Colchicine is associated with a decreased Risk for myocardial infarction in patients with Gout：A systematic review and meta-analysis

Although colonoscopy is considered the most accurate test for the investigation of colorectal polyps, lesions ≤ 10 mm may be missed in approximately 10%. Chromoscopy may increase the detection of colorectal polyps. A systematic review and meta-analysis was performed to investigate the benefit of cromoscopy in colorectal polyps detection. Seven randomized controlled trials were included (incuding 2,727 participants) comparing polyp detection (both neoplastic and non- neoplastic polyps) in patients submitted to conventional colonoscopy or colonoscopy with chromoscopy. Chromoscopy was associated with a significant improvement in all detection endpoints (number of polyps, number of neoplastic polyps, number of diminutive polyps, number of neoplastic diminutive polyps, proportion of patients with at least one polyp and proportion of patients with at least one neoplastic polyp). However, when highdefinition colonoscopes were used in the control group, chromoscopy benefit does not seem to be significant. Besides, routine use of chromoscopy may have implications in the accessibility of colonoscopy and in the effectiveness of screening programs. Moreover, the benefit of chromoscopy in the era of high-definition colonoscopy is questionable.

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Diagnostic Accuracy of COVID-19 Antibody Tests Authorized by FDA Philippines: A Systematic Review and Meta-Analysis

SciMedicine Journal ◽

10.28991/scimedj-2021-0304-1 ◽

2021 ◽

Vol 3 (4) ◽

pp. 283-301

Author(s):

Carmel Reina R. Chua ◽

Esther Delle E. De los Santos ◽

Karla Veronica H. Escasa ◽

Richmond Louis G. Estolas ◽

Junnealyn Feliciano ◽

...

Keyword(s):

Systematic Review ◽

Diagnostic Accuracy ◽

Random Effects ◽

Meta Analysis ◽

Characteristic Curve ◽

Enzyme Linked Immunosorbent Assay ◽

Serological Tests ◽

Random Effects Models ◽

Specificity And Sensitivity ◽

Antibody Tests

Introduction: Coronavirus Disease (COVID-19) is a highly infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) which has infected many people all over the world. One of the best ways to lessen its spread is through early detection and diagnosis. Various serological tests are now being used as a surveillance tool in the detection of antibodies as a response to SARS-CoV-2. The aim of this study is to evaluate the diagnostic accuracy and performance of the available COVID-19 antibody tests authorized by the Food and Drug Administration (FDA) Philippines that make use of Enzyme-Linked Immunosorbent Assay (ELISA), Chemiluminescence Immunoassay (CLIA) and Lateral Flow Immunoassay (LFIA). Method: Complete published journal articles relevant to the diagnostic accuracy of the three antibody tests were collected using trusted medical journal search engines. The quality of journals was assessed using QUADAS-2 to determine the risk of bias and assess the applicability judgments of diagnostic accuracy studies. Forest plots were used to summarize the performance of LFIA, ELISA and CLIA according to their specificity and sensitivity in detecting various antibodies. Pooled sensitivity and specificity were also done using bivariate random-effects models with its log-likelihood, a corresponding chi-square test statistic, and area under the summary Receiver-Operating Characteristic curve to see the potential heterogeneity in the data and to assess the diagnostic accuracy of the COVID-19 antibody tests. Results: Bivariate random-effects model and areas under the sROC curve were used to evaluate the diagnostic accuracy of COVID-19 antibody tests. The pooled sensitivity in detecting IgG based on CLIA, ELISA, and LFIA were 81.7%, 58.7%, and 74.3% respectively, with an overall of 72.0%. For IgM detection, LFIA has a higher pooled sensitivity of 69.6% than CLIA with 61.0%. Overall, the pooled sensitivity is 68.5%. In IgA detection, only ELISA based test was included with a pooled sensitivity of 84.8%. Lastly, pooled sensitivities for combined antibodies based on ELISA and LFIA were 89.0% and 81.6% respectively, with an overall of 82.5%. On the other hand, all tests excluding ELISA-IgA displayed high pooled specificities with a range of 94.0% to 100.0%. Diagnostic accuracies of the test in detecting IgG, IgM, and combined antibodies were found out to be almost perfect based on the computed area under the sROC with values of 0.973, 0.953, and 0.966, respectively. Conclusion: In this systematic review and meta-analysis, existing evidence on the diagnostic accuracy of antibody tests for COVID-19 were found to be characterized by high risks of bias, consistency in the heterogeneity of sensitivities, and consistency in the homogeneity of high specificities except in IgA detection using ELISA. The bivariate random-effects models showed that there are no significant differences in terms of sensitivity among CLIA, ELISA and LFIA in detecting IgG, IgM, and combined antibodies at a 95% confidence interval. Nonetheless, CLIA, ELISA and LFIA were found to have excellent diagnostic accuracies in the detection of IgG, IgM and combined antibodies as reflected by their AUC values. Doi: 10.28991/SciMedJ-2021-0304-1 Full Text: PDF

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Triclosan-Coated Sutures Reduce the Risk of Surgical Site Infections: A Systematic Review and Meta-analysis

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2014.22 ◽

2015 ◽

Vol 36 (2) ◽

pp. 169-179 ◽

Cited By ~ 24

Author(s):

Anucha Apisarnthanarak ◽

Nalini Singh ◽

Aila Nica Bandong ◽

Gilbert Madriaga

Keyword(s):

Systematic Review ◽

Abdominal Surgery ◽

Random Effects ◽

Meta Analysis ◽

Surgical Site Infections ◽

Sensitivity Analyses ◽

Publication Type ◽

Random Effects Models ◽

Meta Regression ◽

Meta Analyses

OBJECTIVETo analyze available evidence on the effectiveness of triclosan-coated sutures (TCSs) in reducing the risk of surgical site infection (SSI).DESIGNSystematic review and meta-analysis.METHODSA systematic search of both randomized (RCTs) and nonrandomized (non-RCT) studies was performed on PubMed Medline, OVID, EMBASE, and SCOPUS, without restrictions in language and publication type. Random-effects models were utilized and pooled estimates were reported as the relative risk (RR) ratio with 95% confidence interval (CI). Tests for heterogeneity as well as meta-regression, subgroup, and sensitivity analyses were performed.RESULTSA total of 29 studies (22 RCTs, 7 non-RCTs) were included in the meta-analysis. The overall RR of acquiring an SSI was 0.65 (95% CI: 0.55–0.77; I2=42.4%, P=.01) in favor of TCS use. The pooled RR was particularly lower for the abdominal surgery group (RR: 0.56; 95% CI: 0.41–0.77) and was robust to sensitivity analysis. Meta-regression analysis revealed that study design, in part, may explain heterogeneity (P=.03). The pooled RR subgroup meta-analyses for randomized controlled trials (RCTs) and non-RCTs were 0.74 (95% CI: 0.61–0.89) and 0.53 (95% CI: 0.42–0.66), respectively, both of which favored the use of TCSs.CONCLUSIONThe random-effects meta-analysis based on RCTs suggests that TCSs reduced the risk of SSI by 26% among patients undergoing surgery. This effect was particularly evident among those who underwent abdominal surgery.Infect Control Hosp Epidemiol 2015;36(2): 1–11

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Benzodiazepine Use and Risk of Dementia in the Elderly Population: A Systematic Review and Meta-Analysis

Neuroepidemiology ◽

10.1159/000454881 ◽

2016 ◽

Vol 47 (3-4) ◽

pp. 181-191 ◽

Cited By ~ 70

Author(s):

Md. Mohaimenul Islam ◽

Usman Iqbal ◽

Bruno Walther ◽

Suleman Atique ◽

Navneet Kumar Dubey ◽

...

Keyword(s):

Systematic Review ◽

Random Effects ◽

Observational Studies ◽

Meta Analysis ◽

Sensitivity Analyses ◽

Control Group ◽

Clinical Heterogeneity ◽

Dementia Risk ◽

Increased Risk ◽

Benzodiazepine Use

Background: Benzodiazepines are a widely used medication in developed countries, particularly among elderly patients. However, benzodiazepines are known to affect memory and cognition and might thus enhance the risk of dementia. The objective of this review is to synthesize evidence from observational studies that evaluated the association between benzodiazepines use and dementia risk. Summary: We performed a systematic review and meta-analysis of controlled observational studies to evaluate the risk of benzodiazepines use on dementia outcome. All control observational studies that compared dementia outcome in patients with benzodiazepine use with a control group were included. We calculated pooled ORs using a random-effects model. Ten studies (of 3,696 studies identified) were included in the systematic review, of which 8 studies were included in random-effects meta-analysis and sensitivity analyses. Odds of dementia were 78% higher in those who used benzodiazepines compared with those who did not use benzodiazepines (OR 1.78; 95% CI 1.33-2.38). In subgroup analysis, the higher association was still found in the studies from Asia (OR 2.40; 95% CI 1.66-3.47) whereas a moderate association was observed in the studies from North America and Europe (OR 1.49; 95% CI 1.34-1.65 and OR 1.43; 95% CI 1.16-1.75). Also, diabetics, hypertension, cardiac disease, and statin drugs were associated with increased risk of dementia but negative association was observed in the case of body mass index. There was significant statistical and clinical heterogeneity among studies for the main analysis and most of the sensitivity analyses. There was significant statistical and clinical heterogeneity among the studies for the main analysis and most of the sensitivity analyses. Key Messages: Our results suggest that benzodiazepine use is significantly associated with dementia risk. However, observational studies cannot clarify whether the observed epidemiologic association is a causal effect or the result of some unmeasured confounding variable. Therefore, more research is needed.

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Evaluation of the Add-On Effect of Chinese Patent Medicine for Patients with Stable or Unstable Angina: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2013/673193 ◽

2013 ◽

Vol 2013 ◽

pp. 1-15 ◽

Cited By ~ 4

Author(s):

Chen Mao ◽

Vincent C. H. Chung ◽

Jin-Qiu Yuan ◽

Yuan-Yuan Yu ◽

Zu-Yao Yang ◽

...

Keyword(s):

Myocardial Infarction ◽

Systematic Review ◽

Unstable Angina ◽

Western Medicine ◽

Meta Analysis ◽

Control Group ◽

Chinese Patent Medicine ◽

Chinese Herbal ◽

Chinese Patent ◽

Randomized Control

Chinese herbal medicine (CHM) has been widely used as an adjunct to western medicine in treating angina in China. We carried out this systematic review to evaluate the effectiveness of CHM on top of western medicine for angina. This meta-analysis included 46 randomized control trials with 4212 patients. For trials that included stable angina patients, the CHM group had significant lower incidence of total heart events (relative risk(RR)=0.50, 95% confidence interval (CI) 0.33–0.78), myocardial infarction (RR=0.32, 95% CI 0.14–0.72), heart failure (RR=0.37, 95% CI 0.15–0.91), and angina (RR=0.46, 95% CI 0.30–0.71) than that of control group. For trials that included unstable angina patients, CHM led to significantly lower occurrence of total heart events (RR=0.46, 95% CI 0.32–0.66), myocardial infarction (RR=0.37, 95% CI 0.26–0.54), and angina (RR=0.36, 95%CI 0.26–0.51). Likewise, for trials that included stable or unstable angina patients, the rates of myocardial infarction (RR=0.34, 95% CI 0.17–0.68) and angina (RR=0.46, 95% CI 0.30–0.70) in CHM group were significantly lower than that in control group. In conclusion, CHM is very likely to be able to improve the survival of angina patients who are already receiving western medicine.

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The incidence of depression and anxiety in patients with ankylosing spondylitis: A systematic review and meta-analysis

10.21203/rs.2.17685/v1 ◽

2019 ◽

Author(s):

Jamie YE Park ◽

Alyssa M Howren ◽

Enav Z Zusman ◽

John M Esdaile ◽

Mary A De Vera

Keyword(s):

Systematic Review ◽

Ankylosing Spondylitis ◽

Meta Analysis ◽

Included Study ◽

Depression And Anxiety ◽

Random Effects Models ◽

Cochrane Database ◽

Increased Risk ◽

Multivariable Regression ◽

Psychiatric Complications

Abstract Background: As awareness for the importance of mental health continues to expand in rheumatology, it is important to understand the epidemiology of psychiatric complications in ankylosing spondylitis (AS) with the ultimate goal of future prevention and improved quality of care. This study aims to review evidence on the incidence and determinants of depression and/or anxiety among patients with AS. Methods: We searched Medline, Embase, Cochrane Database of Systematic Reviews, CINAHL Complete, and PsycINFO for full-length observational studies that involved a sample or population of patients with AS and assessed depression and/or anxiety. Primary outcomes extracted were: 1) risk estimates for depression and/or anxiety (e.g., relative risk [RR]); and 2) determinants or factors identified as independent predictors of depression and/or anxiety using multivariable regression approaches and corresponding estimates (e.g., odds ratios [OR]). Where relevant, we pooled estimates using random effects models. Results: Out of 783 titles from our search strategy, we reviewed 39 manuscripts. Four studies assessed the incidence of depression and meta-analyzing reported estimates from three of these studies yielded a pooled RR of 1.51 (95% CI 1.28 to 1.79). Differences in risk of depression among men and women with AS were inconclusive, suggesting need for further study. The incidence of anxiety was comparatively less studied with only one included study reporting a hazard ratio of 1.85 (95% CI 1.37 to 2.49). Education level was a key determinant, with lower levels associated with higher odds of depression (OR 6.65; 9% CI 1.36 to 32.51) and anxiety (OR 9.31; 9% CI 1.39 to 62.19) among AS patients. Conclusions: Our systematic review and meta-analysis shows an increased risk of depression and anxiety among patients with AS. These findings suggest the importance of monitoring and care for psychiatric conditions in AS.

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Evaluation of Wearable Technology in Dementia: A Systematic Review and Meta-Analysis

Frontiers in Medicine ◽

10.3389/fmed.2020.501104 ◽

2021 ◽

Vol 7 ◽

Author(s):

Alanna C. Cote ◽

Riley J. Phelps ◽

Nina Shaafi Kabiri ◽

Jaspreet S. Bhangu ◽

Kevin “Kip” Thomas

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Wearable Technology ◽

Physiological Data ◽

Web Searches ◽

Random Effects Models ◽

Cochrane Database ◽

Study Heterogeneity ◽

Mean Differences ◽

Meta Analyses

Background: The objective of this analysis was to systematically review studies employing wearable technology in patients with dementia by quantifying differences in digitally captured physiological endpoints.Methods: This systematic review and meta-analysis was based on web searches of Cochrane Database, PsycInfo, Pubmed, Embase, and IEEE between October 25–31st, 2017. Observational studies providing physiological data measured by wearable technology on participants with dementia with a mean age ≥50. Data were extracted according to PRISMA guidelines and methodological quality assessed independently using Downs and Black criteria. Standardized mean differences between cases and controls were estimated using random-effects models.Results: Forty-eight studies from 18,456 screened abstracts (Dementia: n = 2,516, Control: n = 1,224) met inclusion criteria for the systematic review. Nineteen of these studies were included in one or multiple meta-analyses (Dementia: n = 617, Control: n = 406). Participants with dementia demonstrated lower levels of daily activity (standardized mean difference (SMD), −1.60; 95% CI, −2.66 to −0.55), decreased sleep efficiency (SMD, −0.52; 95% CI, −0.89 to −0.16), and greater intradaily circadian variability (SMD, 0.46; 95% CI, 0.27 to 0.65) than controls, among other measures. Statistical between-study heterogeneity was observed, possibly due to variation in testing duration, device type or patient setting.Conclusions and Relevance: Digitally captured data using wearable devices revealed that adults with dementia were less active, demonstrated increased fragmentation of their sleep-wake cycle and a loss of typical diurnal variation in circadian rhythm as compared to controls.

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The mental health of young people who are not in education, employment, or training: a systematic review and meta-analysis

Social Psychiatry and Psychiatric Epidemiology ◽

10.1007/s00127-021-02212-8 ◽

2021 ◽

Author(s):

Geneviève Gariépy ◽

Sofia M. Danna ◽

Lisa Hawke ◽

Joanna Henderson ◽

Srividya N. Iyer

Keyword(s):

Mental Health ◽

Systematic Review ◽

Substance Use ◽

Random Effects ◽

Mental Health Problems ◽

Meta Analysis ◽

Mental Healthcare ◽

Youth Mental Health ◽

Random Effects Models ◽

Substance Use Problems

Abstract Purpose There are increasing concerns about the intersection between NEET (not in education, employment, or training) status and youth mental ill-health and substance use. However, findings are inconsistent and differ across types of problems. This is the first systematic review and meta-analysis (PROSPERO-CRD42018087446) on the association between NEET status and youth mental health and substance use problems. Methods We searched Medline, EMBASE, Web of Science, ERIC, PsycINFO, and ProQuest Dissertations and Theses (1999–2020). Two reviewers extracted data and appraised study quality using a modified Newcastle–Ottawa Scale. We ran robust variance estimation random-effects models for associations between NEET and aggregate groups of mental ill-health and substance use measures; conventional random-effects models for associations with individual mental/substance use problems; and subgroup analyses to explore heterogeneity. Results We identified 24 studies from 6,120 references. NEET status was associated with aggregate groups of mental ill-health (OR 1.28, CI 1.06–1.54), substance use problems (OR 1.43, CI 1.08–1.89), and combined mental ill-health and substance use measures (OR 1.38, CI 1.15–1.64). Each disaggregated measure was associated with NEET status [mood (OR 1.43, CI 1.21–1.70), anxiety (OR 1.55, CI 1.07–2.24), behaviour problems (OR 1.49, CI 1.21–1.85), alcohol use (OR 1.28, CI 1.24–1.46), cannabis use (OR 1.62, CI 1.07–2.46), drug use (OR 1.99, CI 1.19–3.31), suicidality (OR 2.84, CI 2.04–3.95); and psychological distress (OR 1.10, CI 1.01–1.21)]. Longitudinal data indicated that aggregate measures of mental health problems and of mental health and substance use problems (combined) predicted being NEET later, while evidence for the inverse relationship was equivocal and sparse. Conclusion Our review provides evidence for meaningful, significant associations between youth mental health and substance use problems and being NEET. We, therefore, advocate for mental ill-health prevention and early intervention and integrating vocational supports in youth mental healthcare.

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The incidence of depression and anxiety in patients with ankylosing spondylitis: A systematic review and meta-analysis

10.21203/rs.2.17685/v2 ◽

2020 ◽

Author(s):

Jamie YE Park ◽

Alyssa M Howren ◽

Enav Z Zusman ◽

John M Esdaile ◽

Mary A De Vera

Keyword(s):

Systematic Review ◽

Ankylosing Spondylitis ◽

Meta Analysis ◽

Included Study ◽

Depression And Anxiety ◽

Random Effects Models ◽

Cochrane Database ◽

Increased Risk ◽

Multivariable Regression ◽

Psychiatric Complications

Abstract Background: As awareness for the importance of mental health continues to expand in rheumatology, it is important to understand the epidemiology of psychiatric complications in ankylosing spondylitis (AS) with the ultimate goal of future prevention and improved quality of care. This study aims to review evidence on the incidence and determinants of depression and/or anxiety among patients with AS. Methods: We searched Medline, Embase, Cochrane Database of Systematic Reviews, CINAHL Complete, and PsycINFO for full-length observational studies that involved a sample or population of patients with AS and assessed depression and/or anxiety. Primary outcomes extracted were: 1) risk estimates for depression and/or anxiety (e.g., relative risk [RR]); and 2) determinants or factors identified as independent predictors of depression and/or anxiety using multivariable regression approaches and corresponding estimates (e.g., odds ratios [OR]). Where relevant, we pooled estimates using random effects models. Results: Out of 783 titles from our search strategy, we reviewed 39 manuscripts. Four studies assessed the incidence of depression and meta-analyzing reported estimates from three of these studies yielded a pooled RR of 1.51 (95% CI 1.28 to 1.79). Differences in risk of depression among men and women with AS were inconclusive, suggesting need for further study. The incidence of anxiety was comparatively less studied with only one included study reporting a hazard ratio of 1.85 (95% CI 1.37 to 2.49). Education level was a key determinant, with lower levels associated with higher odds of depression (OR 6.65; 9% CI 1.36 to 32.51) and anxiety (OR 9.31; 9% CI 1.39 to 62.19) among AS patients. Conclusions: Our systematic review and meta-analysis shows an increased risk of depression and anxiety among patients with AS. These findings suggest the importance of monitoring and care for psychiatric conditions in AS.

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Efficacy of Corticosteroids in Patients with SARS, MERS and COVID-19: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm9082392 ◽

2020 ◽

Vol 9 (8) ◽

pp. 2392 ◽

Cited By ~ 1

Author(s):

Keum Hwa Lee ◽

Sojung Yoon ◽

Gwang Hun Jeong ◽

Jong Yeob Kim ◽

Young Joo Han ◽

...

Keyword(s):

Systematic Review ◽

Random Effects ◽

Meta Analysis ◽

Random Effect Model ◽

Control Group ◽

Random Effects Model ◽

Number Of Patients ◽

Significant Difference ◽

Meta Analyses ◽

Coronavirus Infections

(1) Background: The use of corticosteroids in critical coronavirus infections, including severe acute respiratory syndrome (SARS), Middle East Respiratory Syndrome (MERS), or Coronavirus disease 2019 (COVID-19), has been controversial. However, a meta-analysis on the efficacy of steroids in treating these coronavirus infections is lacking. (2) Purpose: We assessed a methodological criticism on the quality of previous published meta-analyses and the risk of misleading conclusions with important therapeutic consequences. We also examined the evidence of the efficacy of corticosteroids in reducing mortality in SARS, MERS and COVID-19. (3) Methods: PubMed, MEDLINE, Embase, and Web of Science were used to identify studies published until 25 April 2020, that reported associations between steroid use and mortality in treating SARS/MERS/COVID-19. Two investigators screened and extracted data independently. Searches were restricted to studies on humans, and articles that did not report the exact number of patients in each group or data on mortality were excluded. We calculated odds ratios (ORs) or hazard ratios (HRs) under the fixed- and random-effect model. (4) Results: Eight articles (4051 patients) were eligible for inclusion. Among these selected studies, 3416 patients were diagnosed with SARS, 360 patients with MERS, and 275 with COVID-19; 60.3% patients were administered steroids. The meta-analyses including all studies showed no differences overall in terms of mortality (OR 1.152, 95% CI 0.631–2.101 in the random effects model, p = 0.645). However, this conclusion might be biased, because, in some studies, the patients in the steroid group had more severe symptoms than those in the control group. In contrast, when the meta-analysis was performed restricting only to studies that used appropriate adjustment (e.g., time, disease severity), there was a significant difference between the two groups (HR 0.378, 95% CI 0.221–0.646 in the random effects model, p < 0.0001). Although there was no difference in mortality when steroids were used in severe cases, there was a difference among the group with more underlying diseases (OR 3.133, 95% CI 1.670–5.877, p < 0.001). (5) Conclusions: To our knowledge, this study is the first comprehensive systematic review and meta-analysis providing the most accurate evidence on the effect of steroids in coronavirus infections. If not contraindicated, and in the absence of side effects, the use of steroids should be considered in coronavirus infection including COVID-19.

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