Is e-cigarette use in non-smoking young adults associated with later smoking? A systematic review and meta-analysis

ObjectiveThe aim of this review was to investigate whether e-cigarette use compared with non-use in young non-smokers is associated with subsequent cigarette smoking.Data sourcesPubMed, Embase, Web of Science, Wiley Cochrane Library databases, and the 2018 Society for Research on Nicotine and Tobacco and Society for Behavioural Medicine conference abstracts.Study selectionAll studies of young people (up to age 30 years) with a measure of e-cigarette use prior to smoking and an outcome measure of smoking where an OR could be calculated were included (excluding reviews and animal studies).Data extractionIndependent extraction was completed by multiple authors using a preprepared extraction form.Data synthesisOf 9199 results, 17 studies were included in the meta-analysis. There was strong evidence for an association between e-cigarette use among non-smokers and later smoking (OR: 4.59, 95% CI: 3.60 to 5.85) when the results were meta-analysed in a random-effects model. However, there was high heterogeneity (I2=88%).ConclusionsAlthough the association between e-cigarette use among non-smokers and subsequent smoking appears strong, the available evidence is limited by the reliance on self-report measures of smoking history without biochemical verification. None of the studies included negative controls which would provide stronger evidence for whether the association may be causal. Much of the evidence also failed to consider the nicotine content of e-liquids used by non-smokers meaning it is difficult to make conclusions about whether nicotine is the mechanism driving this association.

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Is e-cigarette use in non-smoking young adults associated with later smoking? A systematic review and meta-analysis

10.1101/19007005 ◽

2019 ◽

Cited By ~ 2

Author(s):

Jasmine N Khouja ◽

Steph F Suddell ◽

Sarah Peters ◽

Amy E Taylor ◽

Marcus R Munafò

Keyword(s):

Animal Studies ◽

Data Extraction ◽

Meta Analysis ◽

Self Report ◽

Smoking History ◽

Cochrane Library ◽

Cigarette Use ◽

Data Synthesis ◽

Study Selection ◽

Negative Controls

AbstractObjectiveThe aim of this review was to investigate whether e-cigarette use compared to non-use in young non-smokers is associated with subsequent cigarette smoking.Data sourcesPubMed, Embase, Web of Science, Wiley Cochrane Library databases, and the 2018 Society for Research on Nicotine and Tobacco and Society for Behavioural Medicine conference abstracts.Study selectionAll studies of young people (up to age 30 years) with a measure of e-cigarette use prior to smoking and an outcome measure of smoking where an odds ratio could be calculated were included (excluding reviews and animal studies).Data ExtractionIndependent extraction was completed by multiple authors using a pre-prepared extraction form.Data synthesisOf 9,199 results, 17 studies were included in the meta-analysis. There was strong evidence for an association between e-cigarette use among non-smokers and later smoking (OR 4.59, 95% CI 3.60 to 5.85) when the results were meta-analysed in a random effects model. However, there was high heterogeneity (I2 = 88%).ConclusionsWhilst the association between e-cigarette use among non-smokers and subsequent smoking appears strong, the available evidence is limited by the reliance on self-report measures of smoking history without biochemical verification. None of the studies included negative controls which would provide stronger evidence for whether the association may be causal. Much of the evidence also failed to consider the nicotine content of e-liquids used by non-smokers meaning it is difficult to make conclusions about whether nicotine is the mechanism driving this association.

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The role of corticosteroids in the management of critically ill patients with coronavirus disease 2019 (COVID-19): A meta-analysis

10.1101/2020.04.17.20069773 ◽

2020 ◽

Cited By ~ 3

Author(s):

Kalyan Kumar Gangopadhyay ◽

Jagat J Mukherjee ◽

Binayak Sinha ◽

Samit Ghosal

Keyword(s):

Critically Ill ◽

Critically Ill Patients ◽

Data Extraction ◽

Meta Analysis ◽

Cochrane Library ◽

Data Synthesis ◽

Systemic Corticosteroids ◽

Study Selection ◽

Coronavirus Infection

AbstractObjectiveThere are no controlled studies on the role of systemic corticosteroids (CS) in patients with coronavirus disease 2019 (COVID-19). In the absence of high-quality evidence, understandably the recommendations from various organizations are cautious. Several randomized controlled trials are underway but shall take time to conclude. We therefore undertook a meta-analysis to ascertain the role of CS in the management of critically ill patients with COVID-19.Data SourcesElectronic databases, including Pubmed, Cochrane library and Embase, were searched, using the keywords of interest and the PICO search technique, from inception to 12th April 2020.Study SelectionStudies highlighting the use of CS in coronavirus infection with severe acute respiratory syndrome (SARS), Middle East Respiratory Syndrome (MERS) and COVID-19 were selected based on pre-determined inclusion criteria.Data extractionData was extracted into an excel sheet and transferred to comprehensive meta-analysis software version 3, Biostat Inc., Englewood, NJ, USA, for analysis.Data synthesisFive studies with SARS-CoV-2 infection were included in the meta-analysis. The rate ratio (RR) for mortality in patients with SARS-CoV-2 infection was 1.26 (95% CI: 0.96-1.65, I2: 74.46), indicating lack of benefit of CS therapy on mortality in critically ill patients with COVID-19. The RR for mortality on analysis of the three studies that particularly reported on patients with significant pulmonary compromise secondary to SARS-CoV-2 infection was neutral (RR: 0.91, 95% CI: 0.63-1.33, I2: 63.38).ConclusionsThe use of CS in critically ill patients with COVID-19 did not improve or worsen mortality. Pending further information from controlled studies, CS can be used in critically ill patients with COVID-19 with ‘critical illness related corticosteroid insufficiency’ and moderate to severe ARDS without the risk of increased mortality.

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Prioritising recommendations following analyses of adverse events in healthcare: a systematic review

BMJ Open Quality ◽

10.1136/bmjoq-2019-000843 ◽

2020 ◽

Vol 9 (4) ◽

pp. e000843

Author(s):

Kelly Bos ◽

Maarten J van der Laan ◽

Dave A Dongelmans

Keyword(s):

Systematic Review ◽

Adverse Events ◽

Data Extraction ◽

Data Sources ◽

Cochrane Library ◽

High Quality ◽

Data Synthesis ◽

Study Selection ◽

Personal Opinion ◽

User Friendly

PurposeThe purpose of this systematic review was to identify an appropriate method—a user-friendly and validated method—that prioritises recommendations following analyses of adverse events (AEs) based on objective features.Data sourcesThe electronic databases PubMed/MEDLINE, Embase (Ovid), Cochrane Library, PsycINFO (Ovid) and ERIC (Ovid) were searched.Study selectionStudies were considered eligible when reporting on methods to prioritise recommendations.Data extractionTwo teams of reviewers performed the data extraction which was defined prior to this phase.Results of data synthesisEleven methods were identified that are designed to prioritise recommendations. After completing the data extraction, none of the methods met all the predefined criteria. Nine methods were considered user-friendly. One study validated the developed method. Five methods prioritised recommendations based on objective features, not affected by personal opinion or knowledge and expected to be reproducible by different users.ConclusionThere are several methods available to prioritise recommendations following analyses of AEs. All these methods can be used to discuss and select recommendations for implementation. None of the methods is a user-friendly and validated method that prioritises recommendations based on objective features. Although there are possibilities to further improve their features, the ‘Typology of safety functions’ by de Dianous and Fiévez, and the ‘Hierarchy of hazard controls’ by McCaughan have the most potential to select high-quality recommendations as they have only a few clearly defined categories in a well-arranged ordinal sequence.

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Risk of Gastrointestinal Bleeding on Treatment With Statin Alone or With Concomitant Administration of Warfarin: A Systematic Review and Meta-analysis of 5.3 Million Participants

Annals of Pharmacotherapy ◽

10.1177/10600280211049727 ◽

2021 ◽

pp. 106002802110497

Author(s):

Akshaya Srikanth Bhagavathula ◽

Kota Vidyasaga ◽

Eyob Alemayehu Gebreyohannes ◽

Wubshet Tesfaye

Keyword(s):

Gastrointestinal Bleeding ◽

Observational Studies ◽

Data Extraction ◽

Meta Analysis ◽

Concomitant Administration ◽

Pooled Analysis ◽

Data Synthesis ◽

Study Selection ◽

Statin Monotherapy ◽

Statin Use

Objective: This study aimed to comprehensively evaluate the risk of gastrointestinal bleeding (GIB) with statin monotherapy or with concomitant warfarin use. Data Sources: PubMed, Web of Science, and EMBASE (via Scopus) were searched for observational studies that reported the risk of GIB in adults on statin therapy or with concomitant warfarin use until August 28, 2021. Study Selection and Data Extraction: Observational studies evaluating the risk of GIB in adults (age >18 years) on statin medication or concomitant use with warfarin were included. Data Synthesis: In all, 14 studies with a total of 5 235 123 participants, reporting 48 677 GIB events (43 734 from statin users and 4943 from users of statin combined with warfarin), were included in the analyses. The pooled analysis revealed no difference in the risk of GIB with statin monotherapy (relative risk [RR]: 0.65; 95% CI: 0.42-1.02) or concomitant statin + warfarin use (RR: 0.97; 95% CI: 0.91-1.02). Prior use of statin was not associated with GIB risk (RR: 0.88; 95% CI: 0.63-1.22), whereas a shorter duration of statin use (<5 years) was associated with a lower risk of GIB (RR: 0.42; 95% CI: 0.18-0.97). Relevance to Patient Care and Clinical Practice: This analysis provides strong evidence on the association between statin use (with/without warfarin) and risk of GIB. Conclusion: Statin alone or combined with warfarin was not significantly associated with either an increased or decreased risk of GIB. The GIB risk was significantly lower when statins were used for a short duration (<5 years). The putative relationship between statins and GIB in warfarin users warrant further investigation.

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Blinding Strategies in Dry Needling Trials: Systematic Review and Meta-Analysis

Physical Therapy ◽

10.1093/ptj/pzz111 ◽

2019 ◽

Vol 99 (11) ◽

pp. 1461-1480 ◽

Cited By ~ 10

Author(s):

Felicity A Braithwaite ◽

Julie L Walters ◽

Lok Sze Katrina Li ◽

G Lorimer Moseley ◽

Marie T Williams ◽

...

Keyword(s):

Data Extraction ◽

Meta Analysis ◽

Cognitive Strategies ◽

Evidence Based ◽

Dry Needling ◽

Data Synthesis ◽

Study Selection ◽

Methodological Bias ◽

Tactile Sensations ◽

Effectiveness Data

Abstract Background Blinding of participants and therapists in trials of physical interventions is a significant and ongoing challenge. There is no widely accepted sham protocol for dry needling. Purpose The purpose of this review was to summarize the effectiveness and limitations of blinding strategies and types of shams that have been used in dry needling trials. Data Sources Twelve databases were searched from inception to February 2016. Study Selection Trials that compared active dry needling with a sham that simulated dry needling were included. Data Extraction The main domains of data extraction were participant/therapist details, intervention details, blinding strategies, blinding assessment outcomes, and key conclusions of authors. Reported blinding strategies and sham types were synthesized descriptively, with available blinding effectiveness data synthesized using a chance-corrected measurement of blinding (blinding index). Data Synthesis The search identified 4894 individual publications with 27 trials eligible for inclusion. In 22 trials, risk of methodological bias was high or unclear. Across trials, blinding strategies and sham types were heterogeneous. Notably, no trials attempted therapist blinding. Sham protocols have focused on participant blinding using strategies related to group standardization and simulation of tactile sensations. There has been little attention given to the other senses or cognitive strategies to enhance intervention credibility. Nonpenetrating sham types may provide effective participant blinding. Limitations Trials were clinically and methodologically diverse, which limited the comparability of blinding effectiveness across trials. Reported blinding evaluations had a high risk of chance findings with power clearly achieved in only 1 trial. Conclusions Evidence-based consensus on a sham protocol for dry needling is required. Recommendations provided in this review may be used to develop sham protocols so that future protocols are more consistent and potentially more effective.

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Preoxygenation before intubation in adult patients with acute hypoxemic respiratory failure: a network meta-analysis of randomized trials

Critical Care ◽

10.1186/s13054-019-2596-1 ◽

2019 ◽

Vol 23 (1) ◽

Cited By ~ 6

Author(s):

Ka Man Fong ◽

Shek Yin Au ◽

George Wing Yiu Ng

Keyword(s):

Respiratory Failure ◽

Data Extraction ◽

Meta Analysis ◽

Adult Patients ◽

Cochrane Library ◽

Controlled Trials ◽

Hypoxemic Respiratory Failure ◽

Acute Hypoxemic Respiratory Failure ◽

Study Selection ◽

Screening Study

Abstract Background Patients with acute hypoxemic respiratory failure are at risk for life-threatening complications during endotracheal intubation. Preoxygenation might help reduce the risk of hypoxemia and intubation-related complications. This network meta-analysis summarizes the efficacy and safety of preoxygenation methods in adult patients with acute hypoxemic respiratory failure. Methods We searched PubMed, EMBASE, and the Cochrane Library Central Register of Controlled Trials through April 2019 for randomized controlled trials (RCT) that studied the use of conventional oxygen therapy (COT), high-flow nasal cannula (HFNC), noninvasive ventilation (NIV), and HFNC and NIV as preoxygenation before intubation in patients with acute hypoxemic respiratory failure. Citations’ screening, study selection, data extraction, and risk of bias assessment were independently performed by two authors. The primary outcome was the lowest SpO2 during the intubation procedure. Results We included 7 RCTs (959 patients). Patients preoxygenated with NIV had significantly less desaturation than patients treated with COT (mean difference, MD 5.53, 95% CI 2.71, 8.34) and HFNC (MD 3.58, 95% CI 0.59, 6.57). Both NIV (odds ratio, OR 0.43, 95% CI 0.21, 0.87) and HFNC (OR 0.49, 95% CI 0.28, 0.88) resulted in a lower risk of intubation-related complications than COT. There were no significant mortality differences among the use of NIV, HFNC, COT, and HFNC and NIV during preoxygenation. Conclusions In adult patients with acute hypoxemic respiratory failure, NIV is a safe and probably the most effective preoxygenation method.

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A Meta-Analysis of Pregnancy Outcomes With Levothyroxine Treatment in Euthyroid Women With Thyroid Autoimmunity

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgz217 ◽

2019 ◽

Vol 105 (4) ◽

pp. 1009-1019 ◽

Cited By ~ 4

Author(s):

Xiaodong Sun ◽

Ningning Hou ◽

Hongsheng Wang ◽

Lin Ma ◽

Jinhong Sun ◽

...

Keyword(s):

Pregnancy Outcomes ◽

Birth Rate ◽

Data Extraction ◽

Meta Analysis ◽

Thyroid Autoimmunity ◽

Data Synthesis ◽

Definitive Evidence ◽

Study Selection ◽

Adverse Pregnancy ◽

Levothyroxine Treatment

Abstract Context Thyroid autoimmunity (TAI), the most common cause of (sub)clinical hypothyroidism, is associated with adverse pregnancy outcomes. The benefits of levothyroxine (LT4) intervention in women with TAI remain controversial. Objective The purpose of this analysis is to determine the effect of LT4 on pregnancy outcomes in euthyroid women with TAI. Data sources Databases were searched up to May 2019. Study selection Randomized controlled trails (RCTs) and retrospective studies that reported effects of LT4 administration on pregnancy outcomes in euthyroid women with TAI were screened. Data extraction Quality assessment and data extraction were conducted independently by 2 researchers. Conflicts were settled by a third researcher. Data synthesis Six trials comprising 2249 women were included. Overall, no beneficial effect on pregnancy outcomes was observed with LT4 supplementation. For women with individualized initial LT4 dosages, the risk of miscarriage decreased (relative risk [RR] 0.62, 95% CI: 0.41-0.93, I2 = 28%); there was no difference among women with fixed LT4 dosages (RR 0.96, 95% CI: 0.74-1.24, I2 = 0%). Women who initiated LT4 treatment in early pregnancy had a significantly lower preterm birth rate (RR 0.54, 95% CI: 0.31-0.92, I2 = 0%) than those who received no treatment or placebo. No improvement was observed among women who initiated treatment before conception (RR 1.14, 95% CI: 0.71-1.84, I2 = 0%). Conclusion No definitive evidence showed improvement of pregnancy outcomes with LT4 supplementation in euthyroid women with TAI. However, therapeutic strategies, especially dosages and initial times of intervention, may be of great importance. Additional large RCTs are needed in the future.

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Neuromuscular Excercise in Children with Down Syndrome. A Systematic Review

10.21203/rs.3.rs-1164740/v1 ◽

2022 ◽

Author(s):

Eliana-Isabel Rodríguez-Grande ◽

Olga-Cecilia Vargas-Pinilla ◽

Martha-Rocio Torres-Narvaez ◽

Nelcy Rodríguez-Malagón

Keyword(s):

Muscle Strength ◽

Randomized Clinical Trials ◽

Data Extraction ◽

Cochrane Library ◽

Exercise Frequency ◽

Data Synthesis ◽

Children With Down Syndrome ◽

Maximum Resistance ◽

Effective Interventions ◽

Study Selection

Abstract Objective to evaluate the effects of neuromuscular exercise, specifying the parameters and characteristics of effective interventions to improve balance, muscle strength and flexibility in children with DS between the ages of 4 and 18 years. Data Sources: A search was carried out on PubMed, PEDro, EMBASE, SCIELO, Lilacs, Cochrane library. Study Selection: The search yielded 1384 eligible articles. Randomized clinical trials were selected, and that would have reported the effectiveness in the outcomes. Data Extraction: The methodology and results of the studies were critically appraised in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes guidelines. Data Synthesis: Ten studies were included. The interventions included mechanotherapy, vibration, and use of different unstable surfaces. The exercise frequency ranged from three days to five days a week, and the duration of each session was between six and 15 minutes. The frequency was between two and three times a week for 6 and 12 weeks and the intensity was between 60% and 80% of maximum resistance (MR). Conclusion neuromuscular exercise appears to be effective for the improvement of both lower limb and chest muscle strength and balance in children over 8 years of age.

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Effect of Virtual Reality Training on Balance and Gait Ability in Patients With Stroke: Systematic Review and Meta-Analysis

Physical Therapy ◽

10.2522/ptj.20160054 ◽

2016 ◽

Vol 96 (12) ◽

pp. 1905-1918 ◽

Cited By ~ 73

Author(s):

Ilona J.M. de Rooij ◽

Ingrid G.L. van de Port ◽

Jan-Willem G. Meijer

Keyword(s):

Virtual Reality ◽

Conventional Therapy ◽

Data Extraction ◽

Meta Analysis ◽

Gait Training ◽

Berg Balance Scale ◽

Cochrane Library ◽

Novel Therapy ◽

Study Selection ◽

Vr Training

AbstractBackgroundVirtual reality (VR) training is considered to be a promising novel therapy for balance and gait recovery in patients with stroke.PurposeThe aim of this study was to conduct a systematic literature review with meta-analysis to investigate whether balance or gait training using VR is more effective than conventional balance or gait training in patients with stroke.Data SourcesA literature search was carried out in the databases PubMed, Embase, MEDLINE, and Cochrane Library up to December 1, 2015.Study SelectionRandomized controlled trials that compared the effect of balance or gait training with and without VR on balance and gait ability in patients with stroke were included.Data Extraction and SynthesisTwenty-one studies with a median PEDro score of 6.0 were included. The included studies demonstrated a significant greater effect of VR training on balance and gait recovery after stroke compared with conventional therapy as indicated with the most frequently used measures: gait speed, Berg Balance Scale, and Timed “Up & Go” Test. Virtual reality was more effective to train gait and balance than conventional training when VR interventions were added to conventional therapy and when time dose was matched.LimitationsThe presence of publication bias and diversity in included studies were limitations of the study.ConclusionsThe results suggest that VR training is more effective than balance or gait training without VR for improving balance or gait ability in patients with stroke. Future studies are recommended to investigate the effect of VR on participation level with an adequate follow-up period. Overall, a positive and promising effect of VR training on balance and gait ability is expected.

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Associations of tobacco retailer density and proximity with adult tobacco use behaviours and health outcomes: a meta-analysis

Tobacco Control ◽

10.1136/tobaccocontrol-2021-056717 ◽

2021 ◽

pp. tobaccocontrol-2021-056717

Author(s):

Joseph G L Lee ◽

Amanda Y Kong ◽

Kerry B Sewell ◽

Shelley D Golden ◽

Todd B Combs ◽

...

Keyword(s):

Health Outcomes ◽

Tobacco Use ◽

Data Extraction ◽

Meta Analysis ◽

Grey Literature ◽

Inclusion Criteria ◽

Data Synthesis ◽

Literature Searches ◽

Adult Participants ◽

Study Selection

ObjectiveWe sought to conduct a systematic review and meta-analysis of evidence to inform policies that reduce density and proximity of tobacco retailers.Data sourcesTen databases were searched on 16 October 2020: MEDLINE via PubMed, PsycINFO, Global Health, LILACS, Embase, ABI/Inform, CINAHL, Business Source Complete, Web of Science and Scopus, plus grey literature searches using Google and the RAND Publication Database.Study selectionIncluded studies used inferential statistics about adult participants to examine associations between tobacco retailer density/proximity and tobacco use behaviours and health outcomes. Of 7373 studies reviewed by independent coders, 37 (0.5%) met inclusion criteria.Data extractionEffect sizes were converted to a relative risk reduction (RRR) metric, indicating the presumed reduction in tobacco use outcomes based on reducing tobacco retailer density and decreasing proximity.Data synthesisWe conducted a random effects meta-analysis and examined heterogeneity across 27 studies through subgroup analyses and meta-regression. Tobacco retailer density (RRR=2.55, 95% CI 1.91 to 3.19, k=155) and proximity (RRR=2.38, 95% CI 1.39 to 3.37, k=100) were associated with tobacco use behaviours. Pooled results including both density and proximity found an estimated 2.48% reduction in risk of tobacco use from reductions in tobacco retailer density and proximity (RRR=2.48, 95% CI 1.95 to 3.02, k=255). Results for health outcomes came from just two studies and were not significant. Considerable heterogeneity existed.ConclusionsAcross studies, lower levels of tobacco retailer density and decreased proximity are associated with lower tobacco use. Reducing tobacco supply by limiting retailer density and proximity may lead to reductions in tobacco use. Policy evaluations are needed.

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