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Intensive Care Medicine Apr 2021Most randomized controlled trials (RCTs) in patients with acute respiratory distress syndrome (ARDS) revealed indeterminate or conflicting study results. We aimed to...
PURPOSE
Most randomized controlled trials (RCTs) in patients with acute respiratory distress syndrome (ARDS) revealed indeterminate or conflicting study results. We aimed to systematically evaluate between-trial heterogeneity in reporting standards and trial outcome.
METHODS
A systematic review of RCTs published between 2000 and 2019 was performed including adult ARDS patients receiving lung-protective ventilation. A random-effects meta-regression model was applied to quantify heterogeneity (non-random variability) and to evaluate trial and patient characteristics as sources of heterogeneity.
RESULTS
In total, 67 RCTs were included. The 28-day control-group mortality rate ranged from 10 to 67% with large non-random heterogeneity (I = 88%, p < 0.0001). Reported baseline patient characteristics explained some of the outcome heterogeneity, but only six trials (9%) reported all four independently predictive variables (mean age, mean lung injury score, mean plateau pressure and mean arterial pH). The 28-day control group mortality adjusted for patient characteristics (i.e. the residual heterogeneity) ranged from 18 to 45%. Trials with significant benefit in the primary outcome reported a higher control group mortality than trials with an indeterminate outcome or harm (mean 28-day control group mortality: 44% vs. 28%; p = 0.001).
CONCLUSION
Among ARDS RCTs in the lung-protective ventilation era, there was large variability in the description of baseline characteristics and significant unexplainable heterogeneity in 28-day control group mortality. These findings signify problems with the generalizability of ARDS research and underline the urgent need for standardized reporting of trial and baseline characteristics.
Topics: Adult; Humans; Respiration, Artificial; Respiratory Distress Syndrome
PubMed: 33713156
DOI: 10.1007/s00134-021-06370-w -
Annals of Clinical and Laboratory... Nov 2017Acute appendicitis (AA) is a common condition in general surgery, often with serious consequences such as septicemia and intra-abdominal infection. Mean platelet volume... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Acute appendicitis (AA) is a common condition in general surgery, often with serious consequences such as septicemia and intra-abdominal infection. Mean platelet volume (MPV) - a platelet parameter - could be an index of inflammation. We carried out the present study to perform a meta-analysis of AA and MPV.
METHODS
A systematic search was conducted in databases of PubMed and Embase from 1966 to 2015. Weighted mean difference and 95% confidence interval (CI) were then calculated. Finally, statistical analysis was carried out using Stata 12.0 software.
RESULTS
Of the 88 selected studies, five case-control studies met the selection criteria. These cases, comprised1416 cases of AA and 685 controls. The results showed a prominent decrease of MPV levels in patients suffering from AA, compared to the control group. (weighted mean difference, -0.64; 95% CI, -0.74 to -0.54; =0.037).
CONCLUSIONS
AA cases had a lower MPV than the controls, which supports MPV as a potential biomarker of AA.
Topics: Acute Disease; Appendicitis; Case-Control Studies; Humans; Mean Platelet Volume; Publication Bias
PubMed: 29263055
DOI: No ID Found -
Clinical Oral Investigations Jan 2017The objective of the study was to assess the impact of periodontal crown lengthening surgery on clinical parameters at adjacent and non-adjacent sites compared to... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The objective of the study was to assess the impact of periodontal crown lengthening surgery on clinical parameters at adjacent and non-adjacent sites compared to treated sites.
MATERIAL AND METHODS
An electronic search was carried out on MEDLINE-PubMed, The Cochrane Library, and ISI Web of Science databases between 1978 and 2015. Methodological quality assessment was based on Cochrane recommendations. Meta-analyses were assessed with RevMan 5.0 and heterogeneity between studies by the Higgin test (I ). Clinical attachment level (CAL) and probing depth (PD) were the primary outcome variables. Four case series studies were included and three in the meta-analysis. All studies showed high risk of bias.
RESULTS
The surgery promoted significant changes in treated, adjacent, and non-adjacent sites. There were greater changes in PD (mean difference -0.14, 95 % CI -0.18 to -0.10, p < 0.00001) and CAL (mean difference 0.16, 95 % CI 0.13 to 0.20, p < 0.00001) in treated sites when compared to adjacent and non-adjacent sites for PD (mean difference -0.09, 95 % CI -0.12 to -0.05, p < 0.00001) and CAL (mean difference 0.91, 95 % CI 0.87 to 0.94, p < 0.00001).
CONCLUSION
Crown lengthening surgery results in changes of clinical parameters in treated, adjacent, and non-adjacent sites.
CLINICAL RELEVANCE
Clinical and esthetic alterations on the adjacent/non-adjacent teeth can lead to clinical and esthetic alterations, which must be considered in surgical planning.
Topics: Crown Lengthening; Humans; Outcome and Process Assessment, Health Care; Periodontal Attachment Loss; Periodontal Diseases; Periodontal Index; Periodontal Pocket
PubMed: 27515522
DOI: 10.1007/s00784-016-1921-1 -
American Journal of Obstetrics &... Jul 2023Many studies have reported the association between platelets and preeclampsia. However, sample sizes were small, and their findings were inconsistent. We conducted a... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Many studies have reported the association between platelets and preeclampsia. However, sample sizes were small, and their findings were inconsistent. We conducted a systematic review and meta-analysis to evaluate the association in pooled samples and in detail.
DATA SOURCES
A systematic literature search was performed using Medline, Embase, ScienceDirect, Web of Science, Cochrane Library, NICHD-DASH, LILACS, and Scopus from inception to April 22, 2022.
STUDY ELIGIBILITY CRITERIA
Observational studies comparing platelet count between women with preeclampsia and normotensive pregnant women were included.
METHODS
The mean differences with 95% confidence interval in platelet count were calculated. Heterogeneity was assessed using I statistics. Sensitivity and subgroup analyses were conducted. Statistical analysis was performed using RevMan 5.3 and ProMeta 3 software.
RESULTS
A total of 56 studies comprising 4892 preeclamptic and 9947 normotensive pregnant women were included. Meta-analysis showed that platelet count was significantly lower in women with preeclampsia than in normotensive controls (overall: mean difference, -32.83; 95% confidence interval, -40.13 to -25.52; P<.00001; I=92%; mild preeclampsia: mean difference, -18.65; 95% confidence interval, -27.17 to -10.14; P<.00001; I=84%; severe preeclampsia: mean difference, -42.61; 95% confidence interval, -57.53 to -27.68; P<.00001; I=94%). Significantly lower platelet count was also observed in the second trimester (mean difference, -28.84; 95% confidence interval, -44.59 to -13.08; P=.0003; I=93%), third trimester (mean difference, -40.67; 95% confidence interval, -52.14 to -29.20; P<.00001; I=92%), and before the diagnosis of preeclampsia (mean difference, -18.81; 95% confidence interval, -29.98 to -7.64; P=.009; I=87%), but not in the first trimester (mean difference, -15.14; 95% confidence interval, -37.71 to 7.43; P=.19; I=71%). Overall, the pooled sensitivity and specificity of platelet count were 0.71 and 0.77, respectively. The area under the curve was 0.80.
CONCLUSION
This meta-analysis confirmed that platelet count was significantly lower in preeclamptic women, irrespective of severity and presence or absence of associated complications, even before the onset of preeclampsia and in the second trimester of pregnancy. Our findings suggest that platelet count may be a potential marker to identify and predict preeclampsia.
Topics: Pregnancy; Female; Humans; Pre-Eclampsia; Platelet Count; Blood Pressure; Pregnancy Trimester, First; Pregnancy Trimester, Third
PubMed: 37098392
DOI: 10.1016/j.ajogmf.2023.100979 -
Psicothema Aug 2017The objective of this research study was to conduct a systematic review of the research on volunteers using Clary et al.’s VFI (1998). A total of 48 research... (Review)
Review
The objective of this research study was to conduct a systematic review of the research on volunteers using Clary et al.’s VFI (1998). A total of 48 research studies including 67 independent samples met eligibility criteria. The total sample of the studies analyzed ranged from 20375 to 21988 participants, depending on the motivation analyzed. The results show that the Values factor obtained the highest mean score, both overall and in each type of volunteering, whereas the lowest scores were for the Career and Enhancement factors. Studies conducted with samples with a mean age under 40 years obtain higher scores on Career and Understanding scales when compared to studies in older samples. The group of studies with less than 50% women yield higher mean scores on the Social scale than studies with more than 50% women in the sample. All the scales show reliability coefficients between .78 and .84. Only eight of the articles provide data on the reliability of the scale with a mean value of .90. Of the 26 studies that performed factor analysis, 18 confirmed the original structure of six factors.
Topics: Humans; Motivation; Volunteers
PubMed: 28693699
DOI: 10.7334/psicothema2016.371 -
JACC. Cardiovascular Imaging Oct 2023Extracellular volume (ECV) is a quantitative measure of extracellular compartment expansion, and an increase in ECV is a marker of myocardial fibrosis. Although cardiac... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Extracellular volume (ECV) is a quantitative measure of extracellular compartment expansion, and an increase in ECV is a marker of myocardial fibrosis. Although cardiac magnetic resonance (CMR) is considered the standard imaging tool for ECV quantification, cardiac computed tomography (CT) has also been used for ECV assessment.
OBJECTIVES
The aim of this meta-analysis was to evaluate the correlation and agreement in the quantification of myocardial ECV by CT and CMR.
METHODS
PubMed and Web of Science were searched for relevant publications reporting on the use of CT for ECV quantification compared with CMR as the reference standard. The authors employed a meta-analysis using the restricted maximum-likelihood estimator with a random-effects method to estimate summary correlation and mean difference. A subgroup analysis was performed to compare the correlation and mean differences between single-energy CT (SECT) and dual-energy CT (DECT) techniques for the ECV quantification.
RESULTS
Of 435 papers, 13 studies comprising 383 patients were identified. The mean age range was 57.3 to 82 years, and 65% of patients were male. Overall, there was an excellent correlation between CT-derived ECV and CMR-derived ECV (mean: 0.90 [95% CI: 0.86-0.95]). The pooled mean difference between CT and CMR was 0.96% (95% CI: 0.14%-1.78%). Seven studies reported correlation values using SECT, and 4 studies reported those using DECT. The pooled correlation from studies utilizing DECT for ECV quantification was significantly higher compared with those with SECT (mean: 0.94 [95% CI: 0.91-0.98] vs 0.87 [95% CI: 0.80-0.94], respectively; P = 0.01). There was no significant difference in pooled mean differences between SECT vs DECT (P = 0.85).
CONCLUSIONS
CT-derived ECV showed an excellent correlation and mean difference of <1% with CMR-derived ECV. However, the overall quality of the included studies was low, and larger, prospective studies are needed to examine the accuracy and diagnostic and prognostic utility of CT-derived ECV.
Topics: Humans; Male; Middle Aged; Aged; Aged, 80 and over; Female; Predictive Value of Tests; Myocardium; Cardiomyopathies; Heart; Magnetic Resonance Imaging; Fibrosis; Contrast Media
PubMed: 37269267
DOI: 10.1016/j.jcmg.2023.03.021 -
Ultrasound (Leeds, England) Aug 2022The aim of this systematic review is to critically assess the efficacy of the cerebroplacental ratio performed in the third trimester at predicting adverse perinatal... (Review)
Review
INTRODUCTION
The aim of this systematic review is to critically assess the efficacy of the cerebroplacental ratio performed in the third trimester at predicting adverse perinatal outcomes and reducing stillbirth rates.
METHOD
The literature search was performed using CINAHL, EMBASE, EMCARE, MEDLINE and PubMed including systematic reviews, retrospective and prospective studies from inception until July 2020 utilising the PRISMA checklist and flowchart. Data displaying sensitivities, specificity and odds ratios (OR) to include 95% confidence interval (CI) were extracted and synthesised.
FINDINGS
Initially, 1226 studies were identified, and nine studies met the inclusion criteria. Sample sizes ranged from 491 to 9772 pregnancies. The cerebroplacental ratio had the strongest diagnostic accuracy of all of the independent variables for detecting fetal demise (mean sensitivity and specificity; 79% and 78%). The cerebroplacental ratio, however, did not perform as favourably at predicting operative delivery (mean sensitivity and specificity; 59% and 82%) or anticipating admission to the neonatal intensive care unit (mean sensitivity and specificity; 55% and 74%).
DISCUSSION
The results from this study showed that the cerebroplacental ratio within third trimester pregnancies has been proven to have moderate to high diagnostic value when detecting adverse perinatal outcomes, in particular fetal demise.
CONCLUSION
Cerebroplacental ratio has the potential as a diagnostic tool to reduce adverse perinatal outcomes, in particular fetal demise and help reduce stillbirth rates. The main study limitation involved heterogeneity within the included studies, in particular with a regard to blinding.
PubMed: 35936964
DOI: 10.1177/1742271X211048213 -
Pediatric Radiology Sep 2023The role of postnatal Doppler measurements of the superior mesenteric artery (SMA) in detecting neonates at risk of necrotizing enterocolitis (NEC) remains uncertain;... (Meta-Analysis)
Meta-Analysis Review
The role of postnatal Doppler measurements of the superior mesenteric artery (SMA) in detecting neonates at risk of necrotizing enterocolitis (NEC) remains uncertain; therefore, we systematically reviewed and meta-analyzed the existing evidence regarding the usefulness of SMA Doppler measurements in detecting neonates at risk for NEC. We used the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, and we included studies which reported the following Doppler ultrasonography indices: peak systolic velocity, end-diastolic velocity, time average mean velocity, differential velocity, pulsatility index (PI) and resistive index. Eight studies were eligible for inclusion in the meta-analysis. Evidence suggested that, during the first postnatal day, neonates who developed NEC had a significantly higher peak systolic velocity (mean difference of 2.65 cm/s (95% confidence interval [CI] 1.23, 4.06, overall effect Z=3.66, P<0.001)), higher PI (mean difference of 1.52 (95% CI 0.00, 3.04, Z=1.96, P=0.05)) and higher resistive index (mean difference of 1.09 (95% CI 0.59, 1.60, Z=4.24, P<0.001)), compared to neonates who did not develop NEC. However, our findings do not support a strong association between the Doppler ultrasound indices and development of NEC at the time of disease onset. This meta-analysis suggests that first postnatal day SMA Doppler parameters, namely peak systolic velocity, PI and resistive index, are higher in neonates who develop NEC. On the other hand, the aforementioned indices are of uncertain significance once the diagnosis of NEC has been established.
Topics: Female; Infant, Newborn; Humans; Enterocolitis, Necrotizing; Mesenteric Artery, Superior; Ultrasonography; Ultrasonography, Doppler; Infant, Newborn, Diseases; Fetal Diseases; Blood Flow Velocity
PubMed: 37310444
DOI: 10.1007/s00247-023-05695-6 -
PloS One 2022Inflammatory bowel disease (IBD) is a chronic gastrointestinal tract inflammatory state, which is affecting millions of individuals in the world. It can affect... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Inflammatory bowel disease (IBD) is a chronic gastrointestinal tract inflammatory state, which is affecting millions of individuals in the world. It can affect alimentary canals such as colon, rectum, ileum and other parts. In IBD, platelet parameters underwent several changes. Therefore, the aim of this review was determining the estimated pooled mean platelet volume and mean difference in inflammatory bowel disease to elucidate its potential diagnostic value.
METHODS
Articles were extensively searched in bibliographic databases using Medical Subject Heading and entry phrases or terms. In addition, articles were directly searched in Google Scholar to account for the studies omission in searching bibliographic databases. Observational (cohort, cross-sectional and case-control) studies, published in English language and conducted on IBD were included. For studies meeting the eligibility criteria, the first author's name, publication year, population, study design, study area, sample size, mean platelet volume and standard deviation were extracted and entered in to Microsoft-excel. The analysis was done by Stata version 11. In order to estimate the pooled mean platelet volume and mean difference, random effect model was done. The heterogeneity was quantified using Higgin's I2 statistics. Publication bias was determined using Egger's test statistics and funnel plot. Sub-group analysis based on population carried to reduce heterogeneity.
RESULTS
A total of 17 relevant articles with 2957 participants (1823 IBD cases and 1134 healthy controls) were included to this study. The pooled estimated MPV was 9.29fl; 95% CI: 9.01-9.57 and 9.50fl; 95% CI: 8.81-10.20 in IBD and control groups, respectively. The standardized pooled estimate of mean difference in mean platelet volume was -0.83fl; 95% CI: -1.15, -0.51; I2: 93.1%; P-value < 0.001. In subgroup analysis based on population, the highest estimated mean difference in MPV was observed among patients of CD; -2.30; 95% CI: -3.46, -1.14; I2: 97.8%; P-value < 0.001.
CONCLUSION
According to the current systematic review and meta-analysis, mean platelet volume was lower in IBD compared to control. The decreased mean platelet volume could be attributed to platelet consumption or sequestration associated with the progression of IBD. As a result, in IBD, mean platelet volume can provide diagnostic and prognostic information.
Topics: Case-Control Studies; Chronic Disease; Cross-Sectional Studies; Humans; Inflammatory Bowel Diseases; Mean Platelet Volume; Prognosis
PubMed: 36040881
DOI: 10.1371/journal.pone.0273417 -
Journal of Hypertension Jan 2017Member states of the WHO, including India, have adopted a target 30% reduction in mean population salt consumption by 2025 to prevent noncommunicable diseases. Our aim... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Member states of the WHO, including India, have adopted a target 30% reduction in mean population salt consumption by 2025 to prevent noncommunicable diseases. Our aim was to support this initiative by summarizing existing data that describe mean salt consumption in India.
METHOD
Electronic databases - MEDLINE via Ovid, EMBASE, CINAHL and the Cochrane Database of Systematic Reviews - were searched up to November 2015 for studies that reported mean or median dietary salt intake in Indian adults aged 19 years and older. Random effects meta-analysis was used to obtain summary estimates of salt intake.
RESULTS
Of 1201 abstracts identified, 90 were reviewed in full text and 21 were included: 18 cross-sectional surveys (n = 225 024), two randomized trials (n = 255) and one case-control study (n = 270). Data were collected between 1986 and 2014, and reported mean salt consumption levels were between 5.22 and 42.30 g/day. With an extreme outlier excluded, overall mean weighted salt intake was 10.98 g/day (95% confidence interval 8.57-13.40). There was significant heterogeneity between the estimates for contributing studies (I = 99.97%) (P homogeneity ≤0.001), which was likely attributable to the different measurement methods used and the different populations studied. There was no evidence of a change in intake over time (P trend = 0.08).
CONCLUSION
The available data leave some uncertainty about exact mean salt consumption in India but there is little doubt that population salt consumption far exceeds the WHO-recommended maximum of 5 g per person per day.
Topics: Adult; Diet; Female; Humans; India; Male; Sodium Chloride, Dietary; Young Adult
PubMed: 27755388
DOI: 10.1097/HJH.0000000000001141