Systematic Reviews
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10.2196/26680 ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. e26680
Mara Pereira Guerreiro ◽  
Leonardo Angelini ◽  
Helga Rafael Henriques ◽  
Mira El Kamali ◽  
Cristina Baixinho ◽  

Background Conversational agents, which we defined as computer programs that are designed to simulate two-way human conversation by using language and are potentially supplemented with nonlanguage modalities, offer promising avenues for health interventions for different populations across the life course. There is a lack of open-access and user-friendly resources for identifying research trends and gaps and pinpointing expertise across international centers. Objective Our aim is to provide an overview of all relevant evidence on conversational agents for health and well-being across the life course. Specifically, our objectives are to identify, categorize, and synthesize—through visual formats and a searchable database—primary studies and reviews in this research field. Methods An evidence map was selected as the type of literature review to be conducted, as it optimally corresponded to our aim. We systematically searched 8 databases (MEDLINE; CINAHL; Web of Science; Scopus; the Cochrane, ACM, IEEE, and Joanna Briggs Institute databases; and Google Scholar). We will perform backward citation searching on all included studies. The first stage of a double-stage screening procedure, which was based on abstracts and titles only, was conducted by using predetermined eligibility criteria for primary studies and reviews. An operational screening procedure was developed for streamlined and consistent screening across the team. Double data extraction will be performed with previously piloted data collection forms. We will appraise systematic reviews by using A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2. Primary studies and reviews will be assessed separately in the analysis. Data will be synthesized through descriptive statistics, bivariate statistics, and subgroup analysis (if appropriate) and through high-level maps such as scatter and bubble charts. The development of the searchable database will be informed by the research questions and data extraction forms. Results As of April 2021, the literature search in the eight databases was concluded, yielding a total of 16,351 records. The first stage of screening, which was based on abstracts and titles only, resulted in the selection of 1282 records of primary studies and 151 records of reviews. These will be subjected to second-stage screening. A glossary with operational definitions for supporting the study selection and data extraction stages was drafted. The anticipated completion date is October 2021. Conclusions Our wider definition of a conversational agent and the broad scope of our evidence map will explicate trends and gaps in this field of research. Additionally, our evidence map and searchable database of studies will help researchers to avoid fragmented research efforts and wasteful redundancies. Finally, as part of the Harnessing the Power of Conversational e-Coaches for Health and Well-being Through Swiss-Portuguese Collaboration project, our work will also inform the development of an international taxonomy on conversational agents for health and well-being, thereby contributing to terminology standardization and categorization. International Registered Report Identifier (IRRID) DERR1-10.2196/26680

Wenhao Luo ◽  
Ye Li

IntroductionBoth Dmab and ZA have been widely used in the prevention and treatment of bone-related diseases, while which drug is an optimal treatment in terms of safety and efficacy remains controversial.Material and methodsPubMed, Embase, Web of Science, the Cochrane Central Library, and were systematically searched up to 1st January 2021, and were evaluated by Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Randomized controlled trials comparing Dmab versus ZA in patients with bone-related diseases were included.ResultsA total of 13 studies involving 21042 participants were included. The incidence of total adverse events was significantly lower in patients receiving Dmab treatment than in those undergoing ZA treatment(OR= 0.84, 95% CI = 0.75–0.94, P = 0.003). 9 trials comparing Dmab with ZA further showed that Dmab was significantly better than ZA in controlling serious adverse events (OR = 0.91, 95% CI = 0.85–0.99, P = 0.02). Compared to ZA, Dmab was correlated with a lower incidence of skeletal-related events (OR = 0.77, 95% CI = 0.70–0.85, P = 0.00001). However, no significant difference was found in the rate of infection events between Dmab and ZA (OR = 1.06, 95% CI = 0.93–1.20, P =0.39).ConclusionsThis study demonstrated superiority of Dmab over ZA in treating bone-related diseases in terms of safety and efficacy.

Dhruv Mahtta ◽  
Ahmed Altibi ◽  
Mohamed M. Gad ◽  
Amjad Samara ◽  
Amr F. Barakat ◽  

Background Well‐conducted meta‐analyses are considered to be at the top of the evidence‐based hierarchy pyramid, with an expansion of these publications within the cardiovascular research arena. There are limited data evaluating the trends and quality of such publications. The objective of this study was to evaluate the methodological rigor and temporal trends of cardiovascular medicine‐related meta‐analyses published in the highest impact journals. Methods and Results Using the Medline database, we retrieved cardiovascular medicine‐related systematic reviews and meta‐analyses published in The New England Journal of Medicine, The Lancet, Journal of the American Medical Association, The British Medical Journal, Annals of Internal Medicine, Circulation, European Heart Journal, and Journal of American College of Cardiology between January 1, 2012 and December 31, 2018. Among 6406 original investigations published during the study period, meta‐analyses represented 422 (6.6%) articles, with an annual decline in the proportion of published meta‐analyses (8.7% in 2012 versus 4.6% in 2018, P trend =0.002). A substantial number of studies failed to incorporate elements of Preferred Reporting Items for Systematic Reviews and Meta‐Analyses or Meta‐Analysis of Observational Studies in Epidemiology guidelines (51.9%) and only a minority of studies (10.4%) were registered in PROSPERO (International Prospective Register of Systematic Reviews). Fewer manuscripts failed to incorporate the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses or Meta‐Analysis of Observational Studies in Epidemiology elements over time (60.2% in 2012 versus 40.0% in 2018, P trend <0.001) whereas the number of meta‐analyses registered at PROSPERO has increased (2.4% in 2013 versus 17.5% in 2018, P trend <0.001). Conclusions The proportion of cardiovascular medicine‐related meta‐analyses published in the highest impact journals has declined over time. Although there is an increasing trend in compliance with quality‐based guidelines, the overall compliance remains low.

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Ying He ◽  
Yuxi Li ◽  
Juan Li ◽  
Ning Li ◽  
Yonggang Zhang ◽  

Objectives. The aim of the current study was to analyze the 100 most-cited systematic reviews or meta-analyses in the field of acupuncture research. Methods. The Web of Science Core Collection was used to retrieve lists of 100 most-cited systematic reviews or meta-analyses in the field of acupuncture research. Two authors screened literature, extracted data, and analyzed the results. Results. The citation number of the 100 most-cited systematic reviews or meta-analyses varied from 65 to 577; they were published between 1989 and 2018. Fourteen authors published more than 1 study as the corresponding author and 10 authors published more than 1 study as the first author. In terms of the corresponding authors, Edzard Ernst and Linde Klaus published the most systematic reviews/meta-analyses (n = 7). The USA published most of the systematic reviews or meta-analyses (n = 24), followed by England (n = 23) and China (n = 14). Most institutions with more than 1 study were from England (4/13). The institutions with the largest numbers of most-cited systematic reviews or meta-analyses were the Technical University of Munich in Germany, the University of Maryland School of Medicine in the USA (n = 8), the Universities of Exeter and Plymouth in England (n = 6), and the University of Exeter in England (n = 6). The journal with the largest number of most-cited systematic reviews or meta-analyses was the Cochrane Database of Systematic Reviews (n = 20), followed by Pain (n = 6). Conclusion. Our study reveals that the 100 most-cited systematic reviews or meta-analyses in the acupuncture research field are mostly from high impact factor journals and developed countries. It will help researchers follow research hot spots, broaden their research scope, expand their academic horizons, and explore new research ideas, thereby improving the quality of acupuncture research.

Hand ◽  
2021 ◽  
pp. 155894472110432
Emily M. Graham ◽  
Jeremie D. Oliver ◽  
Russell Hendrycks ◽  
Dino Maglic ◽  
Shaun D. Mendenhall

Background The Pulvertaft weave technique (PT) is frequently used during tendon repairs and transfers. However, this technique is associated with limitations. In this systematic review and meta-analysis, quantitative and qualitative analyses were performed on in vitro, biomechanical studies that compared the PT with alternative techniques. Methods Articles included for qualitative and/or qualitative analysis were identified following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies included in the meta-analysis were analyzed either as continuous data with inverse variance and random effects or as dichotomous data using a Mantel-Haenszel analysis assuming random effects to calculate an odds ratio. Results A comprehensive electronic search yielded 8 studies meeting inclusion criteria for meta-analysis. Two studies with a total of 65 tendon coaptations demonstrated no significant difference in strength between the PT and traditional side-to-side (STS) techniques ( P = .92). Two studies with a total of 43 tendon coaptations showed that the STS with 1 weave has a higher yield strength than the PT ( P = .03). Two studies with a total of 62 tendon repairs demonstrated no significant difference in strength between the PT and the step-cut (SC) techniques ( P = .70). The final 2 studies included 46 tendon repairs and demonstrated that the wrap around (WA) technique has a higher yield strength than the PT ( P < .001). Conclusions The STS, SC, and WA techniques are preferred for improving tendon form. The STS and WA techniques have superior yield strengths than the PT, and the SC technique withstands similar stress to failure as the PT.

2021 ◽  
Alina Weise ◽  
Roland Brian Büchter ◽  
Dawid Pieper ◽  
Tim Mathes

Abstract Objective: For assessing cost-effectiveness, Health Technology Assessment (HTA) organisations may use primary economic evaluations (P-HEs) or Systematic Reviews of Health Economic evaluations (SR-HEs). The latter pose the question whether the results from existing P-HEs are transferable across decision contexts (e.g. jurisdictions). A particularly pertinent issue is the high variability of costs and resource needs across jurisdictions. Our objective was to review the methods documents of HTA organisations and compare their recommendations on considering transferability in SR-HE. Methods: We systematically hand searched the webpages of 158 HTA organisations for relevant methods documents from January to March 2019. Two independent reviewers performed searches and selected documents according to pre-defined criteria. One reviewer extracted data in standardised and piloted tables and a second reviewer checked them for accuracy. We synthesized data using tabulations and in a narrative way. Results: We identified 155 potentially relevant documents from 63 HTA organisations. Of these, 7 were included in the synthesis. The included organisations have different aims when preparing a SR-HE (e.g. to determine the need for conducting their own P-HE). The recommendations vary regarding the underlying terminology (e.g. transferability/generalisability), the assessment approaches (e.g. structure), the assessment criteria and the integration in the review process.Conclusion: Only few HTA organisations address the assessment of transferability in their methodological recommendations for SR-HEs. Transferability considerations are related to different purposes. The assessment concepts and criteria are heterogeneous. Developing standards to consider transferability in SR-HEs is desirable.

2021 ◽  
Izabela Zibetti Albuquerque ◽  
Lusmaia Damaceno Camargo Costa ◽  
Patrícia Marques Fortes ◽  
Guilherme Matos Abe ◽  
Paulo Sérgio Sucasas da Costa

Abstract Background: Cystic Fibrosis is a genetic disease characterized by a mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, responsible for encoding the protein that regulates the function of chlorine and sodium channels in the cell membrane. The bioactive compound curcumin has shown modulating and restorative effects on sodium, chlorine and water transport, and seems to be a candidate to act in the expression of the function of the chlorine channels. The purpose of this protocol is to demonstrate scientific evidence of molecular and clinical effects of curcumin in cell cultures, animals and subjects with cystic fibrosis.Methods: The search will be conducted in the following databases - MEDLINE/PubMed, SCOPUS, Cochrane Library and EMBASE. Reviewers will select original intervention (in vitro and in vivo) and/or observational articles that analyzed the effects of curcumin on cystic fibrosis. The methodological quality of the studies will be assessed by the Joana Briggs Institute's Checklist for Quasi-Experimental Studies. The GRADE tool will be applied to grade the quality of evidence.Discussion: To date, no systematic reviews have been published that assessed molecular and clinical effects of curcumin on cystic fibrosis. Upon completion of this systematic review, it is expected that the evidence found may contribute to the development of therapeutic formulations capable of modulating the function of the CFTR protein, restoring its properties, and contributing to the reduction of systemic clinical manifestations of cystic fibrosis.Systematic review registration: PROSPERO CRD42021229294

2021 ◽  
Vol 12 ◽  
Jorge E. Morais ◽  
Tiago M. Barbosa ◽  
Pedro Forte ◽  
António J. Silva ◽  
Daniel A. Marinho

Introduction: In youth swimming, researchers are interested in understanding how anthropometry and parameters related to swimming technique (biomechanics, energetics, and efficiency) influence the performance. However, there is not any review in the literature that consolidates the body of knowledge of this topic. The objective of this study was to review systematically the current body of work on the influence of determinant factors related to swimming technique (biomechanics, energetics, and efficiency) and anthropometry in the young performance of swimmers.Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to identify relevant studies.Results: After screening, 240 studies were analyzed and 59 related to swimming performance, and its determinant factors were retained for synthesis. Studies revealed a high-quality index by PEDro scale (mean score was 7.17 ± 1.40). Twenty-five studies were longitudinal designs and the remaining 34 cross-sectional designs. Most of the studies (N = 39, 66.1%) reported concurrently two or more determinant factors (anthropometrics, biomechanics, energetics, and efficiency).Conclusion: Youth swimming research relies on a multifactorial assessment. From the synthesis, it is possible to conclude that the performance of young swimmers is characterized by a multifactorial, holistic, and dynamic phenomenon. Better performance has always been related to better swimming technique and higher anthropometrics. This suggests that both anthropometrics (i.e., nature) and training (i.e., nurture) play key roles in the swimming performance of young swimmers.

2021 ◽  
Andres Jung ◽  
Julia Balzer ◽  
Tobias Braun ◽  
Kerstin Luedtke

Abstract Background: Internal and external validity are the most relevant components when critically appraising randomized controlled trials (RCTs) for systematic reviews. However, there is no gold standard to assess external validity. This might be related to the heterogeneity of terminology as well as to unclear evidence of the measurement properties of available tools. The aim of this review was to identify tools to assess the external validity of RCTs in systematic reviews and to evaluate the quality of evidence regarding their measurement properties.Methods: A two-phase systematic literature search was performed in four databases: MEDLINE via PubMed, Scopus, PsycINFO via OVID, and CINAHL via EBSCO. First, tools to assess the external validity of RCTs were identified. Second, studies aiming to investigate the measurement properties of these tools were selected. The measurement properties of each included tool were appraised using an adapted version of the COnsensus based Standards for the selection of health Measurement INstruments (COSMIN) guidelines.Results: 34 publications reporting on the development or validation of 26 included tools were included. For 62% of the included tools, there was no evidence of any measurement property. For the remaining tools, reliability was assessed most frequently. Reliability was judged as “sufficient” for three tools (very low quality of evidence). Content validity was rated as “sufficient” for one tool (moderate quality of evidence).Conclusions: Based on these results, no available tool can be fully recommended to assess the external validity of RCTs in systematic reviews. Several steps are required to overcome the identified difficulties to either adapt and validate available tools or to develop a new one. There is a need for more research for this purpose.Trial registration: Prospective registration at Open Science Framework (OSF):

2021 ◽  
Vol 30 (161) ◽  
pp. 210132
Alexander G. Mathioudakis ◽  
Olympia Tsilochristou ◽  
Ian M Adcock ◽  
Andras Bikov ◽  
Leif Bjermer ◽  

Guidelines aim to standardise and optimise asthma diagnosis and management. Nevertheless, adherence to guidelines is suboptimal and may vary across different healthcare professional (HCP) groups.Further to these concerns, this European Respiratory Society (ERS)/European Academy of Allergy and Clinical Immunology (EAACI) statement aims to: 1) evaluate the understanding of and adherence to international asthma guidelines by HCPs of different specialties via an international online survey; and 2) assess strategies focused at improving implementation of guideline-recommended interventions, and compare process and clinical outcomes in patients managed by HCPs of different specialties via systematic reviews.The online survey identified discrepancies between HCPs of different specialties which may be due to poor dissemination or lack of knowledge of the guidelines but also a reflection of the adaptations made in different clinical settings, based on available resources. The systematic reviews demonstrated that multifaceted quality improvement initiatives addressing multiple challenges to guidelines adherence are most effective in improving guidelines adherence. Differences in outcomes between patients managed by generalists or specialists should be further evaluated.Guidelines need to consider the heterogeneity of real-life settings for asthma management and tailor their recommendations accordingly. Continuous, multifaceted quality improvement processes are required to optimise and maintain guidelines adherence. Validated referral pathways for uncontrolled asthma or uncertain diagnosis are needed.

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