scholarly journals Effectiveness of feeding supplementation in preterm infants: an overview of systematic reviews

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Keqin Liu ◽  
Jiaxin Tao ◽  
Jixin Yang ◽  
Yufeng Li ◽  
Yanwei Su ◽  
...  

Abstract Background Preterm infants have higher nutrition needs than term infants. The effectiveness of various feeding supplementation was assessed by the improvement of health outcomes in single specific systematic reviews (SRs). The aim of this review was to comprehensively describe the effectiveness of feeding supplementation in promoting health outcomes of preterm infants. Methods A literature search was conducted in the PUBMED, EMBASE, Science Direct, Cochrane library, Web of Science, and Wiley online library. SRs selection followed clear inclusion and exclusion criteria. Pairs of reviewers independently applied the criteria to both titles/abstracts and full texts. Screening and data extraction were performed by using the advanced tables. The methodological quality of SRs and the quality of the evidence were carried out according to the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) tool and the Grades of Recommendation, Assessment, Development, and Evaluation guidelines (GRADE) respectively. A qualitative synthesis of evidence is presented. Results Seventeen SRs were included in the review. Fifteen kinds of feeding supplementation were reported in the SRs. In preterm infants, the effectiveness of feeding supplementation in addition to regular breast-feeding was mainly shown in six aspects: physical health, neurodevelopment, biochemical outcomes, other health outcomes, morbidity and all-cause mortality. And the effectiveness of the interventions on health outcomes in preterm infants was found by most systematic reviews. The methodological quality of all the included SRs was high, and most of the evidences was of low or very low quality. Conclusions Our results will allow a better understanding of the feeding supplementation in preterm infants. Although the feeling supplements may improve the health outcomes of in preterm infants, the existing evidence is uncertain. Therefore, the clinical use of these supplements should be considered cautiously and more well-designed RCTs are still needed to further address the unsolved problems of the included SRs.

2020 ◽  
Author(s):  
Jiaxin Tao ◽  
Jixin Yang ◽  
Yufeng Li ◽  
Yanwei Su ◽  
Jing Mao

Abstract BackgroundPreterm infants have higher nutrition needs than term infants. The effectiveness of various feeding supplementation was assessed by the improvement of health outcomes in single specific systematic reviews (SRs). The aim of this review is to summarise these SRs to provide comprehensive evidence on the effectiveness of these interventions for preterm infants. MethodsA literature search was conducted in the PUBMED, EMBASE, Science Direct, Cochrane library, Web of Science, and Wiley online library. SR selection followed clear inclusion and exclusion criteria. Data extraction was performed by using the pre-designed tables and quality assessment was done by the AMSTAR tool. ResultsSeventeen SRs were included in the review. Fifteen kinds of feeding supplementation were reported in the SRs. The effectiveness of the interventions was defined as positive, having no impact, or inconclusive. Lactoferrin, probiotic, prebiotic, vitamin D, protein, and arginine were concluded to be positive; inositol, iodine, fat, glutamine, and long chain polyunsaturated fatty acid (LCPUFA) were concluded to have no impact; results for prebiotic (for prevention of hyperbilirubinaemia), carbohydrate, multi-nutrient, taurine, calcium, and phosphorus were inconclusive. All the SRs included were graded as being of high quality. ConclusionsSupplements with positive effects on health improvement were considerable to add to the feeding of preterm infants. More well-designed large RCTs are still needed to address the unsolved problems in the SRs concluded as having no impact or where the results were inconclusive.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Pawel Posadzki ◽  
Dawid Pieper ◽  
Ram Bajpai ◽  
Hubert Makaruk ◽  
Nadja Könsgen ◽  
...  

Abstract Background Sedentary lifestyle is a major risk factor for noncommunicable diseases such as cardiovascular diseases, cancer and diabetes. It has been estimated that approximately 3.2 million deaths each year are attributable to insufficient levels of physical activity. We evaluated the available evidence from Cochrane systematic reviews (CSRs) on the effectiveness of exercise/physical activity for various health outcomes. Methods Overview and meta-analysis. The Cochrane Library was searched from 01.01.2000 to issue 1, 2019. No language restrictions were imposed. Only CSRs of randomised controlled trials (RCTs) were included. Both healthy individuals, those at risk of a disease, and medically compromised patients of any age and gender were eligible. We evaluated any type of exercise or physical activity interventions; against any types of controls; and measuring any type of health-related outcome measures. The AMSTAR-2 tool for assessing the methodological quality of the included studies was utilised. Results Hundred and fifty CSRs met the inclusion criteria. There were 54 different conditions. Majority of CSRs were of high methodological quality. Hundred and thirty CSRs employed meta-analytic techniques and 20 did not. Limitations for studies were the most common reasons for downgrading the quality of the evidence. Based on 10 CSRs and 187 RCTs with 27,671 participants, there was a 13% reduction in mortality rates risk ratio (RR) 0.87 [95% confidence intervals (CI) 0.78 to 0.96]; I2 = 26.6%, [prediction interval (PI) 0.70, 1.07], median effect size (MES) = 0.93 [interquartile range (IQR) 0.81, 1.00]. Data from 15 CSRs and 408 RCTs with 32,984 participants showed a small improvement in quality of life (QOL) standardised mean difference (SMD) 0.18 [95% CI 0.08, 0.28]; I2 = 74.3%; PI -0.18, 0.53], MES = 0.20 [IQR 0.07, 0.39]. Subgroup analyses by the type of condition showed that the magnitude of effect size was the largest among patients with mental health conditions. Conclusion There is a plethora of CSRs evaluating the effectiveness of physical activity/exercise. The evidence suggests that physical activity/exercise reduces mortality rates and improves QOL with minimal or no safety concerns. Trial registration Registered in PROSPERO (CRD42019120295) on 10th January 2019.


2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
Romy Lauche ◽  
Holger Cramer ◽  
Winfried Häuser ◽  
Gustav Dobos ◽  
Jost Langhorst

Objectives.This systematic overview of reviews aimed to summarize evidence and methodological quality from systematic reviews of complementary and alternative medicine (CAM) for the fibromyalgia syndrome (FMS).Methods.The PubMed/MEDLINE, Cochrane Library, and Scopus databases were screened from their inception to Sept 2013 to identify systematic reviews and meta-analyses of CAM interventions for FMS. Methodological quality of reviews was rated using the AMSTAR instrument.Results.Altogether 25 systematic reviews were found; they investigated the evidence of CAM in general, exercised-based CAM therapies, manipulative therapies, Mind/Body therapies, acupuncture, hydrotherapy, phytotherapy, and homeopathy. Methodological quality of reviews ranged from lowest to highest possible quality. Consistently positive results were found for tai chi, yoga, meditation and mindfulness-based interventions, hypnosis or guided imagery, electromyogram (EMG) biofeedback, and balneotherapy/hydrotherapy. Inconsistent results concerned qigong, acupuncture, chiropractic interventions, electroencephalogram (EEG) biofeedback, and nutritional supplements. Inconclusive results were found for homeopathy and phytotherapy. Major methodological flaws included missing details on data extraction process, included or excluded studies, study details, and adaption of conclusions based on quality assessment.Conclusions.Despite a growing body of scientific evidence of CAM therapies for the management of FMS systematic reviews still show methodological flaws limiting definite conclusions about their efficacy and safety.


2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Xuanlin Li ◽  
Yang Xie ◽  
Hulei Zhao ◽  
Hailong Zhang ◽  
Xueqing Yu ◽  
...  

Objective. The role of telemonitoring interventions (TIs) for chronic obstructive pulmonary disease (COPD) has been studied in many systematic reviews (SRs) and meta-analyses (MAs), but robust conclusions have not been reached due to wide variations in scopes, qualities, and outcomes. The aim of this overview was to determine the effectiveness of TIs on COPD patients. Methods. PubMed, EMBASE, Web of Science, and Cochrane Library were searched for all reviews on the topic of TI in treating COPD from inception to July 8, 2019, without restrictions on language. According to the inclusion and exclusion criteria, the retrieved literature studies were screened to select SRs and MAs of randomized control trials (RCTs) that evaluated the effects of TIs in COPD patients. The methodological quality of SRs and MAs was assessed with the AMSTAR-2 tool, and the strength of evidence was assessed with the grades of recommendations, assessment, development, and evaluation (GRADE) system for concerned outcomes in terms of mortality, quality of life (SGRQ total scores), exercise capacity (6MWD), and exacerbation-related outcomes (hospitalizations, exacerbation rate, and emergency room visits). Results. Our overview included eight SRs and MAs published in 2011 to 2019, from 95 RCTs involving 10632 participants. After strict evaluation by the AMSTAR-2 tool, 75% of the SRs and MAs in this overview had either low or critically low methodological quality. The effects of TIs for COPD on mortality, quality of life, exercise capacity, and exacerbation-related outcomes are limited, and all of these outcomes scored either low or very low quality of evidence on the GRADE system. Conclusions. There might be insufficient evidence to support the effectiveness of TIs for COPD currently, but the results of this overview should be interpreted dialectically and prudently, and the role of TIs in COPD needs further exploration.


Author(s):  
Ana Beatriz Pizarro ◽  
Sebastián Carvajal ◽  
Adriana Buitrago-López

Introduction: Making decisions based on evidence has been a challenge for health professionals, given the need to have the tools and skills to carry out a critical appraisal of the evidence and assess the validity of the results. Systematic reviews of the literature (SRL) have been used widely to answer questions in the clinical field. Tools have been developed that support the appraisal of the quality of the studies. AMSTAR is one of these, validated and supported by reproducible evidence, which guides the methodological quality of the SRL. Objectives: To show a historical, theoretical and practical guide for critical assessment of systematic reviews using AMSTAR to guide the argumental bases for their use according to the components of this methodological structure in health research, and to provide practical examples of how to apply this checklist. Methods: We conducted a non-exhaustive review of literature in Pubmed and Cochrane Library using “AMSTAR” and “Systematic Reviews” as free terms without language or publication date limit; we also collected information from experts in the evaluation of the quality of the evidence. Conclusions: AMSTAR is an instrument used, validated and supported by reproducible evidence for the evaluation of the internal validity of systematic reviews of the literature. It consists of 16 items that assess the overall methodological quality of an SRL. It is currently used indiscriminately and favorably, but it is not exempt from limitations and future updates based on new reproducibility and validation studies.


BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e025054 ◽  
Author(s):  
Nina Deliu ◽  
Francesco Cottone ◽  
Gary S Collins ◽  
Amélie Anota ◽  
Fabio Efficace

IntroductionWhile there is mounting evidence of the independent prognostic value of patient-reported outcomes (PROs) for overall survival (OS) in patients with cancer, it is known that the conduct of these studies may hold a number of methodological challenges. The aim of this systematic review is to evaluate the quality of published studies in this research area, in order to identify methodological and statistical issues deserving special attention and to also possibly provide evidence-based recommendations.Methods and analysisAn electronic search strategy will be performed in PubMed to identify studies developing or validating a prognostic model which includes PROs as predictors. Two reviewers will independently be involved in data collection using a predefined and standardised data extraction form including information related to study characteristics, PROs measures used and multivariable prognostic models. Studies selection will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, with data extraction form using fields from the Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies (CHARMS) checklist for multivariable models. Methodological quality assessment will also be performed and will be based on prespecified domains of the CHARMS checklist. As a substantial heterogeneity of included studies is expected, a narrative evidence synthesis will also be provided.Ethics and disseminationGiven that this systematic review will use only published data, ethical permissions will not be required. Findings from this review will be published in peer-reviewed scientific journals and presented at major international conferences. We anticipate that this review will contribute to identify key areas of improvement for conducting and reporting prognostic factor analyses with PROs in oncology and will lay the groundwork for developing future evidence-based recommendations in this area of research.Prospero registration numberCRD42018099160.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marilyn Aita ◽  
Gwenaëlle De Clifford Faugère ◽  
Andréane Lavallée ◽  
Nancy Feeley ◽  
Robyn Stremler ◽  
...  

Abstract Background As preterm infants’ neurodevelopment is shaped by NICU-related factors during their hospitalization, it is essential to evaluate which interventions are more beneficial for their neurodevelopment at this specific time. The objective of this systematic review and meta-analysis was to evaluate the effectiveness of interventions initiated during NICU hospitalization on preterm infants’ early neurodevelopment during their hospitalization and up to two weeks corrected age (CA). Methods This systematic review referred to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA] guidelines and was registered in PROSPERO (CRD42017047072). We searched CINAHL, MEDLINE, PubMed, EMBASE (OVID), Cochrane Systematic Reviews, CENTRAL, and Web of Science from 2002 to February 2020 and included randomized controlled/clinical trials conducted with preterm infants born between 24 and 366/7 weeks of gestation. All types of interventions instigated during NICU hospitalization were included. Two independent reviewers performed the study selection, data extraction, assessment of risks of bias and quality of evidence. Results Findings of 12 studies involving 901 preterm infants were synthesized. We combined three studies in a meta-analysis showing that compared to standard care, the NIDCAP intervention is effective in improving preterm infants’ neurobehavioral and neurological development at two weeks CA. We also combined two other studies in a meta-analysis indicating that parental participation did not significantly improve preterm infants’ neurobehavioral development during NICU hospitalization. For all other interventions (i.e., developmental care, sensory stimulation, music and physical therapy), the synthesis of results shows that compared to standard care or other types of comparators, the effectiveness was either controversial or partially effective. Conclusions The overall quality of evidence was rated low to very low. Future studies are needed to identify interventions that are the most effective in promoting preterm infants’ early neurodevelopment during NICU hospitalization or close to term age. Interventions should be appropriately designed to allow comparison with previous studies and a combination of different instruments could provide a more global assessment of preterm infants’ neurodevelopment and thus allow for comparisons across studies. Trial registration Prospero CRD42017047072.


Dermatology ◽  
2021 ◽  
pp. 1-10
Author(s):  
Vanessa Lin ◽  
Raahi Patel ◽  
Alexis Wirtz ◽  
Deepika Mannem ◽  
Ryan Ottwell ◽  
...  

<b><i>Background:</i></b> Spin – the misrepresentation of a study’s results – has been identified in abstracts of studies focused on a variety of disorders from multiple fields of medicine. <b><i>Objectives:</i></b> This study’s primary objective was to evaluate the abstracts of systematic reviews and meta-analyses focused on the treatment of atopic dermatitis for the nine most severe forms of spin. <b><i>Methods:</i></b> We systematically searched Embase and MEDLINE for systematic reviews of atopic dermatitis therapies. Screening and data extraction occurred in a masked, duplicate fashion. Each included study was evaluated for the nine most severe types of spin and other study characteristics. <b><i>Results:</i></b> Our searches retrieved 2,456 studies, of which 113 were included for data extraction. Spin was found in 74.3% of our included studies (84/113). Spin type 6 occurred most frequently (68/113, 60.2%). Spin types 1, 2, and 9 were not identified. All industry-funded systematic reviews contained spin in their abstract. The presence of spin was not associated with any specific study characteristics, including the methodological quality of the study. <b><i>Conclusions:</i></b> Severe forms of spin were found in the majority of abstracts for systematic reviews of atopic dermatitis treatments. Steps should be taken to prevent spin to improve the quality of reporting in abstracts.


2020 ◽  
Author(s):  
Xue Wang ◽  
Jun Xiong ◽  
Jun Yang ◽  
Ting Yuan

Abstract purpose: Tennis elbow is a common orthopedic disease, and there are many ways to treat it. This overview aimed to summarize the evidence of different treatments for tennis elbows, so as to provide the best guidance for clinical treatment.Methods: Use computer to search CNKI, WanFang database, WeiPu database, CBM database, PubMed, Cochrane Library and Embase from the time of establishment to May 31, 2019.Te Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and latest Assessment of Multiple Systematic Reviews 2 (AMSTAR2) checklists were used to assess reporting characteristics and methodological quality, respectively.Results: A total of 37 references were included. Methodological quality and reporting quality were unsatisfactory. Methodological quality was generally low and many key items were not reported. Some research reports are of high quality, but there is no trial registration and protocol written in advance, which may lead to some bias in the research process. The most frequent problems included non-registration of study protocol, absence of a list of excluded studies, and unclear acknowledgment of conflicts of interests. The different types of interventions included have been shown to relieve pain, improve quality of life, and restore elbow function, but there has been a lack of comparative studies.Conclusion: The reporting and methodological quality of systematic reviews and meta-analysis studies were sub-optimal, which demands further improvement. Comparative studies of different types of interventions are needed to determine unclear.PROSPERO registration number: CRD42015017071


2020 ◽  
Author(s):  
Alemu Sufa Melka ◽  
Catherine L Chojenta ◽  
Elizabeth G Holliday ◽  
Ayele G Bali ◽  
Deborah J Loxton

Abstract Background : In the long term, smoking cessation can decrease the risk of cancer, stroke, and heart attacks and improve overall survival. This umbrella review aimed to assess the effect of pharmacological interventions on smoking cessation and to evaluate the methodological quality of previously conducted systematic reviews. Methods: Databases including the Cochrane library, PubMed, MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, Scopus and Google Scholar were used to retrieve reviews. Systematic reviews that included only randomized controlled trials designed to assess pharmacotherapeutic interventions supporting abstinence from smoking were considered in this umbrella review. The methodological quality of the included reviews was assessed using the Assessment of Multiple Systematic Reviews 2 (AMSTAR 2) tool, which contains 16 domains. Two authors (AM, AB) screened the titles and abstracts of all reviews obtained by the search strategy, assessed the full text of selected articles for inclusion and extracted data independently. Two authors (AM, AB) also performed a quality appraisal independently. The findings of the studies were narrated qualitatively to describe the evidence regarding the effectiveness of pharmacotherapies for smoking cessation. Results: Ten reviews were included in this umbrella review . Most of the reviews included in this review reported that Nicotine Replacement Therapy (NRT), bupropion and varenicline and cytisine were effective for smoking cessation. The combination of a nicotine patch with other nicotine formulations was also more effective than monotherapy. Similarly, the combination of nicotine with the non-nicotine therapy varenicline was found to be more effective than varenicline alone. However, the opioid antagonist naltrexone alone was not found to be effective for smoking cessation nor in combination with nicotine replacement therapy. Based on the AMSTAR 2 rating, one review scored high quality, two scored moderate quality, four scored low quality, and three scored critically low quality. Conclusions: This review revealed that drugs approved by the US Food and Drug Administration (FDA) are effective for smoking cessation. A combination of nicotine patches with other nicotine formulations was also effective for smoking cessation compared to nicotine monotherapy.


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