scholarly journals The impact of selection criteria and study design on reported survival outcomes in extracorporeal oxygenation cardiopulmonary resuscitation (ECPR): a systematic review and meta-analysis

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Sameer Karve ◽  
Dominique Lahood ◽  
Arne Diehl ◽  
Aidan Burrell ◽  
David H. Tian ◽  
...  
Keyword(s):  
Systematic Review ◽  
Study Design ◽  
Prospective Studies ◽  
Selection Criteria ◽  
Meta Analysis ◽  
Inclusion Criteria ◽  
Newcastle Ottawa Scale ◽  
Study Designs ◽  
Based Medicine ◽  
The Impact

Abstract Background The use of extracorporeal membrane oxygenation (ECMO) during cardiac arrest (ECPR) has increased exponentially. However, reported outcomes vary considerably due to differing study designs and selection criteria. This review assessed the impact of pre-defined selection criteria on ECPR survival. Methods Systematic review applying PRISMA guidelines. We searched Medline, Embase, and Evidence-Based Medicine Reviews for RCTs and observational studies published from January 2000 to June 2021. Adult patients (> 12 years) receiving ECPR were included. Two investigators reviewed and extracted data on study design, number and type of inclusion criteria. Study quality was assessed using the Newcastle–Ottawa Scale (NOS). Outcomes included overall and neurologically favourable survival. Meta-analysis and meta-regression were performed. Results 67 studies were included: 14 prospective and 53 retrospective. No RCTs were identified at time of search. The number of inclusion criteria to select ECPR patients (p = 0.292) and study design (p = 0.962) was not associated with higher favourable neurological survival. However, amongst prospective studies, increased number of inclusion criteria was associated with improved outcomes in both OHCA and IHCA cohorts. (β = 0.12, p = 0.026) and arrest to ECMO flow time was predictive of survival. (β = -0.023, p < 0.001). Conclusions Prospective studies showed number of selection criteria and, in particular, arrest to ECMO time were associated with significant improved survival. Well-designed prospective studies assessing the relative importance of criteria as well as larger efficacy studies are required to ensure appropriate application of what is a costly intervention.

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 &lt; 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 &lt; 0.0001), and TUNEL (three studies, WMD –4.86%, 95% CI –7.38%, –2.34%; I2=89%, p &lt; 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 &lt; 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

scholarly journals Sleep in youth with autism spectrum disorders: systematic review and meta-analysis of subjective and objective studies

2018 ◽  
Vol 21 (4) ◽  
pp. 146-154 ◽  
Author(s):  
Amparo Díaz-Román ◽  
Junhua Zhang ◽  
Richard Delorme ◽  
Anita Beggiato ◽  
Samuele Cortese
Keyword(s):  
Systematic Review ◽  
Autism Spectrum Disorders ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Autism Spectrum ◽  
Newcastle Ottawa Scale ◽  
Spectrum Disorders ◽  
Sleep Alterations ◽  
The Impact ◽  
Ottawa Scale

BackgroundSleep problems are common and impairing in individuals with autism spectrum disorders (ASD). Evidence synthesis including both subjective (ie, measured with questionnaires) and objective (ie, quantified with neurophysiological tools) sleep alterations in youth with ASD is currently lacking.ObjectiveWe conducted a systematic review and meta-analysis of subjective and objective studies sleep studies in youth with ASD.MethodsWe searched the following electronic databases with no language, date or type of document restriction up to 23 May 2018: PubMed, PsycInfo, Embase+Embase Classic, Ovid Medline and Web of Knowledge. Random-effects models were used. Heterogeneity was assessed with Cochran’s Q and I2 statistics. Publication (small studies) bias was assessed with final plots and the Egger’s test. Study quality was evaluated with the Newcastle Ottawa Scale. Analyses were conducted using Review Manager and Comprehensive Meta-Analysis.FindingsFrom a pool of 3359 non-duplicate potentially relevant references, 47 datasets were included in the meta-analyses. Subjective and objective sleep outcome measures were extracted from 37 and 15 studies, respectively. Only five studies were based on comorbidity free, medication-naïve participants. Compared with typically developing controls, youth with ASD significantly differed in 10/14 subjective parameters and in 7/14 objective sleep parameters. The average quality score in the Newcastle-Ottawa Scale was 5.9/9.Discussion and clinical implicationsA number of subjective and, to a less extent, objective sleep alterations might characterise youth with ASD, but future studies should assess the impact of pharmacological treatment and psychiatric comorbidities.

scholarly journals Effects of mouth breathing on facial skeletal development and malocclusion in children: A systematic review and meta-analysis.

2020 ◽  
Author(s):  
Ziyi Zhao ◽  
Leilei Zheng ◽  
Xiaoya Huang ◽  
Caiyu Li ◽  
Jing Liu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Skeletal Development ◽  
Meta Analysis ◽  
Mouth Breathing ◽  
Occlusal Plane ◽  
Cochrane Library ◽  
Nasal Breathing ◽  
Anterior Teeth ◽  
Newcastle Ottawa Scale ◽  
The Impact

Abstract BACKGROUND: Mouth breathing is closely related to the facial skeletal development and malocclusion. The purpose of this systematic review and meta-analysis was to assess the effect of mouth breathing on facial skeletal development and malocclusion in children. METHODS: An electronic search in PubMed, the Cochrane Library, Medline, Web of Science, EMBASE and Sigle through February 23rd, 2020, was conducted. Methodological quality assessments of the selected articles were performed using the Newcastle-Ottawa Scale. Review Manager 5.3, was used to synthesize various parameters associated with the impact of mouth breathing on facial skeletal development and malocclusion. RESULTS: Following full-text evaluations for eligibility, 7 studies (387 mouth-breathing subjects and 433 nasal-breathing controls) were included in the final quantitative synthesis; they were all high-quality. The included indicators were SNA (p>0.050), ANS-PNS (p>0.050), 1.NB (p>0.050), MP-H (p>0.050), FMA (p>0.050), SNB (MD: -1.99, P <0.0001), ANB (MD: 0.95, P = 0.0005), SN-OP (MD: 3.20, P < 0.0001), SNGoGn (MD: 4.34, P < 0.0001), 1-NA (MD: 0.72, P = 0.004), 1. NA (MD: 1.98, P = 0.020), 1-NB (MD: 1.06, P < 0.0001), SPAS (MD: -5.23, P < 0.0001), PAS (MD: -2.11, P < 0.0001), and C3-H (MD: -1.34, P < 0.0001). CONCLUSIONS: The results showed that mouth breathing can cause underdevelopment of the mandible. The mandible rotated backward and downward, and the occlusal plane was steep. However, there was little effect on the maxilla. In addition, mouth breathing presented a tendency of lip inclination of the upper and lower anterior teeth. Airway stenosis was common in mouth-breathing children. TRIAL REGISTRATION: [email protected]; registration number CRD42019129198 KEYWORDS: Mouth breathing; Facial skeletal development; Children; Systematic review, Meta-analysis.

scholarly journals Strength of functional signature correlates with effect size in autism

2016 ◽  
Author(s):  
Sara Ballouz ◽  
Jesse Gillis
Keyword(s):  
Study Design ◽  
Effect Size ◽  
Statistical Power ◽  
Fragile X ◽  
Meta Analysis ◽  
Autism Spectrum ◽  
Protein Interaction Data ◽  
Functional Convergence ◽  
Study Designs ◽  
The Impact

AbstractBackgroundDisagreements over genetic signatures associated with disease have been particularly prominent in the field of psychiatric genetics, creating a sharp divide between disease burdens attributed to common and rare variation, with study designs independently targeting each. Meta-analysis within each of these study designs is routine, whether using raw data or summary statistics, but combining results across study designs is atypical. However, tests of functional convergence are used across all study designs, where candidate gene sets are assessed for overlaps with previously known properties. This suggests one possible avenue for combining not study data, but the functional conclusions that they reach.MethodIn this work, we test for functional convergence in autism spectrum disorder (ASD) across different study types, and specifically whether the degree to which a gene is implicated in autism is correlated with the degree to which it drives functional convergence. Because different study designs are distinguishable by their differences in effect size, this also provides a unified means of incorporating the impact of study design into the analysis of convergence.ResultsWe detected remarkably significant positive trends in aggregate (p < 2.2e-16) with 14 individually significant properties (FDR<0.01), many in areas researchers have targeted based on different reasoning, such as the fragile X mental retardation protein (FMRP) interactor enrichment (FDR 0.003). We are also able to detect novel technical effects and we see that network enrichment from protein-protein interaction data is heavily confounded with study design, arising readily in control data.ConclusionsWe see a convergent functional signal for a subset of known and novel functions in ASD from all sources of genetic variation. Meta-analytic approaches explicitly accounting for different study designs can be adapted to other diseases to discover novel functional associations and increase statistical power.

scholarly journals Coffee Consumption and Risk of Colorectal Cancer: A Systematic Review and Meta-Analysis of Prospective Studies

Nutrients ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 694 ◽  
Author(s):  
Marina Sartini ◽  
Nicola Bragazzi ◽  
Anna Spagnolo ◽  
Elisa Schinca ◽  
Gianluca Ottria ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Protective Effect ◽  
Prospective Studies ◽  
Meta Analysis ◽  
Coffee Consumption ◽  
Men And Women ◽  
Decaffeinated Coffee ◽  
The Impact ◽  
The Relationship

Coffee is a blend of compounds related to gastrointestinal physiology. Given its popularity and the epidemiology of colorectal cancer, the impact of this beverage on public health could be considerable. Our aim was to provide an updated synthesis of the relationship between coffee consumption and the risk of colorectal cancer. We conducted a systematic review and meta-analysis of 26 prospective studies. Regarding colorectal cancer, no significant relationship was detected. Stratifying for ethnicity, a protective effect emerged in US subjects. Concerning colon cancer, coffee proved to exert a protective effect in men and women combined and in men alone. Stratifying for ethnicity, a significant protective effect was noted in European men only and in Asian women only. Concerning rectal cancer, no association was found. Decaffeinated coffee exhibited a protective effect against colorectal cancer in men and women combined. Studies were appraised for their quality by means of the Newcastle-Ottawa Quality Assessment Scale for Cohort studies. Only one study proved to be of low quality. Ethnicity could explain the heterogeneity of the studies. However, little is known about the relationship between the genetic make-up and the risk of colorectal cancer associated with coffee. Further research is warranted.

scholarly journals POS0522 PREVALENCE OF BRONCHIECTASIS IN RHEUMATOID ARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 494.2-495
Author(s):  
L. Martin ◽  
L. Prisco ◽  
W. Huang ◽  
G. Mcdermott ◽  
N. Shadick ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Random Effects ◽  
Study Design ◽  
Prospective Studies ◽  
Retrospective Studies ◽  
Meta Analysis ◽  
Ct Imaging ◽  
Research Support ◽  
Exclusion Criteria

Background:Bronchiectasis is a known extra-articular manifestation of rheumatoid arthritis (RA) and can lead to decreased quality of life as well as increased risk for infection and mortality. Understanding the burden of bronchiectasis in RA may lead to a better understanding of pathogenesis and improved management. We performed a systematic review and meta-analysis to determine the prevalence of bronchiectasis in RA.Objectives:We investigated the prevalence of RA-related bronchiectasis (RA-BR) using a systematic review and meta-analysis.Methods:We followed the PRISMA-P 2015 guideline for systematic reviews and registered this analysis (ID#199080) on PROSPERO. We queried PubMed and EMBASE databases using the search strategy “rheumatoid arthritis; AND; bronchiectasis” as of July 31, 2020. The inclusion and exclusion criteria were assessed for study eligibility by two independent abstractors. Exclusion criteria included: (1) non-primary literature (i.e., review articles, editorials); (2) case reports involving less than 5 patients; (3) published in a language other than English; (4) did not relate to both RA and bronchiectasis; and (5) studies not involving humans (e.g., mouse models). After the initial screen, we conducted a full text review to verify that inclusion criteria were met: (1) reported frequency of RA-BR and denominator of all RA patients in the study sample. Data including type of study design, method of RA-BR detection, and RA characteristics were extracted by two independent abstractors. We performed meta-analyses using random effects models to estimate prevalence of RA-BR among RA overall and restricted to retrospective or prospective studies.Results:Out of a total of 208 studies, 37 studies were identified that reported frequency of RA-BR among RA. The included studies had heterogeneous methods to identify RA-BR that were based on either clinical or research chest computed tomography (CT) imaging and had varying methods to adjudicate images. Some studies focused on patients with respiratory symptoms or suspected RA-associated interstitial lung disease (RA-ILD). There were a total of 8,646 patients with RA, and 612 were identified as having RA-BR. The pooled overall prevalence of RA-BR in the random effects meta-analysis was 18.2% (95%CI 13.3-23.7%, Figure 1). Among prospective studies (n=24), the prevalence of RA-BR in the meta-analysis was 20.7% (95% CI 14.7-27.4%). Among retrospective studies (n=13) reporting RA-BR, the prevalence was 14.5% (95% CI 7.2-23.7%). Prevalence was lowest in retrospective studies where RA-BR was identified through clinical care (e.g., two large retrospective studies that investigated 4,000 and 1,129 RA patients reported RA-BR prevalence of 0.6% and 2.7%, respectively). The two largest prospective studies that incorporated a research protocol performing chest CT imaging on all enrolled patients investigated 150 and 332 patients with RA and reported a RA-BR prevalence of 8.0% and 9.6%, respectively. Smaller studies of both study design types generally reported higher prevalence of RA-BR.Figure 1.Pooled prevalence of RA-related bronchiectasis in RA among all studies identified (n=37).Conclusion:The prevalence of RA-BR in this systematic review and meta-analysis was 18.2%, emphasizing that bronchiectasis is a common extra-articular feature of RA. However, some studies may have identified subclinical RA-BR through research imaging or RA-BR may have been secondary to RA-ILD. Future studies should standardize methods to identify RA-BR cases and investigate the natural history and clinical course given the relatively high prevalence that we report.Disclosure of Interests:Lily Martin: None declared, Lauren Prisco: None declared, Weixing Huang: None declared, Gregory McDermott: None declared, Nancy Shadick Consultant of: Consultant < 5K Bristol-Myers Squibb, Grant/research support from: BMS Amgen Lilly, Mallinckrodt, and Sanofi, Tracy Doyle Consultant of: Boehringer Ingelheim (<5K), Grant/research support from: Bristol Myers Squibb and Genentech, Jeffrey Sparks Consultant of: Bristol-Myers Squibb, Gilead, Inova Diagnostics, Optum, and Pfizer, Grant/research support from: Bristol-Myers Squibb

scholarly journals Impact of Plasmodium falciparum pfhrp2 and pfhrp3 gene deletions on malaria control worldwide: a systematic review and meta-analysis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Irene Molina-de la Fuente ◽  
Andrea Pastor ◽  
Zaida Herrador ◽  
Agustín Benito ◽  
Pedro Berzosa
Keyword(s):  
Systematic Review ◽  
Central America ◽  
Study Design ◽  
Malaria Control ◽  
Meta Analysis ◽  
World Health ◽  
False Negatives ◽  
Gene Deletions ◽  
South Central ◽  
The Impact

Abstract Background Deletion of pfhrp2 and/or pfhrp3 genes cause false negatives in malaria rapid diagnostic test (RDT) and threating malaria control strategies. This systematic review aims to assess the main methodological aspects in the study of pfhrp2 and pfhrp3 gene deletions and its global epidemiological status, with special focus on their distribution in Africa; and its possible impact in RDT. Methods The systematic review was conducted by examining the principal issues of study design and methodological workflow of studies addressing pfhrp2 deletion. Meta-analysis was applied to represent reported prevalences of pfhrp2 and pfhrp3 single and double deletion in the World Health Organization (WHO) region. Pooled-prevalence of deletions was calculated using DerSimonnian-Laird random effect model. Then, in-deep analysis focused on Africa was performed to assess possible variables related with these deletions. Finally, the impact of these deletions in RDT results was analysed combining reported information about RDT sensitivity and deletion prevalences. Results 49 articles were included for the systematic review and 37 for the meta-analysis, 13 of them placed in Africa. Study design differs significantly, especially in terms of population sample and information reported, resulting in high heterogeneity between studies that difficulties comparisons and merged conclusions. Reported prevalences vary widely in all the WHO regions, significantly higher deletion were reported in South-Central America, following by Africa and Asia. Pfhrp3 deletion is more prevalent (43% in South-Central America; 3% in Africa; and 1% in Asia) than pfhrp2 deletion (18% in South-Central America; 4% in Africa; and 3% in Asia) worldwide. In Africa, there were not found differences in deletion prevalence by geographical or population origin of samples. The prevalence of deletion among false negatives ranged from 0 to 100% in Africa, but in Asia and South-Central America was only up to 90% and 48%, respectively, showing substantial relation between deletions and false negatives. Conclusion The concerning prevalence of pfhrp2, pfhrp3 and pfhrp2/3 gene deletions, as its possible implications in malaria control, highlights the importance of regular and systematic surveillance of these deletions. This review has also outlined that a standardized methodology could play a key role to ensure comparability between studies to get global conclusions.

scholarly journals Animal models of chemotherapy-induced peripheral neuropathy: a machine-assisted systematic review and meta-analysis

2018 ◽  
Author(s):  
Gillian L. Currie ◽  
Helena N. Angel-Scott ◽  
Lesley Colvin ◽  
Fala Cramond ◽  
Kaitlyn Hair ◽  
...  
Keyword(s):  
Systematic Review ◽  
Peripheral Neuropathy ◽  
Experimental Design ◽  
Animal Models ◽  
Study Design ◽  
Outcome Measure ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Behavioural Tests ◽  
The Impact

AbstractBackground and aimsChemotherapy-induced peripheral neuropathy (CIPN) can be a severely disabling side-effect of commonly used cancer chemotherapeutics, requiring cessation or dose reduction, impacting on survival and quality of life. Our aim was to conduct a systematic review and meta-analysis of research using animal models of CIPN to inform robust experimental design.MethodsWe systematically searched 5 online databases (PubMed, Web of Science, Citation Index, Biosis Previews and Embase (September 2012) to identify publications reporting in vivo CIPN modelling. Due to the number of publications and high accrual rate of new studies, we ran an updated search November 2015, using machine-learning and text mining to identify relevant studies.All data were abstracted by two independent reviewers. For each comparison we calculated a standardised mean difference effect size then combined effects in a random effects meta- analysis. The impact of study design factors and reporting of measures to reduce the risk of bias was assessed. We ran power analysis for the most commonly reported behavioural tests.Results341 publications were included. The majority (84%) of studies reported using male animals to model CIPN; the most commonly reported strain was Sprague Dawley rat. In modelling experiments, Vincristine was associated with the greatest increase in pain-related behaviour (−3.22 SD [−3.88; −2.56], n=152, p=0). The most commonly reported outcome measure was evoked limb withdrawal to mechanical monofilaments. Pain-related complex behaviours were rarely reported. The number of animals required to obtain 80% power with a significance level of 0.05 varied substantially across behavioural tests. Overall, studies were at moderate risk of bias, with modest reporting of measures to reduce the risk of bias.ConclusionsHere we provide a comprehensive summary of the field of animal models of CIPN and inform robust experimental design by highlighting measures to increase the internal and external validity of studies using animal models of CIPN. Power calculations and other factors, such as clinical relevance, should inform the choice of outcome measure in study design.

scholarly journals O-195 The impact of the COVID-19 outbreak on psychological distress due to the cancellation of ART. A systematic review and meta-analysis

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Z Donarelli ◽  
G Lo Coco ◽  
S Gullo ◽  
V Oieni ◽  
A Volpes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Psychological Distress ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Infertile Couples ◽  
The Impact ◽  
Infertile Patients

Abstract Study question Is there evidence that infertile patients have been more likely to experience distress during the COVID-19 outbreak with the consequent interruption of treatment plans? Summary answer High levels of psychological distress among infertile patients have been found during the COVID-19 pandemic, greater than that reported in the general population. What is known already Preliminary research on the negative consequences of the COVID-19 outbreak on mental health evidenced heightened levels of anxiety, depression and post-traumatic stress in some clinical populations as well as in community samples. However, little is known about the impact of COVID-19 on psychological distress of infertile patients who have been forced to suspend infertility treatment and postpone parenthood goals during the pandemic. The aim of this meta-analytic review is to summarize extant literature on the prevalence of psychological distress symptoms in infertile patients during the COVID-19 pandemic. Study design, size, duration A systematic review and meta-analysis were conducted following the PRISMA guidelines on PsycInfo, PubMed, Embase, Web of Science, MedRxiv from March 2020 to mid-December 2020. Study inclusion criteria were specified according to the PICOS guideline. All naturalistic or RCT studies published in 2020 that examined infertility as the primary diagnosis and had a quantitative measurement of distress, were eligible. The primary outcomes were symptoms of psychological distress and secondary outcomes were indicators of psychological health. Participants/materials, setting, methods The database search identified 144 papers. Two reviewers independently screened potential studies by title and abstracts based on the inclusion criteria. The full texts were then screened for eligibility. The Newcastle-Ottawa Scale was used to judge the methodological quality of the studies. In order to estimate the pooled prevalence of distress, Odds Ratios with 95% Confidence Interval were calculated as the effect size by using a random-effects model. Heterogeneity was tested using I2 statistics. Main results and the role of chance Fourteen studies met the inclusion criteria and were summarized for the systematic review (N = 6473). Only six studies did not include males although, in the surveys, females made up 92% of the total sample. Ten studies adopted a cross-sectional study design. 100% gathered data through an online survey. Nine studies showed a high risk of bias, and five had a moderate risk. Review results showed that 56,4% of patients wished to resume treatment; participants were mostly worried about the delay in treatment because of their age (&gt;35 years) or diminished ovarian reserve, or money constraints and low education level. Only five studies examined the role of protective factors such as social support, coping, optimism trait and intolerance of uncertainty. Nine studies were included for meta-analysis. The prevalence of psychological distress was 0.58 (95% CI 0.32÷0.84). The pooled point estimates of prevalence for anxiety (N = 6) were 0.56 (95% CI 0.24÷0.88), whereas the prevalence for depression (N = 5) was 0.46 (95% CI 0.15÷0.77). There was significant heterogeneity among studies to estimate the prevalence (I² ranging from 99% to 100%). Limitations, reasons for caution Results are preliminary, given the small number of studies and their cross-sectional data. The risk of bias was high or moderate across studies. Wider implications of the findings Infertile couples reported high levels of distress due to cancellation of their diagnostic procedures or treatment; they would benefit from information, appropriate support and advice from healthcare professionals, with an important role in maintaining the wishes of infertile couples to continue their parenthood goals. Trial registration number not applicable

Gathering Data: Searching Literature and Selection Criteria

2013 ◽  
Author(s):  
Isabelle M. Côté ◽  
Peter S. Curtis ◽  
Hannah R. Rothstein ◽  
Gavin B. Stewart
Keyword(s):  
Systematic Review ◽  
Information Retrieval ◽  
Selection Criteria ◽  
Meta Analysis ◽  
Inclusion Criteria ◽  
Literature Searching ◽  
Scoping Study ◽  
Study Selection ◽  
Important Relationship ◽  
Gathering Data

There is an important relationship between how thorough and unbiased the search for relevant data is and the validity of the resulting meta-analysis. Many reviewers fail to uncover citations to documents relevant to their project because of inadequate search tools or strategies. This chapter covers literature searching and information retrieval, as well as the application of study selection (inclusion) criteria. Best practices include carrying out an initial scoping study to assess how much literature is available and whether a systematic review and meta-analysis are possible; developing an explicit search protocol which details exactly how you will go about searching the literature; and outlining clear study selection criteria so that the reasons for inclusion or exclusion of studies are transparent.

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