Efficacy of interventions incorporating mobile applications in facilitating weight loss and health behavior change in the Asian population: a systematic review and meta-analysis (Preprint)

2021 ◽  
Author(s):  
Siew Min Ang ◽  
Juliana Chen ◽  
Jolyn Johal ◽  
Jia Huan Liew ◽  
Yock Young Dan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Weight Loss ◽  
Health Behavior ◽  
Weight Management ◽  
Weight Change ◽  
Meta Analysis ◽  
Asian Population ◽  
Health Behavior Change ◽  
Controlled Trials

BACKGROUND Smartphone applications (apps) have shown potential in enhancing weight management in the Western population in the short to medium term. With a rapidly growing obesity burden in the Asian populations, researchers are turning to apps as a service delivery platform to reach a greater target audience to efficiently tackle the problem. OBJECTIVE This systematic review and meta-analysis aimed to determine the efficacy of interventions incorporating apps in facilitating weight loss and health behavior change in the Asian population. METHODS Six databases were searched in June 2020. Eligible studies were controlled trials utilizing an app in the intervention in participants aged 18 years or above and from an Asian ethnicity. A meta-analysis to test intervention efficacy, subgroup analyses and post-hoc analyses were conducted to determine the effects of adding app to usual care and study duration. The primary outcome was absolute or percentage weight change while secondary outcomes were changes to lifestyle behaviors. RESULTS A total of 21 studies were included in this review and 17 were selected for the meta-analysis. The pooled effect size across 14 randomized controlled trials for weight change was small to moderate (Hedges’ g = -0.28, 95% CI = -0.44 to -0.12) however, this was not representative of long-term studies (more than a year). Stand-alone app interventions were inefficacious for weight loss but supplementing multi-component usual care with an app led to statistically significant weight change (Hedges’ g = -0.25 95% CI = -0.43 to -0.07). Asian apps were largely culturally adapted and multi-functional, with the most common app features being communication with health professionals and self-monitoring of behaviors and outcomes. CONCLUSIONS More evidence is required to determine the efficacy of apps in the long term and address app non-usage to maximize the potential of the intervention. Future research should determine the efficacy of each component of the multi-component intervention to facilitate study designs that are most effective and cost-efficient for weight management. CLINICALTRIAL PROSPERO REGISTRATION: CRD42020165240.

scholarly journals Efficacy and safety of phentermine/topiramate in adults with overweight or obesity: A meta-analysis and systematic review

2020 ◽  
Author(s):  
Xiang-Guo Lei ◽  
Chen Lai ◽  
Ziyi Sun ◽  
Xi Yang
Keyword(s):  
Systematic Review ◽  
Weight Loss ◽  
Nervous System ◽  
Body Weight ◽  
Adverse Events ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Reduced Body

AbstractObjectiveTo examine the association between phentermine/topiramate therapy and weight loss and adverse events in adults with overweight problems or obesity by meta-analysis and systematic review.MethodsMedical Subject Headings (MeSH) and free-text terms related to phentermine/topiramate were selected to search for eligible trials in PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE up to April 18, 2020. The quality of randomized controlled trials was evaluated by Cochrane risk-of-bias tool. Meta-analysis was performed using random-effect models. Our systematic review protocol, registered on PROSPERO (registration number CRD42020188324).ResultsPhentermine/topiramate therapy resulted in a weight loss of 7.73 kg (95% confidence interval [CI]: 6.60, 8.85) compared to placebo. For phentermine/topiramate subjects in different weight loss subgroups, the weight loss of subjects with ≥5%, ≥10%, and ≥15% baseline weight loss were 3.18 (95% CI: 2.75, 3.67), 5.32 (95% CI: 4.53, 6.25), and 5.65 (95% CI: 3.55, 9.01), respectively. Phentermine/topiramate reduced waist circumference, blood pressure, blood sugar levels, and lipid levels. The adverse effects associated with the treatment mainly included Dysgeusia, Paresthesia, Dry mouth.ConclusionsPhentermine/topiramate reduced body weight and was well tolerated. However, it increased the risk of nervous system-related adverse events to a certain extent, but the symptoms are not serious. Long-term clinical and pharmacological studies are needed to understand the long-term efficacy and safety of phentermine/topiramate.Study Importance QuestionsPhentermine/topiramate was approved by the FDA as an anti-obesity drug. However, the European Medicines Agency refused marketing authorization for phentermine/topiramate owing to safety concerns.Phentermine/topiramate reduced body weight and was well tolerated. However, it remarkably increased the risk of nervous system-related adverse events.In this study, the efficacy and incidence of adverse events of phentermine/topiramate were further evaluated through meta-analysis to provide reference for the clinical use of phentermine/topiramate.

Group programmes for weight loss may be more effective than one-to-one sessions

BMJ ◽  
2021 ◽  
pp. n2771
Author(s):  
Helen Saul ◽  
Deniz Gursul
Keyword(s):  
Systematic Review ◽  
Weight Loss ◽  
Weight Management ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Group Versus ◽  
Controlled Trials ◽  
Lifestyle Interventions ◽  
One To One ◽  
Randomised Controlled

The study Abbott S, Smith E, Tighe B, Lycett D. Group versus one-to-one multi-component lifestyle interventions for weight management: a systematic review and meta-analysis of randomised controlled trials. J Hum Nutr Diet 2021;34:485-93. To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/group-weight-loss-programmes-more-effective-than-one-to-one-sessions/

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

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Josipa Petric ◽  
Tim Bright ◽  
David Liu ◽  
Melissa Wee ◽  
David Watson
Keyword(s):  
Systematic Review ◽  
Hiatus Hernia ◽  
Mesh Repair ◽  
Meta Analysis ◽  
Hernia Recurrence ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Absorbable Mesh ◽  
Hiatal Closure

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

scholarly journals Risk of major bleeding during extended oral anticoagulation in patients with first unprovoked venous thromboembolism: a systematic review and meta-analysis protocol

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Faizan Khan ◽  
Miriam Kimpton ◽  
Tobias Tritschler ◽  
Grégoire Le Gal ◽  
Brian Hutton ◽  
...  
Keyword(s):  
Systematic Review ◽  
Venous Thromboembolism ◽  
Anticoagulant Therapy ◽  
Major Bleeding ◽  
Oral Anticoagulation ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Bleeding Events ◽  
Major Bleeding Events

Abstract Background The optimal duration of anticoagulation after a first unprovoked venous thromboembolism (VTE) remains controversial. Deciding to stop or continue anticoagulant therapy indefinitely after completing 3 to 6 months of initial treatment requires balancing the long-term risk of recurrent VTE if anticoagulation is stopped against the long-term risk of major bleeding if anticoagulation is continued. However, knowledge of the long-term risk for major bleeding events during extended anticoagulation in this patient population is limited. We plan to conduct a systematic review and meta-analysis to quantify the risk for major bleeding events during extended oral anticoagulation in patients with first unprovoked VTE. Methods Electronic databases including MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials will be systematically searched with the assistance of an information specialist (from inception to March 1, 2019) to identify randomized controlled trials and prospective cohort studies reporting major bleeding during extended oral anticoagulation in patients with first unprovoked VTE, who have completed at least 3 months of initial anticoagulant therapy. Study selection, risk of bias assessment, and data extraction will be performed independently by at least two investigators. The number of major bleeding events and person-years of follow-up will be used to calculate the rate (events per 100 person-years) with its 95% confidence interval for each study cohort, during clinically relevant time periods of extended anticoagulant therapy. Results will be pooled using random effect meta-analysis. Discussion The planned systematic review and meta-analysis will provide reliable estimates of the risk for major bleeding events during extended anticoagulation. This information will help inform patient prognosis and assist clinicians with balancing the risks and benefits of treatment to guide management of unprovoked VTE. Systematic review registration PROSPERO CRD42019128597.

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