scholarly journals Introduction to Systematic Reviews and Meta-analyses of Therapeutic Studies

2021 ◽  
Author(s):  
Murtadha Al-Khabori ◽  
Wasif Rasool

A systematic review is a specific and reproducible method to search, identify, select, appraise, and summarize all studies relevant to a particular health care question. In this paper, we will review the concept of level of evidence, define the terms systematic review and meta-analysis, and outline the steps in performing a systematic review and meta-analysis with an illustrative example. In addition, we will introduce some important concepts in systematic reviews and meta-analyses like heterogeneity, publication bias, forest plots, and quality assessment. Finally, this review will focus on systematic reviews addressing therapeutic research questions.

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stefano Granieri ◽  
Francesco Sessa ◽  
Alessandro Bonomi ◽  
Sissi Paleino ◽  
Federica Bruno ◽  
...  

Abstract Background Entero-colovesical fistula is a rare complication of various benign and malignant diseases. The diagnosis is prominently based on clinical symptoms; imaging studies are necessary not only to confirm the presence of the fistula, but more importantly to demonstrate the extent and the nature of the fistula. There is still a lack of consensus regarding the if, when and how to repair the fistula. The aim of the study is to review the different surgical treatment options, focus on surgical indications, and explore cumulative recurrence, morbidity, and mortality rates of entero-vesical and colo-vesical fistula patients. Methods A systematic review of the literature was conducted according to PRISMA guidelines. Random effects meta-analyses of proportions were developed to assess primary and secondary endpoints. I2 statistic and Cochran’s Q test were computed to assess inter-studies’ heterogeneity. Results Twenty-two studies were included in the analysis with a total of 861 patients. Meta-analyses of proportions pointed out 5, 22.2, and 4.9% rates for recurrence, complications, and mortality respectively. A single-stage procedure was performed in 75.5% of the cases, whereas a multi-stage operation in 15.5% of patients. Palliative surgery was performed in 6.2% of the cases. In 2.3% of the cases, the surgical procedure was not specified. Simple and advanced repair of the bladder was performed in 84.3% and 15.6% of the cases respectively. Conclusions Although burdened by a non-negligible rate of complications, surgical repair of entero-colovesical fistula leads to excellent results in terms of primary healing. Our review offers opportunities for significant further research in this field. Level of Evidence Level III according to ELIS (SR/MA with up to two negative criteria).


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Rosemond Qian-Xiu Tan ◽  
Wai Tak Victor Li ◽  
Wing-Zi Shum ◽  
Sheung Chit Chu ◽  
Hang-Long Li ◽  
...  

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has caused recurring and major outbreaks in multiple human populations around the world. The plethora of clinical presentations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been described extensively, of which olfactory dysfunction (OD) was established as an important and common extrapulmonary manifestation of COVID-19 infection. The aim of this protocol is to conduct a systematic review and meta-analysis on peer-reviewed articles which described clinical data of OD in COVID-19 patients. Methods This research protocol has been prospectively registered with the Prospective Register of Systematic Reviews (PROSPERO; CRD42020196202). CINAHL, ClinicalTrials.gov, Cochrane Central, EMBASE, MEDLINE and PubMed, as well as Chinese medical databases China National Knowledge Infrastructure (CNKI), VIP and WANFANG, will be searched using keywords including ‘COVID-19’, ‘coronavirus disease’, ‘2019-nCoV’, ‘SARS-CoV-2’, ‘novel coronavirus’, ‘anosmia’, ‘hyposmia’, ‘loss of smell’, and ‘olfactory dysfunction’. Systematic review and meta-analysis will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Meta-analyses Of Observational Studies in Epidemiology (MOOSE) guidelines. Articles will be screened according to pre-specified inclusion and exclusion criteria to extract studies that include new clinical data investigating the effect of COVID-19 on olfactory dysfunction. Included articles will be reviewed in full; data including patient demographics, clinical characteristics of COVID-19-related OD, methods of olfactory assessment and relevant clinical outcomes will be extracted. Statistical analyses will be performed using the Comprehensive Meta-Analysis version 3. Discussion This systematic review and meta-analysis protocol will aim to collate and synthesise all available clinical evidence regarding COVID-19-related OD as an important neurosensory dysfunction of COVID-19 infection. A comprehensive search strategy and screening process will be conducted to incorporate broad clinical data for robust statistical analyses and representation. The outcome of the systematic review and meta-analysis will aim to improve our understanding of the symptomatology and clinical characteristics of COVID-19-related OD and identify knowledge gaps in its disease process, which will guide future research in this specific neurosensory defect. Systematic review registration PROSPERO registration number: CRD42020196202.


BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017868
Author(s):  
Joey S.W. Kwong ◽  
Sheyu Li ◽  
Wan-Jie Gu ◽  
Hao Chen ◽  
Chao Zhang ◽  
...  

IntroductionEffective selection of coronary lesions for revascularisation is pivotal in the management of symptoms and adverse outcomes in patients with coronary artery disease. Recently, instantaneous ‘wave-free’ ratio (iFR) has been proposed as a new diagnostic index for assessing the severity of coronary stenoses without the need of pharmacological vasodilation. Evidence of the effectiveness of iFR-guided revascularisation is emerging and a systematic review is warranted.Methods and analysisThis is a protocol for a systematic review of randomised controlled trials and controlled observational studies. Electronic sources including MEDLINE via Ovid, Embase, Cochrane databases and ClinicalTrials.gov will be searched for potentially eligible studies investigating the effects of iFR-guided strategy in patients undergoing coronary revascularisation. Studies will be selected against transparent eligibility criteria and data will be extracted using a prestandardised data collection form by two independent authors. Risk of bias in included studies and overall quality of evidence will be assessed using validated methodological tools. Meta-analysis will be performed using the Review Manager software. Our systematic review will be performed according to the guidance from the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.Ethics and disseminationEthics approval is not required. Results of the systematic review will be disseminated as conference proceedings and peer-reviewed journal publication.Trial registration numberThis protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42017065460.


2019 ◽  
Vol 100 (3) ◽  
pp. 312-316
Author(s):  
Jeremiah W. Jaggers ◽  
David Kondrat

This article provides an overview of the systematic review and the meta-analysis. These tools provide a comprehensive picture of current research. What follows is an abridged explanation of each of these techniques. This approach is intended to provide a fundamental overview for social work practitioners, so that they may more readily access important research, while minimizing the time spent doing so.


BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e022359 ◽  
Author(s):  
Tao Wang ◽  
Xue Wang ◽  
Kun Yang ◽  
Jing Zhang ◽  
Jichang Luo ◽  
...  

IntroductionAtherosclerotic intracranial artery stenosis (ICAS) is one of most common causes of stroke, which is the second-leading cause of death worldwide. Medical, surgical and endovascular therapy are three major treatments for ICAS. Currently, medical therapy is considered as the standard of care for most patients with ICAS, while extracranial to intracranial bypass is only used in rare situations. Balloon angioplasty alone, balloon-mounted stent and self-expanding stent, collectively called endovascular treatment, have shown promising potentials in treating specific subgroups of patients with symptomatic ICAS; however, their comparative safety and efficacy is still unclear. Therefore, a systematic review with network meta-analysis is needed to establish a hierarchy of these endovascular treatments.Methods and analysisThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols was followed to establish this protocol. The search will be limited to studies published from 1 January 2000 to the formal search date. Major databases including Cochrane Library, MEDLINE, EMBASE, Chinese Biomedical Literature Database, conference proceedings and grey literature database will be searched for clinical studies comparing at least two interventions for patients with symptomatic ICAS. Primary outcomes include short-term and long-term mortality or stroke rate. Random effects pairwise and network meta-analyses of included studies will be performed on STATA (V.14, StataCorp, 2015). The surface under the cumulative ranking curve and mean rank will be calculated in order to establish a hierarchy of the endovascular treatments. Evaluation of the risk of bias, heterogeneity, consistency, transitivity and quality of evidence will follow the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions.Ethics and disseminationEthics approval is not needed as systematic review is based on published studies. Study findings will be presented at international conferences and published on a peer-reviewed journal.PROSPERO registration numberCRD42018084055; Pre-results.


2015 ◽  
Vol 7 (3) ◽  
pp. 445-450 ◽  
Author(s):  
Seth Himelhoch ◽  
Sarah Edwards ◽  
Mark Ehrenreich ◽  
M. Philip Luber

ABSTRACT Background There is rising concern that fundamental scientific principles critical to lifelong learning and scientific literacy are not sufficiently addressed during residency. Objective We describe the development, implementation, and evaluation of a systematic review and meta-analysis course designed to improve residents' research literacy. Intervention We developed and implemented a novel, interactive, web-enhanced course for third-year psychiatry residents to provide the theoretical and methodological tools for conducting and reporting systematic reviews and meta-analyses. The course is based on Bloom's learning model, and established criteria for reporting systematic reviews and meta-analyses. Eight sequential learning objectives were linked to 8 well-specified assignments, with the objectives designed to build on one another and lead to the creation of a scientific manuscript. Results From 2010–2014, 54 third-year psychiatry residents (19 unique groups) successfully completed the course as part of a graduation requirement. The majority rated the course as being good or very good, and participants reported a statistically significant increase in their confidence to conduct systematic reviews (χ2 = 23.3, P < .05) and meta-analyses (Fisher exact test, P < .05). Estimated total dedicated resident and faculty time over a period of 36 weeks was 36 to 72 hours and 60 hours, respectively. Residents' academic productivity included 11 conference presentations and 4 peer-reviewed published manuscripts, with 2 residents who were awarded honors for their projects. Conclusions A formal training course in systematic reviews and meta-analyses offers a valuable learning experience, which enhances residents' research skills and academic productivity in a feasible and sustainable approach.


2020 ◽  
pp. 219256822090681 ◽  
Author(s):  
Muthu Sathish ◽  
Ramakrishnan Eswar

Study Design: Systematic review. Objectives: To assess the methodological quality of systematic reviews and meta-analyses in spine surgery over the past 2 decades. Materials and Methods: We conducted independent and in duplicate systematic review of the published systematic reviews and meta-analyses between 2000 and 2019 from PubMed Central and Cochrane Database pertaining to spine surgery involving surgical intervention. We searched bibliographies to identify additional relevant studies. Methodological quality was evaluated with AMSTAR score and graded with AMSTAR 2 criteria. Results: A total of 96 reviews met the eligibility criteria, with mean AMSTAR score of 7.51 (SD = 1.98). Based on AMSTAR 2 criteria, 13.5% (n = 13) and 18.7% (n = 18) of the studies had high and moderate level of confidence of results, respectively, without any critical flaws. A total of 29.1% (n = 28) of the studies had at least 1 critical flaw and 38.5% (n = 37) of the studies had more than 1 critical flaw, so that their results have low and critically low confidence, respectively. Failure to analyze the conflict of interest of authors of primary studies included in review and lack of list of excluded studies with justification were the most common critical flaw. Regression analysis demonstrated that studies with funding and studies published in recent years were significantly associated with higher methodological quality. Conclusion: Despite improvement in methodological quality of systematic reviews and meta-analyses in spine surgery in current decade, a substantial proportion continue to show critical flaws. With increasing number of review articles in spine surgery, stringent measures must be taken to adhere to methodological quality by following PRISMA and AMSTAR guidelines to attain higher standards of evidence in published literature.


2020 ◽  
Author(s):  
Cácia Régia de Paula ◽  
Cristiane José Borges ◽  
Flavio Henrique Alves de Lima ◽  
Celmo Celeno Porto ◽  
Marcos André Matos ◽  
...  

Abstract Background: Scientific studies on human health are not remote and show that mortality in this population is increasing. Although male morbidity and mortality rates have a considerable weight in national and international epidemiological profiles, the presence of men in primary health care services is lower than that of women. Many injuries could be avoided if men regularly carried out the first preventive measures. Sensitive Conditions to Primary Care are consolidated as an important marker of access to health services and the resolution capacity of Primary Care. In this systematic review, the objective is to identify what is known about the prevalence and / or incidence of Sensitive Conditions to Primary Care in adult men.Methods: We will identify the studies through systematic research in PUBMED-MEDLINE, SCOPUS, Web of Science, Embase, Cochrane, BDTD and OpenGrey. The quality assessment of retrieved articles will be carried out using the critical assessment tools of the Joanna Briggs Institute (JBI). The quantitative synthesis of the data will be carried out if the studies are homogeneous and provide adequate result data for meta-analysis. Otherwise, the data will be synthesized, using the narrative synthesis approach.Discussion: This review will explore theprevalenceand / orincidenceofSensitiveConditionstoprimarycare (prevalenceofhospitalizations; incidenceofhospitalizationsand deaths from ACSC) in adultmenandwillact as a usefulsource for researchers, policymakersand stakeholders whendevelopingandimplementinginterventions for thatgroup. Systematic review registration: This systematic review protocol was submitted to International Prospective Register of Systematic Reviews (PROSPERO). Submission number: ID 169447. This protocol was prepared using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols checklist (PRISMA-P).


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