Probiotics Evaluation in Oncological Surgery: A Systematic Review of 36 Randomized Controlled Trials Assessing 21 Diverse Formulations

Background: Objectives were to evaluate probiotics safety and efficacy in oncological surgery. Methods: Systematic review methodology guided by Cochrane, PRISMA, SWiM, and CIOMS. Protocol registered on PROSPERO (CRD42018086168). Results: 36 RCTs (on 3305 participants) and 6 nonrandomized/observational studies were included, mainly on digestive system cancers. There was evidence of a beneficial effect on preventing infections, with 70% of RCTs’ (21/30) direction of effect favoring probiotics. However, five RCTs (17%) favored controls for infections, including one trial with RR 1.57 (95% CI: 0.79, 3.12). One RCT that changed (balanced) its antibiotics protocol after enrolling some participants had mortality risk RR 3.55 (95% CI: 0.77, 16.47; 7/64 vs. 2/65 deaths). The RCT identified with the most promising results overall administered an oral formulation of Lactobacillus acidophilus LA-5 + Lactobacillus plantarum + Bifidobacterium lactis BB-12 + Saccharomyces boulardii. Methodological quality appraisals revealed an overall substantial risk-of-bias, with only five RCTs judged as low risk-of-bias. Conclusions: This large evidence synthesis found encouraging results from most formulations, though this was contrasted by potential harms from a few others, thus validating the literature that “probiotics” are not homogeneous microorganisms. Given microbiome developments and infections morbidity, further high-quality research is warranted using those promising probiotics identified herein.

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Methods of conduct and reporting of living systematic reviews: a protocol for a living methodological survey

F1000Research ◽

10.12688/f1000research.18005.2 ◽

2019 ◽

Vol 8 ◽

pp. 221 ◽

Cited By ~ 3

Author(s):

Assem M. Khamis ◽

Lara A. Kahale ◽

Hector Pardo-Hernandez ◽

Holger J. Schünemann ◽

Elie A. Akl

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Evidence Synthesis ◽

Cochrane Library ◽

Cross Sectional Survey ◽

Systematic Review Methodology ◽

Cross Sectional ◽

Prospective Longitudinal ◽

Over Time

Background: The living systematic review (LSR) is an emerging approach for improved evidence synthesis that uses continual updating to include relevant new evidence as soon as it is published. The objectives of this study are to: 1) assess the methods of conduct and reporting of living systematic reviews using a living study approach; and 2) describe the life cycle of living systematic reviews, i.e., describe the changes over time to their methods and findings. Methods: For objective 1, we will begin by conducting a cross-sectional survey and then update its findings every 6 months by including newly published LSRs. For objective 2, we will conduct a prospective longitudinal follow-up of the cohort of included LSRs. To identify LSRs, we will continually search the following electronic databases: Medline, EMBASE and the Cochrane library. We will also contact groups conducting LSRs to identify eligible studies that we might have missed. We will follow the standard systematic review methodology for study selection and data abstraction. For each LSR update, we will abstract information on the following: 1) general characteristics, 2) systematic review methodology, 3) living approach methodology, 4) results, and 5) editorial and publication processes. We will update the findings of both the surveys and the longitudinal follow-up of included LSRs every 6 months. In addition, we will identify articles addressing LSR methods to be included in an ‘LSR methods repository’. Conclusion: The proposed living methodological survey will allow us to monitor how the methods of conduct, and reporting as well as the findings of LSRs change over time. Ultimately this should help with ensuring the quality and transparency of LSRs.

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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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Robotic versus open urological oncological surgery: study protocol of a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-036609 ◽

2020 ◽

Vol 10 (2) ◽

pp. e036609

Author(s):

Giovanni E Cacciamani ◽

Karanvir Gill ◽

Inderbir S Gill

Keyword(s):

Systematic Review ◽

Open Surgery ◽

Meta Analysis ◽

Case Series ◽

Risk Of Bias ◽

Sensitivity Analyses ◽

National Database ◽

Oncological Surgery ◽

Control Series ◽

Open Versus

IntroductionMinimally invasive surgery in urology has grown considerably in application since its initial description in the early 1990s. Herein, we present the protocol for a systematic review and meta-analysis comparing open versus robotic urological oncological surgery for various clinically relevant outcomes, as well as to assess their comparative penetrance over the past 20 years (2000–2020).Methods and analysisWe will document the penetrance of robotic versus open surgery in the urological oncological field using a national database.Second, we will perform a systematic review and meta-analysis of all published full-text English and non-English language articles from Pubmed, Scopus and Web of Science search engines on surgical treatment of localised prostate, bladder, kidney and testis cancer published between 1st January 2000 to 10th January 2020. We will focus on the highest-volume urological oncological surgeries, namely, radical prostatectomy, radical cystectomy, partial nephrectomy, radical nephrectomy and retroperitoneal lymph node dissection. Study inclusion criteria will comprise clinical trials and prospective and retrospective studies (cohort or case–control series) comparing robotic versus open surgery. Exclusion criteria will comprise meta-analyses, multiple papers with overalapping study-periods, studies analysing national databases and case series describing only one approach (robotic or open). Risk of bias for included studies will be assessed by the appropriate Cochrane risk of bias tool. Principal outcomes assessed will include perioperative, functional, oncological survival and financial outcomes of open versus robotic uro-oncological surgery. Sensitivity analyses will be performed to correlate outcomes of interest with key baseline characteristics and surrogates of surgical expertise.Ethics and disseminationThis comprehensive systematic review and meta-analysis will provide rigorous, consolidated information on contemporary outcomes and trends of open versus robotic urological oncological surgery based on all the available literature. These aggregate data will help physicians better advise patients seeking surgical care for urological cancers.PROSPERO registration numberCRD42017064958.

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Methods of conduct and reporting of living systematic reviews: a protocol for a living methodological survey

F1000Research ◽

10.12688/f1000research.18005.1 ◽

2019 ◽

Vol 8 ◽

pp. 221

Author(s):

Assem M. Khamis ◽

Lara A. Kahale ◽

Hector Pardo-Hernandez ◽

Holger J. Schünemann ◽

Elie A. Akl

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Evidence Synthesis ◽

Cochrane Library ◽

Cross Sectional Survey ◽

Systematic Review Methodology ◽

Cross Sectional ◽

Prospective Longitudinal ◽

Over Time

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Finding the optimal treatment model: A systematic review of treatment for co-occurring alcohol misuse and depression

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867418758922 ◽

2018 ◽

Vol 52 (8) ◽

pp. 737-750 ◽

Cited By ~ 6

Author(s):

Breanne Hobden ◽

Jamie Bryant ◽

Mariko Carey ◽

Amanda L Baker ◽

Michael Farrell ◽

...

Keyword(s):

Systematic Review ◽

Alcohol Misuse ◽

Integrated Model ◽

Integrated Treatment ◽

Risk Of Bias ◽

Psychosocial Treatment ◽

Treatment Model ◽

Parallel Model ◽

High Quality Research ◽

Organisation Of Care

Objectives: Alcohol misuse and depression are commonly co-occurring conditions. To date, no review has examined the most efficacious treatment model for psychosocial treatment of co-occurring alcohol misuse and depression. This systematic review determined the: (i) methodological quality of publications examining psychosocial treatment of co-occurring alcohol misuse and depression using a sequential, parallel or integrated treatment model; and (ii) effectiveness of each dual treatment model compared to single treatment for those with co-occurring alcohol misuse and depression. Methods: PubMed, Medline and PsycInfo databases were searched for studies which were included if they involved treatment for alcohol misuse and depression and could be classified into one of the three treatment models. Included studies were assessed using the Cochrane’s Effective Practice and Organisation of Care risk of bias criteria. Relevant study characteristics and outcomes were extracted and are presented in a narrative review format. Results: Seven studies met inclusion criteria. None were categorised as low risk on the risk of bias criteria. No studies examined a sequential model of treatment, three examined a parallel model and four examined an integrated model of dual-focussed treatment. The studies examining the parallel model and two out of four studies examining the effectiveness of an integrated model demonstrated greater improvement for alcohol or depression outcomes compared to control conditions. Conclusion: Evidence for the psychosocial treatment of co-occurring alcohol misuse and depression is limited to a handful of studies. The evidence has several methodological limitations, which impact the interpretation of the findings. Therefore, while international guidelines recommend integrated dual-focussed treatment for co-occurring conditions, there is little evidence supporting the superiority of this treatment format for co-occurring alcohol misuse and depression. High-quality research demonstrating improvements in patient outcomes is required to ensure recommendations for clinical practice are based on strong empirical evidence.

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Factors Influencing an Eruption of Teeth Associated with a Dentigerous Cyst. A Systematic Review

10.21203/rs.3.rs-92689/v1 ◽

2020 ◽

Author(s):

Marek Nahajowski ◽

Sylwia Hnitecka ◽

Michał Sarul ◽

Kornelia Rumin ◽

Magdalena Dubowik ◽

...

Keyword(s):

Systematic Review ◽

Research Question ◽

Dentigerous Cyst ◽

Risk Of Bias ◽

Cochrane Central Register ◽

Alveolar Process ◽

Cyst Size ◽

High Quality Research ◽

Follicular Cyst ◽

Dentigerous Cysts

Abstract AimThis systematic review aimed to identify factors conducive/inconducive to a spontaneous eruption of teeth after a dentigerous cyst's marsupialization.MethodsIn accordance with the PRISMA guidelines, the main research question was defined in the PICO format (P: patients with dentigerous cysts, I: spontaneous eruption after surgery, C: forced eruption, O: determining factors potentially influencing the intervention or the comparison). The MEDLINE, the EMBASE, and the Cochrane Central Register of Controlled Trials databases were searched for the keywords combining dentigerous/odontogenic/follicular cyst with teeth and/or orthodontics, as well as human teeth and eruption pattern/interval/period/duration. The qualified articles (4 out of 3005 found initially) provided following data: a rate of tooth eruption after surgical treatment of the cyst, along with age and gender of patients, a perpendicular projection distance between the top of the tooth cusp and the edge of the alveolar process, tooth angulation, a root formation stage, the cyst size, and space to erupt. The articles underwent analysis of the risk of bias and quality, with the ROBINS-I protocol and the modified Newcastle-Ottawa QAS, respectively. The systematic review was registered in PROSPERO under ID CRD42020189044.ResultsA real risk of bias was assessed as critical, while the quality of the studies was considered high (7-9 points in 9-point scale). Small distance between the top of a tooth cusp and the edge of the alveolar process, and space for eruption larger than tooth dimensions were the factors likely to favor spontaneous eruption. The cyst size was irrelevant, while the influence of the other factors could not be determined from the available data. ConclusionA small number of published studies, as well as their heterogeneity and the critical risk of bias do not allow creating the evidence-based protocol of management the teeth with DC after its marsupialization. More high-quality research is needed to be able to draw more reliable conclusions.

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Factors influencing an eruption of teeth associated with a dentigerous cyst: a systematic review and meta-analysis

BMC Oral Health ◽

10.1186/s12903-021-01542-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Marek Nahajowski ◽

Sylwia Hnitecka ◽

Joanna Antoszewska-Smith ◽

Kornelia Rumin ◽

Magdalena Dubowik ◽

...

Keyword(s):

Systematic Review ◽

Root Formation ◽

Research Question ◽

Dentigerous Cyst ◽

Risk Of Bias ◽

Tooth Eruption ◽

Cochrane Central Register ◽

High Quality Research ◽

Human Teeth ◽

Dentigerous Cysts

Abstract Background A dentigerous cyst (DC) is a pathology embracing the crown of an unerupted tooth at risk of malignant transformation. The causal tooth is usually removed together with the cyst. However, if there are orthodontic contraindications for extraction, two questions arise. (1) Which factors favor spontaneous eruption? (2) Which factors imply the necessity of applying orthodontic traction? This systematic review aimed to identify factors conducive/inconducive to the spontaneous eruption of teeth after dentigerous cyst marsupialization. Methods In accordance with the PRISMA guidelines, the main research question was defined in the PICO format (P: patients with dentigerous cysts; I: spontaneous tooth eruption after surgical DC treatment; C: lack of a spontaneous tooth eruption after surgical DC treatment; O: determining factors potentially influencing spontaneous tooth eruption). The MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases were searched for keywords combining dentigerous/odontogenic/follicular cysts with teeth and/or orthodontics, as well as human teeth and eruption patterns/intervals/periods/durations. The following data were extracted from the qualified articles (4 out of 3005 found initially): the rate of tooth eruption after surgical treatment of the cyst, the age and sex of the patients, the perpendicular projection distance between the top of the tooth cusp and the edge of the alveolar process, tooth angulation, the root formation stage, the cyst area, and the eruption space. The articles were subjected to risk of bias and quality analyses with the ROBINS-I protocol and the modified Newcastle–Ottawa QAS, respectively. Meta-analyses were performed with both fixed and random effects models. The GRADE approach was used to evaluate the quality of the evidence. The systematic review was registered in PROSPERO under ID CRD42020189044. Results Nearly 62% of DC-associated premolars erupted spontaneously after cyst marsupialization/decompression. Young age (mean = 10 years) and root formation not exceeding 1/2 of its fully developed length were the factors likely to favor spontaneous eruption. Conclusion The small number of published studies, as well as their heterogeneity and the critical risk of bias, did not allow the creation of evidence-based protocols for managing teeth with DC after marsupialization. More high-quality research is needed to draw more reliable conclusions.

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Is adiposity associated with back and lower limb pain? A systematic review

PLoS ONE ◽

10.1371/journal.pone.0256720 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0256720

Author(s):

Waruna L. Peiris ◽

Flavia M. Cicuttini ◽

Sultana Monira Hussain ◽

Mahnuma M. Estee ◽

Lorena Romero ◽

...

Keyword(s):

Systematic Review ◽

Musculoskeletal Pain ◽

Lower Limb ◽

Evidence Synthesis ◽

Risk Of Bias ◽

Low Back ◽

Foot Pain ◽

Limb Pain ◽

Lower Limb Pain ◽

Best Evidence Synthesis

Background Back and lower limb pain have a major impact on physical function and quality of life. While obesity is a modifiable risk factor for musculoskeletal pain, the role of adiposity is less clear. This systematic review aimed to examine the relationship between both adiposity and its distribution and back and lower limb pain. Methods A systematic search of electronic databases was conducted to identify studies that examined the association between anthropometric and/or direct measures of adiposity and site specific musculoskeletal pain. Risk of bias was assessed and a best evidence synthesis was performed. Results A total of 56 studies were identified which examined 4 pain regions, including the lower back (36 studies), hip (two studies), knee (13 studies) and foot (eight studies). 31(55%) studies were assessed as having low to moderate risk of bias. 17(30%) studies were cohort in design. The best evidence synthesis provided evidence of a relationship between central adiposity and low back and knee pain, but not hip or foot pain. There was also evidence of a longitudinal relationship between adiposity and the presence of back, knee and foot pain, as well as incident and increasing foot pain. Conclusions This systematic review provides evidence of an association between both body fat and its central distribution and low back and knee pain, and a longitudinal relationship between adiposity and back, knee and foot pain. These results highlight the potential for targeting adiposity in the development of novel treatments at these sites.

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Neurocognitive impairment after neonatal sepsis: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-038816 ◽

2020 ◽

Vol 10 (6) ◽

pp. e038816

Author(s):

Jen Heng Pek ◽

Bei Jun Yap ◽

Ming Ying Gan ◽

Shu Ting Tammie Seethor ◽

Rachel Greenberg ◽

...

Keyword(s):

Systematic Review ◽

Developmental Disability ◽

Neonatal Sepsis ◽

English Language ◽

Data Extraction ◽

Evidence Synthesis ◽

Meta Analysis ◽

Risk Of Bias ◽

Primary Data ◽

Neurocognitive Outcomes

IntroductionThe effect of neonatal sepsis on the developing brain is not well documented. We aim to perform evidence synthesis to determine the outcome of neurodevelopmental impairment and intellectual disability among survivors of neonatal sepsis. The data gathered will inform on the long-term neurocognitive outcomes of neonates with sepsis and the measures used to document their developmental disability.Methods and analysisWe will perform a search based on the following parameters: neonates and infants less than 90 days old diagnosed with sepsis who had neurocognitive outcomes or measures of developmental disability reported. We will search PubMed, Cochrane Central, Embase and Web of Science for articles in English language published between January 2010 and December 2019. Clinical trials and observational studies will be included. Two independent reviewers will screen studies for eligibility. Data extraction will then be performed using a standardised form. The quality of evidence and risk of bias will be assessed using Cochrane Collaboration’s tool and Risk of Bias in Non-randomised Studies of Intervention (ROBINS-I). The results will be synthesised qualitatively and pooled for meta-analysis.Ethics and disseminationNo formal ethical approval is required as there is no collection of primary data. This systematic review and meta-analysis will be disseminated through conference meetings and peer-reviewed publications.PROSPERO registration numberRegistration submitted CRD42020164334

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Introducing a special issue with a focus on systematic reviews

Animal Health Research Reviews ◽

10.1017/s1466252316000128 ◽

2016 ◽

Vol 17 (1) ◽

pp. 1-2 ◽

Cited By ~ 3

Author(s):

J. M. Sargeant ◽

A. M. O'Connor

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Health Research ◽

Animal Health ◽

Risk Of Bias ◽

Special Issue ◽

Systematic Review Methodology ◽

Review Section

AbstractSystematic reviews answer specific review questions by following structured steps and employing specific methods to reduce the risk of bias and to maximize transparency in the process of the review, and systematic review methodology differs from traditional narrative reviews in many ways. As a journal devoted to reviews, it is appropriate that Animal Health Research Reviews (AHRR) includes this approach to reviews of the literature. The aim of this special issue of AHRR was to illustrate the scope of articles that can be considered for submission to the systematic review section of this journal for prospective authors and readers.

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