study quality
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2022 ◽  
Vol 34 (1) ◽  
Author(s):  
Chen Shen ◽  
Xiang-Chang Yin ◽  
Bo-Yang Jiao ◽  
Jing Li ◽  
Peng Jia ◽  
...  

Abstract Objective A systematic review of animal and human studies was conducted on genetically modified (GM) food consumption to assess its safety in terms of adverse effects/events to inform public concerns and future research. Methods Seven electronic databases were searched from January 1st 1983 till July 11th 2020 for in vivo, animal and human studies on the incidence of adverse effects/events of GM products consumption. Two authors independently identified eligible studies, assessed the study quality, and extracted data on the name of the periodical, author and affiliation, literature type, the theme of the study, publication year, funding, sample size, target population characteristics, type of the intervention/exposure, outcomes and outcome measures, and details of adverse effects/events. We used the Chi-square test to compare the adverse event reporting rates in articles funded by industry funding, government funding or unfunded articles. Results One crossover trial in humans and 203 animal studies from 179 articles met the inclusion criteria. The study quality was all assessed as being unclear or having a high risk of bias. Minor illnesses were reported in the human trial. Among the 204 studies, 59.46% of adverse events (22 of 37) were serious adverse events from 16 animal studies (7.84%). No significant differences were found in the adverse event reporting rates either between industry and government funding (χ2 = 2.286, P = 0.131), industry and non-industry funding (χ2 = 1.761, P = 0.185) or funded and non-funded articles (χ2 = 0.491, P = 0.483). We finally identified 21 GM food-related adverse events involving 7 GM events (NK603 × MON810 maize, GTS 40-3-2 soybean, NK603 maize, MON863 maize, MON810 maize, MON863 × MON810 × NK603 maize and GM Shanyou 63 rice), which had all been on regulatory approval in some countries/regions. Conclusion Serious adverse events of GM consumption include mortality, tumour or cancer, significant low fertility, decreased learning and reaction abilities, and some organ abnormalities. Further clinical trials and long-term cohort studies in human populations, especially on GM food-related adverse events and the corresponding GM events, are still warranted. It suggests the necessity of labelling GM food so that consumers can make their own choice.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Habib Yarizadeh ◽  
Bahar Hassani ◽  
Saeed Nosratabadi ◽  
Hussein Baharlooi ◽  
Sara Asadi ◽  
...  

Background. It is uncertain if omega-3 polyunsaturated fatty acids are associated with increase in resting metabolic rate (RMR) in adults. Objective. The aim of the present study was to evaluate the overall effects of omega-3 on RMR. Methods. Both PubMed and Scopus libraries were searched up to April 2021. Study quality was assessed using the Jadad scale. Random- and fixed-effects models were utilized in order to obtain pooled estimates of omega-3 supplementation impacts on RMR, using weight mean difference (WMD). Results. Seven studies including a total of 245 participants were included. There was significantly higher FFM-adjusted RMR in the intervention group than the control group (WMD: 26.666 kcal/kg/day, 95% CI: 9.010 to 44.322, p = 0.003 ). Study quality showed that four of seven included studies were of high quality. However, there was no significant difference in results in the subgroup analysis according to the quality of studies. Subgroup analyses revealed significant changes for sex (for women: WMD = 151.793 kcal/day, 95% CI = 62.249 to 241.337, p = 0.001 ) and BMI (for BMI > 25: WMD = 82.208 kcal/day, 95% CI = 0.937 to 163.480, p = 0.047 ). Influence analysis indicated no outlier among inclusions. Conclusion. The current study depicted that omega-3 polyunsaturated acids can significantly increase RMR in adults. However, further assessments of omega-3 supplementation therapy are critical to monitor its long-term outcomes and potential clinical application.


2021 ◽  
Vol 8 ◽  
Author(s):  
Wenhao Cai ◽  
Fei Liu ◽  
Yongjian Wen ◽  
Chenxia Han ◽  
Manya Prasad ◽  
...  

Background: Pain management is an important priority in the treatment of acute pancreatitis (AP). Current evidence and guideline recommendations are inconsistent on the most effective analgesic protocol. This systematic review and meta-analysis of randomised controlled trials (RCTs) aimed to compare the safety and efficacy of analgesics for pain relief in AP.Methods: A literature search was performed to identify all RCTs assessing analgesics in patients with AP. The primary outcome was the number of participants who needed rescue analgesia. Study quality was assessed using Jadad score. Pooled odds ratios (ORs) or weighted mean differences (WMDs) with 95% confidence intervals (CI) were analysed using a random-effects model.Results: Twelve studies comprising 699 patients with AP (83% mild AP) were analysed. The tested analgesics significantly decreased the need for rescue analgesia (3 studies, OR.36, 95% CI 0.21 to 0.60) vs. placebo or conventional treatment. The analgesics also improved the pain score [Visual Analogue Scale (Δ-VAS)] at 24 h (WMD 18.46, 0.84 to 36.07) and by the 3rd to 7th days (WMD 11.57, 0.87 to 22.28). Opioids vs. non-opioids were associated with a decrease in the need for rescue analgesia (6 studies, OR 0.25, 95% CI 0.07 to 0.86, p = 0.03) but without significance in pain score. In subgroup analyses, opioids were similar to non-steroidal anti-inflammatory drugs (NSAIDs) regarding the primary outcome (4 studies, OR 0.56, 95% CI 0.24 to 1.32, p = 0.18). There were no significant differences in other clinical outcomes and rate of adverse events. Other studies, comparing epidural anaesthesia vs. patient-controlled analgesia and opioid (buprenorphine) vs. opioid (pethidine) did not show significant difference in primary outcome. Study quality issues significantly contributed to overall study heterogeneity.Conclusions: NSAIDs and opioids are equally effective in decreasing the need for rescue analgesia in patients with mild AP. The relative paucity of trials and high-quality data in this setting is notable and the optimal analgesic strategy for patients with moderately severe and severe AP still requires to be determined.


2021 ◽  
Author(s):  
Kimberley J Smith ◽  
Christina Victor

Abstract Background and Objectives Loneliness is proposed to be linked with increased service use. This review examined the association of loneliness and health and social care utilisation (HSCU) in older adults from the general population. Research Design and Methods Four databases were screened for studies that examined the association of loneliness (predictor) with HSCU (outcome) in older adults (defined as majority of sample 60 or older). Study quality was assessed with the NIH scale for observational cohorts and cross-sectional studies. Results We identified 32 studies, of which 9 prospective studies were evaluated as being good or good-fair quality. Two good-fair quality studies found loneliness at baseline was associated with subsequent admission to a residential care home. There was emerging evidence that loneliness was associated with emergency department use (n=1), and CVD-specific hospitalisation (n=1). Once adjusted for confounders the highest quality studies found no association of baseline loneliness with physician utilisation, outpatient service utilisation, skilled nursing facility use, and planned or unplanned hospital admissions. The remaining, studies were cross-sectional, or of fair to poor quality, and inadequate to reliably determine whether loneliness was associated with a subsequent change in HSCU. Discussion and implications There was heterogeneity in study design, measurement, and study quality. This generated an inconsistent evidence base where we cannot determine clear inferences about the relationship between loneliness and HSCU. Only one consistent finding was observed between two good-fair quality studies regarding care home admission. To determine clinical implications and make reliable inferences additional good quality longitudinal research is needed.


2021 ◽  
Vol 37 (S1) ◽  
pp. 21-21
Author(s):  
Clareece Nevill ◽  
Nicola Cooper ◽  
Alex Sutton

IntroductionNetwork meta-analysis (NMA) is a key methodology for comparing the effectiveness of multiple interventions or treatments simultaneously. This project aimed to ascertain current methods and visualizations for treatment ranking within an NMA framework and to subsequently develop a novel graphic within MetaInsight (an interactive NMA web application), to aid clinicians and stakeholders when making decisions regarding the “best” intervention(s) for their patient(s).MethodsCurrent literature on the methodology or visualization of treatment ranking published in the last 10 years was collated and studied. Based on the literature, a novel graphical visualization was developed using RShiny (RStudio, PBC) and integrated within MetaInsight, which is currently hosted on shinyapps.io.ResultsBayesian analyses produce rank probabilities from which mean or median rank and surface under the cumulative ranking curve can be calculated. For frequentist analyses the p-value is available. The simpler methods may be easier to interpret, but they are often more unstable and do not encompass the whole analysis (and vice versa). To aid interpretation and facilitate sensitivity analysis, an interactive graphic was developed that presents rankings alongside treatment effect and study quality results.ConclusionsTreatment ranking is useful, but the results should be interpreted cautiously, and the visualization should be transparent and all-encompassing. A ‘living’ version of MetaInsight, with treatment ranking, would allow interested parties to follow the evidence base as it grows.


BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e052682
Author(s):  
Wenchuan Shi ◽  
Xiaoli Cheng ◽  
Haitao Wang ◽  
Xiao Zang ◽  
Tingting Chen

ObjectivesChina suffers from high burdens of human papillomavirus (HPV) and cervical cancer, whereas the uptake of HPV vaccine remains low. The first Chinese domestic HPV vaccine was released in 2019. However, collective evidence on cost-effectiveness of HPV vaccination in China has yet to be established. We summarised evidence on the cost-effectiveness of HPV vaccine in China.DesignSystematic review and narrative synthesisData sourcesPubMed, EMBASE, China National Knowledge Infrastructure and Wanfang Data were searched through 2 January 2021Eligibility criteria for selecting studiesCost-effectiveness studies using a modelling approach focusing on HPV vaccination interventions in the setting of China were included for review.Data extraction and synthesisWe extracted information from the selected studies focusing on cost-effectiveness results of various vaccination programmes, key contextual and methodological factors influencing cost-effectiveness estimates and an assessment of study quality.ResultsA total of 14 studies were included for review. Considerable heterogeneity was found in terms of the methodologies used, HPV vaccination strategies evaluated and study quality. The reviewed studies generally supported the cost-effectiveness of HPV vaccine in China, although some reached alternative conclusions, particularly when assessed incremental to cervical cancer screening. Cost of vaccination was consistently identified as a key determinant for the cost-effectiveness of HPV vaccination programmes.ConclusionsImplementing HPV vaccination programmes should be complemented with expanded cervical cancer screening, while the release of lower-priced domestic vaccine offers more promising potential for initiating public HPV vaccination programmes. Findings of this study contributes important evidence for policies for cervical cancer prevention in China and methodological implications for future modelling efforts.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Tobias Alt ◽  
Marcus Schmidt

Abstract Background The Nordic Hamstring Exercise (NHE) is very popular for selective eccentric hamstring strengthening. However, NHE-related research is hindered by insufficient details about implementation and reporting. Available tools to assess study quality (e.g., PEDro or TESTEX scale) are too unspecific to account for the specific demands of NHE. Therefore, this study aimed to introduce two rating scales for Assessing Nordic Hamstring Exercise Quality (ANHEQ) of assessment and intervention studies. Methods Eighteen graduated sports scientists, sports physiotherapists and elite coaches with scientific experience independently evaluated the quality of published NHE studies via ANHEQ scales, each comprising eight items and a maximal 13-point score. Inter-rater agreement was analyzed by using criterion-based reference values, while Krippendorff´s alpha determined inter-rater reliability. Systematic differences of the summated ANHEQ scores were determined using Friedman tests. Results Inter-rater agreement was 87 ± 5% for NHE assessments and 88 ± 6% for interventions with single items ranging from 71 to 100%. Alpha values for inter-rater reliability ranged from fair (.250) to perfect (1.00) depending on the item. Total ANHEQ scores revealed coefficients of .829 (almost perfect) and .772 (substantial) without significant inter-rater differences (p = .292). Conclusions The ANHEQ scales are suitable tools to rate NHE execution quality and data presentation. They facilitate a comprehensive review of NHE-related evidence and potentially improve the design and reporting of future NHE studies.


2021 ◽  
Author(s):  
Frida Björkman ◽  
Örjan Ekblom

ABSTRACT Introduction Post-traumatic stress disorder (PTSD) is a cluster of physical and psychiatric symptoms following military or civilian trauma. The effect of exercise on PTSD symptoms has previously been investigated in several studies. However, it has not been fully determined what type of exercise most impacts PTSD symptoms. The aim of the present study was to systematically review the effects of different types of exercise on PTSD symptom severity and symptoms of coexisting conditions in adults. Materials and Methods Electronic searches were conducted in the databases PubMed, APA PsycInfo, and SportDiscus, from database inception up until February 1, 2021. Inclusion criteria were randomized controlled trials published in English, participants having a PTSD diagnosis or clinically relevant symptoms, and participants randomly allocated to either a non-exercising control group or an exercise group. Data concerning the number of participants, age, exercise type and duration, PTSD symptom severity (primary outcome), and symptoms of coexisting conditions (secondary outcomes) were extracted. The subgroup analysis included high or low training dose, military trauma versus non-military trauma, the type of intervention (yoga versus other exercise), active or passive control condition, group training versus individual exercise, and study quality. The study quality and risk of bias were assessed using grading of recommendation assessment, development and evaluation (GRADE) guidelines. A meta-analysis was performed with a mixed-effects model and restricted maximum likelihood as model estimator, and effect size was calculated as the standardized difference in mean and 95% CI. Results Eleven studies were included in the present review. Results showed a main random effect of exercise intervention (0.46; 95% CI: 0.18 to 0.74) and a borderline significant interaction between more voluminous (>20 hours in total) and less voluminous (≤20 hours in total) exercise interventions (P = .07). No significant findings from the subgroup analysis were reported. The secondary outcome analysis showed a small but significant effect of exercise on depressive symptoms (0.20, 95% CI: 0.01 to 0.38), and a larger effect on sleep (0.51, 95% CI: 0.29 to 0.73). For substance use (alcohol and drugs combined) and quality of life, we found significant effects of 0.52 (95% CI: 0.06 to 0.98) and 0.51 (95% CI: 0.34 to 0.69), respectively. No significant effect was found for anxiety (0.18, 95% CI: −0.15 to 0.51), and no sign of publication bias was found. Conclusions Exercise can be an effective addition to PTSD treatment, and greater amounts of exercise may provide more benefits. However, as there were no differences found between exercise type, possibly due to the inclusion of a low number of studies using different methodologies, further research should aim to investigate the optimal type, dose, and duration of activity that are most beneficial to persons with PTSD.


Author(s):  
André Hajek ◽  
Benedikt Kretzler ◽  
Hans-Helmut König

Background: Several empirical studies have shown an association between informal caregiving for adults and loneliness or social isolation. Nevertheless, a systematic review is lacking synthesizing studies which have investigated these aforementioned associations. Therefore, our purpose was to give an overview of the existing evidence from observational studies. Materials and Methods: Three electronic databases (Medline, PsycINFO, CINAHL) were searched in June 2021. Observational studies investigating the association between informal caregiving for adults and loneliness or social isolation were included. In contrast, studies examining grandchild care or private care for chronically ill children were excluded. Data extractions covered study design, assessment of informal caregiving, loneliness and social isolation, the characteristics of the sample, the analytical approach and key findings. Study quality was assessed based on the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Each step (study selection, data extraction and evaluation of study quality) was conducted by two reviewers. Results: In sum, twelve studies were included in our review (seven cross-sectional studies and five longitudinal studies)—all included studies were either from North America or Europe. The studies mainly showed an association between providing informal care and higher loneliness levels. The overall study quality was fair to good. Conclusion: Our systematic review mainly identified associations between providing informal care and higher loneliness levels. This is of great importance in assisting informal caregivers in avoiding loneliness, since it is associated with subsequent morbidity and mortality. Moreover, high loneliness levels of informal caregivers may have adverse consequences for informal care recipients.


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