Impact of Comorbidity on Chemotherapy Use and Outcomes in Solid Tumors: A Systematic Review

2011 ◽  
Vol 29 (1) ◽  
pp. 106-117 ◽  
Author(s):  
Linda Lee ◽  
Winson Y. Cheung ◽  
Esther Atkinson ◽  
Monika K. Krzyzanowska
Keyword(s):  
Systematic Review ◽  
Solid Tumors ◽  
English Language ◽  
Current Data ◽  
Future Research ◽  
Severe Toxicity ◽  
Quality Of Reporting ◽  
Treatment Delays ◽  
The Impact

Background The treatment of cancer in patients with comorbidities can be challenging as these individuals are underrepresented in clinical trials. We conducted a systematic review to determine the impact of comorbidity on chemotherapy use, delivery, tolerability, and survival among patients with solid tumors to summarize current data and provide recommendations for future research. Methods All English-language articles from 1990 to 2009 that explored the association between comorbidity and chemotherapy were identified from MEDLINE and EMBASE. Abstracts were reviewed for eligibility, and data on study design and results were extracted. Results Thirty-four articles met the inclusion criteria. Study populations and design were heterogeneous, and the quality of reporting was generally poor. Most studies were retrospective (76%), were based on a cancer registry linked with administrative data (47%), and assessed the overall effect of comorbidity using an index score (76%). Sixteen studies (47%) investigated chemotherapy use, and 29 (85%) addressed survival. The majority reported decreased chemotherapy use (75%) and inferior survival (69%) for patients with comorbidities compared to those without. In 11 of 14 studies, inferior survival was independent of treatment. Of the few studies that addressed chemotherapy tolerability, seven of 10 reported an increased rate of severe toxicity, and three of five reported increased treatment delays for patients with comorbidity. Conclusion Chemotherapy use and outcomes among cancer patients with comorbidities are generally inferior, but the existing evidence is limited and of insufficient quality to determine the relationship between decreased use and inferior survival. Further studies that are prospective and site and stage specific are warranted.

scholarly journals The Impact of Non-Price In-premise Marketing on Food and Beverage Purchasing and Consumer Behaviour: A Systematic Review

2021 ◽  
Author(s):  
Ross Whitehead ◽  
Stefania Greci ◽  
Hilary Thomson ◽  
Gillian Armour ◽  
Kathryn Angus ◽  
...  
Keyword(s):  
Systematic Review ◽  
Public Policy ◽  
English Language ◽  
Consumer Behaviour ◽  
Future Research ◽  
Inclusion Criteria ◽  
Online Purchase ◽  
Food And Beverage ◽  
The Impact

In-premise marketing is commonly used to promote foods that are high in fat, sugar or salt. In order to inform development of public policy in this area, this systematic review sought to determine the quantity and quality of English-language evidence which examines the role and impact of in-premise advertising (e.g., signage, posters) and positional promotions (e.g., checkout displays) on consumer behaviour and diet-related outcomes in retail, out-of-home (i.e., cafes, restaurants, takeaways) and online purchasing environments. Sixty-two studies met inclusion criteria, of which 69% (n=42) were identified as being methodologically weak. The best-available evidence constitutes findings from four methodologically strong studies, and ten moderate studies which are not confounded by additional promotions such as price or availability. These studies predominantly found evidence that in-premise marketing is likely to be successful in influencing consumer behaviour towards targeted items, across retail and out-of-home settings. These findings provide a basis for authorities to consider acting to restrict in-premise marketing of unhealthy foods and encouraging the in-premise marketing of healthier products. This review identified gaps in the evidence available on non-sales outcomes, and on online purchase environments. These gaps, and identified methodological limitations of the extant evidence remain to be addressed by future research.

scholarly journals A Systematic Review of the Impact of Patient–Physician Non-English Language Concordance on Quality of Care and Outcomes

2019 ◽  
Vol 34 (8) ◽  
pp. 1591-1606 ◽  
Author(s):  
Lisa Diamond ◽  
Karen Izquierdo ◽  
Dana Canfield ◽  
Konstantina Matsoukas ◽  
Francesca Gany
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
English Language ◽  
Language Concordance ◽  
The Impact

Improving health in prisons – from evidence to policy to implementation – experiences from the UK

2017 ◽  
Vol 13 (3/4) ◽  
pp. 139-167 ◽  
Author(s):  
Jane Leaman ◽  
Anna Amelia Richards ◽  
Lynn Emslie ◽  
Eamonn Joseph O’Moore
Keyword(s):  
Systematic Review ◽  
English Language ◽  
World Health ◽  
Limited Resources ◽  
Framework Analysis ◽  
Content Type ◽  
Key Informants ◽  
Evidence Review ◽  
The Impact

Purpose The purpose of this paper is to understand the components of a high-quality prison healthcare system and the impact, ten-years on, of the transfer of accountability in England, from a justice ministry to a health ministry. Design/methodology/approach A rapid evidence review was undertaken, which included a review of 82 papers and qualitative interviews with key informants. The concepts and themes identified were summarised and analysed through a framework analysis, designed to improve population outcomes and address health inequalities. The use of a rapid evidence assessment, rather than a systematic review methodology, the use of abstracts (rather than full-text articles) to extract the data, and limiting the search strategy to articles published in the English language only might mean that some relevant research papers and themes were not identified. The need for the evidence to be produced within a limited time frame and with limited resources determined these pragmatic approaches. Findings The review found that English prison healthcare has undergone “transformation” during this period, leading to increased quality of care through organisational engagement, professionalisation of the healthcare workforce, transparency, use of evidence-based guidance and responsiveness of services. The review also highlighted that there is still room for improvement, for example, relating to the prison regime and the lack of focus on early/preventive interventions, as well as specific challenges from limited resources. Research limitations/implications Time and resource constraints meant a rapid evidence review of papers in the English language was undertaken, rather than a systematic review. This might mean relevant papers have been missed. The review also only covered a small number of countries, which may limit the transferability of findings. The lack of quantitative data necessitated the use of qualitative data gathered from key informants. However, this enabled a good understanding of current practice. Practical implications The review findings support the World Health Organisation position on the value of integrated prison and public health systems in improving quality of healthcare. It also recommends future policy needs to take account of the “whole prison approach” recognising that healthcare in prisons cannot operate in isolation from the prison regime or the community. Originality/value This is unique research which has great value in supporting prison reform in England. It will also be of interest internationally due to the paucity of data in the published peer-reviewed literature on the impact of commissioning models on healthcare or health outcomes.

scholarly journals The impact of childhood psychological maltreatment on mental health outcomes in adulthood: a protocol for a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Zhuoni Xiao ◽  
Mina Murat Baldwin ◽  
Franziska Meinck ◽  
Ingrid Obsuth ◽  
Aja Louise Murray
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Emotional Abuse ◽  
Mental Health Problems ◽  
Meta Analysis ◽  
Psychological Maltreatment ◽  
Future Research ◽  
Long Term Effects ◽  
The Impact

Abstract Background Research suggests that childhood psychological maltreatment (i.e., emotional abuse and emotional neglect) is associated with mental health problems that persist into adulthood, for example anxiety, depression, post-traumatic stress disorder (PTSD), suicidal ideation, and aggression; however, a systematic review and meta-analysis of the existing literature would help clarify the magnitude and moderators of these associations, and the extent to which they may be affected by publication bias, as well as the methodological strengths and weakness of studies in this area. Method The reporting of this protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) Statement. Searches will be carried out via several databases, including Web of Science, Medline, PubMed, PsycINFO, Applied Social Science Index and Abstract, ERIC and EMBASE. Empirical peer-reviewed research articles that fit pre-specified eligibility criteria will be included in the review. Studies will be eligible if they include participants age 18 or over at time of mental health assessment, include information on childhood psychological maltreatment (emotional abuse and/or neglect) perpetrated by a primary caregiver or adult in the same household, and provide quantitative information on the association between these factors. Studies using prospective and retrospective designs and written in either English or Chinese will be eligible. Two independent reviewers will screen and assess studies for inclusion in the review as well as extract the data, with consensus reached through discussion in cases of discrepancy. A third reviewer will be consulted to resolve any discrepancies that remain. The relevant Newcastle–Ottawa scales will be used for assessing the quality of studies. If a sufficient number of comparable studies are retrieved, a meta-analysis will be conducted using a random effects model. Study-level moderators (i.e., year of publication, quality of the study and study geographical location) will be examined in the meta-analyses. Discussion This systematic review will provide an understanding of the long-term effects of childhood psychological maltreatment on adult mental health, which adds to previous reviews focusing primarily on the effects of physical and sexual abuse. The results of the review will help inform clinical practice in approaches to treating those with a history of psychological maltreatment in childhood. The gaps and weaknesses in the evidence identified will also inform recommendations for future research.

scholarly journals The impact of methamphetamine/amphetamine use on receipt and outcomes of medications for opioid use disorder: a systematic review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Madeline C. Frost ◽  
Hannah Lampert ◽  
Judith I. Tsui ◽  
Matthew D. Iles-Shih ◽  
Emily C. Williams
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Data Extraction ◽  
Opioid Use Disorder ◽  
Small Samples ◽  
Future Research ◽  
Opioid Use ◽  
Polysubstance Use ◽  
Amphetamine Use ◽  
The Impact

Abstract Background Methamphetamine/amphetamine use has sharply increased among people with opioid use disorder (OUD). It is therefore important to understand whether and how use of these substances may impact receipt of, and outcomes associated with, medications for OUD (MOUD). This systematic review identified studies that examined associations between methamphetamine/amphetamine use or use disorder and 3 classes of outcomes: (1) receipt of MOUD, (2) retention in MOUD, and (3) opioid abstinence during MOUD. Methods We searched 3 databases (PubMed/MEDLINE, PsycINFO, CINAHL Complete) from 1/1/2000 to 7/28/2020 using key words and subject headings, and hand-searched reference lists of included articles. English-language studies of people with documented OUD/opioid use that reported a quantitative association between methamphetamine/amphetamine use or use disorder and an outcome of interest were included. Study data were extracted using a standardized template, and risk of bias was assessed for each study. Screening, inclusion, data extraction and bias assessment were conducted independently by 2 authors. Study characteristics and findings were summarized for each class of outcomes. Results Thirty-nine studies met inclusion criteria. Studies generally found that methamphetamine/amphetamine use or use disorder was negatively associated with receiving methadone and buprenorphine; 2 studies suggested positive associations with receiving naltrexone. Studies generally found negative associations with retention; most studies finding no association had small samples, and these studies tended to examine shorter retention timeframes and describe provision of adjunctive services to address substance use. Studies generally found negative associations with opioid abstinence during treatment among patients receiving methadone or sustained-release naltrexone implants, though observed associations may have been confounded by other polysubstance use. Most studies examining opioid abstinence during other types of MOUD treatment had small samples. Conclusions Overall, existing research suggests people who use methamphetamine/amphetamines may have lower receipt of MOUD, retention in MOUD, and opioid abstinence during MOUD. Future research should examine how specific policies and treatment models impact MOUD outcomes for these patients, and seek to understand the perspectives of MOUD providers and people who use both opioids and methamphetamine/amphetamines. Efforts to improve MOUD care and overdose prevention strategies are needed for this population.

scholarly journals Evaluating Wellness Interventions for Resident Physicians: A Systematic Review

2020 ◽  
Vol 13 (1) ◽  
pp. 58-69
Author(s):  
Jessica Eskander ◽  
Praveen P. Rajaguru ◽  
Paul B. Greenberg
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Educational Theory ◽  
Well Being ◽  
Validity Evidence ◽  
Resident Physicians ◽  
Resident Wellness ◽  
The Impact ◽  
Wellness Initiatives

ABSTRACT Background Wellness initiatives implemented by graduate medical education programs can help mitigate burnout in resident physicians. Objective This systematic review seeks to identify factors that impact the effectiveness of resident wellness interventions and to provide a conceptual framework to guide future interventions. Methods Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 6 electronic databases were searched in November 2019 using variations of the keywords “resident physicians,” “wellness,” and “intervention.” Peer-reviewed full-text English-language articles on controlled studies were considered for inclusion. The quality of the studies was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guidelines. Results The initial search disclosed 1196 articles, of which 18 studies enrolling 666 resident physicians met inclusion criteria for qualitative review. Interventions using peer support and individual meditation enhanced well-being. Effective wellness interventions also used educational theory to guide program development, surveyed participants to guide intervention design, incorporated programming into existing didactic curricula, and recruited voluntary participants. The quality of most of the included studies was poor (13 of 18, 72%) and could be improved by using standardized wellness assessments supported by validity evidence. Conclusions This systematic review suggests that future resident wellness initiatives should focus on grounding interventions in educational theory, forging consensus on wellness instruments with validity evidence, and examining the impact of initiatives on patient outcomes. A logic model can provide a framework for designing and implementing effective wellness interventions.

Perceived Parental Monitoring: A Systematic Review of Monitoring Instruments

2020 ◽  
pp. JNM-D-19-00045
Author(s):  
Caroline Handschuh ◽  
Lidwine B. Mokkink ◽  
Arlene Smaldone
Keyword(s):  
Systematic Review ◽  
Psychometric Properties ◽  
Parental Monitoring ◽  
Future Research ◽  
Measurement Instruments ◽  
Parent Child Relationship ◽  
Quality Of Reporting ◽  
Meta Analyses ◽  
Psychometric Quality

Background and purposeThe purpose of this systematic review was to evaluate parental monitoring instruments and the theoretical perspectives informing their development.MethodsFollowing Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, seven databases were searched for original studies using a monitoring instrument. The psychometric properties of each identified instrument were assessed using the “COnsensus-based Standards for the selection of health status Measurement INstruments” (COSMIN) methodology.ResultsOf 2,245 articles identified, 72 studies representing six parental monitoring instruments met inclusion criteria. Quality of reporting on psychometric properties varied widely across instruments with only three including content validation studies.ConclusionsFindings of this review reveal inattention to the psychometric quality of child self-reported monitoring instruments. Future research must focus on the psychometric quality of instruments used to measure the parent–child relationship.

scholarly journals Social Robot Interventions for People with Dementia: A Systematic Review on Effects and Quality of Reporting

2020 ◽  
pp. 1-20
Author(s):  
Julian Hirt ◽  
Nicola Ballhausen ◽  
Alexandra Hering ◽  
Matthias Kliegel ◽  
Thomas Beer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Functional Outcomes ◽  
Methodological Quality ◽  
Experimental Studies ◽  
Social Robot ◽  
Cochrane Library ◽  
Quality Of Reporting ◽  
People With Dementia ◽  
The Impact

Background: Using non-pharmacological interventions is a current approach in dementia care to manage responsive behaviors, to maintain functional capacity, and to reduce emotional stress. Novel technologies such as social robot interventions might be useful to engage people with dementia in activities and interactions as well as to improve their cognitive, emotional, and physical status. Objective: Assessing the effects and the quality of reporting of social robot interventions for people with dementia. Methods: In our systematic review, we included quasi-experimental and experimental studies published in English, French, or German, irrespective of publication year. Searching CINAHL, Cochrane Library, MEDLINE, PsycINFO, and Web of Science Core Collection was supplemented by citation tracking and free web searching. To assess the methodological quality of included studies, we used tools provided by the Joanna Briggs Institute. To assess the reporting of the interventions, we applied CReDECI 2 and TIDieR. Results: We identified sixteen studies published between 2012 and 2018, including two to 415 participants with mostly non-defined type of dementia. Eight studies had an experimental design. The predominant robot types were pet robots (i.e., PARO). Most studies addressed behavioral, emotion-related, and functional outcomes with beneficial, non-beneficial, and mixed results. Predominantly, cognitive outcomes were not improved. Overall, studies were of moderate methodological quality. Conclusion: Heterogeneous populations, intervention characteristics, and measured outcomes make it difficult to generalize the results with regard to clinical practice. The impact of social robot interventions on behavioral, emotion-related, and functional outcomes should therefore be assessed considering the severity of dementia and intervention characteristics.

The relationship between time spent in volunteering activities and quality of life in adults over the age of 50 years: A systematic review

2018 ◽  
Vol 81 (11) ◽  
pp. 613-623 ◽  
Author(s):  
Benjamin Milbourn ◽  
Jaya Saraswati ◽  
Angus Buchanan
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Controlled Trial ◽  
Future Research ◽  
Life Outcomes ◽  
Cross Sectional ◽  
Quality Of Life Outcomes ◽  
The Impact ◽  
The Relationship

Introduction Increased attention has focused on the importance of time spent by ageing adults in volunteering. The aim of this systematic review was to analyse literature exploring the relationship between time spent volunteering and quality of life for adults over the age of 50 years. Method Electronic searches of nine databases located relevant articles involving adults over the age of 50 in volunteering activities that included psychological, physical and social quality of life domains. The quality of the selected articles was assessed and data extracted using preferred reporting items for systematic reviews and meta-analyses. Results Of the 65 articles retrieved, 22 were reviewed and eight included in the final review. Studies included one randomised controlled trial, one cross-sectional and six longitudinal studies. Levels of time spent volunteering by participants within the studies varied considerably. Articles retrieved reported positive quality of life outcomes including increases in life satisfaction, self-esteem and social support and a slowed functional decline. Conclusion Volunteering is identified as an important occupation for adults over the age of 50, although the relationship between time spent volunteering and the impact on quality of life outcomes is still not fully understood. Future research is required to better understand the impact of time spent volunteering on quality of life.

A systematic review of the impact of comorbidity on chemotherapy utilization and outcomes in solid tumors

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20646-e20646
Author(s):  
L. M. Lee ◽  
W. Y. Cheung ◽  
M. K. Krzyzanowska
Keyword(s):  
Solid Tumors ◽  
English Language ◽  
Keyword Search ◽  
Poor Quality ◽  
Access To Treatment ◽  
Cancer Registry Data ◽  
Colon Cancers ◽  
Oncology Clinical Trials ◽  
The Impact

e20646 Background: The management of cancer patients (pts) with comorbidities can be challenging as these individuals are underrepresented in oncology clinical trials. We conducted a systematic literature review to determine the impact of comorbidity on utilization, tolerability, and efficacy of chemotherapy among pts with solid tumors. Methods: Using MEDLINE and EMBASE databases, all English-language articles published from 1990–2008 that explored the association between comorbidity and chemotherapy were identified. MeSH and keyword search terms included “comorbidity,” “chemotherapy” and “cancer.” All abstracts were manually reviewed for eligibility based on inclusion and exclusion criteria. Two reviewers independently abstracted data on the design and results of each eligible study, and rated the quality of the article using the STROBE checklist. Results: Of 1,031 citations retrieved by the search, 29 articles met inclusion criteria. Study designs were too heterogeneous to permit a quantitative summary and the overall quality of articles was poor. Comorbidity was investigated most frequently among pts with lung (41%), breast (17%), or colon cancers (17%). Most studies were retrospective (72%), based on cancer registry data (48%), and assessed the effect of cumulative comorbidity based on an index score (76%). Fourteen studies (41%) investigated access and 26 (90%) addressed survival. For pts with comorbidities, the majority reported decreased access (50%) and inferior survival (65%). Of the 12 articles that included both parameters, 6 showed that comorbidity was independently associated with worse survival while 4 demonstrated that impaired access to treatment, not comorbidity, was the stronger predictor of inferior outcomes. Few studies addressed toxicity (24%), ability to complete chemotherapy (7%) or response rates (7%). Among them, no differences based on comorbidity were noted. Conclusions: The evidence regarding the impact of comorbidity on chemotherapy utilization and outcomes among cancer pts is limited and of poor quality. Further better-designed studies are warranted to determine the relationship between decreased access and inferior outcomes and to better define the tolerability and efficacy of chemotherapy in pts with comorbidities. No significant financial relationships to disclose.

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