scholarly journals Endoscopic versus Percutaneous Biliary Drainage in Palliation of Advanced Malignant Hilar Obstruction: A Meta-Analysis and Systematic Review

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Harsha Moole ◽  
Sirish Dharmapuri ◽  
Abhiram Duvvuri ◽  
Sowmya Dharmapuri ◽  
Raghuveer Boddireddy ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Biliary Drainage ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Selection Criterion ◽  
Group Versus ◽  
Random Effects Models ◽  
Study Selection ◽  
Fixed And Random Effects ◽  
Malignant Hilar Obstruction

Background. Palliation in advanced unresectable hilar malignancies can be achieved by endoscopic (EBD) or percutaneous transhepatic biliary drainage (PTBD). It is unclear if one approach is superior to the other in this group of patients.Aims. Compare clinical outcomes of EBD versus PTBD.Methods.(i) Study Selection Criterion. Studies using PTBD and EBD for palliation of advanced unresectable hilar malignancies.(ii) Data Collection and Extraction. Articles were searched in Medline, PubMed, and Ovid journals.(iii) Statistical Method. Fixed and random effects models were used to calculate the pooled proportions.Results. Initial search identified 786 reference articles, in which 62 articles were selected and reviewed. Data was extracted from nine studies (N=546) that met the inclusion criterion. The pooled odds ratio for successful biliary drainage in PTBD versus EBD was 2.53 (95% CI = 1.57 to 4.08). Odds ratio for overall adverse effects in PTBD versus EBD groups was 0.81 (95% CI = 0.52 to 1.26). Odds ratio for 30-day mortality rate in PTBD group versus EBD group was 0.84 (95% CI = 0.37 to 1.91).Conclusions. In patients with advanced unresectable hilar malignancies, palliation with PTBD seems to be superior to EBD. PTBD is comparable to EBD in regard to overall adverse effects and 30-day mortality.

scholarly journals SARS-CoV-2 circulation in the school setting: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Chiara Martinoli ◽  
Carlo La Vecchia ◽  
Sara Raimondi ◽  
Federica Bellerba ◽  
Clementina Sasso ◽  
...  
Keyword(s):  
Systematic Review ◽  
Odds Ratio ◽  
Meta Analysis ◽  
School Setting ◽  
Viral Transmission ◽  
Contact Tracing ◽  
Random Effects Models ◽  
Viral Spread ◽  
Literature Searches ◽  
Index Cases

Background. The contribution of children to viral spread in schools is still under debate. We conducted a systematic review and meta-analysis of studies to investigate SARS-CoV-2 transmission in the school setting. Methods: Literature searches from April, 2021 and repeated on May, 15th 2021 yielded a total of 1088 publications: screening, contact tracing and seroprevalence studies. MOOSE guidelines were followed and data analyzed using random-effects models. Results: From screening studies involving more than 120,000 subjects, we estimated 0.31% (95% Confidence Interval [CI] 0.05-0.81%) SARS-CoV-2 point prevalence in schools. Contact tracing studies, involving a total of 112,622 contacts of children and adults, showed that onward viral transmission was limited (2.54%; 95%CI 0.76-5.31). Young index cases were found to be 74% significantly less likely than adults to favor viral spread (Odds Ratio [OR]=0.26; 95%CI 0.11-0.63) and were less susceptible to infection (OR=0.60; 95% CI 0.25-1.47). Finally, from seroprevalence studies, with a total of 17,879 subjects involved, we estimated that children are 43% significantly less likely than adults to test positive for antibodies (OR=0.57; 95%CI: 0.49-0.68). In conclusion, testing all subjects in schools, independently of symptoms, students less likely than adults favor viral spread and SARS-CoV-2 circulation in schools was found to be limited.

scholarly journals Systematic Review with Meta-Analysis: Endoscopic and Surgical Resection for Ampullary Lesions

2020 ◽  
Vol 9 (11) ◽  
pp. 3622
Author(s):  
Christian Heise ◽  
Einas Abou Ali ◽  
Dirk Hasenclever ◽  
Francesco Auriemma ◽  
Aiste Gulla ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Significant Risk ◽  
Significant Heterogeneity ◽  
Incomplete Resection ◽  
Quality Of Data ◽  
Surgical Interventions ◽  
Random Effects Models ◽  
Fixed And Random Effects

Ampullary lesions (ALs) can be treated by endoscopic (EA) or surgical ampullectomy (SA) or pancreaticoduodenectomy (PD). However, EA carries significant risk of incomplete resection while surgical interventions can lead to substantial morbidity. We performed a systematic review and meta-analysis for R0, adverse-events (AEs) and recurrence between EA, SA and PD. Electronic databases were searched from 1990 to 2018. Outcomes were calculated as pooled means using fixed and random-effects models and the Freeman-Tukey-Double-Arcsine-Proportion-model. We identified 59 independent studies. The pooled R0 rate was 76.6% (71.8–81.4%, I2 = 91.38%) for EA, 96.4% (93.6–99.2%, I2 = 37.8%) for SA and 98.9% (98.0–99.7%, I2 = 0%) for PD. AEs were 24.7% (19.8–29.6%, I2 = 86.4%), 28.3% (19.0–37.7%, I2 = 76.8%) and 44.7% (37.9–51.4%, I2 = 0%), respectively. Recurrences were registered in 13.0% (10.2–15.6%, I2 = 91.3%), 9.4% (4.8–14%, I2 = 57.3%) and 14.2% (9.5–18.9%, I2 = 0%). Differences between proportions were significant in R0 for EA compared to SA (p = 0.007) and PD (p = 0.022). AEs were statistically different only between EA and PD (p = 0.049) and recurrence showed no significance for EA/SA or EA/PD. Our data indicate an increased rate of complete resection in surgical interventions accompanied with a higher risk of complications. However, studies showed various sources of bias, limited quality of data and a significant heterogeneity, particularly in EA studies.

Meta-analysis in Sociological Research: Power and Heterogeneity

2019 ◽  
pp. 004912411988247 ◽  
Author(s):  
Guangyu Tong ◽  
Guang Guo
Keyword(s):  
Random Effects ◽  
Science Studies ◽  
Meta Analysis ◽  
Sociological Research ◽  
Random Effects Models ◽  
Sociological Inquiry ◽  
Wide Range ◽  
Fixed And Random Effects ◽  
Study Heterogeneity ◽  
Analysis Models

Meta-analysis is a statistical method that combines quantitative findings from previous studies. It has been increasingly used to obtain more credible results in a wide range of scientific fields. Combining the results of relevant studies allows researchers to leverage study similarities while modeling potential sources of between-study heterogeneity. This article provides a review of the core methodologies of meta-analysis that we consider most relevant to sociological research. After developing the foundation of the fixed- and random-effects models of meta-analysis models, this article illustrates the utility of the method with regression coefficients reported from two sets of social science studies. We explain the various steps of the process including constructing the meta-sample from primary studies, estimating the fixed- and random-effects models, analyzing the source of heterogeneity across studies, and assessing publication bias. We conclude with a discussion of steps that could be taken to strengthen the development of meta-analysis in sociological research, which will eventually increase the credibility of sociological inquiry via a knowledge-cumulative process.

Fixed- and random-effects models in meta-analysis.

1998 ◽  
Vol 3 (4) ◽  
pp. 486-504 ◽  
Author(s):  
Larry V. Hedges ◽  
Jack L. Vevea
Keyword(s):  
Random Effects ◽  
Meta Analysis ◽  
Random Effects Models ◽  
Fixed And Random Effects

Detecting and correcting for publication bias in meta-analysis – A truncated normal distribution approach

2016 ◽  
Vol 27 (9) ◽  
pp. 2722-2741 ◽  
Author(s):  
Qiaohao Zhu ◽  
KC Carriere
Keyword(s):  
Normal Distribution ◽  
Publication Bias ◽  
Random Effects ◽  
Effect Size ◽  
Meta Analysis ◽  
Truncated Normal Distribution ◽  
Random Effects Models ◽  
Funnel Plot ◽  
Fixed And Random Effects ◽  
Truncated Normal

Publication bias can significantly limit the validity of meta-analysis when trying to draw conclusion about a research question from independent studies. Most research on detection and correction for publication bias in meta-analysis focus mainly on funnel plot-based methodologies or selection models. In this paper, we formulate publication bias as a truncated distribution problem, and propose new parametric solutions. We develop methodologies of estimating the underlying overall effect size and the severity of publication bias. We distinguish the two major situations, in which publication bias may be induced by: (1) small effect size or (2) large p-value. We consider both fixed and random effects models, and derive estimators for the overall mean and the truncation proportion. These estimators will be obtained using maximum likelihood estimation and method of moments under fixed- and random-effects models, respectively. We carried out extensive simulation studies to evaluate the performance of our methodology, and to compare with the non-parametric Trim and Fill method based on funnel plot. We find that our methods based on truncated normal distribution perform consistently well, both in detecting and correcting publication bias under various situations.

scholarly journals Weekend effects of admission and surgery in acute aortic syndrome

2021 ◽  
Author(s):  
Chao Song ◽  
YunLong Fan ◽  
ShiXiong Wei ◽  
Shengli Jiang
Keyword(s):  
Primary Outcome ◽  
Meta Analysis ◽  
Mortality Rates ◽  
Weekend Effect ◽  
Acute Aortic Syndrome ◽  
Random Effects Models ◽  
Acute Aortic Syndromes ◽  
Increased Risk ◽  
Fixed And Random Effects ◽  
All Cause Mortality

Background: The weekend effect is a phenomenon characterized by increased early all-cause mortality among patients hospitalized or undergoing surgery over the weekend for emergencies. Objectives: With this meta-analysis we aimed to determine whether weekend hospitalization/surgery due to acute aortic syndromes (AAS) is associated with increased early all-cause mortality. Methods：Major electronic databases were searched for studies published up to October 2020 reporting early all-cause mortality rates for admissions/operations on weekends versus weekdays. Data were pooled using fixed- and random-effects models. The primary outcome of the study was early all-cause mortality after weekend versus weekday. Results: All the included studies were retrospective, comparative or cohort studies enrolling patients admitted or underwent surgery for AAS and reported early all-cause mortality after weekend (including holiday) versus weekday. A total of 18 studies including a total of 252807 patients were identified. This meta-analysis showed a significant increase in the early all-cause mortality for patients admitted/conducted surgery for AAS on weekends compare with weekdays (fixed-effect: OR 1.1;95% CI 1.06-1.14;P＜0.00001). Conclusion: Weekend admission/surgery for AAS is associated with a increased risk of early all-cause mortality.

scholarly journals Interleukin-18 Polymorphisms Deficiency Association with Asthma Risk: An Update Meta-analysis

2019 ◽  
Author(s):  
Huan LIU ◽  
Yu Feng ◽  
Wei Zhang ◽  
Xiao-Dong Deng ◽  
Ying Ma ◽  
...  
Keyword(s):  
Publication Bias ◽  
Meta Analysis ◽  
Interleukin 18 ◽  
Promoter Polymorphisms ◽  
Random Effects Models ◽  
Asthma Risk ◽  
Genotype Frequencies ◽  
Fixed And Random Effects ◽  
Matching Criteria ◽  
Strength Of Association

Growing evidence indicated conflicting results that Interleukin-18 (IL-18) promoter polymorphisms rs1946518 (A-607C), rs187238 (G-137C) and rs549908 (A-105C) were associated with asthma risk. The aim of this study is to comprehensively evaluate the IL-18 polymorphisms and asthma by a systematic review and meta-analysis. A total of 12 studies testing the association between these polymorphisms and asthma were examined (8 studies for A-607C, 8 studies for G-137C, and 4 studies for A-105C) in the update meta-analysis, up to Dec 30, 2017. Summary odds ratios (ORs) and 95% confidence intervals (CI) were used to estimate the strength of association between each polymorphism and asthma using fixed- and random-effects models when appropriate. Heterogeneity and publication bias were evaluated. The meta-analysis results indicated that any allele frequencies of the IL-18 polymorphisms (A-607C, G-137C and A-105C) was not associated with asthma risk (p>0.05). And no statistically significant association was observed between genotype frequencies of these polymorphisms and asthma under different genetic models (p>0.05). Subgroup analysis results were similar to the main analysis by ethnicity, sample size, genotyping methods, matching criteria and quality score. There was no evidence of publication bias. The present meta-analysis suggests that IL-18 polymorphisms (A-607C, G-137C and A-105C) were unlikely to be associated with asthma risk.

scholarly journals Cortical Bone Trajectory Screw Fixation of Lumbar Spine in Adult Patients with Degenerative and Traumatic Spine Disorders

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A M Elbadrawy ◽  
T M S Elkhateeb ◽  
E M M A Hassan
Keyword(s):  
Lumbar Spine ◽  
Random Effects ◽  
Screw Fixation ◽  
Meta Analysis ◽  
Pedicle Screws ◽  
Fusion Rate ◽  
Random Effects Models ◽  
Fixed And Random Effects ◽  
Spine Disorders ◽  
Lumbar Pedicle

Abstract Background the CBT for placing lumbar pedicle screws is a technique used to improve fixation during instrumented fusion of the lumbar spine. In comparison with traditional trajectory (TT) for pedicle screws, CBT screws (otherwise known as pars screws or cortical screws) have a more medial starting point and are aimed in a medial to lateral, caudal to cranial direction. First reported in 2009 as a method to increase the purchase of lumbar pedicle screws within bone.(1) Aim of the Work to perform a systematic review and meta-analysis to determine whether traditional Pedicles Screw Fixation (PS Fx) or Cortical Bone Trajectory Screw Fixation (CBT Fx); has been successful for the treatment and fixation of lumbar spine in adult patients with degenerative and traumatic spine disorders; and to compare the 2 techniques to identify risk factor for unfavorable outcome through the recent researches about that issue. Methodology this review was done using standard methodology outlined in the Cochrane Handbook and reported the findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement guidelines. Results meta-analysis study showed that; Successful fusion rate in fixed and random-effects models were (92.24% respectively); in SP group.Successful fusion rate in fixed and random-effects models were (92.44% respectively); in CBT group.Fixed and random-effects models showed non-significant difference in successful fusion rate; between the 2 groups of studies (p > 0.05). We calculated safety for each technique through post-operative (failed fusion rate). Conclusion Although there were insignificant p-values in the most of the comparative items but the CBT showed lower average of intraoperative blood loss, operation time and higher average of decrease in VAS & increase in ODI, slightly higher fusion rate in comparison with PS. So we recommend, the use of CBT as an acceptable alternative of PS in lumbar spine fixation.

Sa1454 BILATERAL VERSUS UNILATERAL BILIARY DRAINAGE FOR MALIGNANT HILAR OBSTRUCTION: A SYSTEMIC REVIEW AND META-ANALYSIS

2019 ◽  
Vol 89 (6) ◽  
pp. AB238
Author(s):  
Munish Ashat ◽  
Sumant Arora ◽  
Arvind R. Murali ◽  
Frederick C. Johlin
Keyword(s):  
Biliary Drainage ◽  
Meta Analysis ◽  
Systemic Review ◽  
Malignant Hilar Obstruction
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