scholarly journals Genetic testing for indeterminate thyroid cytology: review and meta-analysis

2018 ◽  
Vol 25 (3) ◽  
pp. R163-R177 ◽  
Author(s):  
Sergio Vargas-Salas ◽  
José R Martínez ◽  
Soledad Urra ◽  
José Miguel Domínguez ◽  
Natalia Mena ◽  
...  
Keyword(s):  
Clinical Performance ◽  
Meta Analysis ◽  
Molecular Testing ◽  
Clinical Use ◽  
Thyroid Cytology ◽  
Molecular Tests ◽  
Indeterminate Nodule ◽  
Health Need ◽  
The Impact

Thyroid cancer is the most frequent endocrine malignancy, and its incidence is increasing. A current limitation of cytological evaluation of thyroid nodules is that 20–25% are reported as indeterminate. Therefore, an important challenge for clinicians is to determine whether an indeterminate nodule is malignant, and should undergo surgery, or benign, and should be recommended to follow-up. The emergence of precision medicine has offered a valuable solution for this problem, with four tests currently available for the molecular diagnosis of indeterminate cytologies. However, efforts to critically analyze the quality of the accumulated evidence are scarce. This systematic review and meta-analysis is aimed to contribute to a better knowledge about the four available molecular tests, their technical characteristics, clinical performance, and ultimately to help clinicians to make better decisions to provide the best care options possible. For this purpose, we address three critical topics: (i) the proper theoretical accuracy, considering the intended clinical use of the test (rule-in vs rule-out) and the impact on clinical decisions; (ii) the quality of the evidence reported for each test (iii) and how accurate and effective have the tests proved to be after their clinical use. Together with the upcoming evidence, this work provides significant and useful information for healthcare system decision-makers to consider the use of molecular testing as a public health need, avoiding unnecessary surgical risks and costs.

scholarly journals Exercise efficacy and prescription during treatment for pancreatic ductal adenocarcinoma: a systematic review

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dominic O’Connor ◽  
Malcolm Brown ◽  
Martin Eatock ◽  
Richard C. Turkington ◽  
Gillian Prue
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Pancreatic Cancer ◽  
Adjuvant Therapy ◽  
Physical Function ◽  
Meta Analysis ◽  
Ductal Adenocarcinoma ◽  
Key Stakeholders ◽  
The Impact

Abstract Background Surgical resection remains the only curative treatment for pancreatic cancer and is associated with significant post-operative morbidity and mortality. Patients eligible for surgery, increasingly receive neo-adjuvant therapy before surgery or adjuvant therapy afterward, inherently exposing them to toxicity. As such, optimizing physical function through exercise during treatment remains imperative to optimize quality of life either before surgery or during rehabilitation. However, current exercise efficacy and prescription in pancreatic cancer is unknown. Therefore, this study aims to summarise the published literature on exercise studies conducted in patients with pancreatic cancer undergoing treatment with a focus on determining the current prescription and progression patterns being used in this population. Methods A systematic review of four databases identified studies evaluating the effects of exercise on aerobic fitness, muscle strength, physical function, body composition, fatigue and quality of life in participants with pancreatic cancer undergoing treatment, published up to 24 July 2020. Two reviewers independently reviewed and appraised the methodological quality of each study. Results Twelve studies with a total of 300 participants were included. Heterogeneity of the literature prevented meta-analysis. Exercise was associated with improvements in outcomes; however, study quality was variable with the majority of studies receiving a weak rating. Conclusions High quality evidence regarding the efficacy and prescription of exercise in pancreatic cancer is lacking. Well-designed trials, which have received feedback and input from key stakeholders prior to implementation, are required to examine the impact of exercise in pancreatic cancer on key cancer related health outcomes.

scholarly journals A Comparison of Lung Ultrasound and Computed Tomography in the Diagnosis of Patients with COVID-19: A Systematic Review and Meta-Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1351
Author(s):  
Mengshu Wang ◽  
Xufei Luo ◽  
Ling Wang ◽  
Janne Estill ◽  
Meng Lv ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Interstitial Pneumonia ◽  
Lung Ultrasound ◽  
Meta Analysis ◽  
Diagnostic Odds Ratio ◽  
Receiver Operating Curve ◽  
Cochrane Library ◽  
Molecular Tests ◽  
Specificity And Sensitivity

Background Lung ultrasound (LUS) and computed tomography (CT) can both be used for diagnosis of interstitial pneumonia caused by coronavirus disease 2019 (COVID-19), but the agreement between LUS and CT is unknown. Purpose to compare the agreement of LUS and CT in the diagnosis of interstitial pneumonia caused by COVID-19. Materials and Methods We searched PubMed, Cochrane library, Embase, Chinese Biomedicine Literature, and WHO COVID-19 databases to identify studies that compared LUS with CT in the diagnosis of interstitial pneumonia caused by COVID-19. We calculated the pooled overall, positive and negative percent agreements, diagnostic odds ratio (DOR) and the area under the standard receiver operating curve (SROC) for LUS in the diagnosis of COVID-19 compared with CT. Results We identified 1896 records, of which nine studies involving 531 patients were finally included. The pooled overall, positive and negative percentage agreements of LUS for the diagnosis of interstitial pneumonia caused by COVID-19 compared with CT were 81% (95% confidence interval [CI] 43–99%), 96% (95% CI, 80–99%, I2 = 92.15%) and 80% (95%CI, 60–92%, I2 = 92.85%), respectively. DOR was 37.41 (95% CI, 9.43–148.49, I2 = 63.9%), and the area under the SROC curve was 0.94 (95% CI, 0.92–0.96). The quality of evidence for both specificity and sensitivity was low because of heterogeneity and risk of bias. Conclusion The level of diagnostic agreement between LUS and CT in the diagnosis of interstitial pneumonia caused by COVID-19 is high. LUS can be therefore considered as an equally accurate alternative for CT in situations where molecular tests are not available.

The impact on quality of life in patients with burning mouth syndrome: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Juliana Vianna Pereira ◽  
Ana Gabriela Costa Normando ◽  
Carla Isabelly Rodrigues-Fernandes ◽  
César Rivera ◽  
Alan Roger Santos-Silva ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Meta Analysis ◽  
Burning Mouth Syndrome ◽  
Burning Mouth ◽  
The Impact

scholarly journals Impact of eating disorders on paid or unpaid work participation and performance: a systematic review and meta-analysis protocol

2022 ◽  
Vol 10 (1) ◽  
Author(s):  
Fatima Safi ◽  
Anna M. Aniserowicz ◽  
Heather Colquhoun ◽  
Jill Stier ◽  
Behdin Nowrouzi-Kia
Keyword(s):  
Systematic Review ◽  
Eating Disorders ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Work Participation ◽  
Unpaid Work ◽  
Cochrane Library ◽  
And Performance ◽  
The Impact

Abstract Background Eating disorders (ED) can reduce quality of life by limiting participation and performance in social and occupational roles, including paid or unpaid work. The association between ED pathologies and work participation and performance must be well understood to strengthen vocational rehabilitation programmes and prevent occupational disruptions in the ED population. The aims of this study are: (1) to examine the degree of association between ED pathologies and work participation and performance in 15-year-olds and older; (2) to highlight the specific ED symptoms that are most correlated with changes in work performance and participation; (3) to compile the most common metrics and assessments used to measure work participation and performance with ED. Methods Medline, Embase, CINAHL, Web of Science, PsycINFO, and Cochrane Library will be searched for observational and experimental studies that meet the following criteria: (1) a clinical sample of typical or atypical ED; (2) paid or unpaid employment or training; (3) an association between ED pathologies and work participation or performance. Unpublished data will also be examined. Title and abstract, and full-text screening will be conducted in duplicate. Risk of bias and quality of evidence assessments will be completed. A random-effect meta-analysis will be performed. Discussion This synthesis can clarify knowledge and gaps around the impact of ED on work functioning, thereby allowing better evaluation, improvements and development of current workplace assessments, interventions, and policies. Trial registration The registration number for this systematic review on PROSPERO is CRD42021255055.

scholarly journals The impact of music on health-related quality of life, as quantified by the SF-36: A systematic review and meta-analysis

2021 ◽  
Author(s):  
J. Matt McCrary ◽  
Eckart Altenmuller ◽  
Clara Kretschmer ◽  
Daniel S. Scholz
Keyword(s):  
Standard Treatment ◽  
Meta Analysis ◽  
Music Listening ◽  
Health Related Quality ◽  
Post Intervention ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related ◽  
The Impact

Background/Objectives: Increasing evidence supports the ability of music to broadly promote wellbeing and health-related quality of life (HRQOL). However, the magnitude of music effects on HRQOL is still unclear, particularly relative to established interventions, limiting inclusion of music interventions in health policy and care. The SF-36 is the most widely used instrument to evaluate HRQOL, with broad validity in evaluating the effects of a range of interventions. This study aims to synthesize and contextualize the impact of music interventions on HRQOL, as assessed by the SF-36. Methods: MEDLINE; EMBASE; Web of Science; PsycINFO, clinicaltrials.gov, and ICTRP databases were searched on 30 July 2021. Randomized and single-group studies of music interventions which reported SF-36 data at pre- and post-intervention timepoints were included. Observational studies were excluded. The quality and certainty of evidence provided by included articles and meta-analysis results was appraised using GRADE. Inverse variance random effects meta-analyses quantified changes in SF-36 mental and physical component summary scores (respectively, MCS and PCS) pre- to post-intervention and vs. common control groups. Results: Analyses included 764 participants from 25 studies. Music interventions (music listening, 10 studies; music therapy, 7 studies; singing, 7 studies; gospel music, 1 study) significantly improved MCS (Mean difference (MD) [95% confidence interval]=3.0 [1.4, 4.6]; p<.001) and PCS (MD=1.0 [0.1, 2.0; p<.04) scores. In a subgroup (8 studies; music group, N=254; control, N=257) addition of music to standard treatment for a range of conditions significantly improved MCS scores vs. standard treatment alone (MD=3.7 [0.4, 7.1; p<.03). Effects did not vary between music listening, therapy and singing intervention types or doses (p>.12); no evidence of small study or publication biases was present in any analysis (p>.31). Music impact on MCS scores meets SF-36 minimum important difference thresholds (MD>/=3) and is within the range of established interventions. Conclusions: This study provides Moderate quality evidence that music interventions can generally be used to provide clinically meaningful improvements in HRQOL. Further study is needed to determine optimal music interventions and doses for distinct clinical and public health scenarios. Funding: Alexander von Humboldt Foundation Registration: PROSPERO (ID: CRD42021276204)

Outcomes of digital biomarker-based interventions: protocol for a systematic review of systematic reviews (Preprint)

2021 ◽  
Author(s):  
Hossein Motahari-Nezhad ◽  
Márta Péntek ◽  
László Gulácsi ◽  
Zsombor Zrubka
Keyword(s):  
Clinical Outcomes ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Level Of Evidence ◽  
Clinical Benefits ◽  
The Cochrane Library ◽  
The Impact ◽  
Digital Biomarkers

BACKGROUND Digital biomarkers are defined as objective, quantifiable physiological and behavioral data that are collected and measured by means of digital devices such as portables, wearables, implantables or digestibles. For their widespread adoption in publicly financed healthcare systems, it is important to understand how their benefits translate into improved patient outcomes, which is essential for demonstrating their value. OBJECTIVE To assess the quality and strength of evidence of the impact of digital biomarkers on clinical outcomes compared to interventions without digital biomarkers, reported in systematic reviews. METHODS A comprehensive search for 2019-2020 will be conducted in the PubMed and the Cochrane Library using keywords related to digital biomarkers and a filter for systematic reviews. Original full-text English publications of systematic reviews comparing clinical outcomes of interventions with and without digital biomarkers via meta-analysis will be included. The AMSTAR-2 tool will be used to assess the methodological quality of reviews. To assess the quality of evidence, we will evaluate systematic reviews using the GRADE tool. To detect the possible presence of reporting bias, we will record whether the protocol of the systematic reviews was published before the start of the study. A qualitative summary of results by digital biomarker technology and outcome will be provided. RESULTS This protocol was submitted before data collection. The next steps in this review will be initiated after the protocol is accepted for publication. CONCLUSIONS Our study will provide a comprehensive summary of the highest level of evidence available on digital biomarker interventions. Our results will help identify clinical areas where the use of digital biomarkers leads to favorable clinical outcomes. In addition, our findings will highlight areas of evidence gaps where the clinical benefits of digital biomarkers have not yet been demonstrated.

scholarly journals Protocol for a systematic review and meta-analysis of respiratory rehabilitation following intensive care unit discharge for COVID-19 survivors

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e041184
Author(s):  
Dan Wang ◽  
Jin Li ◽  
Feilong Zhu ◽  
Qianqin Hong ◽  
Ming Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Meta Analysis ◽  
Biomedical Literature ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
The Impact ◽  
Respiratory Rehabilitation

IntroductionBoth physical and mental disorders may be exacerbated in patients with COVID-19 due to the experience of receiving intensive care; undergoing prolonged mechanical ventilation, sedation, proning and paralysis. Pulmonary rehabilitation is aimed to improve dyspnoea, relieve anxiety and depression, reduce the incidence of related complications, as well as prevent and improve dysfunction. However, the impact of respiratory rehabilitation on discharged patients with COVID-19 is currently unclear, especially on patients who have been mechanically ventilated over 24 hours. Therefore, we aim to investigate the efficacy of respiratory rehabilitation programmes, initiated after discharge from the intensive care unit, on the physical and mental health and health-related quality of life in critical patients with COVID-19.Methods and analysisWe have registered the protocol on PROSPERO and in the process of drafting it, we strictly followed the checklist of Preferred Reporting Items for Systematic Review and Meta-Analysis Potocols. We will search the PubMed, EMBASE, Web of Science, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, WanFang, VIP information databases and Chinese Biomedical Literature Database. Additionally, ongoing trials in the WHO International Clinical Trials Registry Platform, ClinicalTrials.gov and ISRCTN registry will be searched as well. Studies in English or Chinese and from any country will be accepted regardless of study design. Two review authors will independently extract data and assess the quality of included studies. Continuous data are described as standard mean differences (SMDs) with 95% CIs. Dichotomous data from randomised controlled trials are described as risk ratio(RR) with 95% CIs; otherwise, it is described as odds ratio(OR) with 95% CIs. I2 and the Cochrane’s Q statistic will be used to conduct heterogeneity assessment. The quality of evidence of main outcomes will be evaluated according to the Grading of Recommendations, Assessment, Development and Evaluation(GRADE) criteria. When included studies are sufficient, we will conduct subgroup analysis and sensitivity analysis; the publication bias will be statistically analysed using a funnel plot analysis and Egger’s test.Ethics and disseminationOur review, planning to include published studies, does not need the request to the ethical committee. The final results of this review will be published in a peer-reviewed journal after completion.Patient and public involvementNo patient involved.PROSPERO registration numberCRD42020186791.

Early palliative care in haematological patients: a systematic literature review

2020 ◽  
Vol 10 (4) ◽  
pp. 395-403
Author(s):  
Silvia Tanzi ◽  
Francesco Venturelli ◽  
Stefano Luminari ◽  
Franco Domenico Merlo ◽  
Luca Braglia ◽  
...  
Keyword(s):  
Palliative Care ◽  
Comparative Studies ◽  
English Language ◽  
Meta Analysis ◽  
Early Palliative Care ◽  
Study Results ◽  
Registration Number ◽  
Integrated Or ◽  
The Impact

BackgroundEarly palliative care together with standard haematological care for advanced patients is needed worldwide. Little is known about its effect. The aim of the review is to synthesise the evidence on the impact of early palliative care on haematologic cancer patients’ quality of life and resource use.Patients and methodsA systematic review was conducted. The search terms were early palliative care or simultaneous or integrated or concurrent care and haematological or oncohaematological patients. The following databases were searched: PubMed, Embase, Cochrane, CINHAL and Scopus. Additional studies were identified through cross-checking the reference articles. Studies were in the English language, with no restriction for years. Two researchers independently reviewed the titles and abstracts, and one author assessed full articles for eligibility.ResultsA total of 296 studies titles were reviewed. Eight articles were included in the synthesis of the results, two controlled studies provided data on the comparative efficacy of PC interventions, and six one-arm studies were included. Since data pooling and meta-analysis were not possible, only a narrative synthesis of the study results was performed. The quality of the two included comparative studies was low overall. The quality of the six non-comparative studies was high overall, without the possibility of linking the observed results to the implemented interventions.ConclusionsStudies on early palliative care and patients with haematological cancer are scarce and have not been prospectively designed. More research on the specific population target, type and timing of palliative care intervention and standardisation of collected outcomes is required.PROSPERO registration numberCRD42020141322.

scholarly journals Modelling the dietary impact of health-related claims on food labels in the UK

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Asha Kaur ◽  
Peter Scarborough ◽  
Mike Rayner
Keyword(s):  
Nutritional Quality ◽  
Meta Analysis ◽  
Saturated Fat ◽  
Nutritional Composition ◽  
Health Claims ◽  
Baseline Scenario ◽  
Health Related ◽  
Mathematical Equations ◽  
The Impact

AbstractHealth-related claims (HRCs) are statements found on food packets that convey the nutritional quality of a food (nutrition claims) and/or its impact on a health outcome (health claims). Foods carrying HRCs have a slightly improved nutritional profile than foods without HRCs, however, it's unclear whether this translates into dietary improvements. We conducted a modelling study to measure the effect of HRCs on diet. As HRCs are already present on foods it is assumed that any impact that they have upon diet are already in effect. We modelled the impact on food purchases of removing HRCs, by assuming that the sales boost they receive is neutralised. These results can be inverted to estimate the current dietary impact of HRCs. Using the Living Costs Food (LCF) survey data, we calculate the average purchases and nutrient intake per person, per day. The LCF data is divided into sales of products with HRCs and sales of products without HRCs through solving mathematical equations combining LCF sales data with odds ratios from a meta-analysis examining the impact of HRCs on choices and data from a survey of foods examining the prevalence of HRCs and the nutritional quality of foods that carry them so that the sum of the sales of products with HRCs and without HRCs is equal to the total sales of products. Similarly, mathematical equations are solved that combine nutritional composition data with the sales of foods carrying and not carrying HRCs. In the baseline scenario foods carrying HRCs made-up 37% of the total purchases, and contributed 29% (559kcal) of the total kcals purchased (1907kcal). When HRCs are removed from foods there is an average increase of 18kcal/d (95% Uncertainty Intervals [UI] -15, 52), + 2g/d increase in total fat (95% UI -1, 4) and saturated fat (95% UI 1, 3), smaller changes are seen for protein (+ 0.5g/d, 95% UI -1, 2), total sugar (+ 0.5g/d, 95% UI -4, 7) and carbohydrate (-0.5g/d, 95% UI -5, 7). There is reduction in the amount of fruit (-11g/d, 95% UI -34, 26) but an increase in vegetables (+ 6g/d, 95% UI -6, 19). These results should be interpreted with caution due to the large uncertainty intervals. When HRCs are removed, we see a small deterioration in the quality of the average diet. If we invert these findings we can assume HRCs currently have a positive, albeit small, impact on diet.

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