Comparative effectiveness of interventions for treatment of overweight and obesity

Overweight and obesity are amongst most common problems of our time and have a significant negative impact on somatic health. Recently have been published several systematic reviews and meta-analysis that evaluated the effectiveness of various methods for overweight and obesity treatment. These studies are not yet included in the clinical guidelines, but might contain important results.

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Comparative Effectiveness Research: Using Systematic Reviews and Meta-Analyses to Synthesize Empirical Evidence

Research and Theory for Nursing Practice ◽

10.1891/1541-6577.25.3.191 ◽

2011 ◽

Vol 25 (3) ◽

pp. 191-209 ◽

Cited By ~ 2

Author(s):

Maria C. Katapodi ◽

Laurel L. Northouse

Keyword(s):

Systematic Reviews ◽

Comparative Effectiveness Research ◽

Comparative Effectiveness ◽

Meta Analysis ◽

Research Question ◽

Alternative Methods ◽

Evidence Based ◽

Effectiveness Research ◽

Meta Analyses ◽

Research Studies

The increased demand for evidence-based health care practices calls for comparative effectiveness research (CER), namely the generation and synthesis of research evidence to compare the benefits and harms of alternative methods of care. A significant contribution of CER is the systematic identification and synthesis of available research studies on a specific topic. The purpose of this article is to provide an overview of methodological issues pertaining to systematic reviews and meta-analyses to be used by investigators with the purpose of conducting CER. A systematic review or meta-analysis is guided by a research protocol, which includes (a) the research question, (b) inclusion and exclusion criteria with respect to the target population and studies, © guidelines for obtaining relevant studies, (d) methods for data extraction and coding, (e) methods for data synthesis, and (f ) guidelines for reporting results and assessing for bias. This article presents an algorithm for generating evidence-based knowledge by systematically identifying, retrieving, and synthesizing large bodies of research studies. Recommendations for evaluating the strength of evidence, interpreting findings, and discussing clinical applicability are offered.

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Effectiveness of Mobile Health Interventions on Diabetes and Obesity Treatment and Management: Systematic Review of Systematic Reviews (Preprint)

10.2196/preprints.15400 ◽

2019 ◽

Author(s):

Youfa Wang ◽

Jungwon Min ◽

Jacob Khuri ◽

Hong Xue ◽

Bo Xie ◽

...

Keyword(s):

Glycemic Control ◽

Systematic Reviews ◽

Mobile Health ◽

Weight Reduction ◽

Text Messaging ◽

Meta Analysis ◽

Obesity Treatment ◽

Future Research ◽

The Impact ◽

Diabetes And Obesity

BACKGROUND Diabetes and obesity have become epidemics and costly chronic diseases. The impact of mobile health (mHealth) interventions on diabetes and obesity management is promising; however, studies showed varied results in the efficacy of mHealth interventions. OBJECTIVE This review aimed to evaluate the effectiveness of mHealth interventions for diabetes and obesity treatment and management on the basis of evidence reported in reviews and meta-analyses and to provide recommendations for future interventions and research. METHODS We systematically searched the PubMed, IEEE Xplore Digital Library, and Cochrane databases for systematic reviews published between January 1, 2005, and October 1, 2019. We analyzed 17 reviews, which assessed 55,604 original intervention studies, that met the inclusion criteria. Of those, 6 reviews were included in our meta-analysis. RESULTS The reviews primarily focused on the use of mobile apps and text messaging and the self-monitoring and management function of mHealth programs in patients with diabetes and obesity. All reviews examined changes in biomarkers, and some reviews assessed treatment adherence (n=7) and health behaviors (n=9). Although the effectiveness of mHealth interventions varied widely by study, all reviews concluded that mHealth was a feasible option and had the potential for improving patient health when compared with standard care, especially for glycemic control (−0.3% to −0.5% greater reduction in hemoglobin A<sub>1c</sub>) and weight reduction (−1.0 kg to −2.4 kg body weight). Overall, the existing 6 meta-analysis studies showed pooled favorable effects of these mHealth interventions (−0.79, 95% CI −1.17 to −0.42; I2=90.5). CONCLUSIONS mHealth interventions are promising, but there is limited evidence about their effectiveness in glycemic control and weight reduction. Future research to develop evidence-based mHealth strategies should use valid measures and rigorous study designs. To enhance the effectiveness of mHealth interventions, future studies are warranted for the optimal formats and the frequency of contacting patients, better tailoring of messages, and enhancing usability, which places a greater emphasis on maintaining effectiveness over time.

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Epidemiology of obesity and overweight in sub-Saharan Africa: a protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2017-017666 ◽

2017 ◽

Vol 7 (11) ◽

pp. e017666 ◽

Cited By ~ 10

Author(s):

Sibhatu Biadgilign ◽

Tennyson Mgutshini ◽

Demewoz Haile ◽

Bereket Gebremichael ◽

Yonatan Moges ◽

...

Keyword(s):

Systematic Review ◽

Random Effects ◽

Systematic Reviews ◽

Reference Lists ◽

Meta Analysis ◽

Overweight And Obesity ◽

Sub Saharan Africa ◽

Obesity And Overweight ◽

Prevalence Of Obesity ◽

Sub Saharan

IntroductionGlobally, overweight and obesity were estimated to cause 3.4 million deaths, 3.9% of years of life lost and 3.8% of disability-adjusted life years in 2010. Despite the fact that obesity and overweight is a problem of high-income countries, low- and middle-income countries (LMICs), in particular urban settings of sub-Saharan African countries, face the challenge of an increasing trend. The aim of this systematic review and meta-analysis will be to determine the prevalence of obesity and overweight individuals in sub-Saharan Africa and to help guide policy planners in the decision-making process for the increase in non-communicable diseases in Africa.Methods and analysesA comprehensive systematic review and meta-analysis of published studies on the prevalence of obesity and overweight in sub-Saharan Africa will be conducted. A computerised internet search using Medline/PubMed, Google Scholar and EMBASE databases and reference lists of previous prevalence studies and detailed search strategy and cross-checking of reference lists of published peer-reviewed articles will be conducted to identify all epidemiological and/or clinical studies published in English and French. We will use the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement for reporting. The overall effect (pooled estimated effect size) of the prevalence of obesity and overweight will be analysed using the Der Simonian–Laird random effects meta-analysis (random effects model) and the obesity proportion (with 95% CI) will be measured.Ethics and disseminationThe underlying work is based on systematic reviews of published data and thus doed not require ethical review approval. The findings of the systematic review will be disseminated in different conferences and seminars and will be published in a reputable and refereed international peer-reviewed journal.PROSPERO registration numberCRD42017064942.

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The association between labor induction and autism spectrum disorders among children: a meta-analysis

Current Pediatric Reviews ◽

10.2174/1573396317666210521155111 ◽

2021 ◽

Vol 17 ◽

Author(s):

Saeid Bashirian ◽

Mahdieh Seyedi ◽

Katayoon Razjouyan ◽

Ensiyeh Jenabi

Keyword(s):

Negative Impact ◽

Meta Analysis ◽

Random Effect ◽

Autism Spectrum ◽

Labor Induction ◽

Case Control Studies ◽

Increased Risk ◽

Significant Negative Impact ◽

Spectrum Disorders

Background: There was a hypothesis that the oxytocin used during labor could increase the risk of neurodevelopmental disorders, such as ASD. Objective: This meta-analysis pooled all observational studies to obtain the association between labor induction and the risk of ASD among children. We identified all published studies up to August 2020 through PubMed, Scopus, Web of Science and gray literature. The pooled odds ratios (OR), relative ratio (RR) and 95% confidence intervals (CI (were calculated as random effect estimates of association among studies. Results: The pooled estimates of OR and RR reported a significant association between labor induction and ASD among children, respectively (OR = 1.09, 95% CI = 1.04 to 1.15) and (RR = 1.06, 95% CI = 1.02 to 1.09). The subgroup analyses were performed based on the adjusted form and design of studies. OR in crude and adjusted studies were reported 1.25(1.01, 1.49) and 1.08(1.02, 1.14), respectively. A significant association was found in adjusted and crude studies. But there is no significant association between labor induction and ASD in case-control studies (OR=1.08, 95% CI = 0.99, 1.17). Conclusion: The findings showed that labor induction is associated with increased risk of ASD among children. Therefore, the findings support that clinical use of oxytocin during labor has a significant negative impact on the long-term mental health of children.

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Peri-discharge complex interventions for reducing 30-day hospital readmissions among heart failure patients: overview of systematic reviews and network meta-analysis

Perspectives in Public Health ◽

10.1177/1757913920985258 ◽

2021 ◽

pp. 175791392098525

Author(s):

CCW Zhong ◽

CHL Wong ◽

WKW Cheung ◽

E-K Yeoh ◽

CT Hung ◽

...

Keyword(s):

Heart Failure ◽

Disease Management ◽

Systematic Reviews ◽

Comparative Effectiveness ◽

Meta Analysis ◽

Hospital Readmissions ◽

Complex Interventions ◽

Emergency Department Visits ◽

Day Hospital ◽

Overview Of Systematic Reviews

Aims: An overview of systematic reviews (SRs) and network meta-analysis (NMA) was conducted to synthesize evidence of comparative effectiveness of different peri-discharge complex interventions for reducing 30-day hospital readmissions among heart failure (HF) patients. Methods: We searched five databases for SRs from their inception to August 2019 and conducted additional search for randomized controlled trials (RCTs) published between 2003 and 2020. We used random-effect pairwise meta-analysis with pooled risk ratios (RRs) and 95% confidence intervals (CIs) to quantify the effect of complex interventions, and NMA to evaluate comparative effectiveness among complex interventions. Primary outcome was 30-day all-cause hospital readmissions, while secondary outcomes were 30-day HF-related hospital readmissions, 30-day mortality, and 30-day emergency department visits. Results: From 20 SRs and additional RCT search, 21 eligible RCTs ( n = 5362) assessing eight different peri-discharge complex interventions were included. Pairwise meta-analysis showed no significant difference between peri-discharge complex interventions and controls on all outcomes, except that peri-discharge complex interventions were significantly more effective than controls in reducing 30-day mortality (pooled RR = 0.68, 95% CI: 0.49–0.95, 5 RCTs). NMA indicated that for reducing 30-day all-cause hospital readmissions, supportive–educative intervention had the highest probability to be the best intervention, followed by disease management; while for reducing 30-day HF-related hospital readmissions, disease management is likely to be the best intervention. Conclusions: Our results suggest that disease management has the best potential to reduce 30-day all-cause and HF-related hospital readmissions. Benefits of the interventions may vary across health system contexts. Evidence-based complex interventions require local adaptation prior to implementation.

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Obesity as a risk factor for heart failure: overview of systematic reviews

Research Society and Development ◽

10.33448/rsd-v11i1.24380 ◽

2022 ◽

Vol 11 (1) ◽

pp. e0811124380

Author(s):

Cleyton Oliveira Bezerra ◽

Rafael Marinho de Lima Paiva ◽

Thamires Lucena da Silva ◽

Vinicius Soares Ribeiro ◽

Cinthia Caldas Rios ◽

...

Keyword(s):

Heart Failure ◽

Risk Factor ◽

Systematic Reviews ◽

Data Extraction ◽

Meta Analysis ◽

Obesity Paradox ◽

Overweight And Obesity ◽

Risk Of Death ◽

Increased Risk ◽

Overview Of Systematic Reviews

The overweight and population with obesity has an increased risk of mortality from HF. However, some studies point to the existence of an "obesity paradox" where there could be a protective effect on the relative risk of death by HF in these populations with high BMI. In this way, the present study aimed to investigate obesity as a risk factor for heart failure. For this, an overview of systematic reviews was performed by selecting articles from the following databases: "Pubmed", "Scopus" and "SciElo”. A total of 615 articles were found from this initial search, leaving 59 articles for full-text reading, of which 22 articles were included for data extraction using the predefined inclusion criteria. From these 22 studies 73% were meta-analysis and 64% of the studies are of high methodological quality according to AMSTAR-2. Overweight and obesity have demonstrated a close relationship with the onset and increase of mortality by HF, studies have even been found that point to a gene interference in this relationship. In studies reporting on the obesity paradox, the results pointed to a momentary protection from mortality risk.

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Effectiveness of Mobile Health Interventions on Diabetes and Obesity Treatment and Management: Systematic Review of Systematic Reviews

JMIR mhealth and uhealth ◽

10.2196/15400 ◽

2020 ◽

Vol 8 (4) ◽

pp. e15400 ◽

Cited By ~ 5

Author(s):

Youfa Wang ◽

Jungwon Min ◽

Jacob Khuri ◽

Hong Xue ◽

Bo Xie ◽

...

Keyword(s):

Glycemic Control ◽

Systematic Reviews ◽

Mobile Health ◽

Weight Reduction ◽

Text Messaging ◽

Meta Analysis ◽

Obesity Treatment ◽

Future Research ◽

The Impact ◽

Diabetes And Obesity

Background Diabetes and obesity have become epidemics and costly chronic diseases. The impact of mobile health (mHealth) interventions on diabetes and obesity management is promising; however, studies showed varied results in the efficacy of mHealth interventions. Objective This review aimed to evaluate the effectiveness of mHealth interventions for diabetes and obesity treatment and management on the basis of evidence reported in reviews and meta-analyses and to provide recommendations for future interventions and research. Methods We systematically searched the PubMed, IEEE Xplore Digital Library, and Cochrane databases for systematic reviews published between January 1, 2005, and October 1, 2019. We analyzed 17 reviews, which assessed 55,604 original intervention studies, that met the inclusion criteria. Of those, 6 reviews were included in our meta-analysis. Results The reviews primarily focused on the use of mobile apps and text messaging and the self-monitoring and management function of mHealth programs in patients with diabetes and obesity. All reviews examined changes in biomarkers, and some reviews assessed treatment adherence (n=7) and health behaviors (n=9). Although the effectiveness of mHealth interventions varied widely by study, all reviews concluded that mHealth was a feasible option and had the potential for improving patient health when compared with standard care, especially for glycemic control (−0.3% to −0.5% greater reduction in hemoglobin A1c) and weight reduction (−1.0 kg to −2.4 kg body weight). Overall, the existing 6 meta-analysis studies showed pooled favorable effects of these mHealth interventions (−0.79, 95% CI −1.17 to −0.42; I2=90.5). Conclusions mHealth interventions are promising, but there is limited evidence about their effectiveness in glycemic control and weight reduction. Future research to develop evidence-based mHealth strategies should use valid measures and rigorous study designs. To enhance the effectiveness of mHealth interventions, future studies are warranted for the optimal formats and the frequency of contacting patients, better tailoring of messages, and enhancing usability, which places a greater emphasis on maintaining effectiveness over time.

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Acupuncture and related therapies for treating irritable bowel syndrome: overview of systematic reviews and network meta-analysis

Therapeutic Advances in Gastroenterology ◽

10.1177/1756284818820438 ◽

2019 ◽

Vol 12 ◽

pp. 175628481882043 ◽

Cited By ~ 8

Author(s):

Irene X. Y. Wu ◽

Charlene H. L. Wong ◽

Robin S. T. Ho ◽

William K. W. Cheung ◽

Alexander C. Ford ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Systematic Reviews ◽

Comparative Effectiveness ◽

Meta Analysis ◽

Treatment Options ◽

Risk Of Bias ◽

Chinese Herbs ◽

Overview Of Systematic Reviews ◽

Irritable Bowel ◽

Needle Acupuncture

Background: An overview of systematic reviews (SRs) and a network meta-analysis (NMA) were conducted to evaluate the comparative effectiveness of acupuncture and related therapies used either alone, or as an add-on to other irritable bowel syndrome (IBS) treatments. Methods: A total of eight international and Chinese databases were searched for SRs of randomized controlled trials (RCTs). The methodological quality of SRs was appraised using the AMSTAR instrument. From the included SRs, data from RCTs were extracted for the random-effect pairwise meta-analyses. An NMA was used to evaluate the comparative effectiveness of different treatment options. The risk of bias among included RCTs was assessed using the Cochrane risk of bias tool. Results: From 15 SRs of mediocre quality, 27 eligible RCTs ( n = 2141) were included but none performed proper blinding. Results from pairwise meta-analysis showed that both needle acupuncture and electroacupuncture were superior in improving global IBS symptoms when compared with pinaverium bromide. NMA results showed needle acupuncture plus Geshanxiaoyao formula had the highest probability of being the best option for improving global IBS symptoms among 14 included treatment options, but a slight inconsistency exists. Conclusion: The risk of bias and NMA inconsistency among included trials limited the trustworthiness of the conclusion. Patients who did not respond well to first-line conventional therapies or antidepressants may consider acupuncture as an alternative. Future trials should investigate the potential of (1) acupuncture as an add-on to antidepressants and (2) the combined effect of Chinese herbs and acupuncture, which is the norm of routine Chinese medicine practice.

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Complementary and Alternative Therapies for Weight Loss: A Narrative Review

Journal of Evidence-Based Integrative Medicine ◽

10.1177/2515690x211043738 ◽

2021 ◽

Vol 26 ◽

pp. 2515690X2110437

Author(s):

Pei Lin Lua ◽

Nurul Afiedia Roslim ◽

Aryati Ahmad ◽

Mardiana Mansor ◽

Myat Moe Thwe Aung ◽

...

Keyword(s):

Weight Loss ◽

Body Weight ◽

Systematic Reviews ◽

Meta Analysis ◽

Overweight And Obesity ◽

Alternative Therapies ◽

Herbal Extract ◽

Complementary And Alternative Therapies ◽

Ebsco Host ◽

Complementary And Alternative

Despite various strategies, overweight and obesity problems are still increasingly prevalent worldwide with serious health outcomes. Consequently, the continuous demand for more effective, safe and acceptable therapies for reducing body weight is also escalating—including complementary and alternative therapies (CATs). The aim of this review is to provide a summary of the most commonly- and recently-used CATs, with evaluation of their safety and efficacy for weight loss. Electronic scientific databases such as Scopus, PubMed and EBSCO Host were explored for articles that reported CATs for overweight and obesity treatment from 2015 to December 2019. Only systematic reviews, meta-analysis and randomized controlled trials (RCTs) published in English were included. Studies whereby CATs were not utilized for reducing body weight were excluded. Eight systematic reviews and meta-analyses and 11 additional RCTs with 765 participants (50.2% overweight and 49.8% obese) related to hypnotherapy, acupuncture and dietary supplements met the inclusion criteria. Their results suggested that spirulina, chitosan, probiotic, EPA + DHA, vitamin D, fiber, and herbal extract supplementation may all provide small reductions in body weight (ranging from 1-10 kg). Interestingly, hypnotherapy and acupuncture reported significantly greater reduction in body weight compared with placebo (p < 0.001 and p < 0.0001, respectively). Nonetheless, the evidence is still relatively limited and not encouraging to provide a definitive conclusion due to the methodological shortcomings and the presence of adverse events in chitosan and fiber supplementation. Hence, studies of this nature need to be further replicated and improved to corroborate the efficacy and safety of the CATs to combat weight issues.

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Psychotherapy for comorbid depression and somatic disorders: a systematic review and meta-analysis

Psychological Medicine ◽

10.1017/s0033291721004414 ◽

2021 ◽

pp. 1-11

Author(s):

Clara Miguel ◽

Eirini Karyotaki ◽

Marketa Ciharova ◽

Ioana A. Cristea ◽

Brenda W.J.H. Penninx ◽

...

Keyword(s):

Negative Impact ◽

Meta Analysis ◽

Long Term Effects ◽

Effective Treatment Option ◽

Somatic Health ◽

Sustained Effects ◽

Health Related ◽

Somatic Disorders ◽

Control Pain

Abstract Background The treatment of depression in patients with somatic disorders is crucial, given its negative impact on quality of life (QoL), functioning, and even on the somatic disease prognosis. We aimed to examine the most updated evidence on the effects of psychotherapy in patients with depression and somatic disorders, including HIV, oncological, cardiometabolic, and neurological disorders. Methods We conducted a meta-analysis of 75 randomized trials (8209 participants) of psychotherapy for adults with somatic disorders and a diagnosis or elevated symptoms of depression. Outcomes included depression, QoL, somatic health-related outcomes, and mortality. Results Psychotherapy significantly reduced the severity of depression at post-treatment across all categories of somatic disorders (Hedges'g = 0.65; 95% CI 0.52–0.79), with sustained effects at 6–11 months (g = 0.38; 95% CI 0.22–0.53) and at 12 months follow-up or longer (g = 0.13; 95% CI 0.04–0.21). Psychotherapy also showed significant effects on QoL (g = 0.26; 95% CI 0.17–0.35), maintained up to 11 months follow-up (g = 0.25; 95% CI 0.16–0.34). No significant effects were observed on the most frequently reported somatic health-related outcomes (glycemic control, pain), and neither on mortality. Heterogeneity in most analyses was very high, and only 29 (38%) trials were rated at low risk of bias (RoB). Conclusions Psychotherapy may be an effective treatment option for patients with depression and somatic disorders, with long-term effects on depression severity and QoL. However, these results should be interpreted with caution due to heterogeneity and RoB.

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