scholarly journals Development, validation and effectiveness of diagnostic prediction tools for colorectal cancer in primary care: a systematic review

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Bogdan Grigore ◽  
Ruth Lewis ◽  
Jaime Peters ◽  
Sophie Robinson ◽  
Christopher J. Hyde
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Primary Care ◽  
Cost Effectiveness ◽  
Prediction Model ◽  
Prediction Models ◽  
Diagnostic Tools ◽  
Inclusion Criteria ◽  
Impact Studies ◽  
The Impact

Abstract Background Tools based on diagnostic prediction models are available to help general practitioners (GP) diagnose colorectal cancer. It is unclear how well they perform and whether they lead to increased or quicker diagnoses and ultimately impact on patient quality of life and/or survival. The aim of this systematic review is to evaluate the development, validation, effectiveness, and cost-effectiveness, of cancer diagnostic tools for colorectal cancer in primary care. Methods Electronic databases including Medline and Web of Science were searched in May 2017 (updated October 2019). Two reviewers independently screened titles, abstracts and full-texts. Studies were included if they reported the development, validation or accuracy of a prediction model, or assessed the effectiveness or cost-effectiveness of diagnostic tools based on prediction models to aid GP decision-making for symptomatic patients presenting with features potentially indicative of colorectal cancer. Data extraction and risk of bias were completed by one reviewer and checked by a second. A narrative synthesis was conducted. Results Eleven thousand one hundred thirteen records were screened and 23 studies met the inclusion criteria. Twenty-studies reported on the development, validation and/or accuracy of 13 prediction models: eight for colorectal cancer, five for cancer areas/types that include colorectal cancer. The Qcancer models were generally the best performing. Three impact studies met the inclusion criteria. Two (an RCT and a pre-post study) assessed tools based on the RAT prediction model. The third study looked at the impact of GP practices having access to RAT or Qcancer. Although the pre-post study reported a positive impact of the tools on outcomes, the results of the RCT and cross-sectional survey found no evidence that use of, or access to, the tools was associated with better outcomes. No study evaluated cost effectiveness. Conclusions Many prediction models have been developed but none have been fully validated. Evidence demonstrating improved patient outcome of introducing the tools is the main deficiency and is essential given the imperfect classification achieved by all tools. This need is emphasised by the equivocal results of the small number of impact studies done so far.

scholarly journals Polygenic risk prediction models for colorectal cancer: a systematic review

BMC Cancer ◽  
2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Michele Sassano ◽  
Marco Mariani ◽  
Gianluigi Quaranta ◽  
Roberta Pastorino ◽  
Stefania Boccia
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Systematic Review ◽  
Prediction Model ◽  
Risk Prediction ◽  
Genetic Variants ◽  
Prediction Models ◽  
Risk Prediction Models ◽  
Discriminatory Accuracy ◽  
Traditional Risk Factors

Abstract Background Risk prediction models incorporating single nucleotide polymorphisms (SNPs) could lead to individualized prevention of colorectal cancer (CRC). However, the added value of incorporating SNPs into models with only traditional risk factors is still not clear. Hence, our primary aim was to summarize literature on risk prediction models including genetic variants for CRC, while our secondary aim was to evaluate the improvement of discriminatory accuracy when adding SNPs to a prediction model with only traditional risk factors. Methods We conducted a systematic review on prediction models incorporating multiple SNPs for CRC risk prediction. We tested whether a significant trend in the increase of Area Under Curve (AUC) according to the number of SNPs could be observed, and estimated the correlation between AUC improvement and number of SNPs. We estimated pooled AUC improvement for SNP-enhanced models compared with non-SNP-enhanced models using random effects meta-analysis, and conducted meta-regression to investigate the association of specific factors with AUC improvement. Results We included 33 studies, 78.79% using genetic risk scores to combine genetic data. We found no significant trend in AUC improvement according to the number of SNPs (p for trend = 0.774), and no correlation between the number of SNPs and AUC improvement (p = 0.695). Pooled AUC improvement was 0.040 (95% CI: 0.035, 0.045), and the number of cases in the study and the AUC of the starting model were inversely associated with AUC improvement obtained when adding SNPs to a prediction model. In addition, models constructed in Asian individuals achieved better AUC improvement with the incorporation of SNPs compared with those developed among individuals of European ancestry. Conclusions Though not conclusive, our results provide insights on factors influencing discriminatory accuracy of SNP-enhanced models. Genetic variants might be useful to inform stratified CRC screening in the future, but further research is needed.

scholarly journals Systematic Review: Recommendations of Levels of Physical Activity among Colorectal Cancer Patients (2010–2019)

2021 ◽  
Vol 18 (6) ◽  
pp. 2896
Author(s):  
Jineui Hong ◽  
Jungmin Park
Keyword(s):  
Physical Activity ◽  
Colorectal Cancer ◽  
Systematic Review ◽  
Cancer Patients ◽  
The United States ◽  
Inclusion Criteria ◽  
Low Levels ◽  
Colorectal Cancer Patients ◽  
Recommended Guidelines ◽  
The Impact

Background: It is necessary to engage in an appropriate level of physical activity to improve the prognoses of colorectal cancer patients, yet no guidelines currently exist. The goals of this systematic review are to determine the impact of levels of physical activity on the prognoses of colorectal cancer patients and to suggest recommended guidelines for levels of physical activity. Methods: This systematic review was conducted along PRISMA guidelines. Per the inclusion criteria, papers published in academic journals in English from 2010 to 2019 were selected. A literature search was performed on PubMed (Medline), and the results of the selected studies were qualitatively synthesized. Results: Of the 13 cohort studies included in this systematic review, most studies were conducted in the United States (N = 7). Immobility or low levels of physical activity adversely affected the prognoses of colorectal cancer patients. Contrarily, high levels of physical activity increased the survival rate in people with colorectal cancer. Conclusion: For colorectal cancer patients, a level of physical activity of 17.5 to 35 MET hours per week is strongly recommended, which has been shown to reduce mortality by approximately 30 to 40%. Patients with limited physical capacity should maintain a minimum level of physical activity (≥3.5 MET hours/week).

scholarly journals Decision support tools to improve cancer diagnostic decision making in primary care: a systematic review

2019 ◽  
Vol 69 (689) ◽  
pp. e809-e818 ◽  
Author(s):  
Sophie Chima ◽  
Jeanette C Reece ◽  
Kristi Milley ◽  
Shakira Milton ◽  
Jennifer G McIntosh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Decision Making ◽  
Decision Support ◽  
Cost Effectiveness ◽  
Cancer Diagnosis ◽  
Decision Support Tools ◽  
Diagnostic Decision ◽  
Support Tools ◽  
Diagnostic Decision Making

BackgroundThe diagnosis of cancer in primary care is complex and challenging. Electronic clinical decision support tools (eCDSTs) have been proposed as an approach to improve GP decision making, but no systematic review has examined their role in cancer diagnosis.AimTo investigate whether eCDSTs improve diagnostic decision making for cancer in primary care and to determine which elements influence successful implementation.Design and settingA systematic review of relevant studies conducted worldwide and published in English between 1 January 1998 and 31 December 2018.MethodPreferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched, and a consultation of reference lists and citation tracking was carried out. Exclusion criteria included the absence of eCDSTs used in asymptomatic populations, and studies that did not involve support delivered to the GP. The most relevant Joanna Briggs Institute Critical Appraisal Checklists were applied according to study design of the included paper.ResultsOf the nine studies included, three showed improvements in decision making for cancer diagnosis, three demonstrated positive effects on secondary clinical or health service outcomes such as prescribing, quality of referrals, or cost-effectiveness, and one study found a reduction in time to cancer diagnosis. Barriers to implementation included trust, the compatibility of eCDST recommendations with the GP’s role as a gatekeeper, and impact on workflow.ConclusioneCDSTs have the capacity to improve decision making for a cancer diagnosis, but the optimal mode of delivery remains unclear. Although such tools could assist GPs in the future, further well-designed trials of all eCDSTs are needed to determine their cost-effectiveness and the most appropriate implementation methods.

scholarly journals Medicines Related Problems (MRPs) Originating in Primary Care Settings in Older Adults - A Systematic Review

2021 ◽  
pp. 089719002110236
Author(s):  
Rosetta Chinyere Ude-Okeleke ◽  
Zoe Aslanpour ◽  
Soraya Dhillon ◽  
Nkiruka Umaru
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Library Science ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Data Bases ◽  
Primary Care Settings ◽  
Preventative Interventions ◽  
Use Of Health Services

Background: As people age, they become increasingly vulnerable to the untoward effects of medicines due to changes in body systems. These may result in medicines related problems (MRPs) and consequent decline or deterioration in health. Aim: To identify MRPs, indicators of deterioration associated with these MRPs, and preventative interventions from the literature. Design and Setting: Systematic review of primary studies on MRPs originating in Primary Care in older people. Methods: Relevant studies published between 2001 and April 2018 were obtained from Medline (via PubMed), CINAHL, Embase, Psych Info, PASCAL, Scopus, Cochrane Library, Science Direct, and Zetoc. Falls, delirium, pressure ulcer, hospitalization, use of health services and death were agreed indicators of deterioration. The methodological quality of included studies was assessed using the Down and Black tool. Results: There were 1858 articles retrieved from the data bases. Out of these, 21 full text articles met inclusion criteria for the review. MRPs identified were medication error, potentially inappropriate medicines, adverse drug reaction and non-adherence. These were associated with indicators of deterioration. Interventions that involved doctors, pharmacists and patients in planning and implementation yielded benefits in halting MRPs. Conclusion: This Systematic review summarizes MRPs and associated indicators of deterioration. Appropriate interventions appeared to be effective against certain MRPs and their consequences. Further studies to explore deterioration presented in this systematic review is imperative.

ENTREPRENEURSHIP EDUCATION: A SYSTEMATIC REVIEW OF THE METHODS IN IMPACT STUDIES

2013 ◽  
Vol 21 (02) ◽  
pp. 123-151 ◽  
Author(s):  
MICHAEL LORZ ◽  
SUSAN MUELLER ◽  
THIERRY VOLERY
Keyword(s):  
Systematic Review ◽  
Literature Review ◽  
Research Methods ◽  
Systematic Literature Review ◽  
Positive Impact ◽  
Reliability And Validity ◽  
Entrepreneurship Education ◽  
Impact Studies ◽  
Entrepreneurial Attitudes ◽  
The Impact

The majority of studies that analyze the impact of entrepreneurship education on entrepreneurial attitudes, intentions, and venture activities report positive influences. However, several scholars have recently cast doubts about research methods and the generalizability of entrepreneurship education impact studies. In this study, we conducted a systematic literature review of the methods used in entrepreneurship education impact studies. Our results uncover significant methodological deficiencies and question the overwhelmingly positive impact of entrepreneurship education. Based on this evidence, we propose a series of recommendations to improve the reliability and validity of entrepreneurship education impact studies and we outline promising topics which are currently under-researched.

P–004 Effect of varicocelectomy on sperm DNA fragmentation rates in infertile men with clinical varicocele: a systematic review and meta-analysis

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
F Tenori. Lir. Neto ◽  
M Roque ◽  
S Esteves
Keyword(s):  
Systematic Review ◽  
Surgical Technique ◽  
Dna Fragmentation ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Sperm Dna Fragmentation ◽  
Inclusion Criteria ◽  
Infertile Men ◽  
Sperm Dna ◽  
The Impact

Abstract Study question Does varicocelectomy improve sperm DNA quality in men with infertility and clinically detected varicoceles? Summary answer Varicocelectomy reduces sperm DNA fragmentation (SDF) rates in infertile men with clinical varicocele. What is known already Varicocele has been linked to male infertility through various non-mutually exclusive mechanisms, including an increase in reactive oxygen species (ROS) production that may lead to sperm DNA damage. Damage to sperm DNA may result in longer time-to-pregnancy, unexplained infertility, recurrent pregnancy loss, and failed intrauterine insemination or in vitro fertilization/intracytoplasmic sperm injection. Therefore, interventions aimed at decreasing SDF rates, including varicocele repair, have been explored to improve fertility and pregnancy outcomes potentially, either by natural conception or using medically assisted reproduction. Study design, size, duration Systematic review and meta-analysis Participants/materials, setting, methods We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our systematic search included PubMed/Medline, EMBASE, Scielo, and Google Scholar to identify all relevant studies written in English and published from inception until October 2020. Inclusion criteria were studies comparing SDF rates before and after varicocelectomy in infertile men with clinical varicocele. Articles were included if the following SDF assays were utilized: SCSA, TUNEL, SCD test, or alkaline Comet. Main results and the role of chance Thirteen studies fulfilled the inclusion criteria and were selected for the analysis. The estimated weighted mean difference of SDF rates after varicocelectomy was –6.58% (13 studies, 95% CI –8.33%, –4.84%; I2=90% p < 0.0001). Subgroup analysis revealed a significant decrease in SDF rates using SCSA (eight studies, WMD –6.80%, 95% CI –9.31%, –4.28%; I2=89%, p < 0.0001), and TUNEL (three studies, WMD –4.86%, 95% CI –7.38%, –2.34%; I2=89%, p < 0.0001). The test for subgroup difference revealed that pooled results were conservative using the above SDF assays. Comet and SCD tests were used in only one study each; thus, a meta-analysis was not applicable. The studies were further categorized by the surgical technique (microsurgical versus non-microsurgical). This subgroup analysis showed a significant decrease in SDF rates using microsurgical technique (10 studies, WMD –6.70%, 95% CI –9.04%, –4.37%; I2=91%, p < 0.0001). After varicocelectomy, SDF rates were also decreased when non-microsurgical approaches were used, albeit the effect was not statistically significant (2 studies, WMD –6.84%, 95% CI –10.05%, 1.38%; I2=86%) (Figure 3). The heterogeneity was not materially affected by performing analyses by the above subgroups, suggesting that the SDF assay and surgical technique do not explain the inconsistency in the treatment effect across primary studies. Limitations, reasons for caution There were no randomized controlled trials comparing varicocelectomy to placebo for alleviating SDF levels. Heterogeneity was high, which may be explained by the low number of included studies. Pregnancy data are not available in most studies, thus the impact of reduced SDF after varicocelectomy on pregnancy rates unclear. Wider implications of the findings: Our study indicates a positive association between varicocelectomy and reduced postoperative SDF rates in men with clinical varicocele and infertility, independentetly of the assays used to measure SDF. These findings may help counsel and manage infertile men with varicocele and high SDF levels. Trial registration number Not applicable

Breast Density Notification: A Systematic Review of the Impact on Primary Care Practitioners

2021 ◽  
Author(s):  
Brooke Nickel ◽  
Tessa Copp ◽  
Meagan Brennan ◽  
Rachel Farber ◽  
Kirsten McCaffery ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Breast Density ◽  
Primary Care Practitioners ◽  
The Impact

A systematic review of adverse childhood experiences (ACEs) with people with intellectual disabilities: an unsafe gap in the literature

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Chloe Crompton ◽  
Bethany Duncan ◽  
Graham Simpson-Adkins
Keyword(s):  
Systematic Review ◽  
Intellectual Disabilities ◽  
Adverse Childhood Experiences ◽  
World Health ◽  
Inclusion Criteria ◽  
Childhood Experiences ◽  
Content Type ◽  
Adverse Childhood ◽  
People With Intellectual Disabilities ◽  
The Impact

Purpose This paper aims to systematically review the available evidence that explores adverse childhood experiences (ACEs) in people with intellectual disabilities (PwID). It is important to systematically review this literature as, to date, there is little known about the number of studies in this area, despite the World Health Organization declaring ACE prevention and support as a global public health priority. Design/methodology/approach Published studies were identified from electronic database searches. Key journals and reference lists were also hand searched. Findings Two studies met the inclusion criteria and the prevalence and frequency of ACEs experienced by participants of these studies analysed. Overall, due to the small number of studies meeting the inclusion criteria, it is difficult to establish any meaningful conclusions. Originality/value This appears to be the first systematic review to try and identify a research base looking at the prevalence of ACEs within a PwID population. Findings suggest that this is a highly neglected area of research, and the authors hope to have identified that further evidence is required to draw clearer conclusions about the impact of ACEs on PwID.

The Impact of Race/Ethnicity on the Outcomes of Burn Patients: A Systematic Review of the Literature

2021 ◽  
Author(s):  
Jasmine Peters ◽  
Mariel S Bello ◽  
Leigh Spera ◽  
T Justin Gillenwater ◽  
Haig A Yenikomshian
Keyword(s):  
Systematic Review ◽  
Native American ◽  
The United States ◽  
Current Status ◽  
Surgical Trauma ◽  
Insurance Status ◽  
Inclusion Criteria ◽  
Burn Care ◽  
Race Ethnicity ◽  
The Impact

Abstract Racial and ethnic disparities are endemic to the United States and are only beginning to attract the attention of researchers. With an increasingly diverse population, focused and tailored medicine to provide more equitable care is needed. For surgical trauma populations, this topic is a small but expanding field and still rarely mentioned in burn medicine. Disparities in prevention, treatment, and recovery outcomes between different racial and ethnic minorities who are burned are rarely discussed. The purpose of this study is to determine the current status of identified disparities of care in the burn population literature and areas of future research. A systematic review was conducted of literature utilizing PubMed for articles published between 2000-2020. Searches were used to identify articles that crossed the burn term (burn patient OR burn recovery OR burn survivor OR burn care) and a race/ethnicity and insurance status-related term (race/ethnicity OR African-American OR Black OR Asian OR Hispanic OR Latino OR Native American OR Indigenous OR Mixed race OR 2 or more races OR socioeconomic status OR insurance status). Inclusion criteria were English studies in the US that discussed disparities in burn injury outcomes or risk factors associated with race/ethnicity. 1,169 papers were populated, 55 were reviewed, and 36 articles met inclusion criteria. Most studies showed minorities had poorer inpatient and outpatient outcomes. While this is a concerning trend, there is a paucity of literature in this field and more research is needed to create culturally-tailored medical care and address the needs of disadvantaged burn survivors.

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