Meta analysis: an effective analytical tool to interpret multiple original research studies addressing the same research question

The increased demand for evidence-based health care practices calls for comparative effectiveness research (CER), namely the generation and synthesis of research evidence to compare the benefits and harms of alternative methods of care. A significant contribution of CER is the systematic identification and synthesis of available research studies on a specific topic. The purpose of this article is to provide an overview of methodological issues pertaining to systematic reviews and meta-analyses to be used by investigators with the purpose of conducting CER. A systematic review or meta-analysis is guided by a research protocol, which includes (a) the research question, (b) inclusion and exclusion criteria with respect to the target population and studies, © guidelines for obtaining relevant studies, (d) methods for data extraction and coding, (e) methods for data synthesis, and (f ) guidelines for reporting results and assessing for bias. This article presents an algorithm for generating evidence-based knowledge by systematically identifying, retrieving, and synthesizing large bodies of research studies. Recommendations for evaluating the strength of evidence, interpreting findings, and discussing clinical applicability are offered.

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Sarcopenic is associated with hypertension in older adults: a systematic review and meta-analysis

10.21203/rs.2.20678/v1 ◽

2020 ◽

Author(s):

Tingting Bai ◽

Fang Fang ◽

Feika Li ◽

Yan Ren ◽

Jiaan Hu ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Confidence Interval ◽

Handgrip Strength ◽

Meta Analysis ◽

Cochrane Library ◽

Original Research ◽

Inclusion Criteria ◽

Asian Group ◽

Research Studies

Abstract BackgroundBoth sarcopenia and handgrip strength have been observed association with hypertension. However, the results in different studies were inconsistent. In the current study, we conducted a systematic review and meta-analysis to reveal the association between sarcopenia, handgrip strength, and hypertension in older adults.MethodsPubMed, MEDLINE, Cochrane Library, and EMBASE databases were searched from inception to 15 November, 2019for original research studies. The studies that addressed the association between sarcopenia, handgrip strength, and hypertension were included and summarized.Results19 studies met the inclusion criteria and a total of 21301 were included in the meta-analysis. Eight eligible studiesreported the odd ratios (ORs) of hypertension and the ORs ranged from 0.41 to 4.38. When pooled the ORs together, the summarized ORs was 1.29 [95% confidence interval (CI) =1.00-1.67]. The summarized ORs for the Asian group 1.50 (95% CI=1.35-1.67) was significantly higher than that of Caucasian group 1.08 (95% CI=0.39-2.97). Eleven studies provided the data on association between handgrip strength and hypertension. The overall ORs and 95% CI was 0.99 (95% CI=0.80-1.23), showing no association.ConclusionSarcopenia was associated with hypertension but no correlation was found between handgrip strength and hypertension in older adults.

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Gender differences in the accuracy of dietary assessment methods to measure energy intake in adults: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-035611 ◽

2020 ◽

Vol 10 (6) ◽

pp. e035611 ◽

Cited By ~ 1

Author(s):

Briar L McKenzie ◽

Daisy H Coyle ◽

Tracy Burrows ◽

Emalie Rosewarne ◽

Sanne A E Peters ◽

...

Keyword(s):

Systematic Review ◽

Energy Expenditure ◽

Energy Intake ◽

Meta Analysis ◽

Dietary Assessment ◽

Total Energy Expenditure ◽

Self Report ◽

Original Research ◽

Dietary Assessment Methods ◽

Research Studies

IntroductionDiet is an important modifiable risk factor for many chronic diseases. Measurement of dietary intake usually relies on self-report, subject to multiple biases. There is a need to understand gender differences in the self-report of dietary intake and the implications of any differences in targeting nutrition interventions. Literature in this area is limited and it is currently unknown whether self-report dietary assessment methods are equally accurate for women and men. The aim of this systematic review is to determine whether there are differences by gender in reporting energy intake compared with a reference measure of total energy expenditure.Methods and analysisA comprehensive search of published original research studies will be performed in MEDLINE, Scopus, Web of Science, EMBASE, CINAHL and Cochrane library. Original research studies will be included if they were conducted in free-living/unhospitalised adults and included a measure for both women and men of (a) self-reported energy intake and (b) total energy expenditure by doubly labelled water. One author will conduct the electronic database searches, two authors will independently screen studies, conduct a quality appraisal of the included studies using standardised tools and extract data. If further information is needed, then study authors will be contacted. If appropriate, a random-effects meta-analysis will be conducted, with inverse probability weighting, to quantify differences in the mean difference in agreement between reported energy intake and measured energy expenditure between women and men, by self-report assessment method. Subgroup analyses will be conducted by participant factors, geographical factors and study quality.Ethics and disseminationAll data used will be from published primary research studies or deidentified results provided at the discretion of any study authors that we contact. We will submit our findings to a peer-reviewed scientific journal and will disseminate results through presentations at international scientific conferences.PROSPERO registration numberCRD42019131715.

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Yoga - A Salubrious Routine to Prevent Periodontal Diseases: A Meta-analysis

RGUHS Journal of Dental Sciences ◽

10.26715/rjds.13_4_10 ◽

2021 ◽

Vol 13 (4) ◽

pp. 269-278

Author(s):

Veena Kalburgi ◽

Sai Sri Harsha

Keyword(s):

Human Body ◽

Periodontal Diseases ◽

Meta Analysis ◽

The Body ◽

Google Scholar ◽

Original Research ◽

Systemic Diseases ◽

Periodontal Health ◽

Stress Control ◽

Research Studies

Abstract Background: Yoga is a holistic and ancient practice that was originated around 3000 years agoand it activates all the systems in the body and helps us to be active. The name yoga itself means union, intertwining of body, brain and soul. Yoga can prevent periodontal diseases.This may sound extraneous, but it is a scientifically proven truth.Yoga will not only prevent periodontal diseases but also many other systemic diseases. Methods: A search was done to find the articles that were published in various databases Medline/Pubmed, Google scholar, LILACS, Cochrane, open grey and USC Upstate library. We included only original research studies which clearly explained the influence of yoga on periodontitis with specified results. Meta-analysis was done including the clinical periodontal parameters used for observation of the periodontal health. Results: Five studies were selected after analyzing various factors and coincidentally all the selected studies were from various regions of India. Forest plots were made of the studies selected. Conclusion: We conclude very clearly from the analysis done that yoga, an ancient practice has a favourable impact on human body in stress control,therebymaintaining the periodontal health.

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An Epistemological Criticism of Social Entrepreneurship: Is Social Entrepreneurship a Sound Scientific Field of Research

10.31124/advance.7091927.v1 ◽

2018 ◽

Author(s):

Amir Forouharfar

Keyword(s):

Social Entrepreneurship ◽

Social Constructivism ◽

Social Epistemology ◽

American English ◽

Meta Analysis ◽

Research Question ◽

Knowledge Structure ◽

Scientific Field ◽

The Other ◽

First Time

The paper was shaped around the pivotal question: Is SE a sound and scientific field of research? The question has given a critical tone to the paper and has also helped to bring out some of the controversial debates in the realm of SE. The paper was organized under five main discussions to be able to provide a scientific answer to the research question: (1) is “social entrepreneurship” an oxymoron?, (2) the characteristics of SE knowledge, (3) sources of social entrepreneurship knowledge, (4) SE knowledge: structure and limitations and (5) contributing epistemology-making concepts for SE. Based on the sections, the study relied on the relevant philosophical schools of thought in Epistemology (e.g. Empiricism, Rationalism, Skepticism, Internalism vs. Externalism, Essentialism, Social Constructivism, Social Epistemology, etc.) to discuss these controversies around SE and proposes some solutions by reviewing SE literature. Also, to determine the governing linguistic discourse in the realm of SE, which was necessary for our discussion, Corpus of Contemporary American English (COCA) for the first time in SE studies was used. Further, through the study, SE buzzwords which constitute SE terminology were derived and introduced to help us narrowing down and converging the thoughts in this field and demarking the epistemological boundaries of SE. The originality of the paper on one hand lies in its pioneering discussions on SE epistemology and on the other hand in paving the way for a construction of sound epistemology for SE; therefore in many cases after preparing the philosophical ground for the discussions, it went beyond the prevalent SE literature through meta-analysis to discuss the cases which were raised. The results of the study verified previously claimed embryonic pre-paradigmatic phase in SE which was far from a sound and scientific knowledge, although the scholarly endeavors are the harbingers of such a possibility in the future which calls for further mature academic discussion and development of SE knowledge by the SE academia.

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Ineffective Feeding Practices and Their Effect on Malocclusion: A Narrative Review

Journal of Health and Allied Sciences NU ◽

10.1055/s-0041-1731912 ◽

2021 ◽

Author(s):

Pratima R. Mokashi ◽

Srikala Bhandary

Keyword(s):

Positive Impact ◽

Meta Analysis ◽

Normal Growth ◽

Feeding Practices ◽

Bottle Feeding ◽

Narrative Review ◽

World Health ◽

Original Research ◽

Nutritive Sucking

Abstract Objective The aim of this narrative review is to highlight the association of ineffective feeding practices with the development of malocclusion in children and the role of a pediatric dentist in identifying the cues and signs of improper feeds, and encourage effective breastfeeding practices. Introduction There has been an ongoing debate on the role of effective breastfeeding in the prevention of malocclusion. Although no specific claim supports the positive impact of the same, a detailed reviewing of the literature helps to identify the method of feeding to be chosen considering health benefits and personal preference. Materials and Methods A broad search of all resources linked to the topic was performed in PubMed, Medline, World Health Organization web site, government web sites, and Google Scholar search engine. Keywords used in the search included breastfeeding, ineffective breastfeeding, bottle feeding, pacifier, and malocclusion. A total of 60 articles published in the period from 2000 to 2019 were segregated. Selected articles comprised original research, meta-analysis, and systematic reviews. Results Parameters such as duration, posture, and non-nutritive sucking habits had an impact on effective breastfeeding. Discussion Effective breastfeeding and maintaining appropriate posture and duration helps to positively impact the normal growth and development of the jaws, muscular functioning, and speech. Thereby, the risk of developing malocclusion in primary dentition can be prevented. Conclusion An understanding of the role of breastfeeding and malocclusion will help in the early intervention and prevention of malocclusion and deviated muscular function. Highlighting the role of counseling and effective feeding practices is also an area that should be focused upon by budding clinicians.

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Study protocol of a systematic review and qualitative evidence synthesis using two different approaches: Healthcare related needs and desires of older people with post-stroke aphasia

BMJ Open ◽

10.1136/bmjopen-2020-039348 ◽

2021 ◽

Vol 11 (4) ◽

pp. e039348

Author(s):

Nadine Janis Pohontsch ◽

Thorsten Meyer ◽

Yvonne Eisenmann ◽

Maria-Inti Metzendorf ◽

Verena Leve ◽

...

Keyword(s):

Systematic Review ◽

Older People ◽

Evidence Synthesis ◽

Meta Analysis ◽

Research Question ◽

Treatment Success ◽

Qualitative Studies ◽

Qualitative Evidence Synthesis ◽

Healthcare Needs ◽

Qualitative Evidence

IntroductionStroke is a frequent disease in the older population of Western Europe with aphasia as a common consequence. Aphasia is known to impede targeting treatment to individual patients’ needs and therefore may reduce treatment success. In Germany, the postacute care of patients who had stroke is provided by different healthcare institutions of different sectors (rehabilitation, nursing and primary care) with substantial difficulties to coordinate services. We will conduct two qualitative evidence syntheses (QESs) aiming at exploring distinct healthcare needs and desires of older people living with poststroke aphasia. We thereby hope to support the development of integrated care models based on needs of patients who are very restricted to communicate them. Since various methods of QESs exist, the aim of the study embedding the two QESs was to determine if findings differ according to the approach used.Methods and analysisWe will conduct two QESs by using metaethnography (ME) and thematic synthesis (ThS) independently to synthesise the findings of primary qualitative studies. The main differences between these two methods are the underlying epistemologies (idealism (ME) vs realism (ThS)) and the type of research question (emerging (ME) vs fixed (ThS)).We will search seven bibliographical databases. Inclusion criteria comprise: patients with poststroke aphasia, aged 65 years and older, studies in German/English, all types of qualitative studies concerning needs and desires related to healthcare or the healthcare system. The protocol was registered in the International Prospective Register of Systematic Reviews, follows Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines and includes three items from the Enhancing Transparency in Reporting the synthesis of Qualitative Research checklist.Ethics and disseminationEthical approval is not required. Findings will be published in a peer-reviewed journal and presented on national conferences.

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Effects of low back pain on balance performance in elderly people: a systematic review and meta-analysis

European Review of Aging and Physical Activity ◽

10.1186/s11556-021-00263-z ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Le Ge ◽

Chuhuai Wang ◽

Haohan Zhou ◽

Qiuhua Yu ◽

Xin Li

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Elderly People ◽

Meta Analysis ◽

Cochrane Library ◽

Original Research ◽

Low Back ◽

Centre Of Pressure ◽

Balance Performance

Abstract Background Research suggests that individuals with low back pain (LBP) may have poorer motor control compared to their healthy counterparts. However, the sample population of almost 90% of related articles are young and middle-aged people. There is still a lack of a systematic review about the balance performance of elderly people with low back pain. This study aimed to conduct a systematic review and meta-analysis to understand the effects of LBP on balance performance in elderly people. Methods This systematic review and meta-analysis included a comprehensive search of PubMed, Embase, and Cochrane Library databases for full-text articles published before January 2020. We included the articles that 1) investigated the elderly people with LBP; 2) assessed balance performance with any quantifiable clinical assessment or measurement tool and during static or dynamic activity; 3) were original research. Two independent reviewers screened the relevant articles, and disagreements were resolved by a third reviewer. Results Thirteen case-control studies comparing balance performance parameters between LBP and healthy subjects were included. The experimental group (LBP group) was associated with significantly larger area of centre of pressure movement (P < 0.001), higher velocity of centre of pressure sway in the anteroposterior and mediolateral directions (P = 0.01 and P = 0.02, respectively), longer path length in the anteroposterior direction (P < 0.001), slower walking speed (P = 0.05), and longer timed up and go test time (P = 0.004) than the control group. Conclusion The results showed that balance performance was impaired in elderly people with LBP. We should pay more attention to the balance control of elderly people with LBP.

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Getting to Hope: Perspectives from Patients and Caregivers Living with Chronic Childhood Illness

Children ◽

10.3390/children8060525 ◽

2021 ◽

Vol 8 (6) ◽

pp. 525

Author(s):

Emily von Scheven ◽

Bhupinder K. Nahal ◽

Rosa Kelekian ◽

Christina Frenzel ◽

Victoria Vanderpoel ◽

...

Keyword(s):

Conceptual Model ◽

Research Question ◽

Young Patients ◽

Future Research ◽

Childhood Onset ◽

Virtual Focus Groups ◽

Definition Of ◽

Selection Of ◽

Chronic Childhood ◽

Research Studies

Promoting hope was identified in our prior work as the top priority research question among patients and caregivers with diverse childhood-onset chronic conditions. Here, we aimed to construct a conceptual model to guide future research studies of interventions to improve hope. We conducted eight monthly virtual focus groups and one virtual workshop with patients, caregivers, and researchers to explore key constructs to inform the model. Discussions were facilitated by Patient Co-Investigators. Participants developed a definition of hope and identified promotors and inhibitors that influence the experience of hope. We utilized qualitative methods to analyze findings and organize the promotors and inhibitors of hope within three strata of the socio-ecologic framework: structural, interpersonal, and intrapersonal. Participants identified three types of interventions to promote hope: resources, navigation, and activities to promote social connection. The hope conceptual model can be used to inform the selection of interventions to assess in future research studies aimed at improving hope and the specification of outcome measures to include in hope research studies. Inclusion of the health care system in the model provides direction for identifying strategies for improving the system and places responsibility on the system to do better to promote hope among young patients with chronic illness and their caregivers.

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Sacubitril/valsartan in real-life European patients with heart failure with reduced ejection fraction: a systematic review and meta-analysis

European Heart Journal ◽

10.1093/ehjci/ehaa946.1028 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

S Giovinazzo ◽

L Carmisciano ◽

M Toma ◽

M.P Sormani ◽

M Canepa ◽

...

Keyword(s):

Meta Analysis ◽

Nyha Class ◽

Real Life ◽

Original Research ◽

Baseline Characteristic ◽

Class Iii ◽

Real World Data ◽

Full Dose ◽

Reduced Ejection Fraction ◽

Inverse Variance

Abstract Background Real-world data are needed to gauge how a therapy is implemented in clinical practice. Methods We systematically reviewed the abstracts presented at international congresses and the peer-reviewed original research articles, which described the use of sacubitril/valsartan in European patients with HFrEF from Sep 2014 until Nov 30, 2019. Meta-analysis estimates were combined using a random effects model with inverse variance weights. Results 15 abstracts and 11 articles, including 14,179 patients, were selected. Except for a study that evaluated 12,082 (85,2%) subjects, the sample size was 28 (0.2%) to 1,120 (7.9%) patients. Taking as reference PARADIGM-HF, few baseline characteristic were reported for >80% of the pooled population (Table), while all other ones were available for 12% of subjects or less (Figure). Underreporting was less common for articles than for abstracts (OR 0.42, 95% CI: 0.20–0.91). Compared with the patients enrolled in PARADIGM-HF, those in real-life were older and more likely to being previously treated with ARB, MRA and diuretics (Table). NYHA class III-IV (OR 2.39, 95% CI: 1.58–3.59; I2=92%), ICD (OR 4.21, 95% CI: 2.31–7.69; I2=93%) and CRT (OR 4.53, 95% CI: 3.89–5.27; I2=0%) were also more likely, while a history of hypertension was less frequent (OR 0.61, 95% CI: 0.42–0.87; I2=82%). The monthly achievement rate of the full dose of sacubitril/valsartan was 6%. When follow-up was ≥6 months, the percentage of subjects reaching the full dose was about 40% and very homogenous. Age and full dose attainment were inversely related (β −2.71, 95% CI: −5.3 to −0.1). All cause-mortality and hospitalization rates were 6/100 person-year (9 studies, 1046 patients) and 25/100 person-year (5 studies, 775 patients), respectively. Conclusions With the limitation of being heterogeneous and of overall low quality, the literature suggests that, in Europe, sacubitril/valsartan is prescribed to patients with somehow more severe HFrEF than in the pivotal trial, who most often do not reach the full dose. Funding Acknowledgement Type of funding source: None

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