A Comparative Meta-Analysis of the Effects of Concussion on a Computerized Neurocognitive Test and Self-Reported Symptoms

Context: Meta-analyses examining construct-specific cognitive impairment concurrently with self-reported symptoms postconcussion are sparse. Objective: To review the literature on the effects of concussion on construct-specific neurocognitive declines and to compare them with self-reported symptoms before 1 week and between 1 and 3 weeks postconcussion. Data Sources: Relevant studies in PubMed, CINAHL, and PsycINFO published from January 1, 1999 through November 30, 2015. Study Selection: Studies were included if participants completed the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) before and after concussion and if test performance and Postconcussion Symptom Scale (PCSS) scores were reported at both times. Data Extraction: After reviewing the full texts, we extracted data from 17 studies consisting of 29 independent samples; therefore, this meta-analysis consisted of 1777 unique participants. Data Synthesis: The Hedges g effect size (ES) was estimated. A random-effects or fixed-effects model was used based on heterogeneity findings. When heterogeneity was present, we used meta-regression to assess unexplained between-studies variance. Within the first week of injury, the ESs were small to moderate for cognitive declines, ranging from −0.43 (95% confidence interval [CI] = −0.52, −0.35) to −0.67 (95% CI = −0.77, −0.58), and large for the PCSS score (Hedges g = −0.81; 95% CI = −0.91, −0.71). After 1 week, the ESs for cognitive declines (Hedges g range = −0.25 [95% CI = −0.35, −0.15] to −0.37 [95% CI = −0.55, −0.19]) and PCSS score (Hedges g = −0.38; 95% CI = −0.53, −0.22) were also small. Within 2 weeks of injury, PCSS score and time since injury weakly moderated the cognitive ES. Conclusions: When a neurocognitive test was administered within 1 week of injury, the ES was larger for self-reported symptoms than for ImPACT scores generated at the same session. After 1 week of injury, the ESs for ImPACT and PCSS scores were comparable. If the athlete reports symptoms within 1 week of injury, administering a cognitive test does not appear to offer additional information to the clinician. However, if the athlete does not report symptoms postconcussion, cognitive testing may inform the clinical management of the injury.

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A Systematic Review and Meta-Analysis about the Effect of Bisphosphonates on the Risk of Skeletal-Related Event in Men with Prostate Cancer

Anti-Cancer Agents in Medicinal Chemistry ◽

10.2174/1871520620666200521114815 ◽

2020 ◽

Vol 20 (13) ◽

pp. 1604-1612

Author(s):

Congcong Wu ◽

Hua Jiang ◽

Jianghua Chen

Keyword(s):

Prostate Cancer ◽

Fixed Effects ◽

Data Extraction ◽

Controlled Trial ◽

Meta Analysis ◽

Control Group ◽

Fixed Effects Model ◽

Related Event ◽

Mineral Density ◽

Skeletal Related Event

Background: Although the adjuvant therapy of bisphosphonates in prostate cancer is effective in improving bone mineral density, it is still uncertain whether bisphosphonates could decrease the risk of Skeletal- Related Event (SRE) in patients with prostate cancer. We reviewed and analyzed the effect of different types of bisphosphonates on the risk of SRE, defined as pathological fracture, spinal cord compression, radiation therapy to the bone, surgery to bone, hypercalcemia, bone pain, or death as a result of prostate cancer. Methods: A systemic literature search was conducted on PubMed and related bibliographies. The emphasis during data extraction was laid on the Hazard Ratio (HR) and the corresponding 95% Confidence Interval (CI) from every eligible Randomized Controlled Trial (RCT). HR was pooled with the fixed effects model, and preplanned subgroup analyses were performed. Results: 5 RCTs (n = 4651) were included and analyzed finally after screening 51 articles. The meta-analysis of all participants showed no significant decrease in the risk of SRE when adding bisphosphonates to control group (HR = 0.968, 95% CI = 0.874 - 1.072, p = 0.536) with low heterogeneity (I2 = 0.0% (d.f. = 4) p = 0.679). There was no significant improvement on SRE neither in the subgroups with Metastases (M1) or Castration-Sensitive Prostate Cancer (CSPC) (respectively HR = 0.968, 95% CI = 0.874 - 1.072, p = 0.536, I2 = 0.0% (d.f. = 4) p = 0.679; HR = 0.954, 95% CI = 0.837 - 1.088, p = 0.484, I2 = 0.0% (d.f. = 3) p = 0.534). Conclusion: Our study demonstrated that bisphosphonates could not statistically significantly reduce the risk of SRE in patients with prostate cancer, neither in the subgroups with M1 or CSPC.

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Comparison of anterior corpectomy and fusion versus laminoplasty for the treatment of cervical ossification of posterior longitudinal ligament: a meta-analysis

Neurosurgical FOCUS ◽

10.3171/2016.3.focus15596 ◽

2016 ◽

Vol 40 (6) ◽

pp. E8 ◽

Cited By ~ 22

Author(s):

Zihao Chen ◽

Bin Liu ◽

Jianwen Dong ◽

Feng Feng ◽

Ruiqiang Chen ◽

...

Keyword(s):

Data Analysis ◽

Fixed Effects ◽

Data Extraction ◽

Meta Analysis ◽

Japanese Orthopaedic Association ◽

Operation Time ◽

Posterior Longitudinal Ligament ◽

Treatment Method ◽

Fixed Effects Model ◽

Anterior Corpectomy

OBJECTIVE The purpose of this study was to compare the effectiveness and safety of anterior corpectomy and fusion (ACF) with laminoplasty for the treatment of patients diagnosed with cervical ossification of the posterior longitudinal ligament (OPLL). METHODS The authors searched electronic databases for relevant studies that compared the use of ACF with laminoplasty for the treatment of patients with OPLL. Data extraction and quality assessment were conducted, and statistical software was used for data analysis. The random effects model was used if there was heterogeneity between studies; otherwise, the fixed effects model was used. RESULTS A total of 10 nonrandomized controlled studies involving 819 patients were included. Postoperative Japanese Orthopaedic Association (JOA) score (p = 0.02, 95% CI 0.30–2.81) was better in the ACF group than in the laminoplasty group. The recovery rate was superior in the ACF group for patients with an occupying ratio of OPLL of ≥ 60% (p < 0.00001, 95% CI 21.27–34.44) and for patients with kyphotic alignment (p < 0.00001, 95% CI 16.49–27.17). Data analysis also showed that the ACF group was associated with a higher incidence of complications (p = 0.02, 95% CI 1.08–2.59) and reoperations (p = 0.002, 95% CI 1.83–14.79), longer operation time (p = 0.01, 95% CI 17.72 –160.75), and more blood loss (p = 0.0004, 95% CI 42.22–148.45). CONCLUSIONS For patients with an occupying ratio ≥ 60% or with kyphotic cervical alignment, ACF appears to be the preferable treatment method. Nevertheless, laminoplasty seems to be effective and safe enough for patients with an occupying ratio < 60% or with adequate cervical lordosis. However, it must be emphasized that a surgical strategy should be made based on the individual patient. Further randomized controlled trials comparing the use of ACF with laminoplasty for the treatment of OPLL should be performed to make a more convincing conclusion.

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Changing the Physical Activity Behavior of Adults With Fitness Trackers: A Systematic Review and Meta-Analysis

American Journal of Health Promotion ◽

10.1177/0890117119895204 ◽

2019 ◽

Vol 34 (4) ◽

pp. 418-430 ◽

Cited By ~ 5

Author(s):

Chris Lynch ◽

Stephen Bird ◽

Noel Lythgo ◽

Isaac Selva-Raj

Keyword(s):

Physical Activity ◽

Fixed Effects ◽

Randomized Clinical Trials ◽

Data Extraction ◽

Meta Analysis ◽

Physical Activity Behavior ◽

Step Count ◽

Fixed Effects Model ◽

Alternative Intervention ◽

Positive Effect

Objective: To examine whether a fitness tracker (FT) intervention changes physical activity (PA) behavior compared to a control condition or compared to an alternative intervention. Data Source: Searches between January 01, 2010, and January 01, 2019, were conducted in PubMed, CINAHL, Cochrane CENTRAL, EMBASE, and PsycINFO. Inclusion/Exclusion Criteria: Randomized clinical trials of adults using an FT to change PA behavior were included. Nonclinical trials, studies that included the delivery of structured exercise, and/or studies that only used the FT to assess PA were excluded. Data Extraction: Extracted features included characteristics of the study population, intervention components, PA outcomes, and results. Data Synthesis: Papers were pooled in a statistical meta-analysis using a fixed effects model. Where statistical pooling was not possible, standardized mean difference (SMD) and 95% confidence intervals (CI) were calculated. Findings were presented in a narrative form and tables. Results: Of 2076 articles found, 21 were included in the review. A small yet significant positive effect (SMD = 0.25, 95% CI = 0.17-0.32; P < .01; I2 = 56.9%; P = .03) was found in step count for interventions compared to control. A small yet significant negative effect (SMD = −0.11, 95% CI = −0.20 to −0.02; P = .02; I2 = 58.2%; P = 0.03) was found in moderate-to-vigorous PA for interventions compared to an alternative intervention. Conclusion: Trackers may enhance PA interventions, as a general positive effect is found in step count compared to a control. However, there is no evidence of a positive effect when interventions are compared to an alternative intervention. It is unknown whether results are due to other intervention components and/or clinical heterogeneity.

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Associations of dietary vitamin B1, vitamin B2, vitamin B6, and vitamin B12 with the risk of depression: a systematic review and meta-analysis

Nutrition Reviews ◽

10.1093/nutrit/nuab014 ◽

2021 ◽

Author(s):

Yanjun Wu ◽

Liming Zhang ◽

Suyun Li ◽

Dongfeng Zhang

Keyword(s):

Systematic Review ◽

Vitamin B12 ◽

Vitamin B6 ◽

Fixed Effects ◽

Data Extraction ◽

Meta Analysis ◽

Vitamin B1 ◽

Dietary Vitamin ◽

Vitamin B2 ◽

Fixed Effects Model

Abstract Context The results from epidemiologic studies on the intake of dietary vitamin B1, B2, B6, and B12 and association with risk of developing depression have been inconsistent. Objective The purpose of this systematic review and meta-analysis was to summarize the existing evidence and synthesize the results. Data Sources The databases of Web of Science and PubMed were searched for relevant articles published in English until September 2020. Study Selection Observational studies that evaluated the associations between depression and dietary vitamin B1, B2, B6, and B12 were included in this study. Data Extraction The job of data extraction was undertaken by 2 authors, and the pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated using a fixed-effects model. Results Thirteen articles related to 18 studies were eligible for inclusion in this systematic review and meta-analysis. The pooled RR (95% CI) of depression for the highest vs the lowest category of dietary vitamin B1, B2, B6, and B12 was 0.69 (0.55–0.87), 0.77 (0.67–0.89), 0.81 (0.71–0.93), and 0.86 (0.75–0.99), respectively. The pooled RR (95% CI) of depression for the highest vs the lowest category of dietary vitamin B2 was 0.80 (0.64–0.99) in females and 0.83 (0.67–1.02) in males, for dietary vitamin B6 was 0.71 (0.59–0.86) in females and 0.92 (0.76–1.12) in males, and for dietary vitamin B12 was 0.79 (0.65–0.97) in females and 0.94 (0.77–1.15) in males. Conclusion This study suggested that the intake of dietary vitamin B1, B2, B6, and B12 may be inversely associated with the risk of depression; the inverse associations observed between depression and intake of dietary vitamin B2, B6, and B12 were significant in females, but not in males. Further studies are needed to confirm these results.

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Diagnosis and Prognostic Significance of c-Met in Cervical Cancer: A Meta-Analysis

Disease Markers ◽

10.1155/2016/6594016 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 11

Author(s):

Jifeng Peng ◽

Shengnan Qi ◽

Ping Wang ◽

Wanyu Li ◽

Chunxia Liu ◽

...

Keyword(s):

Cervical Cancer ◽

Cervical Carcinoma ◽

Fixed Effects ◽

Data Extraction ◽

Meta Analysis ◽

Prognostic Significance ◽

Disease Free Survival ◽

Cervical Tissue ◽

Fixed Effects Model ◽

China National Knowledge Infrastructure

Objective. A meta-analysis was conducted to analyze c-Met expression in cervical cancer.Methods. Articles related to our study were retrieved from PubMed, Elsevier, and China National Knowledge Infrastructure. State 12.0 was used for literature review, data extraction, and meta-analysis. The random-effects model and fixed-effects model were utilized to pool the relative ratio based on the heterogeneity test in the meta-analysis.Results.Nine studies that include data of 685 cervical carcinoma tissues were analyzed. However, three studies did not thoroughly discuss c-Met expression in nonneoplastic cervical tissue; thus, only six studies involving 364 patients and 228 nonneoplastic cervical tissues were included in the review. c-Met expression was higher in cervical cancer (60.99%) than in nonneoplastic cervical tissue (19.74%). Cervical carcinoma, cervical intraepithelial neoplasm, and normal cervical tissue were also examined. Results showed that increasing malignancy resulted in elevated c-Met expression. The relationship between c-Met expression and clinicopathologic features was also evaluated. c-Met expression correlated with disease-free survival, lymph node involvement, and lymphovascular space invasion. No statistical difference was observed between c-Met expression and other clinicopathological factors.Conclusions.c-Met is a potential diagnostic and prognostic indicator of cervical cancer.

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Statin use and clinical outcomes in patients with COVID-19: An updated systematic review and meta-analysis

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2020-139172 ◽

2021 ◽

pp. postgradmedj-2020-139172

Author(s):

Rimesh Pal ◽

Mainak Banerjee ◽

Urmila Yadav ◽

Sukrita Bhattacharjee

Keyword(s):

Clinical Outcomes ◽

Observational Studies ◽

Fixed Effects ◽

Controlled Trial ◽

Meta Analysis ◽

Adverse Outcomes ◽

Fixed Effects Model ◽

Adjusted Risk ◽

Risk Estimates ◽

Statin Use

PurposeObservations studies have shown that prior use of statins is associated with a reduced risk of adverse clinical outcomes in patients with COVID-19. However, the available data are limited, inconsistent and conflicting. Besides, no randomised controlled trial exists in this regard. Hence, the present meta-analysis was conducted to provide an updated summary and collate the effect of statin use on clinical outcomes in COVID-19 using unadjusted and adjusted risk estimates.MethodsPubMed, Scopus and Web of Science databases were systematically searched using appropriate keywords till December 18 2020, to identify observational studies reporting clinical outcomes in COVID-19 patients using statins versus those not using statins. Prior and in-hospital use of statins were considered. Study quality was assessed using the Newcastle-Ottawa Scale. Unadjusted and adjusted pooled odds ratio (OR) with 95% CIs were calculated.ResultsWe included 14 observational studies pooling data retrieved from 19 988 patients with COVID-19. All the studies were of high/moderate quality. Pooled analysis of unadjusted data showed that statin use was not associated with improved clinical outcomes (OR 1.02; 95% CI 0.69 to 1.50, p=0.94, I2=94%, random-effects model). However, on pooling adjusted risk estimates, the use of statin was found to significantly reduce the risk of adverse outcomes (OR 0.51; 95% CI 0.41 to 0.63, p<0.0005, I2=0%, fixed-effects model).ConclusionsStatin use is associated with improved clinical outcomes in patients with COVID-19. Individuals with multiple comorbidities on statin therapy should be encouraged to continue the drug amid the ongoing pandemic.

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Saliva RNA biomarkers predict concussion duration and detect symptom recovery: a comparison with balance and cognitive testing

Journal of Neurology ◽

10.1007/s00415-021-10566-x ◽

2021 ◽

Author(s):

Gregory Fedorchak ◽

Aakanksha Rangnekar ◽

Cayce Onks ◽

Andrea C. Loeffert ◽

Jayson Loeffert ◽

...

Keyword(s):

Test Performance ◽

Area Under The Curve ◽

Prediction Rule ◽

Cognitive Testing ◽

Cognitive Test ◽

Clinical Tool ◽

Post Injury ◽

Symptom Recovery ◽

Cognitive Test Performance

Abstract Objective The goals of this study were to assess the ability of salivary non-coding RNA (ncRNA) levels to predict post-concussion symptoms lasting ≥ 21 days, and to examine the ability of ncRNAs to identify recovery compared to cognition and balance. Methods RNA sequencing was performed on 505 saliva samples obtained longitudinally from 112 individuals (8–24-years-old) with mild traumatic brain injury (mTBI). Initial samples were obtained ≤ 14 days post-injury, and follow-up samples were obtained ≥ 21 days post-injury. Computerized balance and cognitive test performance were assessed at initial and follow-up time-points. Machine learning was used to define: (1) a model employing initial ncRNA levels to predict persistent post-concussion symptoms (PPCS) ≥ 21 days post-injury; and (2) a model employing follow-up ncRNA levels to identify symptom recovery. Performance of the models was compared against a validated clinical prediction rule, and balance/cognitive test performance, respectively. Results An algorithm using age and 16 ncRNAs predicted PPCS with greater accuracy than the validated clinical tool and demonstrated additive combined utility (area under the curve (AUC) 0.86; 95% CI 0.84–0.88). Initial balance and cognitive test performance did not differ between PPCS and non-PPCS groups (p > 0.05). Follow-up balance and cognitive test performance identified symptom recovery with similar accuracy to a model using 11 ncRNAs and age. A combined model (ncRNAs, balance, cognition) most accurately identified recovery (AUC 0.86; 95% CI 0.83–0.89). Conclusions ncRNA biomarkers show promise for tracking recovery from mTBI, and for predicting who will have prolonged symptoms. They could provide accurate expectations for recovery, stratify need for intervention, and guide safe return-to-activities.

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Association between early bronchiolitis and the development of childhood asthma: a meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-043956 ◽

2021 ◽

Vol 11 (5) ◽

pp. e043956

Author(s):

Guizuo Wang ◽

Dong Han ◽

Zhengdong Jiang ◽

Manxiang Li ◽

Shumei Yang ◽

...

Keyword(s):

Early Life ◽

Fixed Effects ◽

Late Onset ◽

Meta Analysis ◽

Later Life ◽

Analysis Data ◽

Fixed Effects Model ◽

Case Control Studies ◽

Increased Risk ◽

Registration Number

ObjectiveEarly life bronchiolitis has been hypothesised to be associated with the subsequent risk of persistent wheezing or asthma. However, the link remains controversial. The objective of our study was to evaluate the association between bronchiolitis before 2 years of age and the late-onset wheezing/asthma.DesignSystematic review and meta-analysis.MethodsPubMed, Embase and Web of Science databases were systematically searched for studies published between 1955 and January 2020. Meanwhile, we also checked through the reference lists of relevant articles to see whether these references included reports of other studies that might be eligible for the review. Cohort and case–control studies assessing the association between early-life bronchiolitis and late-onset wheezing/asthma were included in this meta-analysis. Data were extracted by two independent reviewers. Results were pooled using a random-effects model or fixed-effects model according to the heterogeneity among studies.Results32 original articles with 292 844 participants, which met the criteria, were included in this meta-analysis. Bronchiolitis before 2 years of age was associated with an increased risk of subsequent wheezing/asthma (relative risk=2.46, 95% CI 2.14 to 2.82, p<0.001). After categorising studies into different groups based on age at the end of follow-up, geographical region and study quality, the association still remained significant.ConclusionsThe meta-analysis indicates an association between bronchiolitis before 2 years of age and the wheezing/asthma in later life. Well-designed and highly standardised prospective studies that better address bias due to potential confounding factors are needed to validate the risk identified in our meta-analysis.PROSPERO registration numberCRD42018089453.

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Recombinant Human Thyrotropin-Stimulated Radioiodine Therapy in Patients with Multinodular Goiters: A Meta-Analysis of Randomized Controlled Trials

Hormone and Metabolic Research ◽

10.1055/a-1240-5058 ◽

2020 ◽

Vol 52 (12) ◽

pp. 841-849

Author(s):

Chunmei Xu ◽

Ping Wang ◽

Huikai Miao ◽

Tianyue Xie ◽

Xiaojun Zhou ◽

...

Keyword(s):

Fixed Effects ◽

Dose Group ◽

Low Dose ◽

Radioiodine Therapy ◽

Meta Analysis ◽

High Dose Group ◽

High Dose ◽

Fixed Effects Model ◽

Recombinant Human Thyrotropin

AbstractA potential reduction of goiter volume (GV) of recombinant human thyrotropin (rhTSH) on multinodular goiters (MNG) was previously reported but controversial. Hence we conducted a meta-analysis to estimate the effect of rhTSH-stimulated radioiodine therapy in patients with MNG. PubMed, Cochrane, CNKI, VIP, and Wanfang databases were searched. Mean difference (MD) and odds ratios with 95% confidence intervals (95% CI) were derived by using an inverse variance random-effects model and fixed-effects model, respectively. Six studies (n=237) were involved in the analysis. For 12 months follow up, high dose (>0.1 mg) of rhTSH significantly reduced GV (MD=17.61; 95% CI=12.17 to 23.04; p<0.00001) compared with placebo. No effective pooled results of low dose of rhTSH (<0.1 mg) were applicable for only one study included. For 6 months follow up, the source of heterogeneity was determined by subgroup and sensitivity analysis. High dose group showed vast improvement in GV reduction (MD=16.62; 95% CI=1.34 to 31.90; p=0.03). The reduction of low dose group compared with placebo was inferior to high dose group. No available data were obtained to assess the influence of rhTSH after 36 months follow up for the only included study. Hypothyroidism incidence was higher for rhTSH group. No publication bias was seen. High dose of rhTSH treatment-stimulated radioactive 131I therapy after 6 months and 12 months follow up had a better effect in reducing GV, but with higher incidence of hypothyroidism. Owing to the limited methodological quality, more clinical researches are warranted in the future.

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Critical illness myopathy in intensive care setting

QJM ◽

10.1093/qjmed/hcab086.044 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Mostafa K Fouad ◽

Ashraf M Hazem ◽

Kareem M Elnaghy

Keyword(s):

Critical Illness ◽

Mortality Rate ◽

Usual Care ◽

Usual Care Group ◽

Fixed Effects ◽

Meta Analysis ◽

Care Group ◽

Fixed Effects Model ◽

Analysis Study ◽

Number Of Patients

Abstract Aim of the Work to provide cumulative data about the efficacy and safety of neuro-muscular electrical stimulation (NMES) combined with usual care (UC) versus usual care alone in ICU patients with Critical Illness Myopathy (CIM). Methodology The current systematic review was done on studies published between 2009 and 2019. The total number of patients in all the included studies was 1259 patients; 652 in NMES group, and 607 in UC group. Our data were divided into two groups: NMES (652 patients), and UC (607 patients). Metaanalysis study was done on 11 studies which described and compared the 2 different techniques for treatment of CIM; with overall number of patients (N = 1259). Results Regarding 1ry outcome measures, we found 8 studies reported critical Critical illness myopathy (CIM), critical illness polyneuropathy (CIP), and the overlap, critical care setting MRC scale for muscle strength, with total number of patients (N = 968). The random-effects model of the meta-analysis study showed non-significant difference in mean MRC scale in NMES group compared to usual care group (p > 0.05). We also found 11 studies reported ICU stay with total number of patients (N = 1259). The random-effects model of the meta-analysis study showed nonsignificant difference in mean ICU stay in NMES group compared to usual care group (p > 0.05). We also found only 2 studies reported SF-36 scale for quality of life, with total number of patients (N = 270). The fixed-effects model of the metaanalysis study showed highly significant decrease in mean SF-36 scale in NMES group compared to usual care group (p = 0.003). Regarding 2ry outcome measure, we found 3 studies reported CIM incidence with total number of patients (N = 394). The fixed-effects model of the meta-analysis study showed marked decrease in CIM incidence in NMES group compared to usual care group, but not reaching statistical significance (p > 0.05). We also found 9 studies reported mortality rate with total number of patients (N = 1044). The fixed-effects model of the meta-analysis study showed non-significant difference in mortality rate in NMES group compared to usual care. Our systematic review and meta-analysis showed that NMES combined with usual care was not associated with significant differences in global muscle strength, ICU stay, quality of life score, CIM incidence and mortality rate in comparison with usual care alone in critically ill patients. Conclusion NMES is not superior to usual care in management of CIM. Usual care remains the mainstay of management of CIM with significant better outcomes, in addition to preventive measures as early aggressive treatment of sepsis and MOF, blood glucose control, optimizing certain drugs use, early enteral nutrition, maintaining water, electrolyte and acidbase balance.

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