Health-economic outcomes in hospital patients with medical-psychiatric comorbidity: A systematic review and meta-analysis

AbstractBackgroundCompared to active ideation, passive ideation remains relatively understudied and its clinical importance poorly defined. The weight that should be accorded passive ideation in clinical risk assessment is therefore unclear.MethodsWe conducted a systematic review and meta-analysis of the prevalence of passive ideation, its psychiatric comorbidity, associated sociodemographic characteristics, as well as psychological and environmental correlates. For reference, pooled effects were also calculated for direct comparisons of passive and active ideation with respect to potential correlates. Relevant articles published since inception to 9 September 2019 were identified through a systematic search of MEDLINE and PsycINFO.ResultsA total of 86 studies were included in this review. The prevalence of passive ideation was high across sample types, ranging from 5.8% for 1-year prevalence to 10.6% for lifetime prevalence in the general population. Passive ideation was strongly associated with sexual minority status, psychiatric comorbidity, psychological characteristics implicated in risk, and suicide attempts. Preliminary evidence exists for a large association with suicide deaths. The effect sizes for individual correlates of passive and active ideation were largely equivalent and mostly non-significant in head-to-head comparisons.ConclusionsPassive ideation is a prevalent clinical phenomenon associated with significant psychiatric comorbidity. Current evidence also suggests notable similarities exist between passive and active ideation in terms of psychiatric comorbidity and psychological and other characteristics traditionally associated with risk.

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PP030 Socioeconomics Of Cardiac Rehabilitation: A Meta-Analysis

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462317002197 ◽

2017 ◽

Vol 33 (S1) ◽

pp. 83-84

Author(s):

Yin Ge ◽

Tomoyuki Takura ◽

Ebata Nozomi

Keyword(s):

Myocardial Infarction ◽

Systematic Review ◽

Health Economic ◽

Cost Effectiveness ◽

Cardiac Rehabilitation ◽

Meta Analysis ◽

Medical Costs ◽

Short Term ◽

Life Years ◽

Observation Period

INTRODUCTION:The Guidelines for Rehabilitation in Patients with Cardiovascular Disease recommends convalescent cardiac rehabilitation (CR) as the standard treatment for patients with ST elevation myocardial infarction (STEMI) (class I, evidence level B) (1). However, health economic evaluation of cardiac rehabilitation (CR) is limited.METHODS:This systematic review, meta-analysis study elucidated the cost-effectiveness of CR in the short term. The target population in this study included convalescent and comprehensive CR patients with coronary artery disease (CAD), most with myocardial infarction (MI). We used mortality, life years (LY, expected life years), medical costs, and cost-effectiveness as the evaluation parameters in this analysis. We set medical costs in the analysis associated with testing, diagnosis, and treatment during the observation period related to CR. For cost-effectiveness analysis, we analyzed medical cost per LY. We examined the differences in effects for two comparisons (CR versus Usual Care, UC) using the Risk Ratio (RR) and Standardized Mean Difference (SMD). We assumed the standard deviation (SD) of cost effectiveness in this study by applying the error propagation.RESULTS:We reviewed fifty-nine studies and identified three that matched our selection criteria. The studies had the following characteristics: two randomized clinical trials and one systematic review/meta-analysis; a control that does not include exercise in patients with CAD; an observation period longer than 1 year; adapting medical costs, LY, cost/LY, and mortality as the evaluation index. In total, 129,272 patients were included. Meta-analysis results revealed that the CR arm significantly improved LY (SMD: -.78, 95 percent Confidence Interval (CI): -1.37, -.19) compared with UC. Similar to LY, the CR arm significantly improved the mortality (SMD: .57, 95 percent CI: .22, 1.47) compared with UC arm. Since medical costs showed a high tendency (SMD:.02, 95 percent CI: -.08, .13), cost/LY demonstrated no improvement (SMD: .00; 95 percent CI: -.17, .18). Substantial statistical heterogeneity was observed between the studies with respect to LY and cost/LY.CONCLUSIONS:While sufficient evidence to conclude health economic efficiency is not available at present, these results suggest that CR is not potentially cost-effective in the short term.

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Is weight regain after bariatric surgery associated with psychiatric comorbidity? A systematic review and meta‐analysis

Obesity Reviews ◽

10.1111/obr.12907 ◽

2019 ◽

Vol 20 (10) ◽

pp. 1413-1425 ◽

Cited By ~ 6

Author(s):

Maria Francisca F.P. Mauro ◽

Marcelo Papelbaum ◽

Marco Antônio Alves Brasil ◽

João Regis Ivar Carneiro ◽

Evandro Silva Freire Coutinho ◽

...

Keyword(s):

Systematic Review ◽

Bariatric Surgery ◽

Weight Regain ◽

Psychiatric Comorbidity ◽

Meta Analysis

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Racism in Australia: a protocol for a systematic review and meta-analysis

10.21203/rs.3.rs-764362/v1 ◽

2021 ◽

Author(s):

Jehonathan Ben ◽

Amanuel Elias ◽

Ayuba Issaka ◽

Mandy Truong ◽

Kevin Dunn ◽

...

Keyword(s):

Systematic Review ◽

Quantitative Research ◽

Meta Analysis ◽

National Level ◽

Health Behaviours ◽

Evidence Base ◽

Health Science ◽

Economic Outcomes ◽

Quantitative Evidence ◽

Over Time

Abstract Background Racism has been identified as a major source of injustice and a health burden in Australia and across the world. Despite the surge in Australian quantitative research on the topic, and the increasing recognition of the prevalence and impact of racism in Australian society, the collective evidence base has yet to be comprehensively reviewed or meta-analysed. This protocol describes the first systematic review and meta-analysis of racism in Australia at the national level. The current study will considerably improve our understanding of racism, including its manifestations and fluctuation over time, variation across settings and between groups, and associations with health and socio-economic outcomes. Methods The research will consist of a systematic literature review and meta-analysis. Searches for relevant studies will focus on the social and health science databases CINAHL, PsycINFO, PubMed and Scopus. Two reviewers will independently screen eligible papers for inclusion, and extract data from included studies. Studies will be included in the review and meta-analysis where they meet the following criteria: 1) report quantitative empirical research based on study participants’ self-reports; 2) report data on the prevalence of racism, or its association with health (e.g., mental health, physical health, health behaviours) or socio-economic outcomes (e.g., education, employment, income); and 3) report Australian data. Existing reviews will be manually searched for additional studies. Study characteristics will be summarised, and a meta-analysis of the prevalence of racism and its associations will be conducted using random effects models and mean weighted effect sizes. Moderation and subgroup analyses will be conducted as well. All analyses will use the software CMA 3.0. Discussion This study will provide a novel and comprehensive synthesis of the quantitative evidence base on racism in Australia. It will answer questions about the fluctuation of racism over time, its variation across settings and groups, and its relationship with health and socio-economic outcomes. Findings will be discussed in relation to broader debates in this growing field of research, and will be widely disseminated to inform anti-racism research, action and policy nationally. Registration: submitted, 20.07.2021.

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