Multi-disciplinary palliative care is effective in people with symptomatic heart failure: A systematic review and narrative synthesis

Background: Despite recommendations, people with heart failure have poor access to palliative care. Aim: To identify the evidence in relation to palliative care for people with symptomatic heart failure. Design: Systematic review and narrative synthesis. (PROSPERO CRD42016029911) Data sources: Databases (Medline, Cochrane database, CINAHL, PsycINFO, HMIC, CareSearch Grey Literature), reference lists and citations were searched and experts contacted. Two independent reviewers screened titles and abstracts and retrieved papers against inclusion criteria. Data were extracted from included papers and studies were critically assessed using a risk of bias tool according to design. Results: Thirteen interventional and 10 observational studies were included. Studies were heterogeneous in terms of population, intervention, comparator, outcomes and design rendering combination inappropriate. The evaluation phase studies, with lower risk of bias, using a multi-disciplinary specialist palliative care intervention showed statistically significant benefit for patient-reported outcomes (symptom burden, depression, functional status, quality of life), resource use and costs of care. Benefit was not seen in studies with a single component/discipline intervention or with higher risk of bias. Possible contamination in some studies may have caused under-estimation of effect and missing data may have introduced bias. There was no apparent effect on survival. Conclusion: Overall, the results support the use of multi-disciplinary palliative care in people with advanced heart failure but trials do not identify who would benefit most from specialist palliative referral. There are no sufficiently robust multi-centre evaluation phase trials to provide generalisable findings. Use of common population, intervention and outcomes in future research would allow meta-analysis.

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Tri-Response Police, Ambulance, Mental Health Crisis Models in Reducing Involuntary Detentions of Mentally Ill People: Protocol for a Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158230 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8230

Author(s):

Julia Heffernan ◽

Ewan McDonald ◽

Elizabeth Hughes ◽

Richard Gray

Keyword(s):

Mental Health ◽

Systematic Review ◽

Assessment Tool ◽

Public Health Practice ◽

Grey Literature ◽

Risk Of Bias ◽

Future Research ◽

Mental Health Crisis ◽

Health Crisis ◽

Response Models

Police, ambulance and mental health tri-response services are a relatively new model of responding to people experiencing mental health crisis in the community, but limited evidence exists examining their efficacy. To date there have been no systematic reviews that have examined the association between the tri-response model and rates of involuntary detentions. A systematic review examining co-response models demonstrated possible reduction in involuntary detention, however, recommended further research. The aim of this protocol is to describe how we will systematically review the evidence base around the relationship of the police, ambulance mental health tri-response models in reducing involuntary detentions. We will search health, policing and grey literature databases and include clinical evaluations of any design. Risk of bias will be determined using the Effective Public Health Practice Project Quality Assessment Tool and a narrative synthesis will be undertaken to synthesis key themes. Risk of bias and extracted data will be summarized in tables and results synthesis tabulated to identify patterns within the included studies. The findings will inform future research into the effectiveness of tri-response police, ambulance, and mental health models in reducing involuntary detentions.

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Nocturnal digital surveillance in aged populations and its effects on health, welfare and social care provision: a systematic review

BMC Health Services Research ◽

10.1186/s12913-021-06624-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Matt X. Richardson ◽

Maria Ehn ◽

Sara Landerdahl Stridsberg ◽

Ken Redekop ◽

Sarah Wamala-Andersson

Keyword(s):

Systematic Review ◽

Standard Care ◽

Social Care ◽

Grey Literature ◽

Care Quality ◽

Risk Of Bias ◽

Future Research ◽

Care Provision ◽

Digital Surveillance

Abstract Background Nocturnal digital surveillance technologies are being widely implemented as interventions for remotely monitoring elderly populations, and often replace person-based surveillance. Such interventions are often placed in care institutions or in the home, and monitored by qualified personnel or relatives, enabling more rapid and/or frequent assessment of the individual’s need for assistance than through on-location visits. This systematic review summarized the effects of these surveillance technologies on health, welfare and social care provision outcomes in populations ≥ 50 years, compared to standard care. Method Primary studies published 2005–2020 that assessed these technologies were identified in 11 databases of peer-reviewed literature and numerous grey literature sources. Initial screening, full-text screening, and citation searching steps yielded the studies included in the review. The Risk of Bias and ROBINS-I tools were used for quality assessment of the included studies. Result Five studies out of 744 identified records met inclusion criteria. Health-related outcomes (e.g. accidents, 2 studies) and social care outcomes (e.g. staff burden, 4 studies) did not differ between interventions and standard care. Quality of life and affect showed improvement (1 study each), as did economic outcomes (1 study). The quality of studies was low however, with all studies possessing a high to critical risk of bias. Conclusions We found little evidence for the benefit of nocturnal digital surveillance interventions as compared to standard care in several key outcomes. Higher quality intervention studies should be prioritized in future research to provide more reliable evidence.

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Psychometric properties of the Jefferson Scale of Empathy: a COSMIN systematic review protocol

Systematic Reviews ◽

10.1186/s13643-019-1240-0 ◽

2019 ◽

Vol 8 (1) ◽

Cited By ~ 1

Author(s):

Brett Williams ◽

Bronwyn Beovich

Keyword(s):

Systematic Review ◽

Psychometric Properties ◽

Methodological Quality ◽

Grey Literature ◽

Risk Of Bias ◽

Measurement Properties ◽

Future Research ◽

Health Measurement ◽

Jefferson Scale Of Empathy

Abstract Background Empathy is an important characteristic to possess for healthcare professionals. It has been found to improve communication between professionals and patients and to improve clinical health outcomes. The Jefferson Scale of Empathy (JSE) was developed to measure this quality and has been used extensively, and psychometrically appraised, with a variety of cohorts and in different cultural environments. However, no study has been undertaken to systematically examine the methodological quality of studies which have assessed psychometric factors of the JSE. This systematic review will examine the quality of published papers that have reported on psychometric factors of the JSE. Methods A systematic review of studies which report on the psychometric properties of the JSE will be conducted. We will use a predefined search strategy to identify studies meeting the following eligibility criteria: original data is reported on for at least one of the psychometric measurement properties described in the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist, examines the JSE in a healthcare cohort (using the student, physician or health profession versions of the JSE), and is published from January 2001 and in the English language. Conference abstracts, editorials and grey literature will be excluded. Six electronic databases (Medline, EMBASE, PsychInfo, PubMed, Web of Science and CINAHL) will be systematically searched for articles meeting these criteria and studies will be assessed for eligibility by two review authors. The methodological quality of included papers will be examined using the COSMIN Risk of Bias checklist. Discussion A narrative description of the findings will be presented along with summary tables. Recommendations for use of the JSE with various cohorts and circumstances will be offered which may inform future research in this field. Systematic review registration PROSPERO CRD42018111412

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Healthcare provider characteristics that influence the implementation of individual-level patient-centered outcome measure (PROM) and patient-reported experience measure (PREM) data across practice settings: a protocol for a mixed methods systematic review with a narrative synthesis

Systematic Reviews ◽

10.1186/s13643-021-01725-2 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Angela C. Wolff ◽

Andrea Dresselhuis ◽

Samar Hejazi ◽

Duncan Dixon ◽

Deborah Gibson ◽

...

Keyword(s):

Systematic Review ◽

Mixed Methods ◽

Point Of Care ◽

Data Extraction ◽

Grey Literature ◽

Healthcare Providers ◽

Influential Factors ◽

Narrative Synthesis ◽

Individual Level ◽

Patient Reported

Abstract Background Substantial literature has highlighted the importance of patient-reported outcome and experience measures (PROMs and PREMs, respectively) to collect clinically relevant information to better understand and address what matters to patients. The purpose of this systematic review is to synthesize the evidence about how healthcare providers implement individual-level PROMs and PREMs data into daily practice. Methods This mixed methods systematic review protocol describes the design of our synthesis of the peer-reviewed research evidence (i.e., qualitative, quantitative, and mixed methods), systematic reviews, organizational implementation projects, expert opinion, and grey literature. Keyword synonyms for “PROMs,” PREMs,” and “implementation” will be used to search eight databases (i.e., MEDLINE, CINAHL, PsycINFO, Web of Science, Embase, SPORTDiscus, Evidence-based Medicine Reviews, and ProQuest (Dissertation and Theses)) with limiters of English from 2009 onwards. Study selection criteria include implementation at the point-of-care by healthcare providers in any practice setting. Eligible studies will be critically appraised using validated tools (e.g., Joanna Briggs Institute). Guided by the review questions, data extraction and synthesis will occur simultaneously to identify biographical information and methodological characteristics as well as classify study findings related to implementation processes and strategies. As part of the narrative synthesis approach, two frameworks will be utilized: (a) Consolidated Framework for Implementation Research (CFIR) to identify influential factors of PROMs and PREMs implementation and (b) Expert Recommendations for Implementing Change (ERIC) to illicit strategies. Data management will be undertaken using NVivo 12TM. Discussion Data from PROMs and PREMs are critical to adopt a person-centered approach to healthcare. Findings from this review will guide subsequent phases of a larger project that includes interviews and a consensus-building forum with end users to create guidelines for implementing PROMs and PREMs at the point of care. Systematic review registration PROSPERO CRD42020182904.

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Measures of trunk muscle strength and their measurement properties: a protocol for a systematic review and narrative synthesis of clinical measures

BMJ Open ◽

10.1136/bmjopen-2020-041499 ◽

2021 ◽

Vol 11 (1) ◽

pp. e041499

Author(s):

Shouq Althobaiti ◽

Alison Rushton ◽

Deborah Falla ◽

Nicola R Heneghan

Keyword(s):

Systematic Review ◽

Muscle Strength ◽

Clinical Setting ◽

Grey Literature ◽

Trunk Muscle ◽

Risk Of Bias ◽

Trunk Muscles ◽

Measurement Properties ◽

Narrative Synthesis ◽

Trunk Muscle Strength

IntroductionSpinal musculoskeletal conditions, including low back and neck pain, are leading causes of disability globally. The trunk muscles, which comprise muscles in the thoracic and lumbar regions, are essential for functional activities, necessitating mobility, motor control and strength. To investigate the effectiveness of interventions directed at improving trunk muscle strength, it is essential to have valid, reliable and responsive performance-based outcome measures (PBOM). While isokinetic dynamometry is considered the gold-standard PBOM, the associated costs, size/weight and operational complexity of this equipment preclude its use in a clinical setting. There is, therefore, a need to evaluate the measurement properties of alternative accessible measures of trunk strength. This systematic review therefore aims to investigate the measurement properties of PBOM of trunk muscle strength measures appropriate for use in a clinical setting.Methods and analysisThis protocol has been designed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. CINAHL, Web of Science, Pedro, MEDLINE, EMBASE, SPORTDiscuss will be searched systematically from the database start date up to 16 April 2020, along with reference checking and the grey literature searching. Eligibility criteria include studies investigating measurement properties of PROM for trunk muscle strength for use in a clinical setting in adults with and without spinal musculoskeletal complaints. Two independent reviewers will determine the eligibility of the studies through screening process of titles, abstract and the full text. Both reviewers will assess the risk of bias using COnsensus-based Standards for the selection of health status Measurement Instruments risk-of-bias tool and then extract the data from included studies. The overall quality of the included studies will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach. A narrative synthesis will be carried out if meta-analysis is not applicable. Findings from this systematic review will aid clinicians and practitioners working in the field for example, sport, in using the most appropriate PBOM to measure trunk muscle strength.Ethics and disseminationNo research ethics application is needed as there are no patient data in this study. The results of this study will be submitted to a peer reviewed journal and presented at conferences.PROSPERO registration numberCRD42020167464.

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Clinical effectiveness of manipulation and mobilisation interventions for the treatment of non-specific neck pain: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-037783 ◽

2020 ◽

Vol 10 (10) ◽

pp. e037783

Author(s):

Elizabeth Bailey ◽

Nicola R Heneghan ◽

Natasha J Cassidy ◽

Deborah Falla ◽

Alison B Rushton

Keyword(s):

Systematic Review ◽

Neck Pain ◽

Outcome Measures ◽

Functional Disability ◽

Meta Analysis ◽

Grey Literature ◽

Neck Disability Index ◽

Risk Of Bias ◽

Range Of Movement ◽

Patient Reported

IntroductionNon-specific neck pain (NSNP) is a common musculoskeletal condition resulting in pain, physical limitations and associated functional disability. Current guidelines recommend manipulation and/or mobilisation as part of the multimodal management of NSNP. This study focuses on intervention at the articular level and aims to identify whether joint mobilisation or joint manipulation has a greater effect on function, range of movement or pain outcomes in the management of NSNP.Methods and analysisA systematic review protocol has been designed and is reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. A targeted search strategy will enable searching of key databases from inception to 31 March 2020: CINAHL, PEDro, AMED, EMBASE, OVID, MEDLINE, Web of Science, PubMed and Google Scholar. Key journals will be searched using predefined keywords determined from preliminary scoping searches for randomised controlled trials of manipulation and mobilisation modalities for adults with NSNP in the absence of radiculopathy or whiplash, published in English. Grey literature and unpublished studies will also be searched. Studies will be screened by title and abstract and full text. Two independent reviewers will conduct the searches independently, extract data, assess risk of bias (Cochrane Risk of Bias Tool 2) and assess overall strength of evidence (Grading of Recommendations, Assessment, Development and Evaluation). Meta-analysis will be performed where individual studies measure comparable outcomes including performance-based outcome measures such as range of movement or patient reported outcome measures such as Neck Disability Index; and where interventions are comparable in their delivery such as number of oscillations and Maitland grading. Where not possible, data will be presented descriptively.Ethics and disseminationThis study does not require ethical approval. Findings will be submitted for publication to relevant peer-reviewed journals and will be presented at profession-specific conferences.PROSPERO registration numberCRD42020164457.

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Nocturnal digital surveillance in aged populations and its effects on health, welfare and social care provision: a systematic review

10.21203/rs.3.rs-373330/v1 ◽

2021 ◽

Author(s):

Matt X. Richardson ◽

Maria Ehn ◽

Sara Landerdahl Stridsberg ◽

Ken Redekop ◽

Sarah Wamala-Andersson

Keyword(s):

Systematic Review ◽

Standard Care ◽

Social Care ◽

Grey Literature ◽

Care Quality ◽

Risk Of Bias ◽

Future Research ◽

Care Provision ◽

Digital Surveillance

Abstract BackgroundThis systematic review summarized the effects of nocturnal digital surveillance technologies on health, welfare and social care provision outcomes in populations ≥ 50 years, compared to standard care.Primary studies published 2005-2020 that assessed these technologies were identified in 11 databases of peer-reviewed literature and numerous grey literature sources. Five publications out of 629 met inclusion criteria. The Risk of Bias 2.0 and ROBINS-I tools were used for quality assessment. ResultHealth-related outcomes (e.g. injuries, unexplained absences) and social care outcomes (e.g. staff burden) did not differ between interventions and standard care. Quality of life and affect showed improvement with some interventions, as did economic outcomes in one setting. The quality of studies was low however, with a serious to critical risk of bias. ConclusionWe found little evidence for the benefit of nocturnal digital surveillance interventions as compared to standard care in several key outcomes. Higher quality intervention studies should be prioritized in future research to provide more reliable evidence.

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Home monitoring of HbA1c in diabetes mellitus: A protocol for systematic review and narrative synthesis on reliability, accuracy, and patient acceptability

10.1101/2021.12.15.21267851 ◽

2021 ◽

Author(s):

Jack Colley ◽

Hajira Dambha-Miller ◽

Beth Stuart ◽

Jazz Bartholomew ◽

Hermione Price

Keyword(s):

Systematic Review ◽

Grey Literature ◽

Capillary Blood ◽

Risk Of Bias ◽

Current Evidence ◽

Haemoglobin A1c ◽

Narrative Synthesis ◽

Patient Acceptability ◽

The Uk ◽

At Home

Introduction Worldwide there are an estimated 463 million people with diabetes. [1] In the UK people with diabetes are offered an annual review including monitoring of Haemoglobin A1c (HbA1c). [2] [3] This can identify people with diabetes who are not meeting their glycaemic targets, enabling early intervention. Those who do not attend these reviews often have higher HbA1c levels and poorer health outcomes. [4] During the Coronavirus disease of 2019 (COVID-19) pandemic, there was a 77% reduction in monitoring of HbA1c in the UK. [5] We hypothesise that people with diabetes could take finger-prick samples at home for the measurement of HbA1c. Method and Analysis We will perform a systematic review of current evidence for capillary blood collected at home for the measurement of HbA1c. We will examine the validity, reliability, safety, and patient acceptability of the use of capillary blood compared with the usual standard of care of venous blood. We will explore variables which affect validity of results. Using core terms of 'Diabetes', 'HbA1c' and 'Capillary sampling' we will search MEDLINE, Embase, CINAHL, Web of Science Core Collection, Google Scholar, Open Grey and other grey literature from database inception until 2021. Risk of bias will be assessed using the 'COSMIN risk of bias tool to assess the quality of studies on reliability and measurement error'. Database searches and data extraction for primary outcomes will be conducted in duplicate. We will produce a narrative synthesis exploring how variables of capillary blood collection impact on validity, as well as exploring the safety and acceptability of patient self-collection. Ethics and Dissemination This review will be submitted for publication in a peer-reviewed open-access journal. We will present our results at both national and international conferences. As a systematic review with no primary participant data or involvement, ethical approval is not applicable. PROSPERO registration number CRD42021225606

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Correction of Thumb Duplication: A Systematic Review of Surgical Techniques

Journal of Hand and Microsurgery ◽

10.1055/s-0039-1700445 ◽

2019 ◽

Vol 12 (02) ◽

pp. 074-084

Author(s):

Robert Miller ◽

Alexandre Kaempfen ◽

Jamil Moledina ◽

Bran Sivakumar ◽

Gill Smith ◽

...

Keyword(s):

Systematic Review ◽

Functional Outcomes ◽

Surgical Techniques ◽

Spare Parts ◽

Risk Of Bias ◽

Future Research ◽

Level Of Evidence ◽

Thumb Duplication ◽

Patient Reported

AbstractSurgical intervention for thumb duplication can be divided into three categories: simple excision of the accessory thumb, excision of the accessory thumb with reconstruction from available “spare parts,” and combining the two thumbs into one, as described by Bilhaut. This prospectively PROSPERO registered systematic review evaluates the overall, aesthetic and functional outcomes for the latter two options (reconstruction from spare parts vs. combining two thumbs into one), aiming to facilitate evidence-based decision making when addressing thumb duplication and direct future research. The review was performed in accordance with the Cochrane Handbook of Systematic Reviews and PRISMA statement. Embase, PubMed, Medline, and Cochrane databases were systematically searched. Studies offering comparisons of techniques were included. Risk of bias was assessed using the Risk of Bias In Non-randomized Studies—of Intervention tool. The quality of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation. Ten retrospective observational studies were included. Data did not consistently allow analysis by procedure type. Four studies reported similar overall outcomes between techniques, while two specifically reported poor overall outcomes for the Bilhaut procedure. Two studies reported comparatively worse aesthetic outcomes for the Bilhaut procedure with four studies reporting comparatively improved functional outcomes for this procedure. Overall, interpretation of outcomes was challenging with no patient-reported outcome measures used. The quality of the evidence was universally “very low” due to all studies being at risk of methodological bias. Based on the available evidence, surgical techniques for thumb duplication correction appear comparable regarding overall outcome. There is limited evidence suggesting reconstruction with spare parts offers superior aesthetic outcomes at the expense of stability. The level of evidence is III.

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Comparative efficacy and safety of interventions for treating head lice: a protocol for systematic review and network meta-analysis

BMJ Paediatrics Open ◽

10.1136/bmjpo-2021-001129 ◽

2021 ◽

Vol 5 (1) ◽

pp. e001129

Author(s):

Bill Stevenson ◽

Wubshet Tesfaye ◽

Julia Christenson ◽

Cynthia Mathew ◽

Solomon Abrha ◽

...

Keyword(s):

Systematic Review ◽

Randomised Controlled Trials ◽

Meta Analysis ◽

Grey Literature ◽

Risk Of Bias ◽

Controlled Trials ◽

Head Lice ◽

Efficacy And Safety ◽

Randomised Controlled ◽

Meta Analyses

BackgroundHead lice infestation is a major public health problem around the globe. Its treatment is challenging due to product failures resulting from rapidly emerging resistance to existing treatments, incorrect treatment applications and misdiagnosis. Various head lice treatments with different mechanism of action have been developed and explored over the years, with limited report on systematic assessments of their efficacy and safety. This work aims to present a robust evidence summarising the interventions used in head lice.MethodThis is a systematic review and network meta-analysis which will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement for network meta-analyses. Selected databases, including PubMed, Embase, MEDLINE, Web of Science, CINAHL and Cochrane Central Register of Controlled Trials will be systematically searched for randomised controlled trials exploring head lice treatments. Searches will be limited to trials published in English from database inception till 2021. Grey literature will be identified through Open Grey, AHRQ, Grey Literature Report, Grey Matters, ClinicalTrials.gov, WHO International Clinical Trials Registry and International Standard Randomised Controlled Trials Number registry. Additional studies will be sought from reference lists of included studies. Study screening, selection, data extraction and assessment of methodological quality will be undertaken by two independent reviewers, with disagreements resolved via a third reviewer. The primary outcome measure is the relative risk of cure at 7 and 14 days postinitial treatment. Secondary outcome measures may include adverse drug events, ovicidal activity, treatment compliance and acceptability, and reinfestation. Information from direct and indirect evidence will be used to generate the effect sizes (relative risk) to compare the efficacy and safety of individual head lice treatments against a common comparator (placebo and/or permethrin). Risk of bias assessment will be undertaken by two independent reviewers using the Cochrane Risk of Bias tool and the certainty of evidence assessed using the Grading of Recommendations, Assessment, Development and Evaluations guideline for network meta-analysis. All quantitative analyses will be conducted using STATA V.16.DiscussionThe evidence generated from this systematic review and meta-analysis is intended for use in evidence-driven treatment of head lice infestations and will be instrumental in informing health professionals, public health practitioners and policy-makers.PROSPERO registration numberCRD42017073375.

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