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British Journal of Anaesthesia Mar 2023Network meta-analyses (NMAs) combine direct and indirect estimates to provide mixed (or network) estimates of effect sizes. The scientific rigour of the conduct and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Network meta-analyses (NMAs) combine direct and indirect estimates to provide mixed (or network) estimates of effect sizes. The scientific rigour of the conduct and reporting of anaesthesia NMAs is unknown. This review assessed the epidemiological, methodological, and statistical characteristics of anaesthesia NMAs.
METHODS
We searched four databases for anaesthesia NMAs and developed a 64-item checklist to evaluate NMAs. For 29 binary items, we defined compliance as 'the ratio of NMAs that was awarded a 'yes' for that item, divided by the total number of NMAs. The compliance of such binary items was reclassified as very low (≤25%), low (26-50%), fair (51-75%), and high (>75%). We amalgamated findings from 29 key items to provide specific recommendations (post hoc). We compared the compliance of NMAs in anaesthesia across 26 items, with that of cancer NMAs and Cochrane NMAs, and analysed improvement over time (post hoc).
RESULTS
Among 62 included NMAs, compliance was low (26-50%) for protocol registration, use of PRISMA-NMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses for NMA), publication bias assessment, evidence appraisal, reporting of Bayesian methodology and consistency evaluation. Compliance was very low (≤25%) for bias assessment, biostatistician involvement, search specialist, and use of predefined important differences.
CONCLUSIONS
Anaesthesia NMAs need improvement in their conduct and reporting. Anaesthesia journals should mandate the registration of protocols and reporting of NMAs using PRISMA-NMA. Authors should carefully assess publication bias, and use updated bias assessment tools, and evidence appraisal methods designed for NMAs.
SYSTEMATIC REVIEW PROTOCOL
PROSPERO CRD42021227608.
Topics: Humans; Anesthesia; Anesthesiology; Bayes Theorem; Checklist; Network Meta-Analysis
PubMed: 36404140
DOI: 10.1016/j.bja.2022.08.042 -
Medical Science Monitor : International... Aug 2021Subjective narrative review articles have an educational and informative role in medical and scientific journals. Systematic review of the literature requires an...
Editorial: Review Articles, Systematic Reviews, Meta-Analysis, and the Updated Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 Guidelines.
Subjective narrative review articles have an educational and informative role in medical and scientific journals. Systematic review of the literature requires an objective and complete review of all available publications on an identified topic. Systematic review that undergoes meta-analysis aims to provide a complete and objective evaluation of all the published data. Data from systematic review and meta-analysis publications support evidence-based medical practice and are prepared as original research articles. These studies require a clear aim and detailed planning with registration and approval of the study protocol before the study commences. Systematic review and meta-analysis studies are designed, conducted, and reported according to mandatory guidelines. The number of these publications has continued to rise during the past decade. However, concerns with the quality of the studies have resulted in more stringent study guidelines. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, guidelines, reporting checklist, and study flow diagram from 2009 were updated and published in March 2021 as PRISMA 2020. The Editorial aims to present the roles and requirements of subjective narrative review articles, systematic review of the literature, and systematic review and meta-analysis, and introduces the revisions and aims of the PRISMA 2020 guidelines.
Topics: Guidelines as Topic; Humans; Meta-Analysis as Topic; Review Literature as Topic
PubMed: 34421116
DOI: 10.12659/MSM.934475 -
Brain, Behavior, and Immunity Jul 2023Psychological interventions are viable, cost-effective strategies for improving clinical and psychological impact of inflammation-related conditions. However, their... (Meta-Analysis)
Meta-Analysis Review
Psychological interventions are viable, cost-effective strategies for improving clinical and psychological impact of inflammation-related conditions. However, their efficacy on immune system function remains controversial. We performed a systematic review and frequentist random-effects network meta-analysis of randomised controlled trials (RCTs) assessing the effects of psychological interventions, against a control condition, on biomarkers of innate and adaptive immunity in adults. PubMed, Scopus, PsycInfo, and Web of Science were searched from inception up to Oct 17, 2022. Cohen's d at 95% confidence interval (CI) was calculated to assess the effect sizes of each class of intervention against active control conditions at post-treatment. The study was registered in PROSPERO (CRD42022325508). Of the 5024 articles retrieved, we included 104 RCTs reporting on 7820 participants. Analyses were based on 13 types of clinical interventions. Compared with the control conditions, cognitive therapy (d = - 0.95, 95% CI: -1.64 to - 0.27), lifestyle (d = - 0.51, 95% CI: -0.99 to - 0.02), and mindfulness-based (d = - 0.38, 95% CI: -0.66 to - 0.09) interventions were associated with post-treatment reduction of proinflammatory cytokines and markers. Mindfulness-based interventions were also significantly associated with post-treatment increase in anti-inflammatory cytokines (d = 0.69, 95% CI: 0.09 to 1.30), while cognitive therapy was associated also with post-treatment increase in white blood cell count (d = 1.89, 95% CI: 0.05 to 3.74). Results on natural killer cells activity were non-significant. Grade of evidence was moderate for mindfulness and low-to-moderate for cognitive therapy and lifestyle interventions; however, substantial overall heterogeneity was detected in most of the analyses.
Topics: Adult; Humans; Psychosocial Intervention; Network Meta-Analysis; Cognitive Behavioral Therapy; Cytokines; Biomarkers
PubMed: 37187256
DOI: 10.1016/j.bbi.2023.05.006 -
Journal of Affective Disorders Aug 2023Over the past 16 years, we have developed a 'Meta-analytic Research Domain' (MARD) of all randomized trials of psychological treatments of depression. A MARD is a... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Over the past 16 years, we have developed a 'Meta-analytic Research Domain' (MARD) of all randomized trials of psychological treatments of depression. A MARD is a living systematic review of a research field, that cannot be otherwise covered by one (network) meta-analysis and includes multiple PICOs. In this paper we give an overview of the findings of this MARD.
METHODS
A narrative review of the results of the 118 meta-analyses on psychotherapies for depression that were published within our MARD.
RESULTS
Most research has been conducted on cognitive-behavioral therapy (CBT), but several other psychotherapies are also effective, with few differences between therapies. They can be effectively delivered in individual, group, telephone and guided self-help format and are effective in many different target groups and across different age groups, although the effects are significantly smaller in children and adolescents. Psychotherapies have comparable effects as pharmacotherapy at the short term but are probably more effective at the longer term. Combined treatment is more effective than either psychotherapy or pharmacotherapy alone at the short, but also at the longer term.
LIMITATIONS
We did not summarize all published meta-analyses (protocols, methodological studies) and have not compared our results to those found in other meta-analyses on comparable subjects.
CONCLUSION
Psychotherapies can contribute considerably to a reduction of the disease burden of depression. MARDs are an important next step in the aggregation of knowledge from randomized controlled trials in psychological treatments of depression as well as in other healthcare sectors.
Topics: Child; Adolescent; Humans; Depression; Psychotherapy; Cognitive Behavioral Therapy; Combined Modality Therapy; Network Meta-Analysis
PubMed: 37178828
DOI: 10.1016/j.jad.2023.05.011 -
International Journal of Environmental... Jun 2022This paper reviews and summarises the evidence of short-term psychosocial interventions (up to 12 sessions delivered within less than eight weeks) on anxiety,... (Meta-Analysis)
Meta-Analysis Review
This paper reviews and summarises the evidence of short-term psychosocial interventions (up to 12 sessions delivered within less than eight weeks) on anxiety, depression, and emotional distress in palliative patients in inpatient settings. We screened publications from the following five databases, Embase, PubMed, PsycINFO, Web of Science, and CINAHL, from their inception to 10 September 2021. The eligible studies included controls receiving standard palliative care, actively treated controls, and wait-list controls. Nine studies met the eligibility criteria and reported the effects of five psychosocial interventions in a total of = 543 patients. We followed PRISMA-guidelines for outcome reporting and the Cochrane Risk of Bias Assessment Tool for assessing study quality. This paper used the network meta-analysis to compare multiple treatments by providing greater statistical power and the cross-validation of observed treatment effects, using the R package BUGSnet. Compared to control groups, the following psychosocial interventions in inpatient settings showed to be superior: life review interventions were the best ranked treatment for improving anxiety and distress, while the top ranked treatment for reducing depression was outlook intervention. The short-term psychosocial interventions investigated in this meta-analysis, especially life review intervention, are feasible and can potentially improve anxiety, depression, and distress in palliative inpatients and should therefore be offered in inpatient settings.
Topics: Bayes Theorem; Humans; Inpatients; Network Meta-Analysis; Palliative Care; Psychosocial Intervention; Psychotherapy
PubMed: 35805365
DOI: 10.3390/ijerph19137711 -
The Bone & Joint Journal Oct 2018The aims of this systematic review were to describe the quantity and methodological quality of meta-analyses in orthopaedic surgery published during the last 17 years. (Review)
Review
AIMS
The aims of this systematic review were to describe the quantity and methodological quality of meta-analyses in orthopaedic surgery published during the last 17 years.
MATERIALS AND METHODS
MEDLINE, EMBASE, and PubMed, between 1 January 2000 and 31 December 2016, were searched for meta-analyses in orthopaedic surgery dealing with at least one surgical intervention. Meta-analyses were included if the interventions involved a human muscle, ligament, bone or joint.
RESULTS
A total of 392 meta-analyses met eligibility criteria, for which the mean AMSTAR quality score was 7.1/11. There was a positive correlation between the year of publication and the quality of the meta-analysis (r = 0.238, p < 0.001). Between 2000 and 2011, the mean AMSTAR score corresponded to that of a medium quality review. However, between 2012 and 2016, the mean scores have been consistently equivalent to those of a high-quality review. The number of meta-analyses published increased 10-fold between 2005 and 2014.
CONCLUSION
The quantity and quality of meta-analyses in orthopaedic surgery which have been published has increased, reaching a plateau in 2012. Methodological flaws remain to be addressed in future meta-analyses in order to continue increasing the quality of the orthopaedic literature. Cite this article: Bone Joint J 2018;100-B:1270-4.
Topics: Humans; Meta-Analysis as Topic; Orthopedic Procedures
PubMed: 30295532
DOI: 10.1302/0301-620X.100B10.BJJ-2017-1142.R2 -
Systematic Reviews Mar 2023There is evidence that antipsychotic drugs differ in their effect on the cognitive symptoms of schizophrenia. So far, there is no comprehensive systematic review...
BACKGROUND
There is evidence that antipsychotic drugs differ in their effect on the cognitive symptoms of schizophrenia. So far, there is no comprehensive systematic review available that would enable providers and patients to make informed choices regarding this important aspect of treatment. With a large number of substances available, conventional pairwise meta-analyses will not be sufficient to inform this choice. To fill this gap, we will conduct a network meta-analysis (NMA), integrating direct and indirect comparisons from randomized controlled trials (RCTs) to rank antipsychotics according to their effect on cognitive functioning.
METHODS
In our NMA, we will include RCTs in patients with schizophrenia or schizophrenia-like psychoses comparing one antipsychotic agent with another antipsychotic agent or placebo that measures cognitive function. We will include studies on patients of every age group, in any phase of illness (e.g., acute or stable, first episode or chronic schizophrenia, in- or outpatients) with an intervention time of at least 3 weeks. The primary outcome will be the composite score of cognitive functioning, preferentially measured with the test battery developed by the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative. The secondary outcomes include the seven cognitive domains that the composite score is composed of, as well as functioning and quality of life. Study selection and data extraction will be conducted by at least two independent reviewers. We will use the Cochrane Risk of Bias tool 2 to determine the risk of bias in studies, and we will evaluate the confidence in the results using Confidence in Network Meta-Analysis (CINeMA). We will perform NMA using R (package netmeta). We will conduct subgroup and sensitivity analyses to explore the heterogeneity and assess the robustness of our findings.
DISCUSSION
This systematic review and network meta-analysis aims to inform evidence-based antipsychotic treatment choice for cognitive deficits in schizophrenia patients by analyzing existing RCTs on this subject. The results have the potential to support patients' and physicians' decision-making processes based on the latest available evidence.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42022312483.
Topics: Humans; Infant, Newborn; Antipsychotic Agents; Network Meta-Analysis; Schizophrenia; Cognition; Systematic Reviews as Topic; Meta-Analysis as Topic
PubMed: 36959619
DOI: 10.1186/s13643-023-02213-5 -
PLoS Computational Biology May 2019
Topics: Humans; Meta-Analysis as Topic; Writing
PubMed: 31095553
DOI: 10.1371/journal.pcbi.1006922 -
Nursing Open Sep 2023To investigate the effectiveness of different dressings on pressure injuries and screen the dressings for efficacy. (Meta-Analysis)
Meta-Analysis
AIM
To investigate the effectiveness of different dressings on pressure injuries and screen the dressings for efficacy.
DESIGN
Systematic review and network meta-analysis.
METHODS
Articles published from several electronic databases and other resources were selected. Two reviewers independently selected studies, extracted data and assessed the quality of selected studies.
RESULTS
Twenty-five studies that contained data on moist dressings (hydrocolloidal dressing, foam dressing, silver ion dressing, biological wound dressing, hydrogel dressing, polymeric membrane dressing) and sterile gauze dressings (traditional gauze dressings) were included. All RCTs were at a medium to high risk of bias. Moist dressings were found to be more advantageous than the traditional dressings. Hydrocolloid dressings [RR = 1.38, 95% CI (1.18, 1.60)] showed a higher cure rate than sterile gauze dressing and foam dressings [RR = 1.37, 95% CI (1.16, 1.61)]. Silver ion dressings [RR = l.37, 95% CI (1.08, 1. 73)] showed a higher cure rate than sterile gauze dressings. Sterile gauze dressing dressings [RR = 0.51, 95% CI (0.44, 0.78)] showed a lower cure rate compared with polymeric membrane dressings; whereas Sterile gauze dressing dressings [RR = 0.80, 95% CI (0.47, 1.37)] had a lower cure rate compared to biological wound dressings. Foam and hydrocolloid dressings were associated with the least healing time. Few dressing changes were required for moist dressings.
Topics: Humans; Bandages, Hydrocolloid; Crush Injuries; Network Meta-Analysis; Polymers; Pressure Ulcer; Silver; Wound Healing
PubMed: 37386783
DOI: 10.1002/nop2.1867 -
BMJ Open Sep 2023Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common dose-limiting side effects of chemotherapeutic drugs. Numerous clinical trials of various...
Efficacy and safety of drug therapy for the prevention and treatment of chemotherapy-induced peripheral neuropathy: a protocol for a systematic review and network meta-analysis.
INTRODUCTION
Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common dose-limiting side effects of chemotherapeutic drugs. Numerous clinical trials of various targeted drugs for the prevention or treatment of CIPN have been conducted; however, previous systematic reviews with direct comparisons have failed to demonstrate the efficacy of these drugs in the prevention or treatment of CIPN. In addition, no systematic reviews have indirectly compared CIPN prevention and treatment. This article describes a protocol for evaluating the efficacy and safety of drug therapy for the prevention and treatment of CIPN. The results of the proposed systematic review with network meta-analysis (NMA) will provide new insights into the prevention and treatment of CIPN.
METHODS AND ANALYSIS
We will conduct a literature search in MEDLINE, PubMed, Embase, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov to find relevant articles published through January 2023. We will include studies that investigated the efficacy and safety of vitamin B, goshajinkigan, non-steroidal anti-inflammatory analgesics, opioids, calcium and magnesium, antidepressants and anticonvulsants on CIPN. Two authors will individually screen the retrieved reports and review the full text based on the selection criteria. The primary outcome is the incidence and severity of CIPN. The risk of bias will be assessed using V.2.0 of the Cochrane risk-of-bias tool. We will apply a frequentist random-effects NMA model to pool effect sizes across trials using risk ratios and mean differences with their 95% CIs. Competing interventions will be ranked using the surface under cumulative ranking probabilities. Heterogeneity will be assessed using the heterogeneity variance τ, Cochran's Q test and I² statistic.
ETHICS AND DISSEMINATION
This review does not require ethical approval. The research will be published in a peer-reviewed journal.
PROSPERO REGISTRATION NUMBER
CRD42022371829.
Topics: Humans; Network Meta-Analysis; Systematic Reviews as Topic; Drug-Related Side Effects and Adverse Reactions; Peripheral Nervous System Diseases; Antineoplastic Agents; Meta-Analysis as Topic; Review Literature as Topic
PubMed: 37699621
DOI: 10.1136/bmjopen-2022-070645