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EFORT Open Reviews May 2020The aim of this systematic review was to present and assess the quality of evidence for learning curve, component positioning, functional outcomes and implant... (Review)
Review
The aim of this systematic review was to present and assess the quality of evidence for learning curve, component positioning, functional outcomes and implant survivorship for imagefree hand-held roboticassisted knee arthroplasty.Searches of PubMed and Google Scholar were performed in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. The criteria for inclusion was any published fulltext article or abstract assessing imagefree hand-held robotic knee arthroplasty and reporting learning curve, implant positioning, functional outcome or implant survival for clinical or non-clinical studies.There were 22 studies included. Five studies reported the learning curve: all were for unicompartmental knee arthroplasty (UKA) - no learning curve for accuracy, operative time was reduced after five to 10 cases and a steady surgical time was achieved after eight cases.There were 16 studies reporting accuracy: rate of outliers was halved, higher rate of joint line and mechanical axis restoration, supported by low root mean square error values.Six studies reported functional outcome: all for UKA, improvement at six to 52 weeks, no difference from manual UKA except when assessed for lateral UKA which showed improved clinical outcomes.Two studies reported survivorship: one reported an unadjusted revision rate of 7% at 20 months for medial UKA and the other found a 99% two-year survival rate for UKA.There was evidence to support more accurate implant positioning for UKA, but whether this is related to superior functional outcomes or improved implant survivorship was not clear and further studies are required. Cite this article: 2020;5:319-326. DOI: 10.1302/2058-5241.5.190065.
PubMed: 32509337
DOI: 10.1302/2058-5241.5.190065 -
BMC Oral Health Dec 2023The development of deep learning (DL) algorithms for use in dentistry is an emerging trend. Periodontitis is one of the most prevalent oral diseases, which has a notable... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The development of deep learning (DL) algorithms for use in dentistry is an emerging trend. Periodontitis is one of the most prevalent oral diseases, which has a notable impact on the life quality of patients. Therefore, it is crucial to classify periodontitis accurately and efficiently. This systematic review aimed to identify the application of DL for the classification of periodontitis and assess the accuracy of this approach.
METHODS
A literature search up to November 2023 was implemented through EMBASE, PubMed, Web of Science, Scopus, and Google Scholar databases. Inclusion and exclusion criteria were used to screen eligible studies, and the quality of the studies was evaluated by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology with the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies) tool. Random-effects inverse-variance model was used to perform the meta-analysis of a diagnostic test, with which pooled sensitivity, specificity, positive likelihood ratio (LR), negative LR, and diagnostic odds ratio (DOR) were calculated, and a summary receiver operating characteristic (SROC) plot was constructed.
RESULTS
Thirteen studies were included in the meta-analysis. After excluding an outlier, the pooled sensitivity, specificity, positive LR, negative LR and DOR were 0.88 (95%CI 0.82-0.92), 0.82 (95%CI 0.72-0.89), 4.9 (95%CI 3.2-7.5), 0.15 (95%CI 0.10-0.22) and 33 (95%CI 19-59), respectively. The area under the SROC was 0.92 (95%CI 0.89-0.94).
CONCLUSIONS
The accuracy of DL-based classification of periodontitis is high, and this approach could be employed in the future to reduce the workload of dental professionals and enhance the consistency of classification.
Topics: Humans; Sensitivity and Specificity; Deep Learning; ROC Curve; Algorithms; Odds Ratio
PubMed: 38114946
DOI: 10.1186/s12903-023-03751-z -
Clinical Hypertension 2019Preeclampsia is a serious pregnancy-related disease which may lead to adverse health effects to the mother and fetus. Besides many publications on the association of red...
BACKGROUND
Preeclampsia is a serious pregnancy-related disease which may lead to adverse health effects to the mother and fetus. Besides many publications on the association of red cell distribution width (RDW) and preeclampsia, there has been no published meta-analysis. This necessitated the present systemic review and met-analysis to assess the RDW in relation to preeclampsia.
METHODS
Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed. Relevant published studies were searched in PubMed, Cochrane library, Google scholar, Scopus, Embase and CINAHL using the term "Preeclampsia OR eclampsia AND red cell distribution width OR red blood cells). Modified Newcastle - Ottawa quality assessment scale was used for critical appraisal of retrieved studies. Pooled Meta logistic regression was computed using OpenMeta Analyst software. Subgroup and meta-regression methods were performed to analyse the heterogeneity.
RESULTS
Eleven case control studies were included in the met-analyses with a total of 951 cases (preeclampsia) and 2024 controls. The mean (SD) of the RDW level was significantly higher in women with preeclampsia compared to controls [15.10 (2.48) % vs. 14.26(1.71) %, < 0.001]. The mean difference was 0.85, 95% CI = 0.26-1.43. Due to a high heterogeneity (I = 90.45, < 0.001), the continuous random effect model was used.Eight studies compared RDW level in the mild ( = 360) with severe cases ( = 354) of preeclampsia. The RDW level was significantly higher in women with severe preeclampsia compared to those with mild preeclampsia [15.37 (2.48) % vs. 14.037(1.79) %, < 0.001]. The mean difference was 1.07, 95% CI = 0.45-1.70. Since there is a high heterogeneity [I = 76.67, < 0.001], the continuous random effect model was used.Through the met-regression model, except for the region of the study ( < 0.001), none of investigated variables (age, parity, quality of the study) was significantly associated with the investigated heterogeneity. The outliers (3studies) were removed to reduce the heterogeneity. The pooled meta-analysis of the remaining 8 studies showed a significant difference in the RDW between preeclamptic women compared with the controls. The mean difference was 0.93, 95% CI = 0.56-1.31, < 0.001. Because of heterogeneity [I = 69.6, = 0.002], the continuous random effect model was used.
CONCLUSION
RDW level was significantly higher in women with preeclampsia compared to controls. Similarly, women with severe preeclampsia had significantly higher RDW than those with the mild form.
PubMed: 31338207
DOI: 10.1186/s40885-019-0119-7 -
Journal of Medical Internet Research Jun 2016Mental health problems are highly prevalent, and there is need for the self-management of (mental) health. Ecological momentary interventions (EMIs) can be used to... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Mental health problems are highly prevalent, and there is need for the self-management of (mental) health. Ecological momentary interventions (EMIs) can be used to deliver interventions in the daily life of individuals using mobile devices.
OBJECTIVES
The aim of this study was to systematically assess and meta-analyze the effect of EMI on 3 highly prevalent mental health outcomes (anxiety, depression, and perceived stress) and positive psychological outcomes (eg, acceptance).
METHODS
PsycINFO and Web of Science were searched for relevant publications, and the last search was done in September 2015. Three concepts were used to find publications: (1) mental health, (2) mobile phones, and (3) interventions. A total of 33 studies (using either a within- or between-subject design) including 43 samples that received an EMI were identified (n=1301), and relevant study characteristics were coded using a standardized form. Quality assessment was done with the Cochrane Collaboration tool.
RESULTS
Most of the EMIs focused on a clinical sample, used an active intervention (that offered exercises), and in over half of the studies, additional support by a mental health professional (MHP) was given. The EMI lasted on average 7.48 weeks (SD=6.46), with 2.80 training episodes per day (SD=2.12) and 108.25 total training episodes (SD=123.00). Overall, 27 studies were included in the meta-analysis, and after removing 6 outliers, a medium effect was found on mental health in the within-subject analyses (n=1008), with g=0.57 and 95% CI (0.45-0.70). This effect did not differ as function of outcome type (ie, anxiety, depression, perceived stress, acceptance, relaxation, and quality of life). The only moderator for which the effect varied significantly was additional support by an MHP (MHP-supported EMI, g=0.73, 95% CI: 0.57-0.88; stand-alone EMI, g=0.45, 95% CI: 0.22-0.69; stand-alone EMI with access to care as usual, g=0.38, 95% CI: 0.11-0.64). In the between-subject studies, 13 studies were included, and a small to medium effect was found (g=0.40, 95% CI: 0.22-0.57). Yet, these between-subject analyses were at risk for publication bias and were not suited for moderator analyses. Furthermore, the overall quality of the studies was relatively low.
CONCLUSIONS
Results showed that there was a small to medium effect of EMIs on mental health and positive psychological well-being and that the effect was not different between outcome types. Moreover, the effect was larger with additional support by an MHP. Future randomized controlled trials are needed to further strengthen the results and to determine potential moderator variables. Overall, EMIs offer great potential for providing easy and cost-effective interventions to improve mental health and increase positive psychological well-being.
Topics: Anxiety; Depression; Ecological Momentary Assessment; Humans; Mental Health; Quality of Life; Self Care; Stress, Psychological
PubMed: 27349305
DOI: 10.2196/jmir.5642 -
Neural Computing & Applications 2021Specialized data preparation techniques, ranging from data cleaning, outlier detection, missing value imputation, feature selection (FS), amongst others, are procedures... (Review)
Review
Specialized data preparation techniques, ranging from data cleaning, outlier detection, missing value imputation, feature selection (FS), amongst others, are procedures required to get the most out of data and, consequently, get the optimal performance of predictive models for classification tasks. FS is a vital and indispensable technique that enables the model to perform faster, eliminate noisy data, remove redundancy, reduce overfitting, improve precision and increase generalization on testing data. While conventional FS techniques have been leveraged for classification tasks in the past few decades, they fail to optimally reduce the high dimensionality of the feature space of texts, thus breeding inefficient predictive models. Emerging technologies such as the metaheuristics and hyper-heuristics optimization methods provide a new paradigm for FS due to their efficiency in improving the accuracy of classification, computational demands, storage, as well as functioning seamlessly in solving complex optimization problems with less time. However, little details are known on best practices for case-to-case usage of emerging FS methods. The literature continues to be engulfed with clear and unclear findings in leveraging effective methods, which, if not performed accurately, alters precision, real-world-use feasibility, and the predictive model's overall performance. This paper reviews the present state of FS with respect to metaheuristics and hyper-heuristic methods. Through a systematic literature review of over 200 articles, we set out the most recent findings and trends to enlighten analysts, practitioners and researchers in the field of data analytics seeking clarity in understanding and implementing effective FS optimization methods for improved text classification tasks.
PubMed: 34404964
DOI: 10.1007/s00521-021-06406-8 -
Molecular Psychiatry Apr 2023Neuroinflammatory processes have been hypothesized to play a role in the pathogenesis of psychiatric and neurological diseases. Studies on this topic often rely on... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Neuroinflammatory processes have been hypothesized to play a role in the pathogenesis of psychiatric and neurological diseases. Studies on this topic often rely on analysis of inflammatory biomarkers in peripheral blood. Unfortunately, the extent to which these peripheral markers reflect inflammatory processes in the central nervous system (CNS) is unclear.
METHODS
We performed a systematic review and found 29 studies examining the association between inflammatory marker levels in blood and cerebrospinal (CSF) samples. We performed a random effects meta-analysis of 21 studies (pooled n = 1679 paired samples) that reported the correlation of inflammatory markers in paired blood-CSF samples.
RESULTS
A qualitative review revealed moderate to high quality of included studies with the majority of studies reporting no significant correlation of inflammatory markers between paired blood-CSF. Meta-analyses revealed a significant low pooled correlation between peripheral and CSF biomarkers (r = 0.21). Meta-analyses of individual cytokines revealed a significant pooled correlation for IL-6 (r = 0.26) and TNFα (r = 0.3) after excluding outlier studies, but not for other cytokines. Sensitivity analyses showed that correlations were highest among participants with a median age above 50 (r = 0.46) and among autoimmune disorder patients (r = 0.35).
CONCLUSION
This systematic review and meta-analysis revealed poor correlation between peripheral and central inflammatory markers in paired blood-CSF samples, with increased correlations in certain study populations. Based on the current findings, peripheral inflammatory markers are a poor reflection of the neuroinflammatory profile.
Topics: Humans; Cytokines; Central Nervous System; Biomarkers
PubMed: 37055513
DOI: 10.1038/s41380-023-01976-6 -
Scientific Reports May 2024Our study aimed to estimate the prevalence of total free flap failure following free flap reconstruction for mandibular osteoradionecrosis (mORN) and assess the impact... (Meta-Analysis)
Meta-Analysis
Our study aimed to estimate the prevalence of total free flap failure following free flap reconstruction for mandibular osteoradionecrosis (mORN) and assess the impact of potential moderators on this outcome. A comprehensive systematic literature search was independently conducted by two reviewers using the Medline, Scopus, Web of Science and Cochrane Library databases. Quality assessment of the selected studies was performed, and prevalence estimates with 95% confidence intervals (CI) were calculated. Outlier and influential analyses were conducted, and meta-regression analyses was employed to investigate the effects of continuous variables on the estimated prevalence. Ultimately, forty-six eligible studies (involving 1292 participants and 1344 free flaps) were included in our meta-analysis. The findings of our study revealed a prevalence of 3.1% (95% CI 1.3-5.4%) for total free flap failure after reconstruction for mORN. No study was identified as critically influential, and meta-regression analysis did not pinpoint any potential sources of heterogeneity. These findings provide valuable insights for researchers and serve as a foundation for future investigations into the management of mandibular osteoradionecrosis and the prevention of free flap failure in this context.
Topics: Humans; Osteoradionecrosis; Free Tissue Flaps; Prevalence; Plastic Surgery Procedures; Mandibular Diseases; Mandibular Reconstruction; Mandible
PubMed: 38750124
DOI: 10.1038/s41598-024-61862-1 -
The American Journal of Clinical... Feb 2016There is no consensus with regard to which charts are most suitable for monitoring the postnatal growth of preterm infants. (Review)
Review
BACKGROUND
There is no consensus with regard to which charts are most suitable for monitoring the postnatal growth of preterm infants.
OBJECTIVE
We aimed to assess the strategies used to develop existing postnatal growth charts for preterm infants and their methodologic quality.
DESIGN
A systematic review of observational longitudinal studies, having as their primary objective the creation of postnatal growth charts for preterm infants, was conducted. Thirty-eight items distributed in 3 methodologic domains ("study design," "statistical methods," and "reporting methods") were assessed in each study. Each item was scored as a "low" or "high" risk of bias. Two reviewers independently selected the studies, assessed the risk of bias, and extracted data. A total quality score [(number of "low risk" of bias marks/total number of items assessed) × 100%] was calculated for each study. Median (range, IQR) quality scores for each methodologic domain and for all included studies were computed.
RESULTS
Sixty-one studies met the inclusion criteria. Twenty-seven (44.3%) of the 61 studies scored ≥50%, of which 10 scored >60% and only 1 scored >66%. The median (range, IQR) quality score for the 61 included studies was 47% (26-75%, 34-56%). The scores for the domains study design, statistical methods, and reporting methods were 44% (19-67%, 33-52%), 25% (0-88%, 13-38%), and 33% (0-100%, 0-33%), respectively. The most common shortcomings were observed in items related to anthropometric measures (the main variable of interest), gestational age estimation, follow-up duration, reporting of postnatal care and morbidities, assessment of outliers, covariates, and chart presentation.
CONCLUSIONS
The overall methodologic quality of existing longitudinal studies was fair to low. To overcome these problems, the Preterm Postnatal Follow-up Study, 1 of the 3 main components of The International Fetal and Newborn Growth Consortium for the 21st Century Project, was designed to construct preterm postnatal growth standards from a prospective cohort of "healthy" pregnancies and preterm newborns without evidence of fetal growth restriction.
Topics: Child Development; Female; Fetal Growth Retardation; Growth Charts; Growth Disorders; Humans; Infant Nutritional Physiological Phenomena; Infant, Newborn; Male; Precision Medicine; Pregnancy; Premature Birth; Ultrasonography, Prenatal
PubMed: 26791186
DOI: 10.3945/ajcn.114.106310 -
Journal of Orthopaedic Surgery and... Sep 2017Quadriceps-sparing (QS) approach is considered to be the most minimally invasive surgery for total knee arthroplasty (TKA). We perform this meta-analysis to evaluate... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Quadriceps-sparing (QS) approach is considered to be the most minimally invasive surgery for total knee arthroplasty (TKA). We perform this meta-analysis to evaluate whether malalignment and malposition are more biased towards the QS approach compared to the traditional medial parapatellar (MP) approach, which is still controversial.
METHODS
According to the PRISMA guidelines, a comprehensive search was conducted in the databases of PubMed, the Cochrane library, and Embase. Relevant measures were extracted independently by two investigators.
RESULTS
Five randomized controlled trials (RCTs) and eight retrospective studies including a total of 1261 cases were identified. The QS approach was associated with more outliers of hip-knee-ankle (HKA) angle (p = 0.03), coronal tibial component angle (p = 0.03), and femoral notch (p = 0.05). However, the differences of the outlier of the coronal femoral component angle between the two groups were not statistically significant.
CONCLUSIONS
This meta-analysis indicates that the QS approach is related to the high risk of malalignment and malposition. However, different studies reported different indicators resulting in small samples for analyzing the radiological outcomes. In addition, both of the relatively long learning curve and the present instruments might increase the risk of malalignment and malposition of the QS approach, which needs further study and improvement.
Topics: Arthroplasty, Replacement, Knee; Bone Malalignment; Humans
PubMed: 28874195
DOI: 10.1186/s13018-017-0627-7 -
Scientific Reports Jul 2023Blood pressure (BP) reactivity to stress is associated with cardiovascular events and the incidence of hypertension, therefore, tolerance to stressors is important for... (Meta-Analysis)
Meta-Analysis
Blood pressure (BP) reactivity to stress is associated with cardiovascular events and the incidence of hypertension, therefore, tolerance to stressors is important for better management of cardiovascular risks. Exercise training is among the strategies that have been investigated as blunting the peak response to stressors, however, its efficacy is poorly explored. The aim was to explore the effects of exercise training (at least four weeks) on BP responses to stressor tasks in adults. A systematic review was performed in five electronic databases (MEDLINE, LILACS, EMBASE, SPORTDiscus, and PsycInfo). Twenty-three studies and one conference abstract was included in the qualitative analysis, totaling 1121 individuals, and k = 17 and 695 individuals in the meta-analysis. Favorable results (random-effects) for exercise training were found, with attenuated peak responses in systolic (standardized mean difference (SMD) = -0.34 [-0.56; -0.11], representing average reductions of 2.5 ± 3.6 mmHg) and null effects on diastolic BP (SMD = -0.20 [-0.54; 0.14], representing average reductions of 2.0 ± 3.5 mmHg). The analysis removing outliers' studies improved the effects for diastolic (SMD = -0.21 [-0.38; -0.05]) but not systolic BP (SMD = -0.33 [-0.53; -0.13]). In conclusion, exercise training seems to lower stress-related BP reactivity, therefore has the potential to improve patients' ability to better respond to stressful situations.
Topics: Adult; Humans; Blood Pressure; Exercise; Hypertension
PubMed: 37414810
DOI: 10.1038/s41598-023-38041-9