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

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.

scholarly journals Evaluating the effect of the temporal intra-oral skeletal anchorage device (TISADs) for facilitating the anchorage reinforcement: A meta-analysis and systematic review

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Ali Amiri ◽  
Setareh Khosravi ◽  
Shiva Torabi ◽  
Hadi Golshekan ◽  
Fan Qi
Keyword(s):  
Systematic Review ◽  
Treatment Time ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Cochrane Collaboration ◽  
Mean Difference ◽  
Cochrane Library ◽  
Significant Difference ◽  
The Mean

Objective: In this meta-analysis and systematic review, we aimed to evaluate the effects of the TISADs to facilitates anchorage reinforcement. Methods:  PubMed, Cochrane Library, Embase, ISI, Scopus, Web of Science, LILACS, BBO, OpenGrey, and Google Scholar, were used from the electronic databases until 2020 perform systematic literature. Two reviewers extracted data blindly and independently from various abstracts as well as full texts of articles they considered for data extraction. Using the Cochrane collaboration's tool, we evaluated the publications' quality. Then, we computed the mean difference of TISADs and conventional anchorage groups with a confidence interval (CI) of 95%, restricted maximum likelihood (REML), and random effect model of the mesial movement of molars and their tipping. Moreover, we employed Stata/MP 16 that has been considered the most rapid version of Stata for evaluating meta-analysis. Results: According to our electronic searches, 134 topics and abstracts with potential relevance were identified according to the research design. Finally, five publications matched the required inclusion criteria of the study. In addition, the Cochrane collaboration instrument exhibited all studies with low to moderate biases. Also, the mean difference of mesial molar movement showed less anchorage loss in the TISADs group vs. the controls, and a significant difference between these two groups (MD= -1.74 with a CI of 95%, -2.76, -0.71. P = 0.00). Conclusions: TISADs can reduce treatment time, and TISADs are more effective in enables the anchorage than other methods and higher tipping in the TISADs.

EXPRESS: Comparison of Mothership versus Drip-and-Ship Models in treating patients with Acute Ischemic Stroke: A systematic review and meta-analysis

2021 ◽  
pp. 174749302110132
Author(s):  
Ahmed Mohamed ◽  
Nida Fatima ◽  
Ashfaq Shuaib ◽  
Maher Saqqur
Keyword(s):  
Functional Outcome ◽  
Meta Analysis ◽  
Critical Time ◽  
Functional Independence ◽  
Models Of Care ◽  
Randomized Control Trials ◽  
Symptomatic Intracerebral Hemorrhage ◽  
Significant Difference ◽  
The Mean ◽  
Randomized Control

Introduction There is controversy if direct to comprehensive center “mothership” (MS) or stopping at primary center for thrombolysis before transfer to comprehensive center “drip-and- ship” (DS) are best models of treatment of acute stroke. In this study, we compare MS and DS models to evaluate the best option of functional outcome. Methods Studies between 1990 and 2020 were extracted from online electronic databases. We compared the clinical outcomes, critical time measurements, functional independence and mortality were then compared. Results A total of 7,824 patients’ data were retrieved from 13 publications (3 randomized control trials and 10 retrospective ones). 4,639 (59.3%) patients were treated under MS model and 3,185 (40.7%) followed the DS model with mean age of 70.01±3.58 vs. 69.03±3.36; p< 0 .001, respectively. The National Institute Health Stroke Scale was 15.57±3.83 for the MS and 15.72±2.99 for the DS model (p=<0.001). The mean symptoms onset-to-puncture time was significantly shorter in the MS group compared to the DS (159.69 min vs. 223.89 min; p=<0.001, respectively). Moreover, the collected data indicated no significant difference between symptom’s onset to intravenous (IV) thrombolysis time and stroke onset-to-successful recanalization time (p=0.205 and p=<0.001, respectively). Patients had significantly worse functional outcome [modified rankin score (mRS)] (3-6) at 90-days in the DS model [Odds Ratio (OR): 1.47, 95% Confidence Interval (CI): 1.13-1.92, p<0.004] and 1.49-folds higher likelihood of symptomatic intracerebral hemorrhage (OR: 1.49, 95%CI: 1.22-1.81, p<0.0001) compared to MS. However, there were no statistically significant difference in terms of mortality (OR: 1.16, 95%CI: 0.87-1.55, p=0.32) and successful recanalization (OR: 1.12, 95%CI: 0.76-1.65, p=0.56) between the two models of care. Conclusion Patients in the MS model have significantly improved functional independence and recovery. Further studies are needed as the data from prospectively randomized studies is not of sufficient quality to make definite recommendations.

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

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.

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.

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.

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

2020 ◽  
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.

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

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.

scholarly journals Surgical versus Conservative Management of Weber B Fibular Fractures

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0014
Author(s):  
Abduljabbar Alhammoud ◽  
Osama Aldahamsheh
Keyword(s):  
Clinical Outcomes ◽  
Surgical Management ◽  
Short Form ◽  
Meta Analysis ◽  
Random Effect Model ◽  
Functional Score ◽  
Type B ◽  
Significant Difference ◽  
Functional Scores ◽  
The Mean

Category: Trauma Introduction/Purpose: Fibular fractures are one of the most common traumatic injuries treated by orthopaedic surgeons. These fractures range from stable to unstable, and accordingly may be treated conservatively with immobilization or operatively with open reduction and internal fixation. Unstable Weber classification type B fibula fractures are at the level of the syndesmosis. When stressed, they show an increased medial clear space widening. Recent studies have suggested these fractures may be treated non-operatively. The purpose of this study was to systematically review the literature to determine whether operative and non-operative management of Weber B fractures exhibit any difference in functional outcomes. Methods: For this study, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRIMSA) guidelines were followed. A systematic review of the literature was performed on the Medline (PubMed), Ovid, and Embase databases in May 2017. Only studies analyzing surgical and non-surgical management of Weber B fibular fractures were included. A meta-analysis was performed to pool difference of the mean for functional outcome scores (Olerud Molander Ankle [OMA] score, American Orthopaedic Foot and Ankle Score [AOFAS], Visual Analogue Scale [VAS], and Short-form 36 [SF36] questionnaire) of the ankles of patients who underwent surgical and non-surgical management. Descriptive, quantitative, and qualitative data were extracted and analyzed using Comprehensive meta-analysis software and SPSS 21. Random effect model used to pool the difference of the mean of the outcomes and I2 to assess the heterogeneity. Results: Of the 823 articles identified, four studies met inclusion criteria for the meta-analysis. A total of 383 unstable Weber type B fibular fractures were identified, with 198 treated operatively and 161 treated non-operatively. There were 158 (41.2%) male and 225 (58.8%) female patients, who averaged 45.6 years of age (Table). Mean follow up was 27.3 months. The pooled mean difference (SMD) for OMA functional score did not show any statistically significant difference between surgical and non-surgical management (SMD = 12.364 [95% CI: -4.684, 29.413]; I2 = 91.93%), although each single paper highlighted the superiority of non-surgical management. Other functional scores could not be pooled because they were not consistently reported within the included studies. Conclusion: The early literature suggests that there is no difference in the clinical outcomes of unstable Weber B fractures, whether they are treated operatively or non-operatively. Longer-term studies are warranted to examine the clinical outcomes of patients managed non-operatively.

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

PLoS ONE ◽  
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.

scholarly journals The incubation period of COVID-19: a global meta-analysis of 53 studies and a Chinese observation study of 11 545 patients

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Cheng Cheng ◽  
DongDong Zhang ◽  
Dejian Dang ◽  
Juan Geng ◽  
Peiyu Zhu ◽  
...  
Keyword(s):  
Incubation Period ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Observation Study ◽  
Effect Model ◽  
Time Of Infection ◽  
The Mainland Of China ◽  
The Mean ◽  
Log Normal

Abstract Background The incubation period is a crucial index of epidemiology in understanding the spread of the emerging Coronavirus disease 2019 (COVID-19). In this study, we aimed to describe the incubation period of COVID-19 globally and in the mainland of China. Methods The searched studies were published from December 1, 2019 to May 26, 2021 in CNKI, Wanfang, PubMed, and Embase databases. A random-effect model was used to pool the mean incubation period. Meta-regression was used to explore the sources of heterogeneity. Meanwhile, we collected 11 545 patients in the mainland of China outside Hubei from January 19, 2020 to September 21, 2020. The incubation period fitted with the Log-normal model by the coarseDataTools package. Results A total of 3235 articles were searched, 53 of which were included in the meta-analysis. The pooled mean incubation period of COVID-19 was 6.0 days (95% confidence interval [CI] 5.6–6.5) globally, 6.5 days (95% CI 6.1–6.9) in the mainland of China, and 4.6 days (95% CI 4.1–5.1) outside the mainland of China (P = 0.006). The incubation period varied with age (P = 0.005). Meanwhile, in 11 545 patients, the mean incubation period was 7.1 days (95% CI 7.0–7.2), which was similar to the finding in our meta-analysis. Conclusions For COVID-19, the mean incubation period was 6.0 days globally but near 7.0 days in the mainland of China, which will help identify the time of infection and make disease control decisions. Furthermore, attention should also be paid to the region- or age-specific incubation period. Graphic Abstract

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