scholarly journals An Overview of Systematic Reviews and Meta Analyses on Acupuncture for Post-Acute Stroke Dysphagia

Author(s):  
Zi-Yu Tian ◽  
Xing Liao ◽  
Ying Gao ◽  
Shi-Bing Liang ◽  
Chong-Yang Zhang ◽  
...  

Background: Many randomized controlled trials (RCTs) and systematic reviews (SRs) on acupuncture treatment for post-acute stroke dysphagia have been published. Due to conflicting results an overview of SRs to summarize and assess the quality of this evidence to determine whether acupuncture is effective for this disease was conducted. Methods: Seven databases were searched for SRs and/or Meta-analysis of RCTs and quasi-RCTs on acupuncture for post-acute stroke dysphagia. Two authors independently identified SRs and meta-analyses, collected data to assess the quality of included SRs and meta analyses according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the revised Assessment of Multiple Systematic Reviews (AMSTAR 2). Results: 31 SRs were identified. Quality of 22 SRs was critically low, 5 SRs were low, and 4 Cochrane SRs were moderate when evaluated by AMSTAR2. 17 SRs reported 85.2-96.3% items of PRISMA. Five SRs included explanatory RCTs, 16 SRs included pragmatic RCTs, and 10 SRs included both. Conclusion: Currently evidence on the effectiveness of acupuncture on post-acute stroke dysphagia is low quality. Type of study appeared to have no direct influence on the result, but the primary outcome measures showed a relationship with the quality of SRs. High quality trials with large sample sizes should be the focus of future research. PROSPERO REGISTRATION NUMBER: CRD42019134163

Geriatrics ◽  
2019 ◽  
Vol 4 (4) ◽  
pp. 68 ◽  
Author(s):  
Zi-Yu Tian ◽  
Xing Liao ◽  
Ying Gao ◽  
Shi-Bing Liang ◽  
Chong-Yang Zhang ◽  
...  

Background: Many randomized controlled trials (RCTs) and systematic reviews (SRs) on acupuncture treatment for post-acute stroke dysphagia have been published. Conflicting results from different SRs necessitated an overview to summarize and assess the quality of this evidence to determine whether acupuncture is effective for this condition. The aim was to evaluate methodological quality and summarizing the evidence for important outcomes. Methods: Seven databases were searched for SRs and/or meta-analysis of RCTs and quasi-RCTs on acupuncture for post-acute stroke dysphagia. Two authors independently identified SRs and meta-analyses, collected data to assess the quality of included SRs and meta analyses according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the revised Assessment of Multiple Systematic Reviews (AMSTAR 2). Results: Searches yielded 382 SRs, 31 were included. The quality of 22 SRs was critically low, five SRs were low, and four Cochrane SRs were moderate when evaluated by AMSTAR2. A total of 17 SRs reported 85.2–96.3% of PRISMA items. Five SRs included explanatory RCTs, 16 SRs included pragmatic RCTs, and 10 SRs included both. Conclusion: Currently, evidence on the effectiveness of acupuncture on post-acute stroke dysphagia is of a low quality. The type of study appeared to have no direct influence on the result, but the primary outcome measures showed a relationship with the quality of SRs. High quality trials with large sample sizes should be the focus of future research.


2014 ◽  
Vol 133 (3) ◽  
pp. 206-217 ◽  
Author(s):  
Valter Silva ◽  
Antonio Jose Grande ◽  
Alan Pedrosa Viegas de Carvalho ◽  
Ana Luiza Cabrera Martimbianco ◽  
Rachel Riera

CONTEXT AND OBJECTIVE: Overviews of Systematic Reviews (OoRs) are a new type of study in which multiple evidence from systematic reviews (SRs) is compiled into an accessible and useful document. The aim here was to describe the state of the art and critically assess Cochrane OoRs that have been published.DESIGN AND SETTING: Descriptive study conducted at a research center.METHODS: The OoRs identified through the filter developed in Part I of this study were evaluated in five domains: methodological quality; quality of evidence; implications for practice; general profile of OoRs; and length of work.RESULTS: All 13 OoRs included had high methodological quality. Some OoRs did not present sufficient data to judge the quality of evidence; using sensitivity analysis, the quality of evidence of the OoRs increased. Regarding implications for practice, 64% of the interventions were judged as beneficial or harmful, while 36% of them showed insufficient evidence for judgment. It is expected (with 95% confidence interval) that one OoR will include 9,462 to 64,469 patients, 9 to 29 systematic reviews and 80 to 344 primary studies, and assess 6 to 21 interventions; and that 50 to 92% of OoRs will produce meta-analysis. The OoRs generated 2 to 26 meta-analyses over a period of 18 to 31 months.CONCLUSION: The OoRs presented high methodological quality; the quality of evidence tended to be moderate/high; most interventions were judged to be beneficial/harmful; the mean length of work was 24 months. The OoR profile adds power to decision-making.


BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e042525
Author(s):  
Michail Arvanitidis ◽  
Deborah Falla ◽  
Andy Sanderson ◽  
Eduardo Martinez-Valdes

IntroductionPerforming contractions with minimum force fluctuations is essential for everyday life as reduced force steadiness impacts on the precision of voluntary movements and functional ability. Several studies have investigated the effect of experimental or clinical musculoskeletal pain on force steadiness but with conflicting findings. The aim of this systematic review is to summarise the current literature to determine whether pain, whether it be clinical or experimental, influences force steadiness.Methods and analysisThis protocol for a systematic review was informed and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols and the Cochrane Handbook for Systematic Reviews of Interventions. Key databases will be searched from inception to 31 August 2020, including MEDLINE, EMBASE, PubMed, CINAHL Plus, ZETOC and Web of Science. Grey literature and key journals will be also reviewed. Risk of bias will be assessed with the Newcastle-Ottawa tool, and the quality of the cumulative evidence assessed with the Grading of Recommendations, Assessment, Development and Evaluation guidelines. If homogeneity exists between groups of studies, meta-analysis will be conducted. Otherwise, a narrative synthesis approach and a vote-counting method will be used, while the results will be presented as net increases or decreases of force steadiness.Ethics and disseminationThe findings will be presented at conferences and the review will be also submitted for publication in a refereed journal. No ethical approval was required.PROSPERO registration numberCRD42020196479


Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3303
Author(s):  
Marianne Uhre Jakobsen ◽  
Anette Bysted ◽  
Heddie Mejborn ◽  
Anders Stockmarr ◽  
Ellen Trolle

We conducted an overview of systematic reviews to summarize reviews of cohort studies on intake of unprocessed and processed meat and the risk of cardiovascular disease (CVD), coronary heart disease (CHD), and stroke. Systematic reviews of cohort studies published between January 2010 and August 2020 were identified through a systematic literature search in PubMed, Embase, and Web of Science. The quality of how each review was conducted was assessed and the overall confidence in the results of each review was rated using AMSTAR 2. The quality of evidence of each meta-analysis was graded using NutriGrade. Three reviews were included, with meta-analyses of unprocessed red meat and CVD (n = 1) and stroke (n = 2); unprocessed poultry and stroke (n = 1); and processed meat and CVD (n = 1), CHD (n = 1), and stroke (n = 3). The overall confidence in the results of each review was rated as critically low. The meta-evidence was graded moderate for a positive association between unprocessed red meat and stroke and moderate for a positive association between processed meat and CHD and stroke. For other associations the meta-evidence was graded as low or very low. In conclusion, the associations between unprocessed and processed meat with CVD and major subtypes of CVD have not been extensively investigated.


2022 ◽  
pp. rapm-2021-102981
Author(s):  
Rachel H McGregor ◽  
Freda M Warner ◽  
Lukas D Linde ◽  
Jacquelyn J Cragg ◽  
Jill A Osborn ◽  
...  

BackgroundIn an attempt to aggregate observations from clinical trials, several meta-analyses have been published examining the effectiveness of systemic, non-opioid, pharmacological interventions to reduce the incidence of chronic postsurgical pain.ObjectiveTo inform the design and reporting of future studies, the purpose of our study was to examine the quality of these meta-analyses.Evidence reviewWe conducted an electronic literature search in Embase, MEDLINE, and the Cochrane Database of Systematic Reviews. Published meta-analyses, from the years 2010 to 2020, examining the effect of perioperative, systemic, non-opioid pharmacological treatments on the incidence of chronic postsurgical pain in adult patients were identified. Data extraction focused on methodological details. Meta-analysis quality was assessed using the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) critical appraisal tool.FindingsOur search yielded 17 published studies conducting 58 meta-analyses for gabapentinoids (gabapentin and pregabalin), ketamine, lidocaine, non-steroidal anti-inflammatory drugs, and mexiletine. According to AMSTAR 2, 88.2% of studies (or 15/17) were low or critically low in quality. The most common critical element missing was an analysis of publication bias. Trends indicated an improvement in quality over time and association with journal impact factor.ConclusionsWith few individual trials adequately powered to detect treatment effects, meta-analyses play a crucial role in informing the perioperative management of chronic postsurgical pain. In light of this inherent value and despite a number of attempts, high-quality meta-analyses are still needed.PROSPERO registration numberCRD42021230941.


2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Furong Zhang ◽  
Mingsheng Sun ◽  
Shanshan Han ◽  
Xiaoyu Shen ◽  
Yanan Luo ◽  
...  

Objectives. As current evidence of the effectiveness on acupuncture for primary dysmenorrhea (PD) is inconsistent, we aimed to critically appraise the evidence from relevant systematic reviews (SRs). Methods. SRs of randomized controlled trials (RCTs) concerning acupuncture and PD were searched in four databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and latest Assessment of Multiple Systematic Reviews 2 (AMSTAR2) checklists were used to assess reporting characteristics and methodological quality, respectively. Results. The literature search yielded 38 potential records, of which five met the inclusion criteria. The total average (SD) for PRISMA was 20.60 (1.14) out of 27. All five SRs have more than one critical weakness in AMSTAR2, so their methodological qualities were considered as critically low. The most frequent problems included nonregistration of study protocol, absence of a list of excluded studies, and unclear acknowledgment of conflicts of interests. The three studies of higher methodological quality reported positive results in pain relief. Conclusion. The reporting and methodological quality of systematic reviews and meta-analysis studies were suboptimal, which demands further improvement. More efforts are needed to improve validity of systematic reviews and RCTs in this area.


2019 ◽  
Vol 6 (2) ◽  
pp. 115-121 ◽  
Author(s):  
Yuan Jia ◽  
Li-Min Guo ◽  
Si-Yuan Yang ◽  
Qian Wu ◽  
Fan-Jie Meng

Abstract Objective This study assessed the methodological quality of systematic reviews/meta-analysis of the effectiveness of probiotics against irritable bowel syndrome (IBS) using the accepted methodological quality assessment scale AMSTAR and explored the factors that influenced the quality of methodology. It was designed to provide a reference for future research and systematic reviews/metaanalysis. Methods The methodological quality of existing systematic reviews/meta-analysis was evaluated using the AMSTAR scale. Influencing factors of methodological quality were statistically analyzed using RevMan 5.3 software. The included systematic reviews/metaanalysis must include the following characteristics: (1) methods using systematic evaluation/meta-analysis, (2) probiotic intervention, and (3) language limitation to Chinese and English. Results The AMSTAR score was 5–9 (7.42 ± 1.22), and the quality is above average. The factors affecting the methodological quality are the number of authors and whether they cooperate with the institution. Conclusions Studies have shown that current systematic reviews/meta-analysis of the effectiveness of probiotics on IBS does not fully comply with methodological quality standards, and therefore the methodological quality of research in this area needs to be strengthened. To better clarify how probiotics affect IBS, future systematic reviews and meta-analyses should not only follow methodological quality standards but also include more effective outcome measures, and they should focus more on the discussion of research results. We look forward to the development of higher-quality randomized controlled trials in the future.


BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017868
Author(s):  
Joey S.W. Kwong ◽  
Sheyu Li ◽  
Wan-Jie Gu ◽  
Hao Chen ◽  
Chao Zhang ◽  
...  

IntroductionEffective selection of coronary lesions for revascularisation is pivotal in the management of symptoms and adverse outcomes in patients with coronary artery disease. Recently, instantaneous ‘wave-free’ ratio (iFR) has been proposed as a new diagnostic index for assessing the severity of coronary stenoses without the need of pharmacological vasodilation. Evidence of the effectiveness of iFR-guided revascularisation is emerging and a systematic review is warranted.Methods and analysisThis is a protocol for a systematic review of randomised controlled trials and controlled observational studies. Electronic sources including MEDLINE via Ovid, Embase, Cochrane databases and ClinicalTrials.gov will be searched for potentially eligible studies investigating the effects of iFR-guided strategy in patients undergoing coronary revascularisation. Studies will be selected against transparent eligibility criteria and data will be extracted using a prestandardised data collection form by two independent authors. Risk of bias in included studies and overall quality of evidence will be assessed using validated methodological tools. Meta-analysis will be performed using the Review Manager software. Our systematic review will be performed according to the guidance from the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.Ethics and disseminationEthics approval is not required. Results of the systematic review will be disseminated as conference proceedings and peer-reviewed journal publication.Trial registration numberThis protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42017065460.


BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e017883 ◽  
Author(s):  
Dongmei Xie ◽  
Yulin Liao ◽  
Jirong Yue ◽  
Chao Zhang ◽  
Yanyan Wang ◽  
...  

ObjectiveTo compare the effectiveness of five kinds of selenium supplementation for the treatment of patients with Kashin-Beck disease, and rank these selenium supplementations based on their performance.DesignWe searched for all publications between 1 January 1966 and 31 March 2017 using seven electronic databases. GRADE system to network meta-analyses (NMAs) was applied to rate the quality of the evidence. We conducted a random effects model NMA in STATA 12.1 to determine comparative effectiveness of each intervention. Rankings were obtained by using the surface under the cumulative ranking curve (SUCRA) values and mean ranks.ResultsA total of 15 randomised controlled trials involving 2931 patients were included. After assessment of the overall quality of the evidence, we downgraded our primary outcomes from high to low or very low quality. NMAs showed that all five kinds of selenium supplementation had higher metaphysis X-ray improvement which were superior to placebo. Ranking on efficacy indicated that selenium salt was ranked the highest, followed by sodium selenite + vitamin E, selenium enriched yeast, sodium selenite and then sodium selenite + vitamin C.ConclusionsBased on the results of NMA, all five types of selenium supplements are more effective than placebo and so that selenium supplementation is of help in repairing metaphyseal lesions. Since the overall quality of the evidence was low or very low, the SUCRA values may be misleading and should be considered jointly with the The Grading of Recommendations Assessment, Development and Evaluation (GRADE) confidence in the estimates for each comparison. The quality of the evidence is insufficient to draw a conclusion about what method of selenium supplementation is most effective.PROSPERO registration numberCRD42016051874.


2018 ◽  
Vol 157 (04) ◽  
pp. 392-399
Author(s):  
Sebastian Scheidt ◽  
Patrick Vavken ◽  
Cornelius Jacobs ◽  
Sebastian Koob ◽  
Davide Cucchi ◽  
...  

AbstractThe rising number of medical publications makes it difficult to keep up-to-date on scientific knowledge. In recent years, reviews in the form of narrative or systematic publications and meta-analyses have increased. These can only be interpreted and evaluated if the reader understands the techniques used. This review article describes the differences between narrative and systematic reviews, together with the characteristics of meta-analysis, and discusses their interpretation. The concept of systematic reviews and meta-analysis includes a systematic literature search and summary, together with an appraisal of the quality of the publications. Systematic reviews are often considered to be original studies due to their structure and ability to reduce bias.


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