The Effectiveness of Internet-Based Self-Help Interventions to Reduce Suicidal Ideation: Protocol for a Systematic Review and Meta-Analysis

Background Suicidal ideation is a highly prevalent condition. There are several barriers for individuals to seek treatment that may be addressed by providing internet-based self-help interventions (ISIs). Current evidence suggests that ISIs for mental disorders may only be effective in reducing suicidal ideation if they specifically target suicidal thoughts or behaviors. Objective The aim of this systematic review and meta-analysis is to investigate the effectiveness of ISIs that directly target suicidal thoughts or behaviors. Methods We will conduct a sensitive systematic literature search in PsycINFO, MEDLINE, the Cochrane Central Register of Controlled Trials, and the Centre for Research Excellence of Suicide Prevention databases. Only randomized controlled trials evaluating the effectiveness of ISIs for suicide prevention will be included. Interventions must be delivered primarily in a Web-based setting; mobile-based interventions and interventions targeting gatekeepers will be excluded. Suicide ideation will be the primary outcome; secondary outcomes will be completed suicides, suicide attempts, depressiveness, anxiety, and hopelessness. Study quality will be assessed using the Cochrane Risk of Bias tool. We will provide a narrative synthesis of included studies. If studies are sufficiently homogenous, we will conduct a meta-analysis of the effectiveness on suicide ideation and, if possible, we will evaluate publication bias using funnel plots. We will evaluate the cumulative evidence in accordance with the Grading of Recommendations Assessment, Development and Evaluation framework. Results This review is in progress, with findings expected by August 2019. Conclusions This systematic review and meta-analysis focuses on the effectiveness of ISIs for suicidal thoughts and behaviors. It will provide guidance to clinical practice and encourage further research by synthesizing the best available evidence. Trial Registration International Prospective Register of Systematic Reviews (PROSPERO) CRD42019130253; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=130253 International Registered Report Identifier (IRRID) PRR1-10.2196/14174

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Effectiveness of Internet-Based Self-Help Interventions to Reduce Suicidal Ideation: Protocol for a Systematic Review and Meta-Analysis (Preprint)

10.2196/preprints.14174 ◽

2019 ◽

Author(s):

Rebekka Büscher ◽

Michelle Torok ◽

Lasse Sander

Keyword(s):

Systematic Review ◽

Suicidal Ideation ◽

Suicide Prevention ◽

Suicide Ideation ◽

Meta Analysis ◽

Current Evidence ◽

Controlled Trials ◽

Cochrane Central Register ◽

Suicidal Thoughts ◽

Self Help

BACKGROUND Suicidal ideation is a highly prevalent condition. Several barriers lead to a gap in healthcare provision, which might be addressed by providing internet-based self-help interventions (ISIs). Current evidence suggests that ISIs for mental disorders might only be effective in reducing suicidal ideation if they specifically target suicidal thoughts or behaviors. OBJECTIVE The aim of this systematic review and meta-analysis is to investigate the effectiveness of ISIs which directly target suicidal thoughts or behaviors. METHODS We will conduct a sensitive systematic literature search in PsycINFO, MEDLINE, the Cochrane Central Register of Controlled Trials (CENTRAL), and the Centre for Research Excellence of Suicide Prevention database (CRESP). Only randomized controlled trials (RCTs) evaluating the effectiveness of ISIs for suicide prevention will be included. Interventions must be delivered primarily in an online setting; mobile-based interventions and interventions targeting gatekeepers will be excluded. Suicide ideation will be the primary outcome; secondary outcomes will be completed suicides, suicide attempts, depressiveness, anxiety and hopelessness. Study quality will be assessed using the Cochrane Risk of Bias tool. We will provide a narrative synthesis of included studies. If studies are sufficiently homogenous, we will conduct a meta-analysis of the effectiveness on suicide ideation and, if possible, we will evaluate publication bias using funnel plots. We will evaluate the cumulative evidence in accordance with the Grading of Recommendations Assessment, Development and Evaluation framework (GRADE). RESULTS This review is in progress, with findings expected by August 2019. CONCLUSIONS This systematic review and meta-analysis focuses on the effectiveness of ISIs for suicidal thoughts and behaviors. It will provide guidance to clinical practice and encourage further research by synthesizing the best available evidence. CLINICALTRIAL PROSPERO International Prospective Register of Systematic Reviews CRD42019130253.

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Mirror therapy simultaneously combined with electrical stimulation for upper limb motor function recovery after stroke: a systematic review and meta-analysis of randomized controlled trials

Clinical Rehabilitation ◽

10.1177/0269215520951935 ◽

2020 ◽

pp. 026921552095193

Author(s):

Alberto Saavedra-García ◽

Jose A Moral-Munoz ◽

David Lucena-Anton

Keyword(s):

Systematic Review ◽

Electrical Stimulation ◽

Motor Function ◽

Upper Limb ◽

Meta Analysis ◽

Mean Difference ◽

Current Evidence ◽

Controlled Trials ◽

Cochrane Central Register ◽

Mirror Therapy

Objective: To evaluate the current evidence on the effectiveness of simultaneous combination of mirror therapy and electrical stimulation in the recovery of upper limb motor function after stroke, compared with conventional therapy, mirror therapy or electrical stimulation isolated. Data sources: Articles published in PubMed, Web of Science, Scopus, Physiotherapy Evidence Database (PEDro), Cochrane Central register of controlled trials and ScienceDirect up to July 2020. Review methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Methodological quality was assessed using the PEDro tool. The RevMan 5.4 statistical software was used to obtain the meta-analysis, through the standardized mean difference and 95% confidence intervals (CI), and to evaluate the risk of bias. The GRADE approach was employed to assess the certainty of evidence. Results: Eight articles were included in this systematic review, seven were included in the meta-analysis. A total of 314 participants were analyzed. The overall quality of the articles included in this review was good. There was no overall significant mean difference on upper limb motor function after stroke using the Upper-Extremity Fugl-Meyer Assessment by 1.56 (95% CI = –2.08, 5.20; P = 0.40; moderate-certainty evidence) and the Box and Block Test results by 1.39 (95% CI = –2.14, 4.92; P = 0.44; high-certainty evidence). There was overall significant difference in the Action Research Arm Test by 3.54 (95% CI = 0.18, 6.90; P = 0.04; high-certainty evidence). Conclusion: Direct scientific evidence about the effectiveness of the combined therapy of mirror therapy and electrical stimulation simultaneously for the improvement of the upper limb motor function after stroke is lacking. Further high-quality and well-designed research is needed.

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Lumbar Fusion for Degenerative Disease: A Systematic Review and Meta-Analysis

Neurosurgery ◽

10.1093/neuros/nyw162 ◽

2017 ◽

Vol 80 (5) ◽

pp. 701-715 ◽

Cited By ~ 31

Author(s):

Daniel Yavin ◽

Steven Casha ◽

Samuel Wiebe ◽

Thomas E Feasby ◽

Callie Clark ◽

...

Keyword(s):

Systematic Review ◽

Cohort Studies ◽

Spinal Stenosis ◽

Lumbar Fusion ◽

Meta Analysis ◽

Current Evidence ◽

Controlled Trials ◽

Cochrane Central Register ◽

Safety And Efficacy ◽

Relative Safety

Abstract BACKGROUND: Due to uncertain evidence, lumbar fusion for degenerative indications is associated with the greatest measured practice variation of any surgical procedure. OBJECTIVE: To summarize the current evidence on the comparative safety and efficacy of lumbar fusion, decompression-alone, or nonoperative care for degenerative indications. METHODS: A systematic review was conducted using PubMed, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (up to June 30, 2016). Comparative studies reporting validated measures of safety or efficacy were included. Treatment effects were calculated through DerSimonian and Laird random effects models. RESULTS: The literature search yielded 65 studies (19 randomized controlled trials, 16 prospective cohort studies, 15 retrospective cohort studies, and 15 registries) enrolling a total of 302 620 patients. Disability, pain, and patient satisfaction following fusion, decompression-alone, or nonoperative care were dependent on surgical indications and study methodology. Relative to decompression-alone, the risk of reoperation following fusion was increased for spinal stenosis (relative risk [RR] 1.17, 95% confidence interval [CI] 1.06-1.28) and decreased for spondylolisthesis (RR 0.75, 95% CI 0.68-0.83). Among patients with spinal stenosis, complications were more frequent following fusion (RR 1.87, 95% CI 1.18-2.96). Mortality was not significantly associated with any treatment modality. CONCLUSION: Positive clinical change was greatest in patients undergoing fusion for spondylolisthesis while complications and the risk of reoperation limited the benefit of fusion for spinal stenosis. The relative safety and efficacy of fusion for chronic low back pain suggests careful patient selection is required (PROSPERO International Prospective Register of Systematic Reviews number, CRD42015020153).

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Exercise for premenstrual syndrome: a systematic review and meta-analysis of randomised controlled trials

BJGP Open ◽

10.3399/bjgpopen20x101032 ◽

2020 ◽

Vol 4 (3) ◽

pp. bjgpopen20X101032 ◽

Cited By ~ 1

Author(s):

Emma Pearce ◽

Kate Jolly ◽

Laura L Jones ◽

Gemma Matthewman ◽

Mandana Zanganeh ◽

...

Keyword(s):

Systematic Review ◽

Premenstrual Syndrome ◽

Randomised Controlled Trials ◽

Primary Outcome ◽

Meta Analysis ◽

Current Evidence ◽

Controlled Trials ◽

Cochrane Central Register ◽

Exercise Interventions ◽

Randomised Controlled

BackgroundExercise is recommended as a treatment for premenstrual syndrome (PMS) in clinical guidelines, but this is currently based on poor-quality trial evidence.AimTo systematically review the evidence for the effectiveness of exercise as a treatment for PMS.Design & settingThis systematic review searched eight major databases, including MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL), and two trial registries from inception until April 2019.MethodRandomised controlled trials (RCTs) comparing exercise interventions of a minimum of 8-weeks duration with non-exercise comparator groups in women with PMS were included. Mean change scores for any continuous PMS outcome measure were extracted from eligible trials and standardised mean differences (SMDs) were calculated where possible. Random-effects meta-analysis of the effect of exercise on global PMS symptoms was the primary outcome. Secondary analyses examined the effects of exercise on predetermined clusters of psychological, physical, and behavioural symptoms.ResultsA total of 436 non-duplicate returns were screened, with 15 RCTs eligible for inclusion (n = 717). Seven trials contributed data to the primary outcome meta-analysis (n = 265); participants randomised to an exercise intervention reported reduced global PMS symptom scores (SMD = -1.08; 95% confidence interval [CI] = -1.88 to -0.29) versus comparator, but with substantial heterogeneity (I2 = 87%). Secondary results for psychological (SMD = -1.67; 95% CI = -2.38 to -0.96), physical (SMD = -1.62; 95% CI = -2.41 to -0.83) and behavioural (SMD = -1.94; 95% CI = -2.45 to -1.44) symptom groupings displayed similar findings. Most trials (87%) were considered at high risk of bias.ConclusionBased on current evidence, exercise may be an effective treatment for PMS, but some uncertainty remains.

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Comprehensive database and individual patient data meta-analysis of randomised controlled trials on psychotherapies reducing suicidal thoughts and behaviour: study protocol

BMJ Open ◽

10.1136/bmjopen-2020-037566 ◽

2020 ◽

Vol 10 (12) ◽

pp. e037566

Author(s):

Mandy Xian Hu ◽

Christina Palantza ◽

Kim Setkowski ◽

Renske Gilissen ◽

Eirini Karyotaki ◽

...

Keyword(s):

Suicidal Ideation ◽

Randomised Controlled Trials ◽

Individual Patient Data ◽

Meta Analysis ◽

Patient Data ◽

Controlled Trials ◽

Cochrane Central Register ◽

Suicidal Thoughts ◽

Comprehensive Database ◽

Randomised Controlled

IntroductionPsychotherapy may reduce suicidal thoughts and behaviour, but its effectiveness is not well examined. Furthermore, conventional meta-analyses are unable to test possible effects of moderators affecting this relationship. This protocol outlines the building of a comprehensive database of the literature in this research field. In addition, we will conduct an individual patient data meta-analysis (IPD-MA) to establish the effectiveness of psychotherapy in reducing suicidality, and to examine which factors moderate the efficacy of these interventions.Methods and analysisTo build a comprehensive database, randomised controlled trials examining the effect of any psychotherapy targeting any psychiatric disorder on suicidal thoughts or behaviour will be identified by running a systematic search in PubMed, Embase, PsycINFO, Web of Science, Scopus and The Cochrane Central Register of Controlled Trials from data inception to 12 August 2019. For the IPD-MA, we will focus on adult outpatients with suicidal ideation or behaviour. In addition, as a comparison group we will focus on a control group (waiting-list, care as usual or placebo). A 1-stage IPD-MA will be used to determine the effectiveness of psychotherapy on suicidal ideation, suicide attempts and/or suicide deaths, and to investigate potential patient-related and intervention-related moderators. Subgroup and sensitivity analyses will be conducted to test the robustness of the findings. Additionally, a conventional MA will be conducted to determine the differences between studies that provided IPD and those that did not. IPD-MA may determine the effectiveness of psychotherapy in reducing suicidality and provide insights into the moderating factors influencing the efficacy of psychotherapy. Answering these questions will inform mental healthcare practitioners about optimal treatments for different groups of individuals with suicidal ideation and/or behaviour and consequently help to reduce suicide risk.Ethics and disseminationAn ethical approval is not required for this study. The results will be published in a peer-review journal.PROSPERO registration numberCRD42020140573

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The Effect of Oat β-Glucan on Postprandial Blood Glucose and Insulin Responses: A Systematic Review and Meta-Analysis

Current Developments in Nutrition ◽

10.1093/cdn/nzab041_048 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 533-533

Author(s):

Andreea Zurbau ◽

Jarvis Noronha ◽

Tauseef Khan ◽

John Sievenpiper ◽

Thomas Wolever

Keyword(s):

Systematic Review ◽

Molecular Weight ◽

Blood Glucose ◽

Meta Analysis ◽

Postprandial Blood Glucose ◽

Current Evidence ◽

Controlled Trials ◽

Cochrane Central Register ◽

Beta Glucan ◽

Soluble Fibre

Abstract Objectives The efficacy of oat beta-glucan (OBG), a viscous soluble fibre, on postprandial glycemic outcomes may depend on the nature of the control and the dose and molecular weight (MW) utilized. We undertook a systematic review and meta-analysis of acute clinical trials to determine whether these features mediate the glycemic and insulinaemic responses to OBG. Methods MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched through October 27, 2020. We included acute, single-meal feeding, controlled trials investigating the effect of OBG (concentrate or oat bran) added to a carbohydrate-containing meal compared to a comparable meal (matched control) or a different carbohydrate-containing meal (unmatched control). Two reviewers extracted the data and assessed the risk of bias and certainty of evidence (GRADE). The primary outcome was incremental area under the curve (iAUC) for blood glucose. Data were pooled using the generic-inverse variance method with random effects model and expressed as ratio of means with [95% Cis]. Results One hundred and three trial comparisons (N = 538) were included. OBG reduced glucose iAUC and iPeak by 23% (0.77 [0.74, 0.81]) and 28% (0.72 [0.64, 0.76]) and insulin by 22% (0.78 [0.72, 0.85]) and 24% (0.76 [0.65, 0.88]), respectively. Dose, molecular-weight and comparator were significant effect modifiers of glucose iAUC and iPeak. Significant linear dose-response relationships were observed for all outcomes. OBG molecular-weight > 300 kg/mol significantly reduced glucose iAUC and iPeak, whereas, molecular-weight < 300 kg/mol did not. Reductions in glucose iAUC (27 vs 20%, p = 0.03) and iPeak (39 vs 25%, p < 0.01) were significantly larger with different vs comparable control-meals. Outcomes were similar in participants with and without diabetes. All outcomes had high certainty-of-evidence. Conclusions Current evidence indicates that the addition of OBG to carbohydrate-containing meals reduces the postprandial glycemic and insulinaemic responses. However, the magnitude of glucose reduction depends on OBG dose, molecular-weight and the comparator. Funding Sources INQUIS Clinical Research Ltd. (formerly GI Labs), and PepsiCo Global R&D

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Inhibition of Aspirin-Induced Gastrointestinal Injury: Systematic Review and Network Meta-Analysis

Frontiers in Pharmacology ◽

10.3389/fphar.2021.730681 ◽

2021 ◽

Vol 12 ◽

Author(s):

Wan-tong Zhang ◽

Miao-ran Wang ◽

Guo-dong Hua ◽

Qiu-yan Li ◽

Xu-jie Wang ◽

...

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Current Evidence ◽

Cochrane Library ◽

Controlled Trials ◽

Large Sample Size ◽

Cochrane Central Register ◽

Gastrointestinal Injury ◽

Randomized Controlled

Background: Administration of aspirin has the potential for significant side effects of gastrointestinal (GI) injury mainly caused by gastric acid stimulation, especially in long-term users or users with original gastrointestinal diseases. The debate on the optimal treatment of aspirin-induced gastrointestinal injury is ongoing. We aimed to compare and rank the different treatments for aspirin-induced gastrointestinal injury based on current evidence.Methods: We searched PubMed, EMBASE, Cochrane Library (Cochrane Central Register of Controlled Trials), and Chinese databases for published randomized controlled trials (RCTs) of different treatments for aspirin-induced gastrointestinal injury from inception to 1 May 2021. All of the direct and indirect evidence included was rated by network meta-analysis under a Bayesian framework.Results: A total of 10 RCTs, which comprised 503 participants, were included in the analysis. The overall quality of evidence was rated as moderate to high. Eleven different treatments, including omeprazole, lansoprazole, rabeprazole, famotidine, geranylgeranylacetone, misoprostol, ranitidine bismuth citrate, chili, phosphatidylcholine complex, omeprazole plus rebamipide, and placebo, were evaluated in terms of preventing gastrointestinal injury. It was suggested that omeprazole plus rebamipide outperformed other treatments, whereas geranylgeranylacetone and placebo were among the least treatments.Conclusion: This is the first systematic review and network meta-analysis of different treatments for aspirin-induced gastrointestinal injury. Our study suggested that omeprazole plus rebamipide might be considered the best option to treat aspirin-induced gastrointestinal injury. More multicenter, high quality, large sample size randomized controlled trials will confirm the advantages of these medicines in the treatment of aspirin-induced gastrointestinal injury in the future.

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Interventional radiology versus operative management for splenic injuries: a study protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-028172 ◽

2019 ◽

Vol 9 (8) ◽

pp. e028172

Author(s):

Masahiro Kashiura ◽

Noritaka Yada ◽

Kazuma Yamakawa

Keyword(s):

Systematic Review ◽

Interventional Radiology ◽

Meta Analysis ◽

Operative Management ◽

Sensitivity Analyses ◽

Definitive Treatment ◽

Controlled Trials ◽

Cochrane Central Register ◽

Statistical Heterogeneity ◽

Non Operative Management

IntroductionOver the past decades, the treatment for blunt splenic injuries has shifted from operative to non-operative management. Interventional radiology such as splenic arterial embolisation generally increases the success rate of non-operative management. However, the type of intervention, such as the first definitive treatment for haemostasis (interventional radiology or surgery) in blunt splenic injuries is unclear. Therefore, we aim to clarify whether interventional radiology improves mortality in patients with blunt splenic trauma compared with operative management by conducting a systematic review and meta-analysis.Methods and analysisWe will search the following electronic bibliographic databases to retrieve relevant articles for the literature review: Medline, Embase and the Cochrane Central Register of Controlled Trials. We will include controlled trials and observational studies published until September 2018. We will screen search results, assess the study population, extract data and assess the risk of bias. Two review authors will extract data independently, and discrepancies will be identified and resolved through a discussion with a third author where necessary. Data from eligible studies will be pooled using a random-effects meta-analysis. Statistical heterogeneity will be assessed by using the Mantel-Haenszel χ² test and the I² statistic, and any observed heterogeneity will be quantified using the I² statistic. We will conduct sensitivity analyses according to several factors relevant for the heterogeneity.Ethics and disseminationOur study does not require ethical approval as it is based on the findings of previously published articles. This systematic review will provide guidance on selecting a method for haemostasis of splenic injuries and may also identify knowledge gaps that could direct further research in the field. Results will be disseminated through publication in a peer-reviewed journal and presentations at relevant conferences.PROSPERO registration numberCRD42018108304.

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632 SUTURED VERSUS MESH-AUGMENTED HIATUS HERNIA REPAIR: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

Diseases of the Esophagus ◽

10.1093/dote/doab052.632 ◽

2021 ◽

Vol 34 (Supplement_1) ◽

Author(s):

Josipa Petric ◽

Tim Bright ◽

David Liu ◽

Melissa Wee ◽

David Watson

Keyword(s):

Systematic Review ◽

Hiatus Hernia ◽

Mesh Repair ◽

Meta Analysis ◽

Hernia Recurrence ◽

Controlled Trials ◽

Cochrane Central Register ◽

Absorbable Mesh ◽

Hiatal Closure

Abstract Repair of large hiatus hernias is increasingly being performed. However, there is no consensus for the optimal technique for hiatal closure between sutured versus mesh-augmented (absorbable or non-absorbable) repair. This meta-analysis systematically reviewed published randomized control trials (RCTs) comparing sutured versus mesh-augmented hiatus hernia (HH) repair. Our primary endpoint was HH recurrence at short- and long-term follow-up. Secondary endpoints were: surgical complications, operative times, dysphagia and quality of life. Methods A systematic review of Medline, Scopus (which encompassed Embase), Cochrane Central Register of Controlled Trials, Web of Science and PubMed was performed to identify relevant studies comparing mesh-augmented versus sutured HH repair. Data were extracted and compared by meta-analysis, using odds ratio and mean differences with 95% confidence intervals. Results Seven RCTs were found which compared mesh-augmented (non-absorbable mesh: n = 296; absorbable mesh: n = 92) with sutured repair (n = 347). There were no significant differences for short-term hernia recurrence (defined as 6–12 months, 10.1% mesh versus 15.5% sutured, P = 0.22), long-term hernia recurrence (defined as 3–5 years, 30.7% mesh vs 31.3% sutured, P = 0.69), functional outcomes and patient satisfaction. The only statistically significant difference was that the mesh repair required a longer operation time (P = 0.05, OR 2.33, 95% CI 0.03–24.69). Conclusion Mesh repair for hiatus hernia does not offer any advantage over sutured hiatal closure. As both techniques deliver good and comparable clinical outcomes, a suture only technique is still an appropriate approach.

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