Methodological issues in reporting of systematic reviews of mobile applications: A scoping review (Preprint)

2019 ◽  
Author(s):  
Rebecca Grainger ◽  
Hemakumar Devan ◽  
Bahram Sangelaji ◽  
Jean Hay-Smith
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Scoping Review ◽  
Mobile Applications ◽  
Data Extraction ◽  
A Priori ◽  
Health Condition ◽  
Systematic Search ◽  
Health Conditions ◽  
App Store

BACKGROUND An emerging literature describes systematic reviews of the app stores to identify mobile applications (apps) to support diagnosis, assessment or management of health conditions. There are currently no guidelines for the conduct and reporting of methods of these studies. The first step in developing guidelines is to evaluate current reporting of methods of systematic reviews of health apps. OBJECTIVE The aims of this scoping review were: 1. To identify what parts of the ‘usual’ methods of systematic review are used and adapted in app-focused systematic reviews; 2. To describe how methods of critical appraisal are adapted and done; and 3. To assess what clinical recommendations are made and the ‘strength’ of those recommendations. METHODS A systematic search of seven databases was undertaken to identify app-focused systematic reviews meeting the inclusion criteria: (1) the article was “systematic” defined by “systematic review” in the title OR an a priori systematic search procedure described in the article methods OR the app search process described based on PRISMA standard flow diagram; (2) the article described a systematic search for apps in at least one app store; (3) the article focused on a named health condition; and (4) the focus of the article was apps for people with any diagnosed acute or chronic health condition or for clinicians in direct clinical care. Articles were excluded if not in English, focused on general or psychological health or nutrition. A data extraction template was created based on standard data elements in PRISMA guidelines. The extracted data from the included articles were summarised by frequencies. RESULTS From 2798 records, 26 of the 177 potentially eligible full text articles were included. In the 26 included app-focused systematic reviews, many of the typical procedures of a systematic review as operationalized for app-focused reviews were not reported at all, or not clearly reported. Absences, lack of clarity or completeness of reporting occured in: a priori review protocol registration or following a reporting guideline; the processes of screening apps in the app stores; the data extracted from app store description or the device the app was downloaded to for data extraction; and appraisal tools for assessing the app quality, usability or clinical content. Further, there was no explicit reporting of clinical efficacy of apps or recommendations for use in the majority of reviews. CONCLUSIONS The reporting of methods used in app-focused systematic reviews is variable and could be substantially improved. Development and publication of consensus reporting guidelines would increase transparency and quality of published studies. A repository for registration of reviews would ensure reviews are easy to find and not duplicated. These steps would also enable clinicians and people with health conditions to more easily find high quality apps.

scholarly journals Appraisal of systematic reviews on interventions for postpartum depression: systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ryan Chow ◽  
Eileen Huang ◽  
Allen Li ◽  
Sophie Li ◽  
Sarah Y. Fu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postpartum Depression ◽  
Systematic Reviews ◽  
Methodological Quality ◽  
A Priori ◽  
Behavioural Therapy ◽  
Therapeutic Interventions ◽  
Current Evidence ◽  
Cochrane Library ◽  
Measurement Tool

Abstract Background Postpartum depression (PPD) is a highly prevalent mental health problem that affects parental health with implications for child health in infancy, childhood, adolescence and beyond. The primary aim of this study was to critically appraise available systematic reviews describing interventions for PPD. The secondary aim was to evaluate the methodological quality of the included systematic reviews and their conclusions. Methods An electronic database search of MEDLINE, Embase, and the Cochrane Library from 2000 to 2020 was conducted to identify systematic reviews that examined an intervention for PPD. A Measurement Tool to Assess Systematic Reviews was utilized to independently score each included systematic review which was then critically appraised to better define the most effective therapeutic options for PPD. Results Of the 842 studies identified, 83 met the a priori criteria for inclusion. Based on the systematic reviews with the highest methodological quality, we found that use of antidepressants and telemedicine were the most effective treatments for PPD. Symptoms of PPD were also improved by traditional herbal medicine and aromatherapy. Current evidence for physical exercise and cognitive behavioural therapy in treating PPD remains equivocal. A significant, but weak relationship between AMSTAR score and journal impact factor was observed (p = 0.03, r = 0.24; 95% CI, 0.02 to 0.43) whilst no relationship was found between the number of total citations (p = 0.27, r = 0.12; 95% CI, − 0.09 to 0.34), or source of funding (p = 0.19). Conclusion Overall the systematic reviews on interventions for PPD are of low-moderate quality and are not improving over time. Antidepressants and telemedicine were the most effective therapeutic interventions for PPD treatment.

scholarly journals Development of the ACTIVE framework to describe stakeholder involvement in systematic reviews

2019 ◽  
Vol 24 (4) ◽  
pp. 245-255 ◽  
Author(s):  
Alex Pollock ◽  
Pauline Campbell ◽  
Caroline Struthers ◽  
Anneliese Synnot ◽  
Jack Nunn ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Health Professionals ◽  
Public Involvement ◽  
Review Process ◽  
Data Extraction ◽  
Stakeholder Involvement ◽  
Decision Makers ◽  
Literature Searching ◽  
Health Decision

Objectives Involvement of patients, health professionals, and the wider public (‘stakeholders’) is seen to be beneficial to the quality, relevance and impact of research and may enhance the usefulness and uptake of systematic reviews. However, there is a lack of evidence and resources to guide researchers in how to actively involve stakeholders in systematic reviews. In this paper, we report the development of the ACTIVE framework to describe how stakeholders are involved in systematic reviews. Methods We developed a framework using methods previously described in the development of conceptual frameworks relating to other areas of public involvement, including: literature searching, data extraction, analysis, and categorization. A draft ACTIVE framework was developed and then refined after presentation at a conference workshop, before being applied to a subset of 32 systematic reviews. Data extracted from these systematic reviews, identified in a systematic scoping review, were categorized against pre-defined constructs, including: who was involved, how stakeholders were recruited, the mode of involvement, at what stage there was involvement and the level of control or influence. Results The final ACTIVE framework described whether patients, carers and/or families, and/or other stakeholders (including health professionals, health decision makers and funders) were involved. We defined: recruitment as either open or closed; the approach to involvement as either one-time, continuous or combined; and the method of involvement as either direct or indirect. The stage of involvement in reviews was defined using the Cochrane Ecosystem stages of a review. The level of control or influence was defined according to the roles and activities of stakeholders in the review process, and described as the ACTIVE continuum of involvement. Conclusions The ACTIVE framework provides a structure with which to describe key components of stakeholder involvement within a systematic review, and we have used this to summarize how stakeholders have been involved in a subset of varied systematic reviews. The ACTIVE continuum of involvement provides a new model that uses tasks and roles to detail the level of stakeholder involvement. This work has contributed to the development of learning resources aimed at supporting systematic review authors and editors to involve stakeholders in their systematic reviews. The ACTIVE framework may support the decision-making of systematic review authors in planning how to involve stakeholders in future reviews.

scholarly journals P071: Artificial intelligence in emergency medicine: A scoping review

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S90-S90
Author(s):  
A. Kirubarajan ◽  
A. Taher ◽  
S. Khan ◽  
S. Masood
Keyword(s):  
Artificial Intelligence ◽  
Emergency Medicine ◽  
Language Processing ◽  
Scoping Review ◽  
Clinical Decision Making ◽  
Data Extraction ◽  
A Priori ◽  
Clinical Decision ◽  
Hospital Environment ◽  
Clinical Implementation

Introduction: The study of artificial intelligence (AI) in medicine has become increasingly popular over the last decade. The emergency department (ED) is uniquely situated to benefit from AI due to its power of diagnostic prediction, and its ability to continuously improve with time. However, there is a lack of understanding of the breadth and scope of AI applications in emergency medicine, and evidence supporting its use. Methods: Our scoping review was completed according to PRISMA-ScR guidelines and was published a priori on Open Science Forum. We systematically searched databases (Medline-OVID, EMBASE, CINAHL, and IEEE) for AI interventions relevant to the ED. Study selection and data extraction was performed independently by two investigators. We categorized studies based on type of AI model used, location of intervention, clinical focus, intervention sub-type, and type of comparator. Results: Of the 1483 original database citations, a total of 181 studies were included in the scoping review. Inter-rater reliability for study screening for titles and abstracts was 89.1%, and for full-text review was 77.8%. Overall, we found that 44 (24.3%) studies utilized supervised learning, 63 (34.8%) studies evaluated unsupervised learning, and 13 (7.2%) studies utilized natural language processing. 17 (9.4%) studies were conducted in the pre-hospital environment, with the remainder occurring either in the ED or the trauma bay. The majority of interventions centered around prediction (n = 73, 40.3%). 48 studies (25.5%) analyzed AI interventions for diagnosis. 23 (12.7%) interventions focused on diagnostic imaging. 89 (49.2%) studies did not have a comparator to their AI intervention. 63 (34.8%) studies used statistical models as a comparator, 19 (10.5%) of which were clinical decision making tools. 15 (8.3%) studies used humans as comparators, with 12 of the 15 (80%) studies showing superiority in favour of the AI intervention when compared to a human. Conclusion: AI-related research is rapidly increasing in emergency medicine. AI interventions are heterogeneous in both purpose and design, but primarily focus on predictive modeling. Most studies do not involve a human comparator and lack information on patient-oriented outcomes. While some studies show promising results for AI-based interventions, there remains uncertainty regarding their superiority over standard practice, and further research is needed prior to clinical implementation.

scholarly journals Pre-arrest and intra-arrest prognostic factors associated with survival after in-hospital cardiac arrest: systematic review and meta-analysis

BMJ ◽  
2019 ◽  
pp. l6373 ◽  
Author(s):  
Shannon M Fernando ◽  
Alexandre Tran ◽  
Wei Cheng ◽  
Bram Rochwerg ◽  
Monica Taljaard ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Arrest ◽  
Prognostic Factors ◽  
Systematic Reviews ◽  
English Language ◽  
Data Extraction ◽  
Meta Analysis ◽  
Research Strategy ◽  
Primary Analysis ◽  
Hospital Cardiac Arrest

Abstract Objective To determine associations between important pre-arrest and intra-arrest prognostic factors and survival after in-hospital cardiac arrest. Design Systematic review and meta-analysis. Data sources Medline, PubMed, Embase, Scopus, Web of Science, and the Cochrane Database of Systematic Reviews from inception to 4 February 2019. Primary, unpublished data from the United Kingdom National Cardiac Arrest Audit database. Study selection criteria English language studies that investigated pre-arrest and intra-arrest prognostic factors and survival after in-hospital cardiac arrest. Data extraction PROGRESS (prognosis research strategy group) recommendations and the CHARMS (critical appraisal and data extraction for systematic reviews of prediction modelling studies) checklist were followed. Risk of bias was assessed by using the QUIPS tool (quality in prognosis studies). The primary analysis pooled associations only if they were adjusted for relevant confounders. The GRADE approach (grading of recommendations assessment, development, and evaluation) was used to rate certainty in the evidence. Results The primary analysis included 23 cohort studies. Of the pre-arrest factors, male sex (odds ratio 0.84, 95% confidence interval 0.73 to 0.95, moderate certainty), age 60 or older (0.50, 0.40 to 0.62, low certainty), active malignancy (0.57, 0.45 to 0.71, high certainty), and history of chronic kidney disease (0.56, 0.40 to 0.78, high certainty) were associated with reduced odds of survival after in-hospital cardiac arrest. Of the intra-arrest factors, witnessed arrest (2.71, 2.17 to 3.38, high certainty), monitored arrest (2.23, 1.41 to 3.52, high certainty), arrest during daytime hours (1.41, 1.20 to 1.66, high certainty), and initial shockable rhythm (5.28, 3.78 to 7.39, high certainty) were associated with increased odds of survival. Intubation during arrest (0.54, 0.42 to 0.70, moderate certainty) and duration of resuscitation of at least 15 minutes (0.12, 0.07 to 0.19, high certainty) were associated with reduced odds of survival. Conclusion Moderate to high certainty evidence was found for associations of pre-arrest and intra-arrest prognostic factors with survival after in-hospital cardiac arrest. Systematic review registration PROSPERO CRD42018104795

Clinical handover and handoff in healthcare: a systematic review of systematic reviews

2020 ◽  
Author(s):  
Melissa Desmedt ◽  
Dorien Ulenaers ◽  
Joep Grosemans ◽  
Johan Hellings ◽  
Jochen Bergs
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Data Extraction ◽  
Implementation Process ◽  
Healthcare Setting ◽  
Well Being ◽  
Role Playing ◽  
Included Study ◽  
Clinical Handover ◽  
Review Team

Abstract Purpose The purpose of this systematic review is to appraise and summarize existing literature on clinical handover. Data sources We searched EMBASE, MEDLINE, Database of Abstracts of Reviews of Effects and Cochrane Database of Systematic Reviews. Study selection Included articles were reviewed independently by the review team. Data extraction The review team extracted data under the following headers: author(s), year of publication, journal, scope, search strategy, number of studies included, type of studies included, study quality assessment, used definition of handover, healthcare setting, outcomes measured, findings and finally some comments or remarks. Results of data synthesis First, research indicates that poor handover is associated with multiple potential hazards such as lack of availability of required equipment for patients, information omissions, diagnosis errors, treatment errors, disposition errors and treatment delays. Second, our systematic review indicates that no single tool arises as best for any particular specialty or use to evaluate the handover process. Third, there is little evidence delineating what constitutes best handoff practices. Most efforts facilitated the coordination of care and communication between healthcare professionals using electronic tools or a standardized form. Fourth, our review indicates that the principal teaching methods are role-playing and simulation, which may result in better knowledge transfer to the work environment, better health and patients’ well-being. Conclusions This review emphasizes the importance of staff education (including simulation-based and team training), non-technical skills and the implementation process of clinical handover in healthcare settings.

scholarly journals Quality assessment of systematic reviews and meta-analyses that examine preventive antibiotic uses and management practices designed to prevent disease in livestock

2019 ◽  
Vol 20 (2) ◽  
pp. 305-318
Author(s):  
Rachael Vriezen ◽  
Jan M. Sargeant ◽  
Ellen Vriezen ◽  
Charlotte B. Winder ◽  
Annette M. O'Connor
Keyword(s):  
Quality Assessment ◽  
Systematic Reviews ◽  
Management Practices ◽  
Disease Risk ◽  
Data Extraction ◽  
A Priori ◽  
Antibiotic Use ◽  
Study Selection ◽  
Meta Analyses

AbstractTo implement effective stewardship in food animal production, it is essential that producers and veterinarians are aware of preventive interventions to reduce illness in livestock. Systematic reviews and meta-analyses (SR/MA) provide transparent, replicable, and quality-assessed overviews. At present, it is unknown how many SR/MA evaluate preventive antibiotic use or management practices aimed at reducing disease risk in animal agriculture. Further, the quality of existing reviews is unknown. Our aim was to identify reviews investigating these topics and to provide an assessment of their quality. Thirty-eight relevant reviews were identified. Quality assessment was based on the AMSTAR 2 framework for the critical appraisal of systematic reviews. The quality of most of the reviews captured was classified as critically low (84.2%, n = 32/38), and only a small percentage of the evaluated reviews did not contain critical weaknesses (7.9%, n = 3/38). Particularly, a small number of reviews reported the development of an a priori protocol (15.8%, n = 6/38), and few reviews stated that key review steps were conducted in duplicate (study selection/screening: 26.3%, n = 10/38; data extraction: 15.8%, n = 6/38). The development of high-quality reviews summarizing evidence on approaches to antibiotic reduction is essential, and thus greater adherence to quality conduct guidelines for synthesis research is crucial.

scholarly journals A Systematic Review of the Effectiveness of Telerehabilitation Interventions for Therapeutic Purposes in the Elderly

2020 ◽  
Vol 59 (02/03) ◽  
pp. 104-109
Author(s):  
Farnia Velayati ◽  
Haleh Ayatollahi ◽  
Morteza Hemmat
Keyword(s):  
Systematic Review ◽  
Elderly People ◽  
Data Extraction ◽  
The Elderly ◽  
Health Conditions ◽  
Cochrane Library ◽  
Chronic Obstructive ◽  
Mobility Limitations ◽  
Significant Difference

Abstract Background Many elderly people suffer from chronic health conditions and mobility limitations. Therefore, they may benefit from traditional rehabilitation or telerehabilitation interventions as an alternative for this type of services. Objective The purpose of this study was to compare the effectiveness of telerehabilitation interventions with traditional rehabilitation services for therapeutic purposes in the elderly. Methods This systematic review was conducted in 2018. The searched databases were Cochrane Library, PubMed, Scopus, Web of Science, Embase, and ProQuest. The search was conducted with no time or language limitation. The selected papers included the randomized clinical trial studies in which elderly people aged 60 and over used telerehabilitation services for treatment purposes. The quality of the studies was evaluated by using the physiotherapy evidence database (PEDro) scale. Data were extracted by using a data extraction form and findings were narratively synthesized. Results After screening the retrieved papers, eight articles were selected to be included in the study. According to the findings, telerehabilitation was used for the elderly after stroke, chronic obstructive pulmonary disease (COPD), total knee replacement, and in patients with the comorbidity of COPD and chronic heart failure. Overall, in most studies, there was no significant difference between the intervention and control groups and the level of improvements was similar for most outcomes. Conclusion Telerehabilitation services can be regarded as an alternative to traditional rehabilitation approaches to reduce outpatient resource utilization and improve quality of life. However, more rigorous studies are suggested to investigate the effectiveness of telerehabilitation services for specific diseases or health conditions.

scholarly journals Assessment of humoral and cell-mediated immune responses to pertussis vaccination: a systematic review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e028109 ◽  
Author(s):  
Funbi Akinola ◽  
Rudzani Muloiwa ◽  
Gregory, D Hussey ◽  
Violette Dirix ◽  
Benjamin Kagina ◽  
...  
Keyword(s):  
Systematic Review ◽  
Immune Response ◽  
Immune Responses ◽  
Public Space ◽  
Systematic Reviews ◽  
Data Extraction ◽  
Meta Analysis ◽  
Grey Literature ◽  
Assessment Tools ◽  
Population Type

IntroductionGlobally, some studies show a resurgence of pertussis. The risks and benefits of using whole-cell pertussis (wP) or acellular pertussis (aP) vaccines in the control of the disease have been widely debated. Better control of pertussis will require improved understanding of the immune response to pertussis vaccines. Improved understanding and assessment of the immunity induced by pertussis vaccines is thus imperative. Several studies have documented different immunological outcomes to pertussis vaccination from an array of assays. We propose to conduct a systematic review of the different immunological assays and outcomes used in the assessment of the humoraland cell-mediated immune response following pertussis vaccination.Methods and analysisThe primary outcomes for consideration are quality and quantity of immune responses (humoral and cell-mediated) post-pertussis vaccination. Of interest as secondary outcomes are types of immunoassays used in assessing immune responses post-pertussis vaccination, types of biological samples used in assessing immune responses post-pertussis vaccination, as well as the types of antigens used to stimulate these samples during post-pertussis vaccination immune response assessments. Different electronic databases (including PubMed, Cochrane, EBSCO Host, Scopus and Web of Science) will be accessed for peer-reviewed published and grey literature evaluating immune responses to pertussis vaccines between 1990 and 2019. The quality of included articles will be assessed using standardised risk and quality assessment tools specific to the study design used in each article. Data extraction will be done using a data extraction form. The extracted data will be analysed using STATA V.14.0 and RevMan V.5.3 software. A subgroup analysis will be conducted based on the study population, type of vaccine (wP or aP) and type of immune response (cell-mediated or humoral). Guidelines for reporting systematic reviews in the revised 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement will be used in this study.Ethics and disseminationEthics approval is not required for this study as it is a systematic review. We will only make use of data already available in the public space. Findings will be reported via publication in a peer-reviewed journal and presented at scientific meetings and workshops.Trial registration numberCRD42018102455.

scholarly journals Clinical, laboratory and imaging predictors for critical illness and mortality in patients with COVID-19: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e039813
Author(s):  
Xinxing Lai ◽  
Jian Liu ◽  
Tianyi Zhang ◽  
Luda Feng ◽  
Ping Jiang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Prognostic Factors ◽  
Critical Illness ◽  
Systematic Reviews ◽  
Clinical Laboratory ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Early Management ◽  
Modifiable Factors

IntroductionWith the threat of a worldwide pandemic of COVID-19, it is important to identify the prognostic factors for critical conditions among patients with non-critical COVID-19. Prognostic factors and models may assist front-line clinicians in rapid identification of high-risk patients, early management of modifiable factors, appropriate triaging and optimising the use of limited healthcare resources. We aim to systematically assess the clinical, laboratory and imaging predictors as well as prediction models for severe or critical illness and mortality in patients with COVID-19.Methods and analysisAll peer-reviewed and preprint primary articles with a longitudinal design that focused on prognostic factors or models for critical illness and mortality related to COVID-19 will be eligible for inclusion. A systematic search of 11 databases including PubMed, EMBASE, Web of Science, Cochrane Library, CNKI, VIP, Wanfang Data, SinoMed, bioRxiv, Arxiv and MedRxiv will be conducted. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data extraction will be performed using the modified version of the Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies checklist and quality will be evaluated using the Newcastle-Ottawa Scale and the Quality In Prognosis Studies tool. The association between prognostic factors and outcomes of interest will be synthesised and a meta-analysis will be conducted with three or more studies reporting a particular factor in a consistent manner.Ethics and disseminationEthical approval was not required for this systematic review. We will disseminate our findings through publication in a peer-reviewed journal.PROSPERO registration numberCRD 42020178798.

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