  
Boryang Kim ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Musculoskeletal Diseases ◽  
Meta Analysis ◽  
Allocation Concealment ◽  
Small Sample ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Reduction Of Pain ◽  
Small Sample Sizes

Background. Pharmacopuncture is a new form of acupuncture combining acupuncture with herbal medicine, and it has been used under various conditions in Korea. The aim of this study is to establish clinical evidence for the safety and efficacy of pharmacopuncture in Korea.Methods. We searched 9 databases and two relevant journals up to December 2014 using keywords, such as pharmacopuncture. All randomized, controlled trials evaluating pharmacopuncture under any conditions in Korea were considered.Results. Twenty-nine studies involving 1,211 participants were included. A meta-analysis of two studies on obesity showed that 5 to 8 weeks of pharmacopuncture reduced weight, waist circumference, and body mass index (BMI) more than normal saline injections. In the 5 studies of musculoskeletal conditions, 7 to 30 days of pharmacopuncture had additional effects on the reduction of pain intensity, and this benefit was maintained by limiting analyses to studies with a low risk of bias for randomization and/or allocation concealment.Conclusions. This systematic review suggests the potential of pharmacopuncture for obesity and musculoskeletal diseases. However, it is difficult to recommend pharmacopuncture as an evidence-based treatment because of methodological flaws and small sample sizes of the included studies. Further well-designed trials are needed to draw a definitive conclusion.

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