scholarly journals Leg length discrepancy: A systematic review on the validity and reliability of clinical assessments and imaging diagnostics used in clinical practice

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261457
Author(s):  
Martin Alfuth ◽  
Patrick Fichter ◽  
Axel Knicker
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Risk Of Bias ◽  
Low Risk ◽  
Reference Standard ◽  
Leg Length ◽  
Validity And Reliability ◽  
Imaging Diagnostics ◽  
Clinical Assessments ◽  
Length Discrepancy

Background A variety of assessments to determine leg length discrepancy (LLD) is used in clinical practice and evidence about validity and reliability may differ. Objective The objective of this systematic review was to identify and describe the validity and reliability of different assessments and imaging diagnostics for the determination of LLD. Materials and methods The review was conducted following the recommendations of Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). The databases Medline (PubMed) and Index to Chiropractic Literature were systematically searched. Studies regarding clinical assessments and imaging diagnostics for the diagnosis of LLD, which reported the clinimetric properties for assessment of LLD, were included and screened for methodological quality using the Quality Assessment of Studies of Diagnostic Accuracy (QUADAS-2) tool for validity studies and the Quality Appraisal of Diagnostic Reliability (QAREL) tool for reliability studies. Results Thirty-seven articles on clinical assessments and 15 studies on imaging diagnostics met the eligibility criteria. Thirteen studies on the validity of clinical assessments and six studies on the validity of imaging diagnostics had a low risk of bias and low concerns regarding applicability for all domains. One study on the reliability of clinical assessments and one study on the reliability of imaging diagnostics had a low risk of bias. Main limitations were, that an analysis of sensitivity and specificity was only performed in a few studies and that a valid reference standard was lacking in numerous studies on clinical assessments. Conclusions For the clinical assessment of LLD, the block test appears to be the most useful method. Full-length standing anteroposterior radiography seems to be the most valid and reliable method and may be used as global reference standard to measure the anatomic LLD when comparing clinical methods and imaging diagnostics.

scholarly journals Systematic Review of the Use of Telepathology During Intraoperative Consultation

2019 ◽  
Vol 153 (2) ◽  
pp. 198-209 ◽  
Author(s):  
Robin L Dietz ◽  
Douglas J Hartman ◽  
Liron Pantanowitz
Keyword(s):  
Systematic Review ◽  
Publication Bias ◽  
Frozen Section ◽  
Strong Support ◽  
Risk Of Bias ◽  
Low Risk ◽  
Reference Standard ◽  
Weighted Mean ◽  
Frozen Section Diagnosis ◽  
Conventional Microscopy

Abstract Objective To compare studies that used telepathology systems vs conventional microscopy for intraoperative consultation (frozen-section) diagnosis. Methods A total of 56 telepathology studies with 13,996 cases in aggregate were identified through database searches. Results The concordance of telepathology with the reference standard was generally excellent, with a weighted mean of 96.9%. In comparison, we identified seven studies using conventional intraoperative consultation that showed a weighted mean concordance of 98.3%. Evaluation of the risk of bias showed that most of these studies were low risk. Conclusions Despite limitations such as variation in reporting and publication bias, this systematic review provides strong support for the safety of using telepathology for intraoperative consultations.

scholarly journals A systematic review on the validity and reliability of tape measurement method in leg length discrepancy

2019 ◽  
Author(s):  
Behshid Farahmand ◽  
Esmaeil Ebrahimi Takamjani ◽  
Hamid Reza Yazdi ◽  
Hassan Saeedi ◽  
Mohammad Kamali ◽  
...  
Keyword(s):  
Systematic Review ◽  
Measurement Method ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
Validity And Reliability ◽  
Length Discrepancy ◽  
Tape Measurement

scholarly journals Clinical effectiveness of convalescent plasma in hospitalized patients with COVID-19: a systematic review and meta-analysis

2021 ◽  
Vol 15 ◽  
pp. 175346662110280
Author(s):  
Roberto Ariel Abeldaño Zuñiga ◽  
Ruth Ana María González-Villoria ◽  
María Vanesa Elizondo ◽  
Anel Yaneli Nicolás Osorio ◽  
David Gómez Martínez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Clinical Improvement ◽  
Data Extraction ◽  
Meta Analysis ◽  
Clinical Effectiveness ◽  
Risk Of Bias ◽  
Hospitalized Patients ◽  
Low Risk ◽  
Controlled Clinical Trials

Aims: Given the variability of previously reported results, this systematic review aims to determine the clinical effectiveness of convalescent plasma employed in the treatment of hospitalized patients diagnosed with COVID-19. Methods: We conducted a systematic review of controlled clinical trials assessing treatment with convalescent plasma for hospitalized patients diagnosed with SARS-CoV-2 infection. The outcomes were mortality, clinical improvement, and ventilation requirement. Results: A total of 51 studies were retrieved from the databases. Five articles were finally included in the data extraction and qualitative and quantitative synthesis of results. The overall risk of bias in the reviewed articles was established at low-risk only in two trials. The meta-analysis suggests that there is no benefit of convalescent plasma compared with standard care or placebo in reducing the overall mortality and the ventilation requirement. However, there could be a benefit for the clinical improvement in patients treated with plasma. Conclusion: Current results led to assume that the convalescent plasma transfusion cannot reduce the mortality or ventilation requirement in hospitalized patients diagnosed with SARS-CoV-2 infection. More controlled clinical trials conducted with methodologies that ensure a low risk of bias are still needed. The reviews of this paper are available via the supplemental material section.

scholarly journals Appraising the quality standard underpinning international clinical practice guidelines for the selection and care of vascular access devices: a systematic review of reviews

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e021040 ◽  
Author(s):  
Ian Blanco-Mavillard ◽  
Miguel Angel Rodríguez-Calero ◽  
Enrique Castro-Sánchez ◽  
Miquel Bennasar-Veny ◽  
Joan De Pedro-Gómez
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Central Venous Access ◽  
Grey Literature ◽  
Bloodstream Infections ◽  
Quality Standard ◽  
Validity And Reliability ◽  
Vascular Access Devices

ObjectiveCatheter-related bloodstream infections are one of the most important adverse events for patients. Evidence-based practice embraces interventions to prevent and reduce catheter-related bloodstream infections in patients. At present, a growing number of guidelines exist worldwide. The purpose of the study was to assess clinical practice guidelines for peripheral and central venous access device care and prevention of related complications.DesignSystematic review of clinical practice guidelines: We conducted a search of the literature published from 2005 to 2018 using Medline/PubMed, Embase, CINAHL, Ovid, ScienceDirect, Scopus and Web of Science. We also evaluated grey literature sources and websites of organisations that compiled or produced guidelines. Guideline quality was assessed with the Appraisal of Guidelines for Research and Evaluation, Second Edition tool by three independent reviewers. Cohen’s kappa coefficient was used to evaluate the concordance between reviewers.ResultsWe included seven guidelines in the evaluation. The concordance between observers was substantial, K=0.6364 (95% CI 0.0247 to 1.2259). We identified seven international guidelines, which scored poorly on crucial domains such as applicability (medium 39%), stakeholder involvement (medium 65%) and methodological rigour (medium 67%). Guidelines by Spanish Health Ministry and UK National Institute for Health and Care Excellence presented the highest quality.ConclusionsIt is crucial to critically evaluate the validity and reliability of clinical practice guidelines so the best, most context-specific document is selected. Such choice is a necessary prior step to encourage and support health organisations to transfer research results to clinical practice. The gaps identified in our study may explain the suboptimal clinical impact of guidelines. Such low adoption may be mitigated with the use of implementation guides accompanying clinical documents.

Psychometric Properties of Postpartum Quality of Life Questionnaires: a Systematic Review and Meta-analysis Protocol

2020 ◽  
Author(s):  
Tahereh Mokhtarian-Gilani ◽  
Nourossadat kariman ◽  
Hamid Sharif-Nia ◽  
Mahbobeh Ahmadi-Doulabi ◽  
Malihe Nasiri
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Psychometric Properties ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Measurement Properties ◽  
Validity And Reliability ◽  
Quality Of Life Questionnaires ◽  
General Quality

Abstract Background:The postpartum quality of life refers to women's understanding of their standing in the postpartum crisis that differs depending on their health status, social support, cultural status and values, attitudes, goals and standards. The present systematic review will identify, describe, and critically assess the psychometric properties of postpartum quality of life questionnaires.Methods/Design:A systematic review will be conducted in databases including PubMed, Embase, Scopus, Web of Science, PsycINFO, and CINAHL from January 2000 to January 2020. The psychometric properties (validity and reliability) of the instruments used in the primary studies will be assessed, and the selection, methodological quality assessment and data extraction processes of the studies will be independently assessed by two reviewers with expertise in conducting systematic reviews, so as to minimize potential personal bias. Eligible resources are selected after any lack of consensus is put to debate.The risk of bias is assessed using the COSMIN RISK of Bias checklist, and to evaluate the quality of the studies, the protocol is written based on the PRISMA-P1 standards. The results of the studies will be judged based on good measurement properties, and the results of all the studies are qualitatively summarized to produce a reference for the general quality of the results. The general quality of the evidence will be determined using a modified GRADE method.Discussion:This study assessed the psychometric properties of questionnaires used for assessing postpartum quality of life and its results can be used to identify the most appropriate tool for health applications in measuring postpartum quality of life. Systematic review registration: reference number in PROSPRO CRD42020166301

scholarly journals Eversion technique versus conventional endarterectomy with patch angioplasty in carotid surgery: protocol for a systematic review with meta-analyses and trial sequential analysis of randomised clinical trials

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e030503 ◽  
Author(s):  
Martijn S. Marsman ◽  
Jorn Wetterslev ◽  
Patrick W.H.E. Vriens ◽  
Ronald L.A.W. Bleys ◽  
Abdelkarime Kh. Jahrome ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sequential Analysis ◽  
Risk Of Bias ◽  
Low Risk ◽  
Trial Sequential Analysis ◽  
Serious Adverse Events ◽  
Symptomatic Carotid ◽  
Patch Angioplasty ◽  
Symptomatic Carotid Stenosis ◽  
Meta Analyses

IntroductionTraditional carotid endarterectomy is considered to be the standard technique for prevention of a new stroke in patients with a symptomatic carotid stenosis. Use of patch angioplasty to restore the arterial wall after longitudinal endarterectomy is, to date, not unequivocally proven to be superior to eversion technique. A systematic review is needed for evaluation of benefits and harms of the eversion technique versus the traditional endarterectomy with patch angioplasty in patients with symptomatic carotid stenosis.Methods and outcomesThe review will be conducted according to this protocol following the recommendations of the ‘Cochrane Handbook for Systematic Reviews’ and reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Randomised clinical trials comparing eversion technique versus endarterectomy with patch angioplasty in patients with a symptomatic stenosis of the internal carotid artery will be included. Primary outcomes are all-cause mortality rate, health-related quality of life and serious adverse events. Secondary outcomes are 30-day stroke and mortality rate, symptomatic arterial restenosis or occlusion and non-serious adverse events. The databases Cochrane Central Register of Controlled Trials, PubMed/MEDLINE and EMBASE will be searched (November 2019). We will primarily base our conclusions on meta-analyses of trials with overall low-risk of bias. We will use trial sequential analysis to assist the evaluation of imprecision in Grading of Recommendations, Assessment, Development and Evaluation. However, if pooled point estimates of all trials are similar to pooled point estimates of trials with overall low risk of bias and there is lack of a statistical significant interaction between estimates from trials with overall high risk of bias and trials with overall low risk of bias we will consider the trial sequential analysis adjusted precision of the estimate achieved in all trials as the result of our meta-analyses.Ethics and disseminationThe proposed systematic review will collect and analyse data from published studies, therefore, ethical approval is not required. The results of the review will be disseminated by publication in a peer-review journal and submitted for presentation at conferences.PROSPERO registration numberCRD42019119361.

scholarly journals Effects of low-level laser therapy on the orthodontic mini-implants stability: a systematic review and meta-analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ana Carolina de Figueiredo Costa ◽  
Thays Allane Cordeiro Maia ◽  
Paulo Goberlânio de Barros Silva ◽  
Lucas Guimarães Abreu ◽  
Delane Viana Gondim ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Laser Therapy ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Low Risk ◽  
Low Level Laser Therapy ◽  
Mini Implants ◽  
Level Laser

Abstract Objectives The aim of this systematic review and meta-analysis was to assess the effects of low-level laser therapy (LLLT) on the orthodontic mini-implants (OMI) stability. Materials and methods An unrestricted electronic database search in PubMed, Science Direct, Embase, Scopus, Web of Science, Cochrane Library, LILACS, Google Scholar, and ClinicalTrials.gov and a hand search were performed up to December 2020. Randomized clinical trials (RCTs) or non-randomized clinical trials (Non-RCTs) that assessed the effects of LLLT on the OMI stability were included. Data regarding the general information, LLLT characteristics, and outcomes were extracted. The authors performed risk of bias assessment with Cochrane Collaboration’s or ROBINS-I tool. Meta-analysis was also conducted. Results Five RCTs and one Non-RCT were included and 108 patients were evaluated. The LLLT characteristics presented different wavelength, power, energy density, irradiation time, and protocol duration. Five RCTs had a low risk of selection bias. Two RCTs had a low risk of performance and detection bias. All RCTs had a low risk of attrition bias, reporting bias and other bias. The Non-RCT presented a low risk of bias for all criteria, except for the bias in selection of participants. The meta-analysis revealed that LLLT significantly increased the OMI stability (p < 0.001, Cohen’s d = 0.67) and the highest clinical benefit was showed after 1 (p < 0.001, Cohen’s d = 0.75), 2 (p < 0.001, Cohen’s d = 1.21), and 3 (p < 0.001, Cohen’s d = 1.51) months of OMI placement. Conclusions LLLT shows positive effects on the OMI stability.

scholarly journals Virtual Reality for Health Professions Education: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration (Preprint)

2018 ◽  
Author(s):  
Bhone Myint Kyaw ◽  
Nakul Saxena ◽  
Pawel Posadzki ◽  
Jitka Vseteckova ◽  
Charoula Konstantia Nikolaou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Virtual Reality ◽  
Clinical Practice ◽  
Health Professionals ◽  
Cognitive Skills ◽  
Meta Analysis ◽  
Health Professions ◽  
Risk Of Bias ◽  
Traditional Learning ◽  
Digital Education

BACKGROUND Virtual reality (VR) is a technology that allows the user to explore and manipulate computer-generated real or artificial three-dimensional multimedia sensory environments in real time to gain practical knowledge that can be used in clinical practice. OBJECTIVE The aim of this systematic review was to evaluate the effectiveness of VR for educating health professionals and improving their knowledge, cognitive skills, attitudes, and satisfaction. METHODS We performed a systematic review of the effectiveness of VR in pre- and postregistration health professions education following the gold standard Cochrane methodology. We searched 7 databases from the year 1990 to August 2017. No language restrictions were applied. We included randomized controlled trials and cluster-randomized trials. We independently selected studies, extracted data, and assessed risk of bias, and then, we compared the information in pairs. We contacted authors of the studies for additional information if necessary. All pooled analyses were based on random-effects models. We used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach to rate the quality of the body of evidence. RESULTS A total of 31 studies (2407 participants) were included. Meta-analysis of 8 studies found that VR slightly improves postintervention knowledge scores when compared with traditional learning (standardized mean difference [SMD]=0.44; 95% CI 0.18-0.69; I2=49%; 603 participants; moderate certainty evidence) or other types of digital education such as online or offline digital education (SMD=0.43; 95% CI 0.07-0.79; I2=78%; 608 participants [8 studies]; low certainty evidence). Another meta-analysis of 4 studies found that VR improves health professionals’ cognitive skills when compared with traditional learning (SMD=1.12; 95% CI 0.81-1.43; I2=0%; 235 participants; large effect size; moderate certainty evidence). Two studies compared the effect of VR with other forms of digital education on skills, favoring the VR group (SMD=0.5; 95% CI 0.32-0.69; I2=0%; 467 participants; moderate effect size; low certainty evidence). The findings for attitudes and satisfaction were mixed and inconclusive. None of the studies reported any patient-related outcomes, behavior change, as well as unintended or adverse effects of VR. Overall, the certainty of evidence according to the GRADE criteria ranged from low to moderate. We downgraded our certainty of evidence primarily because of the risk of bias and/or inconsistency. CONCLUSIONS We found evidence suggesting that VR improves postintervention knowledge and skills outcomes of health professionals when compared with traditional education or other types of digital education such as online or offline digital education. The findings on other outcomes are limited. Future research should evaluate the effectiveness of immersive and interactive forms of VR and evaluate other outcomes such as attitude, satisfaction, cost-effectiveness, and clinical practice or behavior change.

scholarly journals Prediction Models for Severe Manifestations and Mortality due to COVID-19: A Rapid Systematic Review

2021 ◽  
Author(s):  
Jamie L. Miller ◽  
Masafumi Tada ◽  
Michihiko Goto ◽  
Nicholas Mohr ◽  
Sangil Lee
Keyword(s):  
Systematic Review ◽  
Prediction Model ◽  
Prediction Models ◽  
External Validation ◽  
Clinical Signs ◽  
Risk Of Bias ◽  
Low Risk ◽  
Prognostic Models ◽  
Organ Support ◽  
Public Data

ABSTRACTBackgroundThroughout 2020, the coronavirus disease 2019 (COVID-19) has become a threat to public health on national and global level. There has been an immediate need for research to understand the clinical signs and symptoms of COVID-19 that can help predict deterioration including mechanical ventilation, organ support, and death. Studies thus far have addressed the epidemiology of the disease, common presentations, and susceptibility to acquisition and transmission of the virus; however, an accurate prognostic model for severe manifestations of COVID-19 is still needed because of the limited healthcare resources available.ObjectiveThis systematic review aims to evaluate published reports of prediction models for severe illnesses caused COVID-19.MethodsSearches were developed by the primary author and a medical librarian using an iterative process of gathering and evaluating terms. Comprehensive strategies, including both index and keyword methods, were devised for PubMed and EMBASE. The data of confirmed COVID-19 patients from randomized control studies, cohort studies, and case-control studies published between January 2020 and July 2020 were retrieved. Studies were independently assessed for risk of bias and applicability using the Prediction Model Risk Of Bias Assessment Tool (PROBAST). We collected study type, setting, sample size, type of validation, and outcome including intubation, ventilation, any other type of organ support, or death. The combination of the prediction model, scoring system, performance of predictive models, and geographic locations were summarized.ResultsA primary review found 292 articles relevant based on title and abstract. After further review, 246 were excluded based on the defined inclusion and exclusion criteria. Forty-six articles were included in the qualitative analysis. Inter observer agreement on inclusion was 0.86 (95% confidence interval: 0.79 - 0.93). When the PROBAST tool was applied, 44 of the 46 articles were identified to have high or unclear risk of bias, or high or unclear concern for applicability. Two studied reported prediction models, 4C Mortality Score from hospital data and QCOVID from general public data from UK, and were rated as low risk of bias and low concerns for applicability.ConclusionSeveral prognostic models are reported in the literature, but many of them had concerning risks of biases and applicability. For most of the studies, caution is needed before use, as many of them will require external validation before dissemination. However, two articles were found to have low risk of bias and low applicability can be useful tools.

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