scholarly journals A Profile of Injuries Sustained by Firefighters: A Critical Review

2019 ◽  
Vol 16 (20) ◽  
pp. 3931 ◽  
Author(s):  
Robin Orr ◽  
Vinicius Simas ◽  
Elisa Canetti ◽  
Ben Schram
Keyword(s):  
Recent Literature ◽  
Methodological Approach ◽  
Level Of Evidence ◽  
Injury Rates ◽  
Injury Reduction ◽  
Work Related ◽  
Search Terms ◽  
Reduction Strategies ◽  
Meta Analyses

Firefighters, along with other tactical personnel, are at a high risk of work-related physical injury above that of the private sector. The aim of this critical narrative review was to identify, critically appraise and synthesise key findings from recent literature investigating firefighting musculoskeletal injuries to inform injury reduction programs. The methodological approach (search terms, databases, etc.) was registered with PROSPERO and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study quality was assessed using the Downs and Black checklist with scores graded according to the Kennelly grading system. Levels of evidence were ranked according to the Australian National Health and Medical Research Council. Of the 8231 studies identified, 17 met the criteria for inclusion. The methodological quality of the studies was ‘fair’ with a level of evidence of III-2. Reported injury rates ranged from 9% to 74% with the lower extremities and back the leading aggregated bodily sites of injury. Sprains and strains were the leading nature of musculoskeletal injury, often caused by slips, trips and falls, although muscle bending, lifting and squatting or muscle stressing were also prevalent. This review may inform injury reduction strategies and given that injuries reported in firefighters are similar to those of other tactical populations, safety processes to mitigate injuries may be of benefit across the tactical spectrum.

A Meta-Analysis of Complication Rates Among Different SMAS Facelift Techniques

2019 ◽  
Vol 39 (9) ◽  
pp. 927-942 ◽  
Author(s):  
Andrew A Jacono ◽  
A Sean Alemi ◽  
Joseph L Russell
Keyword(s):  
Facial Nerve ◽  
Nerve Injury ◽  
Meta Analysis ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Facial Nerve Injury ◽  
Significant Difference ◽  
Meta Analyses ◽  
Smas Flap

AbstractBackgroundSub-superficial musculo-aponeurotic system (SMAS) rhytidectomy techniques are considered to have a higher complication profile, especially for facial nerve injury, compared with less invasive SMAS techniques. This results in surgeons avoiding sub-SMAS dissection.ObjectivesThe authors sought to aggregate and summarize data on complications among different SMAS facelift techniques.MethodsA broad systematic search was performed. All included studies: (1) described a SMAS facelifting technique categorized as SMAS plication, SMASectomy/imbrication, SMAS flap, high lateral SMAS flap, deep plane, and composite; and (2) reported the number of postoperative complications in participants. Meta-analysis was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.ResultsA total 183 studies were included. High lateral SMAS (1.85%) and composite rhytidectomy (1.52%) had the highest rates of temporary nerve injury and were the only techniques to show a statistically significant difference compared with SMAS plication (odds ratio [OR] = 2.71 and 2.22, respectively, P < 0.05). Risk of permanent injury did not differ among techniques. An increase in major hematoma was found for the deep plane (1.22%, OR = 1.67, P < 0.05) and SMAS imbrication (1.92%, OR = 2.65, P < 0.01). Skin necrosis was higher with the SMAS flap (1.57%, OR = 2.29, P < 0.01).ConclusionsThere are statistically significant differences in complication rates between SMAS facelifting techniques for temporary facial nerve injury, hematoma, seroma, necrosis, and infection. Technique should be selected based on quality of results and not the complication profile.Level of Evidence: 2

scholarly journals Outcome of patients with pregnancy during or after breast cancer: a review of the recent literature

2014 ◽  
Vol 22 ◽  
pp. 8 ◽  
Author(s):  
J. Raphael ◽  
M.E. Trudeau ◽  
K. Chan
Keyword(s):  
Breast Cancer ◽  
Young Women ◽  
Randomized Trials ◽  
Recent Literature ◽  
Stage At Diagnosis ◽  
Control Groups ◽  
Level Of Evidence ◽  
Web Based ◽  
High Level ◽  
Meta Analyses

BackgroundAn increasing number of young women are delaying childbearing; hence, more are diagnosed with breast cancer (bca) before having a family. No clear recommendations are currently available for counselling such a population on the safety of carrying a pregnancy during bca or becoming pregnant after treatment for bca.MethodsUsing a Web-based search of PubMed we reviewed the recent literature about bca and pregnancy. Our objective was to report outcomes for patients diagnosed with bca during pregnancy, comparing them with outcomes for non-pregnant women, and to evaluate prognosis in women diagnosed with and treated for bca who subsequently became pregnant.Results“Pregnancy and bca” should be divided into two entities. Pregnancy-associated bca tends to be more aggressive and advanced in stage at diagnosis than bca in control groups; hence, it has a poorer prognosis. With respect to pregnancy after bca, there is, despite the bias in reported studies and meta-analyses, no clear evidence for a different or worse disease outcome in bca patients who become pregnant after treatment compared with those who do not.ConclusionsPregnancy-associated bca should be treated as aggressively as and according to the standards applicable in nonpregnant women; pregnancy after bca does not jeopardize outcome. The guidelines addressing risks connected to pregnancy and bca lack a high level of evidence for better counselling young women about pregnancy considerations and preventing unnecessary abortions. Ideally, evidence from large prospective randomized trials would set better guidelines, and yet the complexity of such studies limits their feasibility.

Criterion-concurrent Validity of Spinal Mobility Tests in Ankylosing Spondylitis: A Systematic Review of the Literature

2014 ◽  
Vol 42 (2) ◽  
pp. 243-251 ◽  
Author(s):  
Marcelo P. Castro ◽  
Simon M. Stebbings ◽  
Stephan Milosavljevic ◽  
Melanie D. Bussey
Keyword(s):  
Systematic Review ◽  
Ankylosing Spondylitis ◽  
Concurrent Validity ◽  
Spinal Mobility ◽  
Clinical Tests ◽  
High Quality ◽  
Level Of Evidence ◽  
Meta Analyses ◽  
Lumbar Range Of Motion

Objective.To examine the level of evidence for criterion-concurrent validity of spinal mobility assessments in patients with ankylosing spondylitis (AS).Methods.Guidelines proposed in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses were used to undertake a search strategy involving 3 sets of keywords: accura*, truth, valid*; ankylosing spondylitis, spondyloarthritis, spondyloarthropathy, spondylarthritis; mobility, spinal measure*, (a further 16 keywords with similar meaning were used). Seven databases were searched from their inception to February 2014: AMED, Embase, ProQuest, PubMed, Science Direct, Scopus, and Web of Science. The Quality Assessment of Diagnostic Accuracy Studies (with modifications) was used to assess the quality of articles reviewed. An article was considered high quality when it received “yes” in at least 9 of the 13 items.Results.From the 741 records initially identified, 10 articles were retained for our systematic review. Only 1 article was classified as high quality, and this article suggests that 3 variants of the Schober test (original, modified, and modified-modified) poorly reflect lumbar range of motion where radiographs were used as the reference standard.Conclusion.The level of evidence considering criterion-concurrent validity of clinical tests used to assess spinal mobility in patients with AS is low. Clinicians should be aware that current practice when measuring spinal mobility in AS may not accurately reflect true spinal mobility.

Methodological quality and reporting of systematic reviews in hand and wrist pathology

2017 ◽  
Vol 42 (8) ◽  
pp. 852-856 ◽  
Author(s):  
J. Wasiak ◽  
A. Y. Shen ◽  
R. Ware ◽  
T. J. O’Donohoe ◽  
C. M. Faggion
Keyword(s):  
Systematic Reviews ◽  
Methodological Quality ◽  
Reporting Quality ◽  
Assessment Tools ◽  
Cochrane Library ◽  
Measurement Tool ◽  
Level Of Evidence ◽  
Methodological Assessment ◽  
Meta Analyses

The objective of this study was to assess methodological and reporting quality of systematic reviews in hand and wrist pathology. MEDLINE, EMBASE and Cochrane Library were searched from inception to November 2016 for relevant studies. Reporting quality was evaluated using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and methodological quality using a measurement tool to assess systematic reviews, the Assessment of Multiple Systematic Reviews (AMSTAR). Descriptive statistics and linear regression were used to identify features associated with improved methodological quality. A total of 91 studies were included in the analysis. Most reviews inadequately reported PRISMA items regarding study protocol, search strategy and bias and AMSTAR items regarding protocol, publication bias and funding. Systematic reviews published in a plastics journal, or which included more authors, were associated with higher AMSTAR scores. A large proportion of systematic reviews within hand and wrist pathology literature score poorly with validated methodological assessment tools, which may affect the reliability of their conclusions. Level of evidence: I

scholarly journals Defining Return to Sport: A Systematic Review

2021 ◽  
Vol 9 (7) ◽  
pp. 232596712110095
Author(s):  
Joshua Doege ◽  
Jack M. Ayres ◽  
Matthew J. Mackay ◽  
Armin Tarakemeh ◽  
Symone M. Brown ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sports Medicine ◽  
Return To Sport ◽  
Eligibility Criteria ◽  
Level Of Evidence ◽  
Search Terms ◽  
Competition Level ◽  
Or Practice ◽  
Definition Of ◽  
Meta Analyses

Background: Return to sport (RTS) commonly serves as a measure for assessment of clinical outcomes in orthopaedic sports medicine surgery. Unfortunately, while RTS is commonly utilized in research for this purpose, currently there is no widely accepted or standardized definition for when an athlete has officially returned to his or her sport. Purpose: To conduct a systematic review to evaluate and report the differences in specific definitions of RTS utilized in the orthopaedic surgery literature. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was performed using PubMed, EMBASE, and Cochrane Trials databases per PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Search terms consisted of variations of “RTS” combined with variations of “orthopedic surgery” and “define” to capture as many relevant articles as possible. The definition of RTS was recorded and analyzed. Results: A total of 718 articles were identified in the initial search, 29 of which met eligibility criteria, providing a clear definition of RTS. Of the 29 studies included, 20 (69.0%) defined RTS as an athlete competing in a game or other competitive play. Three (10.3%) defined this as the athlete competing in a game or other competitive play but with an explicitly stated competition-level modifier of the athlete returning to his or her preinjury level of competition. Two articles (6.9%) included returning to training or practice, and the remaining 4 articles (13.8%) used terminology other than the standard RTS. Conclusion: There is variability in the definition of RTS used in orthopaedic sports medicine literature. Most studies refer to the athlete competing in a game or other competitive play. Other variants include returning to practice/training and explicitly defined competition levels and objectives. Future studies should aim to standardize the definition of RTS to facilitate more precise assessment of outcome after sports medicine surgery. Using terminology that describes components of the recovery and rehabilitation process, such as “return to participation” and “return to performance,” in addition to RTS will allow us to more clearly understand the athlete’s recovery and associated level of competition or performance.

scholarly journals Evidence for the Effectiveness of Feedback from Wearable Inertial Sensors during Work-Related Activities: A Scoping Review

Sensors ◽  
2021 ◽  
Vol 21 (19) ◽  
pp. 6377
Author(s):  
Roger Lee ◽  
Carole James ◽  
Suzi Edwards ◽  
Geoff Skinner ◽  
Jodi L. Young ◽  
...  
Keyword(s):  
Inertial Sensors ◽  
Inertial Sensor ◽  
Upper Body ◽  
Sensor Technology ◽  
Vibrotactile Feedback ◽  
Level Of Evidence ◽  
Work Related ◽  
Wearable Inertial Sensors ◽  
Effects Of Feedback

Background: Wearable inertial sensor technology (WIST) systems provide feedback, aiming to modify aberrant postures and movements. The literature on the effects of feedback from WIST during work or work-related activities has not been previously summarised. This review examines the effectiveness of feedback on upper body kinematics during work or work-related activities, along with the wearability and a quantification of the kinematics of the related device. Methods: The Cinahl, Cochrane, Embase, Medline, Scopus, Sportdiscus and Google Scholar databases were searched, including reports from January 2005 to July 2021. The included studies were summarised descriptively and the evidence was assessed. Results: Fourteen included studies demonstrated a ‘limited’ level of evidence supporting posture and/or movement behaviour improvements using WIST feedback, with no improvements in pain. One study assessed wearability and another two investigated comfort. Studies used tri-axial accelerometers or IMU integration (n = 5 studies). Visual and/or vibrotactile feedback was mostly used. Most studies had a risk of bias, lacked detail for methodological reproducibility and displayed inconsistent reporting of sensor technology, with validation provided only in one study. Thus, we have proposed a minimum ‘Technology and Design Checklist’ for reporting. Conclusions: Our findings suggest that WIST may improve posture, though not pain; however, the quality of the studies limits the strength of this conclusion. Wearability evaluations are needed for the translation of WIST outcomes. Minimum reporting standards for WIST should be followed to ensure methodological reproducibility.

A pilot study of neurointerventional research level of evidence and collaboration

2016 ◽  
Vol 9 (7) ◽  
pp. 694-697 ◽  
Author(s):  
Kyle M Fargen ◽  
J Mocco ◽  
Alejandro M Spiotta ◽  
Ansaar Rai ◽  
Joshua A Hirsch
Keyword(s):  
Pilot Study ◽  
New Method ◽  
Research Quality ◽  
Level Of Evidence ◽  
Medical Specialties ◽  
Research Level ◽  
Number Of Patients ◽  
Patient Series ◽  
Meta Analyses

IntroductionNo studies have sought to provide a quantitative or qualitative critique of research in the field of neurointerventional surgery.ObjectiveTo analyze recent publications from the Journal of Neurointerventional Surgery (JNIS) to test a new method for assessing research and collaboration.MethodsWe reviewed all JNIS Online First publications from 25 February 2015 to 24 February 2016. All publications—human or non-human research, systematic reviews, meta-analyses, or literature reviews—were included; editorials and commentaries were excluded. For each publication, study design, number of patients, authors, contributing centers, and study subject were recorded. Level of evidence was defined using a new scale.ResultsA total of 206 articles met inclusion criteria. Only 4% were prospective studies. Twenty-eight per cent of scientific research featured patient series of nine or less. The majority of publications were categorized as low-level evidence (91%). Forty-seven per cent involved individuals from a single center, with 87% having collaboration from three or fewer centers. International collaboration was present in 19%. While 256 institutions from 31 countries were represented, 66% were represented in only one publication.ConclusionsWe queried JNIS Online First articles from a 1-year period in a pilot study to test a new method of analyzing research quality and collaboration. The methodology appears to adequately quantify the studies into evidence tiers that emulate previously published, widely accepted scales. This may be useful for future comparison of peer-reviewed journals or for studying the quality of research being performed in different disease processes or medical specialties.

Quality of systematic reviews supporting the 2017 ACC/AHA and 2018 ESC/ESH guidelines for the management of hypertension

2021 ◽  
pp. bmjebm-2021-111675
Author(s):  
Raju Kanukula ◽  
Rupasvi Dhurjati ◽  
Kota Vidyasagar ◽  
Nusrath Rehana ◽  
Arun Talari ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
European Society ◽  
Reporting Quality ◽  
Heart Association ◽  
Measurement Tool ◽  
Level Of Evidence ◽  
Hypertension Guidelines ◽  
European Society Of Cardiology ◽  
Meta Analyses

ObjectiveTo assess the methodological and reporting quality of systematic reviews (SRs) that informed recommendations in the recent American and European hypertension guidelines.Design and settingsMeta-epidemiological study. We identified SRs that were cited for class I recommendations based on Level of Evidence-A in the 2017 American College of Cardiology/American Heart Association (ACC/AHA) and the 2018 European Society of Cardiology/European Society of Hypertension (ESC/ESH) hypertension guidelines.Main outcome measuresMethodological and reporting quality of the SRs was assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR-2) checklist and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, respectively.ResultsA total of 40 SRs was included in the analysis (28 from 2017 ACC/AHA; 22 from 2018 ESC/ESH and 10 were included in both). Based on the AMSTAR-2 assessment, only 7.5% SRs were found to be of high methodological quality, 47.5% were of moderate, each 22.5% were of low and critically low quality. Based on the PRISMA checklist assessment, a mean of 24 items (SD (2.76) were reported appropriately, and only five SRs reported all 27 items appropriately.ConclusionMethodological and reporting quality of SRs were found to vary considerably. Lack of information on the funding source of included studies, use of a protocol, integration of risk of bias assessments while interpreting findings and reporting of excluded studies were major methodological deficiencies.

Clinical utility of the (-2)proPSA and evaluation of the evidence: a systematic review

2016 ◽  
Vol 54 (7) ◽  
Author(s):  
Valentina Pecoraro ◽  
Laura Roli ◽  
Mario Plebani ◽  
Tommaso Trenti
Keyword(s):  
Clinical Utility ◽  
Data Extraction ◽  
Risk Of Bias ◽  
Level Of Evidence ◽  
Grade Method ◽  
Prostate Health Index ◽  
Total Psa ◽  
Meta Analyses ◽  
Prostate Health

AbstractDiagnostic studies usually provide important information about the analytical and diagnostic performances. We investigated the clinical utility of (-2)proPSA in identifying patients with prostate cancer (PCa).We performed electronic searches in five databases as well as a list of reference literature. Studies were included if they evaluated the diagnostic accuracy of (-2)proPSA in men with PSA value ranged from 2.0 to 10 μg/L. We also analyzed data about total PSA (tPSA), %(-2)proPSa, freePSA (fPSA), its percentage (%fPSA) and the prostate health index (phi). The selection of the studies, the screening of the full texts and the data extraction, as well as the assessment of risk of bias using the QUADAS-2 tool were conducted independently by two authors. Grading the quality of the evidence was carried out according to the GRADE method. The random effects model was used for the meta-analyses.We included 17 studies, including 6912 patients. The pooled sensitivity of (-2)proPSA was 90% and the summary specificity was 13%. The tPSA sensitivity and specificity were 89% and 25%, respectively. Considering (-2)proPSA, 225 men out of 1000 have been identified having PCa true positives (TP). However, 652 persons have been incorrectly identified and undergo biopsy. The majority of studies were judged to carry a moderate risk of bias. Therefore, the overall quality of evidences was deemed to be low.The (-2)proPSA could be useful to identify men at risk of PCa, but its accuracy still remains uncertain and the level of evidence does not support an improved clinical utility.

Letter to the Editor: Claims about the effects of botulinum toxin on depression should raise some eyebrows.

2021 ◽  
Author(s):  
Nicholas Alvaro Coles ◽  
Jeff T. Larsen
Keyword(s):  
Botulinum Toxin ◽  
Meta Analysis ◽  
Careful Consideration ◽  
Effect Sizes ◽  
Level Of Evidence ◽  
Letter To The Editor ◽  
Potential Benefits ◽  
Meta Analyses ◽  
Botulinum Toxin Injections

Recently, Schulze and colleagues (2021) and we (Coles, Larsen, Kuribayashi, &amp; Kuelz, 2019) published two separate meta-analyses examining whether glabellar-region botulinum toxin injections can decrease depression. Both meta-analysis teams reviewed similar studies; discussed similar mechanisms-of-action; observed unexpectedly large effect sizes; observed asymmetry in funnel plot distributions; and acknowledged that it is difficult to blind participants. Yet, our two teams came to starkly different conclusions. Whereas Schulze and colleagues concluded that the treatment reaches rigorous “1a level of evidence” standards (p. 338), we concluded the opposite: that the claim is “not yet well substantiated by a credible balance of evidence” (p. 11). In this Letter to the Editor, we clarify why we believe that a more careful consideration of the quality of the evidence, potential costs, and potential benefits is necessary before promoting botulinum toxin as an off-label treatment for depression.

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