scholarly journals Meta-analysis on maternal deaths and assessing significant factors for heterogeneity between states of India during 2016

2021 ◽  
Vol 10 (8) ◽  
pp. 3192
Author(s):  
Vanamail Perumal
Keyword(s):  
Maternal Mortality ◽  
Meta Analysis ◽  
Random Effect ◽  
Maternal Mortality Ratio ◽  
Random Effect Model ◽  
Registration System ◽  
Mortality Ratio ◽  
Meta Regression ◽  
Meta Regression Analysis ◽  
Significant Factors

Objective of the study was to provide a more precise estimate of maternal mortality (MM), maternal mortality ratio (MMR) and to identify significant factors contributing for heterogeneity between the states in India. “Metaprop” procedure in STATA software, which are specific to binomial data was applied on state wise MM data published by sample registration system (SRS) during 2014-16. An overall MM estimate and potential sources of heterogeneity could be identified using meta-regression. Corrected estimates of MMR by states were compared. SRS published the MM data by 17 Major states. Overall reported MM was 8.8 per 100, 000 women. Estimate obtained by random effect model was 8.3 (95% CI: 5.9-11.1) per 100,000 women. Heterogeneity between states was very high (I2-statistics =91.9%), and egger regression revealed no reporting bias (p=0.672). Meta-regression analysis indicated that the percent women attending full antenatal care (ANC) visits found to be highly significant (p<0.001) for MM with inverse relationship implying that the states with a higher percentage of women with full ANC visits are likely to have lesser MM. While the estimate of MMR by SRS was 130 per 100,000 live births, corrected MMR was 123 (95% CI: 87-164) accounting for 26% reduction from previous estimate 167 obtained in 2013. This paper provided a precious estimate of both MM and MMR adjusted for sampling weight. Further, the importance of either full ANC visits or four ANC visits could be demonstrated for reduction in MMR on achieving the Millennium development goal (MDG) in the country. 

scholarly journals Diabetes is associated with increased risk for in-hospital mortality in patients with COVID-19: a systematic review and meta-analysis comprising 18,506 patients

2020 ◽  
Author(s):  
Leonidas Palaiodimos ◽  
Natalia Chamorro-Pareja ◽  
Dimitrios Karamanis ◽  
Weijia Li ◽  
Phaedon D. Zavras ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Hospitalized Patients ◽  
Risk Of Death ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Meta Regression ◽  
Meta Regression Analysis

AbstractBackgroundInfectious diseases are more frequent and can be associated with worse outcomes in patients with diabetes. Our aim was to systematically review and synthesize with a meta-analysis the available observational studies reporting the effect of diabetes in mortality among hospitalized patients with COVID-19.MethodsMedline, Embase, Google Scholar, and medRxiv databases were reviewed. A random-effect model meta-analysis was used and I-square was utilized to assess the heterogeneity. In-hospital mortality was defined as the endpoint. Sensitivity, subgroup, and meta-regression analyses were performed.Results18,506 patients were included in this meta-analysis (3,713 diabetics and 14,793 non-diabetics). Patients with diabetes were associated with a higher risk of death compared to patients without diabetes (OR: 1.65; 95% CI: 1.35-1.96; I2 77.4%). The heterogeneity was high. A study level meta-regression analysis was performed for all the important covariates and no significant interactions were found between the covariates and the outcome of mortality.ConclusionThis meta-analysis shows that that the likelihood of death is 65% higher in diabetic hospitalized patients with COVID-19 compared to non-diabetics. Further studies are needed to assess whether this association is independent or not, as well as to investigate to role of glucose control prior or during the disease.

scholarly journals A Systematic Review, Meta-Analysis, and Meta-Regression Evaluating the Efficacy and Mechanisms of Action of Probiotics and Synbiotics in the Prevention of Surgical Site Infections and Surgery-Related Complications

2018 ◽  
Vol 7 (12) ◽  
pp. 556 ◽  
Author(s):  
Karolina Skonieczna-Żydecka ◽  
Mariusz Kaczmarczyk ◽  
Igor Łoniewski ◽  
Luis Lara ◽  
Anastasios Koulaouzidis ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Surgical Site Infections ◽  
Short Chain Fatty Acids ◽  
Cochrane Central Register ◽  
Reactive Protein ◽  
Central Register ◽  
Meta Regression ◽  
Meta Regression Analysis

Intestinal microbiota play an important role in the pathogenesis of surgical site infections (SSIs) and other surgery-related complications (SRCs). Probiotics and synbiotics were found to lower the risk of surgical infections and other surgery-related adverse events. We systematically reviewed the approach based on the administration of probiotics and synbiotics to diminish SSIs/SRCs rates in patients undergoing various surgical treatments and to determine the mechanisms responsible for their effectiveness. A systematic literature search in PubMed/MEDLINE/Cochrane Central Register of Controlled Trials from the inception of databases to June 2018 for trials in patients undergoing surgery supplemented with pre/pro/synbiotics and randomized to the intervention versus placebo/no treatment and reporting on primarily: (i) putative mechanisms of probiotic/symbiotic action, and secondarily (ii) SSIs and SRCs outcomes. Random-effect model meta-analysis and meta-regression analysis of outcomes was done. Thirty-five trials comprising 3028 adult patients were included; interventions were probiotics (n = 16) and synbiotics (n = 19 trials). We found that C-reactive protein (CRP) and Interleukin-6 (IL-6) were significantly decreased (SMD: −0.40, 95% CI [−0.79, −0.02], p = 0.041; SMD: −0.41, 95% CI [−0.70, −0.02], p = 0.006, respectively) while concentration of acetic, butyric, and propionic acids were elevated in patients supplemented with probiotics (SMD: 1.78, 95% CI [0.80, 2.76], p = 0.0004; SMD: 0.67, 95% CI [0.37, −0.97], p = 0.00001; SMD: 0.46, 95% CI [0.18, 0.73], p = 0.001, respectively). Meta-analysis confirmed that pro- and synbiotics supplementation was associated with significant reduction in the incidence of SRCs including abdominal distention, diarrhea, pneumonia, sepsis, surgery site infection (including superficial incisional), and urinary tract infection, as well as the duration of antibiotic therapy, duration of postoperative pyrexia, time of fluid introduction, solid diet, and duration of hospital stay (p < 0.05). Probiotics and synbiotics administration counteract SSIs/SRCs via modulating gut-immune response and production of short chain fatty acids.

scholarly journals PREVALENCE OF INJURIES IN BRAZILIAN RECREATIONAL STREET RUNNERS: META-ANALYSIS

2019 ◽  
Vol 25 (2) ◽  
pp. 161-167 ◽  
Author(s):  
Wyngrid Porfirio Borel ◽  
José Elias Filho ◽  
Juliano Bergamaschine Mata Diz ◽  
Poliana Fernandes Moreira ◽  
Priscila Monteiro Veras ◽  
...  
Keyword(s):  
Associated Factors ◽  
Low Cost ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Knee Injuries ◽  
Muscle Injuries ◽  
Level Of Evidence ◽  
Meta Regression Analysis ◽  
Type Of Injury

ABSTRACT Street running is an accessible, low-cost form of exercise. However, the occurrence of musculoskeletal injuries may hinder regular practice. This study aimed at estimating the prevalence of injuries in Brazilian street runners and the associated factors. A meta-analysis of Brazilian studies was performed to investigate the prevalence and risk factors of injuries in male and female recreational street runners aged ≥18 years. We excluded systematic review studies, research conducted on professional athletes or triathletes, and duplicate articles. The following databases were used: SciELO, LILACS, PubMed, Web of Science, and Google Scholar. Keywords such as “prevalence,” “injury,” “recreational street runners,” and “Brazil” were used. Prevalence analysis was performed using the random effect model, and a funnel plot was used to assess publication bias. Then the Begg-Mazumdar and Egger tests were applied to quantify the graph results. The Prevalence Critical Appraisal Instrument was used to evaluate the methodological quality of the studies. Associated factors were analyzed with meta-regression analysis. Twenty-three studies with 3,786 runners were included in the review. The prevalence of injury was 36.5% (95% confidence interval [CI] 30.8-42.5%), and a running distance per week greater than 20 km was a predictive variable of injuries. A higher prevalence of injuries was observed in men than in women (28.3%, 95% CI 22.5-35.0%), the knee was the most affected site of injury (32.9%, 95% CI 26.7-39.6%), and muscle injuries were the most frequent type of injury (27.9%, 95% CI 18.2-40.1%). This is the first national meta-analysis conducted to investigate the prevalence of injuries in recreational street runners. Although the prevalence of injuries was moderate, caution is required in terms of the weekly duration of running. Male runners are more susceptible, and muscle and knee injuries are the most common. Level of evidence II, Systematic reviewb of Level II Studies.

scholarly journals Stage 2 Registered Report: Anomalous perception in a Ganzfeld condition - A meta-analysis of more than 40 years investigation

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 234
Author(s):  
Patrizio E. Tressoldi ◽  
Lance Storm
Keyword(s):  
Regression Model ◽  
Effect Size ◽  
Close Agreement ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Questionable Research Practices ◽  
Effect Model ◽  
Meta Regression ◽  
Stage 1

This meta-analysis is an investigation into anomalous perception (i.e., conscious identification of information without any conventional sensorial means). The technique used for eliciting an effect is the ganzfeld condition (a form of sensory homogenization that eliminates distracting peripheral noise). The database consists of studies published between January 1974 and December 2020 inclusive. The overall effect size estimated both with a frequentist and a Bayesian random-effect model, were in close agreement yielding an effect size of .088 (.04-.13). This result passed four publication bias tests and seems not contaminated by questionable research practices. Trend analysis carried out with a cumulative meta-analysis and a meta-regression model with Year of publication as covariate, did not indicate sign of decline of this effect size. The moderators analyses show that selected participants outcomes were almost three-times those obtained by non-selected participants and that tasks that simulate telepathic communication show a two-fold effect size with respect to tasks requiring the participants to guess a target. The Stage 1 Registered Report can be accessed here: https://doi.org/10.12688/f1000research.24868.3

scholarly journals Burden of cervical lesion in Ethiopia: Systematic review and meta-analysis

2019 ◽  
Author(s):  
Ayele Semachew ◽  
Tadesse Dagget ◽  
Yeshiwork Beyene ◽  
Getnet Dessie ◽  
Aklilu Endalamaw ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Cervical Lesion ◽  
Online Databases ◽  
Pooled Prevalence ◽  
Meta Regression Analysis ◽  
Study Participants

Abstract Though cervical cancer is largely preventable, it is still the second most common female cancer globally and the leading cause of cancer deaths among females in African. Though many efforts has been done to study the burden of the disease in Ethiopia, there are still fragmented primary studies reported cervical lesion. Hence, this systematic review and meta-analysis aimed in estimating the pooled prevalence of cervical cancer and its trend in Ethiopia. Methods: This systematic review and meta-analysis was conducted using available data. PubMed, Web of Science, SCOPUS, Science Direct, Google Scholar, African Index Medicus (AIM), African Journals Online databases and Ethiopian University research repositories were searched following the Preferred Items for Systematic review and Meta-analysis (PRISMA) guideline. STATA 15 statistical software was used to analyse the data. The quality of included studies was assessed using the Joanna Briggs Institute (JBI) quality appraisal tool for meta-analysis. Heterogeneity between studies was assessed using Cochrane Q test and I2 test statistics based on the random effects model. A random effect model was computed to estimate the pooled prevalence of cervical lesion in Ethiopia. In addition, the trend of cervical lesion in the country was depicted. Result: Fifteen studies with a total of 25,348 participants were included in the analysis. The overall pooled prevalence of cervical lesion was 16.36 (95 CI: 10.97-21.75). The subgroup analysis by region showed the highest prevalence of cervical lesion at the Southern Nations and Nationalities Peoples Region (19.65%; 95% CI: 15.51 – 23.80). The trend of cervical lesion showed an increased pattern overtime from 1992 to 2018 in the meta-regression analysis. Conclusion: One among six of the study participants had cervical lesion. The trend also showed that there is still an increased cervical lesion in the country. Best practices in achieving high vaccination coverage shall be adapted from other successful countries. Key words: Cervical cancer, cervical lesion, systematic review, Ethiopia

Short-term (ST) versus long-term (LT) hormone treatment (HT) in combination with radiotherapy (RT) for locally advanced prostate cancer (LAPC): Meta-analysis of randomized trials (RCTs)

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5128-5128
Author(s):  
F. Cuppone ◽  
E. Bria ◽  
D. Giannarelli ◽  
M. Milella ◽  
E. M. Ruggeri ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Random Effect ◽  
Locally Advanced ◽  
Random Effect Model ◽  
Hormone Treatment ◽  
Significant Heterogeneity ◽  
Cancer Specific Survival ◽  
Relative Risks ◽  
Number Of Patients ◽  
Meta Regression Analysis

5128 Background: Hormone suppression plus RT is able to significantly decrease the recurrences and the mortality of patients (pts) affected by LAPC. In order to determine if difference exists between ST-HT (HT ≤6 months), and LT-HT (HT ≥8 months) in combination with RT for LAPC, a literature-based meta-analysis was conducted. Methods: Event-based relative risks (RR) with 95% confidence intervals (CI) were derived through a random-effect model. Differences in primary (biochemical failure, BF, and cancer-specific survival, CSS), and secondary outcomes (overall survival, OS, and pattern of recurrence, local or distant, LR/DM) were explored. Absolute differences (AD) and the number of patients needed to treat (NNT) were calculated. Heterogeneity test, a meta-regression analysis with clinico-pathological predictors for outcomes and a correlation analysis for surrogate end-points were conducted as well. Results: Four trials (3,148 patients) were gathered. Data were available for all RCTs only for BF; patient population ranged from 297 to 1,521 pts. Three predictors were identified: median PSA (range 9.5–20.35), Gleason score 7–10 (27–55% pts/trial) and T3–4 (13–77% pts/trial). None of the selected predictors did significantly affect any outcomes. A significant correlation and trend between the log of the BF-RR and DM and OS were found (p=0.029 and p=0.07, respectively). Conclusions: Although with significant heterogeneity (reflecting different patient’ risk stratifications), LT-HT seems to significantly decrease biochemical, local and distant recurrences, and increase cancer specific survival in comparison with ST-HT. Balancing these advantages with toxicities and costs represents the next step of the current analysis. [Table: see text] No significant financial relationships to disclose.

Long-Term Efficacy of Methylphenidate Immediate-Release for the Treatment of Childhood ADHD

2016 ◽  
Vol 21 (1) ◽  
pp. 3-13 ◽  
Author(s):  
Carlos Renato Moreira Maia ◽  
Samuele Cortese ◽  
Arthur Caye ◽  
Thomas Kuhn Deakin ◽  
Guilherme Vanoni Polanczyk ◽  
...  
Keyword(s):  
Random Effect ◽  
Random Effect Model ◽  
Immediate Release ◽  
Long Term Effects ◽  
Childhood Adhd ◽  
Meta Regression ◽  
Meta Regression Analysis ◽  
Inattention And Hyperactivity ◽  
Meta Analyses

Objective: To evaluate the long-term effects of methylphenidate imediate-release (MPH-IR), and to confirm the efficacy established in previous meta-analyses of short-term studies. Method: Published and unpublished studies in which participants were treated with MPH-IR for 12 weeks or more were searched. Pooled effect sizes from these studies were computed with the DerSimonian and Laird random-effect model. Meta-regression analysis was conducted to estimate covariates associated with treatment effects. Results: Seven studies were included. Pooled parents ratings for inattention and hyperactivity/impulsivity resulted in standardized mean difference (SMD) = 0.96 (95% confidence interval [CI] = [0.60, 1.32]) and SMD = 1.12 (95% CI = [0.85, 1.39]), respectively; pooled teachers ratings showed SMD = 0.98 (95% CI = [0.09, 1.86]) for inattention and SMD = 1.25 (95% CI = [0.7, 1.81]) for hyperactivity/impulsivity. No evidence of association of any covariates with treatment effect was detected in the meta-regression. Conclusion: MPH-IR is efficacious for childhood ADHD for periods longer than 12 weeks.

scholarly journals Characteristics of PSA Bounce after Radiotherapy for Prostate Cancer: A Meta-Analysis

Cancers ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2180
Author(s):  
Narisa Dewi Maulany Darwis ◽  
Takahiro Oike ◽  
Nobuteru Kubo ◽  
Soehartati A Gondhowiardjo ◽  
Tatsuya Ohno
Keyword(s):  
Prostate Cancer ◽  
Meta Analysis ◽  
Random Effect ◽  
Specific Antigen ◽  
Risk Classification ◽  
Occurrence Rate ◽  
Psa Bounce ◽  
Random Effect Modeling ◽  
Meta Regression ◽  
Meta Regression Analysis

The rate and characteristics of prostate-specific antigen (PSA) bounce post-radiotherapy remain unclear. To address this issue, we performed a meta-analysis. Reports of PSA bounce post-radiotherapy with a cutoff of 0.2 ng/mL were searched by using Medline and Web of Science. The primary endpoint was the occurrence rate, and the secondary endpoints were bounce characteristics such as amplitude, time to occurrence, nadir value, and time to nadir. Radiotherapy modality, age, risk classification, androgen deprivation therapy, and the follow-up period were extracted as clinical variables. Meta-analysis and univariate meta-regression were performed with random-effect modeling. Among 290 search-positive studies, 50 reports including 26,258 patients were identified. The rate of bounce was 31%; amplitude was 1.3 ng/mL; time to occurrence was 18 months; nadir value was 0.5 ng/mL; time to nadir was 33 months. Univariate meta-regression analysis showed that radiotherapy modality (29.7%), age (20.2%), and risk classification (12.2%) were the major causes of heterogeneity in the rate of bounce. This is the first meta-analysis of PSA bounce post-radiotherapy. The results are useful for post-radiotherapy surveillance of prostate cancer patients.

scholarly journals Socioeconomic Factors and Caries in People between 19 and 60 Years of Age: An Update of a Systematic Review and Meta-Analysis of Observational Studies

2018 ◽  
Vol 15 (8) ◽  
pp. 1775 ◽  
Author(s):  
Simone Costa ◽  
Carolina Martins ◽  
Mânia Pinto ◽  
Mara Vasconcelos ◽  
Mauro Abreu
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Socioeconomic Indicators ◽  
Effect Model ◽  
Statistical Heterogeneity ◽  
Newcastle Ottawa Scale ◽  
Meta Regression ◽  
Ottawa Scale

This study is aimed to perform an update of a systematic review and meta-regression to evaluate the effect modification of the socioeconomic indicators on caries in adults. We included studies that associated social determinants with caries, with no restriction of year and language. The Newcastle-Ottawa Scale was used to evaluate the risk of bias. With regard to the meta-analysis, statistical heterogeneity was evaluated by I2, and the random effect model was used when it was high. A subgroup analysis was conducted for socioeconomic indicators, and a meta-regression was performed. Publication bias was assessed through Egger’s test. Sixty-one studies were included in the systematic review and 25 were included in the meta-analysis. All of the studies were published between 1975 and 2016. The most frequent socioeconomic indicators were schooling, income, and socioeconomic status (SES). In the quantitative analysis, the DMFT (decayed, missing, filled teeth) variation was attributed to the studies’ heterogeneity. The increase of 10.35 units in the proportion of people with lower SES was associated with an increase of one unit in DMFT, p = 0.050. The findings provide evidence that populations with the highest proportions of people with low SES are associated with a greater severity of caries. The results suggest the need for actions to reduce the inequalities in oral health (PROSPERO [CRD42017074434]).

scholarly journals Estimates and Correlates of District-Level Maternal Mortality Ratio in India

2021 ◽  
Author(s):  
Srinivas Goli ◽  
Parul Puri ◽  
Pradeep Salve ◽  
Saseendran Pallikadavath ◽  
K.S. James
Keyword(s):  
Maternal Mortality ◽  
Tamil Nadu ◽  
Health Management ◽  
Spatial Clustering ◽  
Local Level ◽  
Maternal Mortality Ratio ◽  
Health Management Information System ◽  
Maternal Deaths ◽  
Registration System ◽  
Mortality Ratio

Despite the progress achieved, approximately one-quarter of all maternal deaths worldwide occur in India. Till now, India monitors maternal mortality in 18 out of its 36 provinces using information from the periodic sample registration system (SRS). The country does not have reliable routine information on maternal deaths for smaller states and districts. And, this has been a major hurdle in local-level health policy and planning to prevent avoidable maternal deaths. For the first time, using triangulation of routine records of maternal deaths under Health Management Information System (HMIS), Census of India, and SRS, we provide Maternal Mortality Ratio (MMR) for all states and districts of India. Also, we examined socio-demographic and health care correlates of MMR using large-sample and robust statistical tools. The findings suggest that 70% of districts (448 out of 640 districts) in India have reported MMR above 70 deaths-a target set under Sustainable Development Goal-3. According to SRS, only Assam shows MMR more than 200, while our assessment based on HMIS suggests that about 6-states (and two union territory) and 128-districts have MMR above 200. Thus, the findings highlight the presence of spatial heterogeneity in MMR across districts in the country, with spatial clustering of high MMR in North-eastern, Eastern, and Central regions and low MMR in the Southern and Western regions. Even the better-off states such as Kerala, Tamil Nadu, Andhra Pradesh, Karnataka, and Gujarat have districts of medium-to-high MMR. In order of their importance, fertility levels, the sex ratio at birth, health infrastructure, years of schooling, post-natal care, maternal age and nutrition, and poor economic status have emerged as the significant correlates of MMR. In conclusion, we show that HMIS is a reliable, cost-effective, and routine source of information for monitoring maternal mortality ratio in India and its states and districts.

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