Surgical Outcomes for Upper Lumbar Disc Herniations: A Systematic Review and Meta-analysis

Study Design: Systematic review and meta-analysis. Objective: To conduct a literature review on outcomes of discectomy for upper lumbar disc herniations (ULDH), estimate pooled rates of satisfactory outcomes, compare open laminectomy/microdiscectomy (OLM) versus minimally invasive surgical (MIS) techniques, and compare results of disc herniations at L1-3 versus L3-4. Methods: A systematic review of articles reporting outcomes of nonfusion surgical treatment of L1-2, L2-3, and/or L3-4 disc herniations was performed. The inclusion and exclusion of studies was performed according to the latest version of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: A total of 20 articles were included in the quantitative meta-analysis. Pooled proportion of satisfactory outcome (95% CI) was 0.77 (0.70, 0.83) for MIS and 0.82 (0.78, 0.84) for OLM. There was no significant improvement with MIS techniques compared with standard OLM, odds ratio (OR) = 0.86, 95% CI (0.42, 1.74), P = .66. Separating results by levels revealed a trend of higher satisfaction with L3-4 versus L1-3 with OLM surgery, OR = 0.46, 95% CI (0.19, 1.12), P = .08. Conclusion: Our analysis reveals that discectomy for ULDH has an overall success rate of approximately 80% and has not improved with MIS. Discectomy for herniations at L3-4 trends toward better outcomes compared with L1-2 and L2-3, but was not significant.

Download Full-text

Magnesium and mood disorders: systematic review and meta-analysis

BJPsych Open ◽

10.1192/bjo.2018.22 ◽

2018 ◽

Vol 4 (4) ◽

pp. 167-179 ◽

Cited By ~ 12

Author(s):

Danny Phelan ◽

Patricio Molero ◽

Miguel A. Martínez-González ◽

Marc Molendijk

Keyword(s):

Systematic Review ◽

Mood Disorders ◽

Symptom Severity ◽

Odds Ratio ◽

Potential Role ◽

Meta Analysis ◽

Blood Levels ◽

Cross Sectional ◽

Bodily Fluids ◽

Meta Analyses

BackgroundMagnesium (Mg2+) has received considerable attention with regards to its potential role in the pathophysiology of the mood disorders, but the available evidence seems inconclusive.AimsTo review and quantitatively summarise the human literature on Mg2+intake and Mg2+blood levels in the mood disorders and the effects of Mg2+supplements on mood.MethodSystematic review and meta-analyses.ResultsAdherence to a Mg2+-rich diet was negatively associated with depression in cross-sectional (odds ratio = 0.66) but not in prospective studies. Mg2+levels in bodily fluids were on average higher in patients with a mood disorder (Hedge'sg = 0.19), but only in patients treated with antidepressants and/or mood stabilisers. There was no evident association between Mg2+levels and symptom severity. Mg2+supplementation was associated with a decline in depressive symptoms in uncontrolled (g = −1.60) but not in placebo-controlled trials (g = −0.21).ConclusionOur results provide little evidence for the involvement of Mg2+in the mood disorders.Declaration of interestNone.

Download Full-text

Voluntary medical male circumcision and HIV infection among men who have sex with men: Implications from a systematic review

SAGE Open Medicine ◽

10.1177/2050312119869110 ◽

2019 ◽

Vol 7 ◽

pp. 205031211986911 ◽

Cited By ~ 1

Author(s):

Chen Zhang ◽

Han-Zhu Qian ◽

Yu Liu ◽

Sten H Vermund

Keyword(s):

Systematic Review ◽

Confidence Interval ◽

Male Circumcision ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Meta Analysis ◽

Voluntary Medical Male Circumcision ◽

Medical Male Circumcision ◽

Sex With Men ◽

Meta Analyses

Background: With the rapidly-increased HIV epidemic among men who have sex with men worldwide, the effectiveness of voluntary medical male circumcision as the tool of HIV prevention still remains undetermined. Purpose: In the current study, we conducted a systematic review and meta-analysis to assess the association between voluntary medical male circumcision and HIV risk among men who have sex with men. Methods and Conclusion: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline, we conducted a comprehensive literature search through multiple databases. A total of 37 articles/abstracts were included in the analysis. We employed random-effects models and subgroup analyses based upon key study characteristics derived from empirical studies. A total of 117,293 men who have sex with men were included in the meta-analysis, and no randomized control trials have been identified. The odds of being HIV positive were 7% lower among men who have sex with men who were circumcised than among men who have sex with men who were uncircumcised (adjusted odds ratio, 0.93; 95% confidence interval, 0.88–0.99). The evidence for the potential protective effect of voluntary medical male circumcision was stronger among men who have sex with men in Asia and Africa (adjusted odds ratio, 0.62; 95% confidence interval, 0.53–0.73). Our meta-analyses may suggest a protective effect of voluntary medical male circumcision against HIV infection among men who have sex with men, especially in settings like Asia/Africa.

Download Full-text

How to Write a Systematic Review of the Literature

HERD Health Environments Research & Design Journal ◽

10.1177/1937586717747384 ◽

2017 ◽

Vol 11 (1) ◽

pp. 15-30 ◽

Cited By ~ 24

Author(s):

Debajyoti Pati ◽

Lesa N. Lorusso

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Research Question ◽

Cochrane Collaboration ◽

Quality Level ◽

Methodological Rigor ◽

Prisma Statement ◽

Level Of Understanding ◽

Meta Analyses ◽

The Cochrane Collaboration

This article provides a step-by-step approach to conducting and reporting systematic literature reviews (SLRs) in the domain of healthcare design and discusses some of the key quality issues associated with SLRs. SLR, as the name implies, is a systematic way of collecting, critically evaluating, integrating, and presenting findings from across multiple research studies on a research question or topic of interest. SLR provides a way to assess the quality level and magnitude of existing evidence on a question or topic of interest. It offers a broader and more accurate level of understanding than a traditional literature review. A systematic review adheres to standardized methodologies/guidelines in systematic searching, filtering, reviewing, critiquing, interpreting, synthesizing, and reporting of findings from multiple publications on a topic/domain of interest. The Cochrane Collaboration is the most well-known and widely respected global organization producing SLRs within the healthcare field and a standard to follow for any researcher seeking to write a transparent and methodologically sound SLR. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), like the Cochrane Collaboration, was created by an international network of health-based collaborators and provides the framework for SLR to ensure methodological rigor and quality. The PRISMA statement is an evidence-based guide consisting of a checklist and flowchart intended to be used as tools for authors seeking to write SLR and meta-analyses.

Download Full-text

Evaluation of the endorsement of the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) statement on the quality of published systematic review and meta-analyses

European Journal of Public Health ◽

10.1093/eurpub/ckt124.018 ◽

2013 ◽

Vol 23 (suppl_1) ◽

Cited By ~ 2

Author(s):

N Panic ◽

E Leoncini ◽

G de Belvis ◽

W Ricciardi ◽

S Boccia

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Meta Analysis ◽

Prisma Statement ◽

Meta Analyses

Download Full-text

Chondromas of the Lumbar Spine: A Systematic Review

Global Spine Journal ◽

10.1177/2192568220901557 ◽

2020 ◽

pp. 219256822090155

Author(s):

Luis A. Robles ◽

Greg M. Mundis

Keyword(s):

Systematic Review ◽

Case Reports ◽

Lumbar Disc ◽

Spinal Tumor ◽

Clinical Findings ◽

Illustrative Case ◽

Rim Enhancement ◽

Disc Herniations ◽

Meta Analyses ◽

Lumbar Spinal

Study Design: Systematic review and illustrative case. Objectives: Lumbar spinal chondromas (LSCs) are rare spine tumors. The characteristics of these intraspinal lesions are not well described in the literature. The goal of this article is to describe the features of this rare spinal tumor. Methods: A PubMed and Scopus search adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed to include studies reporting patients with LSCs. The data gathered from this review was analyzed to characterize LSCs. Results: The search yielded 14 cases of patients with LSCs. All studies were case reports (Level V of evidence). Different characteristics of LSCs are described, including demographics, clinical findings, imaging, and treatment. Conclusions: The results of this review show that LSCs are almost exclusively seen in the extradural space and may adopt a dumbbell shape. LSCs frequently manifest in a very similar way to lumbar disc herniations; therefore, they should be considered in the differential diagnosis of sciatica, especially if magnetic resonance imaging with gadolinium shows peripheral rim enhancement of the lesion. Different degrees of improvement are usually observed after surgical treatment of these patients.

Download Full-text

Effect of health insurance on the utilisation of allied health services by people with chronic disease: a systematic review and meta-analysis

Australian Journal of Primary Health ◽

10.1071/py13092 ◽

2014 ◽

Vol 20 (1) ◽

pp. 9 ◽

Cited By ~ 8

Author(s):

Elizabeth H. Skinner ◽

Michele Foster ◽

Geoffrey Mitchell ◽

Michele Haynes ◽

Martin O'Flaherty ◽

...

Keyword(s):

Systematic Review ◽

Health Insurance ◽

Chronic Disease ◽

Health Services ◽

Chronic Diseases ◽

Odds Ratio ◽

Allied Health ◽

Meta Analysis ◽

Controlled Trials ◽

Meta Analyses

Allied health services benefit the management of many chronic diseases. The effects of health insurance on the utilisation of allied health services has not yet been established despite health insurance frequently being identified as a factor promoting utilisation of medical and hospital services among people with chronic disease. The objective of this systematic review and meta-analysis was to establish the effects of health insurance on the utilisation of allied health services by people with chronic disease. Medline (Ovid Medline 1948 to Present with Daily Update), EMBASE (1980 to 1 April 2011), CINAHL, PsychINFO and the Cochrane Central Register of Controlled Trials were searched to 12 April 2011 inclusive. Studies were eligible for inclusion if they were published in English, randomised controlled trials, quasi-experimental trials, quantitative observational studies and included people with one or more chronic diseases using allied health services and health insurance. A full-text review was performed independently by two reviewers. Meta-analyses were conducted. One hundred and fifty-eight citations were retrieved and seven articles were included in the meta-analyses. The pooled odds ratio (95% CI) of having insurance (versus no insurance) on the utilisation of allied health services among people with chronic disease was 1.33 (1.16−1.52; P < 0.001). There was a significant effect of insurance on the utilisation of non-physiotherapy services, pooled odds ratio (95% CI) 4.80 (1.46−15.79; P = 0.01) but having insurance compared with insurance of a lesser coverage was not significantly associated with an increase in physiotherapy utilisation, pooled odds ratio (95% CI) 1.53 (0.81−2.91; P = 0.19). The presence of co-morbidity or functional limitation and higher levels of education increased utilisation whereas gender, race, marital status and income had a limited and variable effect, according to the study population. The review was limited by the considerable heterogeneity in the research questions being asked, sample sizes, study methodology (including allied health service), insurance type and dependent variables analysed. The presence of health insurance was generally associated with increased utilisation of allied health services; however, this varied depending on the population, provider type and insurance product.

Download Full-text

Incidence and prevalence of systemic sclerosis globally: a comprehensive systematic review and meta-analysis

Rheumatology ◽

10.1093/rheumatology/keab190 ◽

2021 ◽

Author(s):

Majd Bairkdar ◽

Marios Rossides ◽

Helga Westerlind ◽

Roger Hesselstrand ◽

Elizabeth V Arkema ◽

...

Keyword(s):

Systematic Review ◽

Web Of Science ◽

Meta Analysis ◽

Case Definition ◽

Random Effects Models ◽

Pooled Prevalence ◽

Prisma Statement ◽

The World ◽

Large Heterogeneity ◽

Meta Analyses

Abstract Objectives We aimed to conduct a systematic review and meta-analysis on the incidence and prevalence of SSc covering the entire literature. Methods This study followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement of 2009. We conducted a systematic search in MEDLINE, Web of Science and Embase to identify articles reporting incidence and/or prevalence of SSc. Two authors conducted the search, reviewed articles for inclusion and extracted relevant data. We used random-effects models to estimate the pooled prevalence and incidence of SSc and performed subgroup analyses by sex, case definition and region to investigate heterogeneity. We explored the association between calendar period and reported estimates using meta-regression. Results Among 6983 unique records identified, we included 61 studies of prevalence and 39 studies of incidence in the systematic review. The overall pooled prevalence of SSc was 17.6 (95% CI 15.1, 20.5) per 100 000 and the overall pooled incidence rate of SSc was 1.4 (95% CI 1.1, 1.9) per 100 000 person-years. We observed significant regional variations in reported estimates; studies conducted in North America reported considerably higher estimates than other regions. The pooled incidence and prevalence in women were five times higher than in men. More recent studies reported higher estimates than older ones. Conclusion In this comprehensive review of the incidence and prevalence of SSc across the world, there was large heterogeneity among estimates, which should be taken into consideration when interpreting the results.

Download Full-text

Can we predict the severe course of COVID-19 - a systematic review and meta-analysis of indicators of clinical outcome?

PLoS ONE ◽

10.1371/journal.pone.0255154 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0255154

Author(s):

Stephan Katzenschlager ◽

Alexandra J. Zimmer ◽

Claudius Gottschalk ◽

Jürgen Grafeneder ◽

Stephani Schmitz ◽

...

Keyword(s):

Systematic Review ◽

Cerebrovascular Disease ◽

Odds Ratio ◽

Troponin I ◽

Assessment Tool ◽

Meta Analysis ◽

Clinical Indicators ◽

Co Morbidity ◽

Early Decision ◽

Meta Analyses

Background COVID-19 has been reported in over 40million people globally with variable clinical outcomes. In this systematic review and meta-analysis, we assessed demographic, laboratory and clinical indicators as predictors for severe courses of COVID-19. Methods This systematic review was registered at PROSPERO under CRD42020177154. We systematically searched multiple databases (PubMed, Web of Science Core Collection, MedRvix and bioRvix) for publications from December 2019 to May 31st 2020. Random-effects meta-analyses were used to calculate pooled odds ratios and differences of medians between (1) patients admitted to ICU versus non-ICU patients and (2) patients who died versus those who survived. We adapted an existing Cochrane risk-of-bias assessment tool for outcome studies. Results Of 6,702 unique citations, we included 88 articles with 69,762 patients. There was concern for bias across all articles included. Age was strongly associated with mortality with a difference of medians (DoM) of 13.15 years (95% confidence interval (CI) 11.37 to 14.94) between those who died and those who survived. We found a clinically relevant difference between non-survivors and survivors for C-reactive protein (CRP; DoM 69.10 mg/L, CI 50.43 to 87.77), lactate dehydrogenase (LDH; DoM 189.49 U/L, CI 155.00 to 223.98), cardiac troponin I (cTnI; DoM 21.88 pg/mL, CI 9.78 to 33.99) and D-Dimer (DoM 1.29mg/L, CI 0.9 to 1.69). Furthermore, cerebrovascular disease was the co-morbidity most strongly associated with mortality (Odds Ratio 3.45, CI 2.42 to 4.91) and ICU admission (Odds Ratio 5.88, CI 2.35 to 14.73). Discussion This comprehensive meta-analysis found age, cerebrovascular disease, CRP, LDH and cTnI to be the most important risk-factors that predict severe COVID-19 outcomes and will inform clinical scores to support early decision-making.

Download Full-text