Impact of mHealth CrowdSensing (MHCS) intervention on chronic diseases awareness: Protocol for a systematic review (Preprint)

Statistical Heterogeneity ◽

Message Service ◽

BACKGROUND Mobile Health CrowdSensing (MHCS) involves the use of mobile communication technologies to promote health by supporting health care practices (e.g., health data collection, delivery of health care information, or patient observation and provision of care. MHCS technologies (e.g. smartphones) have sensory capabilities such as GPS, voice, light and camera to collect user-centred data (explicit and implicit), analyse and share. Current literature indicates no scientific study related to MHCS interventions for chronic diseases. Cancer for example, has contributed to a large proportion of global deaths in every country, irrespective of their developmental status. The proposed systematic review will examine the impact of MHCS interventions on chronic diseases awareness. OBJECTIVE The objectives of this study are to identify and describe various MHCS intervention strategies applied to chronic diseases awareness. METHODS Literature from various databases such as MEDLINE, EMBASE, PsycINFO, CINAHL, and Cochrane Central Register of Controlled Trials will be examined. Trial registers, reports, grey literature and unpublished academic theses will also be included. All mobile technologies such as cell phones, personal digital assistants, and tablets that have short message service, multimedia message service, video, and audio capabilities will be included. MHCS is the primary intervention strategy. The search strategy will include keywords such as “mHealth,” “CrowdSensing,” and “awareness”, among other medical subject heading terms. Articles published from January 1, 1945 to December 31, 2019 will be eligible for inclusion. The authors will independently screen and select studies, extract data, and assess the risk of bias, with discrepancies resolved by an independent party not involved in the study. The authors will assess statistical heterogeneity by examining the types of participants, interventions, study designs, and outcomes in each study, and pool studies judged to be statistically homogeneous. In the assessment of heterogeneity, a sensitivity analysis will be considered to explore statistical heterogeneity. Statistical heterogeneity will be investigated using the Chi-square test of homogeneity on Cochrane's Q statistic, and quantified using the I-squared statistic. RESULTS The preliminary search query found one paper. Further literature search commenced in mid-October 2020 and will conclude on December 2020. The proposed systematic review protocol has been registered in Prospero (CRD42020161435). Furthermore, it was found that the use of search data extraction and capturing in Review Manager (RevMan, Version 5.3) will commence from beginning of January 2021 to the end of February 2021. The final stages will include analyses and writing, which is anticipated to start and be completed in March 2021. CONCLUSIONS The knowledge derived from this study will inform healthcare stakeholders, including researchers, policy-makers, investors, health professionals, technologists, and engineers, on the impact of MHCS interventions on chronic diseases awareness. CLINICALTRIAL Prospero CRD42020161435

The Impact of mHealth Interventions on Breast Cancer Awareness and Screening: Systematic Review Protocol (Preprint)

10.2196/preprints.8043 ◽

2017 ◽

Author(s):

Temitope O Tokosi ◽

Jill Fortuin ◽

Tania S Douglas

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Health Care ◽

Search Strategy ◽

Cancer Awareness ◽

Breast Cancer Awareness ◽

Statistical Heterogeneity ◽

Message Service ◽

BACKGROUND Mobile health (mHealth) is the use of mobile communication technologies to promote health by supporting health care practices (eg, health data collection, delivery of health care information). mHealth technologies (such as mobile phones) can be used effectively by health care practitioners in the distribution of health information and have the potential to improve access to and quality of health care, as well as reduce the cost of health services. Current literature shows limited scientific evidence related to the benefits of mHealth interventions for breast cancer, which is the leading cause of cancer deaths in women worldwide and contributes a large proportion of all cancer deaths, especially in developing countries. Women, especially in low- and middle-income countries (LMICs), are faced with low odds of surviving breast cancer. This finding is likely due to multiple factors related to health systems: low priority of women’s health and cancer on national health agendas; lack of awareness that breast cancer can be effectively treated if detected early; and societal, cultural, and religious factors that are prevalent in LMICs. The proposed systematic review will examine the impact of mHealth interventions on breast cancer awareness and screening among women aged 18 years and older. OBJECTIVE The objectives of this study are to identify and describe the various mHealth intervention strategies that are used for breast cancer, and assess the impact of mHealth strategies on breast cancer awareness and screening. METHODS Literature from various databases such as MEDLINE, EMBASE, PsycINFO, CINAHL, and Cochrane Central Register of Controlled Trials will be examined. Trial registers, reports, and unpublished theses will also be included. All mobile technologies such as cell phones, personal digital assistants, and tablets that have short message service, multimedia message service, video, and audio capabilities will be included. mHealth is the primary intervention. The search strategy will include keywords such as “mHealth,” “breast cancer,” “awareness,” and “screening,” among other medical subject heading terms. Articles published from January 1, 1964 to December 31, 2016 will be eligible for inclusion. Two authors will independently screen and select studies, extract data, and assess the risk of bias, with discrepancies resolved by dialogue involving a third author. We will assess statistical heterogeneity by examining the types of participants, interventions, study designs, and outcomes in each study, and pool studies judged to be statistically homogeneous. In the assessment of heterogeneity, a sensitivity analysis will be considered to explore statistical heterogeneity. Statistical heterogeneity will be investigated using the Chi-square test of homogeneity on Cochrane's Q statistic and quantified using the I-squared statistic. RESULTS The search strategy will be refined with the assistance of an information specialist from November 1, 2017 to January 31, 2018. Literature searches will take place from February 2018 to April 2018. Data extraction and capturing in Review Manager (RevMan, Version 5.3) will take place from May 1, 2018 to July 31, 2018. The final stages will include analyses and writing, which is anticipated occur between August 2018 and October 2018. CONCLUSIONS The knowledge derived from this study will inform health care stakeholders, including researchers, policy makers, investors, health professionals, technologists, and engineers, on the impact of mHealth interventions on breast cancer screening and awareness. CLINICALTRIAL Prospero registration number CRD42016050202

P070: Mixed effectiveness of emergency department diversion strategies: a systematic review

CJEM ◽

10.1017/cem.2017.272 ◽

2017 ◽

Vol 19 (S1) ◽

pp. S102

Author(s):

S.W. Kirkland ◽

A. Soleimani ◽

B.H. Rowe ◽

A.S. Newton

Keyword(s):

Systematic Review ◽

Health Care ◽

Emergency Department ◽

Health Care Services ◽

Grey Literature ◽

Study Data ◽

Care Utilization ◽

Alternative Source ◽

Increased Risk ◽

Introduction: Diverting patients away from the emergency department (ED) has been proposed as a solution for reducing ED overcrowding. The objective of this systematic review is to examine the effectiveness of diversion strategies designed to either direct patients seeking care at an ED to an alternative source of care. Methods: Seven electronic databases and grey literature were searched. Randomized/controlled clinical trials and cohort studies assessing the effectiveness of pre-hospital and ED-based diversion interventions with a comparator were eligible for inclusion. Two reviewers independently screened the studies for relevance, inclusion, and risk of bias. Intervention effects are reported as proportions (%) or relative risks (RR) with 95% confidence intervals (CI). Methodological and clinical heterogeneity prohibited pooling of study data. Results: From 7,306 citations, ten studies were included. Seven studies evaluated a pre-hospital diversion strategy and three studies evaluated an ED-based diversion strategy. The impact of diversion on subsequent health services was mixed. One study of paramedic practitioners reported increased ED attendance within 7 days (11.9% vs. 9.5%; p=0.049) but no differences in return visits for similar conditions (75.2% vs. 72.1%; p=0.64). The use of paramedic practitioners was associated with an increased risk of subsequent contact with health care services (RR=1.21, 95% CI 1.06, 1.38), while the use of deferred care was associated with no increase in risk of subsequently seeking physician care (RR=1.09, 95% CI 0.23, 5.26). While two studies reported that diverted patients were at significantly reduced risk for hospitalization, two other studies reported no significant differences between diverted or standard care patients. Conclusion: The evidence regarding the impact of pre-hospital and ED-based diversion on ED utilization and subsequent health care utilization is mixed. Additional high-quality comparative effectiveness studies of diversion strategies are required prior to widespread implementation.

Impact of surgical margin status on the survival outcome after surgical resection of gastric cancer: a protocol for systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-040282 ◽

2020 ◽

Vol 10 (11) ◽

pp. e040282

Author(s):

Zhiyuan Jiang ◽

Zhaolun Cai ◽

Yuan Yin ◽

Chaoyong Shen ◽

Jinming Huang ◽

...

Keyword(s):

Gastric Cancer ◽

Systematic Review ◽

Meta Analysis ◽

Controlled Trials ◽

Curative Intent ◽

Term Survival ◽

Effect Model ◽

Statistical Heterogeneity ◽

IntroductionGenerally, complete resection with cancer cell negative (R0) margin has been accepted as the most effective treatment of gastric cancer and positive resection (R1/R2) margin has been associated with decreased survival to varied degrees. However, the independent impact of microscopical positive (R1) margin on long-term survival may be confounded. No meta-analysis has worked at the association between R1 margin and outcomes of gastric cancer and the available evidence are scant. Therefore, we plan to conduct a systematic review and meta-analysis to quantitatively explore the role of R1 margin on gastric (including oesophagogastric junction) cancer survival after curative intent resection.Methods and analysisThe protocol was conducted according to Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guideline. A systematic search of PubMed, Embase and the Cochrane Central Register of Controlled Trials databases will be performed from their inceptions to 30 April 2020 to identify randomised controlled trials (RCTs), cohort studies and case–control studies focusing on the impact of R1 margin on survival of gastric cancer after curative intent resection. The primary outcome will be the overall survival (OS) and disease-free survival (DFS) and the secondary outcomes will be 5-year OS rate and 5-year DFS rate. The Cochrane tool for bias assessment in randomised trials and Risk Of Bias In Non-randomised Studies-I for the assessment of bias in non-randomised studies (NRS) will be used. Statistical heterogeneity will be assessed by visual inspection of forest plots and measured using the I2 statistics. A fixed-effect model will be used when heterogeneity is low, otherwise, a random-effect model will be chosen. Publication bias will be assessed by funnel plots, subgroup analysis and sensitivity analysis will be performed in the right context. For each outcome, we will perform data synthesis separately for RCTs and NRS using Rev Man V.5.3 software and compile ‘summary of findings’ tables separately for RCTs and NRS using GRADEpro software. Grading of Recommendations, Assessment, Development and Evaluations considerations will also be used to make an overall assessment of the quality of evidence.Ethics and disseminationThere is no requirement for ethics approval because no patient data will be collected at an individual level in this systematic review and meta-analysis.The results of this systematic review will be published in a peer-reviewed journal and presented at relevant conferences, any deviations from the protocol will be clearly documented and explained in its final report.PROSPERO registration numberCRD42020165110.

Mesenchymal stromal cells for COVID-19: A living systematic review protocol

10.1101/2020.04.13.20064162 ◽

2020 ◽

Cited By ~ 1

Author(s):

Gabriel Rada ◽

Javiera Corbalán ◽

Patricio Rojas ◽

Keyword(s):

Systematic Review ◽

Mesenchymal Stromal Cells ◽

Stromal Cells ◽

Direct Evidence ◽

Meta Analysis ◽

Grey Literature ◽

Randomised Trials ◽

Eligibility Criteria ◽

ABSTRACTObjectiveTo determine the impact of mesenchymal stromal cells outcomes important to patients with COVID-19.DesignThis is the protocol of a living systematic review.Data sourcesWe will conduct searches in PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), grey literature and in a centralised repository in L·OVE (Living OVerview of Evidence). L·OVE is a platform that maps PICO questions to evidence from Epistemonikos database. In response to the COVID-19 emergency, L·OVE was adapted to expand the range of evidence it covers and customised to group all COVID-19 evidence in one place. The search will cover the period until the day before submission to a journal.Eligibility criteria for selecting studies and methodsWe adapted an already published common protocol for multiple parallel systematic reviews to the specificities of this question.We will include randomised trials evaluating the effect of mesenchymal stromal cells versus placebo or no treatment in patients with COVID-19. Randomised trials evaluating other coronavirus infections, such as MERS-CoV and SARS-CoV, and non-randomised studies in COVID-19 will be searched in case we find no direct evidence from randomised trials, or if the direct evidence provides low- or very low-certainty for critical outcomes.Two reviewers will independently screen each study for eligibility, extract data, and assess the risk of bias. We will pool the results using meta-analysis and will apply the GRADE system to assess the certainty of the evidence for each outcome.A living, web-based version of this review will be openly available during the COVID-19 pandemic. We will resubmit it every time the conclusions change or whenever there are substantial updates.Ethics and disseminationNo ethics approval is considered necessary. The results of this review will be widely disseminated via peer-reviewed publications, social networks and traditional media.PROSPERO RegistrationSubmitted to PROSPERO (awaiting ID allocation).

Interventions to Decrease Use in Prehospital and Emergency Care Settings Among Super-Utilizers in the United States: A Systematic Review

Medical Care Research and Review ◽

10.1177/1077558719845722 ◽

2019 ◽

Vol 77 (2) ◽

pp. 99-111 ◽

Cited By ~ 5

Author(s):

Samantha Iovan ◽

Paula M. Lantz ◽

Katie Allan ◽

Mahshid Abir

Keyword(s):

Systematic Review ◽

Health Care ◽

Acute Care ◽

Emergency Care ◽

Grey Literature ◽

The United States ◽

Care Utilization ◽

Regression To The Mean ◽

High Quality ◽

Interest in high users of acute care continues to grow as health care organizations look to deliver cost-effective and high-quality care to patients. Since “super-utilizers” of acute care are responsible for disproportionately high health care spending, many programs and interventions have been implemented to reduce medical care use and costs in this population. This article presents a systematic review of the peer-reviewed and grey literature on evaluations of interventions to decrease prehospital and emergency care use among U.S. super-utilizers. Forty-six distinct evaluations were included in the review. The most commonly evaluated intervention was case management. Although a number of interventions reported reductions in prehospital and emergency care utilization and costs, methodological and study design weaknesses—especially regression to the mean—were widespread and call into question reported positive findings. More high-quality research is needed to accurately assess the impact of interventions to reduce prehospital and emergency care use in the super-utilizer population.

A Systematic Review of the Impact of Healthcare Reforms on Access to Emergency Department and Elective Surgery Services

International Journal of Health Services ◽

10.1177/0020731417722089 ◽

2017 ◽

Vol 48 (1) ◽

pp. 81-105 ◽

Cited By ~ 2

Author(s):

Sandeep Reddy ◽

Peter Jones ◽

Harsha Shanthanna ◽

Raechel Damarell ◽

John Wakerman

Keyword(s):

Systematic Review ◽

Health Care ◽

Emergency Department ◽

United Kingdom ◽

Elective Surgery ◽

Grey Literature ◽

Unintended Consequences ◽

Health Care Reforms ◽

The United Kingdom ◽

This systematic review sought to identify whether health care reforms led to improvement in the emergency department (ED) length of stay (LOS) and elective surgery (ES) access in Australia, Canada, New Zealand, and the United Kingdom. The review was registered in the PROSPERO database (CRD42015016343), and nine databases were searched for peer-reviewed, English-language reports published between 1994 and 2014. We also searched relevant “grey” literature and websites. Included studies were checked for cited and citing papers. Primary studies corresponding to national and provincial ED and ES reforms in the four countries were considered. Only studies from Australia and the United Kingdom were eventually included, as no studies from the other two countries met the inclusion criteria. The reviewers involved in the study extracted the data independently using standardized forms. Studies were assessed for quality, and a narrative synthesis approach was taken to analyze the extracted data. The introduction of health care reforms in the form of time-based ED and ES targets led to improvement in ED LOS and ES access. However, the introduction of targets resulted in unintended consequences, such as increased pressure on clinicians and, in certain instances, manipulation of performance data.

Overweight and obesity as potential prognostic factors for severity and mortality in patients with COVID-19: A living systematic review protocol

10.31219/osf.io/t97ab ◽

2020 ◽

Author(s):

Catherine Bonilla-Untiveros ◽

Saby Camacho-Lopez ◽

Eduard Baladia ◽

Luis E. Ortiz-Muñoz ◽

Gabriel Rada

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Grey Literature ◽

Overweight And Obesity ◽

Suspected Infection ◽

Central Register ◽

Review Protocol ◽

The Impact ◽

Overweight Or Obesity

ObjectiveThis living systematic review aims to provide a timely, rigorous and continuously updated summary about the impact of overweight or obesity as a prognostic factor for severity and mortality in patients with COVID-19. DesignThis is a protocol of a living systematic review.Data sourcesWe will conduct searches in MEDLINE/PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), grey literature and in a centralized repository in L·OVE (Living OVerview of Evidence). L·OVE is a platform that maps PICO questions to evidence from Epistemonikos database. In response to the COVID-19 emergency, L·OVE was adapted to expand the range of evidence it covers and customised to group all COVID-19 evidence in one place. The search will cover the period until the day before submission to a journal.Eligibility criteria for selecting studies and methods We adapted an already published common protocol for multiple parallel systematic reviews to the specificities of this question. We will include all primary studies that assess patients with confirmed or suspected infection with SARS-CoV-2 and inform the relation of overweight or obesity with death or disease severity. Two reviewers will independently screen each study for eligibility, extract data, and assess the risk of bias. We will pool the results using meta-analysis and will apply the GRADE system to assess the certainty of the evidence for each outcome. A living, web-based version of this review will be openly available during the COVID-19 pandemic. We will resubmit it every time the conclusions change or whenever there are substantial updates.

Effects of evidence-based clinical practice guidelines in cardiovascular health care quality improvements: A systematic review

F1000Research ◽

10.12688/f1000research.18865.2 ◽

2019 ◽

Vol 8 ◽

pp. 1041

Author(s):

Anggie Ramírez-Morera ◽

Mario Tristan ◽

Juan Carlos Vazquez

Keyword(s):

Systematic Review ◽

Health Care ◽

Clinical Practice ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Control Group ◽

Evidence Based ◽

Health Care Structure ◽

Background: The development of evidence-based clinical practice guidelines (EB-CPGs) has increasing global growth; however, the certainty of impact on patients and health systems, as well as the magnitude of the impact, is not apparent. The objective of this systematic review was to assess the effectiveness of the application of EB-CPGs for the improvement of the quality of health care in three dimensions: structure, process and results in the patient for the management of cardiovascular disease. Methods: We followed the methods described by the Cochrane Handbook and present a descriptive analysis because of the high heterogeneity found across the included studies. We searched the Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE databases, as well as the grey literature, between 1990 and June 2016. No language restrictions were applied. Only randomised clinical trials (RCTs) were selected. Three authors independently carried out the data extraction, using a modified version of the Cochrane Effective Practice and Organization of Care form. Results: Of the total of 84 interventions included in the nine RCTs evaluated, three (4%) were related to health care structure, 54 (64%) to the health care delivery process and 27 (32%) to patient outcomes. Regarding the impact of using the EB-CPGs, in 55 interventions (65%), there were no significant differences between control and experimental groups. In four interventions (5%), the result favoured the control group, and the result favoured the intervention group on 25 of the interventions (30%). Conclusions: This systematic review showed that EB-CPGs could be useful to improve the process and structure of health care and, to a lesser extent, to improve the patients’ outcomes. After analysing many studies, we could have one more hypothesis for further research, which could shed more light upon those undiscovered variables that might interfere with the use of the EB-CPGs. Registration: PROSPERO CRD42013003589

Oxymetazoline for the treatment of rosacea-associated persistent facial erythema. Systematic review and meta-analysis protocol

10.1101/2020.05.25.20111344 ◽

2020 ◽

Author(s):

Geovanna Cárdenas ◽

Francisco Novillo ◽

Shuheng Lai ◽

Héctor Fuenzalida ◽

Francisca Verdugo ◽

...

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Meta Analysis ◽

Grey Literature ◽

Controlled Trials ◽

Eligibility Criteria ◽

Facial Erythema ◽

Central Register ◽

ABSTRACTObjectiveThe objective of this systematic review is to assess the impact of oxymetazoline in patients with moderate to severe rosacea.Data SourcesWe will conduct a comprehensive search in PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Lilacs, the International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov, US National Institutes of Health (NIH) and grey literature, to identify all relevant randomized controlled trials regardless of language or publication status (published, unpublished, in press and in progress).Eligibility criteria for selecting studies and methodsWe will include randomized trials evaluating the effect of oxymetazoline in patients with moderate to severe rosacea. Two reviewers will independently screen each study for eligibility, data extraction, and assess the risk of bias. We will pool the results using meta-analysis and will apply the GRADE [1] system to assess the certainty of the evidence for each outcome.Ethics and DisseminationNo ethics approval is considered necessary. The results of this review will be widely disseminated via peer-reviewed publications, social networks and traditional media.Protocol and RegistrationThis protocol was adapted to the specificities of the question assessed in this review and registered to PROSPERO with the ID CRD42020150262.

Effects of evidence-based clinical practice guidelines in cardiovascular health care quality improvements: A systematic review

F1000Research ◽

10.12688/f1000research.18865.1 ◽

2019 ◽

Vol 8 ◽

pp. 1041

Author(s):

Anggie Ramírez-Morera ◽

Mario Tristan ◽

Juan Carlos Vazquez

Keyword(s):

Systematic Review ◽

Health Care ◽

Clinical Practice ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Care Quality ◽

Control Group ◽

Health Care Structure ◽

Background: The development of clinical practice guidelines (CPGs) has increasing global growth; however, the certainty of impact on patients and health systems, as well as the magnitude of the impact, is not apparent. The objective of this systematic review was to assess the effectiveness of the application of CPGs for the improvement of the quality of health care in three domains: structure, process and results in the patient for the management of cardiovascular disease. Methods: We followed the methods described by the Cochrane Handbook and present a descriptive analysis because of the high heterogeneity found across the included studies. We searched the Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE databases, as well as the grey literature, between 1990 and June 2016. No language restrictions were applied. Only randomised clinical trials (RCTs) were selected. Three authors independently carried out the data extraction, using a modified version of the Cochrane Effective Practice and Organization of Care form. Results: Of the total of 84 interventions included in the nine RCTs evaluated, three (4%) were related to health care structure, 54 (64%) to the health care delivery process and 27 (32%) to patient outcomes. Regarding the impact of using the CPGs, in 55 interventions (65%), there were no significant differences between control and experimental groups. In four interventions (5%), the result favoured the control group, and the result favoured the intervention group on 25 of the interventions (30%). Conclusions: This systematic review showed that CPGs could be useful to improve the process and structure of health care and, to a lesser extent, to improve the results in patients. However, evidence was weak. There are probably still undiscovered variables that interfere with the use of the CPGs and, therefore, with their impact. Therefore, more studies of good quality are needed. Registration: PROSPERO CRD42013003589.