Trials and Tribulations of Systematic Reviews and Meta-Analyses

Hematology ◽  
2007 ◽  
Vol 2007 (1) ◽  
pp. 493-497 ◽  
Author(s):  
Mark A. Crowther ◽  
Deborah J. Cook
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Research Evidence ◽  
Meta Analysis ◽  
Medical Decision ◽  
Future Research ◽  
Optimal Health ◽  
Bodies Of Evidence ◽  
Meta Analyses ◽  
Key Steps

Abstract Systematic reviews can help practitioners keep abreast of the medical literature by summarizing large bodies of evidence and helping to explain differences among studies on the same question. A systematic review involves the application of scientific strategies, in ways that limit bias, to the assembly, critical appraisal, and synthesis of all relevant studies that address a specific clinical question. A meta-analysis is a type of systematic review that uses statistical methods to combine and summarize the results of several primary studies. Because the review process itself (like any other type of research) is subject to bias, a useful review requires rigorous methods that are clearly reported. Used increasingly to inform medical decision making, plan future research agendas, and establish clinical policy, systematic reviews may strengthen the link between best research evidence and optimal health care. In this article, we discuss key steps in how to critically appraise and how to conduct a systematic review or meta-analysis.

scholarly journals A systematic review and meta-analysis protocol examining the clinical characteristics and epidemiological features of olfactory dysfunction (OD) in coronavirus disease 2019 (COVID-19)

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Rosemond Qian-Xiu Tan ◽  
Wai Tak Victor Li ◽  
Wing-Zi Shum ◽  
Sheung Chit Chu ◽  
Hang-Long Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Data ◽  
Systematic Reviews ◽  
Clinical Characteristics ◽  
Meta Analysis ◽  
Olfactory Dysfunction ◽  
Statistical Analyses ◽  
Human Populations ◽  
Meta Analyses ◽  
Analysis Protocol

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has caused recurring and major outbreaks in multiple human populations around the world. The plethora of clinical presentations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been described extensively, of which olfactory dysfunction (OD) was established as an important and common extrapulmonary manifestation of COVID-19 infection. The aim of this protocol is to conduct a systematic review and meta-analysis on peer-reviewed articles which described clinical data of OD in COVID-19 patients. Methods This research protocol has been prospectively registered with the Prospective Register of Systematic Reviews (PROSPERO; CRD42020196202). CINAHL, ClinicalTrials.gov, Cochrane Central, EMBASE, MEDLINE and PubMed, as well as Chinese medical databases China National Knowledge Infrastructure (CNKI), VIP and WANFANG, will be searched using keywords including ‘COVID-19’, ‘coronavirus disease’, ‘2019-nCoV’, ‘SARS-CoV-2’, ‘novel coronavirus’, ‘anosmia’, ‘hyposmia’, ‘loss of smell’, and ‘olfactory dysfunction’. Systematic review and meta-analysis will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Meta-analyses Of Observational Studies in Epidemiology (MOOSE) guidelines. Articles will be screened according to pre-specified inclusion and exclusion criteria to extract studies that include new clinical data investigating the effect of COVID-19 on olfactory dysfunction. Included articles will be reviewed in full; data including patient demographics, clinical characteristics of COVID-19-related OD, methods of olfactory assessment and relevant clinical outcomes will be extracted. Statistical analyses will be performed using the Comprehensive Meta-Analysis version 3. Discussion This systematic review and meta-analysis protocol will aim to collate and synthesise all available clinical evidence regarding COVID-19-related OD as an important neurosensory dysfunction of COVID-19 infection. A comprehensive search strategy and screening process will be conducted to incorporate broad clinical data for robust statistical analyses and representation. The outcome of the systematic review and meta-analysis will aim to improve our understanding of the symptomatology and clinical characteristics of COVID-19-related OD and identify knowledge gaps in its disease process, which will guide future research in this specific neurosensory defect. Systematic review registration PROSPERO registration number: CRD42020196202.

scholarly journals Efficacy and safety of instantaneous wave-free ratio in patients undergoing coronary revascularisation: protocol for a systematic review

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017868
Author(s):  
Joey S.W. Kwong ◽  
Sheyu Li ◽  
Wan-Jie Gu ◽  
Hao Chen ◽  
Chao Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Coronary Revascularisation ◽  
Eligibility Criteria ◽  
Registration Number ◽  
Collection Form ◽  
Randomised Controlled ◽  
Meta Analyses

IntroductionEffective selection of coronary lesions for revascularisation is pivotal in the management of symptoms and adverse outcomes in patients with coronary artery disease. Recently, instantaneous ‘wave-free’ ratio (iFR) has been proposed as a new diagnostic index for assessing the severity of coronary stenoses without the need of pharmacological vasodilation. Evidence of the effectiveness of iFR-guided revascularisation is emerging and a systematic review is warranted.Methods and analysisThis is a protocol for a systematic review of randomised controlled trials and controlled observational studies. Electronic sources including MEDLINE via Ovid, Embase, Cochrane databases and ClinicalTrials.gov will be searched for potentially eligible studies investigating the effects of iFR-guided strategy in patients undergoing coronary revascularisation. Studies will be selected against transparent eligibility criteria and data will be extracted using a prestandardised data collection form by two independent authors. Risk of bias in included studies and overall quality of evidence will be assessed using validated methodological tools. Meta-analysis will be performed using the Review Manager software. Our systematic review will be performed according to the guidance from the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.Ethics and disseminationEthics approval is not required. Results of the systematic review will be disseminated as conference proceedings and peer-reviewed journal publication.Trial registration numberThis protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42017065460.

scholarly journals Conscious sedation for the management of dental anxiety in third molar extraction surgery: a systematic review.

2020 ◽  
Author(s):  
Matteo Melini ◽  
Andrea Forni ◽  
Francesco Cavallin ◽  
Matteo Parotto ◽  
Gastone Zanette
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
Meta Analysis ◽  
Dental Anxiety ◽  
Third Molar ◽  
Future Research ◽  
Third Molar Extraction ◽  
Molar Extraction

Abstract Background: Dental anxiety is a condition associated with avoidance of dental treatment and increased medical and surgical risks. This systematic review aims to summarize available evidence on conscious sedation techniques used for the management of Dental anxiety in patients scheduled for third molar extraction surgery, to identify best approaches and knowledge gaps. Methods: A comprehensive search was conducted including MEDLINE/Pubmed, EMBASE, SCOPUS, clinicaltrials.gov and the Cochrane Database of Systematic Reviews through March 2019. Only randomized controlled trials were included. PRISMA guidelines were followed. Risk of bias was appraised as reported in the Cochrane Handbook for Systematic Reviews of Interventions. Results: Seventeen RCTs with a total of 1,788 patients were included. Some aspects limited the feasibility of a meaningful meta-analysis, thus a narrative synthesis was conducted. Conscious sedation was associated with improvement in Dental anxiety in six studies. One study reported lower cortisol levels with midazolam vs. placebo, while another study found significant variation in perioperative renin levels with remifentanil vs. placebo. Conclusions: This review found inconclusive and conflicting findings about the role of Conscious sedation in managing Dental anxiety during third molar extraction surgery. Relevant questions remain unanswered due to the lack of consistent, standardized outcome measures. Future research may benefit from addressing these limitations in study design.

scholarly journals Obsessive healthy eating and orthorexic eating tendencies in sport and exercise contexts: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Jana Strahler ◽  
Hanna Wachten ◽  
Anett Mueller-Alcazar
Keyword(s):  
Systematic Review ◽  
Gender Differences ◽  
Healthy Eating ◽  
Meta Analysis ◽  
Group Analysis ◽  
Future Research ◽  
Exercise Behaviors ◽  
Sport And Exercise ◽  
Underlying Mechanisms ◽  
Meta Analyses

AbstractBackgroundOrthorexia Nervosa (ON) and exercise addiction (ExAdd) are two phenomena believed to overlap. We conducted a meta-analysis exploring the link between ON and (addictive) exercise behaviors.MethodsA systematic review of major databases and gray literature was carried out for studies reporting on ON and (addictive) exercise behaviors. Random effects meta-analyses were undertaken calculating correlations between ON and (addictive) exercise behaviors. A sub-group analysis investigated gender differences.ResultsTwenty-five studies with 10,134 participants (mean age = 25.21; 56.4% female) were included. Analyses showed a small overall correlation between ON and exercise (21 studies, r = 0.12, 95% CI |0.06–0.18|) and a medium overall correlation between ON and ExAdd (7 studies, r = 0.29, 95% CI |0.13–0.45|). Gender differences were negligible.ConclusionsOrthorexic eating correlated slightly and moderately with exercise and ExAdd, respectively, expressing some unique and shared variance of these behaviors. While this does not suggest ON and addictive exercising to be independent, it does not indicate substantial comorbidity. Future research should focus on clinical relevance, underlying mechanisms, vulnerability, and risk factors.

Research at Work: Systematic Reviews and Meta-Analyses

2019 ◽  
Vol 100 (3) ◽  
pp. 312-316
Author(s):  
Jeremiah W. Jaggers ◽  
David Kondrat
Keyword(s):  
Systematic Review ◽  
Social Work ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Important Research ◽  
Social Work Practitioners ◽  
Comprehensive Picture ◽  
Meta Analyses

This article provides an overview of the systematic review and the meta-analysis. These tools provide a comprehensive picture of current research. What follows is an abridged explanation of each of these techniques. This approach is intended to provide a fundamental overview for social work practitioners, so that they may more readily access important research, while minimizing the time spent doing so.

scholarly journals Endovascular treatment for symptomatic intracranial artery stenosis: protocol for a systematic review and network meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e022359 ◽  
Author(s):  
Tao Wang ◽  
Xue Wang ◽  
Kun Yang ◽  
Jing Zhang ◽  
Jichang Luo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Endovascular Treatment ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Biomedical Literature ◽  
Artery Stenosis ◽  
Intracranial Artery ◽  
Intracranial Artery Stenosis ◽  
Literature Database ◽  
Meta Analyses

IntroductionAtherosclerotic intracranial artery stenosis (ICAS) is one of most common causes of stroke, which is the second-leading cause of death worldwide. Medical, surgical and endovascular therapy are three major treatments for ICAS. Currently, medical therapy is considered as the standard of care for most patients with ICAS, while extracranial to intracranial bypass is only used in rare situations. Balloon angioplasty alone, balloon-mounted stent and self-expanding stent, collectively called endovascular treatment, have shown promising potentials in treating specific subgroups of patients with symptomatic ICAS; however, their comparative safety and efficacy is still unclear. Therefore, a systematic review with network meta-analysis is needed to establish a hierarchy of these endovascular treatments.Methods and analysisThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols was followed to establish this protocol. The search will be limited to studies published from 1 January 2000 to the formal search date. Major databases including Cochrane Library, MEDLINE, EMBASE, Chinese Biomedical Literature Database, conference proceedings and grey literature database will be searched for clinical studies comparing at least two interventions for patients with symptomatic ICAS. Primary outcomes include short-term and long-term mortality or stroke rate. Random effects pairwise and network meta-analyses of included studies will be performed on STATA (V.14, StataCorp, 2015). The surface under the cumulative ranking curve and mean rank will be calculated in order to establish a hierarchy of the endovascular treatments. Evaluation of the risk of bias, heterogeneity, consistency, transitivity and quality of evidence will follow the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions.Ethics and disseminationEthics approval is not needed as systematic review is based on published studies. Study findings will be presented at international conferences and published on a peer-reviewed journal.PROSPERO registration numberCRD42018084055; Pre-results.

scholarly journals Pedestrian–Vehicle Interaction at Unsignalized Crosswalks: A Systematic Review

2020 ◽  
Vol 12 (7) ◽  
pp. 2805 ◽  
Author(s):  
Harley Amado ◽  
Sara Ferreira ◽  
José Pedro Tavares ◽  
Paulo Ribeiro ◽  
Elisabete Freitas
Keyword(s):  
Systematic Review ◽  
Data Collection ◽  
Cellular Automata ◽  
Systematic Reviews ◽  
Video Camera ◽  
Future Research ◽  
Cellular Automata Model ◽  
Micro Simulation ◽  
Field Information ◽  
Meta Analyses

A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), to generate a document that supports the development of future research, compiling the various studies focused on the analysis of the pedestrian-vehicle interaction at unsignalized crosswalks. Firstly, 381 studies were identified by applying the search protocol in the database sources; however, only nine studies were included in this review because most of the studies are not focused on this type of crosswalks or have not considered the micro-simulation perspective. For each study, an analysis of the used methodology for data collection was carried out, in addition to what type of model it was applied, including the variables that represent the PVI (Pedestrian-Vehicle Interaction). The outcomes obtained by this systematic review show that although the video camera observation technique is the most used, it is possible to complement them with other tools to add specific field information. Additionally, variables such as the adjacent yields, speed variables vehicles, pedestrian attitude, and the number of pedestrians waiting at the crossing were those most used in the cellular automata model or micro-simulation, which are the commonly developed models to simulate this interaction.

scholarly journals Teaching Lifelong Research Skills in Residency: Implementation and Outcome of a Systematic Review and Meta-Analysis Course

2015 ◽  
Vol 7 (3) ◽  
pp. 445-450 ◽  
Author(s):  
Seth Himelhoch ◽  
Sarah Edwards ◽  
Mark Ehrenreich ◽  
M. Philip Luber
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Scientific Literacy ◽  
Learning Experience ◽  
Meta Analysis ◽  
Academic Productivity ◽  
Fisher Exact Test ◽  
Psychiatry Residents ◽  
Research Skills ◽  
Meta Analyses

ABSTRACT Background There is rising concern that fundamental scientific principles critical to lifelong learning and scientific literacy are not sufficiently addressed during residency. Objective We describe the development, implementation, and evaluation of a systematic review and meta-analysis course designed to improve residents' research literacy. Intervention We developed and implemented a novel, interactive, web-enhanced course for third-year psychiatry residents to provide the theoretical and methodological tools for conducting and reporting systematic reviews and meta-analyses. The course is based on Bloom's learning model, and established criteria for reporting systematic reviews and meta-analyses. Eight sequential learning objectives were linked to 8 well-specified assignments, with the objectives designed to build on one another and lead to the creation of a scientific manuscript. Results From 2010–2014, 54 third-year psychiatry residents (19 unique groups) successfully completed the course as part of a graduation requirement. The majority rated the course as being good or very good, and participants reported a statistically significant increase in their confidence to conduct systematic reviews (χ2 = 23.3, P < .05) and meta-analyses (Fisher exact test, P < .05). Estimated total dedicated resident and faculty time over a period of 36 weeks was 36 to 72 hours and 60 hours, respectively. Residents' academic productivity included 11 conference presentations and 4 peer-reviewed published manuscripts, with 2 residents who were awarded honors for their projects. Conclusions A formal training course in systematic reviews and meta-analyses offers a valuable learning experience, which enhances residents' research skills and academic productivity in a feasible and sustainable approach.

scholarly journals Systematic Reviews and Meta-Analysis in Spine Surgery—How Good Are They in Methodological Quality? A Systematic Review

2020 ◽  
pp. 219256822090681 ◽  
Author(s):  
Muthu Sathish ◽  
Ramakrishnan Eswar
Keyword(s):  
Systematic Review ◽  
Spine Surgery ◽  
Systematic Reviews ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Eligibility Criteria ◽  
Cochrane Database ◽  
Critical Flaw ◽  
Meta Analyses

Study Design: Systematic review. Objectives: To assess the methodological quality of systematic reviews and meta-analyses in spine surgery over the past 2 decades. Materials and Methods: We conducted independent and in duplicate systematic review of the published systematic reviews and meta-analyses between 2000 and 2019 from PubMed Central and Cochrane Database pertaining to spine surgery involving surgical intervention. We searched bibliographies to identify additional relevant studies. Methodological quality was evaluated with AMSTAR score and graded with AMSTAR 2 criteria. Results: A total of 96 reviews met the eligibility criteria, with mean AMSTAR score of 7.51 (SD = 1.98). Based on AMSTAR 2 criteria, 13.5% (n = 13) and 18.7% (n = 18) of the studies had high and moderate level of confidence of results, respectively, without any critical flaws. A total of 29.1% (n = 28) of the studies had at least 1 critical flaw and 38.5% (n = 37) of the studies had more than 1 critical flaw, so that their results have low and critically low confidence, respectively. Failure to analyze the conflict of interest of authors of primary studies included in review and lack of list of excluded studies with justification were the most common critical flaw. Regression analysis demonstrated that studies with funding and studies published in recent years were significantly associated with higher methodological quality. Conclusion: Despite improvement in methodological quality of systematic reviews and meta-analyses in spine surgery in current decade, a substantial proportion continue to show critical flaws. With increasing number of review articles in spine surgery, stringent measures must be taken to adhere to methodological quality by following PRISMA and AMSTAR guidelines to attain higher standards of evidence in published literature.

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