scholarly journals Systematic Review of Radiofrequency Ablation and Pulsed Radiofrequency for Management of Cervicogenic Headache

2015 ◽  
Vol 2;18 (2;3) ◽  
pp. E109-E130
Author(s):  
Amit Asopa
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Randomized Trials ◽  
Primary Outcome ◽  
Cervicogenic Headache ◽  
Pulsed Radiofrequency ◽  
Rf Ablation ◽  
High Quality ◽  
Level Of Evidence

Background: Cervicogenic headache is a secondary headache that has a source in the upper cervical spine. There is a small but growing body of evidence to establish effectiveness of radiofrequency (RF) neurotomy, and the pulsed RF (PRF) procedure for management of cervicogenic headache. Objective: To investigate the clinical utility of RF neurotomy, and PRF ablation for the management of cervicogenic headache. Study Design: Systematic review. Methods: The review included relevant literature identified through searches of PubMed, Cochrane, Clinical trials, U.S. National Guideline Clearinghouse and EMBASE from 1960 to January 2014.The quality assessment and clinical relevance criteria utilized were the Cochrane Musculoskeletal Review Group criteria for randomized control trials and the Newcastle-Ottawa Scale criteria for observational studies. The level of evidence was classified as good, fair, and poor based on the quality of evidence. Outcomes Measured: The primary outcome measures were reduction in pain scores and improvement in quality of life. Results: The primary outcome measures were headache relief and improved quality of life. Twenty five studies were identified for full text review of these, 9 studies met inclusion criteria. There were 5 non-randomized, among them 4/5 were of moderate quality, 3/5 showed RF ablation and 1/5 showed PRF as an effective intervention for cervicogenic headache. There were 4 randomized trials among them 2/4 were of high quality, 3/4 investigated RF ablation as an intervention for CHA, 1/4 investigated PRF ablation as an intervention for CHA and none of the randomized studies showed strong evidence for RF and PRF ablation as an effective intervention for CHA. Limitations: In the selected studies there were inconsistencies between randomized trials, flaws in trial design, and gaps in the chain of evidence. Conclusion: There is limited evidence to support RF ablation for management of CHA as there are no high quality RCTs and/ or multiple consistent non-RCTs without methodological flaws. There is poor evidence to support PRF for CHA as there are no high quality RCTs or Non-RCTs. Key Words: Chronic pain, cervicogenic headache, radiofrequency (rf) neurotomy, pulsed radiofrequency (PRF) ablation, reduction in pain, improvement in quality of life, level of evidence

scholarly journals Effects of Pharmacologic Therapy on Health-Related Quality of Life in Elderly patients with Atrial Fibrillation: A systematic Review of Randomized and Nonrandomized Trials

2013 ◽  
Vol 7 ◽  
pp. CMC.S10628 ◽  
Author(s):  
Carl J. Pepine
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Systematic Review ◽  
Elderly Patients ◽  
Randomized Trials ◽  
Rhythm Control ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

This systematic review assessed the impact of atrial fibrillation (AF) and pharmacotherapy on health-related quality of life (HRQOL) in elderly patients. Highly prevalent in the elderly, AF is associated with morbidity and symptoms affecting HRQOL. A PubMed and EMBASE search (1999-2010) was conducted using the terms atrial fibrillation, elderly, quality of life, Medicare, and Medicaid. In all, 504 articles were identified and 15 were selected (studies examining pharmacotherapy [rate or rhythm control] and HRQOL in AF patients with a mean age > 65 years). Information, including study design, cohort size, and HRQOL instruments utilized, was extracted. Five observational studies, 5 randomized trials comparing rate and rhythm control, 3 randomized trials investigating pharmacologic agents, and 2 trials examining HRQOL, depression, and anxiety were identified. Elderly AF patients had reduced HRQOL versus patients in normal sinus rhythm, particularly in domains related to physical functioning. HRQOL may be particularly affected in older AF patients. Although data do not indicate whether a pharmacologic intervention or single treatment strategy—namely rate versus rhythm control—is better at improving HRQOL, either of these strategies and many pharmacologic interventions may improve HRQOL in elderly AF patients. Based on reviewed data, an algorithm is suggested to optimize HRQOL among elderly patients.

scholarly journals Evaluating measures of quality of life in adult scoliosis: a protocol for a systematic review and narrative synthesis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
James E. Archer ◽  
Charles Baird ◽  
Adrian Gardner ◽  
Alison B. Rushton ◽  
Nicola R. Heneghan
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Outcome Measures ◽  
Study Design ◽  
Systematic Reviews ◽  
Primary Outcome ◽  
Adult Scoliosis ◽  
Measurement Properties ◽  
Narrative Synthesis

Abstract Background Adult scoliosis represents a distinct subgroup of scoliosis patients for whom the diagnosis can have a large impact on their health-related quality of life (HR-QOL). Therefore, HR-QOL patient-reported outcome measures (PROMs) are essential to assess disease progression and the impact of interventions. The objective of this systematic review is to evaluate the measurement properties of HR-QOL PROMs in adult scoliosis patients. Methods We will conduct a literature search, from their inception onwards, of multiple electronic databases including AMED, CINAHL, EMBASE, Medline, PsychINFO and PubMed. The searches will be performed in two stages. For both stages of the search, participants will be aged 18 and over with a diagnosis of scoliosis. The primary outcome of interest in the stage one searches will be studies which use PROMs to investigate HR-QOL as defined by the Core Outcome Measures in Effectiveness Trials (COMET) taxonomy, the secondary outcome will be to assess the frequency of use of the various PROMs. In stage two, the primary outcome of interest will be studies which assess the measurement properties of the HR-QOL PROMs identified in stage one. No specific measurement property will be given priority. No planned secondary outcomes have been identified but will be reported if discovered. In stage one, the only restriction on study design will be the exclusion of systematic reviews. In Stage two the only restriction on study design will be the exclusion of full-text articles not available in the English language. Two reviewers will independently screen all citations and abstract data. Potential conflicts will be resolved through discussion. The study methodological quality (or risk of bias) will be appraised using the Consensus-based Standards for the selection of Health Measurement Instruments (COSMIN) checklist. The overall strength of the body of evidence will then be assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. A narrative synthesis will be provided with information presented in the main text and tables to summarise and explain the characteristics and findings of the included studies. The narrative synthesis will explore the evidence for currently used PROMs in adult scoliosis patients and any areas that require further study. Discussion The review will help clinicians and researchers identify a HR-QOL PROM for use in patients with adult scoliosis. Findings from the review will be published and disseminated through a peer-reviewed journal and conference presentations. Systematic review registration This systematic review has been registered with the International Prospective Register of Systematic Reviews (PROSPERO), reference number: CRD42020219437

Quality of economic evaluations of drug-coated balloons and drug-eluting stents in peripheral artery disease: a systematic review

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Aurélie Etangsale ◽  
Leonarda Nunno ◽  
Judith Pineau ◽  
Patrice Prognon ◽  
Nicolas Martelli
Keyword(s):  
Systematic Review ◽  
Health Economic Evaluation ◽  
Reporting Quality ◽  
Economic Evaluations ◽  
Peripheral Artery ◽  
High Quality ◽  
Level Of Evidence ◽  
Drug Eluting ◽  
Artery Disease

Abstract Objective We aimed to perform a systematic review of economic evaluations of drug-coated balloons (DCBs) and drug-eluting stents (DESs) in peripheral artery disease (PAD) and to assess the level of evidence of relevant studies. The purpose was not to present economic findings. Methods A systematic review was performed using four electronic databases to identify health economic evaluation studies reporting on the use of DCBs and DESs in PAD. The methodological and reporting quality of the studies was assessed using three different tools, the Drummond, Cooper, and CHEERS (Consolidated Health Economic Evaluation Reporting Standards) checklists. Results Six articles were included in this review of the 1,728 publications identified. Four studies were cost-effectiveness analyses and two cost–utility analyses. According to the Cooper hierarchy scale, the studies used good-quality data sources. The level of evidence used for clinical effect sizes, safety data, baseline clinical data, and costs was of high quality in general. In contrast, an evaluation of the reporting quality suggested that essential information was lacking. Conclusion The present study demonstrates that clinical data used in economic evaluations of DCBs and DESs in PAD are from clinical studies of high quality in general. However, the quality of reporting represents a concern when interpreting the results provided by these economic studies.

scholarly journals Effect of online hemodiafiltration compared with hemodialysis on quality of life in patients with ESRD: A systematic review and meta-analysis of randomized trials

PLoS ONE ◽  
2018 ◽  
Vol 13 (10) ◽  
pp. e0205037 ◽  
Author(s):  
Tatsuya Suwabe ◽  
Francisco J. Barrera-Flores ◽  
Rene Rodriguez-Gutierrez ◽  
Yoshifumi Ubara ◽  
Kenmei Takaichi
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Randomized Trials ◽  
Meta Analysis

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.

scholarly journals Kinesiophobia dilemma for older adults: a systematic review

2020 ◽  
Vol 6 (3) ◽  
Author(s):  
Alebtekin Ahangari ◽  
Mohammad Abdolrahmani
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Older Adults ◽  
Clinical Trials ◽  
Randomized Trials ◽  
Lower Probability ◽  
Low Back ◽  
Healthy Life ◽  
Age Related

Kinesiophobia is one of the pain complications which eventually might cause disability. Several studies showed correlation between age-related problems with kinsiophobia. The objective was to investigate clinical trials about managing kinesiophobia among older adults aged +65 years until March 2020. PubMed, CINAHL, Google Scholar, and PsycINFO databases were electronically searched until March 2020. All studies about kinesiophobia, with clinical trials, and randomized trials study design among older adults aged +65 years were included in the review. Two set of searching terms including ‘kinesiophobia AND intervention’ and ‘fear of movement AND intervention’ were used. From a total of 2669 articles, after excluding for different reasons, only three articles with total of 87 participants, mean age 68.5, all from Turkey related to the objectives of this study remained. Two of them were evaluated using two different physiotherapy approaches to manage neck pain and low back pain and one of them was regarding falls. Kinesiophobia was used as measure for the effectiveness of treatments. Older adults with routine and properly designed exercise and activity are healthier, with a lower probability for disability and therefore higher quality of life and longer healthy life. But to reach those goals, agerelated diseases and barriers should be investigated.

scholarly journals Impact and cost-effectiveness of care farms on health and well-being of offenders on probation: a pilot study

2018 ◽  
Vol 6 (3) ◽  
pp. 1-190 ◽  
Author(s):  
Helen Elsey ◽  
Rachel Bragg ◽  
Marjolein Elings ◽  
Cathy Brennan ◽  
Tracey Farragher ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Cost Effectiveness ◽  
Pilot Study ◽  
Primary Outcome ◽  
Well Being ◽  
Propensity Analysis ◽  
Future Work

Background Care farms (CFs), in which all or part of the farm is used for therapeutic purposes, show potential for improving well-being for disadvantaged groups. We assessed the feasibility of determining the cost-effectiveness of CFs in improving quality of life compared with comparator sites among probationers undertaking community orders (COs). Objectives (1) To conduct a systematic review of CF impacts and mechanisms in improving health and logic model development; (2) to inform future studies by estimating differences in quality of life and other outcomes, identifying factors driving CO allocation and ways to maximise recruitment and follow-up; and (3) to assess feasibility of cost-effectiveness analysis. Review methods A mixed-methods synthesis following Campbell Collaboration guidelines. Pilot study: three probation service regions in England, each with a CF and a comparator CO site. Participants were adult offenders (aged ≥ 18 years) serving COs. The primary outcome was quality of life [as measured via the Clinical Outcome in Routine Evaluation–Outcome Measure (CORE-OM)]. Other outcomes were health behaviours, mental well-being, connectedness to nature and reconvictions. Data sources In November 2014, we searched 22 health, education, environmental, criminal justice and social science electronic databases, databases of grey literature and care farming websites across Europe. There were no language restrictions. A full list of databases searched is given in Appendix 1; some examples include Web of Science, Cumulative Index to Nursing and Allied Health Literature (via EBSCOhost), The Campbell Library, Criminal Justice Abstracts (via EBSCOhost), MEDLINE (via Ovid) and Scopus (Elsevier B.V., Amsterdam, the Netherlands). Results Our systematic review identified 1659 articles: 14 qualitative, 12 quantitative and one mixed-methods study. Small sample sizes and poor design meant that all were rated as being at a high risk of bias. Components of CFs that potentially improve health are being in a group, the role of the farmer and meaningful work, and interaction with animals. There was a lack of quantitative evidence indicating that CFs improve quality of life and there was weak evidence of improved mental health, self-efficacy, self-esteem, affect and mood. In the pilot study we recruited 134 respondents, and only 21 declined; 37% were allocated to three CFs and the remainder to comparators. This was below our recruitment target of 300. Recruitment proved challenging as a result of the changes in probation (probation trusts were disbanded in 2014) and closure of one CF. We found significant differences between CFs and comparator users: those at CFs were more likely to be male, smokers, substance users, at higher risk of reoffending (a confounder) and have more missing CORE-OM questions. Despite these differences, the use of propensity analysis facilitated comparison. Participants consented to our team accessing, and we were able to link, probation and police reconviction data for 90% of respondents. We gained follow-up questionnaire data from 52% of respondents, including health and social care use cost data. We transformed CORE-OM into CORE-6D, allowing derivation of quality-adjusted life-years. As a pilot, our study was not powered to identify significant differences in outcomes. Qualitatively, we observed that within COs, CFs can be formally recognised as rehabilitative but in practice can be seen as punitive. Limitations Changes in probation presented many challenges that limited recruitment and collection of cost data. Conclusions Recruitment is likely to be feasible in a more stable probation environment. Retention among probationers is challenging but assessing reconvictions from existing data is feasible. We found worse health and risk of reoffending among offenders at CFs, reflecting the use of CFs by probation to manage challenging offenders. Future work A sufficiently powered natural experiment is feasible and of value. Using reconvictions (from police data) as a primary outcome is one solution to challenges with retention. Propensity analysis provides a viable method for comparison despite differences in participants at CFs and comparator sites. However, future work is dependent on stability and support for CFs within probation services. Study registration This study is registered as PROSPERO CRD42014013892 and SW2013–04 (the Campbell Collaboration). Funding details The National Institute for Health Research Public Health Research programme.

The effect of weight loss on health-related quality of life: systematic review and meta-analysis of randomized trials

2013 ◽  
Vol 15 (3) ◽  
pp. 169-182 ◽  
Author(s):  
L. M. Warkentin ◽  
D. Das ◽  
S. R. Majumdar ◽  
J. A. Johnson ◽  
R. S. Padwal
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Weight Loss ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

P–302 Levonorgestrel-releasing intrauterine device (LNG-IUD) for symptomatic endometriosis following surgery: a Cochrane systematic review

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
T Gibbons ◽  
E Georgiou ◽  
H Al-Inany ◽  
Y Cheong
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Treatment Satisfaction ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Intrauterine Device ◽  
Postoperative Treatment ◽  
Cochrane Systematic Review ◽  
Troublesome Symptom

Abstract Study question Does levonorgestrel-releasing intrauterine device (LNG-IUD) improve post-operative outcomes for endometriosis when compared to other systemic hormonal treatments or no additional treatment? Summary answer We are uncertain whether LNG-IUD has an impact on dysmenorrhoea when compared to no postoperative treatment or post-operative GnRH agonists (GnRH-a). What is known already Endometriosis is a condition characterised by the presence of ectopic deposits of endometrial-like tissue outside the uterus, usually in the pelvis; inducing a chronic inflammatory response which can lead to pelvic pain and infertility. Various treatment options exist including surgical treatment, ovarian suppression therapy, or a combination of these strategies. The impact of laparoscopic treatment on overall pain is uncertain and a significant proportion of women will require further surgery. Therefore, adjuvant medical therapies such as LNG-IUD have been considered to reduce treatment failure and recurrence of symptoms. Study design, size, duration A Cochrane systematic review and meta-analysis was performed. Electronic searches of the Cochrane Gynaecology and Fertility Specialised Register of Controlled Trials, CENTRAL, MEDLINE, EMBASE, PsycINFO, CINAHL and Epistemonikos were conducted to January 2021 for relevant randomised controlled trials (RCTs). Two independent authors screened studies and extracted data. Risk ratios (RR) were calculated for dichotomous data and standardised mean differences (SMD) for continuous data, with 95% confidence intervals (CI). Heterogeneity was examined via the I² statistic. Participants/materials, setting, methods Participants: women undergoing surgical treatment for endometriosis without hysterectomy Intervention: LNG-IUD insertion within three months of surgery Comparison: No postoperative treatment, placebo IUD or any other systemic treatment Primary outcome: overall pain Secondary outcomes: improvement of the most troublesome symptom, dysmenorrhoea, quality of life, satisfaction with treatment and adverse events. Primary analysis was conducted on data per woman randomised. Main results and the role of chance Four RCTs were included, with a total of 157 women. Five studies are awaiting classification and one is an ongoing study. We corresponded with original study authors to clarify missing outcome data. No studies reported on overall pain or improvement in the most troublesome symptom. We await study author clarification on quality of life and treatment satisfaction data. We are uncertain whether LNG-IUD improves dysmenorrhoea compared to no postoperative treatment at 12 months. Data on this outcome were reported on by 2 RCTs, but were expressed as median and inter-quartile range and so meta-analysis was not possible (RCT 1: delta of median visual analog scale (VAS) 81 versus 50, p = 0.006, n = 55; RCT 2: fall in VAS by 50 (35–65) p = 0.012 versus 30 (25– 40), p = 0.021, n = 40). We are uncertain whether compared to post-operative GnRH-a, LNG-IUD affects rates of dysmenorrhoea at 6 months (VAS SMD 0.79, 95% CI –0.08 to 1.67, p = 0.08, one RCT, n = 22, very low quality evidence). Various adverse events with LNG-IUD were reported including irregular bleeding and weight gain. However, due to a lack of raw data and comparable studies, we were unable to undertake meta-analysis. Limitations, reasons for caution The major limitation of this systematic review was that there were insufficient studies reporting on our prespecified outcomes, including our primary outcome. In addition, the included studies were not all of high quality with limited long-term follow-up. Wider implications of the findings: This systematic review highlights the paucity of RCTs reporting outcomes included in the new core outcome set for endometriosis research. Further high-quality RCTs are needed to assess postoperative adjuvant hormonal therapy and these should prioritise investigating key endometriosis outcomes such as overall pain, quality of life and treatment satisfaction. Trial registration number Not applicable

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