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Journal of the American Academy of... Jul 2024To evaluate the reporting of race/ethnicity data in randomized controlled trials (RCTs) of attention-deficit/hyperactivity disorder (ADHD) medications. Secondary... (Meta-Analysis)
Meta-Analysis
Systematic Review and Meta-Analysis: Reporting and Representation of Race/Ethnicity in 310 Randomized Controlled Trials of Attention-Deficit/Hyperactivity Disorder Medications.
OBJECTIVE
To evaluate the reporting of race/ethnicity data in randomized controlled trials (RCTs) of attention-deficit/hyperactivity disorder (ADHD) medications. Secondary objectives were to estimate temporal trends in the reporting, and to compare the pooled prevalence of racial/ethnic groups in RCTs conducted in the US to national estimates.
METHOD
We drew on, adapted, and updated the search of a network meta-analysis by Cortese et al. (2018) up to March 2022. We calculated the percentage of RCTs reporting data on race/ethnicity of participants in the published article or in related unpublished material. Temporal trends were estimated with logistic regression. The pooled prevalence of each racial/ethnic group across US RCTs was calculated using random-effects model meta-analyses.
RESULTS
We retained 310 RCTs (including 44,447 participants), of which 231 were conducted in children/adolescents, 78 in adults, and 1 in both. Data on race/ethnicity were reported in 59.3% of the RCTs (75% of which were conducted in children/adolescents and 25% in adults) in the published article, and in unpublished material in an additional 8.7% of the RCTs. Reporting improved over time. In the US RCTs, Asian and White individuals were under- and overrepresented, respectively, compared to national estimates in the most recent time period considered.
CONCLUSION
More than 30% of the RCTs of ADHD medications retained in this review did not include data on race/ethnicity in their published or unpublished reports, and more than 40% in their published articles, even though reporting improved over time. Results should inform investigators, authors, editors, regulators, and study participants in relation to efforts to tackle inequalities in ADHD research.
PLAIN LANGUAGE SUMMARY
A systematic review of 310 randomized controlled trials for attention-deficit/hyperactivity disorder (ADHD) medications found that race/ethnicity were reported in only 30% of trials. Compared to national estimates, Asian individuals were underrepresented and non-Hispanic Whites individuals were overrepresented, drawing attention to the inequities in participation in ADHD research.
DIVERSITY & INCLUSION STATEMENT
One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote sex and gender balance in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.
STUDY PREREGISTRATION INFORMATION
Reporting and representation of race/ethnicity in double blind randomised controlled trials of medications for ADHD; https://osf.io/; hfgz8.
Topics: Humans; Attention Deficit Disorder with Hyperactivity; Randomized Controlled Trials as Topic; Child; Adolescent; United States; Adult; Ethnicity
PubMed: 37890665
DOI: 10.1016/j.jaac.2023.09.544 -
Disability and Rehabilitation.... Nov 2023Exoskeleton can assist individuals with spinal cord injuries (SCI) with simple movements and transform their lives by enhancing strength and mobility. Nonetheless, the... (Review)
Review
PURPOSE
Exoskeleton can assist individuals with spinal cord injuries (SCI) with simple movements and transform their lives by enhancing strength and mobility. Nonetheless, the current utilization outside of rehabilitation contexts is limited. To promote the widespread adoption of exoskeletons, it is crucial to consider the acceptance of these devices for both rehabilitation and functional purposes. This systematic review aims to identify the barriers or facilitators of the use of lower limbs exoskeletons, thereby providing strategies to improve interventions and increase the adoption of these devices.
METHODS
A comprehensive search was conducted in EMBASE, Web of Science, Scopus, Cochrane, and PubMed. Studies reporting barriers and facilitators of exoskeleton use were included. The studies' quality was assessed using the Mixed Methods Appraisal Tool and undertook a thematic content analysis for papers examining the barriers and facilitators.
RESULTS
Fifteen articles met the inclusion criteria. These revealed various factors that impact the utilization of exoskeletons. Factors like age, engagement in an active lifestyle, and motivation were identified as facilitators, while fear of falling and unfulfilled expectations were recognized as barriers. Physical aspects such as fatigue, neuropathic discomfort, and specific health conditions were found to be barriers.
CONCLUSION
This systematic review provides a comprehensive overview of the barriers and facilitators to the use of exoskeleton technology. There are therefore still challenges to be faced, efforts must be made to improve its design, functionality, and accessibility. By addressing these barriers, exoskeletons can significantly improve the quality of life of people with SCI.
PubMed: 38009458
DOI: 10.1080/17483107.2023.2287153 -
Diagnostics (Basel, Switzerland) Aug 2023Deep learning (DL), often called artificial intelligence (AI), has been increasingly used in Pathology thanks to the use of scanners to digitize slides which allow us to... (Review)
Review
Deep learning (DL), often called artificial intelligence (AI), has been increasingly used in Pathology thanks to the use of scanners to digitize slides which allow us to visualize them on monitors and process them with AI algorithms. Many articles have focused on DL applied to prostate cancer (PCa). This systematic review explains the DL applications and their performances for PCa in digital pathology. Article research was performed using PubMed and Embase to collect relevant articles. A Risk of Bias (RoB) was assessed with an adaptation of the QUADAS-2 tool. Out of the 77 included studies, eight focused on pre-processing tasks such as quality assessment or staining normalization. Most articles ( = 53) focused on diagnosis tasks like cancer detection or Gleason grading. Fifteen articles focused on prediction tasks, such as recurrence prediction or genomic correlations. Best performances were reached for cancer detection with an Area Under the Curve (AUC) up to 0.99 with algorithms already available for routine diagnosis. A few biases outlined by the RoB analysis are often found in these articles, such as the lack of external validation. This review was registered on PROSPERO under CRD42023418661.
PubMed: 37627935
DOI: 10.3390/diagnostics13162676 -
Annals of Epidemiology Sep 2023To complement conventional testing methods for severe acute respiratory syndrome coronavirus type 2 infections, dogs' olfactory capability for true real-time detection... (Review)
Review
PURPOSE
To complement conventional testing methods for severe acute respiratory syndrome coronavirus type 2 infections, dogs' olfactory capability for true real-time detection has been investigated worldwide. Diseases produce specific scents in affected individuals via volatile organic compounds. This systematic review evaluates the current evidence for canine olfaction as a reliable coronavirus disease 2019 screening tool.
METHODS
Two independent study quality assessment tools were used: the QUADAS-2 tool for the evaluation of laboratory tests' diagnostic accuracy, designed for systematic reviews, and a general evaluation tool for canine detection studies, adapted to medical detection. Various study design, sample, dog, and olfactory training features were considered as potential confounding factors.
RESULTS
Twenty-seven studies from 15 countries were evaluated. Respectively, four and six studies had a low risk of bias and high quality: the four QUADAS-2 nonbiased studies resulted in ranges of 81%-97% sensitivity and 91%-100% specificity. The six high-quality studies, according to the general evaluation system, revealed ranges of 82%-97% sensitivity and 83%-100% specificity. The other studies contained high bias risks and applicability and/or quality concerns.
CONCLUSIONS
Standardization and certification procedures as used for canine explosives detection are needed for medical detection dogs for the optimal and structured usage of their undoubtful potential.
Topics: Animals; Dogs; Humans; COVID-19; SARS-CoV-2; Sensitivity and Specificity; Smell; Systematic Reviews as Topic
PubMed: 37209927
DOI: 10.1016/j.annepidem.2023.05.002 -
BMC Pediatrics Dec 2023Children with Autism spectrum disorder (ASD) was frequently experienced dental anxiety and uncooperative behaviors during dental treatment. Oral health care was...
BACKGROUND
Children with Autism spectrum disorder (ASD) was frequently experienced dental anxiety and uncooperative behaviors during dental treatment. Oral health care was necessary because of the poor oral hygiene and prevalent dental diseases in this population.
AIM
In this systematic review, we evaluated the effectiveness and feasibility for pediatric dentist to manage the dental anxiety in children with ASD.
DESIGN
PubMed, Embase, and Cochrane Library were systematically performed on the literature search. The date of eligible publications was from inception to January 2023. After that, the quality of eligible studies was assessed by the Newcastle Ottawa Scale (NOS). Review findings were summarized using the PRISMA Statement for reporting.
RESULTS
A total of six studies were systematically evaluated according to the inclusion and exclusion criteria. Five studies were conducted to evaluate ASD Children's anxiety and uncooperative performance in the progressive oral examination, oral disease prophylaxis and fluoride application. The other one study evaluated the success rate of treatment in decayed permanent tooth treatment. In the included studies, four studies indicated that it was extremely necessary to reduce dental anxiety of ASD children to increase the cooperation in sensory-adapted dental environment (SADE).
CONCLUSION
It is not always effective and feasible for pediatric dentist to manage the dental anxiety in children with autism during routine oral examination. Meanwhile, it is necessary for ASD children to conduct preoperative psychological assessment, to investigate parents' expectations and cooperation, and to determine whether to start corresponding dental treatment.
Topics: Humans; Child; Autism Spectrum Disorder; Dental Anxiety; Oral Health; Delivery of Health Care; Autistic Disorder
PubMed: 38049774
DOI: 10.1186/s12887-023-04439-7 -
Psychiatria Danubina Dec 2023Children with disabilities (CWDs) are often excluded from scientific research, but no precise data are available on their participation in Clinical Trials. The aim of... (Review)
Review
BACKGROUND
Children with disabilities (CWDs) are often excluded from scientific research, but no precise data are available on their participation in Clinical Trials. The aim of this study was to evaluate the rates of exclusion of CWDs from recent medical research.
SUBJECTS AND METHODS
The protocol of the study was designed according to Prisma-ScR guidelines. All completed interventional Clinical Trials registered on Clinicaltrials.gov between 2010 and 2020 related to the Leading 10 Level 3 causes of global Disability-adjusted life years (DALYs) for both sexes combined for all ages of the updated Global Burden of Disease Study 2019 were analysed. The exclusion criteria were considered explicit if related to the following categories: disability, physical impairment, cognitive impairment, behavioural or psychiatric disorders, language and communication impairment, sensory impairment. Any generic or poorly specified exclusion criteria or statements that left wide discretion to researchers were considered "implicit exclusion criteria". We assessed the appropriateness of explicit exclusion criteria in relation to the primary objectives of the trials and labelled them as "absolute", "relative", or "questionable".
RESULTS
The trials selected according to the inclusion criteria of the scoping review were 328; 166 (50.6%) were pediatric-only studies, and 162 (49.4%) trials comprising subjects of all ages. Explicit exclusion criteria were found in 82 trials (25%) and the disability category most frequently excluded was "Behavioural or psychiatric disorders" present in 46 trials (56.1%). Explicit exclusion criteria were considered "relative" in over 90% of the selected studies. Implicit exclusion criteria were present in 153 trials (46.6%) and the number and percentage of studies with at least one explicit or implicit exclusion criterion were 193 and 58.8% respectively.
CONCLUSIONS
This study highlights a high rate of exclusion of CWDs from medical research and the need for an inclusive approach that comprises the study design and any necessary adaptations for specific needs.
Topics: Male; Female; Humans; Child; Disabled Children; Biomedical Research; Cognitive Dysfunction; Research Design
PubMed: 37994056
DOI: No ID Found -
BMC Medical Research Methodology Sep 2023Trial design plays a key role in clinical trials. Traditional group sequential design has been used in cardiovascular clinical trials over decades as the trials can...
BACKGROUND
Trial design plays a key role in clinical trials. Traditional group sequential design has been used in cardiovascular clinical trials over decades as the trials can potentially be stopped early, therefore, it can reduce pre-planned sample size and trial resources. In contrast, trials with adoptive designs provide greater flexibility and are more efficient due to the ability to modify trial design according to the interim analysis results. In this systematic review, we aim to explore characteristics of adaptive and traditional group sequential trials in practice and to gain an understanding how these trial designs are currently being reported in cardiology.
METHODS
PubMed, Embase and Cochrane Central Register of Controlled Trials database were searched from January 1980 to June 2022. Randomised controlled phase 2/3 trials with either adaptive or traditional group sequential design in patients with cardiovascular disease were included. Descriptive statistics were used to present the collected data.
RESULTS
Of 456 articles found in the initial search, 56 were identified including 43 (76.8%) trials with traditional group sequential design and 13 (23.2%) with adaptive. Most trials were large, multicentre, led by the USA (50%) and Europe (28.6%), and were funded by companies (78.6%). For trials with group sequential design, frequency of interim analyses was determined mainly by the number of events (47%). 67% of the trials stopped early, in which 14 (32.6%) were due to efficacy, and 5 (11.6%) for futility. The commonly used stopping rule to terminate trials was O'Brien- Fleming-type alpha spending function (10 (23.3%)). For trials with adaptive designs, 54% of the trials stopped early, in which 4 (30.8%) were due to futility, and 2 (15.4%) for efficacy. Sample size re-estimation was commonly used (8 (61.5%)). In 69% of the trials, simulation including Bayesian approach was used to define the statistical stopping rules. The adaptive designs have been increasingly used (from 0 to 1999 to 38.6% after 2015 amongst adaptive trials). 25% of the trials reported "adaptive" in abstract or title of the studies.
CONCLUSIONS
The application of adaptive trials is increasingly popular in cardiovascular clinical trials. The reporting of adaptive design needs improving.
Topics: Humans; Bayes Theorem; Cardiovascular Diseases; Computer Simulation; Data Collection; Death; Clinical Trials, Phase II as Topic; Randomized Controlled Trials as Topic
PubMed: 37679710
DOI: 10.1186/s12874-023-02024-1 -
International Journal of Environmental... Oct 2023Work-family conflict is a prominent issue, especially in our society, where people are expected to fulfil many roles simultaneously. Work and family life demands... (Review)
Review
Work-family conflict is a prominent issue, especially in our society, where people are expected to fulfil many roles simultaneously. Work and family life demands significantly impact an individual's overall well-being, especially for women, since they typically balance caregiving for children and elderly relatives with careers. Therefore, highlighting which factors might protect women from experiencing work-family conflict is essential to enhance women's and their family's well-being. Thus, the main aim of the present study was to systematically review previous research on women's coping strategies and protective factors which can reduce the negative effects of work-family conflict. Following the PRISMA guidelines, we conducted a literature search of three databases (PubMed, PsycINFO, and Scopus). After the screening and the eligibility phases, we included a final set of 13 studies. Most of these studies adopted a cross-sectional design (N = 10), and a few adopted a longitudinal one (N = 3). Results highlighted the role of different personal (e.g., hardiness, self-esteem, locus of control) and relational factors (e.g., family and work support) that significantly reduce the negative effects of work-family conflict in women's lives. Findings, practical implications, and future research directions are discussed.
Topics: Child; Humans; Female; Aged; Family Conflict; Protective Factors; Cross-Sectional Studies; Adaptation, Psychological; Family Relations
PubMed: 37947550
DOI: 10.3390/ijerph20216992 -
Sensors (Basel, Switzerland) Apr 2024Reinforcement learning (RL) has emerged as a dynamic and transformative paradigm in artificial intelligence, offering the promise of intelligent decision-making in... (Review)
Review
Reinforcement learning (RL) has emerged as a dynamic and transformative paradigm in artificial intelligence, offering the promise of intelligent decision-making in complex and dynamic environments. This unique feature enables RL to address sequential decision-making problems with simultaneous sampling, evaluation, and feedback. As a result, RL techniques have become suitable candidates for developing powerful solutions in various domains. In this study, we present a comprehensive and systematic review of RL algorithms and applications. This review commences with an exploration of the foundations of RL and proceeds to examine each algorithm in detail, concluding with a comparative analysis of RL algorithms based on several criteria. This review then extends to two key applications of RL: robotics and healthcare. In robotics manipulation, RL enhances precision and adaptability in tasks such as object grasping and autonomous learning. In healthcare, this review turns its focus to the realm of cell growth problems, clarifying how RL has provided a data-driven approach for optimizing the growth of cell cultures and the development of therapeutic solutions. This review offers a comprehensive overview, shedding light on the evolving landscape of RL and its potential in two diverse yet interconnected fields.
Topics: Robotics; Humans; Algorithms; Artificial Intelligence; Delivery of Health Care; Machine Learning
PubMed: 38676080
DOI: 10.3390/s24082461 -
Patient Education and Counseling Sep 2023Children and adolescents are highly affected by their parents` cancer disease. This review aims to summarize peer-group interventions for children and adolescents of... (Review)
Review
OBJECTIVE
Children and adolescents are highly affected by their parents` cancer disease. This review aims to summarize peer-group interventions for children and adolescents of cancer patients, where those affected have the opportunity to exchange and normalize their feelings among equals.
METHODS
A systematic review searching four different databases (MEDLINE, PsycInfo, CINAHL and Web of Science) was conducted. We included studies investigating psychosocial peer-group interventions for offspring of cancer patients. A narrative synthesis summarised the characteristics of the interventions and the findings on effects and evaluation.
RESULTS
Ten articles on seven different peer-group interventions were analysed. Research designs and intervention concepts were heterogeneous. Overall, high acceptance, feasibility and positive effects of peer-group support were reported. Significant effects were found in six studies, e.g. in relation to psychological well-being, quality of life and coping skills.
CONCLUSION
Peer-group interventions are an accepted and helpful form of support. Providing children and adolescents of cancer patients for example with psychoeducation, community and coping strategies, thereby impacting on psychological well-being.
PRACTICE IMPLICATIONS
For comprehensive care, it seems to be important to offer support throughout the parent's cancer journey and to offer support flexibly as needed through group services as well as individual sessions.
Topics: Humans; Child; Adolescent; Quality of Life; Parents; Emotions; Adaptation, Psychological; Neoplasms
PubMed: 37331281
DOI: 10.1016/j.pec.2023.107844