scholarly journals Prevalence And Definitions of Polypharmacy: A Systematic Review And Meta-Analysis

2021 ◽  
Author(s):  
Mahin Delara ◽  
Lauren Murray ◽  
Behnaz Jafari ◽  
Anees Bahji ◽  
Zahra Goodarzi ◽  
...  
Keyword(s):  
Observational Studies ◽  
Meta Analysis ◽  
Population Based ◽  
Administrative Databases ◽  
Significant Heterogeneity ◽  
Cross Sectional ◽  
Factors Associated ◽  
Inpatient Settings ◽  
Study Characteristics ◽  
Meta Regression

Abstract INTRODUCTION: Polypharmacy is common associated with several adverse health outcomes. There are currently no systematic reviews or meta-analyses on the prevalence of polypharmacy and associated factors. We aimed to identify population-based observational studies reporting on the prevalence of polypharmacy and factors associated with polypharmacy. METHODS: MEDLINE, EMBASE, and Cochrane databases with no restriction on date. Population-based observational studies with cross-sectional, case-control, or cohort designs using administrative databases or registries to define or measure polypharmacy among individuals over 19. Using a standardized form, two reviewers independently extracted study characteristics, a crude prevalence rate of polypharmacy and its standard error with 95% confidence intervals (CIs). The risk of bias and quality of studies was assessed using the Newcastle-Ottawa Scale. The main outcome was the prevalence of polypharmacy and factors associated with polypharmacy. Using a random-effects model, pooled prevalence estimates with 95% CI was reported. Subgroup analysis was performed if significant heterogeneity was explored. Meta-regression analysis was conducted to predict polypharmacy prevalence.RESULTS: 106 full-text articles were identifies using 21 unique terms with 138 descriptive definitions of polypharmacy. The pooled estimated prevalence polypharmacy in studies reporting all medication classes was 37% (95% CI: 31%-43%). Differences in polypharmacy prevalence were reported for studies using different numerical threshold and polypharmacy was also associated with study year in meta-regression. Sex, study geography, study design and study setting were not associated with differences in polypharmacy prevalence. DISCUSSION: Our review highlights that polypharmacy is common particularly among older adults and those in inpatient settings. A variety of definitions are used to define polypharmacy and differences in polypharmacy definitions may have implications for understanding the burden or polypharmacy and outcomes associated with polypharmacy. CONCLUSIONS AND IMPLICATIONS: Clinicians should be aware of the common occurrence of polypharmacy in all populations and undertake efforts to minimize inappropriate polypharmacy whenever possible.

scholarly journals Systematic review and meta-analysis of the proportion of non-typhoidal Salmonella cases that develop chronic sequelae

2014 ◽  
Vol 143 (7) ◽  
pp. 1333-1351 ◽  
Author(s):  
J. KEITHLIN ◽  
J. M. SARGEANT ◽  
M. K. THOMAS ◽  
A. FAZIL
Keyword(s):  
Systematic Review ◽  
Haemolytic Uraemic Syndrome ◽  
Observational Studies ◽  
Meta Analysis ◽  
Fisher Syndrome ◽  
Factors Associated ◽  
Inflammatory Bowel ◽  
Meta Regression ◽  
Irritable Bowel ◽  
Chronic Sequelae

SUMMARYThe objective of this systematic review and meta-analysis was to estimate the proportion of cases of non-typhoidal salmonellosis (NTS) that develop chronic sequelae, and to investigate factors associated with heterogeneity. Articles published in English prior to July 2011 were identified by searching PubMed, Agricola, CabDirect, and Food Safety and Technology Abstracts. Observational studies reporting the number of NTS cases that developed reactive arthritis (ReA), Reiter's syndrome (RS), haemolytic uraemic syndrome (HUS), irritable bowel syndrome (IBS), inflammatory bowel disease (IBD) or Guillain–Barré syndrome (GBS), Miller–Fisher syndrome (MFS) were included. Meta-analysis was performed using random effects and heterogeneity was assessed using the I2 value. Meta-regression was used to explore the influence of study-level variables on heterogeneity. A total of 32 studies were identified; 25 reported on ReA, five reported on RS, seven reported on IBS, two reported on IBD, two reported on GBS, one reported on MFS, and two reported on HUS. There was insufficient data in the literature to calculate a pooled estimate for RS, HUS, IBD, GBS, or MFS. The pooled estimate of the proportion of cases of NTS that developed ReA and IBS had substantive heterogeneity, limiting the applicability of a single estimate. Thus, these estimates should be interpreted with caution and reasons for the high heterogeneity should be further explored.

scholarly journals The incidence of pulmonary thromboembolism in COVID-19 patients admitted to the intensive care unit: a meta-analysis and meta-regression of observational studies

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Jun Jie Ng ◽  
Zhen Chang Liang ◽  
Andrew M. T. L. Choong
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Studies ◽  
Pulmonary Thromboembolism ◽  
Meta Analysis ◽  
Weighted Average ◽  
Study Characteristics ◽  
Meta Regression ◽  
Almost All ◽  
Prophylactic Anticoagulation

Abstract Objectives Coronavirus disease 2019 (COVID-19) infection is associated with a prothrombotic state. We performed a meta-analysis of proportions to estimate the weighted average incidence of pulmonary thromboembolism (PTE) in COVID-19 patients who were admitted to the intensive care unit (ICU). Methods We searched various medical databases for relevant studies from 31 December 2019 till 30 September 2020. We included observational studies that reported the incidence of PTE in COVID-19 patients admitted to the ICU. We extracted data related to study characteristics, patient demographics, and the incidence of PTE. Risk of bias was assessed by using the ROBINS-I tool. Statistical analysis was performed with R 3.6.3. Results We included 14 studies with a total of 1182 patients in this study. Almost all patients in this meta-analysis received at least prophylactic anticoagulation. The weighted average incidence of PTE was 11.1% (95% CI 7.7% to 15.7%, I2 = 78%, Cochran’s Q test P < 0.01). We performed univariate and multivariate meta-regression, which identified the proportion of males as a significant source of heterogeneity (P = 0.03, 95% CI 0.00 to − 0.09) Conclusion The weighted average incidence of PTE remains high even after prophylactic anticoagulation. PTE is a significant complication of COVID-19 especially in critically ill patients in the ICU.

scholarly journals Association of parenting with suicidal ideation and attempts in children and youth: protocol for a systematic review and meta-analysis of observational studies

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Florence Perquier ◽  
Sarah Hetrick ◽  
Terri Rodak ◽  
Xin Jing ◽  
Wei Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Suicidal Ideation ◽  
Observational Studies ◽  
Meta Analysis ◽  
Random Effect ◽  
Children And Youth ◽  
Cochrane Library ◽  
Significant Heterogeneity ◽  
Cross Sectional ◽  
Wide Range

Abstract Background Suicide is a leading cause of death in children and youth, with suicidal thoughts and suicide attempts (referred to as non-fatal suicidal behaviors (NFSB)) being among its strongest predictors. Positive parenting (e.g., warmth, responsiveness), negative parenting (e.g., control, hostility), and parent-child relationship quality (e.g., trust, communication) have been reported to be associated with differences in NFSB in this population. To date, no comprehensive systematic review has considered together the wide range of parenting factors studied in relation to NFSB, and no meta-analysis of existing findings has been conducted. The present study will critically appraise and synthesize the existing evidence from observational studies that examine the relationships between parenting factors and (i) suicidal ideation and (ii) suicide attempt in children and youth. Methods Studies will be retrieved from APA PsycInfo, MEDLINE, CINAHL, Embase, Scopus, and the Cochrane Library databases. Retrospective, cross-sectional, and longitudinal studies, conducted in clinical and population settings, among youth aged less than 25 years and published as articles and dissertations in English or French will be eligible. Two reviewers will select articles using the Covidence Software after title and abstract screening and full-text assessment, will extract information using double data entry, and will appraise studies’ quality using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Any disagreements will be discussed with a third reviewer. Publication bias will be evaluated using funnel plots and Egger’s test. In addition to a narrative summary of results, meta-analyses will be conducted using results from at least three studies. Three-level random effect models will allow to derive pooled estimates from dependent effect sizes (from the same sample or study). In case of significant heterogeneity, moderation analyses will be performed considering participants’ characteristics and methodological aspects of studies. The results will be reported according to the PRISMA guidelines, and the certainty of evidence will be assessed using the GRADE approach. Discussion In highlighting parenting factors associated with NFSB and in estimating the overall strength of these associations in children and youth, our results will inform further intervention and prevention strategies designed for young people experiencing NFSB and their families. Systematic review registration PROSPERO CRD42020165345

scholarly journals The Relationship Between Whole Grain Intake and Body Weight: Results of Meta-analyses of Observational Studies and Randomized Controlled Trials (FS18-07-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Kevin Maki ◽  
Orsolya Palacios ◽  
Katie Koecher ◽  
Caleigh Sawicki ◽  
Kara Livingston ◽  
...  
Keyword(s):  
Prospective Cohort ◽  
Observational Studies ◽  
Weight Status ◽  
Meta Analysis ◽  
Whole Grain ◽  
Cross Sectional ◽  
Randomized Controlled ◽  
Meta Regression ◽  
Meta Regression Analysis ◽  
The Relationship

Abstract Objectives To analyze data from observational studies and randomized controlled trials (RCTs) reporting on the relationship between whole grain (WG) intake and weight status. Methods A systematic literature search was conducted, using Ovid/Medline, to identify observational studies and RCTs assessing WG food intake and weight status in adults. Meta-regression analysis was used to derive pooled estimates from cross-sectional studies, and a meta-analysis with random effects modeling was used to derive pooled estimates from RCTs. Prospective cohort results were assessed qualitatively since differences in methods and outcomes prevented completion of a pooled analysis. Results Eleven publications (12 studies; 136,834 subjects) were included in the meta-regression analysis of cross-sectional data, 8 publications (9 studies; 973 subjects) were included in the meta-analysis of RCTs, and 6 publications were reviewed for qualitative assessment of prospective cohort data. RCT intervention lengths ranged from 12–16 weeks, and WG intake from foods ranged from 32–215 g/d in the WG intervention groups. Meta-regression of cross-sectional studies indicated a significant, inverse correlation between body mass index (BMI) and intake of WG from food: weighted slope −0.0141 kg/m2 per g/d [95% confidence interval (CI): −0.0207, −0.0077; r = −0.526, P = 0.0001]. Meta-analysis of data from RCTs showed a non-significant pooled standardized effect size of −0.049 kg (95% CI −0.297, 0.199, P = 0.698) for the mean difference in weight change for the WG intervention groups compared with controls. No significant differences were observed for secondary variables, including waist circumference and % body fat. Prospective cohort results generally showed inverse associations between weight change and baseline WG intake and change in WG intake over follow-up periods of 5 to 20 years. Conclusions Higher WG intake is significantly inversely associated with BMI in observational studies, but results from RCTs do not show an effect of WG intake on change in weight over periods of up to 16 weeks. RCTs with longer intervention periods are needed to further investigate the potential for WG intake to influence body weight and related anthropometrics. Funding Sources General Mills, Inc., Minneapolis, MN.

scholarly journals The Relationship between Whole Grain Intake and Body Weight: Results of Meta-Analyses of Observational Studies and Randomized Controlled Trials

Nutrients ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 1245 ◽  
Author(s):  
Kevin C. Maki ◽  
Orsolya M. Palacios ◽  
Katie Koecher ◽  
Caleigh M. Sawicki ◽  
Kara A. Livingston ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Weight Change ◽  
Prospective Cohort ◽  
Observational Studies ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Whole Grain ◽  
Cross Sectional ◽  
Randomized Controlled ◽  
Meta Regression

Results from some observational studies suggest that higher whole grain (WG) intake is associated with lower risk of weight gain. Ovid Medline was used to conduct a literature search for observational studies and randomized controlled trials (RCTs) assessing WG food intake and weight status in adults. A meta-regression analysis of cross-sectional data from 12 observational studies (136,834 subjects) and a meta-analysis of nine RCTs (973 subjects) was conducted; six prospective cohort publications were qualitatively reviewed. Cross-sectional data meta-regression results indicate a significant, inverse correlation between WG intake and body mass index (BMI): weighted slope, −0.0141 kg/m2 per g/day of WG intake (95% confidence interval (CI): −0.0207, −0.0077; r = −0.526, p = 0.0001). Prospective cohort results generally showed inverse associations between WG intake and weight change with typical follow-up periods of five to 20 years. RCT meta-analysis results show a nonsignificant pooled standardized effect size of −0.049 kg (95% CI −0.297, 0.199, p = 0.698) for mean difference in weight change (WG versus control interventions). Higher WG intake is significantly inversely associated with BMI in observational studies but not RCTs up to 16 weeks in length; RCTs with longer intervention periods are warranted.

scholarly journals Association between HIV infection and hypertension: a global systematic review and meta-analysis of cross-sectional studies

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Katherine Davis ◽  
Pablo Perez-Guzman ◽  
Annika Hoyer ◽  
Ralph Brinks ◽  
Edward Gregg ◽  
...  
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Meta Analysis ◽  
Hiv Status ◽  
Cross Sectional ◽  
Hypertension Risk ◽  
Meta Regression ◽  
Cross Sectional Studies ◽  
The Relationship ◽  
Hiv Negative

Abstract Background Improved access to effective antiretroviral therapy has meant that people living with HIV (PLHIV) are surviving to older ages. However, PLHIV may be ageing differently to HIV-negative individuals, with dissimilar burdens of non-communicable diseases, such as hypertension. While some observational studies have reported a higher risk of prevalent hypertension among PLHIV compared to HIV-negative individuals, others have found a reduced burden. To clarify the relationship between HIV and hypertension, we identified observational studies and pooled their results to assess whether there is a difference in hypertension risk by HIV status. Methods We performed a global systematic review and meta-analysis of published cross-sectional studies that examined hypertension risk by HIV status among adults aged > 15 (PROSPERO: CRD42019151359). We searched MEDLINE, EMBASE, Global Health and Cochrane CENTRAL to August 23, 2020, and checked reference lists of included articles. Our main outcome was the risk ratio for prevalent hypertension in PLHIV compared to HIV-negative individuals. Summary estimates were pooled with a random effects model and meta-regression explored whether any difference was associated with study-level factors. Results Of 21,527 identified studies, 59 were eligible (11,101,581 participants). Crude global hypertension risk was lower among PLHIV than HIV-negative individuals (risk ratio 0.90, 95% CI 0.85–0.96), although heterogeneity between studies was high (I2 = 97%, p < 0.0001). The relationship varied by continent, with risk higher among PLHIV in North America (1.12, 1.02–1.23) and lower among PLHIV in Africa (0.75, 0.68–0.83) and Asia (0.77, 0.63–0.95). Meta-regression revealed strong evidence of a difference in risk ratios when comparing North American and European studies to African ones (North America 1.45, 1.21–1.74; Europe 1.20, 1.03–1.40). Conclusions Our findings suggest that the relationship between HIV status and prevalent hypertension differs by region. The results highlight the need to tailor hypertension prevention and care to local contexts and underscore the importance of rapidly optimising integration of services for HIV and hypertension in the worst affected regions. The role of different risk factors for hypertension in driving context-specific trends remains unclear, so development of further cohorts of PLHIV and HIV-negative controls focused on this would also be valuable.

scholarly journals THE PREVALENCE OF HIV RECOMBINANT FORMS IN RUSSIA AND COUNTRIES OF THE CIS: SYSTEMATIC REVIEW AND METAANALYSIS

2018 ◽  
Vol 8 (2) ◽  
pp. 127-138 ◽  
Author(s):  
O. A. Pasechnik ◽  
A. I. Blokh
Keyword(s):  
Meta Analysis ◽  
Federal District ◽  
Significant Heterogeneity ◽  
Russian Science ◽  
Cross Sectional ◽  
Subtype B ◽  
Russian Science Citation Index ◽  
Meta Regression ◽  
Cis Countries ◽  
Hiv 1

This review was to aimed to access the prevalence of HIV recombinant forms in Russia and countries of the CIS, which have  close social and economic ties. We conducted a search in Russian  Science Citation Index and PubMed for a depth of 8 years. We  included 22 articles, which contained the results of 35 independent  cross-sectional studies, in our review. Meta-analysis of HIV  recombinant forms prevalence was conducted in Open Meta-analyst  with the use of Der Simonian & Laird method, arcsin transformation  and correction factor for zero values. Subgroup analysis was used  along with meta-regression (by date of collection). Pooled prevalence of HIV recombinant forms was 21.3% (95% CI 16.2–26.5) and was  highly heterogeneous. Blood samples from 3,494 HIV patients living  in various regions of the Russian Federation and CIS countries —  Belarus, Kazakhstan, Kyrgyzstan, Uzbekistan, Tajikistan, Armenia,  Georgia — were examined. Among subtypes of HIV-1, the main  share was occupied by subtype A — 75.6% (n = 2643), subtype B —  5.5% (n = 193), C — 0.8% (n = 31), G — 0.2% (n = 7), F —  0.14% (n = 5). Among the recombinant forms (n = 616), the  fraction of CRF02_ AG was 39.6% (n = 244), CRF02_AG/A was  32.9% (n = 203), CRF63_02A1 was 15.9% (n = 98), CRF03_AB —  5.2% (n = 32), CRF06_cpx — 2.1% (n = 13). Unique recombinant  forms were 2.7% (n = 17), including URF63_A1 (2.5%). In Russia, the highest prevalence of recombinant forms of HIV-1 was  registered in the Siberian Federal District (33.2% (95% CI 12.2– 54.1), the lowest in the Northwest Federal District — 1.6% (95% CI  0.9–2.3). In the CIS countries, the highest prevalence of  recombinant forms of HIV-1 is found in a subgroup of the Central  Asian republics — Uzbekistan, Tajikistan, Kyrgyzstan, Kazakhstan —  51.7% (95% CI 38.5–64.9). The significant upward trend was shown with a meta-regression. Our review is the first such research in  Russia and thus is of significant interest, but the result should be  applied with caution due to high risk of publication bias as well as significant heterogeneity of our results.

The association between dietary inflammatory index and risk of central obesity in adults: An updated systematic review and meta-analysis

2020 ◽  
Vol 90 (5-6) ◽  
pp. 535-552 ◽  
Author(s):  
Mahdieh Abbasalizad Farhangi ◽  
Mahdi Vajdi
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Central Obesity ◽  
Assessment Tool ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Dietary Factors ◽  
Cross Sectional ◽  
Inflammatory Status ◽  
Obesity Indices

Abstract. Backgrounds: Central obesity, as a pivotal component of metabolic syndrome is associated with numerous co-morbidities. Dietary factors influence central obesity by increased inflammatory status. However, recent studies didn’t evaluate the association between central obesity and dietary inflammation index (DII®) that give score to dietary factors according to their inflammatory potential. In the current systematic review and meta-analysis, we summarized the studies that investigated the association between DII® with central obesity indices in the general populations. Methods: In a systematic search from PubMed, SCOPUS, Web of Sciences and Cochrane electronic databases, we collected relevant studies written in English and published until 30 October 2019. The population of included studies were apparently healthy subjects or individuals with obesity or obesity-related diseases. Observational studies that evaluated the association between DII® and indices of central obesity including WC or WHR were included. Results: Totally thirty-two studies were included; thirty studies were cross-sectional and two were cohort studies with 103071 participants. Meta-analysis of observational studies showed that higher DII® scores were associated with 1.81 cm increase in WC (Pooled weighted mean difference (WMD) = 1.813; CI: 0.785–2.841; p = 0.001). Also, a non-significant increase in the odds of having higher WC (OR = 1.162; CI: 0.95–1.43; p = 0.154) in the highest DII category was also observed. In subgroup analysis, the continent, dietary assessment tool and gender were the heterogeneity sources. Conclusion: The findings proposed that adherence to diets with high DII® scores was associated with increased WC. Further studies with interventional designs are necessary to elucidate the causality inference between DII® and central obesity indices.

scholarly journals Factors associated with sarcopenia screened by finger-circle test among middle-aged and older adults: a population-based multisite cross-sectional survey in Japan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daiki Watanabe ◽  
Tsukasa Yoshida ◽  
Takashi Nakagata ◽  
Naomi Sawada ◽  
Yosuke Yamada ◽  
...  
Keyword(s):  
Older Adults ◽  
Smoking Status ◽  
Multiple Logistic Regression Analysis ◽  
Population Based ◽  
Middle Aged ◽  
Cross Sectional ◽  
Factors Associated ◽  
Mail Surveys ◽  
Osaka Prefecture ◽  
Middle Aged Adults

AbstractBackgroundPrevious epidemiological studies have demonstrated the prevalence and relationship of various factors associated with sarcopenia in older adults; however, few have examined the status of sarcopenia in middle-aged adults. In this study, we aimed to, 1) evaluate the validity of the finger-circle test, which is potentially a useful screening tool for sarcopenia, and 2) determine the prevalence and factors associated with sarcopenia in middle-aged and older adults.MethodsWe conducted face-to-face surveys of 525 adults, who were aged 40–91 years and resided in Settsu City, Osaka Prefecture, Japan to evaluate the validity of finger-circle test. The finger-circle test evaluated calf circumference by referring to an illustration printed on the survey form. The area under the receiver operating characteristic curves (AUROC) was plotted to evaluate the validity of the finger-circle test for screening sarcopenia and compared to that evaluated by skeletal muscle mass index (SMI) measured using bioimpedance. We also conducted multisite population-based cross-sectional anonymous mail surveys of 9337 adults, who were aged 40–97 years and resided in Settsu and Hannan Cities, Osaka Prefecture, Japan. Participants were selected through stratified random sampling by sex and age in the elementary school zones of their respective cities. We performed multiple logistic regression analysis to explore associations between characteristics and prevalence of sarcopenia.ResultsSarcopenia, defined by SMI, was moderately predicted by a finger-circle test response showing that the subject’s calf was smaller than their finger-circle (AUROC: 0.729, < 65 years; 0.653, ≥65 years); such subjects were considered to have sarcopenia. In mail surveys, prevalence of sarcopenia screened by finger-circle test was higher in older subjects (approximately 16%) than in middle-aged subjects (approximately 8–9%). In a multiple regression model, the factors associated with sarcopenia were age, body mass index, smoking status, self-reported health, and number of meals in all the participants.ConclusionsSarcopenia, screened by the finger-circle test, was present not only among older adults but also among middle-aged adults. These results may provide useful indications for developing public health programs, not only for the prevention, but especially for the management of sarcopenia.Trial registrationUMIN000036880, registered prospectively May 29, 2019, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000042027

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