scholarly journals The use of ‘PICO for synthesis’ and methods for synthesis without meta-analysis: protocol for a survey of current practice in systematic reviews of health interventions

F1000Research ◽  
2021 ◽  
Vol 9 ◽  
pp. 678
Author(s):  
Miranda S. Cumpston ◽  
Joanne E. McKenzie ◽  
James Thomas ◽  
Sue E. Brennan
Keyword(s):  
Health Systems ◽  
Systematic Reviews ◽  
Current Practice ◽  
Meta Analysis ◽  
Visual Display ◽  
Health Interventions ◽  
Synthesis Process ◽  
Future Research ◽  
Synthesis Methods ◽  
Definition Of

Introduction: Systematic reviews involve synthesis of research to inform decision making by clinicians, consumers, policy makers and researchers. While guidance for synthesis often focuses on meta-analysis, synthesis begins with specifying the ’PICO for each synthesis’ (i.e. the criteria for deciding which populations, interventions, comparators and outcomes are eligible for each analysis). Synthesis may also involve the use of statistical methods other than meta-analysis (e.g. vote counting based on the direction of effect, presenting the range of effects, combining P values) augmented by visual display, tables and text-based summaries. This study examines these two aspects of synthesis. Objectives: To identify and describe current practice in systematic reviews of health interventions in relation to: (i) approaches to grouping and definition of PICO characteristics for synthesis; and (ii) methods of summary and synthesis when meta-analysis is not used. Methods: We will randomly sample 100 systematic reviews of the quantitative effects of public health and health systems interventions published in 2018 and indexed in the Health Evidence and Health Systems Evidence databases. Two authors will independently screen citations for eligibility. Two authors will confirm eligibility based on full text, then extract data for 20% of reviews on the specification and use of PICO for synthesis, and the presentation and synthesis methods used (e.g. statistical synthesis methods, tabulation, visual displays, structured summary). The remaining reviews will be confirmed as eligible and data extracted by a single author. We will use descriptive statistics to summarise the specification of methods and their use in practice. We will compare how clearly the PICO for synthesis is specified in reviews that primarily use meta-analysis and those that do not. Conclusion: This study will provide an understanding of current practice in two important aspects of the synthesis process, enabling future research to test the feasibility and impact of different approaches.

scholarly journals Current practice in systematic reviews including the ‘PICO for each synthesis’ and methods other than meta-analysis: protocol for a cross-sectional study

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 678
Author(s):  
Miranda S. Cumpston ◽  
Joanne E. McKenzie ◽  
James Thomas ◽  
Sue E. Brennan
Keyword(s):  
Health Systems ◽  
Systematic Reviews ◽  
Current Practice ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cross Sectional Study ◽  
Synthesis Process ◽  
Future Research ◽  
Synthesis Methods ◽  
Cross Sectional

Introduction: Systematic reviews are used to synthesise research and inform decision making by clinicians, consumers and policy makers. The synthesis component of systematic reviews is often narrowly considered as the use of statistical methods to combine the results of studies, primarily meta-analysis. However, synthesis can be considered more broadly as a process beginning with: (i) defining the groupings of populations, interventions and outcomes to be compared (the ‘PICO for each synthesis’); (ii) examining the characteristics of the available studies; and (iii) applying synthesis methods from among multiple options. To date, there has been limited examination of approaches used in reviews to define and group PICO characteristics and synthesis methods other than meta-analysis. Objectives: To identify and describe current practice in systematic reviews in relation to structuring the PICO for each synthesis and methods for synthesis when meta-analysis is not used. Methods: We will randomly sample 100 systematic reviews of the effects of public health and health systems interventions published in 2018 and indexed in the Health Evidence and Health Systems Evidence databases. Two authors will independently screen studies for eligibility. One author will extract data on approaches to grouping and defining populations, interventions and outcomes, and the rationale for the chosen groups; and the presentation and synthesis methods used (e.g. tabulation, visual displays, statistical synthesis methods such as combining P values, vote counting based on direction of effect). A second author will undertake independent data extraction for a subsample of reviews. Descriptive statistics will be used to summarise the findings. Specifically, we will compare approaches to grouping in reviews that primarily use meta-analysis versus those that do not. Conclusion: This study will provide an understanding of current practice in two important aspects of the synthesis process, enabling future research to test the feasibility and impact of different methodological approaches.

scholarly journals Synthesising quantitative evidence in systematic reviews of complex health interventions

2019 ◽  
Vol 4 (Suppl 1) ◽  
pp. e000858 ◽  
Author(s):  
Julian P T Higgins ◽  
José A López-López ◽  
Betsy J Becker ◽  
Sarah R Davies ◽  
Sarah Dawson ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Guideline Development ◽  
Meta Analysis ◽  
Health Interventions ◽  
Synthesis Methods ◽  
Multiple Stakeholders ◽  
Quantitative Evidence ◽  
Innovative Methods ◽  
Multiple Levels ◽  
Who Guideline

Public health and health service interventions are typically complex: they are multifaceted, with impacts at multiple levels and on multiple stakeholders. Systematic reviews evaluating the effects of complex health interventions can be challenging to conduct. This paper is part of a special series of papers considering these challenges particularly in the context of WHO guideline development. We outline established and innovative methods for synthesising quantitative evidence within a systematic review of a complex intervention, including considerations of the complexity of the system into which the intervention is introduced. We describe methods in three broad areas: non-quantitative approaches, including tabulation, narrative and graphical approaches; standard meta-analysis methods, including meta-regression to investigate study-level moderators of effect; and advanced synthesis methods, in which models allow exploration of intervention components, investigation of both moderators and mediators, examination of mechanisms, and exploration of complexities of the system. We offer guidance on the choice of approach that might be taken by people collating evidence in support of guideline development, and emphasise that the appropriate methods will depend on the purpose of the synthesis, the similarity of the studies included in the review, the level of detail available from the studies, the nature of the results reported in the studies, the expertise of the synthesis team and the resources available.

Effectiveness of Digital Health Interventions on Unintentional Injury, Violence, and Suicide: Meta-Analysis

2020 ◽  
pp. 152483802096734
Author(s):  
Mengtong Chen ◽  
Ko Ling Chan
Keyword(s):  
Interpersonal Violence ◽  
Care Delivery ◽  
Digital Health ◽  
Meta Analysis ◽  
Random Effect ◽  
Unintentional Injury ◽  
Health Interventions ◽  
Effect Sizes ◽  
Future Research ◽  
Face To Face

Digital technologies are increasingly used in health-care delivery and are being introduced into work to prevent unintentional injury, violence, and suicide to reduce mortality. To understand the potential of digital health interventions (DHIs) to prevent and reduce these problems, we conduct a meta-analysis and provide an overview of their effectiveness and characteristics related to the effects. We searched electronic databases and reference lists of relevant reviews to identify randomized controlled trials (RCTs) published in or before March 2020 evaluating DHIs on injury, violence, or suicide reduction. Based on the 34 RCT studies included in the meta-analysis, the overall random effect size was 0.21, and the effect sizes for reducing suicidal ideation, interpersonal violence, and unintentional injury were 0.17, 0.24, and 0.31, respectively, which can be regarded as comparable to the effect sizes of traditional face-to-face interventions. However, there was considerable heterogeneity between the studies. In conclusion, DHIs have great potential to reduce unintentional injury, violence, and suicide. Future research should explore DHIs’ successful components to facilitate future implementation and wider access.

scholarly journals Conscious sedation for the management of dental anxiety in third molar extraction surgery: a systematic review.

2020 ◽  
Author(s):  
Matteo Melini ◽  
Andrea Forni ◽  
Francesco Cavallin ◽  
Matteo Parotto ◽  
Gastone Zanette
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
Meta Analysis ◽  
Dental Anxiety ◽  
Third Molar ◽  
Future Research ◽  
Third Molar Extraction ◽  
Molar Extraction

Abstract Background: Dental anxiety is a condition associated with avoidance of dental treatment and increased medical and surgical risks. This systematic review aims to summarize available evidence on conscious sedation techniques used for the management of Dental anxiety in patients scheduled for third molar extraction surgery, to identify best approaches and knowledge gaps. Methods: A comprehensive search was conducted including MEDLINE/Pubmed, EMBASE, SCOPUS, clinicaltrials.gov and the Cochrane Database of Systematic Reviews through March 2019. Only randomized controlled trials were included. PRISMA guidelines were followed. Risk of bias was appraised as reported in the Cochrane Handbook for Systematic Reviews of Interventions. Results: Seventeen RCTs with a total of 1,788 patients were included. Some aspects limited the feasibility of a meaningful meta-analysis, thus a narrative synthesis was conducted. Conscious sedation was associated with improvement in Dental anxiety in six studies. One study reported lower cortisol levels with midazolam vs. placebo, while another study found significant variation in perioperative renin levels with remifentanil vs. placebo. Conclusions: This review found inconclusive and conflicting findings about the role of Conscious sedation in managing Dental anxiety during third molar extraction surgery. Relevant questions remain unanswered due to the lack of consistent, standardized outcome measures. Future research may benefit from addressing these limitations in study design.

scholarly journals Effectiveness of Mobile Health Interventions on Diabetes and Obesity Treatment and Management: Systematic Review of Systematic Reviews (Preprint)

2019 ◽  
Author(s):  
Youfa Wang ◽  
Jungwon Min ◽  
Jacob Khuri ◽  
Hong Xue ◽  
Bo Xie ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Systematic Reviews ◽  
Mobile Health ◽  
Weight Reduction ◽  
Text Messaging ◽  
Meta Analysis ◽  
Obesity Treatment ◽  
Future Research ◽  
The Impact ◽  
Diabetes And Obesity

BACKGROUND Diabetes and obesity have become epidemics and costly chronic diseases. The impact of mobile health (mHealth) interventions on diabetes and obesity management is promising; however, studies showed varied results in the efficacy of mHealth interventions. OBJECTIVE This review aimed to evaluate the effectiveness of mHealth interventions for diabetes and obesity treatment and management on the basis of evidence reported in reviews and meta-analyses and to provide recommendations for future interventions and research. METHODS We systematically searched the PubMed, IEEE Xplore Digital Library, and Cochrane databases for systematic reviews published between January 1, 2005, and October 1, 2019. We analyzed 17 reviews, which assessed 55,604 original intervention studies, that met the inclusion criteria. Of those, 6 reviews were included in our meta-analysis. RESULTS The reviews primarily focused on the use of mobile apps and text messaging and the self-monitoring and management function of mHealth programs in patients with diabetes and obesity. All reviews examined changes in biomarkers, and some reviews assessed treatment adherence (n=7) and health behaviors (n=9). Although the effectiveness of mHealth interventions varied widely by study, all reviews concluded that mHealth was a feasible option and had the potential for improving patient health when compared with standard care, especially for glycemic control (−0.3% to −0.5% greater reduction in hemoglobin A<sub>1c</sub>) and weight reduction (−1.0 kg to −2.4 kg body weight). Overall, the existing 6 meta-analysis studies showed pooled favorable effects of these mHealth interventions (−0.79, 95% CI −1.17 to −0.42; I2=90.5). CONCLUSIONS mHealth interventions are promising, but there is limited evidence about their effectiveness in glycemic control and weight reduction. Future research to develop evidence-based mHealth strategies should use valid measures and rigorous study designs. To enhance the effectiveness of mHealth interventions, future studies are warranted for the optimal formats and the frequency of contacting patients, better tailoring of messages, and enhancing usability, which places a greater emphasis on maintaining effectiveness over time.

scholarly journals Use of the Safewards Model in healthcare services: a mixed-method scoping review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e039109
Author(s):  
Marie Gerdtz ◽  
Catherine Daniel ◽  
Rebecca Jarden ◽  
Suzanne Kapp
Keyword(s):  
Systematic Reviews ◽  
Scoping Review ◽  
Mixed Method ◽  
Meta Analysis ◽  
Healthcare Services ◽  
Future Research ◽  
Mixed Method Research ◽  
Scoping Reviews ◽  
Ethical Approval ◽  
Safety Considerations

IntroductionSafewards is an organisational approach to delivering inpatient mental health services. The aim of Safewards is to minimise the number of situations in which conflict arises between healthcare workers and patients that lead to the use of coercive interventions (restriction and/or containment).The Safewards Model has been developed, implemented and evaluated for its impact on all forms of containment. Safewards has been adopted as the recommended approach to preventing patient agitation and clinical aggression in some jurisdictions. Notwithstanding these recommendations, the outcomes of Safewards for staff and patients have not been comprehensively described.The aim of the scoping review is to describe (1) Safewards interventions; (2) how Safewards interventions have been implemented in healthcare settings; (3) outcome measures used to evaluate the effectiveness of Safewards; (4) barriers and enablers to the uptake and sustainability of Safewards. This review will provide a foundation for further research and/or systematic review of the effectiveness of Safewards.Methods and analysisPeer-reviewed manuscripts of quantitative, qualitative and mixed-method research in English with be included for the period 01 January 2013– December 31st 2020. Electronic databases including Cumulative Index to Nursing and Allied Health Literature, Cochrane, Embase, Emcare, Joanna Briggs Institute, Medline, Global Health, PsycINFO and Scopus will be searched. Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews checklist and explanation and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol will be followed. Publications will be excluded if they do not include the required participants, concept or context. Two reviewers will independently screen all titles and abstracts and full-text studies for inclusion.Ethics and disseminationEthical approval for this review is not required as the information to be collected is publicly available. There are no participants or safety considerations in this review of published literature. Key findings for future research and clinical practice will be disseminated though peer-reviewed publication, stakeholder reporting and conference presentations.

scholarly journals Applications of qualitative grounded theory methodology to investigate hearing loss: protocol for a qualitative systematic review

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e033537
Author(s):  
Yasmin H K Ali ◽  
Nicola Wright ◽  
David Charnock ◽  
Helen Henshaw ◽  
Derek Hoare
Keyword(s):  
Systematic Review ◽  
Hearing Loss ◽  
Grounded Theory ◽  
Systematic Reviews ◽  
Qualitative Methodology ◽  
Quantitative Methods ◽  
Ethical Issues ◽  
Guideline Development ◽  
Meta Analysis ◽  
Future Research

IntroductionHearing loss is a chronic condition affecting 12 million individuals in the UK. People with hearing loss regularly experience difficulties interacting in everyday conversations. These difficulties in communication can result in a person with hearing loss withdrawing from social situations and becoming isolated. While hearing loss research has largely deployed quantitative methods to investigate various aspects of the condition, qualitative research is becoming more widespread. Grounded theory is a specific qualitative methodology that has been used to establish novel theories on the experiences of living with hearing loss.Method and analysisThe aim of this systematic review is to establish how grounded theory has been applied to investigate the psychosocial aspects of hearing loss. Methods are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols 2015 checklist. Studies included in this review will have applied grounded theory as an overarching methodology or have grounded theory embedded among other methodologies. Studies included will have adult participants (≥18 years) who are either people with an acquired hearing loss, their family and friends (communication partners), or healthcare practitioners including audiologists, general practitioners, ear, nose and throat specialists and hearing therapists. The quality of application of grounded theory in each study will be assessed using the Guideline for Reporting and Evaluating Grounded Theory Research Studies.Ethics and disseminationAs only secondary data will be used in this systematic review, ethical approval is not required. No other ethical issues are foreseen. This review is registered with the International Prospective Register of Systematic Reviews (http://www.crd.york.ac.uk/PROSPERO). Findings will be disseminated via peer-reviewed publications and at relevant academic conferences. Findings may also be published in relevant professional and third sector newsletters and magazines as appropriate. Data will inform future research and guideline development.PROSPERO registration numberCRD42019134197.

scholarly journals Smoking cessation programmes for women living in disadvantaged communities, “We Can Quit 2”: A systematic review protocol

2019 ◽  
Vol 2 ◽  
pp. 10
Author(s):  
Emma Burke ◽  
Fiona Dobbie ◽  
Nadine Dougall ◽  
Mary Adebolu Oluwaseun ◽  
David Mockler ◽  
...  
Keyword(s):  
Systematic Review ◽  
Smoking Cessation ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Future Research ◽  
Successful Implementation ◽  
Systematic Review Protocol ◽  
Socially Disadvantaged ◽  
Review Protocol

Tobacco use is the leading cause of preventable death in Ireland with almost 6,000 smokers dying each year from smoking-related diseases. Amongst younger Irish women, smoking rates are considerably higher in those from socially disadvantaged areas compared to women from affluent areas. Women from poorer areas also experience higher rates of lung cancer. To our knowledge, there are no peer reviewed published systematic reviews on the effectiveness of interventions tailored to reduce smoking rates in women from disadvantaged areas. This systematic review protocol will aim to examine the effectiveness of such interventions and to describe trial processes such as recruitment, follow-up and dropout prevention strategies, as well as barriers and enablers of successful implementation.    A systematic review will be conducted of peer-reviewed randomised controlled trials and associated process evaluations of smoking cessation interventions designed for women living in socially disadvantaged areas. If the search returns, less than five studies are review criteria will expand to include quasi-experimental studies. A number of databases of scholarly literature will be searched from inception using a detailed search strategy. Two independent reviewers will screen titles, abstracts and full-text articles to identify relevant studies using a pre-defined checklist based on PICOS. In the case of disagreement, a third reviewer will be consulted. The quality of included studies will be assessed using the ‘Grading of Recommendations Assessment, Development and Evaluation’ (GRADE) criteria. Quantitative data will be extracted and, if comparable, will be assessed using meta-analysis. A narrative meta-synthesis of qualitative data will be conducted.   This review aims to synthesise information from relevant studies on smoking cessation interventions tailored for women from socially disadvantaged areas. The evidence obtained from studies and presented in this review will help guide future research in this area. Registration: This review will be registered with International Prospective Register of Systematic Reviews (PROSPERO).

scholarly journals Smoking cessation programmes for women living in disadvantaged communities, “We Can Quit 2”: A systematic review protocol

2019 ◽  
Vol 2 ◽  
pp. 10
Author(s):  
Emma Burke ◽  
Fiona Dobbie ◽  
Nadine Dougall ◽  
Mary Adebolu Oluwaseun ◽  
David Mockler ◽  
...  
Keyword(s):  
Systematic Review ◽  
Smoking Cessation ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Future Research ◽  
Successful Implementation ◽  
Systematic Review Protocol ◽  
Socially Disadvantaged ◽  
Review Protocol

Tobacco use is the leading cause of preventable death in Ireland with almost 6,000 smokers dying each year from smoking-related diseases. Amongst younger Irish women, smoking rates are considerably higher in those from socially disadvantaged areas compared to women from affluent areas. Women from poorer areas also experience higher rates of lung cancer. To our knowledge, there are no peer reviewed published systematic reviews on the effectiveness of interventions tailored to reduce smoking rates in women from disadvantaged areas. This systematic review protocol will aim to examine the effectiveness of such interventions and to describe trial processes such as recruitment, follow-up and dropout prevention strategies, as well as barriers and enablers of successful implementation.    A systematic review will be conducted of peer-reviewed randomised controlled trials and associated process evaluations of smoking cessation interventions designed for women living in socially disadvantaged areas. If the search returns, less than five studies are review criteria will expand to include quasi-experimental studies. A number of databases of scholarly literature will be searched from inception using a detailed search strategy. Two independent reviewers will screen titles, abstracts and full-text articles to identify relevant studies using a pre-defined checklist based on PICOS. In the case of disagreement, a third reviewer will be consulted. The quality of included studies will be assessed using the ‘Grading of Recommendations Assessment, Development and Evaluation’ (GRADE) criteria. Quantitative data will be extracted and, if comparable, will be assessed using meta-analysis. A narrative meta-synthesis of qualitative data will be conducted.   This review aims to synthesise information from relevant studies on smoking cessation interventions tailored for women from socially disadvantaged areas. The evidence obtained from studies and presented in this review will help guide future research in this area. Registration: This review will be registered with International Prospective Register of Systematic Reviews (PROSPERO).

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