scholarly journals MANAGEMENT OF ENDOCRINE DISEASE: Imaging for the diagnosis of malignancy in incidentally discovered adrenal masses: a systematic review and meta-analysis

2016 ◽  
Vol 175 (2) ◽  
pp. R51-R64 ◽  
Author(s):  
Jacqueline Dinnes ◽  
Irina Bancos ◽  
Lavinia Ferrante di Ruffano ◽  
Vasileios Chortis ◽  
Clare Davenport ◽  
...  
Keyword(s):  
Systematic Review ◽  
Test Performance ◽  
Fdg Pet ◽  
Citation Index ◽  
Meta Analysis ◽  
High Sensitivity ◽  
Future Research ◽  
Cochrane Central Register ◽  
Adrenal Imaging ◽  
Adrenal Masses

ObjectiveAdrenal masses are incidentally discovered in 5% of CT scans. In 2013/2014, 81 million CT examinations were undertaken in the USA and 5 million in the UK. However, uncertainty remains around the optimal imaging approach for diagnosing malignancy. We aimed to review the evidence on the accuracy of imaging tests for differentiating malignant from benign adrenal masses.DesignA systematic review and meta-analysis was conducted.MethodsWe searched MEDLINE, EMBASE, Cochrane CENTRAL Register of Controlled Trials, Science Citation Index, Conference Proceedings Citation Index, and ZETOC (January 1990 to August 2015). We included studies evaluating the accuracy of CT, MRI, or18F-fluoro-deoxyglucose (FDG)-PET compared with an adequate histological or imaging-based follow-up reference standard.ResultsWe identified 37 studies suitable for inclusion, after screening 5469 references and 525 full-text articles. Studies evaluated the accuracy of CT (n=16), MRI (n=15), and FDG-PET (n=9) and were generally small and at high or unclear risk of bias. Only 19 studies were eligible for meta-analysis. Limited data suggest that CT density >10HU has high sensitivity for detection of adrenal malignancy in participants with no prior indication for adrenal imaging, that is, masses with ≤10HU are unlikely to be malignant. All other estimates of test performance are based on too small numbers.ConclusionsDespite their widespread use in routine assessment, there is insufficient evidence for the diagnostic value of individual imaging tests in distinguishing benign from malignant adrenal masses. Future research is urgently needed and should include prospective test validation studies for imaging and novel diagnostic approaches alongside detailed health economics analysis.

Characterization of Adrenal Masses by Using FDG PET: A Systematic Review and Meta-Analysis of Diagnostic Test Performance

Radiology ◽  
2011 ◽  
Vol 259 (1) ◽  
pp. 117-126 ◽  
Author(s):  
Giles W. L. Boland ◽  
Ben A. Dwamena ◽  
Minal Jagtiani Sangwaiya ◽  
Alexander G. Goehler ◽  
Michael A. Blake ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Test ◽  
Test Performance ◽  
Fdg Pet ◽  
Meta Analysis ◽  
Adrenal Masses ◽  
Diagnostic Test Performance

Systematic review and meta-analysis of interventions for operating room to intensive care unit handoffs

2021 ◽  
pp. bmjqs-2020-012474
Author(s):  
Joanna Abraham ◽  
Alicia Meng ◽  
Sanjna Tripathy ◽  
Michael S Avidan ◽  
Thomas Kannampallil
Keyword(s):  
Systematic Review ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Operating Room ◽  
Meta Analysis ◽  
Intervention Group ◽  
Future Research ◽  
Original Research ◽  
Cochrane Central Register ◽  
The Impact

ObjectiveTo conduct a systematic review and meta-analysis to ascertain the impact of operating room (OR) to intensive care unit (ICU) handoff interventions on process-based and clinical outcomes.MethodWe included all English language, prospective evaluation studies of OR to ICU handoff interventions published as original research articles in peer-reviewed journals. The search was conducted on 11 November 2019 on MEDLINE, CINAHL, EMBASE, Scopus and the Cochrane Central Register of Controlled Trials databases, with no prespecified criteria for the type of comparison or outcome. A meta-analysis of similar outcomes was conducted using a random effects model. Quality was assessed using a modified Downs and Black (D&B) checklist.Results32 studies were included for review. 31 studies were conducted at a single site and 28 studies used an observational study design with a control. Most studies (n=28) evaluated bundled interventions which comprised information transfer/communication checklists and protocols. Meta-analysis showed that the handoff intervention group had statistically significant improvements in time to analgesia dosing (mean difference (MD)=−42.51 min, 95% CI −60.39 to −24.64), fewer information omissions (MD=−2.22, 95% CI −3.68 to –0.77), fewer technical errors (MD=−2.38, 95% CI −4.10 to –0.66) and greater information sharing scores (MD=30.03%, 95% CI 19.67% to 40.40%). Only 15 of the 32 studies scored above 9 points on the modified D&B checklist, indicating a lack of high-quality studies.DiscussionBundled interventions were commonly used to support OR to ICU handoff standardisation. Although the meta-analysis showed significant improvements for a number of clinical and process outcomes, the statistical and clinical heterogeneity must be accounted for when interpreting these findings. Implications for OR to ICU handoff practice and future research are discussed.

scholarly journals Associations of childhood exposure to malaria with cognition and behaviour outcomes: a systematic review protocol

2020 ◽  
Author(s):  
ANDREW SENTOOGO SSEMATA ◽  
JACQUELLINE ANN NAKITENDE ◽  
SIMON KIZITO ◽  
ELIZABETH C WHIPPLE ◽  
PAUL BANGIRANA ◽  
...  
Keyword(s):  
Systematic Review ◽  
Malaria Infection ◽  
Meta Analysis ◽  
Interrupted Time Series ◽  
Bibliographic Databases ◽  
Future Research ◽  
Control Group ◽  
Cochrane Central Register ◽  
Eligibility Criteria ◽  
Cross Sectional

Abstract Background: Malaria is one of the major contributing risk factors for poor development of children living in low- and middle- income countries (LMICs). However, little is known about the specific domains of cognition and behaviour that are impacted by malaria, the extent of these deficits, and the different types of the malaria spectrum that are associated with these deficits. The objective of this systematic review is to determine the association of the different type of malaria infection on cognition and behavioural outcomes among children living in LMICs. Methods and analysis: We will systematically search online bibliographic databases including MEDLINE (via PubMed), CINAHL (via EBSCO), PsycINFO (via EBSCO), Embase and The Cochrane Central Register of Controlled Trials (CENTRAL) as well as Google Scholar and bibliographies of pertinent articles. We will include studies with a comparison group (e.g., clinical trials, cohort, observational, cross-sectional case–control and controlled before and after or interrupted–time–series studies) involving children under 18 years of age living in LMICs, as determined by World Bank Criteria, with either an active malaria infection or history of malaria. Included articles must also measure cognitive and/or behaviour outcomes determined by standardized psychological assessments (questionnaire-based scales and or neurocognitive assessments). Studies will be excluded if they are not in English, lack a control group, take place in a high-income country, or if a standardized instrument was not used. Two reviewers will independently review all articles to determine if they meet eligibility criteria. Any conflicts will be resolved after discussion with a third reviewer. When a list of included articles is finalized, two reviewers will extract data to populate and then cross check within an electronic table. Risk of bias and the strength of evidence and recommendations will be assessed independently using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, and a final score will be given upon consensus. For sufficiently homogeneous data on measured outcomes in multiple studies, we will investigate the possibility of pooling data to perform a meta-analysis. Discussion: This systematic review will evaluate the evidence of the association of malaria on the cognitive and behavioural outcomes. Findings from this planned review will generate insight on the domains affected by the different forms malaria infection and may inform subsequent malaria interventions and future research in paediatric care.Systematic review registration: This systematic review has been registered under the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42020154777)

scholarly journals The relative effectiveness of psychotherapeutic techniques and delivery modalities for chronic pain: a protocol for a systematic review and network meta-analysis.

2020 ◽  
Vol 2 ◽  
pp. 25
Author(s):  
Stephanie Haugh ◽  
Laura O'Connor ◽  
Brian Slattery ◽  
Michelle Hanlon ◽  
Jack Flynn ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Psychological Distress ◽  
Meta Analysis ◽  
Relative Effectiveness ◽  
Pain Interference ◽  
Secondary Outcome ◽  
Future Research ◽  
Controlled Trials ◽  
Cochrane Central Register

Introduction: There is increasing evidence for the use of psychotherapies, including cognitive behavioural therapy, acceptance and commitment therapy, and mindfulness based stress reduction therapy, as an approach to management of chronic pain. Similarly, online psychotherapeutic interventions have been shown to be efficacious, and to arguably overcome practical barriers associated with traditional face-to-face treatment for chronic pain. This is a protocol for a systematic review and network meta-analysis aiming to evaluate and rank psychotherapies (delivered in person and online) for chronic pain patients. Methods/ design: Four databases, namely the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and PsycINFO will be searched from inception. Randomised controlled trials that have evaluated psychological interventions for pain management delivered online or in person will be included in the review. Data will be independently extracted in duplicate and the Cochrane Collaboration Risk of Bias Tool will be used to assess study quality. Measures of pain interference will be extracted as the primary outcome and measures of psychological distress will be extracted as the secondary outcome. A network meta-analysis will generate indirect comparisons of psychotherapies across treatment trials. Rankings of psychotherapies for chronic pain will be made available.   Discussion: A variety of psychotherapies, delivered both online and in person, have been used in an attempt to help manage chronic pain. Although occasional head to head trials have been conducted, little evidence exists to help identify which psychotherapy is most effective in reducing pain interference. The current review will address this gap in the literature and compare the psychotherapies used for internet delivered and in person interventions for chronic pain in relation to the reduction of pain interference and psychological distress. Results will provide a guide for clinicians when determining treatment course and will inform future research into psychotherapies for chronic pain. PROSPERO registration: CRD42016048518 01/11/16

scholarly journals Diagnostic accuracy of18F-FDG PET or PET/CT for the characterization of adrenal masses: a systematic review and meta-analysis

2018 ◽  
pp. 20170520 ◽  
Author(s):  
Seong-Jang Kim ◽  
Sang-Woo Lee ◽  
Kyoungjune Pak ◽  
In-Ju Kim ◽  
Keunyoung Kim
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Fdg Pet ◽  
Meta Analysis ◽  
Pet Ct ◽  
Adrenal Masses

scholarly journals Chest CT versus RT-PCR for the detection of COVID-19: systematic review and meta-analysis of comparative studies

JRSM Open ◽  
2021 ◽  
Vol 12 (5) ◽  
pp. 205427042110118
Author(s):  
Mohammad Karam ◽  
Sulaiman Althuwaikh ◽  
Mohammad Alazemi ◽  
Ahmad Abul ◽  
Amrit Hayre ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ct Scan ◽  
Outcome Measures ◽  
Test Performance ◽  
Meta Analysis ◽  
False Positive Rate ◽  
Chest Ct ◽  
Cochrane Central Register ◽  
Rt Pcr ◽  
Sensitivity Specificity

Objectives To compare the performance of chest computed tomography (CT) scan versus reverse transcription polymerase chain reaction (RT-PCR) as the reference standard in the initial diagnostic assessment of coronavirus disease 2019 (COVID-19) patients. Design A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A search of electronic information was conducted using the following databases: MEDLINE, EMBASE, EMCARE, CINAHL and the Cochrane Central Register of Controlled Trials. Setting Studies that compared the diagnostic performance within the same patient cohort of chest CT scan versus RT-PCR in COVID-19 suspected patients. Participants Thirteen non-randomised studies enrolling 4092 patients were identified. Main outcome measures Sensitivity, specificity and accuracy were primary outcome measures. Secondary outcomes included other test performance characteristics and discrepant findings between both investigations. Results Chest CT had a median sensitivity, specificity and accuracy of 0.91 (range 0.82–0.98), 0.775 (0.25–1.00) and 0.87 (0.68–0.99), respectively, with RT-PCR as the reference. Importantly, early small, China-based studies tended to favour chest CT versus later larger, non-China studies. Conclusions A relatively high false positive rate can be expected with chest CT. It is possible it may still be useful to provide circumstantial evidence, however, in some patients with a suspicious clinical presentation of COVID-19 and negative initial Severe Acute Respiratory Syndrome Coronavirus 2 RT-PCR tests, but more evidence is required in this context. In acute cardiorespiratory presentations, negative CT scan and RT-PCR tests is likely to be reassuring.

scholarly journals The effects of childhood exposure to malaria on cognition and behaviour. A systematic review protocol.

2020 ◽  
Author(s):  
ANDREW SENTOOGO SSEMATA ◽  
JACQUELLINE ANN NAKITENDE ◽  
SIMON KIZITO ◽  
ELIZABETH C WHIPPLE ◽  
PAUL BANGIRANA ◽  
...  
Keyword(s):  
Systematic Review ◽  
Malaria Infection ◽  
Meta Analysis ◽  
Interrupted Time Series ◽  
Bibliographic Databases ◽  
Future Research ◽  
Control Group ◽  
Cochrane Central Register ◽  
Eligibility Criteria ◽  
Cross Sectional

Abstract Background: Malaria is one of the major contributing risk factors for poor development of children living in low- and middle- income countries (LMICs). However, little is known about the specific domains of cognition and behaviour that are impacted by malaria, the extent of these deficits, and the different types of the malaria spectrum that are associated with these deficits. The objective of this systematic review is to determine the effect of the different type of malaria infection on cognition and behaviour among children living in LMICs. Methods and analysis: We will systematically search online bibliographic databases including MEDLINE (via PubMed), CINAHL (via EBSCO), PsycINFO (via EBSCO), EMBASE and The Cochrane Central Register of Controlled Trials (CENTRAL) as well as Google Scholar and bibliographies of pertinent articles. We will include studies with a comparison group (e.g., clinical trials, cohort, observational, cross-sectional case–control and controlled before and after or interrupted–time–series studies) involving children under 18 years of age living in LMICs, as determined by World Bank Criteria, with either an active malaria infection or history of malaria. Included articles must also measure cognitive and/or behaviour outcomes determined by standardized psychological assessments (questionnaire-based scales and or neurocognitive assessments). Studies will be excluded if they are not in English, lack a control group, take place in a high-income country, or if a standardized instrument was not used. Two reviewers will independently review all articles to determine if they meet eligibility criteria. Any conflicts will be resolved after discussion with a third reviewer. When a list of included articles is finalized, two reviewers will extract data to populate and then cross check within an electronic table. Risk of bias and the strength of evidence and recommendations will be assessed independently using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, and a final score will be given upon consensus. For sufficiently homogeneous data on measured outcomes in multiple studies, we will investigate the possibility of pooling data to perform a meta-analysis. Discussion: This systematic review will evaluate the evidence of the effect of malaria on the cognitive and behavioural outcomes. Findings from this planned review will generate insight on the domains affected by the different forms malaria infection and may inform subsequent malaria interventions and future research in paediatric care.Systematic review registration: This systematic review has been registered under PROSPERO: CRD42020154777

scholarly journals An analysis of psychotherapies delivered online and in person for patients with chronic pain: protocol for a systematic review and network meta-analysis.

2019 ◽  
Vol 2 ◽  
pp. 25
Author(s):  
Stephanie Haugh ◽  
Laura O'Connor ◽  
Brian Slattery ◽  
Michelle Hanlon ◽  
Jack Flynn ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Psychological Distress ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Pain Interference ◽  
Secondary Outcome ◽  
Future Research ◽  
Controlled Trials ◽  
Cochrane Central Register

Introduction: There is increasing evidence for the use of psychotherapies, including cognitive behavioural therapy, acceptance and commitment therapy, and mindfulness based stress reduction therapy, as an approach to management of chronic pain. Similarly, online psychotherapeutic interventions have been shown to be efficacious, and to arguably overcome practical barriers associated with traditional face-to-face treatment for chronic pain. This is a protocol for a systematic review and network meta-analysis aiming to evaluate and rank psychotherapies (delivered in person and online) for chronic pain patients. Methods/ design: Four databases, namely the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and PsycINFO will be searched from inception. Randomised controlled trials that have evaluated psychological interventions for pain management delivered online or in person will be included in the review. Data will be independently extracted in duplicate and the Cochrane Collaboration Risk of Bias Tool will be used to assess study quality. Measures of pain interference will be extracted as the primary outcome and measures of psychological distress will be extracted as the secondary outcome. A network meta-analysis will generate indirect comparisons of psychotherapies across treatment trials. Rankings of psychotherapies for chronic pain will be made available.   Discussion: A variety of psychotherapies, delivered both online and in person, have been used in an attempt to help manage chronic pain. Although occasional head to head trials have been conducted, little evidence exists to help identify which psychotherapy is most effective in reducing pain interference. The current review will address this gap in the literature and compare the psychotherapies used for internet delivered and in person interventions for chronic pain in relation to the reduction of pain interference and psychological distress. Results will provide a guide for clinicians when determining treatment course and will inform future research into psychotherapies for chronic pain. PROSPERO registration: CRD42016048518 01/11/16

scholarly journals Randomized trials of housing interventions to prevent malaria and Aedes-transmitted diseases: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244284
Author(s):  
Kok Pim Kua ◽  
Shaun Wen Huey Lee
Keyword(s):  
Systematic Review ◽  
Disease Transmission ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Intervention Group ◽  
Public Health Problem ◽  
Future Research ◽  
Cochrane Central Register ◽  
Secondary Outcomes ◽  
The Impact

Background Mosquito-borne diseases remain a significant public health problem in tropical regions. Housing improvements such as screening of doors and windows may be effective in reducing disease transmission, but the impact remains unclear. Objectives To examine whether housing interventions were effective in reducing mosquito densities in homes and the impact on the incidence of mosquito-borne diseases. Methods In this systematic review and meta-analysis, we searched 16 online databases, including NIH PubMed, CINAHL Complete, LILACS, Ovid MEDLINE, and Cochrane Central Register of Controlled Trials for randomized trials published from database inception to June 30, 2020. The primary outcome was the incidence of any mosquito-borne diseases. Secondary outcomes encompassed entomological indicators of the disease transmission. I2 values were used to explore heterogeneity between studies. A random-effects meta-analysis was used to assess the primary and secondary outcomes, with sub-group analyses for type of interventions on home environment, study settings (rural, urban, or mixed), and overall house type (traditional or modern housing), Results The literature search yielded 4,869 articles. After screening, 18 studies were included in the qualitative review, of which nine were included in the meta-analysis. The studies enrolled 7,200 households in Africa and South America, reporting on malaria or dengue only. The type of home environmental interventions included modification to ceilings and ribbons to close eaves, screening doors and windows with nets, insecticide-treated wall linings in homes, nettings over gables and eaves openings, mosquito trapping systems, metal-roofed houses with mosquito screening, gable windows and closed eaves, and prototype houses using southeast Asian designs. Pooled analysis depicted a lower risk of mosquito-borne diseases in the housing intervention group (OR = 0.68; 95% CI = 0.48 to 0.95; P = 0.03). Subgroup analysis depicted housing intervention reduced the risk of malaria in all settings (OR = 0.63; 95% CI = 0.39 to 1.01; P = 0.05). In urban environment, housing intervention was found to decrease the risk of both malaria and dengue infections (OR = 0.52; 95% CI = 0.27 to 0.99; P = 0.05).Meta-analysis of pooled odds ratio showed a significant benefit of improved housing in reducing indoor vector densities of both Aedes and Anopheles (OR = 0.35; 95% CI = 0.23 to 0.54; P<0.001). Conclusions Housing intervention could reduce transmission of malaria and dengue among people living in the homes. Future research should evaluate the protective effect of specific house features and housing improvements associated with urban development.

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