Variations in patient-reported physical health between cardiac and musculoskeletal diseases: systematic review and meta-analysis of population-based studies

Abstract Introduction Patients with chronic non-cancer pain often report insomnia as a significant comorbidity. Cognitive behavioral therapy for insomnia (CBT-I) is recommended as the first line of treatment for insomnia, and several randomized controlled trials (RCTs) have examined the efficacy of CBT-I on various health outcomes in patients with comorbid insomnia and chronic non-cancer pain. We conducted a systematic review and meta-analysis on the effectiveness of CBT-I on sleep, pain, depression, anxiety and fatigue in adults with comorbid insomnia and chronic non-cancer pain. Methods A systematic search was conducted using ten electronic databases. The duration of the search was set between database inception to April 2020. Included studies must be RCTs assessing the effects of CBT-I on at least patient-reported sleep outcomes in adults with chronic non-cancer pain. Quality of the studies was assessed using the Cochrane risk of bias assessment and Yates quality rating scale. Continuous data were extracted and summarized using standard mean difference (SMD) with 95% confidence intervals (CIs). Results The literature search resulted in 7,772 articles, of which 14 RCTs met the inclusion criteria. Twelve of these articles were included in the meta-analysis. The meta-analysis comprised 762 participants. CBT-I demonstrated a large significant effect on patient-reported sleep (SMD = 0.87, 95% CI [0.55–1.20], p < 0.00001) at post-treatment and final follow-up (up to 9 months) (0.59 [0.31–0.86], p < 0.0001); and moderate effects on pain (SMD = 0.20 [0.06, 0.34], p = 0.006) and depression (0.44 [0.09–0.79], p= 0.01) at post-treatment. The probability of improving sleep and pain following CBT-I at post-treatment was 81% and 58%, respectively. The probability of improving sleep and pain at final follow-up was 73% and 57%, respectively. There were no statistically significant effects on anxiety and fatigue. Conclusion This systematic review and meta-analysis showed that CBT-I is effective for improving sleep in adults with comorbid insomnia and chronic non-cancer pain. Further, CBT-I may lead to short-term moderate improvements in pain and depression. However, there is a need for further RCTs with adequate power, longer follow-up periods, CBT for both insomnia and pain, and consistent scoring systems for assessing patient outcomes. Support (if any):

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The Impact of Diagnostic Criteria for Gestational Diabetes Mellitus on Adverse Maternal Outcomes: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10040666 ◽

2021 ◽

Vol 10 (4) ◽

pp. 666

Author(s):

Fahimeh Ramezani Tehrani ◽

Marzieh Saei Ghare Naz ◽

Razieh Bidhendi Yarandi ◽

Samira Behboudi-Gandevani

Keyword(s):

Systematic Review ◽

Gestational Diabetes ◽

Pregnant Women ◽

Diagnostic Criteria ◽

Meta Analysis ◽

Population Based ◽

Maternal Outcomes ◽

Care Providers ◽

Iadpsg Criteria ◽

The Impact

This systematic review and meta-analysis aimed to examine the impact of different gestational-diabetes (GDM) diagnostic-criteria on the risk of adverse-maternal-outcomes. The search process encompassed PubMed (Medline), Scopus, and Web of Science databases to retrieve original, population-based studies with the universal GDM screening approach, published in English language and with a focus on adverse-maternal-outcomes up to January 2020. According to GDM diagnostic criteria, the studies were classified into seven groups. A total of 49 population-based studies consisting of 1409018 pregnant women with GDM and 7,667,546 non-GDM counterparts were selected for data analysis and knowledge synthesis. Accordingly, the risk of adverse-maternal-outcomes including primary-cesarean, induction of labor, maternal-hemorrhage, and pregnancy-related-hypertension, overall, regardless of GDM diagnostic-criteria and in all diagnostic-criteria subgroups were significantly higher than non-GDM counterparts. However, in meta-regression, the increased risk was not influenced by the GDM diagnostic-classification and the magnitude of the risks among patients, using the IADPSG criteria-classification as the most strict-criteria, was similar to other criteria. In conclusion, a reduction in the diagnostic-threshold increased the prevalence of GDM, but the risk of adverse-maternal-outcome was not different among those women who were diagnosed through more or less intensive strategies. Our review findings can empower health-care-providers to select the most cost-effective approach for the screening of GDM among pregnant women.

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Correction to: Robotic‑arm assisted total knee arthroplasty is associated with improved accuracy and patient reported outcomes: a systematic review and meta‑analysis

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-021-06522-x ◽

2021 ◽

Author(s):

Junren Zhang ◽

Wofhatwa Solomon Ndou ◽

Nathan Ng ◽

Paul Gaston ◽

Philip M. Simpson ◽

...

Keyword(s):

Systematic Review ◽

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Patient Reported Outcomes ◽

Meta Analysis ◽

Robotic Arm ◽

Patient Reported ◽

Total Knee ◽

Improved Accuracy

A correction to this paper has been published: https://doi.org/10.1007/s00167-021-06522-x

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AB0116 THE EFFECTS OF DISEASE MODIFYING ANTI-RHEUMATIC DRUGS ON PATIENT REPORTED OUTCOMES; PRELIMINARY RESULTS OF A SYSTEMATIC REVIEW AND NETWORK META-ANALYSIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.1578 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1087.1-1087

Author(s):

M. Van den Dikkenberg, Msc ◽

N. Luurssen-Masurel ◽

M. Kuijper ◽

M. R. Kok ◽

P. De Jong ◽

...

Keyword(s):

Systematic Review ◽

Patient Reported Outcomes ◽

Treatment Effects ◽

Meta Analysis ◽

Activity Limitations ◽

Definitive Answer ◽

Preliminary Results ◽

Patient Reported ◽

Standard Set ◽

Disease Modifying

Background:The need to involve patient reported outcomes (PROs) in the management of rheumatoid arthritis (RA) increases, since PROs quantify patient relevant outcomes. Although PROs have been incorporated in the core-outcome sets in clinical trials, knowledge about the treatment effects on these PROs is scarce. Therefore, we performed a systematic review on the effects of disease modifying anti-rheumatic drugs (DMARDs), of any type, on relevant PRO domains mentioned in the ICHOM standard set. This might support rheumatologists and RA patients during treatment decisions.Objectives:To get insight in the treatment effects of DMARDs of any type on three PRO domains that matter to patients (pain, activity limitations and fatigue).Methods:A systematic review was performed in Embase, Medline, Web of Science, Cochrane and Google Scholar. Included were all studies that were published before August 2019 and showed DMARD treatment effects in RA on PROs that are part of the ICHOM standard set. Three Bayesian network meta-analyses were performed for the PRO domains pain, activity limitations and fatigue. Preliminary results of DMARDs (in)directly compared to placebo were visualized by forest plots using R.Results:The search strategy yielded n=5974 articles. After selection was performed by 2 independent researchers, n=70 individual articles representing n=53 studies were extracted, over the three PRO domains; pain (n=31), activity limitations (n=41) and fatigue (n=21). In all RCTs, PROs were only reported as secondary or tertiary endpoints. In figure 1, we show the effects on PROs for any type of DMARD investigated compared to placebo. Overall, DMARDs show a greater reduction in pain (standardized mean difference (SMD); -0.97 – -0.22) and most of them in activity limitations (SMD; -0.81 – 0.56). In fatigue, this clear direction is lacking (SMD; -0.86 – 3.5). csDMARDs and anti-TNF seem to perform slightly, but nog significantly, worse than other bDMARDs and tsDMARDs in the first two domains.Conclusion:Within in this systematic review we report a reduction for DMARDs of any type on the domains of pain and activity limitations compared to placebo. However, results are still preliminary and should be interpreted with care. A more comprehensive network analysis might give a more definitive answer which DMARD performs best.Figure 1.Disclosure of Interests:None declared

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Comparison of the clinical effectiveness of treatments for aromatase inhibitor-induced arthralgia in breast cancer patients: a protocol for a systematic review and network meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-033461 ◽

2020 ◽

Vol 10 (5) ◽

pp. e033461

Author(s):

Kyeore Bae ◽

Si Yeon Song

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Pain Intensity ◽

Aromatase Inhibitor ◽

Cancer Patients ◽

Meta Analysis ◽

Indirect Evidence ◽

Secondary Outcome ◽

Breast Cancer Patients ◽

Patient Reported

IntroductionAromatase inhibitor-induced arthralgia (AIA) is a major adverse event of aromatase inhibitors (AIs) and leads to premature discontinuation of AI therapy in breast cancer patients. The objective of this protocol for a systematic review and network meta-analysis (NMA) is to provide the methodology to compare the change in pain intensity between different AIA treatments and demonstrate the rank probabilities for different treatments by combining all available direct and indirect evidence.Methods and analysisPubMed, the Cochrane Controlled Register of Trials (CENTRAL), EMBASE, Web of Science and ClinicalTrials.gov will be searched to identify publications in English from inception to November 2019. We will include randomised controlled trials (RCTs) assessing the effects of different treatments for AIA in postmenopausal women with stage 0–III hormone receptor-positive breast cancer. The primary endpoints will be the change in patient-reported pain intensity from baseline to post-treatment. The number of adverse events will be presented as a secondary outcome.Both pairwise meta-analysis and NMA with the Frequentist approach will be conducted. We will demonstrate summary estimates with forest plots in meta-analysis and direct and mixed evidence with a ranking of the treatments as the P-score in NMA. The revised Cochrane risk-of-bias tool for randomised trials will be used to assess the methodological quality within individual RCTs. The quality of evidence will be assessed.Ethics and disseminationAs this review does not involve individual patients, ethical approval is not required. The results of this systematic review and NMA will be published in a peer-reviewed journal. This review will provide valuable information on AIA therapeutic options for clinicians, health practitioners and breast cancer survivors.PROSPERO registration numberCRD42019136967.

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The prevalence of diabetes in Afghanistan: a systematic review and meta-analysis

BMC Public Health ◽

10.1186/s12889-021-10993-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sohail Akhtar ◽

Jamal Abdul Nasir ◽

Amara Javed ◽

Mariyam Saleem ◽

Sundas Sajjad ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Methodological Quality ◽

Meta Analysis ◽

Population Based ◽

Included Study ◽

Cochrane Library ◽

Or Education ◽

Meta Regression

Abstract Background The aim of this paper is to investigate the prevalence of diabetes and its associated risk factors in Afghanistan through a systematic review and meta–analysis. Methods A comprehensive literature search was conducted using EMBASE, PubMed, Web of Sciences, Google Scholar and the Cochrane library, carried out from inception to April 312,020, without language restriction. Meta–analysis was performed using DerSimonian and Laird random-effects models with inverse variance weighting. The existence of publication bias was initially assessed by visual inspection of a funnel plot and then tested by the Egger regression test. Subgroup analyses and meta-regression were used to explore potential sources of heterogeneity. This systematic review was reported by following the PRISMA guidelines and the methodological quality of each included study was evaluated using the STROBE guidelines. Results Out of 64 potentially relevant studies, only 06 studies fulfilled the inclusion criteria and were considered for meta-analysis. The pooled prevalence of diabetes in the general population based on population-based studies were 12.13% (95% CI: 8.86–16.24%), based on a pooled sample of 7071 individuals. Results of univariate meta-regression analysis revealed that the prevalence of diabetes increased with mean age, hypertension and obesity. There was no significant association between sex (male vs female), smoking, the methodological quality of included articles or education (illiterate vs literate) and the prevalence of diabetes. Conclusions This meta-analysis reports the 12.13% prevalence of diabetes in Afghanistan,with the highest prevalence in Kandahar and the lowest in Balkh province. The main risk factors include increasing age, obesity and hypertension. Community-based care and preventive training programmes are recommended. Trial registration This review was registered on PROSPERO (registration number CRD42020172624).

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Mini-Implant-Retained Overdentures for the Rehabilitation of Completely Edentulous Maxillae: A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084377 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4377

Author(s):

Serena Vi ◽

Damon Pham ◽

Yu Yian Marina Du ◽

Himanshu Arora ◽

Santosh Kumar Tadakamadla

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Survival Rate ◽

Data Extraction ◽

Meta Analysis ◽

Empirical Studies ◽

Implant Survival ◽

Patient Reported ◽

Full Text Review

Purpose: Mini-dental implants (MDIs) have been used to support and retain overdentures, providing patients with a less invasive placement procedure. Although lucrative, the use of MDIs to retain a maxillary overdenture is still not an established treatment modality. This systematic review aims to answer the question: Do mini-implant-retained maxillary overdentures provide a satisfactory treatment outcome for complete edentulism? Methods: A systematic search for relevant articles was conducted to include articles published until April 2021 in the following electronic databases: CINAHL, Cochrane, EMBASE, PubMed, and Web of Science. All empirical studies evaluating the biological, survival, or patient-reported outcomes after placing mini-implant-retained overdentures in maxilla were considered for inclusion. The risk of bias was assessed by utilizing the Joanna Briggs Institute critical appraisal checklist. Study screening and data extraction were conducted by three reviewers independently. Results: The electronic search retrieved 1276 titles after omitting duplicates. Twenty articles were considered for full-text review, of which six studies were included in this systematic review. The included studies evaluated a total of 173 participants with a mean age of 66.3 years. The overall mini-implant survival rate was 77.1% (95% CI: 64.7–89.5%) with a mean follow-up time of 1.79 years (range: 6 months to 3 years). Implant survival differed significantly when comparing complete and partial palatal coverage overdentures. Those with complete palatal coverage exhibited less bone loss overall compared to partial coverage overdentures. Participants of all studies reported an increase in the quality of life and in satisfaction after rehabilitation treatment with MDIs. Conclusions: The survival rate of mini-implants retaining an overdenture in the maxilla was observed to be lower than the values reported for traditional implants in the literature. Improvements were observed in all aspects in terms of patient satisfaction, quality of life, oromyofunction, and articulation after the treatment.

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Prevalence of pelvic organ prolapse among US racial populations: A systematic review and meta‐analysis of population‐based screening studies

Neurourology and Urodynamics ◽

10.1002/nau.24672 ◽

2021 ◽

Author(s):

Tsung Mou ◽

Kristina Warner ◽

Oluwateniola Brown ◽

Chen Yeh ◽

Molly Beestrum ◽

...

Keyword(s):

Systematic Review ◽

Pelvic Organ Prolapse ◽

Meta Analysis ◽

Pelvic Organ ◽

Population Based

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“Outcome evaluation of fruit and vegetables distribution interventions in schools: A systematic review and meta-analysis”

Public Health Nutrition ◽

10.1017/s1368980021001683 ◽

2021 ◽

pp. 1-34

Author(s):

M. R. Ismail ◽

J. A. Seabrook ◽

J. A. Gilliland

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Population Based ◽

Outcome Evaluation ◽

Fruit And Vegetables ◽

Post Intervention ◽

Health Strategy ◽

Rigorous Study ◽

Mean Differences

Abstract Objective: Fruit and vegetables (FVs) distribution interventions have been implemented as a public health strategy to increase children’s intake of FVs at school settings. The purpose of this review was to examine whether snack-based FVs distribution interventions can improve school-aged children’s consumption of FVs. Design: Systematic Review and meta-analysis of articles published in English, in a peer-review journals were identified by searching six databases up to August 2020. Standardized Mean Differences (SMDs) and 95% Confidence Interval (CI) were calculated using a random effects model. Heterogeneity was quantified using I2 statistics. Setting: Population-based studies of interventions where the main focus was the effectiveness of distributed FVs as snacks to schoolchildren in North America, Europe and Pacific were included. Results: Forty-seven studies, reporting on 15 different interventions, were identified; 10 studies were included in the meta-analysis. All interventions were effective in increasing children’s consumption of FVs, with only one intervention demonstrating a null effect. Pooled results under all classifications showed effectiveness in improving children’s consumption of FVs, particularly for multi-component interventions at post-intervention (SMD 0.20, CI 0.13, 0.27) and free distribution interventions at follow-up (SMD 0.19, CI 0.12, 0.27). Conclusions: Findings suggest that utilizing FV distribution interventions provide a promising avenue by which children’s consumption can be improved. Nonetheless, our results are based on a limited number of studies, and further studies should be performed to confirm these results. More consistent measurement protocols in terms of rigorous study methodologies, intervention duration, and follow-up evaluation are needed to improve comparability across studies.

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