Comparative Effectiveness and Harms of Intraoperative Transesophageal Echocardiography in Noncardiac Surgery: A Systematic Review

2018 ◽  
Vol 22 (2) ◽  
pp. 122-136 ◽  
Author(s):  
Ashraf Fayad ◽  
Sasha Shillcutt ◽  
Massimiliano Meineri ◽  
Terrence D. Ruddy ◽  
Mohammed Toseef Ansari
Keyword(s):  
Systematic Review ◽  
Transesophageal Echocardiography ◽  
Comparative Effectiveness ◽  
Noncardiac Surgery ◽  
Cochrane Library ◽  
Serious Adverse Events ◽  
Ovid Medline ◽  
Quantitative Synthesis ◽  
The Cochrane Library ◽  
Important Design

Intraoperative use of transesophageal echocardiography (TEE) has become commonplace in high-risk noncardiac surgeries but the balance of benefits and harms remains unclear. This systematic review investigated the comparative effectiveness and harms of intraoperative TEE in noncardiac surgery. We searched Ovid MEDLINE, PubMed, EMBASE, and the Cochrane Library from 1946 to March 2017. Two reviewers independently screened the literature for eligibility. Studies were assessed for the risk of selection bias, confounding, measurement bias, and reporting bias. Three comparative and 13 noncomparative studies were included. Intraoperative TEE was employed in a total of 1912 of 3837 patients. Studies had important design limitations. Data were not amenable to quantitative synthesis due to clinical and methodological diversity. Reported incidence of TEE complications ranged from 0% to 1.7% in patients undergoing various procedures (5 studies, 540 patients). No serious adverse events were observed for mixed surgeries (2 studies, 197 patients). Changes in surgical or medical management attributable to the use of TEE were noted in 17% to 81% of patients (7 studies, 558 patients). The only randomized trial of intraoperative TEE was grossly underpowered to detect meaningful differences in 30-day postoperative outcomes. There is lack of high-quality evidence of effectiveness and harms of intraoperative TEE in the management of non-cardiac surgeries. Evidence, however, indicates timely evaluation of cardiac function and structure, and hemodynamics. Future studies should be comparative evaluating confounder-adjusted impact on both intraoperative and 30-day postoperative clinical outcomes.

scholarly journals The Effect of Hysteroscopy on the Reproductive Outcomes of Infertile Women Without Intrauterine Pathologies: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Soo Yeon Yang ◽  
Seon Heui Lee ◽  
Seung-Joo Chon
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Reproductive Outcomes ◽  
Vitro Fertilization ◽  
Infertile Women ◽  
Ovid Medline ◽  
Meta Analyses ◽  
The Cochrane Library

(1) Background: The aim of this work was to systematically review existing studies on whether hysteroscopy improves the reproductive outcomes of women with infertility even in the absence of intrauterine pathologies when compared to women who did not receive a hysteroscopy. (2) Methods: We established the Participant-Intervention-Comparison-Outcome strategy and used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement to conduct a systematic review of 11 studies which were retrieved from 3 electronic databases: Ovid-Medline, Ovid-Embase, and the Cochrane Library. Two independent investigators extracted the data from the included studies and used the Cochrane risk-of-bias tool to assess their quality. (3) Results: The primary outcome measures were the clinical pregnancy rates (CPRs) and live birth rates (LBRs) in the in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles. Hysteroscopy in infertile women without intrauterine pathologies showed higher CPRs and LBRs than those in the same population who did not receive hysteroscopy in cases of recurrent implantation failure and IVF (odds ratio: 1.79 and 1.46, 95% confidence interval: 1.46-2.30 and 1.08-1.97 for CPR and LBR, respectively); however, the degree of significance was not as high for LBR. (4) Conclusions: Hysteroscopy before IVF/ICSI in infertile women without intrauterine pathologies may potentially be effective in improving the CPRs and LBRs in patients with RIF. Robust and high-quality randomized trials are warranted to confirm this finding.

scholarly journals Smoking and Outcomes After Knee and Hip Arthroplasty: A Systematic Review

2011 ◽  
Vol 38 (9) ◽  
pp. 1824-1834 ◽  
Author(s):  
JASVINDER A. SINGH
Keyword(s):  
Systematic Review ◽  
Postoperative Complication ◽  
Risk Ratio ◽  
Hip Arthroplasty ◽  
Cochrane Library ◽  
Death Risk ◽  
Ovid Medline ◽  
Complication Risk ◽  
The Cochrane Library ◽  
Proquest Dissertation

Objective.Studies have suggested higher rates of perioperative and postoperative complications in smokers compared to nonsmokers. The objective of this systematic review was to assess the association of smoking and postoperative outcomes following total hip arthroplasty (THA) or total knee arthroplasty (TKA).Methods.A search of 6 databases (The Cochrane Library, Scopus, Proquest Dissertation abstracts, CINAHL, Ovid Medline, and Embase) was performed by a Cochrane librarian. All titles and abstracts were screened by 2 independent reviewers with expertise in performing systematic reviews. Studies were included if they were fully published reports that included smoking and any perioperative or postoperative clinical outcome in patients with TKA or THA.Results.A total of 21 studies were included for the review, of which 6 provided multivariable-adjusted analyses, 14 univariate analyses, and one statistical modeling. For most outcomes, results from 1–2 studies could be pooled. Current smokers were significantly more likely to have any postoperative complication (risk ratio 1.24, 95% CI 1.01 to 1.54) and death (risk ratio 1.63, 95% CI 1.06 to 2.51) compared to nonsmokers. Former smokers were significantly more likely to have any post-operative complication (risk ratio 1.32, 95% CI 1.05 to 1.66) and death (risk ratio 1.69, 95% CI 1.08 to 2.64) compared to nonsmokers.Conclusion.This systematic review found that smoking is associated with significantly higher risk of postoperative complication and mortality following TKA or THA. Studies examining longterm consequences of smoking on implant survival and complications are needed. Smoking cessation may improve outcomes after THA or TKA.

scholarly journals Trends and Effectiveness of ICT Interventions for the Elderly to Reduce Loneliness: A Systematic Review

Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 293
Author(s):  
Hee Kyung Choi ◽  
Seon Heui Lee
Keyword(s):  
Systematic Review ◽  
Social Participation ◽  
Data Extraction ◽  
Health And Safety ◽  
The Elderly ◽  
Development Trend ◽  
Basic Knowledge ◽  
Cochrane Library ◽  
Ovid Medline ◽  
The Cochrane Library

Elderly people are sensitive to loneliness, which may contribute to mental and physical health, serious illness, and increased mortality. This study investigates the development trend of information communication technology (ICT) interventions designed for the elderly to reduce loneliness and synthesize its effect. We searched relevant articles on 23 May 2020 using three databases: Ovid-Medline, Ovid-EMBASE, and the Cochrane library. Data extraction and quality assessment were independently performed by two authors. The development is changing from animal robots to online social platforms and from simple emotional support to a multifaceted system that promotes social participation, cognition, physical activity, and nutrition. Our systematic review reported that ICT interventions are being developed to alleviate loneliness and increase social participation. Our study revealed an increase in the use of ICT interventions among the elderly and a positive change in their attitude toward ICT interventions. ICT interventions in the field of nursing should continue to be developed in the future to meet social, health, and safety needs. In the context of coronavirus disease 2019 (COVID-19), ICT interventions are needed to respond effectively to the needs of the elderly. This study is expected to provide basic knowledge for the development of ICT interventions for the elderly.

scholarly journals The impact of institutional repositories: a systematic review

2020 ◽  
Vol 108 (2) ◽  
Author(s):  
Michelle R. Demetres ◽  
Diana Delgado ◽  
Drew N. Wright
Keyword(s):  
Systematic Review ◽  
Information Science ◽  
Positive Impact ◽  
Citation Count ◽  
Cochrane Library ◽  
Institutional Repositories ◽  
Scholarly Output ◽  
Ovid Medline ◽  
The Cochrane Library ◽  
The Impact

Objective: Institutional repositories are platforms for presenting and publicizing scholarly output that might not be suitable to publish in a peer-reviewed journal or that must meet open access requirements. However, there are many challenges associated with their launch and up-keep. The objective of this systematic review was to define the impacts of institutional repositories (IRs) on an academic institution, thus justifying their implementation and/or maintenance.Methods: A comprehensive literature search was performed in the following databases: Ovid MEDLINE, Ovid EMBASE, the Cochrane Library (Wiley), ERIC (ProQuest), Web of Science (Core Collection), Scopus (Elsevier), and Library, Information Science & Technology Abstracts (EBSCO). A total of 6,593 citations were screened against predefined inclusion and exclusion criteria.Results: Thirteen included studies were divided into 3 areas of impact: citation count, exposure or presence, and administrative impact. Those focusing on citation count (n=5) and exposure or presence (n=7) demonstrated positive impacts of IRs on institutions and researchers. One study focusing on administrative benefit demonstrated the utility of IRs in automated population of ORCID profiles.Conclusion: Based on the available literature, IRs appear to have a positive impact on citation count, exposure or presence, and administrative burden. To draw stronger conclusions, more and higher-quality studies are needed.

scholarly journals Efficacy and safety of VNS therapy or continued medication management for treatment of adults with drug-resistant epilepsy: systematic review and meta-analysis

2022 ◽  
Author(s):  
Sarah Batson ◽  
Rohit Shankar ◽  
Joan Conry ◽  
Jane Boggs ◽  
Rodney Radtke ◽  
...  
Keyword(s):  
Systematic Review ◽  
Seizure Frequency ◽  
Meta Analysis ◽  
Medication Management ◽  
Cochrane Library ◽  
Seizure Freedom ◽  
Drug Resistant ◽  
Serious Adverse Events ◽  
Drug Resistant Epilepsy ◽  
The Cochrane Library

AbstractVagus nerve stimulation (VNS) Therapy® is an adjunctive neurostimulation treatment for people with drug-resistant epilepsy (DRE) who are unwilling to undergo resective surgery, have had unsuccessful surgery or are unsuitable for surgery. A systematic review and meta-analysis were conducted to determine the treatment effects of VNS Therapy as an adjunct to anti-seizure medications (ASMs) for the management of adults with DRE. A literature search was performed in August 2020 of the Medline®, Medline® Epub Ahead of Print, Embase, and the Cochrane library databases. Outcomes examined included reduction in seizure frequency, seizure freedom, ASM load, discontinuations, and serious adverse events (SAEs). Comparators included best medical practice, ASMs, low-stimulation or sham VNS Therapy. Four RCTs and six comparative observational studies were identified for inclusion. Against comparators, individuals treated with VNS had a significantly better odds of experiencing a ≥ 50% reduction in seizure frequency (OR: 2.27 [95% CI 1.47, 3.51]; p = 0.0002), a ≥ 75% reduction in seizure frequency (OR: 3.56 [95% CI 1.59, 7.98]; p = 0.002) and a reduced risk for increased ASM load (risk ratio: 0.36 [95% CI 0.21, 0.62]; p = 0.0002). There was no difference in the odds of discontinuation or the rate of SAEs between VNS versus comparators. This meta-analysis demonstrated the benefits of VNS Therapy in people with DRE, which included improvement in seizure frequency without an increase in the rate of SAEs or discontinuations, thereby supporting the consideration of VNS Therapy for people who are not responding to ASMs and those unsuitable or unwilling to undergo surgery.

scholarly journals Efficacy and Safety of VNS Therapy or Continued Medication Management for Treatment of Adults with Drug-Resistant Epilepsy: Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Joan Conry ◽  
Sarah Batson ◽  
Stephen Mitchell ◽  
Rohit Shankar ◽  
Jane Boggs ◽  
...  
Keyword(s):  
Systematic Review ◽  
Seizure Frequency ◽  
Meta Analysis ◽  
Medication Management ◽  
Cochrane Library ◽  
Seizure Freedom ◽  
Serious Adverse Events ◽  
Drug Resistant Epilepsy ◽  
The Cochrane Library ◽  
Load Risk

Abstract Vagus nerve stimulation (VNS) Therapy® is an adjunctive neurostimulation treatment for people withdrug-resistant epilepsy (DRE) who are unwilling to undergo resective surgery, have had unsuccessfulsurgery or are unsuitable for surgery. A systematic review and meta-analysis were conducted todetermine the treatment effects of VNS Therapy as an adjunct to anti-seizure medications (ASMs) forthe management of adults with DRE.A literature search was performed in August 2020 of the Medline®, Medline® Epub Ahead of Print,Embase, and the Cochrane library databases. Outcomes examined included reduction in seizurefrequency, seizure freedom, ASM load, discontinuations, and serious adverse events (SAEs).Comparators included best medical practice, ASMs, low-stimulation or sham VNS Therapy.Four RCTs and six comparative observational studies were identified for inclusion. Against comparators,individuals treated with VNS had a significantly better odds of experiencing a ≥50% reduction in seizurefrequency (OR: 2.27 [95% CI: 1.47, 3.51]; p=0.0002), a ≥75% reduction in seizure frequency (OR: 3.56[95% CI: 1.59, 7.98]; p=0.002) and a reduced risk for increased ASM load (risk ratio: 0.36 [95% CI: 0.21,0.62]; p=0.0002). There was no difference in the odds of discontinuation or the rate of SAEs betweenVNS versus comparators.This meta-analysis demonstrated the benefits of VNS Therapy in people with DRE, which includedimprovement in seizure frequency without an increase in the rate of SAEs or discontinuations, therebysupporting the consideration of VNS Therapy for people who are not responding to ASMs and thoseunsuitable or unwilling to undergo surgery.

scholarly journals P102 Reporting of innovations in surgery: a systematic review of robotic liver resections

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Sarah Biggs ◽  
Keng Siang Lee ◽  
Max Shah ◽  
Tom Brankin-Frisby ◽  
Tjun Wei Leow ◽  
...  
Keyword(s):  
Systematic Review ◽  
Descriptive Analysis ◽  
Cochrane Library ◽  
Research Reporting ◽  
Liver Resections ◽  
Surgical Access ◽  
Ovid Medline ◽  
Study Characteristics ◽  
The Cochrane Library ◽  
The Ideal

Abstract Introduction Liver resections are most commonly performed for either primary or secondary cancers. Consensus guidelines recommend that minor liver resections should be attempted laparoscopically, however this technique has limitations. These include difficulties with surgical access, ergonomics and visualization. Consequently, there has been increasing interest in innovative solutions such as robotic surgery. The IDEAL Collaboration has provided guidance for the reporting of surgical innovations, but it is not known how robotic liver resections have been reported. The aim of this study is to summarize technique descriptions and governance procedures, and understand which clinical outcomes have been reported. Methods A systematic review is being conducted in accordance with the PRISMA guideline. A search of Embase, Ovid Medline, the Cochrane Library and Web of Science was performed, using search concepts of “robotic” and “liver resection”. Articles will be screened to select primary research reporting outcomes of robotic liver resections. Data will be extracted on the reporting of study characteristics, governance and ethical arrangements, mitigations of harm, techniques and modifications, and outcomes. A descriptive summary of the data will be produced. The results will be critiqued in relation to guidance from the IDEAL Collaboration. Results The search returned 3063 articles, with 2385 remaining after de-duplication. An interim descriptive analysis of the data will be presented, summarizing how robotic liver resections have been reported. A critique of the available results in the context of IDEAL guidance will be provided. Conclusion This systematic review will describe how robotic liver resections have been reported as surgical innovations.

scholarly journals P106 Robotic Roux-en-Y gastric bypass: A systematic review to examine reporting of a surgical innovation

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
H Robertson ◽  
M Huttman ◽  
L Dixon ◽  
R Macefield ◽  
S Hossaini ◽  
...  
Keyword(s):  
Systematic Review ◽  
Gastric Bypass ◽  
Clinical Practice ◽  
Cochrane Library ◽  
Surgical Innovation ◽  
Ovid Medline ◽  
Study Characteristics ◽  
Patients At Risk ◽  
The Cochrane Library ◽  
The Ideal

Abstract Introduction Roux-en-Y gastric bypass (RYGB) is one of the most commonly performed bariatric procedures, and robotic methods are increasingly used. Perceived benefits of robotic surgery include improved visualisation and ergonomics, fewer complications, and shorter hospital stay. Rigorous processes that facilitate the safe transition of surgical innovations such as robotic RYGB into clinical practice are currently lacking. This may place patients at risk, and lead to research waste. The IDEAL Collaboration has produced guidance on the reporting of surgical innovations, but it is not known how robotic RYGB has been reported. This project aims to summarise technique description, governance arrangements and outcome reporting in robotic RYGB. Methods A systematic review is being conducted, using PRISMA guidance. A search of Embase, Ovid Medline, the Cochrane Library and Web of Science was performed to identify primary studies reporting outcomes of robotic RYGB. Data will be extracted on study characteristics, governance and ethical arrangements, descriptions of technique, and outcomes. The data will be evaluated in relation to IDEAL principles. Results The literature search yielded 1012 studies; 754 remained after de-duplication. Following screening by abstract, 229 full texts were screened. 67 studies will undergo extraction of data. A descriptive summary of the data will be presented, with a critique of the findings. Conclusion This study will summarise and appraise how robotic RYGB has been reported. This will contribute towards the development of a standardised and methodical process for the introduction of surgical innovation into clinical practice.

scholarly journals Efficacy and Safety of VNS Therapy or Continued Medication Management for Treatment of Adults with Drug-Resistant Epilepsy: Systematic Review and Meta-Analysis

2022 ◽  
Author(s):  
Joan Conry ◽  
Sarah Batson ◽  
Stephen Mitchell ◽  
Rohit Shankar ◽  
Jane Boggs ◽  
...  
Keyword(s):  
Systematic Review ◽  
Seizure Frequency ◽  
Meta Analysis ◽  
Medication Management ◽  
Cochrane Library ◽  
Seizure Freedom ◽  
Serious Adverse Events ◽  
Drug Resistant Epilepsy ◽  
The Cochrane Library ◽  
Load Risk

Abstract Vagus nerve stimulation (VNS) Therapy® is an adjunctive neurostimulation treatment for people withdrug-resistant epilepsy (DRE) who are unwilling to undergo resective surgery, have had unsuccessfulsurgery or are unsuitable for surgery. A systematic review and meta-analysis were conducted todetermine the treatment effects of VNS Therapy as an adjunct to anti-seizure medications (ASMs) forthe management of adults with DRE.A literature search was performed in August 2020 of the Medline®, Medline® Epub Ahead of Print,Embase, and the Cochrane library databases. Outcomes examined included reduction in seizurefrequency, seizure freedom, ASM load, discontinuations, and serious adverse events (SAEs).Comparators included best medical practice, ASMs, low-stimulation or sham VNS Therapy.Four RCTs and six comparative observational studies were identified for inclusion. Against comparators,individuals treated with VNS had a significantly better odds of experiencing a ≥50% reduction in seizurefrequency (OR: 2.27 [95% CI: 1.47, 3.51]; p=0.0002), a ≥75% reduction in seizure frequency (OR: 3.56[95% CI: 1.59, 7.98]; p=0.002) and a reduced risk for increased ASM load (risk ratio: 0.36 [95% CI: 0.21,0.62]; p=0.0002). There was no difference in the odds of discontinuation or the rate of SAEs betweenVNS versus comparators.This meta-analysis demonstrated the benefits of VNS Therapy in people with DRE, which includedimprovement in seizure frequency without an increase in the rate of SAEs or discontinuations, therebysupporting the consideration of VNS Therapy for people who are not responding to ASMs and thoseunsuitable or unwilling to undergo surgery.

Characteristics of the Frequency-Following Response to Speech in Neonates and Potential Applicability in Clinical Practice: A Systematic Review

2020 ◽  
Vol 63 (5) ◽  
pp. 1618-1635
Author(s):  
Céline Richard ◽  
Mary Lauren Neel ◽  
Arnaud Jeanvoine ◽  
Sharon Mc Connell ◽  
Alison Gehred ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cochrane Library ◽  
Neurodevelopmental Outcomes ◽  
Frequency Following Response ◽  
Ovid Medline ◽  
Published Evidence ◽  
Mesh Terms ◽  
Potential Applicability ◽  
Clinical Potential

Purpose We sought to critically analyze and evaluate published evidence regarding feasibility and clinical potential for predicting neurodevelopmental outcomes of the frequency-following responses (FFRs) to speech recordings in neonates (birth to 28 days). Method A systematic search of MeSH terms in the Cumulative Index to Nursing and Allied HealthLiterature, Embase, Google Scholar, Ovid Medline (R) and E-Pub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Web of Science, SCOPUS, COCHRANE Library, and ClinicalTrials.gov was performed. Manual review of all items identified in the search was performed by two independent reviewers. Articles were evaluated based on the level of methodological quality and evidence according to the RTI item bank. Results Seven articles met inclusion criteria. None of the included studies reported neurodevelopmental outcomes past 3 months of age. Quality of the evidence ranged from moderate to high. Protocol variations were frequent. Conclusions Based on this systematic review, the FFR to speech can capture both temporal and spectral acoustic features in neonates. It can accurately be recorded in a fast and easy manner at the infant's bedside. However, at this time, further studies are needed to identify and validate which FFR features could be incorporated as an addition to standard evaluation of infant sound processing evaluation in subcortico-cortical networks. This review identifies the need for further research focused on identifying specific features of the neonatal FFRs, those with predictive value for early childhood outcomes to help guide targeted early speech and hearing interventions.

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