Meta-Analysis of The Association Between Gene Mutation and Tumor Spread Through Air Space in Lung Adenocarcinoma

Abstract Background A series of studies have shown that spread through air spaces (STAS) has a significant effect on surgical outcomes in patients with lung adenocarcinoma. Objectives: The aims of this study are to evaluate the association between gene mutation and STAS in lung adenocarcinoma for preoperative prediction of STAS in lung adenocarcinoma, eventually, which could help us choose appropriate surgical type. Methods The retrieval period was from 2015 to December 2020. The Newcastle-Ottawa quality assessment scale (NOS) was used for assessing the quality of each study. High-quality study was defined as those with ≥6 stars at the NOS. Statistical results were analyzed using the Stata16 statistical package. Results A total of 12 studies were included, including 4790 patients. The results of meta-analysis showed that: In patients with lung adenocarcinoma, the expression of EGFR, KRAS, BRAF, ALK and ROS1 were correlated with the occurrence of STAS, with RR values (95%CI) of 0.75 (0.63~0.90), 1.173 (1.00~1.37), 2.116 (1.17~3.84), 1.71 (1.53~1.90), 1.565 (1.35~1.82), respectively. Conclusion Mutations in KRAS, BRAF, ALK, and ROS1 increase the incidence of STAS in patients with lung adenocarcinoma. Mutations in EGFR decrease the incidence of STAS in patients with lung adenocarcinoma.

Download Full-text

The effectiveness of M-Health associated with cardiac rehabilitation on functional capacity and cardiovascular risk factors: a systematic review and meta-analysis

European Heart Journal ◽

10.1093/eurheartj/ehab724.3118 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

A C Campagnolo Goncalves Toledo ◽

N Soares De Almeida ◽

A Pierucci ◽

A Straioto Salomao ◽

I Ribeiro Lemes ◽

...

Keyword(s):

Functional Capacity ◽

Meta Analysis ◽

Medium Term ◽

Short Term ◽

High Quality ◽

Quality Of Evidence ◽

High Quality Evidence ◽

Quality Evidence

Abstract Introduction Smartphone applications for health (M-Health) seem to overcome barriers to access Cardiovascular Rehabilitation Programs (CRP), because of their high degree of acceptance and also their potential to influence the frequency of physical exercise in weight loss. Objective To analyze the effectiveness of the combination of M-Health and CRP compared to CRP alone on functional capacity, adherence to CRP, management of cardiovascular risk factors in cardiac patients. Design Systematic Review and Meta-Analysis. Methods The following databases were used Medline via Ovid, EMBASE, Central, PEDro and SPORTDiscus via EBSCOhost from their inception until July/2020. We included randomized controlled trials investigating the effects of M-Health in combination with CRP compared to CRP alone in adults with heart disease, and the interventions with M-Health consisted of text messages, e-mails, and applications. The primary outcome of this review was functional capacity, measured by VO2peak, or self-reported physical activity (METs.min/week). PEDro scale was used to assess the methodological quality of the studies and the GRADE approach to assess the overall quality of evidence. Pooled estimates were calculated using a random effect model to obtain mean difference (MD) or standardized mean differences (SMD) and their respectives 95% confidence intervals (CI). Results Nineteen RCTs were eligible, the median risk of bias was 7 out of 10 points. The primary endpoint was analyzed by subgroups, time of intervention and kind of type CRP, eigthteen of these studies assessed functional capacity. CRP in combination with a m-health intervention was more effective than CRP alone in improving VO2peak, ml/min/kg, (MD: 0.84, CI: 0.30 to 1.38; I2=0%, high quality evidence, 12 trials, n=1889) at short-term follow-up, but at medium-term follow-up (MD: 0.84, CI: −0.26 to 1.41; I2=0%, high quality evidence, 8 trials, n=927,). Similarly, CRP associated with m-health was superior to CRP alone in increasing self-reported at short-term, METs.min/week, (MD:1.31, CI: −0.24 to 2.37; I2 = not aplicable, very low quality evidence, 1 trial, n=18), and at medium-term follow-up (MD: 0.18, CI: −0.01 to 0.36; I2=56%, moderate quality evidence, 4 trials, n=1107). Conclusion High quality of evidence shows that M-Health improves cardiorespiratory fitness at short-term follow-up. In addition, supervised program showed to be more effective than non-supervised. Funding Acknowledgement Type of funding sources: None.

Download Full-text

Evidence-based approaches to psychiatry

Shorter Oxford Textbook of Psychiatry ◽

10.1093/med/9780198747437.003.0006 ◽

2017 ◽

pp. 119-134

Author(s):

Paul Harrison ◽

Philip Cowen ◽

Tom Burns ◽

Mina Fazel

Keyword(s):

Patient Experience ◽

Meta Analysis ◽

Psychiatric Research ◽

Evidence Based ◽

High Quality ◽

Qualitative Methodologies ◽

Meta Analyses ◽

Based Medicine ◽

Quality Evidence

‘Evidence-based approaches to psychiatry’ describes the application of evidence-based medicine (EBM) to psychiatric practice. The chapter covers the key processes in EBM, including the formulation of a clinically relevant question, the systematic search for high-quality evidence and the meta-analytic synthesis of data. It demonstrates how evidence-based approaches to psychiatry have led to important developments showing quantitative effects of different treatments through advanced meta-analysis of data from randomized trials. This has underpinned the development of clinical guidelines that have the aim of improving the reliability and quality of treatments that patients receive. The chapter also describes how meta-analyses should be critically reviewed, as well as their problems and limitations. Not all relevant questions in psychiatric research are susceptible to the quantitative approach offered by EBM, and the chapter also outlines how qualitative methodologies can play a key role in answering important questions related, for example, to the patient experience.

Download Full-text

Association between sense of coherence and dental caries: systematic review and meta-analysis

Health Promotion International ◽

10.1093/heapro/daz038 ◽

2019 ◽

Vol 35 (3) ◽

pp. 586-597 ◽

Cited By ~ 2

Author(s):

Thaís Ariane Perdigão Torres ◽

Larissa Corradi-Dias ◽

Patrícia Drummond Oliveira ◽

Carolina Castro Martins ◽

Saul Martins Paiva ◽

...

Keyword(s):

Systematic Review ◽

Dental Caries ◽

Quality Assessment ◽

Sense Of Coherence ◽

Web Of Science ◽

Meta Analysis ◽

Reference List ◽

High Quality ◽

Hand Search ◽

Quality Study

Abstract Sense of coherence (SOC) is regarded as the individuals' capacity for managing the stressors over their lifespan. The aim of this systematic review and meta-analysis was to evaluate the association between SOC and dental caries. Electronic searchers were conducted in six databases: PubMed, Medline, Scopus, Web of Science, Lilacs and Proquest from their date of inception until November/2017. An update took place in August/2018. A hand search in the reference list of the included articles and gray literature search were also carried out. Retrieved titles/abstracts were screened by two review authors. Data of the included articles were extracted and quality assessment was also conducted. The first search retrieved 346 titles/abstracts. The update retrieved 33 records. Following the removal of 70 duplicates, 309 references were screened and 17 were included. The quality assessment ranged from low quality articles to high quality articles. High quality study showed that adult individuals with lower SOC were more likely to have dental caries. Meta-analysis showed that adolescents with low SOC were 5.41 times more likely to present dental caries than adolescents with high SOC (CI = 2.15–13.59). Mothers with low SOC were 5.55 times more likely to have children/adolescents with dental caries than mothers with high SOC (CI = 2.92–10.57). The subgroup analysis exploring continuous data showed that the SOC of mothers of children/adolescents without dental caries was significantly higher than the SOC of mothers of children/adolescents with dental caries (CI = 0.10–0.51). Higher levels of SOC seem to be associated with lower levels of dental caries.

Download Full-text

Medical visit time and predictors in health facilities: a mega systematic review and meta-analysis

International Journal of Human Rights in Healthcare ◽

10.1108/ijhrh-05-2019-0036 ◽

2019 ◽

Vol 12 (5) ◽

pp. 373-402 ◽

Cited By ~ 1

Author(s):

Sakineh Hajebrahimi ◽

Ali Janati ◽

Morteza Arab-Zozani ◽

Mobin Sokhanvar ◽

Elaheh Haghgoshayie ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Visit Time ◽

Medical Visit ◽

High Quality ◽

Content Type ◽

Face To Face ◽

Significant Difference ◽

Meta Analyses

Purpose Visit time is a crucial aspect of patient–physician interaction; its inadequacy can negatively impact the efficiency of treatment and diagnosis. In addition, visit time is a fundamental demand of patients, and it is one of the rights of every patient. The purpose of this paper is to determine factors influencing the consultation length of physicians and to compare consultation length in different countries. Design/methodology/approach MEDLINE (PubMed), Web of Science, Cochrane, ProQuest, Scopus, and Google Scholar were searched. In addition, references of references were checked, and publication lists of individual scholars in the field were examined. We used data sources up to June 2018, without language restriction. We used a random-effects model for the meta-analyses. Meta-analyses were conducted using Comprehensive Meta-Analysis Version (CMA) 3.0. Findings Of 16,911 identified studies, 189 studies were assessed of which 125 cases (67 percent) have been conducted in the USA. A total of 189 studies, 164 (86.77 percent) involved face-to face-consultations. The effects of three variables, physician gender, patient gender, and type of consultation were analyzed. According to moderate and strong evidence studies, no significant difference was found in the consultation lengths of female and male doctors (Q=42.72, df=8, I2=81.27, p=0.891) and patients’ gender (Q=55.98, df=11, I2=80.35, p=0.314). In addition, no significant difference was found in the telemedicine or face-to-face visits (Q=41.25, df=5, I2=87.88, p=0.170). Originality/value In this systematic review and meta-analysis, all of physicians’ visits in 34 countries were surveyed. The evidence suggests that specified variables do not influence the length of consultations. Good relationship is essential to a safe and high-quality consultation and referral process. A high-quality consultation can improve decisions and quality of visits, treatment effectiveness, efficiency of service, quality of care, patient safety and physician and patient satisfaction.

Download Full-text

A Meta-Analysis on the Relationship Between Prayer and Student Outcomes

Education and Urban Society ◽

10.1177/0013124519896841 ◽

2020 ◽

Vol 52 (8) ◽

pp. 1223-1237 ◽

Cited By ~ 1

Author(s):

William Jeynes

Keyword(s):

Socioeconomic Status ◽

Urban Schools ◽

Student Outcomes ◽

Meta Analysis ◽

Behavioral Outcomes ◽

High Quality ◽

Race And Gender ◽

And Gender ◽

The Relationship

A meta-analysis, including 13 studies, was undertaken on the relationship between the exercise of student prayer and academic and behavioral outcomes in urban schools. Analyses both with and without sophisticated controls (e.g., socioeconomic status, race, and gender) were used. Additional analyses were done to determine whether the effects of prayer differed by the quality of the study. The results indicated that the exercise of prayer is associated with better levels of student outcomes. Moreover, the effects of prayer were greater for high-quality studies. The significance of these results is discussed.

Download Full-text

The Effect of Prehospital Epinephrine in Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis

Prehospital and Disaster Medicine ◽

10.1017/s1049023x19004758 ◽

2019 ◽

Vol 34 (05) ◽

pp. 532-539 ◽

Cited By ~ 3

Author(s):

K.T. Ng ◽

W.Y. Teoh

Keyword(s):

Systematic Review ◽

Hospital Discharge ◽

Odds Ratio ◽

Meta Analysis ◽

Spontaneous Circulation ◽

High Quality ◽

Quality Of Evidence ◽

Return Of Spontaneous Circulation ◽

Hospital Cardiac Arrest

AbstractIntroduction:Epinephrine has been recommended for out-of-hospital cardiac arrest (OHCA) resuscitation for nearly one century, but its efficacy and safety remain unclear in the literature. The primary aim of this review was to determine whether epinephrine increases the return of spontaneous circulation in OHCA patients.Methods:A systematic review and meta-analysis were conducted using the following databases: MEDLINE, EMBASE, and CENTRAL, from their inception until October 2018. All the randomized controlled trials (RCTs) were included. Observational studies, case reports, case series, and non-systematic reviews were excluded.Results:Two trials including 8,548 patients were eligible for inclusion in the data synthesis. In patients who received epinephrine during OHCA, the incidence of return of spontaneous circulation was increased, with an odds ratio (95%CI) of 4.25 (3.79-4.75), P <.001, high-quality of evidence. The number of patients transported to hospital was increased in patients who had prehospital epinephrine, with an odds ratio (95%CI) of 2.31 (2.11-2.53), P <.001, high-quality of evidence. The prehospital use of epinephrine was associated with an increased survival to hospital discharge, the odds ratio (95%CI) being 1.43 (1.10-1.87), P = .008, moderate-quality of evidence. No significant effect was noted on the favorable neurologic state of patient at hospital discharge, with an odds ratio (95%CI) of 1.21 (0.90-1.64), P = .21, moderate-quality of evidence.Conclusions:This meta-analysis suggests that the prehospital use of epinephrine increases return of spontaneous circulation, transport of patients to hospital, and survival to hospital discharge for OHCA. However, no significant effects on favorable neurologic function at hospital discharge were demonstrated. The general quality of evidence ranged from moderate to high.

Download Full-text

Meta-analysis of association between CT-based features and tumor spread through air spaces in lung adenocarcinoma

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-020-01287-9 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Qifan Yin ◽

Huien Wang ◽

Hongshang Cui ◽

Wenhao Wang ◽

Guang Yang ◽

...

Keyword(s):

Lung Adenocarcinoma ◽

Tumor Size ◽

Large Scale ◽

Meta Analysis ◽

Systematic Research ◽

Ct Image ◽

Significant Independent Predictor ◽

Tumor Spread ◽

Solid Nodule ◽

Spread Through Air Spaces

Abstract Objective Spread through air space (STAS) is a novel invasive pattern of lung adenocarcinoma and is also a risk factor for recurrence and worse prognosis of lung adenocarcinoma after sublobar resection. The aims of this study are to evaluate the association between computed tomography (CT)-based features and STAS for preoperative prediction of STAS in lung adenocarcinoma, eventually, which could help us choose appropriate surgical type. Methods Systematic research was conducted to search for studies published before September 1, 2019. The association between CT-based features of radiological tumor size>2 cm、pure solid nodule、 part-solid nodule or Percentage of solid component (PSC)>50% and STAS was evaluated. According to rigorous inclusion and exclusion criteria. Eight studies including 2385 patients published between 2015 and 2018 were finally enrolled in our meta-analysis. Results Our results clearly depicted that there is no significant relationship between radiological tumor size>2 cm and STAS with the combined OR of 1.47(95% CI:0.86–2.51). Meta-analysis of 3 studies showed that pure solid nodule in CT image were more likely to spread through air spaces with pooled OR of 3.10(95%CI2.17–4.43). Meta-analysis of 5 studies revealed the part-solid nodule in CT image may be more likely to appear STAS in adenocarcinoma (ADC) (combined OR:3.10,95%CI:2.17–4.43). PSC>50% in CT image was a significant independent predictor in the diagnosis of STAS in ADC from our meta-analysis with combined OR of 2.95(95%CI:1.88–4.63). Conclusion In conclusion, The CT-based features of pure solid nodule、part-solid nodule、PSC>50% are promising imaging biomarkers for predicting STAS in ADC and may substantially influence the choice of surgical type. In future, more studies with well-designed and large-scale are needed to confirm the conclusion.

Download Full-text

Efficacy and Safety of Fuzi Formulae on the Treatment of Heart Failure as Complementary Therapy: A Systematic Review and Meta-Analysis of High-Quality Randomized Controlled Trials

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2019/9728957 ◽

2019 ◽

Vol 2019 ◽

pp. 1-21

Author(s):

Meng-Qi Yang ◽

Yong-Mei Song ◽

Huan-Yu Gao ◽

Yi-Tao Xue

Keyword(s):

Heart Failure ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Risk Of Bias ◽

Controlled Trials ◽

Efficacy And Safety ◽

High Quality ◽

Randomized Controlled ◽

Link Type

Objective. Heart failure is a major public health problem worldwide nowadays. However, the morbidity, mortality, and awareness of heart failure are not satisfied as well as the status of current treatments. According to the standard treatment for chronic heart failure (CHFST), Fuzi (the seminal root of Aconitum carmichaelii Debx.) formulae are widely used as a complementary treatment for heart failure in clinical practice for a long time. We are aiming to assess the efficacy and safety of Fuzi formulae (FZF) on the treatment of heart failure according to high-quality randomized controlled trials (RCTs). Methods. RCTs in PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), and Wanfang Database were searched from their inception until June 2019. In addition, the U.S. National Library of Medicine (clinicaltrials.gov) and the Chinese Clinical Trial Registry (http://www.chictr.org.cn) were also searched. We included RCTs that test the efficacy and safety of FZF for the treatment of heart failure, compared with placebo, CHFST, or placebo plus CHFST. The methodological quality of included studies were evaluated by the Cochrane Collaboration’s tool for assessing risk of bias. RCTs with Cochrane risk of bias (RoB) score ≥4 were included in the analysis. The meta-analysis was conducted through RevMan 5.2 software. The GRADE approach was used to assess the quality of the evidence. Results. Twelve RCTs with 1490 participants were identified. The studies investigated the efficacy and safety of FZF, such as FZF plus the CHFST vs placebo plus CHFST (n = 4), FZF plus CHFST vs CHFST (n = 6), FZF plus digoxin tablets (DT) plus CHFST vs placebo plus DT plus CHFST (n = 1), and FZF plus placebo plus CHFST vs placebo plus DT plus CHFST (n = 1). Meta-analysis indicated that FZF have additional benefits based on the CHFST in reducing plasma NT-proBNP level, MLHFQ scores, Lee’s heart failure scores (LHFs), and composite cardiac events (CCEs). Meanwhile, it also improved the efficacy on TCM symptoms (TCMs), NYHA functional classification (NYHAfc), 6MWD, and LVEF. Adverse events were reported in 6 out of 12 studies without significant statistical difference. However, after assessing the strength of evidence, it was found that only the quality of evidence for CCEs was high, and the others were either moderate or low or very low. So we could not draw confirmative conclusions on its additional benefits except CCEs. Further clinical trials should be well designed to avoid the issues that were identified in this study. Conclusion. The efficacy and additional benefits of FZF for CCEs were certain according to the high-quality evidence assessed through GRADE. However, the efficacy and additional benefits for the other outcomes were uncertain judging from current studies. In addition, the safety assessment has a great room for improvement. Thus, further research studies are needed to find more convincing proofs.

Download Full-text

Predictors of efficacy in depression prevention programmes

The British Journal of Psychiatry ◽

10.1192/bjp.183.5.384 ◽

2003 ◽

Vol 183 (5) ◽

pp. 384-397 ◽

Cited By ~ 123

Author(s):

Eva Jané-Llopis ◽

Clemens Hosman ◽

Rachel Jenkins ◽

Peter Anderson

Keyword(s):

Depressive Symptoms ◽

Research Design ◽

Psychiatric Symptoms ◽

Meta Analysis ◽

Age Groups ◽

High Quality ◽

Prevention Programmes ◽

Quality Of Research ◽

Different Levels

BackgroundWorldwide, 340 million people are affected by depression, with high comorbid, social and economic costs.AimsTo identify potential predictors of effect in prevention programmes.MethodA meta-analysis was made of 69 programmes to reduce depression or depressive symptoms.ResultsThe weighted mean effect size of 0.22 was effective for different age groups and different levels of risk, and in reducing risk factors and depressive or psychiatric symptoms. Programmes with larger effect sizes were multi-component, included competence techniques, had more than eight sessions, had sessions 60–90 min long, had a high quality of research design and were delivered by a health care provider in targeted programmes. Older people benefited from social support, whereas behavioural methods were detrimental.ConclusionsAn 11% improvement in depressive symptoms can be achieved through prevention programmes. Single trial evaluations should ensure high quality of the research design and detailed reporting of results and potential predictors.

Download Full-text