ROBITT: a tool for assessing the risk-of-bias in studies of temporal trends in ecology

1. Aggregated species occurrence and abundance data from disparate sources are increasingly accessible to ecologists for the analysis of temporal trends in biodiversity. However, sampling biases relevant to any given research question are often poorly explored and infrequently reported; this has the potential to undermine statistical inference. In other disciplines, but particularly medicine, researchers are frequently required to complete “risk-of-bias” assessments to expose and document the potential for biases to undermine inference. The huge growth in available data, and recent controversies surrounding their use to infer temporal trends, indicate that similar tools are urgently needed in ecology.2. We introduce ROBITT, a structured tool for assessing the “Risk-Of-Bias In studies of Temporal Trends in ecology”. ROBITT has a similar format to its counterparts in other disciplines: it comprises signalling questions designed to elicit information on the potential for bias in key study domains. In answering these, users will define their inferential goal(s) and relevant statistical population. This information is used to assess potential sampling biases across domains relevant to the research question (e.g. geography, taxonomy, environment), and how these vary through time. If assessments indicate likely sampling biases, then the user must explain what mitigating action will be taken.3. Everything that users need to complete a ROBITT assessment is provided: the tool, a guidance document, and a worked example. Following other disciplines, the tool and guidance document were developed through a consensus-forming process across experts working in relevant areas of ecology and evidence synthesis.4. We propose that researchers should be strongly encouraged to include a ROBITT assessment as supplementary information when publishing studies of biodiversity trends. This will help researchers to structure their thinking, clearly acknowledge potential sampling issues, and provides an opportunity to describe data checks that might otherwise not be reported. ROBITT will also enable reviewers, editors, and readers to establish whether research conclusions are supported given a particular dataset combined with some analytical approach. In turn, it should strengthen evidence-based policy and practice, reduce differing interpretations of data, and provide a clearer picture of the uncertainties associated with our understanding of ecological reality.

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Study protocol of a systematic review and qualitative evidence synthesis using two different approaches: Healthcare related needs and desires of older people with post-stroke aphasia

BMJ Open ◽

10.1136/bmjopen-2020-039348 ◽

2021 ◽

Vol 11 (4) ◽

pp. e039348

Author(s):

Nadine Janis Pohontsch ◽

Thorsten Meyer ◽

Yvonne Eisenmann ◽

Maria-Inti Metzendorf ◽

Verena Leve ◽

...

Keyword(s):

Systematic Review ◽

Older People ◽

Evidence Synthesis ◽

Meta Analysis ◽

Research Question ◽

Treatment Success ◽

Qualitative Studies ◽

Qualitative Evidence Synthesis ◽

Healthcare Needs ◽

Qualitative Evidence

IntroductionStroke is a frequent disease in the older population of Western Europe with aphasia as a common consequence. Aphasia is known to impede targeting treatment to individual patients’ needs and therefore may reduce treatment success. In Germany, the postacute care of patients who had stroke is provided by different healthcare institutions of different sectors (rehabilitation, nursing and primary care) with substantial difficulties to coordinate services. We will conduct two qualitative evidence syntheses (QESs) aiming at exploring distinct healthcare needs and desires of older people living with poststroke aphasia. We thereby hope to support the development of integrated care models based on needs of patients who are very restricted to communicate them. Since various methods of QESs exist, the aim of the study embedding the two QESs was to determine if findings differ according to the approach used.Methods and analysisWe will conduct two QESs by using metaethnography (ME) and thematic synthesis (ThS) independently to synthesise the findings of primary qualitative studies. The main differences between these two methods are the underlying epistemologies (idealism (ME) vs realism (ThS)) and the type of research question (emerging (ME) vs fixed (ThS)).We will search seven bibliographical databases. Inclusion criteria comprise: patients with poststroke aphasia, aged 65 years and older, studies in German/English, all types of qualitative studies concerning needs and desires related to healthcare or the healthcare system. The protocol was registered in the International Prospective Register of Systematic Reviews, follows Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines and includes three items from the Enhancing Transparency in Reporting the synthesis of Qualitative Research checklist.Ethics and disseminationEthical approval is not required. Findings will be published in a peer-reviewed journal and presented on national conferences.

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Understanding Unfulfilled AP Potential Across the Participation Pipeline by Race and Income

Teachers College Record ◽

10.1177/016146812012200909 ◽

2020 ◽

Vol 122 (9) ◽

pp. 1-38

Author(s):

Awilda Rodriguez ◽

Esmeralda Hernandez-Hamed

Keyword(s):

Extracurricular Activities ◽

Low Income ◽

Self Efficacy ◽

Research Question ◽

Working Hours ◽

Subject Area ◽

School Level ◽

Policy And Practice ◽

Student Centered ◽

Teacher Recommendations

Background/Context Each year, large shares of students who could do well in Advanced Placement courses and exams—known as AP potential students—do not participate, particularly students of color and low-income students. There are a number of prevailing reasons, both structural (schools do not offer the courses, or teachers do not accurately identify students) and as well as student- centered (lack of motivation, conflicts with other activities, or lack of self-efficacy). Purpose/Objective/Research Question/Focus of Study This study seeks to empirically test these common reasons for foregoing AP participation with the following research questions: How are student and school characteristics related to the probabilities of students attending a high school that offers a corresponding course, enrolling in the course, and taking the exam? To what extent are explanations such as students’ constraints on time, lack of motivation, or lack of self-efficacy related to the probability of AP course- and exam-taking, net of student- and school-level measures? How well do AP potential estimates align with teacher recommendations into advanced coursework? We focused on differences across race and class throughout. Research Design We define AP potential as a 60% percent probability or better of receiving at least a 3 on an AP exam in either math or English. Using a nationally representative sample of sophomores in 2002 whom we identified as having AP potential, we answered the first research question with a sequential logit. We then used postestimation commands in Stata to examine motivation, hours working, hours in extracurricular activities, and measures of English and math self-efficacy to address the second research question. For the third research question, we modeled the probability of student misidentification—or the probability that the teacher of a student with AP potential will not identify them for honors or AP courses—using a logit. Conclusions/Recommendations We found that large shares of students did not fulfill their AP potential, which varied by student background and subject area. We did not find support for many of the student-centered reasons for forgoing AP, such as lack of motivation and constraints on time due to work or extra-curricular activities. We did find, however, that teacher identification and academic self-efficacy mattered to AP course- and exam-taking, especially for marginalized students, suggesting viable policy and practice levers to improve equitable AP participation. We discuss implications for policy, practice, and research.

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Relationship between hormonal contraceptives and sleep among women of reproductive age: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2020-045819 ◽

2021 ◽

Vol 11 (10) ◽

pp. e045819

Author(s):

Jinhui Ma ◽

Megan Cheng ◽

Lehana Thabane ◽

Caihong Ma ◽

Ning Zhang ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Research Question ◽

Risk Of Bias ◽

Reproductive Age ◽

Hormonal Contraceptives ◽

Controlled Trials ◽

Cochrane Central Register ◽

Women Of Reproductive Age

IntroductionThe aetiology of sleep disruptions is unknown, but hormonal fluctuations during the menstrual cycle, pregnancy and menopause have been shown to potentially affect how well a woman sleeps. The aim of this systematic review was to investigate whether hormonal contraceptives are associated with a decreased quality of sleep and increased sleep duration in women of reproductive age.MethodsThis review will analyse data from randomised controlled trials or non-randomised comparative studies investigating the association between hormonal contraceptives and sleep outcomes among women of reproductive age. Reviews addressing the same research question with similar eligibility criteria will be included. A literature search will be performed using the MEDLINE, Embase and Cochrane Central Register of Controlled Trials databases from inception to 7 March 2021. The Cochrane Collaboration’s Risk of Bias for Randomised Trials V.2.0 and The Risk of Bias for Non-randomised Studies of Interventions tool will be used to assess risk of bias for each outcome in eligible studies. Two reviewers will independently assess eligibility of studies and risk of bias and extract the data. All extracted data will be presented in tables and narrative form. For sleep measures investigated by two or more studies with low heterogeneity, we will conduct random-effects meta-analysis to estimate the magnitude of the overall effect of hormonal contraceptives. If studies included in this systematic review form a connected network, a network meta-analysis will be conducted to estimate the comparative effect of different contraceptives. The Grading of Recommendations, Assessment, Development, and Evaluation approach will be used to summarise the quality of evidence. Our protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols 2015 guidelines.Ethics and disseminationEthics approval is not required as data were sourced from previously reported studies. The findings of this review will be published in a peer-reviewed journal and presented at relevant conferences.PROSPERO registration numberCRD42020199958.

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OP5 A two armed, randomised, controlled exploratory study of adding the ambugard cleaning system to normal deep cleaning procedures in a regional ambulance service

Emergency Medicine Journal ◽

10.1136/emermed-2020-999abs.5 ◽

2020 ◽

Vol 37 (10) ◽

pp. e4.1-e4

Author(s):

Graham McClelland ◽

Karl Charlton ◽

Jacqueline Mains ◽

Karen Millican ◽

Caroline Cullerton

Keyword(s):

Controlled Trial ◽

Research Question ◽

Single Point ◽

Temporal Trends ◽

Ambulance Service ◽

Transmission Risk ◽

Steering Wheel ◽

Coagulase Negative Staphylococci ◽

North East ◽

Randomised Controlled

BackgroundAmbulance services transport patients with infections and diseases and could pose a cross transmission risk to patients and staff through environmental contamination. The literature suggests that environmental pathogens are present on ambulances, cleaning is inconsistent and patient/staff impact is difficult to quantify. Eco-Mist developed a dry misting decontamination system for ambulance use called AmbuGard which works in <30 minutes and is 99.9999% effective against common pathogens. The research question is ‘What pathogens are present on North East Ambulance Service ambulances and what impact does adding the AmbuGard to the deep cleaning process make?’MethodsA two armed, randomised controlled trial enrolled fourteen ambulances during their regular 24 week deep clean which were 1:1 randomised to deep cleaning (control arm) or deep cleaning plus AmbuGard (intervention arm). Polywipe swabs were taken before and after cleaning from five locations selected for high rates of contact (steering wheel, shelf, side door grab rail, patient seat armrest, rear door handle/grab rail). Microbiology culture methods identified the presence and amount of bacterial organisms present including the selected pathogens: Enterococcus spp.; Enterobacter spp.; Klebsiella spp.; Staphylococcus aureus; Acinetobacter spp.; Pseudomonas spp.; Clostridium difficile; coagulase-negative staphylococci (CoNS)). The researcher taking the swabs and the laboratory were blinded to the trial arm.ResultsPathogens of interest were found on 10 (71%) vehicles. CoNS were found on all vehicles. Pathogens were found on all locations swabbed. Normal deep cleaning was effective at eliminating pathogens and the addition of AmbuGard showed no obvious improvement in effectiveness.ConclusionPathogens associated with healthcare acquired infections were found throughout all ambulances. Normal deep cleaning was effective and adding AmbuGard showed no obvious improvement. This was a small study at a single point in time. Further research is needed into temporal trends, how to reduce pathogens during normal clinical duties and patient/staff impact.

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Laboratory Tests and Outcome for Patients with Coronavirus Disease 2019: A Systematic Review and Meta-Analysis

The Journal of Applied Laboratory Medicine ◽

10.1093/jalm/jfaa098 ◽

2020 ◽

Vol 5 (5) ◽

pp. 1038-1049 ◽

Cited By ~ 1

Author(s):

Anne Alnor ◽

Maria B Sandberg ◽

Charlotte Gils ◽

Pernille J Vinholt

Keyword(s):

Systematic Review ◽

Disease Severity ◽

Laboratory Tests ◽

Evidence Synthesis ◽

Meta Analysis ◽

Severe Disease ◽

Risk Of Bias ◽

Mean Difference ◽

Routine Laboratory ◽

Standard Mean Difference

Abstract Background Severe acute respiratory syndrome coronavirus 2 causes coronavirus disease 2019 (COVID-19) and poses substantial challenges for healthcare systems. With a vastly expanding number of publications on COVID-19, clinicians need evidence synthesis to produce guidance for handling patients with COVID-19. In this systematic review and meta-analysis, we examine which routine laboratory tests are associated with severe COVID-19 disease. Content PubMed (Medline), Scopus, and Web of Science were searched until March 22, 2020, for studies on COVID-19. Eligible studies were original articles reporting on laboratory tests and outcome of patients with COVID-19. Data were synthesized, and we conducted random-effects meta-analysis, and determined mean difference (MD) and standard mean difference at the biomarker level for disease severity. Risk of bias and applicability concerns were evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2. Summary 45 studies were included, of which 21 publications were used for the meta-analysis. Studies were heterogeneous but had low risk of bias and applicability concern in terms of patient selection and reference standard. Severe disease was associated with higher white blood cell count (MD, 1.28 ×109/L), neutrophil count (MD, 1.49 ×109/L), C-reactive protein (MD, 49.2 mg/L), lactate dehydrogenase (MD, 196 U/L), D-dimer (standardized MD, 0.58), and aspartate aminotransferase (MD, 8.5 U/L); all p < 0.001. Furthermore, low lymphocyte count (MD −0.32 × 109/L), platelet count (MD −22.4 × 109/L), and hemoglobin (MD, −4.1 g/L); all p < 0.001 were also associated with severe disease. In conclusion, several routine laboratory tests are associated with disease severity in COVID-19.

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Does the Use of Reservoirs Have Any Impact on the Efficacy of At-Home Bleaching? A Systematic Review

Brazilian Dental Journal ◽

10.1590/0103-6440201902422 ◽

2019 ◽

Vol 30 (3) ◽

pp. 285-294 ◽

Cited By ~ 1

Author(s):

Eveline Claudia Martini ◽

Sibelli Olivieri Parreiras ◽

Eric Dario Acuña ◽

Alessandro Dourado Loguercio ◽

Alessandra Reis

Keyword(s):

Systematic Review ◽

Latin American ◽

Randomized Clinical Trials ◽

Color Change ◽

Research Question ◽

Grey Literature ◽

Risk Of Bias ◽

Cochrane Library ◽

Tooth Sensitivity ◽

At Home

Abstract To answer the following focused question through a systematic review: “Are the risk and intensity of tooth sensitivity (TS) and bleaching efficacy different between adult patients who undergo at-home bleaching using trays with reservoirs and those who use trays without reservoirs?”. A comprehensive search was performed in the MEDLINE via PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database, Brazilian Library in Dentistry, Cochrane Library, and grey literature without restrictions. Abstracts from conferences; unpublished and ongoing trial registries, dissertations and theses (ProQuest Dissertations and Periódicos Capes Theses databases) were searched. Only randomized clinical trials (RCTs) were included. We used the Risk of Bias tool (RoB) from the Cochrane Collaboration for quality assessment. After the removal of duplicates, title and abstract screening and full-text examination, nine RCTs remained for qualitative analyses. The great majority of the studies did not report the method of randomization, allocation concealment, and examiner blinding during color assessment. From the nine studies, eight were at unclear risk of bias. In regard to color change, four studies reported no change and two reported improved color change with reservoirs. Only four studies recorded tooth sensitivity and they reported no significant differences. Only one study reported greater gingival irritation with reservoirs. Lack of data reporting prevented us from running a meta-analysis. Further well-designed RCT should be conducted to answer this research question. So far there is not evidence to support that reservoirs in bleaching trays improve color change. PROSPERO - CRD42016037628

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What causes prescribing errors in children? Scoping review

BMJ Open ◽

10.1136/bmjopen-2018-028680 ◽

2019 ◽

Vol 9 (8) ◽

pp. e028680 ◽

Cited By ~ 2

Author(s):

Richard L Conn ◽

Orla Kearney ◽

Mary P Tully ◽

Michael D Shields ◽

Tim Dornan

Keyword(s):

Scoping Review ◽

Evidence Synthesis ◽

Research Question ◽

Grey Literature ◽

Qualitative Evidence Synthesis ◽

Prescribing Errors ◽

Prescribing Error ◽

Stakeholder Consultation ◽

Published Evidence ◽

Included Review

Objectives(1) Systematically assemble, analyse and synthesise published evidence on causes of prescribing error in children. (2) Present results to a multidisciplinary group of paediatric prescribing stakeholders to validate findings and establish how causative factors lead to errors in practice.DesignScoping review using Arksey and O’Malley’s framework, including stakeholder consultation; qualitative evidence synthesis.MethodsWe followed the six scoping review stages. (1) Research question—the research question was ‘What is known about causes of prescribing error in children?’ (2) Search strategy—we searched MEDLINE, EMBASE, CINAHL (from inception to February 2018), grey literature and reference lists of included studies. (3) Article selection—all published evidence contributing information on the causes of prescribing error in children was eligible for inclusion. We included review articles as secondary evidence to broaden understanding. (4) Charting data—results were collated in a custom data charting form. (5) Reporting results—we summarised article characteristics, extracted causal evidence and thematically synthesised findings. (6) Stakeholder consultation—results were presented to a multidisciplinary focus group of six prescribing stakeholders to establish validity, relevance and mechanisms by which causes lead to errors in practice.Results68 articles were included. We identified six main causes of prescribing errors: children’s fundamental differences led to individualised dosing and calculations; off-licence prescribing; medication formulations; communication with children; and experience working with children. Primary evidence clarifying causes was lacking.ConclusionsSpecific factors complicate prescribing for children and increase risk of errors. Primary research is needed to confirm and elaborate these causes of error. In the meantime, this review uses existing evidence to make provisional paediatric-specific recommendations for policy, practice and education.

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Disabilities within Sweden’s Art and Music Schools: Discourses of inclusion, policy and practice

Policy Futures in Education ◽

10.1177/1478210319855572 ◽

2019 ◽

Vol 18 (3) ◽

pp. 391-409

Author(s):

Adriana Di Lorenzo Tillborg

Keyword(s):

Discourse Analysis ◽

Music Education ◽

School Leaders ◽

Research Question ◽

Social Constructionist ◽

Discursive Practices ◽

Policy And Practice ◽

Music School ◽

Music Schools ◽

Starting Point

The aim of this paper is to investigate the discourses that emerge when Sweden’s Art and Music School leaders talk about the inclusion of pupils with disabilities in relation to policy. A starting point is that both earlier studies and policy documents have revealed inclusion problems within Art and Music Schools. The research question is: how are Art and Music School practice, policy and inclusion of pupils with disabilities connected within and through leaders’ discursive practices? The data are based on three focus group conversations with a total of 16 Art and Music School leaders from northern, central and southern Sweden. Discourse analysis as a social constructionist approach is applied since it provides a means to investigate the connection between social change and discourse. Concepts from both discursive psychology and Foucauldian-inspired discourse analysis are applied in order to investigate connections between rhetorical strategies on a micro level and discourses on an institutional level. The concept of multicentric inclusion is introduced and applied in the analysis. In addition, concepts from educational policy theories are applied in order to analyse how policies are conceptualised and enacted in the context of leaders’ discursive practices. Regarding terminology, the results challenge this researcher when the concept of mixed abilities is introduced by the participants. The analysis exposes three discourses: multicentric inclusion discourse, normality discourse and specialisation discourse. There are tensions between the multicentric inclusion discourse and the normality discourse, as well as between the multicentric inclusion discourse and the specialisation discourse. The analysis leads to the following suggestions in order to achieve justice in music education practices and policies: (a) to enforce a specific national inclusion policy, (b) to challenge the normality discourse and (c) to bring together the multicentric inclusion discourse with the specialisation discourse.

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When poorly conducted systematic reviews and meta-analyses can mislead: a critical appraisal and update of systematic reviews and meta-analyses examining the effects of probiotics in the treatment of functional constipation in children

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqz071 ◽

2019 ◽

Vol 110 (1) ◽

pp. 177-195 ◽

Cited By ~ 7

Author(s):

Rebecca G Harris ◽

Elizabeth P Neale ◽

Isabel Ferreira

Keyword(s):

Systematic Reviews ◽

Evidence Synthesis ◽

Weighted Mean Difference ◽

Treatment Success ◽

Functional Constipation ◽

Risk Of Bias ◽

Current Evidence ◽

Success Rates ◽

Defecation Frequency ◽

Meta Analyses

ABSTRACT Background Recent systematic reviews and meta-analyses on the efficacy of probiotics in the treatment of functional constipation in children have yielded conflicting results. Objectives The aim of this study was to critically review and update the evidence in this field by mapping all the steps involved against those reported in previous reviews, in an attempt to understand the nature of their conflicting results. Methods Four literature databases, trial registries, and citations were searched through December 1, 2018. We included randomized controlled trials (RCTs) that assessed the effects of probiotics compared with placebo or treatment as usual on defecation frequency [bowel movements (BMs)/wk] or treatment success rates in children with functional constipation. Independent reviewers extracted the data and assessed risk of bias in each RCT. Data were pooled with (inverse variance) random-effects models. Results We identified 17 RCTs, of which 14 and 11 provided sufficient data to enable meta-analysis of the effects of probiotics compared with control on defecation frequency (n = 965) or treatment success (n = 835), respectively. When compared to (any) control intervention, probiotics did not significantly increase defecation frequency [weighted mean difference (WMD): 0.28 BMs/wk; 95% CI: −0.12, 0.69; P = 0.165] but were more efficacious in achieving treatment success (RR: 1.24; 95% CI: 1.03, 1.50; P = 0.024). These effects did not differ by type of control (i.e., active or inactive) intervention. However, in analyses confined to the RCTs that were free of high risk of bias (only 5), probiotics did not confer any beneficial effects on defecation frequency (WMD: −0.55 BMs/wk; 95% CI: −1.37, 0.26; P = 0.185) and achievement of treatment success (RR: 1.01; 95% CI: 0.90, 1.13; P = 0.873), compared with control interventions. Conclusions The current evidence thus does not support the use of probiotics as a single or coadjuvant therapy for treatment of functional constipation in children and refutes recently published reviews reporting favorable effects of probiotics. Conflicting findings of previous reviews resulted from methodologic errors, highlighting the susceptibility of evidence synthesis to oversights in study selection, quality assessments, and data extraction and collation. This review was registered at PROSPERO as CRD42019119109.

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Intimacy between care home residents with dementia: Findings from a review of the literature

Dementia ◽

10.1177/1471301216659771 ◽

2016 ◽

Vol 18 (1) ◽

pp. 94-107 ◽

Cited By ~ 2

Author(s):

Esther Wiskerke ◽

Jill Manthorpe

Keyword(s):

Research Question ◽

Care Home ◽

Good Practice ◽

Sexual Intimacy ◽

Policy And Practice ◽

Emotional Intimacy ◽

Care Home Staff ◽

Care Workers ◽

Person With Dementia ◽

Best Responses

Background There is limited research on what family members and frontline care home staff consider to be the best responses to the sexual expression of a person with dementia, whilst at the same time respecting relatives’ feelings, managing their possible distress and conflict, and how good practice should be reflected in care home policy and practice guidance. Methods This literature review explored what is known of the views of relatives and care workers of new relationships or sexual intimacy between care home residents with dementia, whilst still married to another person. It reports the findings of searches of three databases undertaken in August 2014 (Medline, Embase and PsychINFO). Findings Nine papers were found relevant to the research question. The following themes emerged from a synthesis of the papers located: sexuality in old age, dementia and sexuality, hyper-sexuality, views regarding sexuality of older people living in care homes, the law, ethics and consent, relationships and communication between care home and relatives, and new relationships or intimacy between residents with dementia. Conclusion While studies of residents’ expression of sexuality and their engaging in sexual behaviour with other resident(s) may be challenging to manage in care home settings and can be emotionally painful or uncomfortable for families, the review found that studies are few in number and span emotional intimacy and distressing behaviour.

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