scholarly journals The role of hospitals in bridging the care continuum: a systematic review of coordination of care and follow-up for adults with chronic conditions

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Melissa De Regge ◽  
Kaat De Pourcq ◽  
Bert Meijboom ◽  
Jeroen Trybou ◽  
Eric Mortier ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Conditions ◽  
Coordination Of Care ◽  
Care Continuum

scholarly journals Multimorbidity, inflammation, and disability: a longitudinal mediational analysis

2018 ◽  
Vol 10 ◽  
pp. 204062231880684 ◽  
Author(s):  
Elliot M. Friedman ◽  
Daniel K. Mroczek ◽  
Sharon L. Christ
Keyword(s):  
Chronic Conditions ◽  
Structural Equation ◽  
Structural Equation Models ◽  
Functional Limitations ◽  
The United States ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Mediational Analysis

Background: Using longitudinal data from the Survey of Mid-Life Development in the United States, this study examined the role of systemic inflammation in mediating the link between multimorbidity and increases in and onset of functional limitations over a 17–19 year follow-up period. Methods: Participants completed questionnaire assessments of chronic conditions and functional limitations. Interleukin-6, C-reactive protein, and fibrinogen were assayed in serum. Structural equation models were used to predict increases in and onset of functional limitations associated with baseline multimorbidity status; mediation by inflammation was also determined. Results: Multimorbidity ( versus 0–1 conditions) predicted more functional limitations and greater odds of onset of limitations over time. Significant indirect effects showed that inflammation partially mediated the link between multimorbidity and changes in, but not onset of, limitations. Discussion: These results show that inflammation, a nonspecific marker of multiple disease conditions, explains in part the degree to which multimorbidity is disabling.

Unstimulated high-sensitive thyroglobulin is a powerful prognostic predictor in patients with thyroid cancer

2019 ◽  
Vol 58 (1) ◽  
pp. 130-137 ◽  
Author(s):  
Luca Giovanella ◽  
Marco Castellana ◽  
Pierpaolo Trimboli
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Differentiated Thyroid Carcinoma ◽  
Level Of Evidence ◽  
Prognostic Performance ◽  
Clinical Scenarios ◽  
High Level ◽  
Operating Points

Abstract Background Differentiated thyroid carcinoma (DTC) has an excellent prognosis and the role of high-sensitive thyroglobulin measured during levothyroxine (ON-T4 hs-Tg) testing to discriminate patients with structural from not-evidence of disease (SED and NED, respectively) has been investigated. We conducted a systematic review and meta-analysis evaluating the performance of ON-T4 hs-Tg in two clinical scenarios considering its negative predictive value (NPV) as primary outcome: (1) diagnostic performance of Tg when undetectable value and NED status are simultaneously demonstrated; (2) prognostic performance of undetectable Tg in predicting NED in the subsequent follow-up. Methods This systematic review and meta-analysis were registered on PROSPERO (CRD42019125092). PubMed, Scopus, CENTRAL and Web of Science were searched until February 12, 2019. Original articles reporting data on SED/NED in patients with detectable/undetectable ON-T4 hs-Tg were selected. Summary operating points were estimated using a random-effects model. Results Out of 1413 retrieved papers, 10 studies evaluating 1796 patients were included. Participants were outpatients diagnosed with DTC, treated with near-total (NTx) or total thyroidectomy (TTx) with or without radioactive iodine (RAI). The NPV of ON-T4 hs-Tg for diagnostic and prognostic performance was 99.4% (95% CI 98.9–99.9; I2 = 13%) and 99.4% (95% CI 98.8–100; I2 = 0%), respectively. Conclusions Our findings show that ON-T4 hs-Tg is an excellent diagnostic tool and prognostic factor to rule-out SED. A high level of evidence is provided to decrease the intensity and frequency of follow-up in those DTC patients having undetectable high-sensitive Tg.

scholarly journals A Call for Research on the Prognostic Role of Follow-Up Histology in Celiac Disease: A Systematic Review

2019 ◽  
Vol 10 ◽  
Author(s):  
Zsolt Szakács ◽  
Noémi Gede ◽  
Zoltán Gyöngyi ◽  
Margit Solymár ◽  
Dezső Csupor ◽  
...  
Keyword(s):  
Systematic Review ◽  
Celiac Disease ◽  
Prognostic Role

scholarly journals A Systematic Review Investigating the Presence of Inflammatory Synovitis in Hip and Knee Joint Replacement Surgery

Arthritis ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Sherif Hosny ◽  
Francesco Strambi ◽  
Nidhi Sofat ◽  
Richard Field
Keyword(s):  
Systematic Review ◽  
Joint Replacement ◽  
Critical Appraisal ◽  
Clinical Symptoms ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Cytokines And Chemokines ◽  
Appraisal Tool

Synovial tissue can display an inflammatory response in the presence of OA. There is increasing interest to better understand the role of inflammation in OA, particularly with regard to those who require joint replacement. A systematic review of inflammatory synovitis in OA of literature databases was undertaken from their inception until October 14, 2014. Independent critical appraisal of each study was undertaken using the CASP appraisal tool. From a total of sixty-six identified citations, twenty-three studies were deemed eligible for review. The studies presented moderate to strong methodological quality. Strong correlation was identified between histological and imaging synovitis severity. Correlation was weaker between clinical symptoms and imaging and/or histological synovitis severity. There was little consensus, with regard to expressed cytokines and chemokines at the different stages of OA disease progression. Few studies investigated the influence of inflammatory synovitis on the outcome of major joint replacement. Research into inflammatory synovitis in OA is an emerging field. Longitudinal studies applying proven imaging modalities, histological analysis, and longer follow-up are required in order to further define our understanding of the role of synovitis in the pathogenesis of OA and its effects on outcomes following major joint replacement.

The role of the family in supporting the self-management of chronic conditions: A qualitative systematic review

2017 ◽  
Vol 27 (1-2) ◽  
pp. 22-30 ◽  
Author(s):  
Lisa Whitehead ◽  
Elisabeth Jacob ◽  
Amanda Towell ◽  
Ma'en Abu-qamar ◽  
Amanda Cole-Heath
Keyword(s):  
Systematic Review ◽  
Chronic Conditions ◽  
The Self ◽  
Self Management ◽  
Qualitative Systematic Review ◽  
The Family

Latest Evidence on the Role of Multiparametric Magnetic Resonance Imaging in Active Surveillance for Insignificant Prostate Cancer: A Systematic Review

2018 ◽  
Vol 18 (7) ◽  
pp. 925-930 ◽  
Author(s):  
Francesco Cantiello ◽  
Stefano Manno ◽  
Giorgio I. Russo ◽  
Sebastiano Cimino ◽  
Salvatore Privitera ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Systematic Review ◽  
Magnetic Resonance ◽  
Active Surveillance ◽  
Resonance Imaging ◽  
Multiparametric Magnetic Resonance Imaging ◽  
Clinically Significant

Objective: Multiparametric Magnetic Resonance Imaging (mpMRI) has become a very useful tool in the management of PCa. Particularly, there is a great interest in using mpMRI for men on Active Surveillance (AS) for low risk PCa. The aim of this systematic review was to critically review the latest literature concerning the role of mpMRI in this clinical setting, underlying current strengths and weakness. Evidence Acquisition: A comprehensive literature research for English-language original and review articles was carried out using the National Center for Biotechnology Information PubMed database with the aim to identify studies pertaining to mpMRI for AS in low risk PCa patients. The following search terms were used: active surveillance, prostate cancer and multiparametric magnetic resonance imaging. Evidence Synthesis: Data from 28 recent original studies and reviews were reviewed. We only considered studies on the use of mpMRI in selecting AS patients and during AS follow-up, in order to solve two important questions: -Can mpMRI have a role in improving the detection of clinically significant disease, better selecting AS patients? -Can mpMRI identify the progression of disease and, consequently, be used during AS follow-up? Conclusions: mpMRI is useful to better select the ideal candidates to AS and to monitor them during follow-up. However, despite many advantages, there are yet important limitations to detect all clinically significant PCa and to better define mpMRI-radiological progression during AS. Further larger prospective studies are needed to definitively solve these important problems.

Applying the evidence to your patient: The role of systematic reviews in your knowledge tool box

2020 ◽  
Vol 13 (12) ◽  
pp. 747-753
Author(s):  
David Tovey
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Knowledge Resource

This article explores how systematic reviews can provide a useful addition to a general practitioner’s knowledge toolbox and explores scenarios where systematic reviews can be used to help inform a decision. The article also explores how the trustworthiness of the information from a systematic review or indeed any knowledge resource, can be assessed, and describes some of the ways that systematic reviews are changing. A follow up article will explore, in more detail, how to appraise, understand and use the information in a systematic review.

scholarly journals Study of family medicine role in breast cancer prevention: A systematic review

2021 ◽  
Vol 6 (2) ◽  
pp. e32-e32
Author(s):  
Zahra Sadr ◽  
Mehrnaz Jamali Moghaddam ◽  
Hamideh Sabet Rouhani ◽  
Nadia Sani’ee ◽  
Maryam Biglari Abhari
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Cancer Prevention ◽  
Family Physicians ◽  
Breast Cancer Prevention ◽  
The World ◽  
Review Study

Breast cancer is one of the most common cancers and is one of the biggest health threats in women around the world. Since the systematic review study in Iran has not been conducted so far, this study was designed to determine the role of family physicians or first-level care physicians in preventing breast cancer at various levels. In this systematic review, we found family physicians could play a significant role in all levels of breast cancer prevention, including roles in education, risk assessment and early detection of cancer, treatment and follow-up of patients with breast cancer and rehabilitation, and help improve quality of life. Survivors and those treated for breast cancer.

scholarly journals The role of patient navigators in ambulatory care: overview of systematic reviews

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hannah Budde ◽  
Gemma A. Williams ◽  
Juliane Winkelmann ◽  
Laura Pfirter ◽  
Claudia B. Maier
Keyword(s):  
Ambulatory Care ◽  
Patient Outcomes ◽  
Systematic Reviews ◽  
Chronic Conditions ◽  
Patient Navigation ◽  
Transitional Care ◽  
Patient Navigators ◽  
Abstract Screening

Abstract Background Patient navigators have been introduced across various countries to enable timely access to healthcare services and to ensure completion of diagnosis and follow-up of care. There is an increasing evidence on the the role of patient navigation for patients and healthcare systems. The aim of this study was to analyse the evidence on patient navigation interventions in ambulatory care and to evaluate their effects on individuals and health system outcomes. Methods An overview of reviews was conducted, following a prespecified protocol. All patients in ambulatory care or transitional care setting were included in this review as long as it was related to the role of patient navigators. The study analysed patient navigators covering a wide range of health professionals such as physicians, nurses, pharmacists, social workers and lay health workers or community-based workers with no or very limited training. Studies including patient-related measures and health system-related outcomes were eligible for inclusion. A rigorous search was performed in multiple data bases. After reaching a high inter-rater agreement of 0.86, title and abstract screening was independently performed. Of an initial 14,248 search results and an additional 62 articles identified through the snowballing approach, a total of 7159 hits were eligible for title/abstract screening. 679  articles were included for full-text screening. Results Eleven systematic reviews were included covering various patient navigation intervention in cancer care, disease screening, transitional care and for various chronic conditions and multimorbidity. Nine systematic reviews primarily tailored services to ethnic minorities or other disadvantaged groups. Patient navigators performed tasks such as providing education and counselling, translations, home visits, outreach, scheduling of appointments and follow-up. Eight reviews identified positive outcomes in expanding access to care, in particular for vulnerable patient groups. Two reviews on patient navigation in transitional care reported improved patient outcomes, hospital readmission rates and mixed evidence on quality of life and emergency department visits. Two reviews demonstrated improved patient outcomes for persons with various chronic conditions and multimorbidity. Conclusions Patient navigators were shown to expand access to screenings and health services for vulnerable patients or population groups with chronic conditions who tend to underuse health services.

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