scholarly journals Insight and equality: A systematic review and meta-analysis of socio-demographic associations

2021 ◽  
pp. 002076402110361
Author(s):  
Kevin Ariyo ◽  
Alex Ruck Keene ◽  
Anthony S David ◽  
Gareth S Owen
Keyword(s):  
Decision Making ◽  
Meta Analysis ◽  
Empirical Studies ◽  
Cochrane Library ◽  
Bibliographic Databases ◽  
Sociodemographic Variables ◽  
White Ethnicity ◽  
Decision Making Capacity ◽  
Study Characteristics ◽  
Legal Contexts

Background: Insight into illness is often used in clinical and legal contexts, for example, as evidence of decision-making capacity. However, it is unclear whether this disadvantages certain groups protected under equality legislation. To our knowledge, this question has yet to be addressed systematically. Therefore, the present study reviews empirical studies that look at the relationship between insight and sociodemographic variables. Methods: A systematic search of six bibliographic databases (CENTRAL, CINAHL, Cochrane Library of Systematic Reviews, EMBASE, MEDLINE and PsycINFO) was conducted, which yielded 6,192 results. Study characteristics and outcomes (associations between insight and socio-demographic variables) were then extracted from 207 eligible studies. This included protected characteristics under the Equality Act (2010): age, sex, ethnicity, marital status and religion. Weighted confidence estimates were calculated and relevant moderators included in a random effects meta-analysis. A study protocol was registered prospectively on PROSPERO, ID: CRD42019120117. Results: Insight was not strongly associated with any sociodemographic variable. Better insight was weakly but significantly associated with white ethnicity, being employed, younger age and more years of education. The age associations were mostly explained by relevant moderating variables. For people with schizophrenia, the associations between sociodemographic variables and insight were comparable to associations with decision making capacity. Conclusions: Our results suggest that insight is not strongly associated with any sociodemographic variables. Further research is needed to clarify potential associations, particularly with non-white ethnicity and proxies for social support.

scholarly journals Insight and equality: A systematic review and meta-analysis of socio-demographic associations. 

2021 ◽  
Author(s):  
Kevin Ariyo ◽  
Alex Ruck Keene ◽  
Anthony S. David ◽  
Gareth S. Owen
Keyword(s):  
Decision Making ◽  
Cultural Context ◽  
Meta Analysis ◽  
Empirical Studies ◽  
Cochrane Library ◽  
Bibliographic Databases ◽  
Sociodemographic Variables ◽  
White Ethnicity ◽  
Decision Making Capacity ◽  
Study Characteristics

Abstract BACKGROUNDInsight is often used in clinical and legal contexts e.g. as evidence of decision-making capacity. However, it is unclear whether this disadvantages certain groups protected under equality legislation. To our knowledge, this question has yet to be addressed systematically. Therefore, the present study reviews empirical studies that look at the relationship between insight and sociodemographic variables. METHODSA systematic search of six bibliographic databases (CENTRAL, CINAHL, Cochrane Library of Systematic Reviews, EMBASE, MEDLINE and PsycINFO) was conducted, which yielded 6192 results. Study characteristics and outcomes (associations between insight and socio-demographic variables) were then extracted from 207 eligible studies. This included protected characteristics under the Equality Act (2010): age, sex, ethnicity, marital status and religion. Weighted confidence estimates were calculated and relevant moderators included in a random effects meta-analysis. A study protocol was registered prospectively on PROSPERO, ID: CRD42019120117. RESULTSInsight was not strongly associated with age, gender or ethnicity. Better insight was weakly but significantly associated with white ethnicity, being employed, younger age and more years of education. The age associations were mostly explained relevant moderating variables. Cultural context (studies done in individualistic versus collectivist countries) did not moderate associations. For people with schizophrenia, the associations between sociodemographic variables and insight were comparable to associations with decision making capacity. CONCLUSIONSOur results moderate some concerns over whether insight is discriminatory if used as evidence in mental capacity assessment. We have identified specific subgroups where further research is needed to clarify potential associations.

scholarly journals Dialysis decisions concerning cognitively impaired adults: a scoping literature review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jordan A. Parsons ◽  
Jonathan Ives
Keyword(s):  
Decision Making ◽  
Kidney Disease ◽  
Scoping Review ◽  
Cultural Sensitivity ◽  
Empirical Studies ◽  
The United States ◽  
Adult Patients ◽  
Cochrane Library ◽  
Cognitively Impaired ◽  
Decision Making Capacity

AbstractBackgroundChronic kidney disease is a significant cause of global deaths. Those who progress to end-stage kidney disease often commence dialysis as a life-extending treatment. For cognitively impaired patients, the decision as to whether they commence dialysis will fall to someone else. This scoping review was conducted to map existing literature pertaining to how decisions about dialysis are and should be made with, for, and on behalf of adult patients who lack decision-making capacity. In doing so, it forms the basis of a larger body of work that is exploring how these decisions ought to be made.MethodsTo identify relevant papers, searches were conducted on Ovid MEDLINE(R), Embase, PsychINFO, The Cochrane Library, and Web of Science. Inclusion criteria were then applied, requiring that papers: report on empirical studies about how decisions about dialysis are madeand/ordiscuss how decisions about dialysis should be made with, for, and on behalf of adult patients who lack decision-making capacity; be published from 1961 onwards; and be published in English. This resulted in 27 papers eligible for inclusion.ResultsOf note, the majority of papers originated in the United States. There was wide variation across the included papers. Extracted data were grouped under the following themes: involving various parties (patient involvement, family dominance, and wider communication); objectivity about care options (including difficulties with family detachment); cultural sensitivity; medical versus non-medical factors; managing nonadherent patients; and the role and prevalence of substituted judgement. The literature shows that there is inconsistency in the principles and processes surrounding decisions made about dialysis with, for, and on behalf of adult patients who lack decision-making capacity.ConclusionsThis scoping review demonstrates that there is significant variation in both the practice and theory of dialysis decision making with, for, and on behalf of cognitively impaired adult patients. Complexity arises in considering who should get a say, how influential their say should be in a decision, and what factors are most relevant to the decision. A lack of up-to-date literature exploring this issue is highlighted, with this scoping review providing a useful groundwork from which further research can be undertaken.

scholarly journals Diversity or disarray? A systematic review of decision-making capacity for treatment and research in schizophrenia and other non-affective psychoses

2017 ◽  
Vol 47 (11) ◽  
pp. 1906-1922 ◽  
Author(s):  
B. W. J. Spencer ◽  
G. Shields ◽  
T. Gergel ◽  
M. Hotopf ◽  
G. S. Owen
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Wide Spectrum ◽  
Meta Analysis ◽  
Research Participation ◽  
Demographic Factors ◽  
Neurocognitive Deficits ◽  
Ovid Medline ◽  
Decision Making Capacity ◽  
Socio Demographic Factors

BackgroundValid consent for treatment or research participation requires that an individual has decision-making capacity (DMC), which is the ability to make a specific decision. There is evidence that the psychopathology of schizophrenia can compromise DMC. The objective of this review was to examine the presence or absence of DMC in schizophrenia and the socio-demographic/psychopathological factors associated.MethodsWe searched three databases Embase, Ovid MEDLINE(R), and PsycINFO for studies reporting data on the proportion of DMC for treatment and research (DMC-T and DMC-R), and/or socio-demographic/psychopathological associations with ability to make such decisions, in people with schizophrenia and related illnesses.ResultsA total of 40 studies were identified. While high levels of heterogeneity limited direct comparison, meta-analysis of inpatient data showed that DMC-T was present in 48% of people. Insight was strongly associated with DMC-T. Neurocognitive deficits were strongly associated with lack of DMC-R and to a lesser extent DMC-T. With the exception of years of education, there was no evidence for an association with socio-demographic factors.ConclusionsInsight and neurocognitive deficits are most closely associated with DMC in schizophrenia. The lack of an association with socio-demographic factors dispels common misperceptions regarding DMC and characteristics such as age. Although our results reveal a wide spectrum of DMC-T and DMC-R in schizophrenia, this could be partly due to the complexity of the DMC construct and the heterogeneity of existing studies. To facilitate systematic review research, there is a need for improvement within research study design and increased consistency of concepts and tools.

The MacArthur Competence Assessment Tools for assessing decision-making capacity in schizophrenia: A meta-analysis

2017 ◽  
Vol 183 ◽  
pp. 56-63 ◽  
Author(s):  
Shi-Bin Wang ◽  
Yuan-Yuan Wang ◽  
Gabor S. Ungvari ◽  
Chee H. Ng ◽  
Ren-Rong Wu ◽  
...  
Keyword(s):  
Decision Making ◽  
Meta Analysis ◽  
Assessment Tools ◽  
Competence Assessment ◽  
Decision Making Capacity

USING THE AMSTAR CHECKLIST FOR RAPID REVIEWS: IS IT FEASIBLE?

2016 ◽  
Vol 32 (4) ◽  
pp. 276-283 ◽  
Author(s):  
Jessica Tajana Mattivi ◽  
Barbara Buchberger
Keyword(s):  
Systematic Reviews ◽  
Conflicts Of Interest ◽  
Meta Analysis ◽  
Time Frame ◽  
Cochrane Library ◽  
Overview Of Reviews ◽  
Surgical Interventions ◽  
Rapid Reviews ◽  
Study Characteristics ◽  
The Cochrane Library

Objectives: Rapid reviews can be conducted in a narrower time frame, as compared to systematic reviews, by featuring restrictions. To estimate the validity of the results, assessment of methodological quality is required. Our aim was to analyze the methodological restrictions of rapid reviews compared with systematic reviews using the AMSTAR checklist and assess its feasibility for rapid reviews.Methods: A systematic search for literature on rapid reviews of surgical interventions was conducted in three databases: Medline, Embase, and the Cochrane library. Additionally, health technology assessment (HTA) databases were searched. We analyzed reviews using AMSTAR and additionally compared the results with those of an overview of reviews on the same topic.Results: Items found more frequently in rapid reviews were search for gray literature (65 percent versus 33 percent), listing of excluded studies (59 percent versus 37 percent), and provision of study characteristics (77 percent versus 44 percent), whereas consideration of study quality in formulating conclusions, conduct of meta-analysis, and statement of conflicts of interest were less frequent. Median time between search and publication was 8 months, with a range between 1 and 27.Conclusions: With some adjustments, AMSTAR can be used as a checklist for rapid reviews to describe methodological restrictions in comparison to systematic reviews and to roughly estimate the validity of the results. Strikingly, only 14.3 percent of rapid reviews were published within 3 months.

scholarly journals Burden of tinea capitis among children in Africa: protocol for a systematic review and meta-analysis of observational studies, 1990–2020

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e041230
Author(s):  
Felix Bongomin ◽  
Ronald Olum ◽  
Lauryn Nsenga ◽  
Joseph Baruch Baluku
Keyword(s):  
Systematic Review ◽  
Tinea Capitis ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Trend Test ◽  
Qualitative Synthesis ◽  
Institutional Review ◽  
Ethical Approval ◽  
Study Characteristics ◽  
The Impact

IntroductionTinea capitis is the most common form of dermatophytosis among children, contributing significantly to the global burden of skin and hair infections. However, an accurate account of its burden in Africa, where most cases are thought to occur, is lacking. We aim to systematically evaluate the burden, aetiology and epidemiological trend of tinea capitis among children over a 30-year period in Africa.Methods and analysisA systematic review will be conducted using Embase, PubMed, African Journals Online, Web of Science and the Cochrane Library of Systematic Review. These resources will be used to identify studies published between 1990 and December 2020, which report the prevalence, aetiology and trend of tinea capitis among children younger than 18 years in Africa. Articles in English and French will be considered. Two independent reviewers will screen the articles for eligibility, and any discrepancies will be resolved by discussion and consensus between the authors. Methodological quality of all studies will be assessed and critically appraised. We will perform a metaregression to assess the impact of study characteristics on heterogeneity and also to correct the meta-analytical estimates for biases. A qualitative synthesis will be performed, and STATA V.16.0 software will be used to estimate the pooled prevalence and aetiology of tinea capitis. The Mann-Kendall trend test will be use to evaluate the trend in the prevalence of tinea capitis over the study period.Ethics and disseminationEthical approval from an institutional review board or research ethics committee is not required for this systematic review and meta-analysis. The results will be published in a peer-reviewed journal and presented in conferences.

Thrombophilic abnormalities, oral contraceptives, and risk of cerebral vein thrombosis: a meta-analysis

Blood ◽  
2006 ◽  
Vol 107 (7) ◽  
pp. 2766-2773 ◽  
Author(s):  
Francesco Dentali ◽  
Mark Crowther ◽  
Walter Ageno
Keyword(s):  
Oral Contraceptives ◽  
Meta Analysis ◽  
Factor V Leiden ◽  
Cochrane Library ◽  
Cerebral Vein ◽  
Factor V ◽  
Cerebral Vein Thrombosis ◽  
Vein Thrombosis ◽  
Increased Risk ◽  
Study Characteristics

AbstractRecent studies suggest that thrombophilic abnormalities and the use of oral contraceptives (OCs) are the leading causes of cerebral vein thrombosis (CVT). The purpose of this study was to assess the association between CVT and thrombophilic states, OCs, and their interaction. For data sources, we used the MEDLINE, EMBASE, and Cochrane Library databases (January 1994 to March 2005), reference lists of retrieved articles, and contact with content experts. We selected studies comparing the prevalence of OC use and the prevalence of prothrombitic abnormalities in patients with CVT compared with healthy controls. Two reviewers independently selected studies and extracted study characteristics, quality, and outcomes. Odds ratios (ORs) were calculated for each trial and pooled using the Mantel-Haenszel method. Seventeen studies were included. There was an increased risk of CVT in patients using OCs (OR 5.59; 95% confidence interval [CI] 3.95 to 7.91; P < .001), and in patients with factor V Leiden (OR 3.38; 95% CI 2.27 to 5.05; P < .001), with mutation G20 210A of prothrombin (OR 9.27; 95% CI 5.85 to 14.67; P < .001) and with hyperhomocysteinemia (OR 4.07; 95% CI 2.54 to 6.52; P < .001). We concluded that OC users, and patients with factor V Leiden, the prothrombin G20 120A mutation, and hyperhomocysteinemia are at a significantly increased risk of CVT.

scholarly journals Are Randomized Controlled Trials on Pharmacotherapy and Psychotherapy for Positive Symptoms of Schizophrenia Comparable? A Systematic Review of Patient and Study Characteristics

2019 ◽  
Vol 46 (3) ◽  
pp. 496-504 ◽  
Author(s):  
Irene Bighelli ◽  
Claudia Leucht ◽  
Maximilian Huhn ◽  
Cornelia Reitmeir ◽  
Felicitas Schwermann ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Treatment Strategies ◽  
Patient Characteristics ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Positive Symptoms ◽  
Randomized Controlled ◽  
Study Characteristics

Abstract Background We examined patient and study characteristics of pharmacotherapy and psychotherapy trials to establish whether the effects of these 2 treatment strategies can be compared meaningfully. Methods We inspected all randomized controlled trials included in 2 recent meta-analyses on antipsychotics and psychotherapy in patients with positive symptoms of schizophrenia, searching EMBASE, MEDLINE, PsycINFO, Cochrane Library, and ClinicalTrials.gov. Differences between psychotherapy and pharmacotherapy trials were analyzed with Wilcoxon–Mann–Whitney and chi-square tests. Results Eighty studies with 18 271 participants on antipsychotic drugs and 53 studies with 4068 participants on psychotherapy were included. Psychotherapy studies included less severely ill patients (P &lt; .0001), with a shorter duration of illness (P = .021), lasted for a longer period (P &lt; .0001), administered the intervention as add-on to antipsychotics (P &lt; .0001), had higher risk of bias in some domains including blinding of outcome assessment (P &lt; .0001), and were funded publicly more frequently (P &lt; .0001). Antipsychotic trials had larger sample sizes (P &lt; .0001) and more study centers (P &lt; .0001), included more males (P = .0001), inpatients (P &lt; .0001), and slightly older patients (P = .031), more often used diagnostic operationalized criteria (P = .006), and were sponsored by pharmaceutical companies. They did not differ in conflict of interest (P = .24). Conclusions We found key differences between the 2 groups of studies that encompass higher risk of bias in psychotherapy studies and the inclusion of more severe patients in drug trials. These differences imply that study and patient characteristics should be carefully taken into account before considering a network meta-analysis. In the interest of patients, psychopharmacologists and psychotherapists should optimize their treatments rather than seeing them in competition.

A Systematic Review and Meta-Analysis of Nutritional Supplementation in Chronic Lower Extremity Wounds

2016 ◽  
Vol 15 (4) ◽  
pp. 296-302 ◽  
Author(s):  
Junna Ye ◽  
Raj Mani
Keyword(s):  
Systematic Review ◽  
Lower Extremity ◽  
Sickle Cell ◽  
Meta Analysis ◽  
Nutritional Supplementation ◽  
Cochrane Library ◽  
Similar Data ◽  
Venous Ulcers ◽  
Study Characteristics ◽  
Meta Analyses

A systematic review and meta-analyses of nutritional supplementation to treat chronic lower extremity wounds was done in order to test the premise that impaired nutrition is implicated in healing. The databases of Ovid MEDLINE, Ovid EMBASE, Cochrane Library, and EBSCO CINAHL (1972-October 2014) were searched systematically. Only randomized controlled trials in adults with chronic lower extremity wounds were included. Both topical and systemic routes of supplementing nutrition were considered. The primary outcome was wound healing. Study characteristics, outcomes, and risk of bias were extracted by trained researchers and confirmed by the principal investigator. Twenty-three of 278 (8.3%) retrieved articles met the inclusion criteria and were selected. Most of the studies were of unclear or low risk. Overall, nutritional supplementation was favorable (risk ratio [RR] = 1.44, 95% confidence interval [CI] = 1.25-1.66). The systemic route was marginally better than the topical one (RR = 1.51, 95% CI = 1.36-1.67; RR = 1.14, 95% CI = 0.96-1.36, respectively). For venous ulcers, the data showed nutritional supplementation to be significantly beneficial compared to placebo (RR = 1.44, 95% CI = 1.31-1.59). Similar data were found for diabetic foot and sickle cell ulcers (RR = 1.17, 95% CI = 0.93-1.47; RR = 1.56, 95% CI = 0.94-2.60, respectively). These data permit the inferences that nutritional supplementation in the populations studied showed significant benefits in the healing of venous ulcers and tendency (nonsignificant trends) in the healing of diabetic and sickle cell ulcers.

scholarly journals The Prevalence of Vascular Dementia in China: A Systematic Review and Meta-Analysis from 2009-2019

2021 ◽  
Author(s):  
Chenze JIAO ◽  
Shouchao WEI ◽  
Tingting LIU ◽  
Xiao BAO ◽  
Wenrong CHEN ◽  
...  
Keyword(s):  
Vascular Dementia ◽  
Urban Areas ◽  
Meta Analysis ◽  
Evaluation Criteria ◽  
Vascular Cognitive Impairment ◽  
Epidemiological Studies ◽  
Biomedical Literature ◽  
Cochrane Library ◽  
Bibliographic Databases ◽  
The North

Background: Vascular dementia (VD), as the second-largest type of dementia, is a serious stage of vascular cognitive impairment. It is significant to conduct retrospective epidemiological studies to characterize further the disease for public health. This study estimated the prevalence of VD among the population aged 18 yr and older in China. Methods: Epidemiological investigations on VD published in journals and covering the period from 1999 to 2019 were identified manually and online by using Chinese databases (such as Chinese BioMedical Literature Database, Chinese National Knowledge Infrastructure database, Chinese science-technology databases, and the Chinese Wanfang and Chongqing VIP database) and English databases (such as PubMed, Elsevier Science Bibliographic Databases and Cochrane library). Studies were included if the diagnostic criteria for VD are clear and the quality of the included literature was evaluated using the quality evaluation criteria of epidemiological research methods. A random-effects model was employed according to the statistical test of homogeneity. Results: Twenty-six studies met the inclusion criteria, including 100,923 subjects and 977 VD patients. The pooled prevalence of VD was 0.96% (95% [confidence interval, CI] 0.63%~2.1%). The prevalence of VD increased with increasing age. There was a higher prevalence of VD in the northeast China population, in urban areas and males. Conclusion: We stratified the included studies based on age, location, gender, and geographical distribution for prevalence. The prevalence of VD has slowly risen since 1999. It is obviously different between the North & South and urban &rural districts. While there are many benefits of systematic reviews, the methods presented have inherent limitations.

Sign in / Sign up

Export Citation Format

Share Document