scholarly journals Comparison of Mifepristone plus Misoprostol with Misoprostol Alone for First Trimester Medical Abortion: A Systematic Review & Meta -Analysis Protocol

2019 ◽  
Author(s):  
Tariku Shimels ◽  
Mebratu Abraha ◽  
Mensur Shafie ◽  
Lemi Belay ◽  
Melsew Getnet
Keyword(s):  
Systematic Review ◽  
Side Effects ◽  
English Language ◽  
Meta Analysis ◽  
Medical Abortion ◽  
First Trimester ◽  
Clinical Trial Registry ◽  
Trimester Abortion ◽  
Registration Number ◽  
Randomized Control

Abstract Background Original clinical trials have demonstrated that the combined mifepristone plus misoprostol has a marked effectiveness on first trimester abortion practices compared to the misoprostol alone regimen. However, there is no clear evidence if this effect holds consistent direction for all main outcomes and, whether subsequent complications or side effects are minimal or not. This review is intended to provide aggregated evidence for this question through comparison of the respective regimens based on findings from previous randomized control trial studies. Methods Randomized control trials which compared mifepristone plus misoprostol with misoprostol alone for first trimester medical abortion and published in English language will be included in the review. Articles attempted to evaluate procedures and mechanisms of first trimester abortion other than mifepristone plus misoprostol combined regimen with misoprostol alone will be excluded. An internet based search of different engines will be undertaken to identify articles on the proposed topic. Using text words contained in the titles and abstracts of relevant articles, a full search of PubMed/Medline, Cochrane CENTRAL, EMBASE, WHO international clinical Trial registry platform and google scholar will be made. Data on participants, study methods, interventions, and outcomes will be abstracted. Included studies will be pooled for meta-analysis. Results will be reported in odds or risk ratio at 95% confidence interval. Discussion This systematic review intends to review the available literature on effectiveness of mifepristone plus misoprostol as compared to misoprostol alone for inducing abortion in the first trimester of pregnancy. In addition, we anticipate that the review will evaluate and compare the incidence of potential complications and side effects following administration of the respective regimen in both populations. Systematic review registration number CRD42019134213

scholarly journals Comparing the efficacy of anti‐infectious drugs for the treatment of mild to severe COVID-19 patients: a protocol for a systematic review and network meta-analysis of randomized clinical trials

2021 ◽  
Author(s):  
Dejene Tolossa Debela ◽  
Kidist Digamo Heraro
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
English Language ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Standard Of Care ◽  
Ethical Considerations ◽  
Primary Endpoints ◽  
Registration Number ◽  
Independent Review

Background: COVID-19 is a viral infection spreading at a great speed and has quickly caused an extensive burden to individuals, families, countries, and the world. No intervention has yet been proven highly effective for the treatment of COVID-19. Different drugs were being evaluated and reported through randomized clinical trials, and more are currently under trial. This review aimed to compare the efficacy of anti-infectious drugs with a comparator of the standard of care or placebo in patients with COVID-19. Methods and analysis: Two independent review authors will extract data and assess a risk of bias using RoB2. Randomized controlled trials (RCT) that evaluate single and/or combined antiviral drugs recommended by WHO latest guideline for the treatment of COVID-19 will be included. We will search for Pub Med, the Cochrane Center for Clinical Trial database (CENTRAL), clinicaltrials.gov, etc. databases for articles published in the English language between December 2019 to April 2021. We will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) involving Network Meta-analysis guidelines for the design and reporting of the results. The primary endpoints will be time to clinical recovery and time to RNA negativity. The certainty of evidence will be evaluated using the GRADE extension of NMA. Data analysis will be performed using the frequentist NMA approach with a netmeta package implemented in R. Ethics and dissemination: There are no ethical considerations associated with this study as we will use publicly available data from previously published studies. We plan to publish results in open access peer-reviewed journals. PROSPERO registration number: ID=CRD42021230919.

scholarly journals Effectiveness, Uses and Safety of Granulocyte Colony Stimulating Factor biosimilars: a protocol for systematic review and meta-analysis

2021 ◽  
Author(s):  
Chi-kadibia Theophilus Ukoma ◽  
Emmanuel Okechukwu Nna ◽  
Helen Chioma Okoye ◽  
Augustine Nwakuche Duru ◽  
Samuel Osobuchi Ngene ◽  
...  
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Reference Product ◽  
Meta Analysis ◽  
Severe Neutropenia ◽  
Cochrane Library ◽  
Published Data ◽  
Mesh Terms ◽  
Statistical Heterogeneity ◽  
Registration Number

Abstract Background Granulocyte Colony-stimulating factors (G-CSF) biosimilars are recombinant biologics that are similar to a reference product, neupogen, a 175 amino acid recombinant human G-CSF. Characteristically, biosimilars are produced from living cells as high molecular weight, heterogenous compounds that are highly immunogenic. They are primarily used to treat febrile and severe neutropenia in oncology patients as well as mobilize peripheral stem cells in transplant donors. However, as biosimilars are produced by biological processes rather than chemical synthesis, their comparable effectiveness and safety are very paramount to clinical uses. We aimed to produce a protocol for consistent and accurate systematic review and meta-analysis of G-CSF biosimilars.Methods We developed a search strategy using MeSH terms, key words and entry terms to search 9 databases: PubMed, AJOL, Embase, Google Scholar, Scopus, Cochrane Library, CINAHL, Web of Science and ResearchGate. Only randomized controlled trials retreivable in the English language will be included in this study. The primary measurable outcomes in this study are uses, effectiveness and safety of G-CSF biosimilars. Identified primary studies will be screened, deduplicated and selected based on study design, inclusion/exclusion criteria and outcome measures using DistillerSR software. Studies will be assessed for methodological, clinical and statistical heterogeneity. Extractable data items for effectiveness measure are: i) proportion of patients with 50% increase in absolute neutrophil count within 3–7 days; ii) resolution of fever within 3–7 days, iii) resolution of intra-oral mucosa ulcers within 7–10 days and iv) resoluton of difficulty in swallowing within 7–10 days. Measures of safety are i) proportion of patients with immunologic reactions, ii) any other documented adverse events. Quality scores and risk of bias for individual studies will be reported. Funnel Plots will be used for assessing publication bias in selected studies. Effect size, variance, SE and % CI and heterogeneity tests will be reported on forest plots using the CMA software version 3. Subgroup analysis and meta-regression will also be included using secondary outcomes as moderators and explanatory variables. The systematic review and meta-analysis will be reported according to PRISMA 2015 Statement.Discussion Ethical approval will not be required since this study will be based on published data. G-CSF biosimilars will be compared with the reference product, neupogen (filgrastin). The uses, effectiveness and safety of the biosimilars will be discussed. The study will also examine short and long acting biosimilars and compare their overall effectiveness. The strength of evidence from this study will be assessed using the NIH Quality assessment for systematic review and meta-analysis.Trial Registration Number The study is registered with PROSPERO, with registration number CRD42021232375

Chasing the Anchor: A Systematic Review and Meta-analysis of Perceptual Anchoring Deficits in Developmental Dyslexia

2020 ◽  
Author(s):  
Kurt D Shulver ◽  
Nicholas A Badcock
Keyword(s):  
Systematic Review ◽  
Reading Ability ◽  
English Language ◽  
Prediction Interval ◽  
Meta Analysis ◽  
Visual Assessment ◽  
Individual Performance ◽  
Future Research ◽  
Significant Heterogeneity ◽  
Eligibility Criteria

We report the results of a systematic review and meta-analysis investigating the relationship between perceptual anchoring and dyslexia. Our goal was to assess the direction and degree of effect between perceptual anchoring and reading ability in typical and atypical (dyslexic) readers. We performed a literature search of experiments explicitly assessing perceptual anchoring and reading ability using PsycInfo (Ovid, 1860 to 2020), MEDLINE (Ovid, 1860 to 2019), EMBASE (Ovid, 1883 to 2019), and PubMed for all available years up to June (2020). Our eligibility criteria consisted of English-language articles and, at minimum, one experimental group identified as dyslexic - either by reading assessment at the time, or by previous diagnosis. We assessed for risk of bias using an adapted version of the Newcastle-Ottawa scale. Six studies were included in this review, but only five (n = 280 participants) were included in the meta-analysis (we were unable to access the necessary data for one study).The overall effect was negative, large and statistically significant; g = -0.87, 95% CI [-1.47, 0.27]: a negative effect size indicating less perceptual anchoring in dyslexic versus non-dyslexic groups. Visual assessment of funnel plot and Egger’s test suggest minimal bias but with significant heterogeneity; Q (4) = 9.70, PI (prediction interval) [-2.32, -0.58]. The primary limitation of the current review is the small number of included studies. We discuss methodological limitations, such as limited power, and how future research may redress these concerns. The variability of effect sizes appears consistent with the inherent variability within subtypes of dyslexia. This level of dispersion seems indicative of the how we define cut-off thresholds between typical reading and dyslexia populations, but also the methodological tools we use to investigate individual performance.

scholarly journals Repetitive transcranial magnetic stimulation treatment for peripartum depression: systematic review & meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hyune June Lee ◽  
Sung Min Kim ◽  
Ji Yean Kwon
Keyword(s):  
Systematic Review ◽  
Transcranial Magnetic Stimulation ◽  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Effect Size ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Peripartum Depression

Abstract Background Peripartum depression is a common disorder with very high potential hazards for both the patients and their babies. The typical treatment options include antidepressants and electroconvulsive therapy. However, these treatments do not ensure the safety of the fetus. Recently, repetitive transcranial magnetic stimulation has emerged as a promising treatment for neuropathies as well as depression. Nevertheless, many studies excluded pregnant women. This systematic review was conducted to confirm whether repetitive transcranial magnetic stimulation was a suitable treatment option for peripartum depression. Methods We performed a systematic review that followed the PRISMA guidelines. We searched for studies in the MEDLINE, PsycINFO, EMBASE, and Cochrane library databases published until the end of September 2020. Eleven studies were selected for the systematic review, and five studies were selected for quantitative synthesis. Data analysis was conducted using Comprehensive Meta-Analysis 3 software. The effect size was analyzed using the standardized mean difference, and the 95% confidence interval (CI) was determined by the generic inverse variance estimation method. Results The therapeutic effect size of repetitive transcranial magnetic stimulation for peripartum depression was 1.394 (95% CI: 0.944–1.843), and the sensitivity analysis effect size was 1.074 (95% CI: 0.689–1.459), indicating a significant effect. The side effect size of repetitive transcranial magnetic stimulation for peripartum depression was 0.346 (95% CI: 0.214–0.506), a meaningful result. There were no severe side effects to the mothers or fetuses. Conclusions From various perspectives, repetitive transcranial magnetic stimulation can be considered an alternative treatment to treat peripartum depression to avoid exposure of fetuses to drugs and the severe side effects of electroconvulsive therapy. Further research is required to increase confidence in the results.

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