EXPRESS: A meta-analysis of aspirin and subarachnoid haemorrhage in patients with intracranial aneurysms yields different results to the general population

2021 ◽  
pp. 174749302110048
Author(s):  
Frederick Ewbank ◽  
Jacqueline Birks ◽  
Diederik Bulters
Keyword(s):  
General Population ◽  
Subarachnoid Haemorrhage ◽  
Confidence Intervals ◽  
Random Effects ◽  
Intracranial Aneurysms ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Random Effects Models ◽  
Hazard Ratios ◽  
Unruptured Intracranial Aneurysms

Abstract Background Some studies have shown a protective association between aspirin use and subarachnoid haemorrhage (SAH). Other studies have found no relationship or the reverse. These studies differ in their study populations and definitions of SAH. Aims Our aim was to establish 1) if there is an association between aspirin and SAH, 2) how this differs between the general population and those with intracranial aneurysms. Summary of review Studies reporting aspirin use and the occurrence of SAH were included and grouped based on population (general population vs aneurysm population). Odds ratios, hazard ratios and confidence intervals were combined in random-effects models. 11 studies were included. Overall, there was an association between aspirin and SAH (OR 0.68 [0.48, 0.96]). However, populations were diverse and heterogeneity between studies high (p<0.00001), questioning the validity of combining these studies and justifying analysis by population. In the general population there was no difference in aspirin use between individuals with and without SAH (OR 1.15 [0.96, 1.38]). In patients with intracranial aneurysms, aspirin use was greater in patients without SAH (OR 0.37 [0.24, 0.58]), although these studies were at higher risk of bias. Conclusions There is an association between aspirin use and SAH in patients with intracranial aneurysms. This apparent protective relationship is not seen in the general population. Prospective randomised studies are required to further investigate the effect of aspirin on unruptured intracranial aneurysms.

scholarly journals Association of bisphenol A with puberty timing: a meta-analysis

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Hui Meng ◽  
Yunping Zhou ◽  
Yunxia Jiang
Keyword(s):  
Bisphenol A ◽  
Confidence Intervals ◽  
Random Effects ◽  
Strong Correlation ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Random Effects Models ◽  
Study Heterogeneity ◽  
The Relationship ◽  
Prevalence Ratios

AbstractObjectivesThe results of existing studies on bisphenol A (BPA) and puberty timing did not reach a consensus. Thereby we performed this meta-analytic study to explore the association between BPA exposure in urine and puberty timing.MethodsMeta-analysis of the pooled odds ratios (OR), prevalence ratios (PR) or hazards ratios (HR) with 95% confidence intervals (CI) were calculated and estimated using fixed-effects or random-effects models based on between-study heterogeneity.ResultsA total of 10 studies involving 5621 subjects were finally included. The meta-analysis showed that BPA exposure was weakly associated with thelarche (PR: 0.96, 95% CI: 0.93–0.99), while no association was found between BPA exposure and menarche (HR: 0.99, 95% CI: 0.89–1.12; OR: 1.02, 95% CI: 0.73–1.43), and pubarche (OR: 1.00, 95% CI: 0.79–1.26; PR: 1.00, 95% CI: 0.95–1.05).ConclusionsThere was no strong correlation between BPA exposure and puberty timing. Further studies with large sample sizes are needed to verify the relationship between BPA and puberty timing.

scholarly journals Prognostic Significance of MicroRNAs in Glioma: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-14 ◽  
Author(s):  
Yanming Zhang ◽  
Jigang Chen ◽  
Qiang Xue ◽  
Junyu Wang ◽  
Liang Zhao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Confidence Intervals ◽  
Random Effects ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Cochrane Library ◽  
Clinical Settings ◽  
Random Effects Model ◽  
Hazard Ratios ◽  
The Relationship

Purpose. Different microRNAs (miRs) have been demonstrated to relate with the outcome of glioma patients, while the conclusions are inconsistent. We perform a meta-analysis to clarify the relationship between different miRs and prognosis of glioma.Methods. Related studies were retrieved from PubMed, Embase, and Cochrane Library. Pooled hazard ratios (HRs) of different miRs expression for survival and 95% confidence intervals (CIs) were calculated using random-effects model.Results. A total of 15 miRs with 4708 glioma patients were ultimately included. Increased expression of miR-15b (HR, 1.584; 95% CI, 1.199-2.092), 21 (HR, 1.591; 95% CI, 1.278-1.981), 148a (HR, 1.122; 95% CI, 1.023-1.231), 196 (HR, 1.877; 95% CI, 1.033-3.411), 210 (HR, 1.251; 95% CI, 1.010-1.550), and 221 (HR, 1.269; 95% CI, 1.054-1.527) or decreased expression of miR-106a (HR, 0.809; 95% CI, 0.655-0.998) and 124 (HR, 0.833; 95% CI, 0.729-0.952) was correlated with poor outcome of glioma patients.Conclusions. miR-15b, 21, 148a, 196, 210, 221, 106a, and 124 are valuable biomarkers for the prognosis of glioma which might be used in clinical settings.

scholarly journals Dyslipidaemia and mortality in COVID-19 patients - a meta-analysis

QJM ◽  
2021 ◽  
Author(s):  
Marco Zuin ◽  
Gianluca Rigatelli ◽  
Claudio Bilato ◽  
Carlo Cervellati ◽  
Giovanni Zuliani ◽  
...  
Keyword(s):  
Random Effects ◽  
Mortality Risk ◽  
Meta Analysis ◽  
Random Effect ◽  
Final Analysis ◽  
Short Term ◽  
Random Effects Models ◽  
Pooled Prevalence ◽  
Statistical Heterogeneity ◽  
Trim And Fill

Abstract Objective The prevalence and prognostic implications of pre-existing dyslipidaemia in patients infected by the SARS-CoV-2 remain unclear. To perform a systematic review and meta-analysis of prevalence and mortality risk in COVID-19 patients with pre-existing dyslipidaemia. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed in abstracting data and assessing validity. We searched MEDLINE and Scopus to locate all the articles published up to January 31, 2021, reporting data on dyslipidaemia among COVID-19 survivors and non-survivors. The pooled prevalence of dyslipidaemia was calculated using a random effects model and presenting the related 95% confidence interval (CI), while the mortality risk was estimated using the Mantel-Haenszel random effects models with odds ratio (OR) and related 95% CI. Statistical heterogeneity was measured using the Higgins I2 statistic. Results Eighteen studies, enrolling 74.132 COVID-19 patients [mean age 70.6 years], met the inclusion criteria and were included in the final analysis. The pooled prevalence of dyslipidaemia was 17.5% of cases (95% CI: 12.3-24.3%, p &lt; 0.0001), with high heterogeneity (I2=98.7%). Pre-existing dyslipidaemia was significantly associated with higher risk of short-term death (OR: 1.69, 95% CI: 1.19-2.41, p = 0.003), with high heterogeneity (I2=88.7%). Due to publication bias, according to the Trim-and-Fill method, the corrected random-effect ORs resulted 1.61, 95% CI 1.13-2.28, p &lt; 0.0001 (one studies trimmed). Conclusions Dyslipidaemia represents a major comorbidity in about 18% of COVID-19 patients but it is associated with a 60% increase of short-term mortality risk.

scholarly journals To which extent are per-and poly-fluorinated substances associated to metabolic syndrome?

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Maryam Zare Jeddi ◽  
Rozita Soltanmohammadi ◽  
Giulia Barbieri ◽  
Aline S. C. Fabricio ◽  
Gisella Pitter ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
General Population ◽  
Meta Analysis ◽  
Small Body ◽  
Epidemiological Studies ◽  
Cross Sectional ◽  
Random Effects Models ◽  
Epidemiologic Evidence ◽  
Adults And Children ◽  
Meta Analyses

Abstract Exposure to per- and polyfluoroalkyl substances (PFAS), ubiquitous persistent environmental contaminants, has led to substantial global concern due to their potential environmental and human health effects. Several epidemiological studies have assessed the possible association between PFAS exposure and risk of metabolic syndrome (MetS), however, the results are ambiguous. The aim of this study was to assess the current human epidemiologic evidence on the association between exposure to PFAS and MetS. We performed a systematic search strategy using three electronic databases (PubMed, Scopus, and Web of Science) for relevant studies concerning the associations of PFAS with MetS and its clinical relevance from inception until January 2021. We undertook meta-analyses where there were five or more studies with exposure and outcomes assessments that were reasonably comparable. The pooled odd ratios (ORs) were calculated using random effects models and heterogeneity among studies was assessed by I2 index and Q test. A total of 12 cross-sectional studies (10 studies on the general population and two studies in the occupational settings) investigated the association between PFAS exposure and MetS. We pooled data from seven studies on the general population for perfluorooctanoic acid (PFOA) and perfluorooctanesulfonate (PFOS) and five studies for perfluorohexanesulfonate (PFHxS) and perfluorononanoic acid (PFNA). Predominately, most studies reported no statistically significant association between concentrations of PFAS and MetS. In the meta-analysis, the overall measure of effect was not statistically significant, showing no evidence of an association between concentrations of PFOA, PFOS, PFNA, and PFHxS and the risk of MetS. Based on the results of the meta-analysis, current small body of evidence does not support association between PFAS and MetS. However, due to limited number of studies and substantial heterogeneity, results should be interpreted with caution. Further scrutinizing cohort studies are needed to evaluate the association between various and less well-known PFAS substances and their mixture with MetS and its components in both adults and children in different settings.

scholarly journals Daily sodium consumption and CVD mortality in the general population: systematic review and meta-analysis of prospective studies

2014 ◽  
Vol 18 (4) ◽  
pp. 695-704 ◽  
Author(s):  
Rosana Poggio ◽  
Laura Gutierrez ◽  
María G Matta ◽  
Natalia Elorriaga ◽  
Vilma Irazola ◽  
...  
Keyword(s):  
Systematic Review ◽  
Relative Risk ◽  
General Population ◽  
Prospective Studies ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Random Effects Models ◽  
Meta Regression ◽  
Cvd Mortality

AbstractObjectiveThe purpose of the present study was to determine whether elevated dietary Na intake could be associated with CVD mortality.DesignWe performed a systematic review and meta-analysis of prospective studies representing the general population. The adjusted relative risks and their 95 % confidence intervals were pooled by the inverse variance method using random-effects models. Heterogeneity, publication bias, subgroup and meta-regression analyses were performed.SettingsMEDLINE (since 1973), Embase (since 1975), the Cochrane Library (since 1976), ISI Web of Science, Google Scholar (until September 2013) and secondary referencing were searched for inclusion in the study.SubjectEleven prospective studies with 229 785 participants and average follow-up period of 13·37 years (range 5·5–19 years).ResultsHigher Na intake was significantly associated with higher CVD mortality (relative risk=1·12; 95 % CI 1·06, 1·19). In the sensitivity analysis, the exclusion of studies with important relative weights did not significantly affect the results (relative risk=1·08; 95 % CI 1·01, 1·15). The meta-regression analysis showed that for every increase of 10 mmol/d in Na intake, CVD mortality increased significantly by 1 % (P=0·016). Age, hypertensive status and length of follow-up were also associated with increased CVD mortality.ConclusionsHigher Na intake was associated with higher CVD mortality in the general population; this result suggests a reduction in Na intake to prevent CVD mortality from any cause.

Tobacco, alcohol and illicit drugs during pregnancy and risk of neuroblastoma: systematic review

2017 ◽  
Vol 103 (5) ◽  
pp. F467-F473 ◽  
Author(s):  
Eloise Müller-Schulte ◽  
Gerhard Kurlemann ◽  
Anja Harder
Keyword(s):  
Illicit Drugs ◽  
Illicit Drug ◽  
Data Extraction ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Drug Consumption ◽  
Case Control Studies ◽  
Bias Analysis ◽  
Random Effects Models ◽  
Registration Number

ObjectiveTo determine whether prenatal and perinatal maternal consumption of alcohol, tobacco and/or illicit drugs is associated with risk of neuroblastoma.Data sourcesMedline and Embase (both from inception to February 2017), and reference lists of included studies.Study selectionTo be eligible, a study had to be an original report including data on intake of alcohol, tobacco smoking and/or consumption of illicit drugs during pregnancy and risk of neuroblastoma in the child.Data extractionFrom eligible studies, data study characteristics as well as effect measures and confounders were extracted. We assessed unadjusted and confounder-adjusted estimates, performed risk of bias analysis, constructed random-effects models and assessed heterogeneity.ResultsWe identified 14 case–control studies (1987–2016) involving a total of 3114 children with neuroblastoma. Meta-analysis of unadjusted estimates showed an association between alcohol (OR 1.26; 95% CI 1.07 to 1.49), tobacco (OR 1.22; 95% CI 1.04 to 1.44) and illicit drug consumption during pregnancy and risk of neuroblastoma during childhood, with illicit drug consumption showing the strongest association (OR 3.26; 95% CI 1.36 to 7.86). However, adjusted estimates were highly heterogeneous.LimitationsAll studies were at high risk of bias.ConclusionsSmoking, alcohol or illicit drugs during pregnancy might play a role in the development of neuroblastoma. However, well-designed studies are needed to assess whether these exposures are causal and whether time period during pregnancy, dose or co-consumption of substances is critical.Trial registration numberRegistration number CRD42016036165.

Abstract WP65: Low-Versus Standard-Dose Alteplase for AcuteIschemic Strokes Within 4.5 Hours: An updated Meta Analysis

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Huaguang Zheng ◽  
Xu Tong ◽  
Liping Liu ◽  
Zixiao Li ◽  
Xiaoling Liao ◽  
...  
Keyword(s):  
Cohort Studies ◽  
Random Effects ◽  
Standard Dose ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Tissue Type ◽  
Random Effects Models ◽  
Dose Treatment ◽  
Randomized Controlled ◽  
Type Plasminogen Activator

Background and Purpose: We performed a meta-analysis to compare the outcomes between lower dose and standard dose intravenous tissue-type plasminogen activator (tPA) for acute ischemic stroke in randomized and non- randomized controlled trials. Methods: We searched PubMed for relevant studies and calculated pooled odds ratios (ORs) using random effects models.The primary endpoint was good functional outcome[modified Rankin Scale (mRS) of 0-1] at 3 month after stroke onset. Other major end points were all-cause mortality and symptomatic intracerebral haemorrhage (sICH). Results: From 2010 to 2016, 7 Cohort studies and 1 randomized controlled trial (ENCHANTED trial) were pooled in meta-analysis. The lower tPA strategy was likely to be less effective than the standard dose treatment (OR=0.87; 95% confidence interval [CI], 0.73-1.04, P=0.136; I 2 =47.9%, P=0.044 in random effects models and OR=0.88; 95% CI 0.88-0.98,P=0.016 ;I 2 =0.0%, P=0.693 in non- random effects models after 2 cohort studies were excluded due to heterogeneity). No difference was found for mortality at 90 days (OR=0.87; 95% CI 0.74-1.03, P=0.102 ;I 2 =0.0%, P=0.635 in non-random effects models)and sICH (OR=1.12; 95% CI 0.68-1.83,P=0.659; I 2 =57.6%, P=0.016 in random effects models and OR=1.23; 95% CI 0.92-1.65, P=0.168; I 2 =0.0%, P=0.547 in non-random effects models after 2 cohort studies were excluded due to heterogeneity ) between lower tPA group and standard dose . Conclusions: The low-dose alteplase strategy was less effective comparable to the standard-dose treatment .The safety was similar between the two strategies.

Statistical methods for detecting outlying and influential studies in meta-analysis of diagnostic test accuracy studies

2019 ◽  
Vol 29 (4) ◽  
pp. 1227-1242 ◽  
Author(s):  
Zelalem F Negeri ◽  
Joseph Beyene
Keyword(s):  
Diagnostic Test ◽  
Random Effects ◽  
Ad Hoc ◽  
Meta Analysis ◽  
Analysis Data ◽  
Diagnostic Test Accuracy ◽  
Statistical Reasoning ◽  
Test Accuracy ◽  
Analysis Tool ◽  
Random Effects Models

Bivariate random-effects models are currently widely used to synthesize pairs of test sensitivity and specificity across studies. Inferences drawn based on these models may be distorted in the presence of outlying or influential studies. Currently, subjective methods such as inspection of forest plots are used to identify outlying studies in meta-analysis of diagnostic test accuracy studies. We proposed objective methods based on solid statistical reasoning for identifying outlying and/or influential studies. The proposed methods have been validated using simulation study and illustrated on two published meta-analysis data. Our methods outperform and neglect the subjectivity of the currently used ad hoc methods. The proposed methods can be used as a sensitivity analysis tool concurrently with the current bivariate random-effects models or as a preliminary analysis tool for robust models that accommodate outlying and/or influential studies in meta-analysis of diagnostic test accuracy studies.

scholarly journals P.114 Headache outcomes after treatment of unruptured intracranial aneurysms: systematic review and meta-analysis

2019 ◽  
Vol 46 (s1) ◽  
pp. S43-S44
Author(s):  
C Dandurand ◽  
H Parhar ◽  
F Naji ◽  
S Prakash ◽  
PA Gooderham
Keyword(s):  
Systematic Review ◽  
Intracranial Aneurysm ◽  
Intracranial Aneurysms ◽  
Rating Scale ◽  
Meta Analysis ◽  
Effect Estimate ◽  
Significant Heterogeneity ◽  
Unruptured Intracranial Aneurysm ◽  
Standard Mean Difference ◽  
Unruptured Intracranial Aneurysms

Background: Headaches are a major cause of disability and healthcare cost worldwide. When investigating headaches etiology, incidental unruptured intracranial aneurysms are often considered unrelated. We conducted a systematic review and meta-analysis to assess headaches outcomes (severity) after treatment of unruptured intracranial aneurysm. Methods: MEDLINE and EMBASE were systematically reviewed. Results: The data from eligible studies (n=7) was extracted and analyzed. 309 nonduplicated patients provided patient-level data for analysis. All studies used the 10-point numeric rating scale (NRS). 88% of patients were treated with endovascular technique. Overall, the observed effect estimate under a random effects model was found to be a standard mean difference in pre- and post-intervention headache severity of -0.448 (95% CI: -0.566 to -0.329). No significant heterogeneity was noted. No significant publication bias was demonstrated. Conclusions: This is the first and largest systematic review assessing postoperative headache outcomes after treatment of unruptured intracranial aneurysm. A significant reduction in headache intensity after treatment is observed in the current published literature. This study highlights an interesting clinical phenomenon that still warrants scientific effort before it can influence clinical practice. We encourage future study to stratify headache outcomes by aneurysm size, location and treatment modality.

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