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2021 ◽  
Vol 28 (5) ◽  
pp. 3771-3794
Author(s):  
Robert Koucheki ◽  
Aaron M. Gazendam ◽  
Jonathan R. Perera ◽  
Anthony Griffin ◽  
Peter Ferguson ◽  
...  

Aim: The aim of this study was to systematically assess the risk of bias in osteosarcoma and Ewing’s sarcoma (ES) randomized controlled trials (RCT) and to examine the relationships between bias and conflict of interest/industry sponsorship. Methods: An OVID-MEDLINE search was performed (1976–2019). Using the Cochrane Collaboration guidelines, two reviewers independently assessed the prevalence of risk of bias in different RCT design domains. The relationship between conflicts of interest and industry funding with the frequency of bias was examined. Results: 73 RCTs met inclusion criteria. Prevalence of low-risk bias domains was 47.3%, unclear-risk domains 47.8%, and 4.9% of the domains had a high-risk of bias. Domains with the highest risk of bias were blinding of participants/personnel and outcome assessors, followed by randomization and allocation concealment. Overtime, frequency of unclear-risk of bias domains decreased (χ2 = 5.32, p = 0.02), whilst low and high-risk domains increased (χ2 = 8.13, p = 0.004). Studies with conflicts of interest and industry sponsorships were 4.2 and 3.1 times more likely to have design domains with a high-risk of bias (p < 0.05). Conclusion: This study demonstrates that sources of potential bias are prevalent in both osteosarcoma and ES RCTs. Studies with financial conflicts of interest and industry sponsors were significantly more likely to have domains with a high-risk of bias. Improvements in reporting and adherence to proper methodology will reduce the risk of bias and improve the validity of the results of RCTs in osteosarcoma and ES.


2021 ◽  
pp. 1-16
Author(s):  
Zoë Thijs ◽  
Laura Bruneel ◽  
Guy De Pauw ◽  
Kristiane M. Van Lierde

<b><i>Background:</i></b> Relationships between malocclusion and orofacial myofunctional disorders (OMD), as well as malocclusions and articulation disorders (AD) have been described, though the exact relationships remain unclear. Given the high prevalence of these disorders in children, more clarity is needed. <b><i>Summary:</i></b> The purpose of this study was to determine the association between OMD (specifically, bruxism, deviate swallowing, caudal resting tongue posture, and biting habits), AD, and malocclusions in children and adolescents aged between 3 and 18 years. To conduct a systematic review, 4 databases were searched (MEDLINE, Embase, Web of Science, and Scopus). The identified articles were screened for the eligibility criteria. Data were extracted from the selected articles and quality assessment was performed using the tool of Munn et al. [Int J Health Policy Manag. 2014;3:123–81] in consensus. Using the search strategy, the authors identified 2,652 articles after the removal of duplicates. After reviewing the eligibility criteria, 17 articles were included in this study. One of the included articles was deemed to have an unclear risk of bias, whereas all other articles were considered to have a low risk of bias. The articles showed a relationship between anterior open bite and apico-alveolar articulatory distortions, as well as between anterior open bite and deviate swallowing. For the biting habits, bruxism, and low tongue position no clear conclusions could be drawn. <b><i>Key Messages:</i></b> The current review suggests a link between specific types of malocclusion and OMD and AD. However, more high-quality evidence (level 1 and level 2, Oxford Levels of Evidence) is needed to clarify the cooccurrence of other OMD, AD, and malocclusions.


2021 ◽  
Author(s):  
Benjamin Woolf ◽  
Phil Edwards

AbstractBackgroundStudy results can be badly affected by non-response. One way to potentially reduce non-response is by sending potential study participants advance communication. During the update of a systematic review examining the effect of pre-notification on response rates, a number of study authors needed to be contacted for further information.ObjectivesTo conduct an RCT to investigate the effect of pre-notification, nested within the request for further information for a systematic review.MethodsStudy authors included in the systematic review, whose studies were at unclear risk of bias, and who were contactable, were randomly sent or not set a pre-notification email prior to being sent the request for further information email.ResultsAt the end of follow up, 14/33 (42.4%) authors in the pre-notification condition had returned responses to the questionnaire, and 18/42 (42.9%). There was not evidence of a difference between these groups.ConclusionsThis study’s results do not support the hypothesis that pre-notification does increase response from participants.


Author(s):  
Camilla Preda ◽  
Andrea Butera ◽  
Silvia Pelle ◽  
Eleonora Pautasso ◽  
Alessandro Chiesa ◽  
...  

Objectives: To compare the efficacy of rotating-oscillating heads (ORHs) VS sonic action heads (SAHs) powered toothbrushes on plaque accumulation and gingival inflammation. Methods: An electronic (MEDLINE, Embase, Inspec, PQ SciTech and BIOSIS) and a complementary manual search were made to detect eligible studies. RCTs meeting the following criteria were included: final timepoint longer than 15 days; year of publication after 2000; patients without orthodontic appliances or severe systemic/psychiatric diseases. Studies comparing two or more different types of sonic/roto-oscillating toothbrushes were excluded. Selection of articles, extraction of data, and assessment of quality were made independently by several reviewers. Results: 12 trials (1433 participants) were included. The differences between ORHs and SAHs toothbrushes were expressed as weighted mean differences (WMD) and 95% confidence intervals (CI). The heterogeneity of data was evaluated. Concerning Plaque Index, both toothbrushes obtained comparable results. Six trials of up to 3 months and at an unclear risk of bias provided significant outcomes in terms of gingival inflammation in favor of ORHs toothbrush. Evidence resulting from three trials of up to 6 months and at a high/low risk of bias stated SAHs toothbrush superiority in gingival inflammation. Conclusions: Both ORHs and SAHs toothbrushes improved the outcomes measured from the baseline. In most of the good quality trials included, SAHs toothbrush showed statistical better long-term results. Due to the shortage of investigations, no further accurate conclusions can be outlined with reference to the superiority of a specific powered toothbrush over the other.


2021 ◽  
Vol 14 ◽  
pp. 1179173X2110168
Author(s):  
Ravina Barrett ◽  
Hajar Aldamkhi

Introduction: Pharmacy staff are a trusted source of advice on the safe and appropriate use of medicines and devices. Retail pharmacies deliver smoking cessation services and sell e-cigarettes in the UK. This review asks ‘what knowledge, experience and ability do staff have to support e-cigarette users to quit smoking’. Methods: A systematic literature search was undertaken drawn on predefined eligibility criteria and a comprehensive search strategy following the PRISMA guideline. Eligible papers reported survey-research published in English from 2015 to 2020. PubMed, Google Scholar, OVID, EMBASE and MEDLINE Databases were searched. No restrictions on study design or language were applied. Two reviewers independently screened for inclusion/exclusion and then extracted the relevant information from the articles for synthesis. Results: Of 12 potentially eligible full-text studies, 1 was a duplicate, 7 were excluded as per eligibility criteria. Four papers were finally included in this literature review. Two studies indicated that pharmacy staff are less confident in giving advice on e-cigarette use. Knowledge on the adverse effects of e-cigarettes compared to traditional smoking cessation aids remain unclear. In one study, 42% of community pharmacists did not believe that e-cigarettes could be used for smoking cessation. Three studies identified need for specific regulations and professional support. The overall certainty of the evidence is ‘low’ or ‘very low’, with moderate levels of bias. Conclusion: Pharmacists may be well placed to implement e-cigarette smoking cessation interventions, but most practitioners lacked knowledge and ability to support these customers citing unclear risk of harm. Pharmacists felt secure in recommending traditional cessation tools. Further regulation, guidelines and training is needed. Findings may be less generalizable in countries where e-cigarettes are banned. Their extent of knowledge, experience and ability to support users of e-cigarettes within their community to quit smoking is lacking.


Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Amit Dang ◽  
Sheshank Madiraju ◽  
Jagan Mohan Venkateswara Rao P ◽  
Navya Sri Gurram ◽  
Sandeep Digijarala ◽  
...  

Background: We critically evaluated the risk of bias in published systematic reviews (SRs) and meta-analyses (MAs) pertaining to COVID-19 using ROBIS tool. Materials And Methods: Medline and Cochrane Central Library were searched for SRs/MAs on 14th May 2020, including studies of all designs describing various facets of COVID-19 in humans; no restrictions were applied for interventions, comparators, and outcomes. Two reviewers independently assessed all the SRs/MAs with ROBIS. Results: Out of 204 identified records, 48 SRs/MAs were included. The most frequently reviewed topics were therapy outcomes, diagnosis, and comorbidities (15, 8, and 6 papers respectively). Only 29/48(60.41%) papers had made a mention of using PRISMA or other guidelines for drafting the SR/MA. Only 5/48(10.42%) of all included SRs/MAs had low overall risk of bias as per ROBIS tool; 41/48(85.42%) had high risk of bias, 2/48(4.17%) had unclear risk of bias. The highest proportion of bias was found in data synthesis and findings (30/48, 62.50% of studies had high risk of bias), followed by study identification and selection (29/48, 60.42%). The IRR for methodological quality assessment was substantial, with the Cohen’s kappa values being 0.64, 0.68, 0.62, and 0.75 for domains 1-4 of ROBIS tool, and 0.66 for overall risk of bias assessment. Conclusion: There are serious concerns about the methodology employed to generate the results of the SRs/ MAs pertaining to COVID-19, with ‘quantity’ seemingly being given more importance than ‘quality’ of the paper.


Societies ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. 63
Author(s):  
Dan Grabowski ◽  
Julie Meldgaard ◽  
Morten Hulvej Rod

When the Danish society went into COVID-19 lockdown, it dramatically changed the conditions for living with a chronic disease like diabetes. The present article highlights the psychosocial effects of this change. The dataset consists of 20 semi-structured online interviews with people with diabetes. The data were analyzed using radical hermeneutics and interpreted using Luhmann’s operative constructivist systems theory. The analysis produced three main themes: (1) people with diabetes experience altered self-observations–mainly due to society labelling them as vulnerable, (2) people with diabetes have unclear risk perceptions due to lack of concrete knowledge about the association between COVID-19 and diabetes, and (3) changes in conditions for maintaining and creating meaningful relations have a significant impact on everyday life with diabetes. These findings have important implications for risk communication. People respond in a multitude of ways to communications issued by health authorities and with close relations, and their meaning-making is shaped by, and shapes, their self-observations, risk perceptions and relational environments. This calls for more targeted communication strategies as well as increased use of peer support; the goal being to help people create meaning in their own environments.


2020 ◽  
Vol 4 (1) ◽  
pp. 109
Author(s):  
Putri Permata Oktaviani ◽  
Entang Adhy Muhtar ◽  
Nina Karlina

Drinking-Water Company (PAM) Jaya as a regional company is responsible for supply clean water in DKI Jakarta, is demanded to conduct partnerships with the private sector, namely PT Palyja and PT Aetra Air Jakarta. After the partnership, there are still many people who do not have access to clean water services. The purpose of this study is to find out and analyze the implementation of the Public-Private Partnership implemented by PAM Jaya and private partners in the supply of clean water in DKI Jakarta. The research method used qualitative research methods.  The theory used is the utilization of the Public-Private Partnership proposed by Emanual Savas (2000) which consists of roles and functions, competition, regulation, risk, procurement, and financing. The results of this study the implementation of the Public-Private Partnership in the supply of clean water in DKI Jakarta has not been effective because of the failure to fully utilize the Public-Private Partnership. The absence of competition and procurement processes between partners, the absence of regulations referred to so that the impact on the Cooperation Agreement (PKS) did not reflect public interests. There were roles and functions of PAM Jaya and private partners that were not conducted, unclear risk-sharing and compensation to private partners were more giving loss to the PAM Jaya, resulting in a shortfall. The author suggests that the PKS contract is needed, also the Provincial Government of DKI Jakarta needs to issue strict and clear regulations, improve services to the public, and no longer use the form of concession cooperation. 


PLoS ONE ◽  
2020 ◽  
Vol 15 (7) ◽  
pp. e0235535
Author(s):  
Maaike M. Rademaker ◽  
Geerte G. J. Ramakers ◽  
Adriana L. Smit ◽  
Lotty Hooft ◽  
Inge Stegeman

2020 ◽  
Vol 29 (12) ◽  
pp. 1019-1032 ◽  
Author(s):  
Ana Luisa Neves ◽  
Lisa Freise ◽  
Liliana Laranjo ◽  
Alexander W Carter ◽  
Ara Darzi ◽  
...  

ObjectiveTo evaluate the impact of sharing electronic health records (EHRs) with patients and map it across six domains of quality of care (ie, patient-centredness, effectiveness, efficiency, timeliness, equity and safety).DesignSystematic review and meta-analysis.Data sourcesCINAHL, Cochrane, Embase, HMIC, Medline/PubMed and PsycINFO, from 1997 to 2017.Eligibility criteriaRandomised trials focusing on adult subjects, testing an intervention consisting of sharing EHRs with patients, and with an outcome in one of the six domains of quality of care.Data analysisThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Title and abstract screening were performed by two pairs of investigators and assessed using the Cochrane Risk of Bias Tool. For each domain, a narrative synthesis of the results was performed, and significant differences in results between low risk and high/unclear risk of bias studies were tested (t-test, p<0.05). Continuous outcomes evaluated in four studies or more (glycated haemoglobin (HbA1c), systolic blood pressure (SBP) and diastolic blood pressure (DBP)) were pooled as weighted mean difference (WMD) using random effects meta-analysis. Sensitivity analyses were performed for low risk of bias studies, and long-term interventions only (lasting more than 12 months).ResultsTwenty studies were included (17 387 participants). The domain most frequently assessed was effectiveness (n=14), and the least were timeliness and equity (n=0). Inconsistent results were found for patient-centredness outcomes (ie, satisfaction, activation, self-efficacy, empowerment or health literacy), with 54.5% of the studies (n=6) demonstrating a beneficial effect. Meta-analyses showed a beneficial effect in effectiveness by reducing absolute values of HbA1c (unit: %; WMD=−0.316; 95% CI −0.540 to −0.093, p=0.005, I2=0%), which remained significant in the sensitivity analyses for low risk of bias studies (WMD= −0.405; 95% CI −0.711 to −0.099), and long-term interventions only (WMD=−0.272; 95% CI −0.482 to −0.062). A significant reduction of absolute values of SBP (unit: mm Hg) was found but lost in sensitivity analysis for studies with low risk of bias (WMD= −1.375; 95% CI −2.791 to 0.041). No significant effect was found for DBP (unit: mm Hg; WMD=−0.918; 95% CI −2.078 to 0.242, p=0.121, I2=0%). Concerning efficiency, most studies (80%, n=4) found either a reduction of healthcare usage or no change. A beneficial effect was observed in a range of safety outcomes (ie, general adherence, medication safety), but not in medication adherence. The proportion of studies reporting a beneficial effect did not differ between low risk and high/unclear risk studies, for the domains evaluated.DiscussionOur analysis supports that sharing EHRs with patients is effective in reducing HbA1c levels, a major predictor of mortality in type 2 diabetes (mean decrease of −0.405, unit: %) and could improve patient safety. More studies are necessary to enhance meta-analytical power and assess the impact in other domains of care.Protocol registrationhttp://www.crd.york.ac.uk/PROSPERO (CRD42017070092).


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