The screening value of mammography for breast cancer : an overview of 22 systematic reviews with evidence mapping (Preprint)

2021 ◽  
Author(s):  
Jiyuan Shi Jr ◽  
Ya Gao Sr ◽  
Peng Wang 2nd ◽  
Liang Zhao ◽  
Shuang Wu 4th ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Reviews ◽  
Mammography Screening ◽  
Meta Analysis ◽  
Breast Cancer Mortality ◽  
Digital Breast Tomosynthesis ◽  
Recall Rate ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Evidence Mapping

UNSTRUCTURED Several meta-analyses have evaluated the screening value of mammography for breast cancer, but the overall results have remained mixed or inconclusive. Comprehensive literature search was conducted for SRs (systematic reviews) in Chinese Biomedical Databases (CBM), Cochrane Library, EMBASE, and PubMed until July 10, 2020. SRs with meta-analysis reported the benefit and performance of mammography screening were included. Two reviewers independently extracted data and performed the methodological quality assessments using The Risk Of Bias In Systematic Reviews (ROBIS). The characteristics of included SRs, the results of the quality of Risk of bias (RoBs) assessment and the pooled estimates of effect size were descriptively summarized using systematically structured tables and evidence mapping. Twenty two systematic reviews with meta-analysis were included. Only 13.6% of SRs were assessed as low-risk bias according to the overall risk of bias rating results in ROBIS tool. Pooled estimates for a reduction in breast cancer mortality attributable to mammography screening were range from 0.51 (OR, 95% CI: 0.46-0.55) to 1.04 (RR, 95% CI: 0.84-1.27). Sensitivity of difference mammography was ranged from 55% to 91%, specificity of difference mammography was ranged from 84% to 97%. According to the results of included SRs suggested, the statistically significant was observed that digital breast tomosynthesis (DBT) increased the cancer detected rate (CDR) and reduced the recall rate compared to digital mammography (DM), DM increased the CDR compared to screen-film mammography (SFM), and add DBT to digital or synthetic mammography increases the sensitivity, specificity, and CDR than DBT alone. Further study should investigate the value of different imaging technology in breast cancer screening.

scholarly journals The Screening Value of Mammography for Breast Cancer: An Overview of 22 Systematic Reviews with Evidence Mapping

2020 ◽  
Author(s):  
Jiyuan Shi ◽  
Jiang Li ◽  
Lili Zhang ◽  
Ya Gao ◽  
Yamin Chen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Reviews ◽  
Mammography Screening ◽  
Meta Analysis ◽  
Breast Cancer Mortality ◽  
Digital Breast Tomosynthesis ◽  
Recall Rate ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Evidence Mapping

Abstract Background: Several meta-analyses have evaluated the screening value of mammography for breast cancer, but the overall results have remained mixed or inconclusive. Methods: Comprehensive literature search was conducted for SRs (systematic reviews) in Chinese Biomedical Databases (CBM), Cochrane Library, EMBASE, and PubMed until July 10, 2020. SRs with meta-analysis reported the benefit and performance of mammography screening were included. Two reviewers independently extracted data and performed the methodological quality assessments using The Risk Of Bias In Systematic Reviews (ROBIS). The characteristics of included SRs, the results of the quality of Risk of bias (RoBs) assessment and the pooled estimates of effect size were descriptively summarized using systematically structured tables and evidence mapping. Results: Twenty two systematic reviews with meta-analysis were included. Only 13.6% of SRs were assessed as low-risk bias according to the overall risk of bias rating results in ROBIS tool. Pooled estimates for a reduction in breast cancer mortality attributable to mammography screening were range from 0.51 (OR, 95% CI: 0.46-0.55) to 1.04 (RR, 95% CI: 0.84-1.27). Sensitivity of difference mammography was ranged from 55% to 91%, specificity of difference mammography was ranged from 84% to 97%. According to the results of included SRs suggested, the statistically significant was observed that digital breast tomosynthesis (DBT) increased the cancer detected rate (CDR) and reduced the recall rate compared to digital mammography (DM), DM increased the CDR compared to screen-film mammography (SFM), and add DBT to digital or synthetic mammography increases the sensitivity, specificity, and CDR than DBT alone. Conclusions: Further study should investigate the value of different imaging technology in breast cancer screening.Systematic review registration: PROSPERO CRD42020207227

scholarly journals Worldwide Review and Meta-Analysis of Cohort Studies Measuring the Effect of Mammography Screening Programmes on Incidence-Based Breast Cancer Mortality

Cancers ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 976
Author(s):  
Amanda Dibden ◽  
Judith Offman ◽  
Stephen W. Duffy ◽  
Rhian Gabe
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Cancer Mortality ◽  
Mammography Screening ◽  
Meta Analysis ◽  
Breast Cancer Mortality ◽  
Substantial Reduction ◽  
Healthcare Setting ◽  
Actual Attendance

In 2012, the Euroscreen project published a review of incidence-based mortality evaluations of breast cancer screening programmes. In this paper, we update this review to October 2019 and expand its scope from Europe to worldwide. We carried out a systematic review of incidence-based mortality studies of breast cancer screening programmes, and a meta-analysis of the estimated effects of both invitation to screening and attendance at screening, with adjustment for self-selection bias, on incidence-based mortality from breast cancer. We found 27 valid studies. The results of the meta-analysis showed a significant 22% reduction in breast cancer mortality with invitation to screening, with a relative risk of 0.78 (95% CI 0.75–0.82), and a significant 33% reduction with actual attendance at screening (RR 0.67, 95% CI 0.61–0.75). Breast cancer screening in the routine healthcare setting continues to confer a substantial reduction in mortality from breast cancer.

scholarly journals Effect of Preemptive Acetaminophen on Opioid Consumption: A Meta-Analysis

2021 ◽  
pp. E153-E160
Keyword(s):  
General Anesthesia ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Potential Method ◽  
Included Study ◽  
Risk Of Bias ◽  
Opioid Consumption ◽  
Preemptive Analgesia ◽  
Cochrane Library ◽  
Pain Scores

BACKGROUND: Strategies for reducing postoperative opioid consumption have been explored in many recent studies, due in large part to the recent opioid epidemic. Preemptive analgesia has been proposed as a potential method, but its use is still controversial. OBJECTIVES: This review aimed to evaluate the efficacy of a single dose of acetaminophen as preemptive analgesia for patients undergoing general anesthesia. STUDY DESIGN: A meta-analysis of randomized controlled trials (RCTs). SETTING: The electronic databases of PubMed, EMBASE, Cochrane Library, and the Web of Science were searched. The protocol was previously registered in the PROSPERO database under the registration number CRD 42020165634. METHODS: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. RCTs that compared preemptive acetaminophen with placebo in surgical patients receiving general anesthesia were included. The risk of bias for each included study was independently assessed using the criteria outlined in the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS: Six studies with 563 patients were included. Overall, the studies showed a reduction in 24-hour opioid consumption (standardized mean difference [SMD], –1.45; 95% confidence interval [CI], –2.36 to –0.55; P = 0.002), pain scores at 12 hours postoperatively (SMD, –0.86; 95% CI, –1.25 to –0.48; P < 0.0001), and a lower incidence of postoperative nausea (risk ratio [RR] 0.45; 95% CI, 0.34–0.58; P < 0.001) and vomiting (RR 0.39; 95% CI, 0.22–0.72; P = 0.002). LIMITATIONS: The major limitation of this meta-analysis relates to the risk of bias in the limited number of included studies. CONCLUSIONS: Preemptive acetaminophen administration significantly reduces opioid consumption within the initial 24 hours following general anesthesia, with lower pain scores at 12 hours after surgery, and less nausea and vomiting. However, well-conducted RCTs are still needed. KEY WORDS: Acetaminophen, preemptive analgesia, perioperative pain management, postoperative opioid consumption, opioid-related side effects

Effectiveness of Mammography Screening in Reducing Breast Cancer Mortality in Women Aged 39–49 Years: A Meta-Analysis

2011 ◽  
Vol 20 (6) ◽  
pp. 845-852 ◽  
Author(s):  
Maria C. Magnus ◽  
Ma Ping ◽  
Miao Miao Shen ◽  
John Bourgeois ◽  
Jeanette H. Magnus
Keyword(s):  
Breast Cancer ◽  
Cancer Mortality ◽  
Mammography Screening ◽  
Meta Analysis ◽  
Breast Cancer Mortality

scholarly journals Effectiveness and Safety of Acupuncture for Migraine: An Overview of Systematic Reviews

2020 ◽  
Vol 2020 ◽  
pp. 1-14 ◽  
Author(s):  
Yu-Xi Li ◽  
Xi-li Xiao ◽  
Dong-Ling Zhong ◽  
Liao-Jun Luo ◽  
Han Yang ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Western Medicine ◽  
Data Extraction ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Measurement Tool ◽  
High Quality ◽  
Quality Of Evidence

Background. Migraine is a common neurological disease, which burdens individuals and society all over the world. Acupuncture, an important method in Traditional Chinese Medicine, is widely used in clinical practice as a treatment for migraine. Several systematic reviews (SRs) have investigated the effectiveness and safety of acupuncture for migraine. Objective. To summarize and critically assess the quality of relevant SRs and present an objective and comprehensive evidence on the effectiveness and safety of acupuncture for migraine. Data Sources. MEDLINE, Embase, Cochrane Library, PROSPERO database, Chinese National Knowledge Infrastructure (CNKI), Chinese Biological Medicine (CBM), China Science and Technology Journal (SCTJ), and WanFang database (WF) were searched from inception to December 2019 and grey literatures were manually searched. Selection Criteria. SRs which meet the criteria were independently selected by 2 reviewers according to a predetermined protocol. Data Extraction. Characteristics of included SRs were independently extracted by 2 reviewers following a predefined data extraction form. Review Appraisal. The methodological quality, risk of bias, and reporting quality of included SRs were assessed, respectively, by a Measurement Tool to Assess Systematic Reviews (AMSTAR) 2, the Risk of Bias in Systematic reviews (ROBIS) tool, and the Preferred Reporting Item for Systematic Review and Meta-analysis-Acupuncture (PRISMA-A) statement. The quality of outcomes was evaluated by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results. A total of 15 SRs were included. All the SRs were published between 2011–2019. Based on AMSTAR 2, 14 out of 15 SRs were rated critically low quality and 1 was rated low quality. According to ROBIS tool, 9 SRs (60%) were low risk of bias. With the PRISMA-A checklist, we found 11 out of 15 SRs were found adequately reported over 70%. With the GRADE tool, we found high quality of evidence indicated that the effective rate of acupuncture was superior to western medicine in treatment of migraine. Besides, acupuncture reduced more headache days and the times of using painkiller and was more effective in reducing the frequency and degree of headache than western medicine and sham acupuncture. Limitations. There might be some missing information. The accuracy of the conclusions may be decreased reduced since we were unable to synthesis all the evidence. Conclusions. Based on high quality of evidence, we concluded that acupuncture may be an effective and safe therapy for migraine. However, the quality of SRs in acupuncture for migraine still needs more improvement.

scholarly journals Meta Analysis: Effect of Mammography Screening on Breast Cancer Mortality

2021 ◽  
Vol 6 (2) ◽  
pp. 148-157
Author(s):  
Bening Rahimi Titisari ◽  
◽  
Vitri Widyaningsih ◽  
Bhisma Murti ◽  
◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Mortality ◽  
Mammography Screening ◽  
Meta Analysis ◽  
Breast Cancer Mortality

CDK4/6 inhibitors in advanced hormone receptor-positive/HER2-negative breast cancer: A network meta-analysis (NMA) of randomized controlled trials (RCTs).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e12545-e12545
Author(s):  
Muhammad Husnain ◽  
Irbaz Bin Riaz ◽  
Farva R. Gondal ◽  
Saad Malik ◽  
Qurat Ul Ain Riaz Sipra ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormone Receptor ◽  
Meta Analysis ◽  
Indirect Comparison ◽  
Qt Prolongation ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Resistant Disease ◽  
Hormone Receptor Positive ◽  
Consistency Model

e12545 Background: Palbociclib(P), Ribociclib(R) and Abemaciclib(A) in combination with Endocrine therapy (ET) have demonstrated progression free survival (PFS) in patients with metastatic hormone receptor positive, HER2-negative breast cancer as compared to ET alone. In the absence of head to head clinical trials and to provide clinical guidance, we performed an indirect comparison for P, R and A using network Meta-Analysis (NMA). Methods: MEDLINE, EMBASE and the Cochrane Library were searched to identify RCTs comparing P+ET, R+ET, A+ ET vs ET alone. NMA for PFS and toxicity endpoints was conducted using a multivariate random-effects meta-regression, using a consistency model, as described by White and colleagues. We used a frequentist approach and provided a point estimate from the network and a 95% CI from the frequency distribution of the estimate. We also estimated the relative ranking of the different treatments for each outcome using the distribution of the ranking probabilities and the surface under the cumulative ranking curves (SUCRA). Risk of bias was assessed using Cochrane Collaboration tool. Results: 8 RCTs were identified including 4580 patients. Risk of bias was low. 5 RCTs tested CDK 4/6 inhibitors in endocrine naive and 2 in the refractory setting, while MONALESSA-3 included patients both with endocrine naive and endocrine resistant disease. In the endocrine naïve patients, PFS for P was similar when compared indirectly with R (HR, 0.95, 95% CI 0.67-1.35) or A (HR, 1.00, 95% CI 0.62-1.61). Similarly, indirect comparison between R vs A did not show any statistical significant (HR, 0.95, 95% CI 0.62-1.45). In endocrine refractory patients, P showed no difference when compared indirectly to A (HR 1.12, 95% CI 0.67-1.87) or R (HR 0.98, 95% CI 0.52-1.86). R vs A did not show any statistically significant PFS either (HR, 1.14, 95% CI 1.61-4.51). P was ranked first in terms of PFS in frontline setting (SUCRA of 70.5) while R ranked first in the refractory setting (SUCRA of 39.5). QT prolongation was reported for R only. P caused more neutropenia while A caused more fatigue, anemia and diarrhea, although the results were not statistically significant. Conclusions: The efficacy of using either palbociclib, ribociclib or abemaciclib in combination with ET was similar in terms of PFS in either endocrine naïve or resistant disease. Palbociclib causes more neutropenia, abemaciclib causes more fatigue, anemia and diarrhea while ribociclib causes QT prolongation.

scholarly journals Performance of Digital Breast Tomosynthesis, Synthetic Mammography and Digital Mammography in Breast Cancer Screening: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Mostafa Alabousi ◽  
Akshay Wadera ◽  
Mohammed Kashif Al-Ghita ◽  
Rayeh Kashef Al-Ghetaa ◽  
Jean-Paul Salameh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Digital Mammography ◽  
Statistical Tests ◽  
Meta Analysis ◽  
Digital Breast Tomosynthesis ◽  
Recall Rate ◽  
Breast Tomosynthesis

Abstract Background To perform a systematic review and meta-analysis comparing the breast cancer detection rate (CDR), invasive CDR, recall rate, and positive predictive value 1 (PPV1) of digital breast tomosynthesis (DBT), combined DBT and digital mammography (DM), combined DBT and synthetic 2 D-mammography (S2D), and DM alone. Methods MEDLINE and Embase were searched until April 2020 to identify comparative design studies reporting on patients undergoing routine breast cancer screening. Random effects model proportional meta-analyses estimated CDR, invasive CDR, recall rate, and PPV1. Meta-regression modeling was utilized to compare imaging modalities. All statistical tests were two-sided. Results Forty-two studies reporting on 2,606,296 patients (13,003 breast cancer cases) were included. CDR was highest in combined DBT and DM (6.36 per 1,000 screened, 95% confidence interval [CI]=5.62–7.14; P &lt; .001), and combined DBT and S2D (7.40 per 1,000 screened, 95% CI = 6.49–8.37; P &lt; .001) compared to DM alone (4.68 per 1,000 screened, 95% CI = 4.28–5.11). Invasive CDR was highest in combined DBT and DM (4.53 per 1,000 screened, 95% CI = 3.97–5.12, P = .003), and combined DBT and S2D (5.68 per 1,000 screened, 95% CI = 4.43–7.09; P &lt; .001) compared to DM alone (3.42 per 1,000 screened, 95% CI = 3.02–3.83). Recall rate was lowest in combined DBT and S2D (42.3%, 95% CI = 37.4%–60.4%, P &lt; .001). PPV1 was highest in combined DBT and DM (10.0%, 95% CI = 8.0–12.0; P = .004), and combined DBT and S2D (16.0%, 95% CI = 10.0–23.0; P &lt; .001), while no difference was detected for DBT alone (7.0%, 95% CI = 6.0%–8.0%; P = .75) compared to DM alone (7.0%, 95.0% CI = 5.0%–8.0%). Conclusion Our findings provide evidence on key performance metrics for DM, DBT alone, combined DBT and DM, and combined DBT and S2D, which may inform optimal application of these modalities for breast cancer screening.

scholarly journals Effectiveness of Nutritional Education for Obese Older Adults With Frailty: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 401-401
Author(s):  
Yue-Heng Yin ◽  
Liu Yat Justina
Keyword(s):  
Systematic Review ◽  
Physical Function ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Well Being ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Nutritional Education ◽  
Hand Search ◽  
Education Interventions

Abstract Obesity has been shown to intensify the decline of physical function and lead to frailty. Nutrition is an important method in managing obesity and frailty, while seldom reviews have ever explored the effects of nutritional education interventions. We conducted a systematic review (PROSPERO: CRD42019142403) to explore the effectiveness of nutritional education interventions in managing body composition and physio-psychosocial parameters related to frailty. Randomized controlled trials and quasi-experimental studies were searched in CINAHL, Cochrane Library, EMBASE, MEDLINE, PsycINFO, PubMed and Scopus from 2001 to 2019. Hand search for the reference lists of included papers was conducted as well. We assessed the quality of included studies by Cochrane risk of bias tool. Meta-analyses and narrative synthesis were used to analyse the data. Two studies with low risk of bias were screened from 180 articles, which involved 177 older people with an average age of 69.69±4.08 years old. The results showed that nutritional education was significantly effective in reducing body weight and fat mass than exercises, and it was beneficial to enhancing physical function and psychosocial well-being. But the effects of nutritional education in increasing muscle strength were not better than exercises. The combined effects of nutritional education and exercises were superior than either exercises or nutritional education interventions solely in preventing the loss of lean mass and bone marrow density, and in improving physical function. Due to limited numbers of relevant studies, the strong evidence of effectiveness of nutritional education interventions on reversing frailty is still lacking.

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