scholarly journals Tackling Research Inefficiency in Degenerative Cervical Myelopathy: Illustrative Review (Preprint)

2019 ◽  
Author(s):  
Danyal Zaman Khan ◽  
Muhammad Shuaib Khan ◽  
Mark RN Kotter ◽  
Benjamin Marshall Davies
Keyword(s):  
Systematic Reviews ◽  
Cervical Myelopathy ◽  
Search Strategy ◽  
Research Synthesis ◽  
International Classification Of Diseases ◽  
Medical Subject Headings ◽  
Cord Injury ◽  
Pubmed Search ◽  
Meta Analyses ◽  
Degenerative Cervical Myelopathy

BACKGROUND Degenerative cervical myelopathy (DCM) is widely accepted as the most common cause of adult myelopathy worldwide. Despite this, there is no specific term or diagnostic criteria in the International Classification of Diseases 11th Revision and no Medical Subject Headings (MeSH) or an equivalent in common literature databases. This makes searching the literature and thus conducting systematic reviews or meta-analyses imprecise and inefficient. Efficient research synthesis is integral to delivering evidence-based medicine and improving research efficiency. OBJECTIVE This study aimed to illustrate the difficulties encountered when attempting to carry out a comprehensive and accurate evidence search in the field of DCM by identifying the key sources of imprecision and quantifying their impact. METHODS To identify the key sources of imprecision and quantify their impact, an illustrative search strategy was developed using a validated DCM hedge combined with contemporary strategies used by authors in previous systematic reviews and meta-analyses. This strategy was applied to Medical Literature Analysis and Retrieval System Online (MEDLINE) and Excerpta Medica dataBASE (EMBASE) databases looking for relevant DCM systematic reviews and meta-analyses published within the last 5 years. RESULTS The MEDLINE via PubMed search strategy returned 24,166 results, refined to 534 papers after the application of inclusion and exclusion criteria. Of these, 32.96% (176/534) results were about DCM, and 18.16% (97/534) of these were DCM systematic reviews or meta-analyses. Non-DCM results were organized into imprecision categories (spinal: 268/534, 50.2%; nonspinal: 84/534, 15.5%; and nonhuman: 8/534, 1.5%). The largest categories were spinal cord injury (75/534, 13.67%), spinal neoplasms (44/534, 8.24%), infectious diseases of the spine and central nervous system (18/534, 3.37%), and other spinal levels (ie, thoracic, lumbar, and sacral; 18/534, 3.37%). Counterintuitively, the use of human and adult PubMed filters was found to exclude a large number of relevant articles. Searching a second database (EMBASE) added an extra 12 DCM systematic reviews or meta-analyses. CONCLUSIONS DCM search strategies face significant imprecision, principally because of overlapping and heterogenous search terms, and inaccurate article indexing. Notably, commonly employed MEDLINE filters, human and adult, reduced search sensitivity, whereas the related articles function and the use of a second database (EMBASE) improved it. Development of a MeSH labeling and a standardized DCM definition would allow comprehensive and specific indexing of DCM literature. This is required to support a more efficient research synthesis.

scholarly journals Tackling Research Inefficiency in Degenerative Cervical Myelopathy: Illustrative Review

10.2196/15922 ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. e15922 ◽  
Author(s):  
Danyal Zaman Khan ◽  
Muhammad Shuaib Khan ◽  
Mark RN Kotter ◽  
Benjamin Marshall Davies
Keyword(s):  
Systematic Reviews ◽  
Cervical Myelopathy ◽  
Search Strategy ◽  
Research Synthesis ◽  
International Classification Of Diseases ◽  
Medical Subject Headings ◽  
Cord Injury ◽  
Pubmed Search ◽  
Meta Analyses ◽  
Degenerative Cervical Myelopathy

Background Degenerative cervical myelopathy (DCM) is widely accepted as the most common cause of adult myelopathy worldwide. Despite this, there is no specific term or diagnostic criteria in the International Classification of Diseases 11th Revision and no Medical Subject Headings (MeSH) or an equivalent in common literature databases. This makes searching the literature and thus conducting systematic reviews or meta-analyses imprecise and inefficient. Efficient research synthesis is integral to delivering evidence-based medicine and improving research efficiency. Objective This study aimed to illustrate the difficulties encountered when attempting to carry out a comprehensive and accurate evidence search in the field of DCM by identifying the key sources of imprecision and quantifying their impact. Methods To identify the key sources of imprecision and quantify their impact, an illustrative search strategy was developed using a validated DCM hedge combined with contemporary strategies used by authors in previous systematic reviews and meta-analyses. This strategy was applied to Medical Literature Analysis and Retrieval System Online (MEDLINE) and Excerpta Medica dataBASE (EMBASE) databases looking for relevant DCM systematic reviews and meta-analyses published within the last 5 years. Results The MEDLINE via PubMed search strategy returned 24,166 results, refined to 534 papers after the application of inclusion and exclusion criteria. Of these, 32.96% (176/534) results were about DCM, and 18.16% (97/534) of these were DCM systematic reviews or meta-analyses. Non-DCM results were organized into imprecision categories (spinal: 268/534, 50.2%; nonspinal: 84/534, 15.5%; and nonhuman: 8/534, 1.5%). The largest categories were spinal cord injury (75/534, 13.67%), spinal neoplasms (44/534, 8.24%), infectious diseases of the spine and central nervous system (18/534, 3.37%), and other spinal levels (ie, thoracic, lumbar, and sacral; 18/534, 3.37%). Counterintuitively, the use of human and adult PubMed filters was found to exclude a large number of relevant articles. Searching a second database (EMBASE) added an extra 12 DCM systematic reviews or meta-analyses. Conclusions DCM search strategies face significant imprecision, principally because of overlapping and heterogenous search terms, and inaccurate article indexing. Notably, commonly employed MEDLINE filters, human and adult, reduced search sensitivity, whereas the related articles function and the use of a second database (EMBASE) improved it. Development of a MeSH labeling and a standardized DCM definition would allow comprehensive and specific indexing of DCM literature. This is required to support a more efficient research synthesis.

scholarly journals Errors in search strategies used in systematic reviews and their effects on information retrieval

2019 ◽  
Vol 107 (2) ◽  
Author(s):  
José Antonio Salvador-Oliván ◽  
Gonzalo Marco-Cuenca ◽  
Rosario Arquero-Avilés
Keyword(s):  
Systematic Reviews ◽  
Search Strategies ◽  
Primary Objective ◽  
Free Text ◽  
Medical Subject Headings ◽  
Search Terms ◽  
Pubmed Search ◽  
Meta Analyses ◽  
Mesh Database ◽  
Controlled Language

Objectives: Errors in search strategies negatively affect the quality and validity of systematic reviews. The primary objective of this study was to evaluate searches performed in MEDLINE/PubMed to identify errors and determine their effects on information retrieval.Methods: A PubMed search was conducted using the systematic review filter to identify articles that were published in January of 2018. Systematic reviews or meta-analyses were selected from a systematic search for literature containing reproducible and explicit search strategies in MEDLINE/PubMed. Data were extracted from these studies related to ten types of errors and to the terms and phrases search modes.Results: The study included 137 systematic reviews in which the number of search strategies containing some type of error was very high (92.7%). Errors that affected recall were the most frequent (78.1%), and the most common search errors involved missing terms in both natural language and controlled language and those related to Medical Subject Headings (MeSH) search terms and the non-retrieval of their more specific terms.Conclusions: To improve the quality of searches and avoid errors, it is essential to plan the search strategy carefully, which includes consulting the MeSH database to identify the concepts and choose all appropriate terms, both descriptors and synonyms, and combining search techniques in the free-text and controlled-language fields, truncating the terms appropriately to retrieve all their variants.

Hotspots in Psychology – 2020 Edition

2020 ◽  
Vol 228 (1) ◽  
pp. 1-2
Author(s):  
Michael Bošnjak ◽  
Nadine Wedderhoff
Keyword(s):  
Systematic Reviews ◽  
Research Synthesis ◽  
Synthesis Methods ◽  
Common Denominator ◽  
The Common ◽  
Meta Analyses

Abstract. This editorial gives a brief introduction to the six articles included in the fourth “Hotspots in Psychology” of the Zeitschrift für Psychologie. The format is devoted to systematic reviews and meta-analyses in research-active fields that have generated a considerable number of primary studies. The common denominator is the research synthesis nature of the included articles, and not a specific psychological topic or theme that all articles have to address. Moreover, methodological advances in research synthesis methods relevant for any subfield of psychology are being addressed. Comprehensive supplemental material to the articles can be found in PsychArchives ( https://www.psycharchives.org ).

scholarly journals Perioperative Complications of Surgery for Degenerative Cervical Myelopathy: A Comparison Between 3 Procedures

2021 ◽  
pp. 219256822199830
Author(s):  
Mohamed Kamal Mesregah ◽  
Blake Formanek ◽  
John C. Liu ◽  
Zorica Buser ◽  
Jeffrey C. Wang
Keyword(s):  
Propensity Score ◽  
Cervical Myelopathy ◽  
Perioperative Complications ◽  
International Classification Of Diseases ◽  
Significance Level ◽  
Chi Squared ◽  
Retrospective Comparative Study ◽  
Posterior Laminectomy ◽  
Degenerative Cervical Myelopathy ◽  
New Onset

Study Design: Retrospective comparative study. Objectives: To compare the perioperative complications of propensity score-matched cohorts of patients with degenerative cervical myelopathy (DCM), who were treated with anterior cervical discectomy and fusion (ACDF), posterior laminectomy with fusion, or laminoplasty. Methods: The Humana PearlDiver Patient Record Database was queried using the International Classification of Diseases (ICD-9 and ICD-10) and the Current Procedural Terminology (CPT) codes. Propensity score-matched analysis was done using multiple Chi-squared tests with Bonferroni correction of the significance level. Results: Cohorts of 11,790 patients who had ACDF, 2,257 patients who had posterior laminectomy with fusion, and 477 patients who had laminoplasty, were identified. After propensity score matching, all the 3 groups included 464 patients. The incidence of dysphagia increased significantly following ACDF compared to laminoplasty, P < 0.001, and in laminectomy with fusion compared to laminoplasty, P < 0.001. The incidence of new-onset cervicalgia was higher in ACDF compared to laminoplasty, P = 0.005, and in laminectomy with fusion compared to laminoplasty, P = 0.004. The incidence of limb paralysis increased significantly in laminectomy with fusion compared to ACDF, P = 0.002. The revision rate at 1 year increased significantly in laminectomy with fusion compared to laminoplasty, P < 0.001, and in ACDF compared to laminoplasty, P < 0.001. Conclusions: The incidence of dysphagia following laminectomy with fusion was not different compared to ACDF. Postoperative new-onset cervicalgia and revisions were least common in laminoplasty. The highest rate of postoperative limb paralysis was noticed in laminectomy with fusion.

scholarly journals CogTale: An online platform for the evaluation, synthesis and dissemination of evidence from cognitive interventions studies

2020 ◽  
Author(s):  
Julieta Sabates ◽  
Sylvie Belleville ◽  
Mary Castellani ◽  
Tzvi Dwolatsky ◽  
Benjamin M. Hampstead ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Intervention Studies ◽  
Evidence Synthesis ◽  
Research Synthesis ◽  
Cognitive Intervention ◽  
Synthesis Methods ◽  
Data Synthesis ◽  
Advanced Search ◽  
Health Related ◽  
Meta Analyses

Abstract Systematic reviews and meta-analyses are critical in health-related decision making, and are considered the gold standard in research synthesis methods. However, with new trials being regularly published and with the development of increasingly rigorous standards of data synthesis, systematic reviews often require much expertise and long periods of time to be completed. Automation of some of the steps of evidence synthesis productions is a promising improvement in the field, capable of reducing the time and costs associated with the process. This article describes the development and main characteristics of a novel online repository of cognitive intervention studies entitled Cognitive Treatments Article Library and Evaluation (CogTale). The platform is currently in a Beta Release phase, as it is still under development. However, it already contains over 70 studies, and the CogTale team is continuously coding and uploading new studies into the repository. Key features include advanced search options, the capability to generate meta-analyses, and an up-to-date display of relevant published studies.

scholarly journals Is there a role for postoperative physiotherapy in degenerative cervical myelopathy? A systematic review

2018 ◽  
Vol 32 (9) ◽  
pp. 1169-1174 ◽  
Author(s):  
Abdul Badran ◽  
Benjamin M Davies ◽  
Heidi-Marie Bailey ◽  
Sukhvinder Kalsi-Ryan ◽  
Mark RN Kotter
Keyword(s):  
Clinical Outcome ◽  
Cervical Myelopathy ◽  
Postoperative Recovery ◽  
Study Quality ◽  
Postoperative Rehabilitation ◽  
Assessment Development ◽  
Recovery Study ◽  
Meta Analyses ◽  
Degenerative Cervical Myelopathy ◽  
Determine Effect

Objective: To review peer-reviewed literature relating to postoperative physiotherapy for degenerative cervical myelopathy (DCM), to determine efficacy in improving clinical outcome and recovery. Data sources: MEDLINE, EMBASE, CENTRAL, PEDro, ISRCTN registry, WHO ICTRP and Clinicaltrials.gov . References and citations of relevant articles were searched. Methods: A systematic search was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO CRD42016039511) from the origins of the databases till 15 February 2018. Included were all studies investigating physiotherapy as an intervention after surgical treatment of DCM to determine effect on clinical outcome and recovery. Study quality was determined using the Grades of Recommendation, Assessment, Development and Evaluation guidelines. Results: In all, 300 records were identified through tailored systematic searches, after removing duplicates. After screening, only one investigated postoperative rehabilitation using physiotherapy for DCM; however, this was retrospective with no controls. This study suggested that rehabilitation including physiotherapy improved postoperative recovery. There are currently two registered trials investigating the use of postoperative physiotherapy for DCM. Conclusions: The literature provides insufficient evidence to make any evidence-based recommendations regarding postoperative physiotherapy use in DCM.

scholarly journals The Natural History of Degenerative Cervical Myelopathy and the Rate of Hospitalization Following Spinal Cord Injury: An Updated Systematic Review

2017 ◽  
Vol 7 (3_suppl) ◽  
pp. 28S-34S ◽  
Author(s):  
Lindsay A. Tetreault ◽  
Spyridon Karadimas ◽  
Jefferson R. Wilson ◽  
Paul M. Arnold ◽  
Shekar Kurpad ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Natural History ◽  
Cervical Myelopathy ◽  
Cochrane Collaboration ◽  
Level Of Evidence ◽  
Cord Injury ◽  
History Of ◽  
Degenerative Cervical Myelopathy

Study Method: Systematic review (update). Objective: Degenerative cervical myelopathy (DCM) is a degenerative spine disease and the most common cause of spinal cord dysfunction in adults worldwide. The objective of this study is to determine the natural history of DCM by updating the systematic review by Karadimas et al. The specific aims of this review were (1) to describe the natural history of DCM and (2) to determine potential risk factors of disease progression. Method: An updated search based on a previous protocol was conducted in PubMed and the Cochrane Collaboration library for studies published between November 2012 and February 15, 2015. Results: The updated search yielded 3 additional citations that met inclusion criteria and reported the incidence of spinal cord injury and severe disability in patients with DCM. Based on 2 retrospective cohort studies, the incidence rate of hospitalization for spinal cord injury is 13.9 per 1000 person-years in patients with cervical spondylotic myelopathy and 4.8 per 1000 person-years in patients with myelopathy secondary to ossification of the posterior longitudinal ligament (OPLL). In a third small prospective study, the risk of being wheelchair bound or bedridden was 66.7% in DCM patients with OPLL. Conclusion: The overall level of evidence for these estimated rates of hospitalization following spinal cord injury was rated as low.

Cervical Myelopathy

2018 ◽  
pp. 71-80
Author(s):  
Mario Ganau ◽  
So Kato ◽  
Michael G. Fehlings
Keyword(s):  
Spinal Cord ◽  
Cervical Myelopathy ◽  
Deformity Correction ◽  
Kyphotic Deformity ◽  
Surgical Team ◽  
Comprehensive Management ◽  
Cord Injury ◽  
Pros And Cons ◽  
Spinal Cord Decompression ◽  
Degenerative Cervical Myelopathy

Patients with kyphotic deformity and degenerative cervical myelopathy are at elevated risk for traumatic and nontraumatic spinal cord injury and require comprehensive management entailing a careful clinical assessment with dedicated functional scales and radiological study of spinal balance. Surgical strategies to address this clinical scenario including anterior, posterior, and combined approaches. Whatever the choice, the surgical plan should always envisage spinal cord decompression and stabilization along with deformity correction. The surgical team should discuss pros and cons of the most appropriate surgical plan with the patient, anticipate possible complications, and propose alternate strategies. This chapter details the most important practical aspects of surgical management, ranging from technical advantages of multiple osteotomies and selection of implants for instrumented fusion, to the surgical and anesthesiological nuances to avoid intraoperative and postoperative complications. An overview is provided of scientific literature regarding the correction of kyphotic deformity and ongoing clinical trials.

scholarly journals Using MeSH (Medical Subject Headings) to Enhance PubMed Search Strategies for Evidence-Based Practice in Physical Therapy

2012 ◽  
Vol 92 (1) ◽  
pp. 124-132 ◽  
Author(s):  
Randy R. Richter ◽  
Tricia M. Austin
Keyword(s):  
Search Strategy ◽  
Evidence Based Practice ◽  
Physical Therapists ◽  
Mesh Term ◽  
Evidence Based ◽  
Medical Subject Headings ◽  
Search Terms ◽  
Mesh Terms ◽  
Subject Headings ◽  
Pubmed Search

Background Evidence-based practice (EBP) is an important paradigm in health care. Physical therapists report lack of knowledge and time constraints as barriers to EBP. Objective The purpose of this technical report is to illustrate how Medical Subject Headings (MeSH), a controlled vocabulary thesaurus of indexing terms, is used to efficiently search MEDLINE, the largest component of PubMed. Using clinical questions, this report illustrates how search terms common to physical therapist practice do or do not map to appropriate MeSH terms. A PubMed search strategy that takes advantage of text words and MeSH terms is provided. Results A search of 139 terms and 13 acronyms was conducted to determine whether they appropriately mapped to a MeSH term. The search results were categorized into 1 of 5 outcomes. Nearly half (66/139) of the search terms mapped to an appropriate MeSH term (outcome 1). When a search term did not appropriately map to a MeSH term, it was entered into the MeSH database to search for an appropriate MeSH term. Twenty-one appropriate MeSH terms were found (outcomes 2 and 4), and there were 52 search terms for which an appropriate MeSH term was not found (outcomes 3 and 5). Nearly half of the acronyms did not map to an appropriate MeSH term, and an appropriate MeSH term was not found in the database. Limitations The results are based on a limited number of search terms and acronyms. Conclusions Understanding how search terms map to MeSH terms and using the PubMed search strategy can enable physical therapists to take full advantage of available MeSH terms and should result in more-efficient and better-informed searches.

Prospects of cell replacement therapy for the treatment of degenerative cervical myelopathy

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Graham Ka Hon Shea ◽  
Paul Aarne Koljonen ◽  
Ying Shing Chan ◽  
Kenneth Man Chee Cheung
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Replacement Therapy ◽  
Cervical Myelopathy ◽  
Neurological Function ◽  
Traumatic Spinal Cord Injury ◽  
Cell Replacement Therapy ◽  
Cell Replacement ◽  
Cord Injury ◽  
Degenerative Cervical Myelopathy

AbstractDegenerative cervical myelopathy (DCM) presents insidiously during middle-age with deterioration in neurological function. It accounts for the most common cause of non-traumatic spinal cord injury in developed countries and disease prevalence is expected to rise with the aging population. Whilst surgery can prevent further deterioration, biological therapies may be required to restore neurological function in advanced disease. Cell replacement therapy has been inordinately focused on treatment of traumatic spinal cord injury yet holds immense promise in DCM. We build upon this thesis by reviewing the pathophysiology of DCM as revealed by cadaveric and molecular studies. Loss of oligodendrocytes and neurons occurs via apoptosis. The tissue microenvironment in DCM prior to end-stage disease is distinct from that following acute trauma, and in many ways more favourable to receiving exogenous cells. We highlight clinical considerations for cell replacement in DCM such as selection of cell type, timing and method of delivery, as well as biological treatment adjuncts. Critically, disease models often fail to mimic features of human pathology. We discuss directions for translational research towards clinical application.

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