A meta-analysis of antibacterial envelope use in prevention of cardiovascular implantable electronic device infection

Objectives: Cardiac implantable electronic device (CIED) infection has been a major clinical problem in addition to being a major financial burden. In spite of antimicrobial prophylaxis, CIED infection rates have been increasing disproportionately. We therefore conducted this meta-analysis to assess the role of TYRX antibiotic envelope for the prevention of CIED infection. Methods: Using extensive online search, we conducted a meta-analysis of studies reporting CIED infections with versus without the use of TYRX antibiotic envelope. A random-effect model was used, and between studies heterogeneity was estimated with I2. All analyses were performed with RevMan (version 5.0.20). Results: Five cohort studies were included in this meta-analysis. The pooled odds ratio (OR) of included studies was 0.29 [95% confidence interval (CI): 0.09–0.94; p < 0.004]. There was evidence of heterogeneity with I2 of 58%. There was also evidence of publication bias on funnel plot analysis. On sensitivity analysis, no statistically significant difference was noted when stratified by study design or duration of follow-up. Conclusion: The results of our study demonstrate a significant beneficial effect of TYRX antibiotic envelope for the prevention of CIED infections.

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Prevalence of HTN in Iran: Meta-analysis of Published Studies in 2004-2018

Current Hypertension Reviews ◽

10.2174/1573402115666190118142818 ◽

2019 ◽

Vol 15 (2) ◽

pp. 113-122

Author(s):

Mehdi Jafari Oori ◽

Farahnaz Mohammadi ◽

Kian Norozi ◽

Masoud Fallahi-Khoshknab ◽

Abbas Ebadi ◽

...

Keyword(s):

Sample Size ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Effect Model ◽

Significant Difference ◽

Standard Tool ◽

Egger Test ◽

Significant Health

Introduction: Prevalence of hypertension (HTN) is increasing in the developing countries like Iran. Various studies have reported different rates of HTN in Iran. The purpose of this study was to estimate an overall prevalence of HTN in Iran. Methodology: Using the English and Persian key derived from Mesh, the databases including MagIran, Iran Medex, SID, Web of Sciences, PubMed, Science Direct and Google Scholar as a searching engine were reviewed: from 2004 to 2018. The overall prevalence of MA was estimated using Random effect model. The I2 test was used to assess the heterogeneity of the studies. Additionally, the quality of studies was evaluated using a standard tool. Publication bias was conducted with the Egger test. Meta-regression and analysis of subgroups were analyzed based on variables such as age, marital status, region and tools. Data were analyzed using STATA 12 software. Results: Analysis of 58 primary articles with a sample size of 902580 showed that the prevalence of HTN in Iran was 25% (with 95% CI of 22-28). The highest prevalence of HTN was related to elderly (42%). The prevalence of HTN was 25% (95% CI: 19-31) in women and 24% (95% CI: 20-28) in men with no significant difference (p = 0.758). The results also indicated that the prevalence of HTN was not related to the year of studies (p = 0.708) or sample size (p = 769). Conclusion: Despite the advancements in science and technology, along with health and prevention of diseases, the overall prevalence of HTN raised in Iran. Since HTN is a silent disease with significant health consequences and economic burden, programs designed to better HTN control seem vital to enhance community health.

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How much is reasonable to expect about overall survival (OS) benefit when designing studies with new drugs for patients affected by castration resistant prostate cancer (CRPC)? Meta-analysis of 23 randomized clinical trials (RCT) including 17,640 patients.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e16053 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e16053-e16053

Author(s):

Francesco Massari ◽

Francesca Maines ◽

Sara Pilotto ◽

Camillo Porta ◽

Paolo Carlini ◽

...

Keyword(s):

Treatment Strategy ◽

Significant Interaction ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Phase Iii ◽

Sensitivity Analyses ◽

Significant Heterogeneity ◽

Significant Difference

e16053 Background: Treatment decision making in patients affected by CRPC is difficult because the numerous available therapeutic opportunities can significantly affect OS. To demonstrate that comparing results in absence of head-to-head studies may lead to biased survival estimations, a literature-based meta-analysis was conducted. Methods: Hazard Ratios (HR) with 95% confidence intervals (CI) were extracted and cumulated according to a random-effect model from phase III trials. Sensitivity analyses were performed according to: 1) Treatment Strategy (TS, Chemotherapy versus Hormonal versus Immunotherapy versus Other), 2) Comparison (Chemotherapy versus Placebo versus Other), and 3) Disease setting with regard to treatment with Docetaxel (DOC),. Testing for heterogeneity was performed as well. Results: A significant heterogeneity for the 3 sensitivity analyses was found (p<0.0001). The cumulative HR in favor of (any) experimental arm was 0.91 (95% CI 0.84-0.99, p=0.028). We found a significant interaction according to the chosen TS (p<0.0001), in fact a significant difference in OS was more likely to be detected in RCT evaluating hormonal drugs (HR 0.76, 95% CI 0.64-0.92, p=0.005) versus studies testing immunotherapy (HR 1.16, 95% CI 0.86-1.56, p=0.31). With regard to Comparison, a significant interaction (p<0.0001) was found in favor of RCT having placebo as control (HR 0.86, 95% CI 0.76-0.97, p=0.015), versus studies evaluating chemotherapy (HR 1.00, 95% CI 0.84, 1.19, p=0.99). A significant interaction according to DOC-treatment was also detected (p<0.0001), being the Post-DOC the Setting where a significant OS benefit was more likely to be determined (HR 0.77, 95% CI 0.66-0.90, p=0.001). Conclusions: The cross-trials interpretation in absence of formal direct comparisons may drive biased conclusions with regard to OS estimation. When designing trials to evaluate drugs (or strategies) in CRPC, the expected OS benefit must take into account the comparator, the treatment strategy and the (eventual) pre-treatment with DOC.

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Annual incidence of osteoporotic hip fractures in Iran: a systematic review and meta-analysis

BMC Geriatrics ◽

10.1186/s12877-021-02603-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kiarash Tanha ◽

Noushin Fahimfar ◽

Shahrzad Nematollahi ◽

Sayed Mahmoud Sajjadi-Jazi ◽

Safoora Gharibzadeh ◽

...

Keyword(s):

Hip Fractures ◽

Financial Burden ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Osteoporotic Fractures ◽

Fragility Fractures ◽

Population Based ◽

Annual Incidence ◽

Language Restriction

Abstract Background Osteoporosis (OP) is progressively becoming a global concern with the aging of the world’s populations. Osteoporotic fractures are associated with significantly increased mortality rates and a financial burden to health systems. This Meta-analysis aims to estimate the annual incidence of osteoporotic fractures in Iran. Methods A comprehensive systematic literature search was performed through Medline (PubMed), Embase, Scopus, Web of Science, and Google Scholar to identify studies which contain an investigation of the incidence of osteoporotic fractures in Iran up to December 3rd 2020, with no time and language restriction. For the risk of bias assessments of studies, the Joanna Briggs Institute (JBI) critical appraisal checklist for studies reporting prevalence data was used. The pooled estimation of the incidence of osteoporotic fractures in population aged≥50 years was calculated using random-effects meta-analysis, and the heterogeneity of included studies was quantified with the I2 statistic. Results In all, 6708 papers were initially retrieved from the electronic databases, among which seven studies were included in the meta-analysis. The pooled standardized annual cumulative incidence of hip fractures was estimated as 138.26 (95% CI: 98.71–193.65) per 100,000 population and 157.52 (95% CI: 124.29–199.64) per 100,000 population in men and women, respectively. Conclusion This study showed a high incidence rate of osteoporotic hip fractures in Iran. Early detection and treatment of individuals with higher risks of primary fragility fractures at primary health care as well as implementing fracture liaison services to prevent secondary fractures are highly recommended. The results suffer from the following limitations: first, a low number of studies that were eligible for inclusion; second, the lack of population-based studies; and presence of highly heterogeneous studies despite the use of a random effect model.

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Regional and chronological differences in prevalences of olfactory and gustatory dysfunction in coronavirus disease (COVID-19): a systemic review and meta-analysis

10.21203/rs.3.rs-58460/v1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Jeong-Whun Kim ◽

Seung Cheol Han ◽

Hyung Dong Jo ◽

Sung-Woo Cho ◽

Jin Youp Kim

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Olfactory Dysfunction ◽

Systemic Review ◽

Effect Model ◽

Geographical Regions ◽

Significant Difference ◽

Subgroup Analyses

Abstract Olfactory and gustatory dysfunction are frequently reported in patients with coronavirus disease (COVID-19). However, the reported prevalence of olfactory and/or gustatory dysfunction varies widely, and the reason for the inter-study differences is unclear. Hence, in this meta-analysis, we performed subgroup analyses to investigate the factors that contribute to the inter-study variability in the prevalence of olfactory and gustatory dysfunction. Out of 943 citations, we included 55 eligible studies with 13,527 patients with COVID-19 for a systematic review. The overall pooled prevalences of olfactory and gustatory dysfunction were 51.4% and 47.5%, respectively, in the random-effect model. In subgroup analyses, the prevalences of olfactory and gustatory dysfunction were significantly different among four geographical regions (both P < 0.001, respectively). Although the prevalences of olfactory and gustatory dysfunction did not significantly differ according to the time of enrollment, the subgroup analyses including only studies from the same geographical region (Europe) revealed a significant difference in olfactory dysfunction according to the time of enrollment. The regional and chronological differences in the prevalences of olfactory and gustatory dysfunctions partly explain the wide inter-study variability.

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Evaluation of Childbirth Self-Efficacy in Pregnant Women with Variables: A Systematic Review and Meta-Analysis

Current Psychiatry Research and Reviews ◽

10.2174/2666082217666211210102459 ◽

2021 ◽

Vol 17 ◽

Author(s):

Ayse Deliktas Demirci ◽

Merve Kochan ◽

Kamile Kabukcuoglu

Keyword(s):

Self Efficacy ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Moderating Variables ◽

Moderator Analysis ◽

Effect Model ◽

Significant Difference ◽

New Variables

Objective : The present study aims to examine childbirth self-efficacy levels with potential moderating variables. Methods: The systematic searches were conducted in nine databases in July 2019. The PRISMA checklist was used. The quality of studies was evaluated by two researchers. The random-effect model was used in the present meta-analysis. The heterogeneity tests and moderator analyses were performed. There were 18 eligible articles. Results: Results indicated that childbirth self-efficacy levels do not change based on parity (Q=0.784, p=0.376 for efficacy expectancy, Q=0.190, p=0.663 for outcome expectancy). The between-study variance was not significant for subdimensions of CBSEI (Qb = 1.531, p = .216), which means no significant difference between OE and EE levels was found. The between-study variance was not significant for OE levels (Qb = 0.333, p = .847), which means no significant difference was found between Outcome-AL, Outcome-SS, and OE-16. The moderator analysis, including Efficacy-AL, Efficacy-SS, and EE-16 presented a higher pooled mean score for EE-16 (111.56; 95% CI = 98.66 to 124.46). However, the between-study variance was not significant for EE levels (Qb = 4.240, p = .120). Despite the moderator analysis, the finding of high heterogeneity suggests the need for further studies which examine the concept of childbirth self-efficacy with additional variables. Conclusion: The study presents that childbirth self-efficacy levels do not change based on parity, stages of labor and subdimensions of CBSEI. Researchers need to examine the concept of childbirth self-efficacy with new variables for further clarify of concept.

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Abstract 16310: Association Between the Use of Antithrombotics and Cardiac Implantable Electronic Device Infections: A Systematic Review and Meta-analysis

Circulation ◽

10.1161/circ.142.suppl_3.16310 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Chol Techorueangwiwat ◽

Chanavuth Kanitsoraphan ◽

Jakrin Kewcharoen

Keyword(s):

Systematic Review ◽

Effect Size ◽

Electronic Device ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Systemic Infection ◽

Cardiac Implantable Electronic Device ◽

Inverse Variance ◽

Increased Risk

Introduction: Studies have shown that the use of antiplatelet and anticoagulant increases the risk of cardiac implantable electronic device (CIED) infection following the implantation. However, results were contradicting. In this study, we performed a systematic review and meta-analysis to explore the effect of antiplatelets and anticoagulants and the risk of CIED infection following the implantation. Methods: We searched the databases of MEDLINE and EMBASE from inception to March 2020. Included studies were published studies of patients undergoing CIED implantations which reported effect size of the use of either antiplatelet or anticoagulant, or both, on the risk of CIED infections. CIED infection was defined as either device-related local or systemic infection. Data from each study were combined using the random-effects, generic inverse variance method of Der Simonian and Laird to calculate effect size and 95% confidence intervals (CI). Results: Fifteen studies from 2008-2019 involving a total of 72,028 patients were included. In random-effect model, we found that the use of antiplatelet was not associated with an increased risk of CIED infections (risk ratio (RR) =1.13, 95% CI: 0.89-1.44, p=0.314, I 2 =51.3%), while the use of anticoagulant was associated with increased risk of CIED infections (RR =1.50, 95%CI: 1.02-2.21, p=0.038, I 2 =75%). There was no publication bias observed in the funnel plot as well as no small-study effect observed in Egger’s test. Conclusions: Our meta-analysis demonstrated that the use of anticoagulant significantly increases the risk of CIED infection following the implantation by up to 1.50-fold, however, this effect was not observed with antiplatelet use. Our study suggested that patients on anticoagulation considering CIED implantations should proceed with caution.

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The Impact of Delirium On Prognosis In Stroke: A Systematic Review and Meta-Analyses of Observational Studies

10.21203/rs.3.rs-750658/v1 ◽

2021 ◽

Author(s):

jing zhang ◽

xin wang ◽

jie wang ◽

kai liu ◽

tao he ◽

...

Keyword(s):

Hospital Stay ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Length Of Hospital Stay ◽

Clinical Problem ◽

Cochrane Library ◽

Inpatient Mortality ◽

Increased Risk ◽

The Impact

Abstract Background The outcomes of post-stroke delirium are inconsistent. Therefore, we conduct a meta-analysis to provide a comprehensive description of the impact of delirium on the outcomes including including length of hospital stay and inpatient mortality after stroke. Methods We searched electronic databases including PubMed, Google scholar, Web of Science and Cochrane Library databases up to April, 2021. Fixed-effect or random-effect model was used to summary odds ratio (OR) and mean difference (MD ) with 95% confidence interval (CI). Results 13 individual studies with total of 3592 patients met the inclusion criteria. The summary results revealed that stroke patients with delirium increased risk of inpatient mortality (OR = 6.35, 95% CI: 4.35–9.25, p < 0.0001), and had longer length of hospital stay (MD = 5.93, 95% CI: 2.79–9.07, p < 0.0001) compared to non-delirious patients. Conclusions Delirium is associated with unfavorable outcomes in patients with stroke, particularly in higher inpatient mortality and longer length of stay. We should pay more attention to this clinical problem and managed appropriately to prevent poor prognosis.

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Binocular treatment for amblyopia: A meta-analysis of randomized clinical trials

PLoS ONE ◽

10.1371/journal.pone.0257999 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0257999

Author(s):

Matilde Roda ◽

Marco Pellegrini ◽

Natalie Di Geronimo ◽

Aldo Vagge ◽

Michela Fresina ◽

...

Keyword(s):

Clinical Trials ◽

Visual Acuity ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Complementary Therapy ◽

Convincing Evidence ◽

Cochrane Central Register ◽

Significant Difference

Background To date, there is still no consensus regarding the effect of binocular treatment for amblyopia. The purpose of this systematic review and meta-analysis was to summarize the available evidence to determine whether binocular treatment is more effective than patching in children with amblyopia. Methods Four electronic databases (PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials) were searched for studies that compared binocular treatment and patching in children with amblyopia. The outcome measures were visual acuity and stereopsis. Pooled effects sizes were calculated with a random-effect model. The standardized difference in means (SDM) with 95% confidence intervals (CI) was calculated. Sensitivity analysis and assessment of publication bias were performed. Results Five randomized clinical trials were included. No significant difference in visual acuity between patients treated with binocular treatment and patching was observed (SDM = -0.12; 95% CI: -0.45–0.20; P = 0.464). No significant difference in stereopsis between patients treated with binocular treatment and patching was observed (SDM = -0.07; 95% CI: -0.61–0.48; P = 0.809). For both variables, the between-study heterogeneity was high (respectively, I2 = 61% and I2 = 57%). Conclusions This meta-analysis found no convincing evidence supporting the efficacy of binocular treatment as an alternative to conventional patching. Therefore, the binocular treatment cannot fully replace traditional treatment but, to date, it can be considered a valid complementary therapy in peculiar cases. Further studies are required to determine whether more engaging therapies and new treatment protocols are more effective.

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Functional Outcome & Revision Rate Of Pfna Vs Dhs For Osteoporotic Intertrochanteric Femur Fracture: A Meta Analysis

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00030 ◽

2020 ◽

Vol 8 (5_suppl5) ◽

pp. 2325967120S0003

Author(s):

Sherly Desnita Savio ◽

I Made Arya Susila ◽

Cokorda Gde Oka Dharmayuda

Keyword(s):

Functional Outcome ◽

Femur Fracture ◽

Revision Rate ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Harris Hip Score ◽

Significant Difference ◽

The Mean ◽

Intertrochanteric Femur Fracture

Objectives: Intertrochanteric femur fracture in elderly presents a challenge as the source of morbidity and mortality if not well-treated. This study investigates the functional outcome and revision rate of two of the most common treatments of choice for this condition, Proximal Femoral Nail Antirotation (PFNA) and Dynamic Hip Screw (DHS), while furthermore investigate the secondary functional outcome of the two procedures if proceeded to Conversion to Total Hip Arthroplasty (CTHA). Methods: A systematic search was conducted to identify relevant studies through PubMed, Google Scholar, and Cochrane database. A total of 9 studies (2.251 patients) were included, divided into 3 meta-analysis. Random effect model was used for continuous outcomes using Review Manager. Results: For primary Harris Hip Score (HHS), the mean HHS at 12-months follow-up for PFNA (n = 184) was 77.77, as for DHS (n = 187) was 78.33, indicating no significant difference (P = 0.73). The mean revision rates for PFNA (n=784) was 2.68%, as for DHS (n=766) was 2.48%, indicating no significant difference (P = 0.61). For secondary HHS after CTHA, the mean HHS 12-months postoperatively for PFNA (n =142) was 83.97, as for DHS (n = 190) was 83.65, indicating no significant difference (P = 0.59). Discussion: PFNA and DHS can both be considered in osteoporotic intertrochanter femur fracture, as the two procedures offer similar 1-year functional outcome and revision rate. However, PFNA may benefit with less blood loss and operation time. Some potential revision causes, such as peri-implant femoral fracture, infection, and implant failure should always be monitored perioperatively. Furthermore, when CTHA is indicated for revision, the two procedures offer comparable secondary functional outcome. Conclusion: Current meta-analysis suggests that PFNA and DHS both have comparable primary functional outcome, revision rate, and post-CTHA secondary functional outcome.

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Meta-Analysis of Depressive Symptoms in Dual-Diagnosis Schizophrenia

Australian & New Zealand Journal of Psychiatry ◽

10.1080/00048670701579041 ◽

2007 ◽

Vol 41 (10) ◽

pp. 792-799 ◽

Cited By ~ 31

Author(s):

Stéphane Potvin ◽

Amir Ali Sepehry ◽

Emmanuel Stip

Keyword(s):

Depressive Symptoms ◽

Dual Diagnosis ◽

Rating Scale ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Negative Consequences ◽

Hamilton Depression Rating Scale ◽

Significant Difference ◽

Patients Experience

Substance abuse is highly prevalent in schizophrenia and associated with numerous negative consequences. While studies have regularly reported more severe depressive symptoms in addicted schizophrenia patients relative to non-abusing patients, some studies have not corroborated this finding. The current meta-analysis was performed to quantify the relative severity of depressive symptoms in dual-diagnosis schizophrenia. A search of the literature using computerized engines was undertaken. Studies were retained in the analysis if (i) they assessed depressive symptoms using validated scales specific to depression (e.g. Hamilton Depression Rating Scale); and (ii) groups of schizophrenia patients were divided according to substance use disorders (alcohol, amphetamines, cannabis, cocaine, hallucinogens, heroin and/or phencyclidine). According to the inclusion criteria, 20 studies were available for mathematical analysis. A small, positive and significant effect size estimate (n =3283; 1680 dual diagnosis; 1603 single diagnosis; adjusted Hedges's g =0.292; p =0.003) was obtained, within a random-effect model, suggesting that some dual-diagnosis patients experience more severe depressive symptoms than single-diagnosis patients. This significant difference was found only for studies using the Hamilton Depression Rating Scale but not for other depression scales. The results of the present meta-analysis suggest that addicted schizophrenia patients experience more severe depressive symptoms compared to non-abusing patients, but that the difference is smaller than commonly assumed. The meta-analysis also shows that the significance of results is related to the scale used to measure depressive symptoms. These results have methodological implications for future studies of depressive symptoms in dual-diagnosis patients, and potential implications for the prevention and treatment of depressive symptoms in schizophrenia.

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