Towards a consensus definition of maternal sepsis: results of a systematic review and expert consultation

ABSTRACTBackground:Half a century after the inception of the term “successful aging (SA),” a consensus definition has not emerged. The current study aims to provide a comprehensive snapshot of operational definitions of SA.Methods:A systematic review across MedLine, PsycInfo, CINAHL, EMBASE, and ISI Web of Knowledge of quantitative operational definitions of SA was conducted.Results:Of the 105 operational definitions, across 84 included studies using unique models, 92.4% (97) included physiological constructs (e.g. physical functioning), 49.5% (52) engagement constructs (e.g. involvement in voluntary work), 48.6% (51) well-being constructs (e.g. life satisfaction), 25.7% (27) personal resources (e.g. resilience), and 5.7% (6) extrinsic factors (e.g. finances). Thirty-four definitions consisted of a single construct, 28 of two constructs, 27 of three constructs, 13 of four constructs, and two of five constructs. The operational definitions utilized in the included studies identify between <1% and >90% of study participants as successfully aging.Conclusions:The heterogeneity of these results strongly suggests the multidimensionality of SA and the difficulty in categorizing usual versus successful aging. Although the majority of operationalizations reveal a biomedical focus, studies increasingly use psychosocial and lay components. Lack of consistency in the definition of SA is a fundamental weakness of SA research.

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Malnutrition assessment methods in adult patients with tuberculosis: a systematic review

BMJ Open ◽

10.1136/bmjopen-2021-049777 ◽

2021 ◽

Vol 11 (12) ◽

pp. e049777

Author(s):

Lies ter Beek ◽

Mathieu S Bolhuis ◽

Harriët Jager-Wittenaar ◽

René X D Brijan ◽

Marieke G G Sturkenboom ◽

...

Keyword(s):

Systematic Review ◽

Body Composition ◽

Cognitive Function ◽

Assessment Method ◽

Assessment Methods ◽

International Consensus ◽

Consensus Definition ◽

Tb Treatment ◽

Registration Number ◽

Definition Of

ObjectivesMalnutrition is associated with a twofold higher risk of dying in patients with tuberculosis (TB) and considered an important potentially reversible risk factor for failure of TB treatment. The construct of malnutrition has three domains: intake or uptake of nutrition; body composition and physical and cognitive function. The objectives of this systematic review are to identify malnutrition assessment methods, and to quantify how malnutrition assessment methods capture the international consensus definition for malnutrition, in patients with TB.DesignDifferent assessment methods were identified. We determined the extent of capturing of the three domains of malnutrition, that is, intake or uptake of nutrition, body composition and physical and cognitive function.ResultsSeventeen malnutrition assessment methods were identified in 69 included studies. In 53/69 (77%) of studies, body mass index was used as the only malnutrition assessment method. Three out of 69 studies (4%) used a method that captured all three domains of malnutrition.ConclusionsOur study focused on published articles. Implementation of new criteria takes time, which may take longer than the period covered by this review. Most patients with TB are assessed for only one aspect of the conceptual definition of malnutrition. The use of international consensus criteria is recommended to establish uniform diagnostics and treatment of malnutrition.PROSPERO registration numberCRD42019122832.

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Prevalence of postural hypotension in primary, community and institutional care: a systematic review and meta-analysis

BMC Family Practice ◽

10.1186/s12875-020-01313-8 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Sinead T. J. McDonagh ◽

Natasha Mejzner ◽

Christopher E. Clark

Keyword(s):

Systematic Review ◽

Blood Pressure ◽

Primary Care ◽

Postural Hypotension ◽

Blood Pressure Measurement ◽

Institutional Care ◽

Consensus Definition ◽

Meta Regression ◽

Definition Of ◽

Meta Analyses

Abstract Background Postural hypotension (PH), the reduction in blood pressure when rising from sitting or lying 0to standing, is a risk factor for falls, cognitive decline and mortality. However, it is not often tested for in primary care. PH prevalence varies according to definition, population, care setting and measurement method. The aim of this study was to determine the prevalence of PH across different care settings and disease subgroups. Methods Systematic review, meta-analyses and meta-regression. We searched Medline and Embase to October 2019 for studies based in primary, community or institutional care settings reporting PH prevalence. Data and study level demographics were extracted independently by two reviewers. Pooled estimates for mean PH prevalence were compared between care settings and disease subgroups using random effects meta-analyses. Predictors of PH were explored using meta-regression. Quality assessment was undertaken using an adapted Newcastle-Ottawa Scale. Results One thousand eight hundred sixteen studies were identified; 61 contributed to analyses. Pooled prevalences for PH using the consensus definition were 17% (95% CI, 14–20%; I2 = 99%) for 34 community cohorts, 19% (15–25%; I2 = 98%) for 23 primary care cohorts and 31% (15–50%; I2 = 0%) for 3 residential care or nursing homes cohorts (P = 0.16 between groups). By condition, prevalences were 20% (16–23%; I2 = 98%) with hypertension (20 cohorts), 21% (16–26%; I2 = 92%) with diabetes (4 cohorts), 25% (18–33%; I2 = 88%) with Parkinson’s disease (7 cohorts) and 29% (25–33%, I2 = 0%) with dementia (3 cohorts), compared to 14% (12–17%, I2 = 99%) without these conditions (P < 0.01 between groups). Multivariable meta-regression modelling identified increasing age and diabetes as predictors of PH (P < 0.01, P = 0.13, respectively; R2 = 36%). PH prevalence was not affected by blood pressure measurement device (P = 0.65) or sitting or supine resting position (P = 0.24), however, when the definition of PH did not fulfil the consensus description, but fell within its parameters, prevalence was underestimated (P = 0.01) irrespective of study quality (P = 0.04). Conclusions PH prevalence in populations relevant to primary care is substantial and the definition of PH used is important. Our findings emphasise the importance of considering checking for PH, particularly in vulnerable populations, to enable interventions to manage it. These data should contribute to future guidelines relevant to the detection and treatment of PH. PROSPERO:CRD42017075423.

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3 Epidemiology of running-related injuries in the Korean population: a cross-sectional survey of 1046 runners

British Journal of Sports Medicine ◽

10.1136/bjsm-2021-basemabs.3 ◽

2021 ◽

Vol 55 (16) ◽

pp. 941.1-941

Author(s):

HC Rhim ◽

SJ Kim ◽

JS Jeon ◽

HW Nam ◽

KM Jang

Keyword(s):

Systematic Review ◽

Sports Medicine ◽

Online Survey ◽

Korean Population ◽

List Type ◽

Long Distance ◽

Consensus Definition ◽

Cross Sectional ◽

Delphi Approach ◽

Definition Of

AimsRunning is the oldest form of exercise in human history and the most popular exercise in the world.1 While running can improve physical fitness and reduce chronic health problems such as obesity and cardiovascular disease, it is also associated with injuries in lower extremities.2 However, because there was no consensus definition of running-related injury, the prevalence and incidence of running-related injuries had been reported to vary between 19% and 92%.3 Moreover, epidemiology of running-related injuries in Asian populations has been rarely investigated. Therefore, this study was first to use the consensus definition of running-related injuries published in 20153 and investigated the epidemiology of running-related injuries in the Korean population.MethodsIn cross-sectional design, an online survey was circulated among various running communities in Korea. The questionnaire contained information on presence and location of pain attributed to running, demographic characteristics, weekly running mileage, training intensity, running pace, type of shoes, foot strike, reason for running, and exercise experience prior to running.ResultsAmong 1046 runners (male=624, female 422) who responded, 94.7% experienced some kind of pain while running, but only 37% were categorized to have running-related injuries. The most common site of injury was the knee followed by ankle. Exercise experience prior to running (OR 1.57 95% CI 1.13–2.21), setting of specific running goals (OR 1.57 95% CI 1.08–2.27), and mileage increases from 20–30 km to 30–40 km (OR 1.66 95% CI 1.06–2.63) were associated with significant increases in running-related injuries.ConclusionIn order to avoid running-related injuries, runners should be careful in increasing weekly mileage. Moreover, runners with previous exercise experience may need to approach running more cautiously. Setting goals may be motivating but at the same time can increase the risk of running-related injuries.ReferencesVidebæk S, Bueno AM, Nielsen RO, Rasmussen S. Incidence of running-related injuries per 1000 h of running in different types of runners: a systematic review and meta-analysis. Sports medicine 2015;45(7):1017–26.Van Gent R, Siem D, van Middelkoop M, Van Os A, Bierma-Zeinstra S, Koes B. Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review. British Journal of Sports Medicine 2007;41(8):469–80.Yamato TP, Saragiotto BT, Lopes AD. A consensus definition of running-related injury in recreational runners: a modified Delphi approach. Journal of orthopaedic & sports physical therapy 2015;45(5):375–80.

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Toward a consensus definition of pathological video-gaming: A systematic review of psychometric assessment tools

Clinical Psychology Review ◽

10.1016/j.cpr.2013.01.002 ◽

2013 ◽

Vol 33 (3) ◽

pp. 331-342 ◽

Cited By ~ 221

Author(s):

Daniel L. King ◽

Maria C. Haagsma ◽

Paul H. Delfabbro ◽

Michael Gradisar ◽

Mark D. Griffiths

Keyword(s):

Systematic Review ◽

Assessment Tools ◽

Video Gaming ◽

Psychometric Assessment ◽

Consensus Definition ◽

Definition Of

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Definition of a systematic review used in overviews of systematic reviews, meta-epidemiological studies and textbooks

BMC Medical Research Methodology ◽

10.1186/s12874-019-0855-0 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 10

Author(s):

Marina Krnic Martinic ◽

Dawid Pieper ◽

Angelina Glatt ◽

Livia Puljak

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Evidence Synthesis ◽

Epidemiological Studies ◽

Reference Points ◽

Sources Of Information ◽

Consensus Definition ◽

Starting Point ◽

Definition Of ◽

Overviews Of Systematic Reviews

Abstract Background A standard or consensus definition of a systematic review does not exist. Therefore, if there is no definition about a systematic review in secondary studies that analyse them or the definition is too broad, inappropriate studies might be included in such evidence synthesis. The aim of this study was to analyse the definition of a systematic review (SR) in health care literature, elements of the definitions that are used and to propose a starting point for an explicit and non-ambiguous SR definition. Methods We included overviews of systematic reviews (OSRs), meta-epidemiological studies and epidemiology textbooks. We extracted the definitions of SRs, as well as the inclusion and exclusion criteria that could indicate which definition of a SR the authors used. We extracted individual elements of SR definitions, categorised and quantified them. Results Among the 535 analysed sources of information, 188 (35%) provided a definition of a SR. The most commonly used reference points for the definitions of SRs were Cochrane and the PRISMA statement. We found 188 different elements of SR definitions and divided them into 14 categories. The highest number of SR definition elements was found in categories related to searching (N = 51), analysis/synthesis (N = 23), overall methods (N = 22), quality/bias/appraisal/validity (N = 22) and aim/question (N = 13). The same five categories were also the most commonly used combination of categories in the SR definitions. Conclusion Currently used definitions of SRs are vague and ambiguous, often using terms such as clear, explicit and systematic, without further elaboration. In this manuscript we propose a more specific definition of a systematic review, with the ultimate aim of motivating the research community to establish a clear and unambiguous definition of this type of research.

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Prevalence of postural hypotension in primary, community and institutional care: A systematic review and meta-analysis

10.21203/rs.3.rs-38629/v2 ◽

2020 ◽

Author(s):

Sinead TJ McDonagh ◽

Natasha Mejzner ◽

Christopher E Clark

Keyword(s):

Systematic Review ◽

Blood Pressure ◽

Primary Care ◽

Postural Hypotension ◽

Blood Pressure Measurement ◽

Institutional Care ◽

Consensus Definition ◽

Meta Regression ◽

Definition Of ◽

Meta Analyses

Abstract Background: Postural hypotension (PH), the reduction in blood pressure when rising from sitting or lying to standing, is a risk factor for falls, cognitive decline and mortality. However, it is not often tested for in primary care. PH prevalence varies according to definition, population, care setting and measurement method. The aim of this study was to determine the prevalence of PH across different care settings and disease subgroups. Methods: Systematic review, meta-analyses and meta-regression. We searched Medline and Embase to October 2019 for studies based in primary, community or institutional care settings reporting PH prevalence. Data and study level demographics were extracted independently by two reviewers. Pooled estimates for mean PH prevalence were compared between care settings and disease subgroups using random effects meta-analyses. Predictors of PH were explored using meta-regression. Quality assessment was undertaken using an adapted Newcastle-Ottawa Scale. Results: 1816 studies were identified; 61 contributed to analyses. Pooled prevalences for PH using the consensus definition were 17% (95% CI, 14-20%; I2=99%) for community cohorts, 19% (15-25%; I2=98%) for 23 primary care cohorts and 31% (15-50%; I2=0%) for 3 residential care or nursing homes cohorts (P=0.16 between groups). By condition, prevalences were 20% (16-23%; I2=98%) with hypertension (20 cohorts), 21% (16-26%; I2=92%) with diabetes (4 cohorts), 25% (18-33%; I2=88%) with Parkinson’s disease (7 cohorts) and 29% (25-33%; I2=0%) with dementia (3 cohorts), compared to 14% (12-17%; I2=99%) without these conditions (P<0.01 between groups). Multivariable meta-regression modelling identified increasing age and diabetes as predictors of PH (P<0.01, P=0.13, respectively; R2=36%). PH prevalence was not affected by blood pressure measurement device (P=0.65) or sitting or supine resting position (P=0.24), however, when the definition of PH did not fulfil the consensus description, but fell within its parameters, prevalence was underestimated (P=0.01) irrespective of study quality (P=0.04). Conclusions: PH prevalence in populations relevant to primary care is substantial and the definition of PH used is important. Our findings emphasise the importance of considering checking for PH, particularly in vulnerable populations, to enable interventions to manage it. These data should contribute to future guidelines relevant to the detection and treatment of PH. PROSPERO:CRD42017075423.

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Definition and Measurement of Physical and Chemical Restraint in Long-Term Care: A Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073639 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3639

Author(s):

Lauren M. Robins ◽

Den-Ching A. Lee ◽

J Simon Bell ◽

Velandai Srikanth ◽

Ralph Möhler ◽

...

Keyword(s):

Systematic Review ◽

Long Term Care ◽

Physical Restraint ◽

Consensus Definition ◽

Term Care ◽

Chemical Restraint ◽

Restraint Use ◽

Definition Of ◽

Physical And Chemical

This systematic review aimed to identify thematic elements within definitions of physical and chemical restraint, compare explicit and implicit definitions, and synthesize reliability and validity of studies examining physical and/or chemical restraint use in long-term care. Studies were included that measured prevalence of physical and/or chemical restraint use, or evaluated an intervention to reduce restraint use in long-term care. 86 papers were included in this review, all discussed physical restraint use and 20 also discussed chemical restraint use. Seven themes were generated from definitions including: restraint method, setting resident is restrained in, stated intent, resident capacity to remove/control, caveats and exclusions, duration, frequency or number, and consent and resistance. None of the studies reported validity of measurement approaches. Inter-rater reliability was reported in 27 studies examining physical restraint use, and only one study of chemical restraint. Results were compared to an existing consensus definition of physical restraint, which was found to encompass many of the thematic domains found within explicit definitions. However, studies rarely applied measurement approaches that reflected all of the identified themes of definitions. It is necessary for a consensus definition of chemical restraint to be established and for measurement approaches to reflect the elements of definitions.

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Recovery from chronic fatigue syndrome: a systematic review—heterogeneity of definition limits study comparison

Archives of Disease in Childhood ◽

10.1136/archdischild-2020-320196 ◽

2021 ◽

pp. archdischild-2020-320196

Author(s):

Yasmin Moore ◽

Teona Serafimova ◽

Nina Anderson ◽

Hayley King ◽

Alison Richards ◽

...

Keyword(s):

Systematic Review ◽

Chronic Fatigue Syndrome ◽

School Attendance ◽

Core Outcome Set ◽

Chronic Fatigue ◽

Cochrane Library ◽

Consensus Definition ◽

Fatigue Syndrome ◽

Definition Of ◽

Detailed Search

BackgroundPaediatric chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) is a common illness with a major impact on quality of life. Recovery is poorly understood. Our aim was to describe definitions of recovery in paediatric CFS/ME, the rate of recovery and the time to recovery.MethodsThis systematic review included a detailed search of MEDLINE, EMBASE, PsycInfo and Cochrane Library between 1994 and July 2018. Inclusion criteria were (1) clinical trials and observational studies, (2) participants aged <19 years with CFS/ME, (3) conducted in Western Healthcare systems and (4) studies including a measure of recovery and time taken to recover.ResultsTwelve papers (10 studies) were identified, involving 826 patients (range 23–135). Recovery rates were highly varied, ranging between 4.5% and 83%.Eleven distinct definitions of recovery were used; six were composite outcomes while five used unidimensional outcomes. Outcome measures used to define recovery were highly heterogeneous. School attendance (n=8), fatigue (n=6) and physical functioning (n=4) were the most common outcomes included in definition of recovery. Only five definitions included a personal measure of recovery.ImplicationsDefinitions of recovery are highly variable, likely secondary to differences in study design, outcomes used, follow-up and study populations. Heterogeneous definitions of recovery limit meaningful comparison between studies, highlighting the need for a consensus definition going forward. Recovery is probably best defined from the child’s own perspective with a single self-reported measure. If composite measures are used for research, there should be agreement on the core outcome set used.

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