scholarly journals The diagnostic accuracy of the Kimberley Indigenous Cognitive Assessment (KICA) tool: a systematic review

2017 ◽  
Vol 25 (3) ◽  
pp. 282-287 ◽  
Author(s):  
Suzanne M Dyer ◽  
Kate Laver ◽  
Margeret Friel ◽  
Craig Whitehead ◽  
Maria Crotty
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Cognitive Assessment ◽  
Assessment Tool ◽  
Indigenous Australians ◽  
Indigenous Australian ◽  
Cross Sectional ◽  
Diagnosis Of Dementia ◽  
In Series ◽  
Similar Accuracy

Objectives: The objective of this study was to conduct a systematic review of evidence for the accuracy of the Kimberley Indigenous Cognitive Assessment (KICA) tool in supporting the diagnosis of dementia in Indigenous Australian populations. Methods: Cross-sectional diagnostic accuracy studies of the KICA with an appropriate reference standard published to November 2015 were included. Comparison to an alternative cognitive assessment tool was required in non-remote populations. Case control analyses were excluded. Results: Four studies were included: one of the KICA-Cog and KICA-Carer, one of the KICA Screen, and two of the modified-KICA. All tools developed for remote populations had a sensitivity of ≥76% and a specificity of ≥71% for the diagnosis of dementia. The KICA-Cog and KICA-Carer conducted in series had the highest sensitivity and specificity (91% and 94% respectively). In an urban and regional population, the mKICA had similar accuracy to the Mini-Mental State Examination (MMSE) (AUC 0.93, 95% CI 0.88–0.99 vs 0.94, 95% CI 0.89–0.99). Key risk of bias limitations related to lack of pre-determined cut-points and population selection methods. Conclusion: The use of the KICA in remote Indigenous Australians may assist in timely diagnosis of dementia in this population. Using the KICA-Cog and KICA-Carer in series may maximise specificity, decreasing false positive results without compromising sensitivity.

The association between dietary inflammatory index and risk of central obesity in adults: An updated systematic review and meta-analysis

2020 ◽  
Vol 90 (5-6) ◽  
pp. 535-552 ◽  
Author(s):  
Mahdieh Abbasalizad Farhangi ◽  
Mahdi Vajdi
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Central Obesity ◽  
Assessment Tool ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Dietary Factors ◽  
Cross Sectional ◽  
Inflammatory Status ◽  
Obesity Indices

Abstract. Backgrounds: Central obesity, as a pivotal component of metabolic syndrome is associated with numerous co-morbidities. Dietary factors influence central obesity by increased inflammatory status. However, recent studies didn’t evaluate the association between central obesity and dietary inflammation index (DII®) that give score to dietary factors according to their inflammatory potential. In the current systematic review and meta-analysis, we summarized the studies that investigated the association between DII® with central obesity indices in the general populations. Methods: In a systematic search from PubMed, SCOPUS, Web of Sciences and Cochrane electronic databases, we collected relevant studies written in English and published until 30 October 2019. The population of included studies were apparently healthy subjects or individuals with obesity or obesity-related diseases. Observational studies that evaluated the association between DII® and indices of central obesity including WC or WHR were included. Results: Totally thirty-two studies were included; thirty studies were cross-sectional and two were cohort studies with 103071 participants. Meta-analysis of observational studies showed that higher DII® scores were associated with 1.81 cm increase in WC (Pooled weighted mean difference (WMD) = 1.813; CI: 0.785–2.841; p = 0.001). Also, a non-significant increase in the odds of having higher WC (OR = 1.162; CI: 0.95–1.43; p = 0.154) in the highest DII category was also observed. In subgroup analysis, the continent, dietary assessment tool and gender were the heterogeneity sources. Conclusion: The findings proposed that adherence to diets with high DII® scores was associated with increased WC. Further studies with interventional designs are necessary to elucidate the causality inference between DII® and central obesity indices.

Do Electronic Medical Records Improve Advance Directive Documentation? A Systematic Review

2018 ◽  
Vol 36 (3) ◽  
pp. 255-263 ◽  
Author(s):  
Christopher Lemon ◽  
Michael De Ridder ◽  
Mohamed Khadra
Keyword(s):  
Systematic Review ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Planning Process ◽  
Assessment Tool ◽  
Controlled Trial ◽  
Decision Aids ◽  
Automatic Identification ◽  
Cross Sectional ◽  
Identification Software

Background: Documentation rates of advance directives (ADs) remain low. Using electronic medical records (EMRs) could help, but a synthesis of evidence is currently lacking. Objectives: To evaluate the evidence for using EMRs in documenting ADs and its implications for overcoming challenges associated with their use. Design: Systematic review of articles in English, published from inception of databases to December 2017. Data Sources: PubMed, PsycINFO, EMBASE, and CINAHL. Methods/Measurements: Four databases were searched from inception to December 2017. Randomized and nonrandomized quantitative studies examining the effects of EMRs on creation, storage, or use of ADs were included. All featured an advance care planning process. Evidence was evaluated using the Cochrane Collaboration’s risk assessment tool. Results: Fifteen studies were included: 1 randomized controlled trial, 1 randomized pilot, 4 pre–post studies, 4 cross-sectional studies, 1 retrospective cohort study, 1 historical control study, 1 retrospective observational study, 1 retrospective review, and 1 evaluation of an EMR feature. Seven studies showed that EMR-based reminders, AD templates, and decision aids can improve AD documentation rates. Three demonstrated that EMR search functions, decision aids, and automatic identification software can help identify patients who have or need ADs according to certain criteria. Five showed EMRs can create documentation challenges, including locating ADs, and making some patients more likely than others to have an AD. Most studies had an unclear or high risk of bias. Conclusions: Limited evidence suggests EMRs could be used to help address AD documentation challenges but may also create additional problems. Stronger evidence is needed to more conclusively determine how EMR may assist in population approaches to improving AD documentation.

Diagnostic accuracy of centralised assays for TB detection and detection of resistance to rifampicin and isoniazid: a systematic review and meta-analysis

2020 ◽  
Vol 57 (2) ◽  
pp. 2000747
Author(s):  
Mikashmi Kohli ◽  
Emily MacLean ◽  
Madhukar Pai ◽  
Samuel G. Schumacher ◽  
Claudia M. Denkinger
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Tracheal Aspirate ◽  
Rifampicin Resistance ◽  
Isoniazid Resistance ◽  
Cross Sectional ◽  
Molecular Assays ◽  
Index Tests ◽  
Resistance Detection

Various diagnostic companies have developed high throughput molecular assays for tuberculosis (TB) and resistance detection for rifampicin and isoniazid. We performed a systematic review and meta-analyses to assess the diagnostic accuracy of five of these tests for pulmonary specimens. The tests included were Abbott RealTime MTB, Abbott RealTime RIF/INH, FluoroType MTB, FluoroType MTDBR and BD Max MDR-TB assay.A comprehensive search of six databases for relevant citations was performed. Cross-sectional, case-control, cohort studies, and randomised controlled trials of any of the index tests were included. Respiratory specimens (such as sputum, bronchoalveolar lavage, tracheal aspirate, etc.) or their culture isolates.A total of 21 included studies contributed 26 datasets. We could only meta-analyse data for three of the five assays identified, as data were limited for the remaining two. For TB detection, the included assays had a sensitivity of 91% or more and the specificity ranged from 97% to 100%. For rifampicin resistance detection, all the included assays had a sensitivity of more than 92%, with a specificity of 99–100%. Sensitivity for isoniazid resistance detection varied from 70 to 91%, with higher specificity of 99–100% across all index tests. Studies that included head-to-head comparisons of these assays with Xpert MTB/RIF for detection of TB and rifampicin resistance suggested comparable diagnostic accuracy.In people with symptoms of pulmonary TB, the centralised molecular assays demonstrate comparable diagnostic accuracy for detection of TB, rifampicin and isoniazid resistance to Xpert MTB/RIF assay, a WHO recommended molecular test.

scholarly journals Grip strength among Indigenous and non-Indigenous Australian adults: a longitudinal study of the effects of birth size and current size

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e024749
Author(s):  
Timothy Howarth ◽  
Belinda Davison ◽  
Gurmeet Singh
Keyword(s):  
Young Adults ◽  
Grip Strength ◽  
Lean Mass ◽  
Low Birthweight ◽  
Indigenous Australians ◽  
Birth Size ◽  
Indigenous Australian ◽  
Cross Sectional ◽  
Increased Risk ◽  
Lower Grip

ObjectivesIndigenous Australians are born smaller than non-Indigenous Australians and are at an increased risk of early onset of frailty. This study aimed to identify the relationship between birth size, current size and grip strength, as an early marker of frailty, in Indigenous and non-Indigenous young adults.DesignCross sectional data from two longitudinal studies: Aboriginal birth cohort (Indigenous) and top end cohort (non-Indigenous).SettingParticipants reside in over 40 urban and remote communities across the Northern Territory, Australia.ParticipantsYoung adults with median age 25 years (IQR 24–26); 427 participants (55% women), 267 (63%) were remote Indigenous, 55 (13%) urban Indigenous and 105 (25%) urban non-Indigenous.Outcome measuresReliable birth data were available. Anthropometric data (height, weight, lean mass) and grip strength were directly collected using standardised methods. Current residence was classified as urban or remote.ResultsThe rate of low birthweight (LBW) in the non-Indigenous cohort (9%) was significantly lower than the Indigenous cohort (16%) (−7%, 95% CI −14 to 0, p=0.03). Indigenous participants had lower grip strength than non-Indigenous (women, −2.08, 95% CI −3.61 to –0.55, p=0.008 and men, −6.2, 95% CI −9.84 to –2.46, p=0.001). Birth weight (BW) was associated with grip strength after adjusting for demographic factors for both women (β=1.29, 95% CI 0.41 to 2.16, p=0.004) and men (β=3.95, 95% CI 2.38 to 5.51, p<0.001). When current size (lean mass and body mass index [BMI]) was introduced to the model BW was no longer a significant factor. Lean mass was a positive indicator for grip strength, and BMI a negative indicator.ConclusionsAs expected women had significantly lower grip strength than men. Current size, in particular lean mass, was the strongest predictor of adult grip strength in this cohort. BW may have an indirect effect on later grip strength via moderation of lean mass development, especially through adolescence and young adulthood.

Dietary intakes and anthropometric measures of Indigenous Australian women and their infants in the Gomeroi gaaynggal cohort

2016 ◽  
Vol 7 (5) ◽  
pp. 481-497 ◽  
Author(s):  
A. M. Ashman ◽  
C. E. Collins ◽  
L. J. Weatherall ◽  
L. Keogh ◽  
L. J. Brown ◽  
...  
Keyword(s):  
Small Sample Size ◽  
Saturated Fat ◽  
Small Sample ◽  
Indigenous Australians ◽  
Breastfeeding Initiation ◽  
Dietary Intakes ◽  
Nutrient Intakes ◽  
Indigenous Australian ◽  
Anthropometric Measures ◽  
Cross Sectional

Indigenous Australians continue to experience disparities in chronic diseases, many of which have nutrition-related trajectories. Optimal nutrition throughout the lifespan is protective for a number of adverse health outcomes, however little is known about current dietary intakes and related anthropometric outcomes of Indigenous women and their infants. Research is required to identify nutrition issues to target for health promotion activities. The Gomeroi gaaynggal programme is an ongoing, prospective cohort of pregnant Indigenous Australian women and their children. A cross-sectional examination of postnatal dietary intakes and anthropometric outcomes of mothers and children are reported. To date, 73 mother–child dyads have participatedpostpartum. Breastfeeding initiation was 85.9% and median (interquartile range) duration of any breastfeeding was 1.4 (0.5–4.0) months. Infants were introduced to solid foods at 5.0 months (4.0–6.0) and cow’s milk at 12.0 (10.0–13.0) months. At 12 monthspostpartum, 66.7% of women were overweight or obese, 63.7% at 2 years. Compared with recommendations, reported median maternal nutrient intakes from 24-h recall were low in fibre, folate, iodine, calcium, potassium and vitamin D and high in proportions of energy from total and saturated fat. Limitations of this study include a small sample size and incomplete data for the cohort at each time point. Preliminary data from this ongoing cohort of Indigenous Australian women and children suggest that women may need support to optimize nutrient intakes and to attain a healthy body weight for themselves and their children.

Kimberley Indigenous Cognitive Assessment tool (KICA): development of a cognitive assessment tool for older indigenous Australians

2006 ◽  
Vol 18 (2) ◽  
pp. 269-280 ◽  
Author(s):  
D. LoGiudice ◽  
K. Smith ◽  
J. Thomas ◽  
N. T. Lautenschlager ◽  
O. P. Almeida ◽  
...  
Keyword(s):  
Cognitive Abilities ◽  
Cognitive Assessment ◽  
Assessment Tool ◽  
Indigenous Health ◽  
Aged Care ◽  
Indigenous Australians ◽  
Internal Reliability ◽  
Reliable Assessment ◽  
Intraclass Correlations ◽  
Icd 10

Background: Indigenous Australians have a unique cultural heritage dating back many thousands of years. Unfortunately, there is no validated tool to assess cognition in older indigenous Australians. This study was designed to address this deficiency. The Kimberley Indigenous Cognitive Assessment (KICA) was developed with Indigenous health and aged care organizations, and comprises cognitive, informant and functional sections. The psychometric properties of the cognitive assessment section (KICA-Cog) are described in this paper.Methods: The KICA-Cog was tested in 70 indigenous subjects, of varying cognitive abilities and diagnoses, over 45 years of age. Subjects were interviewed using the KICA-Cog and then independently assessed by expert clinical raters using DSM-IV and ICD-10 criteria. Interrater and internal reliability were determined.Results: The KICA-Cog score showed no systematic interrater difference; the mean was −0.07 (SD = 1.83). Interrater reliability for 16 individual questions from the cognitive section revealed a κ-value ≥ 0.6 and intraclass correlations for 12 questions. Internal consistency, as assessed by Cronbach's α, was 0.88. Three items on the cognitive score (pension week, recall and free recall) effectively discriminated 85–7% of dementia cases. Sensitivity and specificity were 90.6% and 92.6%, respectively, using a cut-off score of 31/32.Conclusions: The KICA-Cog appears to be a reliable assessment tool for cognitive impairment in an Australian older traditionally living indigenous population.

scholarly journals Diagnosing serious infections in older adults presenting to ambulatory care: a systematic review

2020 ◽  
Author(s):  
Thomas Struyf ◽  
Hanne A Boon ◽  
Alma C van de Pol ◽  
Jos Tournoy ◽  
Alexander Schuermans ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Ambulatory Care ◽  
Clinical Features ◽  
Risk Of Bias ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Prediction Rules ◽  
Blood Tests ◽  
Serious Infections

Abstract Objectives to summarise all available evidence on the accuracy of clinical features and blood tests for diagnosing serious infections in older patients presenting to ambulatory care. Methods systematic review, searching seven databases using a comprehensive search strategy. We included cross-sectional prospective diagnostic studies on (1) clinical features, (2) diagnostic prediction rules based on clinical features alone, (3) blood tests and (4) diagnostic prediction rules combining clinical features and blood tests. Study participants had to be community-dwelling adults aged ≥65 years, in whom a physician suspected an infection. We used QUADAS-2 to assess risk of bias. We calculated measures of diagnostic accuracy and present descriptive statistics. Results out of 13,757 unique articles, only six studies with a moderate to high risk of bias were included. There was substantial clinical heterogeneity across these studies. Clinical features had LR− ≥0.61 and LR+ ≤4.94. Twelve prediction rules using clinical features had LR− ≥0.30 and LR+ ≤2.78. There was evidence on four blood tests of which procalcitonin was the most often investigated: levels &lt;0.37 ng/ml (LR− = 0.20; 95%CI 0.10–0.42) were suitable to rule out sepsis in moderately high prevalence situations. Two diagnostic prediction rules combining clinical features and procalcitonin had LR− of ≤0.12 (95%CI 0.05–0.33) and LR+ of maximum 1.39 (95%CI 1.30–1.49). Conclusions we found few studies on the diagnostic accuracy of clinical features and blood tests to detect serious infections in older people presenting to ambulatory care. The risk of bias was mostly moderate to high, leading to substantial uncertainty.

A systematic review in prosthetics and orthotics education research

2020 ◽  
Vol 44 (3) ◽  
pp. 116-132 ◽  
Author(s):  
Cody L McDonald ◽  
Deborah Kartin ◽  
Sara J Morgan
Keyword(s):  
Systematic Review ◽  
Education Research ◽  
Assessment Tool ◽  
Quality Criteria ◽  
Bibliographic Databases ◽  
Cross Sectional ◽  
Collaborative Education ◽  
Critical Appraisal Skills ◽  
Teaching Learning ◽  
State Of The Science

Background: Formal prosthetic/orthotic education has evolved greatly since its inception in the 1950s. The International Society for Prosthetics and Orthotics has established guidelines and recognition for prosthetic/orthotic programs worldwide. However, the current state-of-the-science in prosthetic/orthotic education is largely unknown. Objectives: To evaluate and synthesize available prosthetic/orthotic education research. Study design: Systematic review. Methods: Three bibliographic databases were searched and quality of included articles assessed using criteria from the National Institutes for Health Quality Assessment Tool for Observational Cohort, Cross-Sectional Studies, and the Critical Appraisal Skills Programme Qualitative Research Checklist, and Delphi quality criteria. Results: This review included 25 articles from 23 studies. Included studies explored description, development, implementation, and/or assessment of the teaching/learning methods, curriculum, program, or country/region level. Studies were conducted in 18 countries and published in 14 journals. Methodological quality was rated high in 6 articles, moderate in 6, and low in 13. Content synthesis was not attempted due to the heterogeneous literature. Conclusion: This systematic review suggests that prosthetic/orthotic education research is only being conducted at a limited level. There is a strong need for high quality, collaborative education research to be conducted and published in peer-reviewed journals to improve prosthetic/orthotic education and build a global conversation. Clinical relevance Research in prosthetic/orthotic education is limited. The current body of literature is not sufficient to inform and guide future education of prosthetic/orthotic students. Opportunities to improve prosthetic/orthotic education research include academic collaborations, a dedicated education special issue or journal, and disciplinary support for prosthetic/orthotic education research.

scholarly journals Heritability of glaucoma and glaucoma-related endophenotypes: systematic review and meta-analysis protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e019049 ◽  
Author(s):  
Nigus Gebrmedhin Asefa ◽  
Anna Neustaeter ◽  
Nomdo M Jansonius ◽  
Harold Snieder
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Vision Loss ◽  
Assessment Tool ◽  
Open Angle Glaucoma ◽  
Meta Analysis ◽  
Scientific Journal ◽  
Secondary Data ◽  
Cross Sectional ◽  
Age Related

IntroductionGlaucoma is the second leading cause of age-related vision loss worldwide; it is an umbrella term that is used to describe a set of complex ocular disorders with a multifactorial aetiology. Both genetic and lifestyle risk factors for glaucoma are well established. Thus far, however, systematic reviews on the heritability of glaucoma have focused on the heritability of primary open-angle glaucoma only. No systematic review has comprehensively reviewed or meta-analysed the heritability of other types of glaucoma, including glaucoma-related endophenotypes. The aim of this study will be to identify relevant scientific literature regarding the heritability of both glaucoma and related endophenotypes and summarise the evidence by performing a systematic review and meta-analysis.Methods and analysisThis systematic review will follow the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols 2015 checklist, which provides a standardised approach for carrying out systematic reviews. To capture as much literature as possible, a comprehensive step-by-step systematic search will be undertaken in MEDLINE (PubMed), EMBASE, Web of Science and ScienceDirect, and studies published until 31 December 2017 will be included. Two reviewers will independently search the articles for eligibility according to predefined selection criteria. A database will be used for screening of eligible articles. The quality of the included studies will be rated independently by two reviewers, using the National Health Institute Quality Assessment tool for Observational Cohort and Cross-Sectional Studies. A random-effects model will be used for the meta-analysis. This systematic review is registered with the International Prospective Register of Systematic Reviews with a registration number: CRD42017064504.Ethics and disseminationWe will use secondary data from peer-reviewed published articles, and hence there is no requirement for ethics approval. The results of this systematic review will be disseminated through publication in a peer-reviewed scientific journal.

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