Accuracy of mRNA HPV Tests for Triage of Precursor Lesions and Cervical Cancer: A Systematic Review and Meta-Analysis

Objective. This systematic review evaluates the accuracy of the mRNA HPV biomarker in cervical smears to identify cervical intraepithelial neoplasia (CIN) 2 or 3 and cervical cancer. Data Source. Eligible studies were identified by performing a search of electronic databases on Medline via Pubmed, Lilacs, Cochrane Library, Embase, and Grey literature for papers published between January 1990 and June 2018. Study Eligibility Criteria. As no randomized studies were identified, this review focuses on observational studies in which the mRNA HPV diagnostic test was compared to a histopathology reference standard. We analyzed studies that included women screened for cervical cancer using mRNA HPV. Study Appraisal and Synthesis Methods. After screening, 61 studies including 29,674 patients met the inclusion criteria and were analyzed. Dichotomization was performed by defining CIN2 or worse (CIN2+) versus CIN1, HPV infection, and normal (CIN 1-). The analysis was discriminated by the following tests: Aptima, PreTect HPV Profeer, NucliSens EasyQ HPV, OncoTect, and Quantivirus. Results. Analyzing by technique, Aptima, with 28 studies, exhibited superior performance, showing for the outcomes CIN2+ and CIN3+ an AUC of 0.88 (0.82-0.95) and 0.91 (0.84-0.99), a pooled sensitivity of 92.8% (95%CI 91.9-93.7) and 95.6% (95%CI 94.5-96.5), and a pooled specificity of 60.5% (95%CI 59.8-61.3) and 61.9% (95%CI 61.1-62.7), respectively. Conclusion. This study supports the current hypothesis that the mRNA HPV assay is an adequate tool for secondary cervical cancer screening.

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Protocol for a systematic review of research on HPV and cervical cancer in Ghana, up until the year 2017: informing research and policy direction on cervical cancer prevention in Ghana

BMJ Open ◽

10.1136/bmjopen-2017-020183 ◽

2018 ◽

Vol 8 (7) ◽

pp. e020183

Author(s):

Adolf Kofi Awua ◽

Edna Dzifa Doe

Keyword(s):

Systematic Review ◽

Cervical Cancer ◽

Meta Analysis ◽

Grey Literature ◽

Cervical Cancer Prevention ◽

Specific Information ◽

Cochrane Central Register ◽

Eligibility Criteria ◽

Digital Collections ◽

The Status

IntroductionFor a country that lacks a national cervical cancer screening/prevention programme, there is the need to assess the volume of country-specific information, and the status of research on HPV and cervical cancer, in order to provide evidence that will inform policy and further research. The aim of this protocol is to plan an intended systematic review, which is to identify research gaps, prevent unnecessary duplication of work and enable collaboration.Methods and analysisThis protocol, developed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols statement and registered by PROSPERO (CRD42017075583), will apply a 13-point eligibility criteria to screening and selecting peer-reviewed research articles and grey literature. These will be obtained from searches in databases, including, among others, those of the National Centre for Biotechnology Information, Cochrane Central Register of Controlled Trials, Google Scholar and the digital collections database of research publications of Universities in Ghana. Collected data will be aggregated and summarised according to emerging themes and simple descriptive statistics.Ethics and disseminationThe study will use publicly available data and will not identify authors of the publication by name. In light of these and as has been indicted, research ethics clearance is not required for evidence syntheses in such reviews. The review will be published in peer-reviewed scientific journals and presented at local and internal conferences as the opportunity becomes available.PROSPERO registration numberCRD42017075583.

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Effectiveness of interventions for the prevention of occupational violence against professionals in health services: a protocol for a systematic review

BMJ Open ◽

10.1136/bmjopen-2019-036558 ◽

2020 ◽

Vol 10 (9) ◽

pp. e036558

Author(s):

Caroline Vieira Cláudio Okubo ◽

Renata Cristina Campos Pereira Silveira ◽

Maria José Quina Galdino ◽

Daiane Rubinato Fernandes ◽

Aline Aparecida Oliveira Moreira ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Grey Literature ◽

Cochrane Review ◽

Health Sector ◽

Risk Of Bias ◽

Cochrane Library ◽

Eligibility Criteria ◽

Occupational Violence

IntroductionOccupational violence affects several categories of workers; however, the health sector category has been considered at a high risk, exposing workers to physical and psychological abuse. Thus, occupational violence has decreased the quality of care in health service. This review aims to evaluate the effectiveness of interventions for the prevention and reduction of occupational violence against health professionals.Methods and analysisThis protocol is consistent with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Searches will be conducted in PubMed, Embase, Cochrane Library, LILACS, Web of Science, Scopus, CINAHL and LIVIVO along with a comprehensive review of grey literature. The search will be conducted on August 1 st 2020, without language and time restrictions. Following the eligibility criteria, two independent reviewers will select the titles and abstracts and subsequently screen the full articles. If necessary, a third reviewer will assess any disagreements. All references will be imported into EndNote, and any duplicates will be removed. The data will be extracted using an extraction-based form from Cochrane. Statistical analyses will be performed using the software Cochrane Review Manager, and a meta-analysis will be performed if possible for the statistical combination of at least two studies. The risk of bias of the randomised clinical trials will be evaluated by the Risk of Bias tool from Cochrane, and the risk of bias of the non-randomised intervention studies will be evaluated using the Downs and Black scale. The quality of the evidence and strength of the classification recommendations will be assessed by the Grading of Recommendations, Assessment, Development and Evaluation.Ethics and disseminationThis review will not evaluate individual patient information and therefore does not require ethical approval. The results will be disseminated through publications in peer-reviewed journals, presentations at conferences and the doctoral thesis of the leading author.PROSPERO registration numberCRD42018111383.

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The Clinical Effectiveness of Cognitive Behavioral Therapy for Patients with Insomnia and Depression: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/8071821 ◽

2020 ◽

Vol 2020 ◽

pp. 1-14

Author(s):

Guiyu Feng ◽

Mei Han ◽

Xun Li ◽

Le Geng ◽

Yingchun Miao

Keyword(s):

Randomized Controlled Trials ◽

Meta Analysis ◽

Grey Literature ◽

Clinical Effectiveness ◽

Cochrane Library ◽

Controlled Trials ◽

Synthesis Methods ◽

China National Knowledge Infrastructure ◽

Eligibility Criteria ◽

Randomized Controlled

Background. Insomnia and depression often co-occurr. However, there is lack of effective treatment for such comorbidity. CBT-I has been recommended as the first-line treatment for insomnia; whether it is also effective for comorbidity of insomnia and depression is still unknown. Therefore, we conducted this meta-analysis of randomized controlled trials to assess the clinical effectiveness and safety of CBT-I for insomnia comorbid with depression. Data Sources. Seven electronic databases, including China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science Technology Journal Database, SinoMed Database, PubMed, the Cochrane Library, and EMBASE, as well as grey literature, were searched from the beginning of each database to July 1, 2019. Study Eligibility Criteria. Randomized controlled trials that compared CBT-I to no treatment or hypnotics (zopiclone, estazolam, and benzodiazepine agonist) for insomnia comorbid with depression and reported both insomnia scales and depression scales. Study Assessment and Synthesis Methods. Cochrane Reviewer’s Handbook was used for evaluating the risk of bias of included studies. Review Manager 5.3 software was used for meta-analysis. Online GRADEpro was used to assess the quality of evidence. Results. The pooled data showed that CBT-I was superior to no treatment for insomnia, while it was unsure whether CBT-I was better than no treatment for depression. And the effectiveness of CBT-I was comparable to hypnotics for both insomnia and depression. CBT-I was likely to be safe due to its noninvasive nature. The methodological quality varied across these trials. The evidence quality varied from moderate to very low, and the recommendation level was low. Conclusions. Currently, findings support that CBT-I seems to be effective and safe for insomnia comorbid with depression to improve the insomnia condition, while it is unsure whether CBT-I could improve depression condition. More rigorous trials are needed to confirm our findings.

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Prevalence of human papillomavirus by geographical regions, sexual orientation and HIV status in China: a systematic review and meta-analysis

Sexually Transmitted Infections ◽

10.1136/sextrans-2017-053412 ◽

2018 ◽

Vol 94 (6) ◽

pp. 434-442 ◽

Cited By ~ 13

Author(s):

Xiaomeng Ma ◽

Qian Wang ◽

Jason J Ong ◽

Christopher K Fairley ◽

Shu Su ◽

...

Keyword(s):

Systematic Review ◽

Cervical Cancer ◽

Human Papillomavirus ◽

Meta Analysis ◽

Hpv Vaccination ◽

Hpv Infection ◽

Central China ◽

Hiv Positive ◽

Heterosexual Men ◽

Hpv Prevalence

ObjectiveHuman papillomavirus (HPV) infection causes multiple cancers in both women and men. In China, both HPV vaccination and cervical cancer screening coverages are low. We aim to investigate the temporal and geographical trends of HPV DNA prevalence in heterosexual men, women, men who have sex with men (MSM) and people living with HIV (PLHIV) in China.MethodsWe conducted a systematic review, collecting publications in PubMed, Web of Science, China National Knowledge Infrastructure (CNKI) and Wanfang Data from January 2000 to May 2017. A total of 247 studies were selected for this meta-analysis to estimate pooled HPV prevalence, incidence of cervical cancer and risk of infection for subgroups. Meta-regression was applied to identify contributing factors to prevalence heterogeneities.ResultsThe national HPV prevalence was 15.6% (95% CI (14.4% to 16.9%)) in women with normal cervical cytology, and Central China had the highest prevalence (20.5% (15.2% to 25.8%)). HPV prevalence in heterosexual men (14.5% (11.3% to 17.7%)) was comparable with that of women (OR=1.09 (0.98 to 1.17)), but HPV prevalence in MSM (59.9% (52.2% to 67.6%)) was significantly higher than that in heterosexual men (OR=8.81 (8.01 to 9.69)). HIV-positive women (45.0% (38.4% to 51.6%)) and HIV-positive MSM (87.5% (82.3% to 90.9%)) had 4.67 (3.61 to 6.03) and 6.46 (5.20 to 8.02) times higher risk of HPV infection than their HIV negative counterparts.ConclusionHPV infection is prevalent in China, particularly in Central China, in comparison with the global level and neighbouring countries. Targeted HPV vaccination for women, MSM and PLHIV and scale-up of cervical screening for women are priorities in curbing the HPV epidemic in China.

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Prevalence and risk factors associated with birth asphyxia among neonates delivered in Ethiopia: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0255488 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0255488

Author(s):

Ritbano Ahmed ◽

Hassen Mosa ◽

Mohammed Sultan ◽

Shamill Eanga Helill ◽

Biruk Assefa ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Meta Analysis ◽

Grey Literature ◽

Birth Asphyxia ◽

Public Health Problem ◽

Cochrane Library ◽

Chronic Hypertension ◽

Factors Associated ◽

Pooled Prevalence

Background A number of primary studies in Ethiopia address the prevalence of birth asphyxia and the factors associated with it. However, variations were seen among those studies. The main aim of this systematic review and meta-analysis was carried out to estimate the pooled prevalence and explore the factors that contribute to birth asphyxia in Ethiopia. Methods Different search engines were used to search online databases. The databases include PubMed, HINARI, Cochrane Library and Google Scholar. Relevant grey literature was obtained through online searches. The funnel plot and Egger’s regression test were used to see publication bias, and the I-squared was applied to check the heterogeneity of the studies. Cross-sectional, case-control and cohort studies that were conducted in Ethiopia were also be included. The Joanna Briggs Institute checklist was used to assess the quality of the studies and was included in this systematic review. Data entry and statistical analysis were carried out using RevMan 5.4 software and Stata 14. Result After reviewing 1,125 studies, 26 studies fulfilling the inclusion criteria were included in the meta-analysis. The pooled prevalence of birth asphyxia in Ethiopia was 19.3%. In the Ethiopian context, the following risk factors were identified: Antepartum hemorrhage(OR: 4.7; 95% CI: 3.5, 6.1), premature rupture of membrane(OR: 4.0; 95% CI: 12.4, 6.6), primiparas(OR: 2.8; 95% CI: 1.9, 4.1), prolonged labor(OR: 4.2; 95% CI: 2.8, 6.6), maternal anaemia(OR: 5.1; 95% CI: 2.59, 9.94), low birth weight(OR = 5.6; 95%CI: 4.7,6.7), meconium stained amniotic fluid(OR: 5.6; 95% CI: 4.1, 7.5), abnormal presentation(OR = 5.7; 95% CI: 3.8, 8.3), preterm birth(OR = 4.1; 95% CI: 2.9, 5.8), residing in a rural area (OR: 2.7; 95% CI: 2.0, 3.5), caesarean delivery(OR = 4.4; 95% CI:3.1, 6.2), operative vaginal delivery(OR: 4.9; 95% CI: 3.5, 6.7), preeclampsia(OR = 3.9; 95% CI: 2.1, 7.4), tight nuchal cord OR: 3.43; 95% CI: 2.1, 5.6), chronic hypertension(OR = 2.5; 95% CI: 1.7, 3.8), and unable to write and read (OR = 4.2;95%CI: 1.7, 10.6). Conclusion According to the findings of this study, birth asphyxia is an unresolved public health problem in the Ethiopia. Therefore, the concerned body needs to pay attention to the above risk factors in order to decrease the country’s birth asphyxia. Review registration PROSPERO International prospective register of systematic reviews (CRD42020165283).

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Associations of Cervical Vaginal Microflora with HPV Infection, Cervical Intraepithelial Neoplasia and Cancer: A Systematic Review and Network Meta-Analysis

Advances in Clinical Medicine ◽

10.12677/acm.2021.112101 ◽

2021 ◽

Vol 11 (02) ◽

pp. 698-713

Author(s):

丽秦

Keyword(s):

Systematic Review ◽

Cervical Intraepithelial Neoplasia ◽

Meta Analysis ◽

Intraepithelial Neoplasia ◽

Hpv Infection ◽

Vaginal Microflora

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Diagnostic Value of TLE1 in Synovial Sarcoma: A Systematic Review and Meta-Analysis

Sarcoma ◽

10.1155/2020/7192347 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Marc El Beaino ◽

Daniel C. Jupiter ◽

Tarek Assi ◽

Elie Rassy ◽

Alexander J. Lazar ◽

...

Keyword(s):

Systematic Review ◽

Synovial Sarcoma ◽

Predictive Value ◽

Meta Analysis ◽

Diagnostic Value ◽

Cochrane Library ◽

Specific Marker ◽

Eligibility Criteria ◽

Depth Analysis ◽

The Mean

Background. Synovial sarcoma can present morphologically in multiple forms, including biphasic and monophasic subtypes. As a result, the histological diagnosis can sometimes be challenging. Transducin-Like Enhancer 1 (TLE1) is a transcriptional corepressor that normally is involved in embryogenesis and hematopoiesis but is also expressed in certain tumors. This systematic review examines the potential role of TLE1 as a diagnostic biomarker for the synovial sarcoma. Materials and Methods. A literature review and meta-analysis were conducted using the electronic databases Pubmed, the Cochrane Library, and Google Scholar. Thirteen studies met our eligibility criteria and were selected for in-depth analysis. Results. The mean sensitivity and specificity of TLE1 in detecting synovial sarcoma were 94% (95% CI 91%–97%) and 81% (95% CI 72%–91%), respectively, when all studies were aggregated together. The mean positive predictive value (PPV) of TLE1 was 75% (95% CI 62%–87%), whereas the negative predictive value (NPV) was 96% (95% CI 93%–98%). Conclusion. TLE1 is a sensitive and specific marker for synovial sarcoma that can aid in its diagnosis. Due to its involvement in several relevant signaling pathways, TLE1 might have direct relevance to the pathophysiology of the disease.

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Experiences of informal caregivers after cardiac surgery: a systematic integrated review of qualitative and quantitative studies

BMJ Open ◽

10.1136/bmjopen-2019-032751 ◽

2019 ◽

Vol 9 (11) ◽

pp. e032751 ◽

Cited By ~ 3

Author(s):

Ann Kristin Bjørnnes ◽

Philip Moons ◽

Monica Parry ◽

Sigrun Halvorsen ◽

Theis Tønnessen ◽

...

Keyword(s):

Cardiac Surgery ◽

Information Needs ◽

Intervention Studies ◽

Meta Analysis ◽

Grey Literature ◽

Recovery Period ◽

Informal Caregivers ◽

Cochrane Library ◽

Eligibility Criteria ◽

Qualitative And Quantitative

ObjectivesTo provide a comprehensive synthesis of informal caregivers’ experiences of caring for a significant other following discharge from cardiac surgery.DesignSystematic integrated review without meta-analysis.Data sourcesA bibliographic search for publications indexed in six databases (Cochrane Library, CINAHL, MEDLINE, EMBASE, AMED and PsycINFO), including a scan of grey literature sources (GreyNet International, Google Scholar, Web of Science, WorldCat and the Clinical Trials Registry) was conducted in October 2018.Eligibility criteria for selecting studiesStudies were included if they described views and perspectives of informal caregivers of cardiac surgery patients (non-intervention studies (qualitative and quantitative)), and the effectiveness of interventions to evaluate support programme for informal caregivers of cardiac surgery patients (intervention studies).ResultsOf the 4912 articles identified in searches, 42 primary research studies were included in a narrative synthesis with 5292 participants, including 3231 (62%) caregivers of whom 2557 (79%) were women. The median sample size across studies was 96 (range 6–734). Three major themes emerged from the qualitative study data: (1) caregiver information needs; (2) caregiver work challenges and (3) caregivers adaption to recovery. Across the observational studies (n=22), similar themes were found. The trend across seven intervention studies focused on caregiver information needs related to patient disease management and symptom monitoring, and support for caregivers to reduce symptoms of emotional distress.ConclusionInformal caregivers want to assist in the care of their significant others after hospital discharge postcardiac surgery. However, caregivers feel insecure and overwhelmed and they lack clear/concise discharge information and follow-up support during the early at-home recovery period. The burden of caregiving has been recognised and reported since the early 1990s, but there remains a limited number of studies that assesses the effectiveness of caregiver interventions.PROSPERO registration numberCRD42018096590.

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Safety and efficacy of mycophenolate mofetil in treating neuromyelitis optica spectrum disorders: a protocol for systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-040371 ◽

2020 ◽

Vol 10 (11) ◽

pp. e040371

Author(s):

Mengyu Han ◽

Luqi Nong ◽

Ziqiang Liu ◽

You Chen ◽

Yang Chen ◽

...

Keyword(s):

Systematic Review ◽

Mycophenolate Mofetil ◽

Neuromyelitis Optica ◽

Meta Analysis ◽

Grey Literature ◽

Relevant Literature ◽

Biomedical Literature ◽

Cochrane Library ◽

Neuromyelitis Optica Spectrum Disorders ◽

Spectrum Disorders

IntroductionNeuromyelitis optica spectrum disorders (NMOSD) is an inflammatory and heterogeneous astrocyte disorder of the central nervous system with the characteristic of higher incidence in women and Asian people. Most patients with NMOSD have a course of recurrence and remission that is prone to cause paralysis and blindness. Several studies have confirmed the efficacy and promising prospect of mycophenolate mofetil (MMF) in the treatment of NMOSD. Yet its therapeutic effect and safety are controversial. Although there has been two published literature that is relevant to the topic of this study, both of them have certain defects, and they can only provide answers about the efficacy or safety of MMF in the treatment of NMOSD from partial perspectives or conclusions. This research aims to perform a direct and comprehensive systematic review and meta-analysis to evaluate MMF’s effectiveness and safety in treating NMOSD.Methods and analysisThis systematic review will cover all comparative researches, from randomised controlled trials to cohort studies, and case–control study. A relevant literature search will be conducted in PubMed, Web of Science, EMBASE, the Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database and Chinese Biomedical Literature Database from their inception to 31 June 2020. We will also search registers of clinical trials, potential grey literature and abstracts from conferences. There are no limits on language and publication status. The reporting quality and risk of bias will be assessed by two researchers independently. Expanded Disability Status Scales and annualised relapse rate will be evaluated as the primary outcome. The secondary outcomes will consist of the frequency and severity of adverse events, best-corrected visual acuity, relapse-free rate and time to the next attack. A meta-analysis will be performed using RevMan V.5.3 software provided by the Cochrane Collaboration and Stata V.12.0.Ethics and disseminationBecause the data used for this systematic review will be exclusively extracted from published studies, ethical approval and informed consent of patients will not be required. The systematic review will be published in a peer-reviewed journal, presented at conferences and will be shared on social media platforms.PROSPERO registration numberCRD42020164179.

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Incidence and trend of preterm birth in China, 1990–2016: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-039303 ◽

2020 ◽

Vol 10 (12) ◽

pp. e039303

Author(s):

Shiwen Jing ◽

Chang Chen ◽

Yuexin Gan ◽

Joshua Vogel ◽

Jun Zhang

Keyword(s):

Systematic Review ◽

Preterm Birth ◽

Birth Rate ◽

Meta Analysis ◽

Northwest China ◽

Cochrane Library ◽

Case Control Studies ◽

Eligibility Criteria ◽

Rate Of Increase ◽

Preterm Birth Rate

ObjectivesTo update the WHO estimate of preterm birth rate in China in 1990–2016 and to further explore variations by geographic regions and years of occurrence.DesignSystematic review and meta-analysis.Data sourcesPubmed, Embase, Cochrane Library and Sinomed databases were searched from 1990 to 2018.Eligibility criteriaStudies were included if they provided preterm birth data with at least 500 total births. Reviews, case–control studies, intervention studies and studies with insufficient information or published before 1990 were excluded. We estimated pooled incidence of preterm birth by a random effects model, and preterm birth rate in different year, region and by livebirths or all births in subgroup analyses.ResultsOur search identified 3945 records. After the removal of duplicates and screening of titles and abstracts, we reviewed 254 studies in full text and excluded 182, leaving 72 new studies. They were combined with the 82 studies included in the WHO report (154 studies, 187 data sets in total for the meta-analysis), including 24 039 084 births from 1990 to 2016. The pooled incidence of preterm birth in China was 6.09% (95% CI 5.86% to 6.31%) but has been steadily increasing from 5.36% (95% CI 4.89% to 5.84%) in 1990–1994 to 7.04% (95% CI 6.09% to 7.99%) in 2015–2016. The annual rate of increase was about 1.05% (95% CI 0.85% to 1.21%). Northwest China appeared to have the highest preterm birth rate (7.3%, 95% CI 4.92% to 9.68% from 1990 to 2016).ConclusionsThe incidence of preterm birth in China has been rising gradually in the past three decades. It was 7% in 2016. Preterm birth rate varied by region with the West having the highest occurrence.

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