scholarly journals Statin and mortality in COVID-19: a systematic review and meta-analysis of pooled adjusted effect estimates from propensity-matched cohorts

2021 ◽  
pp. postgradmedj-2021-140409
Author(s):  
Ahmad Fariz Malvi Zamzam Zein ◽  
Catur Setiya Sulistiyana ◽  
Uswatun Khasanah ◽  
Arief Wibowo ◽  
Michael Anthonius Lim ◽  
...  
Keyword(s):  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Male Gender ◽  
Effect Estimate ◽  
Inverse Probability ◽  
Risk Of Mortality ◽  
Registration Number ◽  
Multivariable Regression ◽  
Randomised Controlled

PurposeStatin potentially improved outcome in patients with COVID-19. Patients who receive statin generally have a higher proportion of comorbidities than those who did not, which may introduce bias. In this meta-analysis, we aimed to investigate the association between statin use and mortality in patients with COVID-19 by pooling the adjusted effect estimates from propensity-score matching (PSM) matched studies or randomised controlled trials to reduce bias.MethodsA systematic literature search using the PubMed, Scopus and Embase databases were performed up until 1 March 2021. Studies that were designed the study to assess statin and mortality using PSM with the addition of Inverse Probability Treatment Weighting or multivariable regression analysis on top of PSM-matched cohorts were included. The effect estimate was reported in term of relative risk (RR).Results14 446 patients were included in the eight PSM-matched studies. Statin was associated with decreased mortality in patients with COVID-19 (RR 0.72 (0.55, 0.95), p=0.018; I2: 84.3%, p<0.001). Subgroup analysis in patients receiving statin in-hospital showed that it was associated with lower mortality (RR 0.71 (0.54, 0.94), p=0.030; I2: 64.1%, p<0.025). The association of statin and mortality was not significantly affected by age (coefficient: −0.04, p=0.382), male gender (RR 0.96 (0.95, 1.02), p=0.456), diabetes (RR 1.02 (0.99, 1.04), p=0.271) and hypertension (RR 1.01 (0.97, 1.04), p=0.732) in this pooled analysis.ConclusionIn this meta-analysis of PSM-matched cohorts with adjusted analysis, statin was shown to decrease the risk of mortality in patients with COVID-19.PROSPERO registration numberCRD42021240137.

Mucositis reduction with probiotics in children with cancer: a randomised-controlled feasibility study

2021 ◽  
pp. archdischild-2020-319968
Author(s):  
Hadeel Hassan ◽  
Sally Kinsey ◽  
Bob Phillips
Keyword(s):  
Direct Contact ◽  
Randomised Controlled Trials ◽  
Healthcare Professionals ◽  
Meta Analysis ◽  
Paediatric Oncology ◽  
Children With Cancer ◽  
Patient Diary ◽  
Registration Number ◽  
Randomised Controlled ◽  
To Receive

BackgroundA recent systematic review and meta-analysis identified a paucity of randomised-controlled trials (RCTs) investigating the use of probiotics to reduce or prevent mucositis and infection in children with cancer.ObjectiveThis study evaluated the feasibility of undertaking an RCT and investigated the efficacy of probiotics for reducing or preventing mucositis and infection in children with cancers.SettingThe Paediatric Oncology and Haematology department at Leeds Teaching Hospital, UK.PatientsChildren aged 1 year or older, receiving chemotherapies likely to cause mucositis.InterventionsParticipants were randomised to receive the probiotic or placebo on day 1–14 of a chemotherapy cycle. Participants were also required to complete a patient diary for 21 days.Main outcome measuresTo assess whether it is feasible to recruit children diagnosed with cancer who are at risk of developing mucositis to an adequately powered RCT.ResultsBetween May and November 2019, 34 out of 39 eligible participants were approached. Ten patients were recruited (4 probiotic and 6 placebo) of which 2 participants withdrew. Seven participants partially completed the diary but only two participants completed 80% or more. Eligible participants appeared to prefer giving informal verbal feedback when in direct contact with research and healthcare professionals.ConclusionThis study demonstrated that recruitment needs to be improved prior to undertaking an adequately powered RCT.Trial registration numberNCT03785938.

scholarly journals Effect of Uric Acid-Lowering Agents on Patients With Heart Failure: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

2021 ◽  
Vol 8 ◽  
Author(s):  
Hongxuan Xu ◽  
Yunqing Liu ◽  
Lingbing Meng ◽  
Li Wang ◽  
Deping Liu
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Uric Acid ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Controlled Trials ◽  
Heart Failure Patients ◽  
All Cause Mortality ◽  
Randomised Controlled

Background: Elevated serum uric acid (SUA) level is considered an independent predictor of all-cause mortality and the combined endpoint of death or readmission in cardiovascular disease patients. However, the causal relationship between uric acid-lowering therapies (ULTs) and heart failure is still controversial.Design: Meta-analyses were performed to systematically compile available evidence to determine the overall effect of ULTs on heart failure patients.Method: We conducted this systematic review following the PRISMA statement guidelines. Databases were searched to identify randomised controlled trials related to the influence of a ULT intervention in people with heart failure. Data extracted from the included studies were subjected to a meta-analysis to compare the effects of ULTs to a control.Results: Pooled analysis of left ventricular ejection fraction (LEVF) showed an insignificant result towards the ULT group (MD, 1.63%; 95%CI, −1.61 to 4.88; p = 0.32; three studies). Pooled analysis of the 6-Minute Walk Test (6MWT) showed an insignificant result towards the ULT group (MD, 4.59; 95%CI, −12.683 to 22.00; p = 0.61; four studies). Pooled analysis of BNP/NT-pro-BNP led to a nearly statistically significant result towards the ULT group (SMD, −0.30; 95%CI, −0.64 to 0.04; p = 0.08; five studies). Pooled analysis of all-cause mortality and cardiovascular death between ULTs (all XOIs) and placebo did not show a significant difference (RR, 1.26; 95% CI, 0.74 to 2.15, p = 0.39).Conclusion: ULTs did not improve LVEF, BNP/NT-pro-BNP, 6MWT, all-cause mortality, and CV death in heart failure patients. UA may just be a risk marker of heart failure.

Effectiveness of school-based physical activity programmes on cardiorespiratory fitness in children: a meta-analysis of randomised controlled trials

2017 ◽  
Vol 52 (19) ◽  
pp. 1234-1240 ◽  
Author(s):  
Diana P Pozuelo-Carrascosa ◽  
Antonio García-Hermoso ◽  
Celia Álvarez-Bueno ◽  
Mairena Sánchez-López ◽  
Vicente Martinez-Vizcaino
Keyword(s):  
Physical Activity ◽  
Cardiorespiratory Fitness ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Healthy Children ◽  
Physical Activity Interventions ◽  
School Based ◽  
Registration Number ◽  
Randomised Controlled

ObjectiveTo conduct a meta-analysis of randomised controlled trials aimed at testing whether school-based physical activity programmes improve cardiorespiratory fitness (CRF) in children.DesignSystematic review with meta-analysis.Data sourcesUsing keywords, we performed a computerised search in five databases: MEDLINE, EMBASE, CINAHL, Web of Science and SportDiscus.Eligibility criteria for selecting studiesStudies that assessed the effectiveness of school-based physical activity programmes on improving CRF in children (3–12 years old). We selected interventions that included an additional physical activity programme and not only a physical activity educational component. The reference lists of selected full-text articles and systematic reviews were also searched for relevant studies. Pooled effect size (Hedges′ g) was calculated assuming a random-effects model.ResultsTwenty trials with 7287 healthy children aged 3–12 years were included in the meta-analysis. School-based physical activity interventions with aerobic games and activities were associated with a significant small increase in CRF (Hedges′ g=0.22; 95% CI 0.14 to 0.30; p<0.001). Based on subgroup analysis, the increase in CRF was significant in girls (Hedges′ g=0.25; 95% CI 0.13 to 0.37; p<0.001), but not in boys (Hedges′ g=0.02; 95% CI −0.10 to 0.14; p=0.731).SummaryModerate quality evidence supports the effectiveness of school-based physical activity interventions on improving CRF in children.Trial registration numberProtocol PROSPERO registration number CRD42016050173.

scholarly journals Do mobile device apps designed to support medication adherence demonstrate efficacy? A systematic review of randomised controlled trials, with meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e032045 ◽  
Author(s):  
Laura Catherine Armitage ◽  
Aikaterini Kassavou ◽  
Stephen Sutton
Keyword(s):  
Systematic Review ◽  
Medication Adherence ◽  
Effect Size ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Secondary Outcome ◽  
Controlled Trials ◽  
Behaviour Change Techniques ◽  
Registration Number ◽  
Randomised Controlled

ObjectivesTo estimate the efficacy of app-based interventions designed to support medication adherence and investigate which behaviour change techniques (BCTs) used by the apps are associated with efficacy.DesignSystematic review of randomised controlled trials (RCTs), with meta-analysis.SettingMedline/PubMed, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Embase and Web of Science were searched from 1990 to November 2018 for RCTs conducted in any healthcare setting.ParticipantsStudies of participants of any age taking prescribed medication for any health condition and for any duration.InterventionAn app-based intervention delivered through a smartphone, tablet computer or personal digital assistant to help, support or advise about medication adherence.ComparatorOne of (1) usual care, (2) a control app which did not use any BCTs to improve medication adherence or (3) a non-app-based comparator.Primary and secondary outcome measuresThe primary outcome was the pooled effect size of changes in medication adherence. The secondary outcome was the association between BCTs used by the apps and the effect size.ResultsThe initial search identified 13 259 citations. After title and abstract screening, full-text articles of 83 studies were screened for eligibility. Nine RCTs with 1159 recruited participants were included. The mean age of participants was >50 years in all but one study. Health conditions of target populations included cardiovascular disease, depression, Parkinson’s disease, psoriasis and multimorbidity. The meta-analysis indicated that patients who use mobile apps to support them in taking medications are more likely to self-report adherence to medications (OR 2.120, 95% CI 1.635 to 2.747, n=988) than those in the comparator groups. Meta-regression of the BCTs did not reveal any significant associations with effect size.ConclusionsApp-based medication adherence interventions may have a positive effect on patient adherence. Larger scale studies are required to further evaluate this effect, including long-term sustainability, and intervention and participant characteristics that are associated with efficacy and app usage.Prospero registration numberPROSPERO Protocol Registration Number: CRD42017080150.

scholarly journals Dyslipidemia Increases the Risk of Severe COVID-19: A Systematic Review, Meta-analysis, and Meta-regression

2021 ◽  
Vol 14 ◽  
pp. 117955142199067
Author(s):  
Indriwanto Sakidjan Atmosudigdo ◽  
Michael Anthonius Lim ◽  
Basuni Radi ◽  
Joshua Henrina ◽  
Emir Yonas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Literature Search ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Male Gender ◽  
Composite Outcome ◽  
Funnel Plot ◽  
Poor Outcome ◽  
Registration Number ◽  
Meta Regression

Objective: This systematic review and meta-analysis aimed to evaluate whether dyslipidemia affects the mortality and severity of COVID-19, we also aimed to evaluate whether other comorbidities influence the association. Methods: A systematic literature search using PubMed, Embase, and EuropePMC was performed on 8 October 2020. This study’s main outcome is a poor composite outcome, comprising of mortality and severe COVID-19. Results: There were 9 studies with 3663 patients. The prevalence of dyslipidemia in this pooled analysis was 18% (4%-32%). Dyslipidemia was associated with increased composite poor outcome (RR 1.39 [1.02, 1.88], P = .010; I2: 56.7%, P = .018). Subgroup analysis showed that dyslipidemia was associated with severe COVID-19 (RR 1.39 [1.03, 1.87], P = .008; I2: 57.4%, P = .029). Meta-regression showed that the association between dyslipidemia and poor outcome varies by age (coefficient: −0.04, P = .033), male gender (coefficient: −0.03, P = .042), and hypertension (coefficient: −0.02, P = .033), but not diabetes (coefficient: −0.24, P = .135) and cardiovascular diseases (coefficient: −0.01, P = .506). Inverted funnel-plot was relatively symmetrical. Egger’s test indicates that the pooled analysis was not statistically significant for small-study effects ( P = .206). Conclusion: Dyslipidemia potentially increases mortality and severity of COVID-19. The association was stronger in patients with older age, male, and hypertension. PROSPERO Registration Number: CRD42020213491

scholarly journals Daily consumption of 100% orange juice does not increase body weight in adults: a meta-analysis of randomised controlled trials

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Carrie Ruxton ◽  
Graham Horgan ◽  
Johan De Rycker
Keyword(s):  
Orange Juice ◽  
Randomised Controlled Trials ◽  
Intervention Studies ◽  
Fruit Juice ◽  
Meta Analysis ◽  
Control Group ◽  
Effect Estimate ◽  
Daily Consumption ◽  
Randomised Controlled ◽  
Q Statistic

AbstractThere is convincing evidence that sugar-sweetened beverages increase the risk of body weight (BW) gain and higher body mass index. In contrast, observational studies on regular consumption of 100% fruit juice provide conflicting results, with most indicating a neutral impact on BW and body mass index, while others suggest positive or even inverse associations. The lack of agreement may be due to confounding factors, or studies incorrectly grouping sugar-sweetened juice drinks with 100% fruit juice, which by law does not contain added sugars.Intervention studies provide an opportunity to investigate the short-to-medium term impact of daily 100% orange juice (OJ) on BW. From 17 available studies (none of which individually reported statistically significant BW gain following OJ consumption), 6 randomised controlled trials in adults (n = 236) were selected for a meta-analysis. Inclusion criteria were an OJ intervention group and a non-OJ control group. Comparison with a control group was essential as some were weight loss studies with additional BW loss components, and for consistency this comparison between groups was used for all studies.The meta-analysis focussed on the differences in BW change between OJ and control arms of each study. Where the standard deviation (SD) or standard error (SE) of the change was not reported and could not be obtained from the authors, it was imputed by using the mean SD from studies where it was available. The combined effect estimate was obtained from a random effects model using the DerSimonian-Laird estimator. Cochran's Q statistic was used to test for study heterogeneity.The resulting forest plot revealed no statistically significant change in BW following OJ intakes of 250–500 ml per day for 4 to 12 weeks (which would theoretically provide 102–205 kcal on average). The Q statistic was 10.6 (I2 = 53%, p = 0.059) while the combined effect estimate was -0.34 kg (95% CI -1.11, 0.43). Interestingly, a similar finding was noted in a meta-analysis (Onakpoya et al. 2017) investigating BW change and daily grapefruit juice consumption from 3 intervention studies (n = 233); mean difference -0.45 kg [95% CI:-1.06 to 0.16; I2 = 53%].In conclusion, daily consumption of OJ does not appear to have an adverse impact on BW. This may be due to dietary energy compensation (conscious or unconscious) or a satiety effect linked with the low glycemic index of OJ (GI = 50).Onakpoya I et al. (2017) Crit Rev Food Sci Nutr 57: 602–612.

scholarly journals Smoking cessation in individuals who use vaping as compared with traditional nicotine replacement therapies: a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e044222
Author(s):  
Catherine M Pound ◽  
Jennifer Zhe Zhang ◽  
Ama Tweneboa Kodua ◽  
Margaret Sampson
Keyword(s):  
Systematic Review ◽  
Smoking Cessation ◽  
Cigarette Smoking ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Smoking Reduction ◽  
Registration Number ◽  
Randomised Controlled

ObjectivesDespite the aggressive marketing of electronic nicotine device systems (ENDS) as smoking cessation tools, the evidence of their effectiveness is mixed. We conducted a systematic review of randomised controlled trials to determine the effect of ENDS on cigarette smoking cessation, as compared with other types of nicotine replacement therapies (NRT).DesignSystematic review and meta-analysis using the Grading of Recommendations Assessment, Development and Evaluation approach.Data sourcesMEDLINE, Embase, the CENTRAL Trials Registry of the Cochrane Collaboration using the Ovid interface, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform trials registries were searched through 17 June 2020.Eligibility criteria for studiesRandomised controlled trials in which any type of ENDS was compared with any type of NRT, in traditional cigarette users.Data extraction and synthesisThe primary outcome was smoking cessation, defined as abstinence from traditional cigarette smoking for any time period, as reported in each included study, regardless of whether abstinence is self-reported or biochemically validated. Secondary outcomes included smoking reduction, harms, withdrawal and acceptance of therapy. A random-effect model was used, and data were pooled in meta-analyses where appropriate.ResultsSix studies were retained from 270. Most outcomes were judged to be at high risk of bias. The overall quality of evidence was graded as ‘low’ or ‘very low’. Pooled results showed no difference in smoking cessation (rate ratio (RR) 1.42, 95% CI 0.97 to 2.09), proportion of participants reducing smoking consumption (RR 1.25, 95% CI 0.79 to 1.98), mean reduction in cigarettes smoked per day (mean difference 1.11, 95% CI −0.41 to 2.63), or harms (RR 0.96, 95% CI 0.76 to 1.20), between groups.ConclusionWe found no difference in smoking cessation, harms and smoking reduction between e-cigarette and NRT users. However, the quality of the evidence was low. Further research is needed before widespread recommendations are made with regard to the use of ENDS.PROSPERO registration numberSystematic review registration number: protocol registered with the International Prospective Register of Systematic Reviews (PROSPERO) on February 27th, 2020; CRD42020169416.

scholarly journals Efficacy of mood stabilisers in the treatment of impulsive or repetitive aggression: systematic review and meta-analysis

2011 ◽  
Vol 198 (2) ◽  
pp. 93-98 ◽  
Author(s):  
Roland M. Jones ◽  
James Arlidge ◽  
Rebecca Gillham ◽  
Shuja Reagu ◽  
Marianne van den Bree ◽  
...  
Keyword(s):  
Aggressive Behaviour ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Diagnostic Category ◽  
Pooled Analysis ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Brain Disorder ◽  
Impulsive Aggression ◽  
Randomised Controlled

BackgroundIndividuals with repetitive or impulsive aggression in the absence of other disorders may be diagnosed with intermittent explosive disorder according to DSM–IV, but no such diagnostic category exists in ICD–10. Mood stabilisers are often used off-license for the treatment of aggression associated with a variety of psychiatric conditions, but their efficacy in these and in idiopathic aggression is not known.AimsTo summarise and evaluate the evidence for the efficacy of mood stabilisers (anticonvulsants/lithium) in the treatment of impulsive or repetitive aggression in adults.MethodA meta-analysis of randomised controlled trials that compared a mood stabiliser with placebo in adults without intellectual disability, organic brain disorder or psychotic illness, identified as exhibiting repetitive or impulsive aggression.ResultsTen eligible trials (489 participants) were identified A pooled analysis showed an overall significant reduction in the frequency/severity of aggressive behaviour (standardised mean difference (SMD) =–1.02, 95% CI −1.54 to −0.50), although heterogeneity was high (I2 = 84.7%). When analysed by drug type, significant effects were found in the pooled analysis of three phenytoin trials (SMD =–1.34, 95% CI −2.16 to −0.52), one lithium trial (SMD =–0.81, 95% CI −1.35 to −0.28), and two oxcarbazepine/carbamazepine trials (SMD =–1.20, 95% CI −1.83 to −0.56). However, when the results of only those studies that had a low risk of bias were pooled (347 participants), there was no significant reduction in aggression (SMD =–0.28, 95% CI −0.73 to 0.17, I2 = 71.4%).ConclusionsThere is evidence that mood stabilisers as a group are significantly better than placebo in reducing aggressive behaviour, but not all mood stabilisers appear to share this effect. There is evidence of efficacy for carbamazepine/oxcarbazepine, phenytoin and lithium. Many studies, however, were at risk of bias and so further randomised controlled trials are recommended.

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