scholarly journals Effectiveness of Mobile Health Interventions on Diabetes and Obesity Treatment and Management: Systematic Review of Systematic Reviews (Preprint)

2019 ◽  
Author(s):  
Youfa Wang ◽  
Jungwon Min ◽  
Jacob Khuri ◽  
Hong Xue ◽  
Bo Xie ◽  
...  

BACKGROUND Diabetes and obesity have become epidemics and costly chronic diseases. The impact of mobile health (mHealth) interventions on diabetes and obesity management is promising; however, studies showed varied results in the efficacy of mHealth interventions. OBJECTIVE This review aimed to evaluate the effectiveness of mHealth interventions for diabetes and obesity treatment and management on the basis of evidence reported in reviews and meta-analyses and to provide recommendations for future interventions and research. METHODS We systematically searched the PubMed, IEEE Xplore Digital Library, and Cochrane databases for systematic reviews published between January 1, 2005, and October 1, 2019. We analyzed 17 reviews, which assessed 55,604 original intervention studies, that met the inclusion criteria. Of those, 6 reviews were included in our meta-analysis. RESULTS The reviews primarily focused on the use of mobile apps and text messaging and the self-monitoring and management function of mHealth programs in patients with diabetes and obesity. All reviews examined changes in biomarkers, and some reviews assessed treatment adherence (n=7) and health behaviors (n=9). Although the effectiveness of mHealth interventions varied widely by study, all reviews concluded that mHealth was a feasible option and had the potential for improving patient health when compared with standard care, especially for glycemic control (−0.3% to −0.5% greater reduction in hemoglobin A<sub>1c</sub>) and weight reduction (−1.0 kg to −2.4 kg body weight). Overall, the existing 6 meta-analysis studies showed pooled favorable effects of these mHealth interventions (−0.79, 95% CI −1.17 to −0.42; I2=90.5). CONCLUSIONS mHealth interventions are promising, but there is limited evidence about their effectiveness in glycemic control and weight reduction. Future research to develop evidence-based mHealth strategies should use valid measures and rigorous study designs. To enhance the effectiveness of mHealth interventions, future studies are warranted for the optimal formats and the frequency of contacting patients, better tailoring of messages, and enhancing usability, which places a greater emphasis on maintaining effectiveness over time.

10.2196/15400 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e15400 ◽  
Author(s):  
Youfa Wang ◽  
Jungwon Min ◽  
Jacob Khuri ◽  
Hong Xue ◽  
Bo Xie ◽  
...  

Background Diabetes and obesity have become epidemics and costly chronic diseases. The impact of mobile health (mHealth) interventions on diabetes and obesity management is promising; however, studies showed varied results in the efficacy of mHealth interventions. Objective This review aimed to evaluate the effectiveness of mHealth interventions for diabetes and obesity treatment and management on the basis of evidence reported in reviews and meta-analyses and to provide recommendations for future interventions and research. Methods We systematically searched the PubMed, IEEE Xplore Digital Library, and Cochrane databases for systematic reviews published between January 1, 2005, and October 1, 2019. We analyzed 17 reviews, which assessed 55,604 original intervention studies, that met the inclusion criteria. Of those, 6 reviews were included in our meta-analysis. Results The reviews primarily focused on the use of mobile apps and text messaging and the self-monitoring and management function of mHealth programs in patients with diabetes and obesity. All reviews examined changes in biomarkers, and some reviews assessed treatment adherence (n=7) and health behaviors (n=9). Although the effectiveness of mHealth interventions varied widely by study, all reviews concluded that mHealth was a feasible option and had the potential for improving patient health when compared with standard care, especially for glycemic control (−0.3% to −0.5% greater reduction in hemoglobin A1c) and weight reduction (−1.0 kg to −2.4 kg body weight). Overall, the existing 6 meta-analysis studies showed pooled favorable effects of these mHealth interventions (−0.79, 95% CI −1.17 to −0.42; I2=90.5). Conclusions mHealth interventions are promising, but there is limited evidence about their effectiveness in glycemic control and weight reduction. Future research to develop evidence-based mHealth strategies should use valid measures and rigorous study designs. To enhance the effectiveness of mHealth interventions, future studies are warranted for the optimal formats and the frequency of contacting patients, better tailoring of messages, and enhancing usability, which places a greater emphasis on maintaining effectiveness over time.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Israel Júnior Borges do Nascimento ◽  
Dónal P. O’Mathúna ◽  
Thilo Caspar von Groote ◽  
Hebatullah Mohamed Abdulazeem ◽  
Ishanka Weerasekara ◽  
...  

Abstract Background Navigating the rapidly growing body of scientific literature on the SARS-CoV-2 pandemic is challenging, and ongoing critical appraisal of this output is essential. We aimed to summarize and critically appraise systematic reviews of coronavirus disease (COVID-19) in humans that were available at the beginning of the pandemic. Methods Nine databases (Medline, EMBASE, Cochrane Library, CINAHL, Web of Sciences, PDQ-Evidence, WHO’s Global Research, LILACS, and Epistemonikos) were searched from December 1, 2019, to March 24, 2020. Systematic reviews analyzing primary studies of COVID-19 were included. Two authors independently undertook screening, selection, extraction (data on clinical symptoms, prevalence, pharmacological and non-pharmacological interventions, diagnostic test assessment, laboratory, and radiological findings), and quality assessment (AMSTAR 2). A meta-analysis was performed of the prevalence of clinical outcomes. Results Eighteen systematic reviews were included; one was empty (did not identify any relevant study). Using AMSTAR 2, confidence in the results of all 18 reviews was rated as “critically low”. Identified symptoms of COVID-19 were (range values of point estimates): fever (82–95%), cough with or without sputum (58–72%), dyspnea (26–59%), myalgia or muscle fatigue (29–51%), sore throat (10–13%), headache (8–12%) and gastrointestinal complaints (5–9%). Severe symptoms were more common in men. Elevated C-reactive protein and lactate dehydrogenase, and slightly elevated aspartate and alanine aminotransferase, were commonly described. Thrombocytopenia and elevated levels of procalcitonin and cardiac troponin I were associated with severe disease. A frequent finding on chest imaging was uni- or bilateral multilobar ground-glass opacity. A single review investigated the impact of medication (chloroquine) but found no verifiable clinical data. All-cause mortality ranged from 0.3 to 13.9%. Conclusions In this overview of systematic reviews, we analyzed evidence from the first 18 systematic reviews that were published after the emergence of COVID-19. However, confidence in the results of all reviews was “critically low”. Thus, systematic reviews that were published early on in the pandemic were of questionable usefulness. Even during public health emergencies, studies and systematic reviews should adhere to established methodological standards.


2020 ◽  
Author(s):  
Matteo Melini ◽  
Andrea Forni ◽  
Francesco Cavallin ◽  
Matteo Parotto ◽  
Gastone Zanette

Abstract Background: Dental anxiety is a condition associated with avoidance of dental treatment and increased medical and surgical risks. This systematic review aims to summarize available evidence on conscious sedation techniques used for the management of Dental anxiety in patients scheduled for third molar extraction surgery, to identify best approaches and knowledge gaps. Methods: A comprehensive search was conducted including MEDLINE/Pubmed, EMBASE, SCOPUS, clinicaltrials.gov and the Cochrane Database of Systematic Reviews through March 2019. Only randomized controlled trials were included. PRISMA guidelines were followed. Risk of bias was appraised as reported in the Cochrane Handbook for Systematic Reviews of Interventions. Results: Seventeen RCTs with a total of 1,788 patients were included. Some aspects limited the feasibility of a meaningful meta-analysis, thus a narrative synthesis was conducted. Conscious sedation was associated with improvement in Dental anxiety in six studies. One study reported lower cortisol levels with midazolam vs. placebo, while another study found significant variation in perioperative renin levels with remifentanil vs. placebo. Conclusions: This review found inconclusive and conflicting findings about the role of Conscious sedation in managing Dental anxiety during third molar extraction surgery. Relevant questions remain unanswered due to the lack of consistent, standardized outcome measures. Future research may benefit from addressing these limitations in study design.


F1000Research ◽  
2021 ◽  
Vol 9 ◽  
pp. 678
Author(s):  
Miranda S. Cumpston ◽  
Joanne E. McKenzie ◽  
James Thomas ◽  
Sue E. Brennan

Introduction: Systematic reviews involve synthesis of research to inform decision making by clinicians, consumers, policy makers and researchers. While guidance for synthesis often focuses on meta-analysis, synthesis begins with specifying the ’PICO for each synthesis’ (i.e. the criteria for deciding which populations, interventions, comparators and outcomes are eligible for each analysis). Synthesis may also involve the use of statistical methods other than meta-analysis (e.g. vote counting based on the direction of effect, presenting the range of effects, combining P values) augmented by visual display, tables and text-based summaries. This study examines these two aspects of synthesis. Objectives: To identify and describe current practice in systematic reviews of health interventions in relation to: (i) approaches to grouping and definition of PICO characteristics for synthesis; and (ii) methods of summary and synthesis when meta-analysis is not used. Methods: We will randomly sample 100 systematic reviews of the quantitative effects of public health and health systems interventions published in 2018 and indexed in the Health Evidence and Health Systems Evidence databases. Two authors will independently screen citations for eligibility. Two authors will confirm eligibility based on full text, then extract data for 20% of reviews on the specification and use of PICO for synthesis, and the presentation and synthesis methods used (e.g. statistical synthesis methods, tabulation, visual displays, structured summary). The remaining reviews will be confirmed as eligible and data extracted by a single author. We will use descriptive statistics to summarise the specification of methods and their use in practice. We will compare how clearly the PICO for synthesis is specified in reviews that primarily use meta-analysis and those that do not. Conclusion: This study will provide an understanding of current practice in two important aspects of the synthesis process, enabling future research to test the feasibility and impact of different approaches.


2017 ◽  
Vol 13 (2) ◽  
pp. 106-132 ◽  
Author(s):  
Satish Kumar ◽  
Sisira Colombage ◽  
Purnima Rao

Purpose The purpose of this paper is to study the status of studies on capital structure determinants in the past 40 years. This paper highlights the major gaps in the literature on determinants of capital structure and also aims to raise specific questions for future research. Design/methodology/approach The prominence of research is assessed by studying the year of publication and region, level of economic development, firm size, data collection methods, data analysis techniques and theoretical models of capital structure from the selected papers. The review is based on 167 papers published from 1972 to 2013 in various peer-reviewed journals. The relationship of determinants of capital structure is analyzed with the help of meta-analysis. Findings Major findings show an increase of interest in research on determinants of capital structure of the firms located in emerging markets. However, it is observed that these regions are still under-examined which provides more scope for research both empirical and survey-based studies. Majority of research studies are conducted on large-sized firms by using secondary data and regression-based models for the analysis, whereas studies on small-sized firms are very meager. As majority of the research papers are written only at the organizational level, the impact of leverage on various industries is yet to be examined. The review highlights the major determinants of capital structure and their relationship with leverage. It also reveals the dominance of pecking order theory in explaining capital structure of firms theoretically as well as statistically. Originality/value The paper covers a considerable period of time (1972-2013). Among very few review papers on capital structure research, to the best of authors’ knowledge; this is the first review to identify what is missing in the literature on the determinants of capital structure while offering recommendations for future studies. It also synthesize the findings of empirical studies on determinants of capital structure statistically.


2021 ◽  
Author(s):  
Hossein Motahari-Nezhad ◽  
Márta Péntek ◽  
László Gulácsi ◽  
Zsombor Zrubka

BACKGROUND Digital biomarkers are defined as objective, quantifiable physiological and behavioral data that are collected and measured by means of digital devices such as portables, wearables, implantables or digestibles. For their widespread adoption in publicly financed healthcare systems, it is important to understand how their benefits translate into improved patient outcomes, which is essential for demonstrating their value. OBJECTIVE To assess the quality and strength of evidence of the impact of digital biomarkers on clinical outcomes compared to interventions without digital biomarkers, reported in systematic reviews. METHODS A comprehensive search for 2019-2020 will be conducted in the PubMed and the Cochrane Library using keywords related to digital biomarkers and a filter for systematic reviews. Original full-text English publications of systematic reviews comparing clinical outcomes of interventions with and without digital biomarkers via meta-analysis will be included. The AMSTAR-2 tool will be used to assess the methodological quality of reviews. To assess the quality of evidence, we will evaluate systematic reviews using the GRADE tool. To detect the possible presence of reporting bias, we will record whether the protocol of the systematic reviews was published before the start of the study. A qualitative summary of results by digital biomarker technology and outcome will be provided. RESULTS This protocol was submitted before data collection. The next steps in this review will be initiated after the protocol is accepted for publication. CONCLUSIONS Our study will provide a comprehensive summary of the highest level of evidence available on digital biomarker interventions. Our results will help identify clinical areas where the use of digital biomarkers leads to favorable clinical outcomes. In addition, our findings will highlight areas of evidence gaps where the clinical benefits of digital biomarkers have not yet been demonstrated.


Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Shimeng Liu ◽  
Wuwei Feng ◽  
Pratik Y Chhatbar ◽  
Bruce I Ovbiagele

Background: The overwhelming majority of strokes can be prevented via optimal vascular risk factor control. However, there remains an evidence practice gap with regard to treatment of vascular risk factors. With the rapid growth worldwide in cell-phone use, Internet connectivity, and digital health technology, mobile health (mHealth) technology may offer a promising approach to bridge these treatment gaps and reduce the global burden of stroke. Objective: To evaluate the effectiveness of mHealth in vascular risk factor control through a systemic review and meta-analysis. Methods: We searched PubMed from January 1, 2000 to May 17, 2016 using keywords: mobile health, mhealth, short message, cellular phone, mobile phone, stroke prevention and control, diabetes mellitus, hypertension, hyperlipidemia and smoking cessation. We performed a meta-analysis of all eligible randomized control clinical trials that assessed the long-term (at 6 months) effect of mHealth. Results: Of 79 articles identified, 13 of them met eligibility criteria (6 for glycemic control and 7 for smoking cessation) and were included for the final meta-analysis. There were no eligible studies for dyslipidemia or hypertension. mHealth resulted in greater HbA1c reduction at 6 months (6 studies; 663 subjects; SMD: -0.44; 95% CI: [-0.82, -0.06], P =0.02; Mean difference of decrease in HbA1c: -0.39%; 95% CI: [-0.74,-0.04], P =0.03). mHealth also led to relatively higher smoking abstinence rates at 6 months (7 studies; 9,514 subjects; OR: 1.54; 95% CI: [1.24, 1.90], P <0.0001). Conclusion: Use of mHealth improves glycemic control and smoking abstinence rates, two factors that may lead to better stroke outcomes. Future mHealth studies should focus on modifying premier vascular risk factors like hypertension, specifically in people with or at risk of stroke.


Author(s):  
Zhihui Li ◽  
Min Chen ◽  
Chunzhi Tang

Objective: The aim of this study is to investigate the impact of acupuncturetherapy on relapse of patients with gouty arthritis (GA). Methods: “gout ORgouty arthritis” AND “a cupuncture therapy OR acupuncture OR moxibustionOR electroacupuncture OR fire needle OR acupotomology OR blood lettingpuncture OR plum blossom needle” were used as search strategies forsearching related studies. Twenty two studies involving 2394 patient s wereenrolled in this research through the analysis of databases of CNKI, Wanfang,VIP, PubMed, Embase and Cochrane Library. Results: The results of pairwise metaanalysis and network meta analysis (NMA) indicated that patients withacupuncture therapy had a significantly lower relapse rate (RR) compared withthose without acupuncture therapy (OR = 0.21, 95% CI: 0.16 0.26, P <0.00001); the follow up time (TFU) and serum urate concentration (SUA)before treatment had no significant effect on the reductio n of RR caused byacupuncture therapy (P > 0.05); and patients treated with acupuncture plusWestern medicine (WM) had the lowest RR (surface under the cumulativeranking [SUCRA] = 85.0%), followed by acupuncture plus traditional Chinesemedicine (TCM, SUC RA = 73.5%), acupuncture only (SUCRA = 72.8%),fourthly acupuncture plus TCM and WM (SUCRA = 33.0%), then TCM(SUCRA = 28.7%), finally WM (SUCRA = 7.0%). Conclusion: Our findingmay facilitate the application of acupuncture therapy in patients with GA. Ourresearch also offered some information for the future research.


2019 ◽  
pp. 429-449
Author(s):  
Kenneth David Strang

The chapter examines the impact of global terrorism on the top most-impacted nations. Global terrorism continues to impact many nations. There are two impacts – actual attacks causing deaths injuries and/or property damage as well as the emerging culture of fear where human rights have regressed – both impact the risk and contingency management community of practice. The critical analysis method is integrated with a meta-analysis of selected studies. Retrospective and inductive analysis techniques are applied. The risk of global terrorism is reviewed and calculated for the most-impacted nations. The recommendations address the emergent risks for contingency planning specialists, practitioners and researchers to consider. Additionally, future research directions are provided.


2019 ◽  
Vol 37 (6) ◽  
pp. 1462-1479 ◽  
Author(s):  
Fernando De Oliveira Santini ◽  
Wagner Junior Ladeira ◽  
Frederike Monika Budiner Mette ◽  
Mateus Canniatti Ponchio

Purpose The purpose of this paper is to determine the antecedents and consequences of financial literacy by using meta-analytic techniques. Design/methodology/approach The authors conducted a meta-analysis of 44 valid studies, which generated a total of 690 observations (effect sizes). Findings The findings showed that the factors influencing financial literacy were as follows: educational level, financial attitude, financial knowledge, financial behaviour, gender, household income and investments. The consequences of financial literacy were the behaviour of incurring avoidable credit and checking fees, credit score, and the willingness to take investment risks. The authors also find some methodological, cultural, economic and theoretical moderations effects between financial literacy and antecedent/consequent constructs. Research limitations/implications This meta-analysis reviewed the relationships found worldwide in the literature on financial literacy. The authors also identified new avenues for future research. Some specific limitations, such as the non-use of qualitative studies, are registered. Originality/value This research tested the impact of the antecedents, consequences and moderators of financial literacy via a meta-analytical review. This meta-analysis contributes to the marketing and financial literature by offering a set of empirical generalisations about the direct and moderation effects investigated.


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