scholarly journals Estimate of false-positive breast cancer diagnoses from accuracy studies: a systematic review

2017 ◽  
Vol 70 (4) ◽  
pp. 282-294 ◽  
Author(s):  
Nereo Segnan ◽  
Silvia Minozzi ◽  
Antonio Ponti ◽  
Cristina Bellisario ◽  
Sara Balduzzi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
False Positive ◽  
Surgical Excision ◽  
Cochrane Library ◽  
Needle Core Biopsy ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
The Impact ◽  
Positive Breast Cancer

BackgroundFalse-positive histological diagnoses have the same consequences of overdiagnosis in terms of unnecessary treatment. The aim of this systematic review is to assess their frequency at needle core biopsy (CB) and/or surgical excision of the breast.MethodsPubMed, Embase, Cochrane Library were systematically searched up to 30 October 2015. Eligibility criteria: cross-sectional studies assessing diagnostic accuracy of CB compared with surgical excision; studies assessing reproducibility of pathologists reading the same slides. Outcomes: false-positive rates; Misclassification of Benign as Malignant (MBM) histological diagnosis; K statistic. Independent reviewers extracted data and assessed quality using an adapted QUADAS-2 tool.ResultsSixteen studies assessed CB false-positive rates. In 10 studies (41 989 screen-detected lesions), the range of false-positive rates was 0%–7.1%. Twenty-seven studies assessed pathologists' reproducibility. Studies with consecutive, random or stratified samples of all the specimens: at CB the MBM range was 0.25%–2.4% (K values 0.83–0.98); at surgical excision, it was 0.67%–1.2% (K values 0.86–0.94). Studies with enriched samples: the MBM range was 1.4%–6.2% (K values 0.57–0.86). Studies of cases selected for second opinion: the MBM range was 0.29%–12.2% (K values 0.48 and 0.50).ConclusionsHigh heterogeneity of the included studies precluded formal pooling estimates. When considering studies of higher sample size or methodological quality, false-positive rates and MBM are around 1%. The impact of false-positive histological diagnoses of breast cancer on unnecessary treatment, as well as that of overdiagnosis, is not negligible and is of importance in clinical practice.

scholarly journals Women’s leadership in academic medicine: a systematic review of extent, condition and interventions

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e032232 ◽  
Author(s):  
Lulu Alwazzan ◽  
Samiah S Al-Angari
Keyword(s):  
Systematic Review ◽  
Leadership Development ◽  
Academic Medicine ◽  
Medical Schools ◽  
Women's Leadership ◽  
Research Quality ◽  
Cochrane Library ◽  
Cross Sectional ◽  
Quantitative Studies ◽  
The Impact

ObjectivesBecause culture reflects leadership, the making of diverse and inclusive medical schools begins with diversity among leaders. The inclusion of women leaders remains elusive, warranting a systematic exploration of scholarship in this area. We ask: (1) What is the extent of women’s leadership in academic medicine? (2) What factors influence women’s leadership? (3) What is the impact of leadership development programmes?DesignSystematic review.Data sourcesA systematic search of six online databases (OvidMEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Library and ERIC) from the earliest date available to April 2018 was conducted. Bridging searches were conducted from April 2018 until October 2019.Eligibility criteria(1) Peer-reviewed; (2) English; (3) Quantitative studies (prospective and retrospective cohort, cross-sectional and preintervention/postintervention); evaluating (4) The extent of women’s leadership at departmental, college and graduate programme levels; (5) Factors influencing women’s leadership; (6) Leadership development programmes. Quantitative studies that explored women’s leadership in journal editorial boards and professional societies and qualitative study designs were excluded.Data extraction and synthesisTwo reviewers screened retrieved data of abstracts and full-texts for eligibility, assessment and extracted study-level data independently. The included studies were objectively appraised using the Medical Education Research Quality Study Instrument with an inter-rater reliability of (κ=0.93).ResultsOf 4024 records retrieved, 40 studies met the inclusion criteria. The extent of women’s leadership was determined through gender distribution of leadership positions. Women’s leadership emergence was hindered by institutional requirements such as research productivity and educational credentials, while women’s enactment of leadership was hindered by lack of policy implementation. Leadership development programmes had a positive influence on women’s individual enactment of leadership and on medical schools’ cultures.ConclusionsScholarship on women’s leadership inadvertently produced institute-centric rather than women-centric research. More robust contextualised scholarship is needed to provide practical-recommendations; drawing on existing conceptual frameworks and using more rigorous research methods.

scholarly journals The impact of decision aids in patients with colorectal cancer: a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e028379 ◽  
Author(s):  
Jenaya Goldwag ◽  
Priscilla Marsicovetere ◽  
Peter Scalia ◽  
Heather A Johnson ◽  
Marie-Anne Durand ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Cancer Treatment ◽  
Data Extraction ◽  
Decision Aids ◽  
Case Series ◽  
Cochrane Library ◽  
Eligibility Criteria ◽  
The Impact ◽  
Colorectal Cancer Treatment

ObjectivesOur aim was to conduct a systematic review of the literature to determine the impact of patient decision aids (PDA) on patients facing treatment decisions for colorectal cancer.DesignSystematic review.Data sourcesSources included Embase, Medline, Web of Science, CINAHL and the Cochrane Library from inception to June, 20, 2019.Eligibility criteriaWe included randomised controlled trials (RCTs), cohort studies, mixed methods and case series in which a PDA for colorectal cancer treatment was used. Qualitative studies were excluded from our review.Data extraction and synthesisFollowing execution of the search strategy by a medical librarian, two blinded independent reviewers identified articles for inclusion. Two blinded reviewers were also responsible for data extraction, risk of bias and study quality assessments. Any conflict in article inclusion or extraction was resolved by discussion.ResultsOut of 3773 articles identified, three met our inclusion criteria: one RCT, one before-and-after study and one mixed-method study. In these studies, the use of a PDA for colorectal cancer treatment was associated with increased patient knowledge, satisfaction and preparation for making a decision. On quality assessment, two of three studies were judged to be of low quality.ConclusionA paucity of evidence exists on the effect of PDA for colorectal cancer treatment with existing evidence being largely of low quality. Further investigation is required to determine the effect of decision aids for colorectal cancer treatment as well as reasons for the lack of PDA development and implementation in this area.Prospero registration numberCRD42018095153.

scholarly journals Prevalence of delirium, depression, anxiety, and post-traumatic stress disorder among COVID-19 patients: protocol for a living systematic review

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Jiyuan Shi ◽  
Ya Gao ◽  
Liang Zhao ◽  
Yuanyuan Li ◽  
Meili Yan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Virus Disease ◽  
Cochrane Library ◽  
Post Traumatic Stress ◽  
Cross Sectional ◽  
Post Traumatic ◽  
The Impact

Abstract Background Previous studies on the impact of corona virus disease 2019 (COVID-19) on the mental health of the patients has been limited by the lack of relevant data. With the rapid and sustained growth of the publications on COVID-19 research, we will perform a living systematic review (LSR) to provide comprehensive and continuously updated data to explore the prevalence of delirium, depression, anxiety, and post-traumatic stress disorder (PTSD) among COVID-19 patients. Methods We will perform a comprehensive search of the following databases: Cochrane Library, PubMed, Web of Science, EMBASE, and Chinese Biomedicine Literature to identify relevant studies. We will include peer-reviewed cross-sectional studies published in English and Chinese. Two reviewers will independently assess the methodological quality of included studies using the Joanna Briggs Institute Prevalence Critical Appraisal tool and perform data extraction. In the absence of clinical heterogeneity, the prevalence estimates with a 95% confidence interval (CI) of delirium, depression, anxiety, and post-traumatic stress disorder (PTSD) will be calculated by using random-effects model to minimize the effect of between-study heterogeneity separately. The literature searches will be updated every 3 months. We will perform meta-analysis if any new eligible studies or data are obtained. We will resubmit an updated review when there were relevant changes in the results, i.e., when outcomes became statistically significant (or not statistically significant anymore) or when heterogeneity became substantial (or not substantial anymore). Discussion This LSR will provide an in-depth and up-to-date summary of whether the common neuropsychiatric conditions observed in patients hospitalized for severe acute respiratory syndrome (SARS-CoV) and Middle East respiratory syndrome (MERS) are also prevalent in a different stage of COVID-19 patients. Systematic review registration PROSPERO CRD42020196610

scholarly journals Neighbourhood socioeconomic status and overweight/obesity: a systematic review and meta-analysis of epidemiological studies

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e028238 ◽  
Author(s):  
Shimels Hussien Mohammed ◽  
Tesfa Dejenie Habtewold ◽  
Mulugeta Molla Birhanu ◽  
Tesfamichael Awoke Sissay ◽  
Balewgizie Sileshi Tegegne ◽  
...  
Keyword(s):  
Systematic Review ◽  
Socioeconomic Status ◽  
Observational Studies ◽  
Data Extraction ◽  
Meta Analysis ◽  
Epidemiological Studies ◽  
Cochrane Library ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Neighbourhood Socioeconomic Status

ObjectiveLow neighbourhood socioeconomic status (NSES) has been linked to a higher risk of overweight/obesity, irrespective of the individual’s own socioeconomic status. No meta-analysis study has been done on the association. Thus, this study was done to synthesise the existing evidence on the association of NSES with overweight, obesity and body mass index (BMI).DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, Scopus, Cochrane Library, Web of Sciences and Google Scholar databases were searched for articles published until 25 September 2019.Eligibility criteriaEpidemiological studies, both longitudinal and cross-sectional ones, which examined the link of NSES to overweight, obesity or BMI, were included.Data extraction and synthesisData extraction was done by two reviewers, working independently. The methodological quality of included studies was assessed using the Newcastle-Ottawa Scale for the observational studies. The summary estimates of the relationships of NSES with overweight, obesity and BMI statuses were calculated with random-effects meta-analysis models. Heterogeneity was assessed by Cochran’s Q and I2 statistics. Subgroup analyses were done by age categories, continents, study designs and NSES measures. Publication bias was assessed by visual inspection of funnel plots and Egger’s regression test.ResultA total of 21 observational studies, covering 1 244 438 individuals, were included in this meta-analysis. Low NSES, compared with high NSES, was found to be associated with a 31% higher odds of overweight (pooled OR 1.31, 95% CI 1.16 to 1.47, p<0.001), a 45% higher odds of obesity (pooled OR 1.45, 95% CI 1.21 to 1.74, p<0.001) and a 1.09 kg/m2 increase in mean BMI (pooled beta=1.09, 95% CI 0.67 to 1.50, p<0.001).ConclusionNSES disparity might be contributing to the burden of overweight/obesity. Further studies are warranted, including whether addressing NSES disparity could reduce the risk of overweight/obesity.PROSPERO registration numberCRD42017063889

scholarly journals Binge drinking in young people: protocol for a systematic review of neuropsychological, neurophysiological and neuroimaging studies

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e023629 ◽  
Author(s):  
Briana Lees ◽  
Louise Mewton ◽  
Lexine Stapinski ◽  
Lindsay M Squeglia ◽  
Caroline Rae ◽  
...  
Keyword(s):  
Systematic Review ◽  
Alcohol Use ◽  
Young People ◽  
Binge Drinking ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Primary Data ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
The Impact

IntroductionBinge drinking is the most common pattern of alcohol use among young people in Western countries. Adolescence and young adulthood is a vulnerable developmental period and binge drinking during this time has a higher potential for neurotoxicity and interference with ongoing neural and cognitive development. The purpose of this systematic review will be to assess and integrate evidence of the impact of binge drinking on cognition, brain structure and function in youth aged 10–24 years. Cross-sectional studies will synthesise the aberrations associated with binge drinking, while longitudinal studies will distinguish the cognitive and neural antecedents from the cognitive and neural effects that are a consequence of binge drinking.Methods and analysisA total of five peer-reviewed databases (PubMed, EMBASE, Medline, PsychINFO, ProQuest) will be systematically searched and the search period will include all studies published prior to 1 April 2018. The search terms will be a combination of MeSH keywords that are based on previous relevant reviews. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and study quality will be assessed using The Grades of Recommendation, Assessment, Development and Evaluation approach. All studies will be screened against eligibility criteria designed to synthesise studies that examined a young binge drinking sample and used neuropsychological, neurophysiological or neuroimaging assessment techniques. Studies will be excluded if participants were significantly involved in other substances or if they had been clinically diagnosed with an alcohol use disorder, or any psychiatric, neurological or pharmacological condition. If available data permits, a meta-analysis will be conducted.Ethics and disseminationFormal ethics approval is not required as primary data will not be collected. The results will be disseminated through a peer-reviewed publication, conference presentations and social media.Trial registration numberInternational Prospective Register for Systematic Reviews (PROSPERO) number: CRD42018086856.

scholarly journals Pulmonary Nocardiosis in Suspected Tuberculosis Patients: A Systematic Review and Meta-Analysis of Cross-Sectional Studies

2020 ◽  
Vol 30 (2) ◽  
Author(s):  
Susan Mansuri Mehrabadi ◽  
Mina Taraghian ◽  
Aliyar Pirouzi ◽  
Azad Khaledi ◽  
Alireza Neshani ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pulmonary Tuberculosis ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Medical Subject Headings ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Pulmonary Nocardiosis ◽  
Suspected Tuberculosis ◽  
Cross Sectional Studies

BACKGROUND: nocardiosis is an opportunistic infectious disease in immunocompromised patients. The most common form of nocardiosis infection in humans is pulmonary nocrdiosis caused by inhaling Nocardia species from the environment. Thus, this study aimed to evaluate the pulmonary nocardiosis in patients with suspected tuberculosis using systematic review and meta-analysis.METHODS: We conducted a systematic search for cross-sectional studies focused on the pulmonary nocardiosis among patients with pulmonary tuberculosis based on the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) published from January 2001 to October 2019. The search was conducted in MEDLINE/PubMed, Web of Science, Scopus, Cochrane Library, Google Scholar, Science Direct databases, and Iranian databases. Medical subject headings (MeSH) and text words were searched: “pulmonary nocardiosis”, “nocardiosis”, OR “nocardial infection”, “pulmonary nocardial infections/agents”, AND “pulmonary tuberculosis”, OR “pulmonary TB”, AND “Iran”. Two of the reviewers enrolled independently articles published in English and Persian languages according to the inclusion and the exclusion criteria. Comprehensive Meta-Analysis software (Version 3.3.070) was used for meta-analysis.RESULTS: Only 4 studies met the eligibility criteria. The pulmonary nocardiosis prevalence varied from 1.7% to 6.7%. The combined prevalence of nocardiosis among patients with suspected pulmonary tuberculosis in Iran was 4.8% (95% CI: 3-7.3, Q=5.8, Z=12.7). No heterogeneity was observed between studies because I2 was 48.3. N. cyriacigeorgica and N. asteroides were reported as the prevalent isolates, respectively.CONCLUSIONS: This review showed in patients suspected TB when they were negative in all diagnosis laboratory tests, nocardiosis cases which be considered.

scholarly journals Prevalence of delirium, depression, anxiety, and post-traumatic stress disorder among COVID-19 patients: protocol for a living systematic review

2020 ◽  
Author(s):  
Jiyuan Shi ◽  
Ya Gao ◽  
Liang Zhao ◽  
Yuanyuan Li ◽  
Meili Yan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Virus Disease ◽  
Cochrane Library ◽  
Post Traumatic Stress ◽  
Cross Sectional ◽  
Post Traumatic ◽  
The Impact

Abstract Background Previous studies on the impact of corona virus disease 2019 (COVID-19) on the mental health of the patients has been limited by the lack of relevant data. With the rapid and sustained growth of the publications on COVID-19 research, we will perform a living systematic review (LSR) to provide comprehensive and continuously updated data to explore the prevalence of delirium, depression, anxiety, and post-traumatic stress disorder (PTSD) among COVID-19 patients.Methods We will perform a comprehensive search of the following databases: Cochrane Library, PubMed, Web of Science, Embase, and Chinese Biomedicine Literature to identify relevant studies. We will include peer-reviewed cross-sectional studies published in English and Chinese. Two reviewers will independently assess the methodological quality of included studies using the Joanna Briggs Institute Prevalence Critical Appraisal tool and perform data extraction. In the absence of clinical heterogeneity, the prevalence estimates with a 95% confidence interval (CI) of delirium, depression, anxiety, and post-traumatic stress disorder (PTSD) will be calculated by using random-effects model to minimize the effect of between-study heterogeneity separately. The literature searches will be updated every three months. We will perform meta-analysis if any new eligible studies or data are obtained. We will resubmit an updated review when there were relevant changes in the results, i.e. when outcomes became statistically significant (or not statistically significant anymore) or when heterogeneity became substantial (or not substantial anymore).Discussion This LSR will provide an in-depth and up-to-date summary of whether the common neuropsychiatric conditions observed in patients hospitalized for severe acute respiratory syndrome (SARS-CoV) and Middle East respiratory syndrome (MERS) are also prevalent in a different stage of COVID-19 patients.Systematic review registrationPROSPERO CRD42020196610

scholarly journals Cost-Effectiveness Analysis of Imaging Modalities for Breast Cancer Surveillance Among BRCA1/2 Mutation Carriers: A Systematic Review

2022 ◽  
Vol 11 ◽  
Author(s):  
Jiaxin Li ◽  
Ziqi Jia ◽  
Menglu Zhang ◽  
Gang Liu ◽  
Zeyu Xing ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Cost Effectiveness ◽  
Cost Effective ◽  
Cancer Surveillance ◽  
Cochrane Library ◽  
Mutation Carriers ◽  
Life Years ◽  
Screening Strategies ◽  
The Impact

BackgroundBRCA1/2 mutation carriers are suggested with regular breast cancer surveillance screening strategies using mammography with supplementary MRI as an adjunct tool in Western countries. From a cost-effectiveness perspective, however, the benefits of screening modalities remain controversial among different mutated genes and screening schedules.MethodsWe searched the MEDLINE/PubMed, Embase, Cochrane Library, Scopus, and Web of Science databases to collect and compare the results of different cost-effectiveness analyses. A simulated model was used to predict the impact of screening strategies in the target group on cost, life-year gained, quality-adjusted life years, and incremental cost-effectiveness ratio (ICER).ResultsNine cost-effectiveness studies were included. Combined mammography and MRI strategy is cost-effective in BRCA1 mutation carriers for the middle-aged group (age 35 to 54). BRCA2 mutation carriers are less likely to benefit from adjunct MRI screening, which implies that mammography alone would be sufficient from a cost-effectiveness perspective, regardless of dense breast cancer.ConclusionsPrecision screening strategies among BRCA1/2 mutation carriers should be conducted according to the acceptable ICER, i.e., a combination of mammography and MRI for BRCA1 mutation carriers and mammography alone for BRCA2 mutation carriers.Systematic Review RegistrationPROSPERO, identifier CRD42020205471.

scholarly journals Obesity paradox in subarachnoid hemorrhage: a systematic review

2019 ◽  
Vol 43 (6) ◽  
pp. 1555-1563
Author(s):  
Ilari Rautalin ◽  
Jaakko Kaprio ◽  
Miikka Korja
Keyword(s):  
Systematic Review ◽  
Subarachnoid Hemorrhage ◽  
Obesity Paradox ◽  
Research Field ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Bias Estimation ◽  
Obese People ◽  
Eligibility Criteria ◽  
The Impact

AbstractAs the number of obese people is globally increasing, reports about the putative protective effect of obesity in life-threatening diseases, such as subarachnoid hemorrhage (SAH), are gaining more interest. This theory—the obesity paradox—is challenging to study, and the impact of obesity has remained unclear in survival of several critical illnesses, including SAH. Thus, we performed a systematic review to clarify the relation of obesity and SAH mortality. Our study protocol included systematic literature search in PubMed, Scopus, and Cochrane library databases, whereas risk-of-bias estimation and quality of each selected study were evaluated by the Critical Appraisal Skills Program and Cochrane Collaboration guidelines. A directional power analysis was performed to estimate sufficient sample size for significant results. From 176 reviewed studies, six fulfilled our eligibility criteria for qualitative analysis. One study found paradoxical effect (odds ratio, OR = 0.83 (0.74–0.92)) between morbid obesity (body mass index (BMI) > 40) and in-hospital SAH mortality, and another study found the effect between continuously increasing BMI and both short-term (OR = 0.90 (0.82–0.99)) and long-term SAH mortalities (OR = 0.92 (0.85–0.98)). However, according to our quality assessment, methodological shortcomings expose all reviewed studies to a high-risk-of-bias. Even though two studies suggest that obesity may protect SAH patients from death in the acute phase, all reviewed studies suffered from methodological shortcomings that have been typical in the research field of obesity paradox. Therefore, no definite conclusions could be drawn.

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