scholarly journals Effectiveness of trauma centers verification: Protocol for a systematic review

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Brice Batomen ◽  
Lynne Moore ◽  
Mabel Carabali ◽  
Pier-Alexandre Tardif ◽  
Howard Champion ◽  
...  
Keyword(s):  
Systematic Review ◽  
Trauma Center ◽  
Assessment Tool ◽  
Meta Analysis ◽  
The Body ◽  
World Health ◽  
Trauma Patients ◽  
Assessment Development ◽  
Health Organization

Abstract Background The implementation of trauma systems in many high-income countries over the last 50 years has led to important reductions in injury mortality and disability in many healthcare jurisdictions. Injury organizations including the American College of Surgeons and the Trauma Association of Canada as well as the World Health Organization provide consensus-based recommendations on resources and processes for optimal injury care. Many hospitals treating trauma patients seek verification to demonstrate that they meet these recommendations. This process may be labeled differently across jurisdictions. In Canada for example, it is called accreditation, but it has the same objective and very similar modalities. The objective of the study described in this protocol is to systematically review evidence on the effectiveness of trauma center verification for improving clinical processes and patient outcomes in injury care. Methods We will perform a systematic review of studies evaluating the association between trauma center verification and hospital mortality (primary outcome), as well as morbidity, resource utilization, and processes of care (secondary outcomes). We will search CINAHL, EMBASE, HealthStar, MEDLINE, and ProQuest databases, as well as key injury organization websites for gray literature. We will assess the methodological quality of studies using the Risk Of Bias In Non-randomized Studies – of Interventions (ROBINS-I) assessment tool. We are planning to conduct a meta-analysis if feasible based on the number of included studies and their heterogeneity. We will evaluate the quality of cumulative evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group methodology. Discussion This review will provide a synthesis of the body of evidence on trauma center verification effectiveness. Results could reinforce current verification modalities and may suggest ways to optimize them. Results will be published in a peer-reviewed journal and presented at an international clinical conference. Systematic review registration PROSPERO CRD42018107083.

scholarly journals A living WHO guideline on drugs to prevent covid-19

BMJ ◽  
2021 ◽  
pp. n526
Author(s):  
François Lamontagne ◽  
Thomas Agoritsas ◽  
Reed Siemieniuk ◽  
Bram Rochwerg ◽  
Jessica Bartoszko ◽  
...  
Keyword(s):  
Systematic Review ◽  
Guideline Development ◽  
Meta Analysis ◽  
World Health ◽  
Policy And Practice ◽  
Assessment Development ◽  
Research Priority ◽  
Health Organization ◽  
Almost All ◽  
Drug Interventions

Abstract Clinical question What is the role of drugs in preventing covid-19? Why does this matter? There is widespread interest in whether drug interventions can be used for the prevention of covid-19, but there is uncertainty about which drugs, if any, are effective. The first version of this living guideline focuses on the evidence for hydroxychloroquine. Subsequent updates will cover other drugs being investigated for their role in the prevention of covid-19. Recommendation The guideline development panel made a strong recommendation against the use of hydroxychloroquine for individuals who do not have covid-19 (high certainty). How this guideline was created This living guideline is from the World Health Organization (WHO) and provides up to date covid-19 guidance to inform policy and practice worldwide. Magic Evidence Ecosystem Foundation (MAGIC) provided methodological support. A living systematic review with network analysis informed the recommendations. An international guideline development panel of content experts, clinicians, patients, an ethicist and methodologists produced recommendations following standards for trustworthy guideline development using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Understanding the new recommendation The linked systematic review and network meta-analysis (6 trials and 6059 participants) found that hydroxychloroquine had a small or no effect on mortality and admission to hospital (high certainty evidence). There was a small or no effect on laboratory confirmed SARS-CoV-2 infection (moderate certainty evidence) but probably increased adverse events leading to discontinuation (moderate certainty evidence). The panel judged that almost all people would not consider this drug worthwhile. In addition, the panel decided that contextual factors such as resources, feasibility, acceptability, and equity for countries and healthcare systems were unlikely to alter the recommendation. The panel considers that this drug is no longer a research priority and that resources should rather be oriented to evaluate other more promising drugs to prevent covid-19. Updates This is a living guideline. New recommendations will be published in this article and signposted by update notices to this guideline. Readers note This is the first version of the living guideline for drugs to prevent covid-19. It complements the WHO living guideline on drugs to treat covid-19. When citing this article, please consider adding the update number and date of access for clarity.

scholarly journals Developing WHO guidelines: Time to formally include evidence from mathematical modelling studies

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1584 ◽  
Author(s):  
Matthias Egger ◽  
Leigh Johnson ◽  
Christian Althaus ◽  
Anna Schöni ◽  
Georgia Salanti ◽  
...  
Keyword(s):  
Mathematical Modelling ◽  
The Body ◽  
World Health ◽  
Who Guidelines ◽  
Problem Model ◽  
Assessment Development ◽  
Modelling Studies ◽  
Health Organization

In recent years, the number of mathematical modelling studies has increased steeply. Many of the questions addressed in these studies are relevant to the development of World Health Organization (WHO) guidelines, but modelling studies are rarely formally included as part of the body of evidence. An expert consultation hosted by WHO, a survey of modellers and users of modelling studies, and literature reviews informed the development of recommendations on when and how to incorporate the results of modelling studies into WHO guidelines. In this article, we argue that modelling studies should routinely be considered in the process of developing WHO guidelines, but particularly in the evaluation of public health programmes, long-term effectiveness or comparative effectiveness.  There should be a systematic and transparent approach to identifying relevant published models, and to commissioning new models.  We believe that the inclusion of evidence from modelling studies into the Grading of Recommendations Assessment, Development and Evaluation (GRADE) process is possible and desirable, with relatively few adaptations.  No single “one-size-fits-all” approach is appropriate to assess the quality of modelling studies. The concept of the ‘credibility’ of the model, which takes the conceptualization of the problem, model structure, input data, different dimensions of uncertainty, as well as transparency and validation into account, is more appropriate than ‘risk of bias’.

scholarly journals Developing WHO guidelines: Time to formally include evidence from mathematical modelling studies

F1000Research ◽  
2018 ◽  
Vol 6 ◽  
pp. 1584 ◽  
Author(s):  
Matthias Egger ◽  
Leigh Johnson ◽  
Christian Althaus ◽  
Anna Schöni ◽  
Georgia Salanti ◽  
...  
Keyword(s):  
Mathematical Modelling ◽  
The Body ◽  
World Health ◽  
Who Guidelines ◽  
Problem Model ◽  
Assessment Development ◽  
Modelling Studies ◽  
Health Organization

In recent years, the number of mathematical modelling studies has increased steeply. Many of the questions addressed in these studies are relevant to the development of World Health Organization (WHO) guidelines, but modelling studies are rarely formally included as part of the body of evidence. An expert consultation hosted by WHO, a survey of modellers and users of modelling studies, and literature reviews informed the development of recommendations on when and how to incorporate the results of modelling studies into WHO guidelines. In this article, we argue that modelling studies should routinely be considered in the process of developing WHO guidelines, but particularly in the evaluation of public health programmes, long-term effectiveness or comparative effectiveness.  There should be a systematic and transparent approach to identifying relevant published models, and to commissioning new models.  We believe that the inclusion of evidence from modelling studies into the Grading of Recommendations Assessment, Development and Evaluation (GRADE) process is possible and desirable, with relatively few adaptations.  No single “one-size-fits-all” approach is appropriate to assess the quality of modelling studies. The concept of the ‘credibility’ of the model, which takes the conceptualization of the problem, model structure, input data, different dimensions of uncertainty, as well as transparency and validation into account, is more appropriate than ‘risk of bias’.

scholarly journals The global prevalence of maternal near miss: a systematic review and meta-analysis

2019 ◽  
Vol 9 (4) ◽  
pp. 255-262
Author(s):  
Sedigheh Abdollahpour ◽  
Hamid Heidarian Miri ◽  
Talat Khadivzadeh
Keyword(s):  
Systematic Review ◽  
Maternal Health ◽  
Meta Analysis ◽  
Near Miss ◽  
World Health ◽  
Maternal Near Miss ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Organization

Background: Improving the maternal health is one of the world’s most challenging problems. Despite significant movements over the past decades, maternal health has been still considered as a central goal for sustainable development. Maternal near miss (MNM) cases experience long-term physical and psychological effects. To present a clear portrait of the current situation, we performed a systematic review and meta-analysis with the purpose to assess the worldwide prevalence of MNM. Methods: We conducted a systematic review on PubMed, Scopus and Web of Science electronic databases to find published papers in English, before March 2019 and regardless of the type of study. We, then, assessed the prevalence of MNM according to the World Health Organization(WHO) criteria. Finally, 49 papers were included in the study. Random effects meta-analysis was used to pool the available prevalence. The quality of studies was also evaluated. Results: The weighted pooled worldwide prevalence of MNM, was 18.67/1000 (95% CI: 16.28-21.06). Heterogeneity was explored using subgroup analyses based on the continent and the country. We used meta-regression of MNM on MD which resulted in adjusted R-squared as78.88%. Conclusion: The prevalence of MNM was considerable. Low- and middle-income countries should develop systematic approaches to improve quality of care in the facilities and to reducethe risk of MNM events, with the hope to women’s health.

scholarly journals Favipiravir for treating novcl coronavirus (COVID-19) patients: protocol for a systematic review and meta-analysis of Controlled trials

2020 ◽  
Author(s):  
Morteza Arab-Zozani ◽  
Soheil Hassanipour ◽  
Djavad Ghoddoosi-Nejad
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Treatment Options ◽  
World Health ◽  
Eligibility Criteria ◽  
Data Synthesis ◽  
Clinical Trial Registries ◽  
Statistical Heterogeneity ◽  
Health Organization

Abstract Background An outbreak of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was reported in Wuhan, China in mid-December 2019, and declared a pandemic by the World Health Organization (WHO) on March 11, 2020. Due to the unknown nature of the disease and the lack of specific drugs, several potential treatments were used for patients. This systematic review and meta-analysis will evaluate studies of the effects of Favipiravir in COVID-19 pneumonia. Methods We will search electronic databases including LitCovid hub, PubMed, Scopus, ISI web of Sciences, Cochrane, and Embase using keywords related to COVID-19 and Favipiravir. We will search the reference lists of all included studies and reviews. We will also search for clinical trial registries, such as clinicaltrial.gov for the ongoing clinical trials. Two investigators (MAZ and SH) will independently screen titles, abstracts, and full-text of included studies based on eligibility criteria. These investigators will also independently extract data and appraise the quality of studies. All potential discrepancies will be resolved through consultation with the third reviewer. Data synthesis will be conducted using the Review Manager software (version 5.3) or CMA (version 2). Statistical heterogeneity will be assessed using a standard I 2 test. A funnel plot, Egger’s test, and Begg’s test will be used for asymmetry to explore possible publication bias. Discussion The findings of this systematic review with proportional meta-analysis will help to identify the safety and efficacy of Favipiravir for COVID-19 patients. Knowledge gained from this research will also assist physicians in selecting better treatment options and developing a guideline in this field.

A mixed-methods systematic review on barriers to exclusive breastfeeding

2020 ◽  
Vol 26 (4) ◽  
pp. 323-346
Author(s):  
Divya Sussana Patil ◽  
Prachi Pundir ◽  
Vijay Shree Dhyani ◽  
Jisha B. Krishnan ◽  
Shradha S Parsekar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Exclusive Breastfeeding ◽  
Meta Analysis ◽  
Reproductive Age ◽  
World Health ◽  
Factors Affecting ◽  
Health Organization ◽  
Context Specific

Introduction: The World Health Organization recommends exclusive breastfeeding for every newborn during the first 6 months of life, yet women come across various challenges to continuing it. Aim: This systematic review was intended to identify barriers to exclusive breastfeeding among mothers. Methods: MEDLINE, Cumulative Index to Nursing and Allied health literature, ProQuest, Web of Science and Scopus databases were searched from January 1990 to October 2017. The systematic review included quantitative, qualitative and mixed-methods studies to identify barriers to exclusive breastfeeding among mothers of reproductive age with an infant aged between 0 and 12 months. All studies were screened based on titles, abstracts and full text by two reviewers independently. The methodological quality of included studies was assessed using appropriate tools. Of the 9737 eligible records, 44 studies were included for analysis. Classification of barriers to exclusive breastfeeding was adopted from the conceptual framework of factors affecting breastfeeding practices given by Hector and colleagues. Results: In total 32 barriers were grouped under individual, group and society level factors. Meta-analysis indicated that mothers who smoked had 2.49 times more odds of not exclusively breastfeeding than non-smoking mothers and mothers who had undergone caesarean section had 1.69 times more risk of cessation of exclusive breastfeeding than mothers who have had a vaginal childbirth. Conclusion: The systematic review revealed a complex interplay of various barriers related to exclusive breastfeeding. It is recommended that context-specific strategies should be designed in accordance with barriers existing in a region or country.

The study of Iranian children and adolescents’ physical activity: a systematic review and meta-analysis

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Adel Alizadeh ◽  
Reza Negarandeh ◽  
Fahimehe Bagheri Amiri ◽  
Zahra Yazdani
Keyword(s):  
Physical Activity ◽  
Children And Adolescents ◽  
Meta Analysis ◽  
World Health ◽  
Chi Square ◽  
The Status ◽  
Newcastle Ottawa Scale ◽  
Health Organization ◽  
Iranian Children

Abstract Objectives This systematic and meta-analysis review was conducted to determine the status of Iranian children and adolescents’ physical activity. Content All the related articles which were published in the major databases, including Pubmed, Scopus, Web of Science, Embase, Magiran, SID from the beginning of 2010 to the end of 2019, were reviewed by researchers. The Newcastle-Ottawa scale was also used to evaluate the quality of articles. Moreover, I 2 index and chi-square were used to assess the heterogeneity between the results. Summary 490 articles were found as a result of the search in the selected international and local databases, where finally, 10 articles were included into the meta-analysis after the elimination of the duplicated articles and applying inclusion and exclusion criteria. The results indicated that 29.5% of the girls were considered active according to WHO criteria (16.1–42.8: 95% CI) and also 20.5% of the boys (7.3–33.7: 95% CI). Outlook Overall, this study’s findings showed that a large percentage of Iranian children and adolescents do not achieve the level of physical activity recommended by the World Health Organization. This can lead to undesirable consequences for this group of population that is considered as the human capital of any country; consequently, it seems necessary to take basic measures at the micro and macro levels in order to reduce such problems in the society.

scholarly journals The efficacy and safety of interferons for the treatment of patients with COVID-19: protocol for systematic review and meta-analysis of controlled trials

2021 ◽  
Author(s):  
Afsaneh Noormandi ◽  
Mohammad Fathalipour ◽  
Reza Daryabeygi-Khotbehsara ◽  
Soheil Hassanipour
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Meta Analysis ◽  
World Health ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Global Pandemic ◽  
The World ◽  
Health Organization ◽  
Time Of Administration

Background and objective: COVID-19 has since been declared a global pandemic by the World Health Organization (WHO), infecting millions worldwide. The use of Interferon (INF) subtypes previously examined in the treatment of SARS and MERS is also being initiated in some clinical trials. Although different clinical trials were evaluated IFNs in the treatment of COVID-19, their efficacy and safety remain unknown. Therefore, this study aims to systematically assess IFNs efficacy and safety in treating patients with COVID-19. Methods: The protocol has been registered in the PROSPERO International Prospective Register (CRD42020200643) on 24 July 2020. This protocol has been arranged according to the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) 2015 checklist. Discussion: Due to lack of approved medication for the covid-19 treatment and also various mutations of this virus, evaluated the efficacy and safety of medications by various studies could help for finding treatments with high effectiveness. IFNs are one of the medications that have been administered in covid-19 infection.  Moreover, the best time of administration and dose of this medication was unknown. Although meta-analysis is a potent source for assessing the accuracy of subjects, heterogeneity of articles is a potent limitation of our work.

scholarly journals Effect of Anticoagulant Administration on the Mortality of Hospitalized Patients With COVID-19: An Updated Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Luojia Jiang ◽  
Yupei Li ◽  
Heyue Du ◽  
Zheng Qin ◽  
Baihai Su
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Anticoagulation Therapy ◽  
Hospitalized Patients ◽  
Severe Bleeding ◽  
Bleeding Events ◽  
Assessment Development ◽  
Dichotomous Variables ◽  
Lower Mortality Risk

Background: Anticoagulation is generally used in hospitalized patients with coronavirus disease 2019 (COVID-19) as thromboprophylaxis. However, results from different studies comparing the effect of anticoagulation on the mortality of COVID-19 patients with non-anticoagulation are inconclusive.Methods: Our systematic review included observational trials if they studied anticoagulant therapy in hospitalized patients with COVID-19 for mortality or bleeding events. Dichotomous variables from individual studies were pooled by risk ratio (RR) and their 95% confidence interval (95% CI) using the random-effects model. Grading of Recommendations Assessment, Development and Evaluation was used to assess the quality of evidence.Results: A total of 11 observational studies enrolling 20,748 hospitalized COVID-19 patients overall were included. A pooled meta-analysis of these studies showed that anticoagulation therapy, compared with non-anticoagulation therapy, was associated with lower mortality risk (RR 0.70, 95% CI 0.52–0.93, p = 0.01). The evidence of benefit was stronger among critically ill COVID-19 patients in the intensive care units (RR 0.59, 95% CI 0.43–0.83, p = 0.002). Additionally, severe bleeding events were not associated with the administration of anticoagulants (RR 0.93, 95% CI 0.71–1.23, p = 0.63).Conclusion: Among patients with COVID-19 admitted to hospital, the administration of anticoagulants was associated with a decreased mortality without increasing the incidence of bleeding events.

Sign in / Sign up

Export Citation Format

Share Document