scholarly journals Use of mobile health technologies for postoperative care in paediatric surgery: A systematic review

2020 ◽  
pp. 1357633X2093468
Author(s):  
Nam Nguyen ◽  
Etienne Leveille ◽  
Elena Guadagno ◽  
Luc Malemo Kalisya ◽  
Dan Poenaru
Keyword(s):  
Systematic Review ◽  
Mobile Health ◽  
Postoperative Care ◽  
Data Extraction ◽  
Intervention Group ◽  
Paediatric Surgery ◽  
High Quality Research ◽  
Health Technologies ◽  
Surgery Patient ◽  
Wide Range

Introduction Mobile health (mHealth) is the use of mobile communication devices such as smartphones, wireless patient monitoring devices and tablet computers to deliver health services. Paediatric surgery patient care could potentially benefit from these technologies. This systematic review summarises the current literature on the use of mHealth for postoperative care after children’s surgery. Methods Seven databases were searched by a senior medical librarian. Studies were included if they reported the use of mHealth systems for postoperative care for children  <18 years old. Data extraction and risk of bias assessment were performed in duplicate. Results A total of 18 studies were included after screening. mHealth use was varied and included appointment or medication reminders, postoperative monitoring and postoperative instruction delivery. mHealth systems included texting systems and mobile applications, and were implemented for a wide range of surgical conditions and countries. Discussion Studies showed that mHealth systems can increase the postoperative follow-up appointment attendance rate ( p < 0.001), decrease the rate of postoperative complications and returns to the emergency department and reliably monitor postoperative pain. mHealth systems were generally appreciated by patients. Most non-randomised and randomised studies had many methodological problems, including lack of appropriate control groups, lack of blinding and a tendency to devote more time to the care of the intervention group. mHealth systems have the potential to improve postoperative care, but the lack of high-quality research evaluating their impact calls for further studies exploring evidence-based mHealth implementation.

Systematic review of interventions to improve gender equity in graduate medicine

2021 ◽  
pp. postgradmedj-2020-138864
Author(s):  
Sinéad Lydon ◽  
Emily O'Dowd ◽  
Chloe Walsh ◽  
Angela O'Dea ◽  
Dara Byrne ◽  
...  
Keyword(s):  
Systematic Review ◽  
Gender Equity ◽  
English Language ◽  
Clinical Medicine ◽  
Data Extraction ◽  
Self Report ◽  
Clinical Settings ◽  
Reference List ◽  
High Quality Research ◽  
Work Settings

Women are substantially underrepresented in senior and leadership positions in medicine and experience gendered challenges in their work settings. This systematic review aimed to synthesise research that has evaluated interventions for improving gender equity in medicine. English language electronic searches were conducted across MEDLINE, CINAHL, Academic Search Complete, PsycINFO and Web of Science. Reference list screening was also undertaken. Peer-reviewed studies published between 2000 and March 2020 that evaluated interventions to improve gender equity, or the experiences of women, in academic or clinical medicine were reviewed. Dual reviewer data extraction on setting, participants, type of intervention, measurement and outcomes was completed. Methodological rigour and strength of findings were evaluated. In total, 34 studies were included. Interventions were typically focused on equipping the woman (82.4%), that is, delivering professional development activities for women. Fewer focused on changing cultures (20.6%), ensuring equal opportunities (23.5%) or increasing the visibility or valuing of women (23.5%). Outcomes were largely positive (87.3%) but measurement typically relied on subjective, self-report data (69.1%). Few interventions were implemented in clinical settings (17.6%). Weak methodological rigour and a low strength of findings was observed. There has been a focus to-date on interventions which Equip the Woman. Interventions addressing systems and culture change require further research consideration. However, institutions cannot wait on high quality research evidence to emerge to take action on gender equity. Data collated suggest a number of recommendations pertaining to research on, and the implementation of, interventions to improve gender equity in academic and clinical settings.

scholarly journals Zinc supplementation combined with antidepressant drugs for treatment of patients with depression: a systematic review and meta-analysis

2020 ◽  
Vol 79 (1) ◽  
pp. 1-12
Author(s):  
Laís Eloy Machado da Silva ◽  
Mônica Leila Portela de Santana ◽  
Priscila Ribas de Farias Costa ◽  
Emile Miranda Pereira ◽  
Carina Márcia Magalhães Nepomuceno ◽  
...  
Keyword(s):  
Systematic Review ◽  
Placebo Group ◽  
Depressive Symptoms ◽  
Zinc Supplementation ◽  
Data Extraction ◽  
Meta Analysis ◽  
Intervention Group ◽  
Antidepressant Drugs ◽  
Language Restriction ◽  
Registration Number

Abstract Context Zinc is an essential trace mineral required for the function of brain and neural structures. The role of zinc supplementation in the prevention and treatment of depression has been suggested in clinical studies that reported a reduction in depressive symptoms. Objective The aim of this review was to determine whether zinc supplementation vs placebo can prevent or improve depressive symptoms in children, adolescents, or adults. Data Sources Five electronic databases were searched, and studies published until September 2019 were included without language restriction. Study Selection Randomized, controlled, crossover trials that evaluated the effect of zinc supplementation vs a comparator for prevention or improvement of depressive symptoms in children, adolescents, or adults were eligible for inclusion. Data Extraction Two authors independently performed data extraction and risk-of-bias assessment. Results The initial search identified 12 322 studies, 5 of which were eligible for meta-analysis. The standardized mean difference (SMD) showed an average reduction of 0.36 point (95%CI, −0.67 to −0.04) in the intervention group compared with the placebo group. Forstudies in which the mean age of participants was ≥ 40 years, the SMD was reduced by 0.61 point (95%CI, −1.12 to −0.09) in the intervention group vs the placebo group. The meta-analysis by sample size (&lt; 60 individuals and  ≥ 60 individuals) did not show an effect of zinc supplementation in reducing depressive symptoms (SMD −0.28; 95%CI, −0.67 to −0.10; and SMD −0.52; 95%CI, −1.10 to 0.06). Conclusion Zinc supplementation may reduce depressive symptoms in individuals treated with antidepressant drugs for clinical depression. Systematic Review Registration PROSPERO registration number CRD42018081691.

scholarly journals Usability of Mobile Health Apps for Postoperative Care: Systematic Review

10.2196/19099 ◽  
2020 ◽  
Vol 3 (2) ◽  
pp. e19099
Author(s):  
Ben Patel ◽  
Arron Thind
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Mobile Health ◽  
Conflicts Of Interest ◽  
Data Extraction ◽  
Measurement Tool ◽  
Validated Questionnaire ◽  
System Usability Scale ◽  
Meta Analyses ◽  
Mhealth Apps

Background Mobile health (mHealth) apps are increasingly used postoperatively to monitor, educate, and rehabilitate. The usability of mHealth apps is critical to their implementation. Objective This systematic review evaluates the (1) methodology of usability analyses, (2) domains of usability being assessed, and (3) results of usability analyses. Methods The A Measurement Tool to Assess Systematic Reviews checklist was consulted. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline was adhered to. Screening was undertaken by 2 independent reviewers. All included studies were assessed for risk of bias. Domains of usability were compared with the gold-standard mHealth App Usability Questionnaire (MAUQ). Results A total of 33 of 720 identified studies were included for data extraction. Of the 5 included randomized controlled trials (RCTs), usability was never the primary end point. Methodology of usability analyses included interview (10/33), self-created questionnaire (18/33), and validated questionnaire (9/33). Of the 3 domains of usability proposed in the MAUQ, satisfaction was assessed in 28 of the 33 studies, system information arrangement was assessed in 11 of the 33 studies, and usefulness was assessed in 18 of the 33 studies. Usability of mHealth apps was above industry average, with median System Usability Scale scores ranging from 76 to 95 out of 100. Conclusions Current analyses of mHealth app usability are substandard. RCTs are rare, and validated questionnaires are infrequently consulted. Of the 3 domains of usability, only satisfaction is regularly assessed. There is significant bias throughout the literature, particularly with regards to conflicts of interest. Future studies should adhere to the MAUQ to assess usability and improve the utility of mHealth apps.

scholarly journals Educational Initiatives and Implementation of Electroencephalography into the Acute Care Environment: a protocol of a Systematic Review

2020 ◽  
Author(s):  
Shaurya Taran ◽  
Wael Ahmed ◽  
Esther Bui ◽  
Lara Prisco ◽  
Cecil Hahn ◽  
...  
Keyword(s):  
Systematic Review ◽  
Acute Care ◽  
Training Programs ◽  
Data Extraction ◽  
Meta Analysis ◽  
Case Series ◽  
Primary Objective ◽  
Eeg Abnormalities ◽  
Wide Range ◽  
Structure Patterns

Abstract Background: Use of electroencephalography (EEG) is currently recommended by the American Clinical Neurophysiology Society for a wide range of indications, including diagnosis of nonconvulsive status epilepticus and evaluation of unexplained disorders of consciousness. Data interpretation usually occurs by expert personnel (e.g. epileptologists, neurophysiologists), with information relayed to the primary care team. However, data cannot always be read in time-sensitive fashion, leading to potential delays in EEG interpretation and patient management. Multiple training programs have recently been described to enable non-experts to rapidly interpret EEG at the bedside. A comprehensive review of these training programs, including the tools used, outcomes obtained, and potential pitfalls, is currently lacking. Therefore, the optimum training program and implementation strategy remain unknown. Methods: We will conduct a systematic review of descriptive studies, case series, cohort studies and randomized controlled trials assessing training programs for EEG interpretation by non-experts. Our primary objective is to comprehensively review educational programs in this domain and report their structure, patterns of implementation, limitations, and trainee feedback. Our secondary objective will be to compare the performance of non-experts for EEG interpretation with a gold standard (e.g. interpretation by a certified electroencephalographers). Studies will be limited to those performed in acute care settings in both adult and paediatric populations (intensive care unit, emergency department, or post-anesthesia care units). Comprehensive search strategies will be developed for MEDLINE, EMBASE, WoS, CINAHL, and CENTRAL to identify studies for review. The gray literature will be scanned for further eligible studies. Two reviewers will independently screen the search results to identify studies for inclusion. A standardized data extraction form will be used to collect important data from each study. If possible, we will attempt to meta-analyse the quantitative data. If heterogeneity between studies is too high, we will present meaningful quantitative comparisons of secondary outcomes as per the synthesis without meta-analysis (SWiM) reporting guidelines. Discussion: We will aim to summarize the current literature in this domain to understand the structure, patterns, and pitfalls of EEG training programs for non-experts. This review is undertaken with a view to inform future education designs, potentially enabling rapid detection of EEG abnormalities and timely intervention by the treating physician. PROSPERO registration: Submitted and undergoing review (URL currently unavailable).

scholarly journals Usability of Mobile Health Apps for Postoperative Care: Systematic Review (Preprint)

2020 ◽  
Author(s):  
Ben Patel ◽  
Arron Thind
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Mobile Health ◽  
Conflicts Of Interest ◽  
Data Extraction ◽  
Measurement Tool ◽  
Validated Questionnaire ◽  
System Usability Scale ◽  
Meta Analyses ◽  
Mhealth Apps

BACKGROUND Mobile health (mHealth) apps are increasingly used postoperatively to monitor, educate, and rehabilitate. The usability of mHealth apps is critical to their implementation. OBJECTIVE This systematic review evaluates the (1) methodology of usability analyses, (2) domains of usability being assessed, and (3) results of usability analyses. METHODS The A Measurement Tool to Assess Systematic Reviews checklist was consulted. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline was adhered to. Screening was undertaken by 2 independent reviewers. All included studies were assessed for risk of bias. Domains of usability were compared with the gold-standard mHealth App Usability Questionnaire (MAUQ). RESULTS A total of 33 of 720 identified studies were included for data extraction. Of the 5 included randomized controlled trials (RCTs), usability was never the primary end point. Methodology of usability analyses included interview (10/33), self-created questionnaire (18/33), and validated questionnaire (9/33). Of the 3 domains of usability proposed in the MAUQ, satisfaction was assessed in 28 of the 33 studies, system information arrangement was assessed in 11 of the 33 studies, and usefulness was assessed in 18 of the 33 studies. Usability of mHealth apps was above industry average, with median System Usability Scale scores ranging from 76 to 95 out of 100. CONCLUSIONS Current analyses of mHealth app usability are substandard. RCTs are rare, and validated questionnaires are infrequently consulted. Of the 3 domains of usability, only satisfaction is regularly assessed. There is significant bias throughout the literature, particularly with regards to conflicts of interest. Future studies should adhere to the MAUQ to assess usability and improve the utility of mHealth apps.

scholarly journals The “Epulis” Dilemma. Considerations from Provisional to Final Diagnosis. A Systematic Review

Oral ◽  
2021 ◽  
Vol 1 (3) ◽  
pp. 224-235
Author(s):  
Paola Costa ◽  
Matteo Peditto ◽  
Antonia Marcianò ◽  
Antonio Barresi ◽  
Giacomo Oteri
Keyword(s):  
Systematic Review ◽  
Microscopic Examination ◽  
Wide Spectrum ◽  
Data Extraction ◽  
Final Diagnosis ◽  
Electronic Search ◽  
Wide Range ◽  
Gingival Enlargement ◽  
Neoplastic Lesions ◽  
Slow Growing

“Epulis” is a widely used term to describe a localized gingival enlargement. However, a wide range of neoformations might present as localized, slow-growing, asymptomatic gingival masses. A systematic review was conducted to outline the pathological entities that were provisionally dignosed as “epulis” and whose final diagnosis was made after microscopic examination. An electronic search of PubMed, Google Scholar and Scopus databases from January 2000 to February 2021 was performed. An initial search of the databases identified a total of 864 documents, and after a careful process of screening and selection, 14 studies were included in this systematic review and processed for data extraction. The results show that histological examination, sometimes combined with immunohistochemistry, might reveal a wide spectrum of lesions, including hamartomatous lesions, non-neoplastic lesions, benign and malign neoplasms and metastases from distant cancers.

Associations between Behaviour Change Techniques and engagement with mobile health apps: Systematic review protocol (Preprint)

2021 ◽  
Author(s):  
Madison Milne-Ives ◽  
Sophie Homer ◽  
Jackie Andrade ◽  
Edward Meinert
Keyword(s):  
Systematic Review ◽  
Behaviour Change ◽  
Mobile Health ◽  
Data Extraction ◽  
Behaviour Change Techniques ◽  
Systematic Review Protocol ◽  
Health Apps ◽  
Health Behaviour Change ◽  
Mobile Health Apps ◽  
Review Protocol

BACKGROUND The use of digitally-enabled care and the emphasis on self-management of health is growing. Mobile health apps provide a promising means of supporting health behaviour change; however, engagement with them is often poor and evidence of their impact on health outcomes is lacking. As engagement is a key prerequisite to health behaviour change, it is essential to understand how engagement with mobile health apps and their target health behaviours can be better supported. Despite an increasing recognition of the importance of engagement in the literature, there is still a lack of understanding of how different components of engagement are associated with specific techniques that aim to change behaviours. OBJECTIVE The purpose of this systematic review protocol is to provide a synthesis of the associations between various Behaviour Change Techniques (BCTs)and the different components of engagement (and their outcome measures) with mobile health apps. METHODS The review protocol was structured using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) and the Population, Intervention, Comparator, and Outcome (PICO) frameworks. Six databases will be systematically searched: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), APA PsycInfo, ScienceDirect, and Web of Science. Title and abstract screening, full-text review, and data extraction will be conducted by two independent reviewers. Data will be extracted into a predetermined form, and any disagreements in screening or data extraction will be discussed, with a third reviewer consulted if consensus cannot be reached. Risk of bias will be assessed using the Cochrane Collaboration Risk of Bias 2 and ROBINS-I tools and descriptive and thematic analyses will be used to summarise the relationships between BCTs and the different components of engagement. RESULTS The systematic review has not been started. It is expected to be completed and submitted for publication by January 2022. CONCLUSIONS This systematic review will summarize the associations between different BCTs and various components and measures of engagement with mobile health apps. This will identify areas where further research is needed to examine BCTs that could potentially support effective engagement and help to inform the design and evaluation of future mobile health apps. CLINICALTRIAL PROSPERO (reference number TBD)

scholarly journals Characterising long-term covid-19: a rapid living systematic review

2020 ◽  
Author(s):  
Melina Michelen ◽  
Lakshmi Manoharan ◽  
Natalie Elkheir ◽  
Vincent Cheng ◽  
Drew Dagens ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Quality Assessment ◽  
Data Extraction ◽  
Evidence Base ◽  
Risk Of Bias ◽  
Research Database ◽  
Persistent Symptoms ◽  
Wide Range

Objective To understand the frequency, profile, and duration of persistent symptoms of covid-19 and to update this understanding as new evidence emerges. Design: A living systematic review produced in response to the rapidly evolving evidence base for long covid. Data sources Medline and CINAHL (EBSCO), Global Health (Ovid), WHO Global Research Database on covid-19, LitCOVID, and Google Scholar to 28th September 2020. Study selection Studies reporting long-term symptoms and complications among people with confirmed or suspected covid-19, both in those previously hospitalised and those never hospitalised. Only studies incorporating over 100 participants qualified for data extraction and were assessed for risk of bias. Results were analysed using descriptive statistics. Quality assessment Risk of bias was assessed using a quality assessment checklist for prevalence studies. Results Twenty-eight studies qualified for data extraction; 16 of these were cohort studies, ten cross-sectional, and two large case series. The analysis included 9,442 adults with covid-19 from 13 countries. The longest mean follow-up period was 111 (SD: 11) days post-hospital discharge. A wide range of systemic, cardiopulmonary, gastrointestinal, neurological, and psychosocial symptoms was reported, of which the most common were breathlessness, fatigue, smell and taste disturbance, and anxiety. Persistent symptoms were described across both previously hospitalised and non-hospitalised populations. The quality of evidence was low, with a high risk of bias and heterogeneity in prevalence. The incorporated studies demonstrated limited external validity, a lack of control subjects, and inconsistent data collection methods. Few studies were conducted in primary care, no studies focused solely on children, and no studies were set in low- and middle-income countries. Conclusion: Our findings suggest that long covid is a complex, heterogeneous condition; however, the limited evidence base currently precludes a precise definition of its symptoms and prevalence. There is a clear need for robust, controlled, prospective cohort studies, including different at-risk populations and settings, incorporating appropriate investigations, collected and recorded in a standardised way.

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