scholarly journals How to prepare and manage a systematic review and meta-analysis of clinical studies

2019 ◽  
Vol 4 (5) ◽  
pp. 213-220 ◽  
Author(s):  
James R. Berstock ◽  
Michael R. Whitehouse
Keyword(s):  
External Validity ◽  
Literature Search ◽  
Search Strategy ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Sensitivity Analyses ◽  
Clinical Question ◽  
Eligibility Criteria ◽  
Bias Assessment ◽  
Review Protocol

Use the PICO framework to formulate a specific clinical question. Formulate a search strategy. Prospectively register the review protocol. Execute the literature search. Apply eligibility criteria to exclude irrelevant studies. Extract data and appraise each study for risk of bias and external validity. Provide a narrative review. If appropriate data are available, perform a meta-analysis. Report the review findings in the context of the risk of bias assessment, any sensitivity analyses and the analysis of risk of publication bias. Useful resources include the Cochrane Handbook, PROSPERO, GRADE and PRISMA. Cite this article: EFORT Open Rev 2019;4:213-220. DOI: 10.1302/2058-5241.4.180049

scholarly journals B waves: a systematic review of terminology, characteristics, and analysis methods

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Isabel Martinez-Tejada ◽  
Alexander Arum ◽  
Jens E. Wilhjelm ◽  
Marianne Juhler ◽  
Morten Andresen
Keyword(s):  
Systematic Review ◽  
Intracranial Pressure ◽  
Literature Search ◽  
Search Strategy ◽  
Morphological Characteristics ◽  
Systematic Review Protocol ◽  
Eligibility Criteria ◽  
Wave Characteristics ◽  
Search Terms ◽  
Review Protocol

Abstract Background Although B waves were introduced as a concept in the analysis of intracranial pressure (ICP) recordings nearly 60 years ago, there is still a lack consensus on precise definitions, terminology, amplitude, frequency or origin. Several competing terms exist, addressing either their probable physiological origin or their physical characteristics. To better understand B wave characteristics and ease their detection, a literature review was carried out. Methods A systematic review protocol including search strategy and eligibility criteria was prepared in advance. A literature search was carried out using PubMed/MEDLINE, with the following search terms: B waves + review filter, slow waves + review filter, ICP B waves, slow ICP waves, slow vasogenic waves, Lundberg B waves, MOCAIP. Results In total, 19 different terms were found, B waves being the most common. These terminologies appear to be interchangeable and seem to be used indiscriminately, with some papers using more than five different terms. Definitions and etiologies are still unclear, which makes systematic and standardized detection difficult. Conclusions Two future lines of action are available for automating macro-pattern identification in ICP signals: achieving strict agreement on morphological characteristics of “traditional” B waveforms, or starting a new with a fresh computerized approach for recognition of new clinically relevant patterns.

scholarly journals Does advance contact with research participants increase response to questionnaires: A Systematic Review and meta-Analysis

2021 ◽  
Author(s):  
Benjamin Woolf ◽  
Phil Edwards
Keyword(s):  
Systematic Review ◽  
Data Extraction ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Eligibility Criteria ◽  
Bias Assessment ◽  
Response Data ◽  
Randomised Control Trials ◽  
Study Participants ◽  
The Impact

AbstractBackgroundQuestionnaires remain one of the most common forms of data collection in epidemiology, psychology and other human-sciences. However, results can be badly affected by non-response. One way to potentially reduce non-response is by sending potential study participants advance communication. The last systematic review to examine the effect of questionnaire pre-notification on response is ten years old, and lacked a risk of bias assessment.ObjectivesUpdate Edwards et al. (2009) to include 1) recently published studies, 2) an assessment of risk of bias.MethodsData sources: Edwards et al. (2009); 13 data-bases; the references in, and citations of included studies. Eligibility criteria: Randomised control trials examining the impact of pre-notification on response. Data extraction: data extraction was done twice by a single unblinded reviewer. Risk of bias was assessed using the Cochrane Risk of Bias tool and funnel plots.Results103 trials were included. Over-all pre-notification increased response, OR = 1.38 (95%CI: 1.25-1.53). However, when studies at high or unclear risk of bias were excluded the effect was greatly reduced (OR = 1.11, 95% CI: 1.01-1.21).ConclusionsThe evidence implies that while pre-notification does increase response rates, this may not be of clinical utility.

scholarly journals Association of UCP1 and UCP2 variants with diabetic retinopathy susceptibility in type-2 diabetes mellitus patients: a meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xujia Liu ◽  
Zehua Jiang ◽  
Guihua Zhang ◽  
Tsz Kin Ng ◽  
Zhenggen Wu
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Fixed Effects ◽  
Literature Search ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Fixed Effects Models ◽  
Type 2 Dm ◽  
Subgroup Analyses

Abstract Background Genetic association of uncoupling proteins (UCPs) variants with the susceptibility of diabetic retinopathy (DR) in diabetes mellitus (DM) patients has been reported but with controversy. Here we aimed to conduct a meta-analysis to confirm the association of different UCPs variants with DR. Methods Three databases (Medline Ovid, Embase Ovid and CENTRAL) were applied in the literature search. Five genetic models, including allelic, homozygous, heterozygous, dominant and recessive models, were evaluated. Odds ratios (OR) were estimated under the random or fixed-effects models. Subgroup analyses, publication bias and sensitivity analyses were also conducted. Results Eleven studies on 2 UCPs variants (UCP1 rs1800592 and UCP2 rs659366) were included. Our meta-analysis showed that UCP1 rs1800592 was not associated with DR in type-2 DM patients, and UCP2 rs659366 also showed no association with DR. In the subgroup analyses on the stage of DR, allele G of UCP1 rs1800592 significantly increased the susceptibility of proliferative diabetic retinopathy (PDR) in type-2 DM patients in the allelic (OR = 1.26, P = 0.03) and homozygous models (OR = 1.60, P = 0.04). Subgroup analysis on ethnicity did not found any significant association of rs1800592 and rs659366 with DR. Conclusion Our meta-analysis confirmed the association of UCP1 rs1800592 variant with PDR in patients with type-2 DM, suggesting its potential as a genetic marker for PDR prediction in population screening.

Mortality Benefit From the Passive Leg Raise Maneuver in Guiding Resuscitation of Septic Shock Patients: A Systematic Review and Meta-Analysis of Randomized Trials

2021 ◽  
pp. 088506662110197
Author(s):  
Moosa Azadian ◽  
Suyee Win ◽  
Amir Abdipour ◽  
Carolyn Krystal Kim ◽  
H. Bryant Nguyen
Keyword(s):  
Systematic Review ◽  
Septic Shock ◽  
Fluid Resuscitation ◽  
Standard Care ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Time Interval ◽  
Eligibility Criteria ◽  
Significant Difference ◽  
Passive Leg Raise

Background: Fluid therapy plays a major role in the management of critically ill patients. Yet assessment of intravascular volume in these patients is challenging. Different invasive and non-invasive methods have been used with variable results. The passive leg raise (PLR) maneuver has been recommended by international guidelines as a means to determine appropriate fluid resuscitation. We performed this systematic review and meta-analysis to determine if using this method of volume assessment has an impact on mortality outcome in patients with septic shock. Methods: This study is a systematic review and meta-analysis. We searched available data in the MEDLINE, CINAHL, EMBASE, and CENTRAL databases from inception until October 2020 for prospective, randomized, controlled trials that compared PLR-guided fluid resuscitation to standard care in adult patients with septic shock. Our primary outcome was mortality at the longest duration of follow-up. Results: We screened 1,425 article titles and abstracts. Of the 23 full-text articles reviewed, 5 studies with 462 patients met our eligibility criteria. Odds ratios (ORs) and associated 95% confidence intervals (CIs) for mortality at the longest reported time interval were calculated for each study. Using random effects modeling, the pooled OR (95% CI) for mortality with a PLR-guided resuscitation strategy was 0.82 (0.52 -1.30). The included studies were not blinded and they ranged from having low to high risk of bias using the Cochrane Risk of Bias Tool. Conclusion: Our analysis showed there was no statistically significant difference in mortality among septic shock patients treated with PLR-guided resuscitation vs. those with standard care.

scholarly journals Risk of dementia in gout and hyperuricaemia: a meta-analysis of cohort studies

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e041680
Author(s):  
Shu-Yue Pan ◽  
Rui-Juan Cheng ◽  
Zi-Jing Xia ◽  
Qiu-Ping Zhang ◽  
Yi Liu
Keyword(s):  
Cohort Studies ◽  
Quality Assessment ◽  
Publication Bias ◽  
Data Extraction ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Cochrane Library ◽  
Crystal Formation ◽  
Medical Subject Headings ◽  
Eligibility Criteria

ObjectivesGout, characterised by hyperuricaemia with monosodium urate crystal formation and inflammation, is the most common inflammatory arthritis in adults. Recent studies have found that elevated uric acid levels are related to the occurrence of dementia. We conducted a study to investigate the association between dementia and gout or hyperuricaemia.DesignSystematic review and meta-analysis of cohort studies.Data sourcesStudies were screened from inception to 28 June 2019 by searching Medline, Embase and the Cochrane Library databases.Eligibility criteriaCohort studies comparing the risk of dementia in patients with gout and hyperuricaemia versus non-gout and non-hyperuricaemia controls were enrolled.Data extraction and analysisTwo reviewers separately selected studies and extracted data using the Medical Subject Headings without restriction on languages or countries. The adjusted HRs were pooled using the DerSimonian and Laird random effects model. Sensitivity analyses were conducted to evaluate the stability of the results. Publication bias was evaluated using Egger’s and Begg’s tests. Quality assessment was performed according to the Newcastle-Ottawa Scale.ResultsFour cohort studies that met the inclusion criteria were included in our meta-analysis. We found that gout and hyperuricaemia did not increase the risk of dementia, with a pooled HR of 0.94 (95% CI 0.69 to 1.28), but might decrease the risk of Alzheimer’s disease (AD), with a pooled HR of 0.78 (95% CI 0.64 to 0.95). There was little evidence of publication bias. Quality assessment of the included studies was high (range: 6–8 points).ConclusionsOur study shows that gout and hyperuricaemia do not increase the risk of dementia. However, gout and hyperuricaemia might have a protective effect against AD. Due to the limited number of research articles, more investigations are needed to demonstrate the potential relationship between dementia and gout or hyperuricaemia.

scholarly journals Effectiveness and safety of herbal medicines for induction of labour: a systematic review and meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e022499 ◽  
Author(s):  
Collins Zamawe ◽  
Carina King ◽  
Hannah Maria Jennings ◽  
Chrispin Mandiwa ◽  
Edward Fottrell
Keyword(s):  
Systematic Review ◽  
Data Extraction ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Herbal Medicines ◽  
Risk Of Bias ◽  
Induction Of Labour ◽  
Quality Data ◽  
Eligibility Criteria ◽  
Significant Difference

ObjectiveThe use of herbal medicines for induction of labour (IOL) is common globally and yet its effects are not well understood. We assessed the efficacy and safety of herbal medicines for IOL.DesignSystematic review and meta-analysis of published literature.Data sourcesWe searched in MEDLINE, AMED and CINAHL in April 2017, updated in June 2018.Eligibility criteriaWe considered experimental and non-experimental studies that compared relevant pregnancy outcomes between users and non-user of herbal medicines for IOL.Data extraction and synthesisData were extracted by two reviewers using a standardised form. A random-effects model was used to synthesise effects sizes and heterogeneity was explored through I2statistic. The risk of bias was assessed using ‘John Hopkins Nursing School Critical Appraisal Tool’ and ‘Cochrane Risk of Bias Tool’.ResultsA total of 1421 papers were identified through the searches, but only 10 were retained after eligibility and risk of bias assessments. The users of herbal medicine for IOL were significantly more likely to give birth within 24 hours than non-users (Risk Ratio (RR) 4.48; 95% CI 1.75 to 11.44). No significant difference in the incidence of caesarean section (RR 1.19; 95% CI 0.76 to 1.86), assisted vaginal delivery (RR 0.73; 95% CI 0.47 to 1.14), haemorrhage (RR 0.84; 95% CI 0.44 to 1.60), meconium-stained liquor (RR 1.20; 95% CI 0.65 to 2.23) and admission to nursery (RR 1.08; 95% CI 0.49 to 2.38) was found between users and non-users of herbal medicines for IOL.ConclusionsThe findings suggest that herbal medicines for IOL are effective, but there is inconclusive evidence of safety due to lack of good quality data. Thus, the use of herbal medicines for IOL should be avoided until safety issues are clarified. More studies are recommended to establish the safety of herbal medicines.

scholarly journals Association between Prior Calcium Channel Blocker use and Mortality in Septic Patients: A Meta-Analysis of Cohort Studies

2020 ◽  
Author(s):  
Xianfei Ding ◽  
Yuqing Cui ◽  
Yanhui Zhu ◽  
Huoyan Liang ◽  
Dong Wang ◽  
...  
Keyword(s):  
Septic Shock ◽  
Cohort Studies ◽  
Calcium Channel ◽  
Calcium Channel Blocker ◽  
Channel Blocker ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Sensitivity Analyses ◽  
Sepsis Management ◽  
Term Survival

Abstract Background: To comprehensively review the literature and synthesize evidence concerning the relationship between preadmission calcium channel blocker (CCB) use and mortality in patients with sepsis.Methods: The MEDLINE, EMBASE, and Cochrane CENTRAL databases were searched from their inception to April 9, 2020. Cohort studies that related to prior CCB use in patients with sepsis were analysed. Pairs of reviewers independently screened studies, extracted data, and assessed the risk of bias. Two primary outcomes related to mortality, namely, 30-day mortality and 90-day mortality, were analysed; heterogeneity between studies was assessed using I2 and was considered moderate if I2 was equivalent to 50–75% and high if I2 ≥ 75%. Fixed and random-effects models were used to calculate the pooled odds ratios (ORs) and 95% confidence intervals (CIs). The quality of outcomes was evaluated with the Newcastle-Ottawa Scale (NOS). Sensitivity analyses were performed to examine the robustness of the results.Results: 552 potentially relevant studies were identified, and the full texts of 25 articles were reviewed. Ultimately, five cohort studies involving 280,982 patients were confirmed to have a low risk of bias and were included. Preadmission CCB use was associated with a significantly lower 30-day mortality in septic shock (OR, 0.61 [0.38-0.97]; P = 0.035; I2 = 62.4%), not in sepsis (OR, 0.83 [0.66-1.04]; P = 0.103; I2 = 95.4%). Moreover, prior CCB use could significantly reduce 30-day mortality in sepsis (OR, 0.90 [0.85-0.95]; P < 0.001; I2 = 31.9%). Conclusions: This meta-analysis suggests that preadmission CCB use is significantly associated with improving long-term prognosis of sepsis, and also short-term survival of septic shock patients. This finding may provide an attractive direction for sepsis management.

Relative Effectiveness of Cell-Cultured versus Egg-Based Seasonal Influenza Vaccines in Preventing Influenza-Related Outcomes in Subjects 18 Years Old or Older: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Joan Puig-Barberà ◽  
Sonia Tamames-Gómez ◽  
Pedro Plans-Rubio ◽  
José María Eirós-Bouza
Keyword(s):  
Systematic Review ◽  
Seasonal Influenza ◽  
Influenza Season ◽  
Meta Analysis ◽  
Relative Effectiveness ◽  
Risk Of Bias ◽  
Influenza Vaccines ◽  
Sensitivity Analyses ◽  
Exclusion Criteria ◽  
Seed Cell

Avian mutations in vaccine strains obtained from embryonated eggs could impair vaccine effec-tiveness. We performed a systematic review and meta-analysis of the adjusted relative vaccine effectiveness (arVE) of seed cell-cultured influenza vaccines (ccIV) compared to egg-based influ-enza vaccines (eIV) in preventing laboratory-confirmed influenza related outcomes (IRO) or IRO by clinical codes, in subjects 18 and over. We completed the literature search in January 2021; ap-plied exclusion criteria, evaluated risk of bias of the evidence, and performed heterogeneity, pub-lication bias, qualitative, quantitative and sensitivity analyses. All estimates were computed us-ing a random approach. International Prospective Register of Systematic Reviews, CRD42021228290. We identified 12 publications that reported 26 adjusted arVE results. Five publications reported 13 laboratory confirmed arVE and seven reported 13 code-ascertained arVE. Nine publications with 22 results were at low risk of bias. Heterogeneity was explained by season and risk of bias. We found a significant 11% (8 to 14%) adjusted arVE favoring ccIV in preventing any IRO in the 2017-2018 influenza season. The arVE was 3% (-01 to 7%) in the 2018-2019 influenza season. We found moderate evidence of a significant advantage of the ccIV in preventing IRO, compared to eIV, in a well-matched A(H3N2) predominant season.

scholarly journals Virtual and augmented reality in the vestibular rehabilitation of peripheral vestibular disorders: systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Austin Heffernan ◽  
Mohammed Abdelmalek ◽  
Desmond A. Nunez
Keyword(s):  
Side Effects ◽  
Augmented Reality ◽  
Meta Analysis ◽  
Vestibular Rehabilitation ◽  
Vestibular Dysfunction ◽  
Symptom Improvement ◽  
Vestibular Disorders ◽  
Post Intervention ◽  
Eligibility Criteria ◽  
Bias Assessment

AbstractVestibular rehabilitation therapy is an established treatment for patients with vestibular dysfunction. Virtual reality (VR) and augmented reality (AR) can be utilised in vestibular rehabilitation. Evidence of the efficacy of VR and AR delivered rehabilitation in patients with peripheral vestibular disorders is reviewed. MEDLINE, EMBASE, CENTRAL, CINAHL, PsychInfo, PsychBITE, OTSeeker, Ei Compendex, IEE, Clinical trials.gov and WebofScience databases were searched. Reduction in vestibular dysfunction symptoms 0–3 months post-intervention was the primary outcome. Secondary outcomes included long-term symptom improvement and side effects. Risk of bias assessment and meta analyses were planned. Five studies meeting eligibility criteria were included. Dizziness Handicap Inventory (DHI) scores 0–3 months post-intervention were reported by four studies. Meta-analysis identified a 1.13 (95% CI, − 1.74, − 0.52) standardized mean difference reduction in DHI in VR and AR treated patients compared to controls. Side effects reported by two studies were reduced by week four of VR intervention. Bias assessment identified DHI scores and side effects to be at high risk or of some concern. Adjunct VR interventions reduced patient DHI significantly more than vestibular rehabilitation alone 0–3 months post-intervention in adult patients diagnosed with unilateral vestibular disease. High quality studies are needed.

scholarly journals Panoramic versus CBCT used to reduce inferior alveolar nerve paresthesia after third molar extractions: a systematic review and meta-analysis

2020 ◽  
Vol 49 (4) ◽  
pp. 20190265
Author(s):  
Nathalia Calzavara Del Lhano ◽  
Rosangela Almeida Ribeiro ◽  
Carolina Castro Martins ◽  
Neuza Maria Souza Picorelli Assis ◽  
Karina Lopes Devito
Keyword(s):  
Systematic Review ◽  
Panoramic Radiography ◽  
Meta Analysis ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Risk Of Bias ◽  
Third Molar Surgery ◽  
Reference List ◽  
Significant Heterogeneity ◽  
Eligibility Criteria

Objectives: The aim of this systematic review was to verify whether CBCT in comparison with panoramic radiography reduced the cases of temporary paresthesias of the inferior alveolar nerve (IAN) associated with third molar extractions. Methods: The literature search included five databases (PubMed, Scopus, Web of Science, Cochrane, SciELO), in addition to gray literature and hand search of reference list of included studies. Two reviewers independently screened titles/abstracts, and full texts according to eligibility criteria, extracted data and evaluated risk of bias through Revised Cochrane Risk of Bias Tool for Randomized Trials (RoB 2.0). Data were meta-analyzed by comparing CBCT versus panoramic radiographs for number of events (temporary paresthesia after third molar surgery). Fixed effect model was used for non-significant heterogeneity; relative risk (RR) and 95% CI were calculated. The certainty of evidence was evaluated by Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Results: Four randomized controlled trials (RCTs) were included in meta-analysis, and for the majority of domains they presented low risk of bias. RR was 1.23 (95% IC: 0.75–2.02; I2: 0%; p = 0.43) favouring panoramic radiography, but without significant effect, and with moderate certainty of evidence. Conclusions: We concluded that both interventions had a similar ability to reduce temporary paresthesia of the IAN after third molar surgery with moderate certainty of evidence.

Sign in / Sign up

Export Citation Format

Share Document