Anti-Caries Effect of Arginine-Containing Formulations in vivo: A Systematic Review and Meta-Analysis

Objective: To assess the anti-caries effect of arginine-containing formulations in vivo on caries lesions compared with fluorides or placebo. Methods: Randomized or quasi-randomized human clinical trials wherein arginine was delivered by any method were considered. The MEDLINE, Web of Science, EMBASE, Cochrane Library, and CBM databases were searched to identify relevant articles published up to December 2014. Grey literature was also searched. Two authors performed data extraction independently and in duplicate using data collection forms. Each included study was assessed using the Cochrane risk of bias assessment tool. Results: Of the 470 studies screened, 31 full articles were scrutinized and assessed for eligibility. Ten studies (n = 15,546 participants) were selected for final inclusion. The meta-analysis results (n = 7 studies) demonstrated a synergistic effect of arginine when used in conjunction with fluoride on early coronal and root caries compared with placebo or fluoride alone. No specific side effects related to arginine usage were identified. Conclusions: When used in combination with a calcium compound and fluoride, arginine potentially provides a superior anti-caries effect compared with matched formulations of fluoride alone. However, the level of evidence was downgraded because of risks of bias and potential publication bias. In the future, more high quality, non-industry-supported clinical studies in this research area are required before any definitive recommendations can be made.

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Effectiveness of personal letters to healthcare professionals in changing clinical practice behaviours: A Systematic Review protocol

10.21203/rs.3.rs-55534/v1 ◽

2020 ◽

Author(s):

Aikaterini Grimani ◽

Louis Goffe ◽

Mei Yee Tang ◽

Fiona Beyer ◽

Falko F. Sniehotta ◽

...

Keyword(s):

Systematic Review ◽

Clinical Practice ◽

Healthcare Professionals ◽

Assessment Tool ◽

Data Extraction ◽

Meta Analysis ◽

Grey Literature ◽

Cochrane Library ◽

Behaviour Change Techniques ◽

Hand Search

Abstract Background: Letters are regularly sent by healthcare organisations to healthcare professionals to encourage them to take action, change practice or implement guidance. However, whether letters are an effective tool in delivering a change in clinical practice behaviour is currently uncertain. In addition, there are currently no evidence-based guidelines to support providers and health authorities with advice on how to formulate the communication, what information and behaviour change techniques to include in order to optimise the potential effect on the behaviour of the receivers. To address this research gap, we aim to inform such guidance through this systematic review.Methods/ Design: A systematic literature search of published and unpublished studies (the grey literature) in electronic databases will be conducted to identify studies that meet our inclusion criteria. The search will be conducted in five electronic databases: MEDLINE, EMBASE, PsycINFO, the Cochrane Library and CINAHL. We will also conduct supplementary searches in Google Scholar, hand search relevant journals, and conduct backward and forward citation searching for included studies and relevant reviews. A systematic approach to searching, screening, reviewing and data extraction will be applied based on Preferred Reporting Items for Systematic reviews and Meta-Analysis. Titles, abstracts, full-texts for eligibility will be examined independently by researchers. The quality of the included studies will be assessed using quality assessment tool for studies with diverse design and Cochrane risk of bias tool. Disagreements will be resolved by a consensus procedure.Discussion: This review aims to provide comprehensive evidence of the effectiveness of personal letters to healthcare professionals in changing clinical practice behaviours. Health policy makers across government will benefit from being able to increase compliance in clinical settings by applying theories of behaviour to design of policy communications. The synthesized findings will be disseminated through peer-reviewed publication.Systematic review registration: PROSPERO CRD42020167674

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Dental implants survival after nasal floor elevation: a systematic review

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-21-00219 ◽

2021 ◽

Author(s):

Eduardo Anitua ◽

Beatriz Anitua ◽

Mohammad Hamdan Alkhraisat ◽

Laura Piñas ◽

Asier Eguia ◽

...

Keyword(s):

Systematic Review ◽

Assessment Tool ◽

Case Reports ◽

Meta Analysis ◽

Lateral Approach ◽

Cochrane Library ◽

Good Survival ◽

Quality Level ◽

Level Of Evidence ◽

Nasal Floor

Purpose The aim of this work is to assess the clinical outcomes of implants placed after a nasal floor elevation procedure. Methods A systematic review was conducted using four electronic databases; Medline (Pubmed), Cochrane library, DOAJ and SCOPUS, following the PRISMA statement recommendations to answer the PICO question: “In patients undergoing dental implant placement in the maxillary anterior region (P), Do implants placed after nasal floor elevation (I) have a different survival (O) from those implants placed without grafting procedures (C)?. The study was pre-registered in PROSPERO (CRD42021229479). Included articles quality was assessed using the “NIH quality assessment tool”, “The Newcastle-Ottawa scale” and “JBI critical appraisal tools for case reports''. Results Twelve articles were finally selected, including 151 patients and 460 implants. The weighted mean follow-up was 32.2 months, and the weighted survival rate after this period was 97.64% (range 89.2-100%). No statistical differences could be inferred between the treatments performed in one-stage or two-stage, following a lateral approach or a transcrestal approach or using different grafting materials. A great heterogeneity was found in terms of study design and methodological aspects. For this reason, a quantitative analysis followed by meta-analysis was not possible. Conclusion Within the limitations of this study, implants placed after a nasal floor elevation present a good survival and a low range of complications. In absence of randomized studies, the level of evidence was low, attending the GRADE system and based on the study quality level, the strength of evidence attending the SORT taxonomy was B.

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The Long-Lasting Effects of “Placebo Injections” in Knee Osteoarthritis: A Meta-Analysis

Cartilage ◽

10.1177/1947603520906597 ◽

2020 ◽

pp. 194760352090659 ◽

Cited By ~ 7

Author(s):

Davide Previtali ◽

Giulia Merli ◽

Giorgio Di Laura Frattura ◽

Christian Candrian ◽

Stefano Zaffagnini ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Randomized Controlled Trials ◽

Placebo Effect ◽

Meta Analysis ◽

Grey Literature ◽

Cochrane Library ◽

Controlled Trials ◽

Level Of Evidence ◽

Randomized Controlled ◽

The Impact

Objectives To quantify the placebo effect of intraarticular injections for knee osteoarthritis in terms of pain, function, and objective outcomes. Factors influencing placebo effect were investigated. Design Meta-analysis of randomized controlled trials; Level of evidence, 2. PubMed, Web of Science, Cochrane Library, and grey literature databases were searched on January 8, 2020, using the string: (knee) AND (osteoarthritis OR OA) AND (injections OR intra-articular) AND (saline OR placebo). The following inclusion criteria were used: double-blind, randomized controlled trials on knee osteoarthritis, including a placebo arm on saline injections. The primary outcome was pain variation. Risk of bias was assessed using the RoB 2.0 tool, and quality of evidence was graded following the GRADE (Grading of Recommendations Assessment, Development and Evaluation) guidelines. Results Out of 2,363 records, 50 articles on 4,076 patients were included. The meta-analysis showed significant improvements up to the 6-month follow-up: Visual Analogue Scale (VAS)-pain −13.4 mean difference (MD) (95% confidence interval [CI]: −21.7/−5.1; P < 0.001), Western Ontario and McMaster Osteoarthritis Index (WOMAC)-pain −3.3 MD (95% CI: −3.9/−2.7; P < 0.001). Other significant improvements were WOMAC-stiffness −1.1 MD (95% CI: −1.6/−0.6; P < 0.001), WOMAC-function −10.1 MD (95% CI: −12.2/−8.0; P < 0.001), and Evaluator Global Assessment −21.4 MD (95% CI: −29.2/−13.6; P < 0.001). The responder rate was 52% (95% CI: 40% to 63%). Improvements were greater than the “minimal clinically important difference” for all outcomes (except 6-month VAS-pain). The level of evidence was moderate for almost all outcomes. Conclusions The placebo effect of knee injections is significant, with functional improvements lasting even longer than those reported for pain perception. The high, long-lasting, and heterogeneous effects on the scales commonly used in clinical trials further highlight that the impact of placebo should not be overlooked in the research on and management of knee osteoarthritis.

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The Effectiveness and Safety of Thunder Fire Moxibustion for Treating Allergic Rhinitis: A PRISMA Compliant Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/6760436 ◽

2020 ◽

Vol 2020 ◽

pp. 1-13

Author(s):

Ting Yuan ◽

Jun Xiong ◽

Jun Yang ◽

Xue Wang ◽

Yunfeng Jiang ◽

...

Keyword(s):

Allergic Rhinitis ◽

Adverse Events ◽

Assessment Tool ◽

Total Effective Rate ◽

Meta Analysis ◽

Effective Rate ◽

Cochrane Library ◽

Level Of Evidence ◽

Randomized Controlled ◽

Significant Difference

Background. Allergic rhinitis (AR) is a noninfectious inflammatory disease caused by allergic individuals exposed to allergens. Western medicine therapy for treating AR causes obvious adverse events, while thunder fire moxibustion (TFM) is known as a safe and effective treatment for AR. Therefore, we conducted this meta-analysis to evaluate the effectiveness and safety of TFM for treating AR. Methods. PubMed, Web of Science, Embase, the Cochrane Library, CNKI, WanFang, VIP, and CBM from inception to April 5, 2020, were searched without any language restriction. Reviewers identified studies, extracted data, and assessed the quality, independently. The primary outcomes were the total effective rate and the TNSS. The secondary outcomes included TNNSS, RQLQ, VAS, serum IgE, IgA, or IgG level, and adverse events. Randomized controlled trials (RCTs) were collected; methodological quality was evaluated using the Cochrane risk of bias assessment tool (RoB), and the level of evidence was rated using the GRADE approach. Meta-analysis was performed using the RevMan5.3.0 software. Results. A total of 18 RCTs were included, including 1600 patients. The results of this meta-analysis showed a statistically significant effect in a total effective rate of T = TFM (RR = 1.07; 95% CI [1.03, 1.12]; P=0.45; I2 = 0%) and T = TFM + other treatments (RR = 1.18; 95% CI [1.11, 1.25]; P=0.03; I2 = 53%). In addition, TFM intervention also showed significant difference in total symptom score (T = TFM + other treatments) (MD = −1.42; 95% CI [−1.55, −1.29]; P=0.03; I2 = 60%) in patients with AR. Conclusion. Existing evidence shows that TFM is safe and effective for AR. Due to the universal low quality of the eligible trials and low evidence level, we should draw our conclusions with caution. Therefore, clinical researchers should carry out more large-sample, multicentre, high-quality randomized controlled clinical trials in the future to verify the clinical efficacy of TFM in treating AR.

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Effectiveness of health technology electronic prescribing: A protocol for systematic review and meta-analysis Study

Internal Medicine And Medical Investigation Journal ◽

10.24200/imminv.v2i4.101 ◽

2017 ◽

Vol 3 (1) ◽

pp. 8

Author(s):

Saeed Eslami ◽

Hamidreza Dehghan ◽

Mahdieh Namayandeh ◽

Arezo Dehghani ◽

Saeed Hajian Dashtaki ◽

...

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Meta Analysis ◽

Grey Literature ◽

Quality Criteria ◽

Analysis Data ◽

Healthcare Services ◽

Electronic Prescribing ◽

Cochrane Library ◽

Policy Makers

INTRODUCTION: There is increasing evidence that electronic prescribing (ePrescribing) can improve the quality and safety of healthcare services. However, it has also become clear that this implementation is not straightforward and may create unintended or undesired consequences once in use. In this context, the systematic review can provide us with a general overview of the results of the studies and can help us find the truth. This review will aim to identify, appraise and synthesise clinical trial studies on ePrescribing in hospital settings.METHODS AND ANALYSIS: Data sources will include the following databases: pubmed, scopus and cochrane library. In addition, other sources will be searched for ongoing studies (ClinicalTrials.gov) and grey literature. Studies will be independently screened for eligibility by 2 reviewers and data extraction is done by 2 people. Articles are evaluated on the basis of the quality criteria of JADAD. The data is analyzed by the STATA software.DISSEMINATION: The results of the study will be published in a peer-reviewed journal and presented at relevant conferences. Policy makers and healthcare decision-makers can use these results.

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Safety and immunogenicity of inactivated SARS-CoV-2 vaccines in healthy individuals: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2021-056106 ◽

2021 ◽

Vol 11 (11) ◽

pp. e056106

Author(s):

Mao Li ◽

Xuhong Yang ◽

Lianyan Jiang ◽

Dongdong Yang

Keyword(s):

Systematic Review ◽

Assessment Tool ◽

Meta Analysis ◽

Grey Literature ◽

Cochrane Collaboration ◽

Cochrane Library ◽

High Morbidity ◽

Healthy Individuals ◽

Control And Prevention ◽

Randomised Controlled

IntroductionCOVID-19 has spread with high morbidity and mortality worldwide. Many inactivated SARS-CoV-2 vaccines are being tested at various clinical trial stages for the control and prevention of COVID-19. We aim to comprehensively and objectively evaluate the safety and immunogenicity of inactivated SARS-CoV-2 vaccines in healthy individuals through a systematic review and meta-analysis of randomised controlled trials (RCTs).Methods and analysisWe will search electronic databases of PubMed, the Cochrane Library, Web of Science and EMBASE for RCTs from inception to 31 December 2021. We will also search conference abstracts, reference lists, and grey literature of all available records. Two reviewers will independently screen and extract information from the literature. Bias and the quality of included studies will be evaluated with the risk-bias assessment tool provided by the Cochrane Collaboration. Statistical analysis will be performed using Cochrane’s Review Manager (RevMan), V.5.3.Ethics and disseminationEthics approval and patient informed consent are not required because we will be including published literature only. The findings of this research will be disseminated in a peer-reviewed journal and likely through other scientific events such as conferences, seminars and symposia.PROSPERO registration numberCRD42021266285.

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Outpatient total knee arthroplasty leads to a higher number of complications: a meta-analysis

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-01925-x ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Vittorio Bordoni ◽

Alberto Poggi ◽

Stefano Zaffagnini ◽

Davide Previtali ◽

Giuseppe Filardo ◽

...

Keyword(s):

Complication Rate ◽

Meta Analysis ◽

Grey Literature ◽

Operative Management ◽

Risk Of Bias ◽

Cochrane Library ◽

Moderate Risk ◽

Level Of Evidence ◽

Quality Of Evidence

Abstract Background Careful pre- and post-operative management can allow surgeons to perform outpatient TKA, making this a more affordable procedure. The aim of the present meta-analysis is to compare outpatient and inpatient TKA. Methods A systematic search of the literature was performed in July 2020 on PubMed, Web of Science, Cochrane library, and on the grey literature databases. The papers collected were used for a meta-analysis comparing outpatient and inpatient TKA in terms of complication and readmission rates. Risk of bias and quality of evidence were defined according to Cochrane guidelines. Results The literature search resulted in 4107 articles; of these, 8 articles were used for the meta-analysis. A total of 212,632 patients were included, 6607 of whom were TKA outpatients. The overall complication rate for outpatient TKAs was 16.1%, while inpatient TKAs had an overall lower complication rate of 10.5% (p = 0.003). The readmission rate was 4.9% in outpatient TKAs and 5.9% in inpatient TKAs. Only 3 studies reported the number of deaths, which accounted for 0%. The included studies presented a moderate risk of bias, and according to GRADE guidelines, the level of evidence for complications and readmissions was very low. Conclusions This meta-analysis documented that outpatient TKA led to an increased number of complications although there were no differences in the number of readmissions. However, future high-level studies are needed to confirm results and indications for the outpatient approach, since the studies currently available have a moderate risk of bias and a very low quality of evidence.

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Studies on the prevalence of blindness in Ethiopia: a protocol for the systematic review and meta-analysis

BMJ Open Ophthalmology ◽

10.1136/bmjophth-2021-000881 ◽

2021 ◽

Vol 6 (1) ◽

pp. e000881

Author(s):

Merkineh Markos ◽

Biruktawit Kefyalew ◽

Hana Belay Tesfaye

Keyword(s):

Systematic Review ◽

English Language ◽

Assessment Tool ◽

Data Extraction ◽

Meta Analysis ◽

Cochrane Library ◽

Design Strategies ◽

Cross Sectional ◽

Standard Data ◽

Potential Sources

IntroductionBlindness refers to a lack of vision and/or defined as presenting visual acuity worse than 3/60 in the better eye. Its highest proportion has been conforming to the developing countries such as Ethiopia. So, timely information is crucial to design strategies. However, the study on the magnitude of blindness in Ethiopia was outdated, that means it was conducted in 2005–2006. Therefore, this protocol has been proposed to estimate the pooled prevalence of blindness in Ethiopia to provide up-to-date, comprehensive evidence on this theme.Methods and analysisThe following databases will be used to search articles: PubMed, Cochrane Library, Google Scholar and retrieving references. Standard data extraction approach will be employed and presented using Preferred Reporting Items for Systematic Review and Meta-Analysis. The Newcastle–Ottawa Scale quality assessment tool will be used to evaluate the quality of studies. Analysis will be held using STATA V.11. Funnel plot and Egger’s regression test will be applied to check for the potential sources of bias. Heterogeneity among the studies will be tested using Higgins method in which I² statistics will be calculated and compared with the standard. Meta-regression and subgroup analysis will be done to identify the potential sources of heterogeneity. Cross-sectional and survey studies conducted in Ethiopia and published in English language will be included.Ethics and disseminationEthics approval and consent are not required. On completion, the result will be submitted to a reputable peer-reviewed journal.Trial registration numberCRD42021268448.

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What is the clinical evidence of Bulk Fill resins performance of in primary and permanent teeth? a systematic review and meta-analysis

Research Society and Development ◽

10.33448/rsd-v10i10.18981 ◽

2021 ◽

Vol 10 (10) ◽

pp. e552101018981

Author(s):

Ana Carolina Soares Diniz ◽

Vinicius Souza Correa ◽

Meire Coelho Ferreira ◽

Leily Macedo Firoozmand

Keyword(s):

Systematic Review ◽

Color Change ◽

Clinical Performance ◽

Data Extraction ◽

Meta Analysis ◽

Composite Resins ◽

Permanent Teeth ◽

Level Of Evidence ◽

Posterior Teeth

With the increasing acceptance of the clinical use of bulk-fill resins, it is necessary to investigate the in vivo performance of these restorative materials. In this perspective, this systematic review to evaluate the clinical performance of Bulk-fill resins in restorations of vital, primary and permanent posterior teeth. PubMed, Cochrane, Scopus, LILACS, BBO and Capes publications search base were searched without restriction regarding the year of publication or language of the article. The inclusion criteria were clinical trials that evaluated the efficacy of resins composed of bulk-fill compared to the incremental technique. For the selection of articles and data extraction, two calibrated evaluators evaluated abstracts and complete articles. A total of 1443 abstracts were identified, of which 14 articles were included in the review. Of these, 01 was classified with a high level of evidence; 08 were moderate and 05 with a low level of evidence. The studies presented an average follow-up of the restorations of 35.1 months. A large part of the studies (75%) demonstrated that the occurrence of postoperative sensitivity. The high failure rate was more prevalent in class II restorations. The marginal adaptation/color change was material dependent and the occurrence of secondary caries in bulk-fill resin restorations was not significant concerning conventional resins in most studies. In the short term, the satisfactory clinical performance of bulk-fill resins used in primary and permanent restorations, with clinical outcomes and results equivalent to conventional composite resins were observed.

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Role of N-Acetylcysteine in the Treatment of Acute Nonacetaminophen, Nonalcoholic and Nonviral Hepatitis: A Meta-analysis

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwaa017 ◽

2020 ◽

Author(s):

Waleed Aljohani ◽

Brian Pak Ho Chan ◽

Mohammad Yaghoobi

Keyword(s):

Overall Survival ◽

Data Extraction ◽

Meta Analysis ◽

Included Study ◽

Random Model ◽

Significant Heterogeneity ◽

Level Of Evidence ◽

Study Selection ◽

Grade Of Recommendation ◽

Study Population

Abstract Introduction N-acetylcysteine (NAC) has been extensively investigated for the use in acetaminophen and alcoholic hepatitis and is indicated in acetaminophen overdose. Studies assessing the effect of NAC on other forms of acute hepatitis in adult patients are limited and therefore here we aimed at evaluating the effect of NAC on survival in nonacetaminophen, nonalcoholic and nonviral hepatitis in adults. Methods A comprehensive literature search up to September 2019 was completed for randomized controlled trials (RCTs) comparing NAC to placebo in the management of acute nonacetaminophen, nonalcoholic and nonviral hepatitis. Studies with insufficient data, non-RCT or nonprospective design, paediatric studies and studies with no comparator were excluded. Study selection, quality assessment and data extraction were independently performed by two co-authors. Primary outcome was survival. Secondary outcomes were an increase in infection rate. We used random model Mantel–Haenszel meta-analysis with Cochrane risk of bias to assess the quality of included studies. The recommendation was presented using the GRADE framework. Results Seven out of 42 retrieved studies were included. Study population included patients with post-liver transplant, postsurgical, hypoxia-induced, ischemic and other nonalcoholic hepatitis. There was no difference in overall survival between NAC and placebo (odds ratio [OR] 0.95 [0.55 to 1.62]) in seven studies including 1033 patients. Furthermore, there was no difference in the rate of infection between NAC and placebo (OR 0.87 [0.43 to 1.79]). Random model analysis was used to adjust the effect of statistically significant heterogeneity in both analyses (P = 0.02). Lack of blinding in one study was found as a possible source of heterogeneity. Conclusions NAC does not improve overall survival or the rate of infection in patients with acute nonacetaminophen, nonalcoholic and nonviral hepatitis as compared to placebo and should not be recommended in such setting which may even delay a transplant evaluation (level of evidence: 2a, GRADE of recommendation: B).

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