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Neuroscience and Biobehavioral Reviews Sep 2023This systematic review summarizes empirical evidence on risky decision-making (objective risk and ambiguity) in specific domains of problematic use of the internet (PUI)... (Meta-Analysis)
Meta-Analysis Review
This systematic review summarizes empirical evidence on risky decision-making (objective risk and ambiguity) in specific domains of problematic use of the internet (PUI) focusing on online addictive behaviors. We conducted a pre-registered (PROSPERO: CRD42020188452) PubMed search for PUI domains: gaming, social-network use, online buying-shopping, online pornography use, and unspecified PUI. We used the Newcastle-Ottawa Scale for quality assessment. Relevant studies were identified only for gaming (n = 19), social-network use (n = 8), unspecified PUI (n = 7), and online gambling (n = 1). The meta-analyses included 25 studies (2498 participants) comparing PUI and control groups regarding decision-making performance under objective risk and ambiguity. Across PUI domains, individuals with PUI compared to control participants showed more disadvantageous decision-making in measures of objective risk (g = -0.42 [-0.69, -0.16], p = .002) but not ambiguity (g = -0.22 [-0.47, -0.04], p = .096). PUI domain and gender were significant moderators. In the risk domain, effects were particularly present in gaming disorder, especially in exclusively male samples. Overall, the paucity of empirical studies in the considered area necessitates further research to identify probable gender- and disorder-specific cognitive relationships.
Topics: Humans; Male; Gambling; Behavior, Addictive; Internet; Video Games
PubMed: 37277009
DOI: 10.1016/j.neubiorev.2023.105271 -
Supportive Care in Cancer : Official... Dec 2023This systematic review updates the MASCC/ESMO recommendations for high-emetic-risk chemotherapy (HEC) published in 2016-2017. HEC still includes cisplatin, carmustine,...
PURPOSE
This systematic review updates the MASCC/ESMO recommendations for high-emetic-risk chemotherapy (HEC) published in 2016-2017. HEC still includes cisplatin, carmustine, dacarbazine, mechlorethamine, streptozocin, and cyclophosphamide in doses of > 1500 mg/m and the combination of cyclophosphamide and an anthracycline (AC) in women with breast cancer.
METHODS
A systematic review report following the PRISMA guidelines of the literature from January 1, 2015, until February 1, 2023, was performed. PubMed (Ovid), Scopus (Google), and the Cochrane Database of Systematic Reviews were searched. The literature search was limited to randomized controlled trials, systematic reviews, and meta-analyses.
RESULTS
Forty-six new references were determined to be relevant. The main topics identified were (1) steroid-sparing regimens, (2) olanzapine-containing regimens, and (3) other issues such as comparisons of antiemetics of the same drug class, intravenous NK receptor antagonists, and potentially new antiemetics. Five updated recommendations are presented.
CONCLUSION
There is no need to prescribe steroids (dexamethasone) beyond day 1 after AC HEC, whereas a 4-day regimen is recommended in non-AC HEC. Olanzapine is now recommended as a fixed part of a four-drug prophylactic antiemetic regimen in both non-AC and AC HEC. No major differences between 5-HT receptor antagonists or between NK receptor antagonists were identified. No new antiemetic agents qualified for inclusion in the updated recommendations.
Topics: Female; Humans; Emetics; Antiemetics; Consensus; Olanzapine; Nausea; Vomiting; Antineoplastic Agents; Cyclophosphamide; Anthracyclines
PubMed: 38127246
DOI: 10.1007/s00520-023-08221-4 -
International Journal of Nursing... Dec 2023Nurses' clinical decision-making, i.e., the data collection, analysis, and evaluation process through which they reach clinical judgements and makes clinical decisions,... (Review)
Review
BACKGROUND
Nurses' clinical decision-making, i.e., the data collection, analysis, and evaluation process through which they reach clinical judgements and makes clinical decisions, is at the core of nursing practice and essential to provide safe and quality care. Instruments to assess nurses' perceptions of their clinical decision-making abilities or skills have been developed for research and education. Thus, it is essential to determine the most valid and reliable instruments available to reflect nurses' self-reported clinical decision-making accurately.
OBJECTIVE
To evaluate the measurement properties of self-reported clinical decision-making instruments in nursing.
METHODS
A systematic review based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) was conducted (PROSPERO registration: CRD42022364549). Five bibliographical databases were searched in July 2022 using descriptors and keywords related to nurses, clinical decision-making, and studies on measurement properties. Two independent reviewers conducted reference selection and data extraction. The evaluation of the instruments' measurement properties involved assessing the quality of the studies, the quality of each measurement property (i.e., validity, reliability, responsiveness), and the quality of evidence based on the COSMIN.
RESULTS
Nine instruments evaluated in eleven studies with registered nurses or nursing students from various clinical contexts were identified. Five of the nine instruments were originals; four were translations or adaptations. Most focused on analytical and intuitive decision-making, although some were based on clinical judgment and clinical reasoning theories. Structural validity and internal consistency were the most frequently reported measurement properties; other properties, such as measurement error, criterion validity, and responsiveness, were not assessed for any instruments. A gap was also identified in the involvement of nurses or nursing students in the instrument development process and the content validity assessment. Six instruments appear promising based on the COSMIN criteria, but further studies are needed to confirm their validity and reliability.
CONCLUSIONS
The evidence regarding instruments to assess nurses' self-reported clinical decision-making is still minimal. Although no instruments could be recommended based on the COSMIN criteria, the Nurses Clinical Reasoning Scale had the most robust supporting evidence, followed by the adapted version of the Clinical Decision Making in Nursing Scale. Future efforts should be made to systematically assess content validity through the involvement of the target population and by ensuring that the results of other measurement properties, such as reliability, measurement error, or hypothesis testing, are rigorously assessed and reported.
TWEETABLE ABSTRACT
Despite limited evidence, this COSMIN review identified six promising instruments to assess nurses' clinical #decision-making, especially the Nurses Clinical Reasoning Scale and an adaptation of the Clinical Decision Making in Nursing Scale. #nursingresearch #nursingeducation.
PubMed: 38746590
DOI: 10.1016/j.ijnsa.2023.100122 -
International Journal of Medical... Dec 2023Motivation and objective: Emergency medicine is becoming a popular application area for artificial intelligence methods but remains less investigated than other... (Review)
Review
UNLABELLED
Motivation and objective: Emergency medicine is becoming a popular application area for artificial intelligence methods but remains less investigated than other healthcare branches. The need for time-sensitive decision-making on the basis of high data volumes makes the use of quantitative technologies inevitable. However, the specifics of healthcare regulations impose strict requirements for such applications. Published contributions cover separate parts of emergency medicine and use disparate data and algorithms. This study aims to systematize the relevant contributions, investigate the main obstacles to artificial intelligence applications in emergency medicine, and propose directions for further studies.
METHODS
The contributions selection process was conducted with systematic electronic databases querying and filtering with respect to established exclusion criteria. Among the 380 papers gathered from IEEE Xplore, ACM Digital Library, Springer Library, ScienceDirect, and Nature databases 116 were considered to be a part of the survey. The main features of the selected papers are the focus on emergency medicine and the use of machine learning or deep learning algorithms.
FINDINGS AND DISCUSSION
The selected papers were classified into two branches: diagnostics-specific and triage-specific. The former ones are focused on either diagnosis prediction or decision support. The latter covers such applications as mortality, outcome, admission prediction, condition severity estimation, and urgent care prediction. The observed contributions are highly specialized within a single disease or medical operation and often use privately collected retrospective data, making them incomparable. These and other issues can be addressed by creating an end-to-end solution based on human-machine interaction.
CONCLUSION
Artificial intelligence applications are finding their place in emergency medicine, while most of the corresponding studies remain isolated and lack higher generalization and more sophisticated methodology, which can be a matter of forthcoming improvements.
Topics: Humans; Artificial Intelligence; Retrospective Studies; Algorithms; Emergency Medicine; Machine Learning
PubMed: 37944275
DOI: 10.1016/j.ijmedinf.2023.105274 -
Journal of Clinical Medicine Nov 2023Childbirth is a remarkable, life-changing process and is frequently regarded as an excruciating, physically and emotionally demanding experience that women endure. Labor... (Review)
Review
Childbirth is a remarkable, life-changing process and is frequently regarded as an excruciating, physically and emotionally demanding experience that women endure. Labor pain management poses a significant challenge for obstetricians and expectant mothers. Although pharmacological pain management is the gold standard, it still imposes risks on the mother and baby. Recently, non-pharmacological pain management (NPPM) has emerged as a safe, effective option. Six databases were searched for articles published up to 2023 using specific related keywords and defined inclusion and exclusion criteria. The extraction and gathering of data was made so as to be categorized into physical, psychological, and complementary NPPM techniques. In light of the enormous development and diversity of NPPM techniques, the present review aims to examine contemporary NPPM knowledge and application, discussing efficacy, advantages, limitations, and potential adverse effects, with a specific focus on women's individual requirements, to strengthen obstetricians' knowledge in guiding decision-making for women in childbirth.
PubMed: 38068274
DOI: 10.3390/jcm12237203 -
Journal of Foot and Ankle Research Sep 2023Surgical resection of Morton's neuroma includes dorsal and plantar approaches. However, there is no consensus on the choice of approach in clinic. The purpose of this... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Surgical resection of Morton's neuroma includes dorsal and plantar approaches. However, there is no consensus on the choice of approach in clinic. The purpose of this study was to conduct a systematic review and meta-analysis to compare the surgical results of dorsal and plantar approaches.
METHODS
The literatures of PubMed, Cochrane library, Embase and Web of Science were searched on April 26th, 2023. A systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The data were extracted after screening the literature and evaluating the quality of the methodology included in the study. The RevMan5.4 software was used to analyze and calculate the OR value and 95% confidence interval.
RESULTS
A total of 7 randomized controlled trials and comparative studies were published, of which only 5 were included. There were 158 feet via plantar approach (plantar group, PG) and 189 via dorsal approach (dorsal group, DG). There was no significant difference between PG and DG in overall adverse events, sensory problems, incision infection and deep vein thrombosis (p > 0.05). In terms of scar problems, PG showed more than DG (OR, 2.90[95%CI, 1.40 to 5.98]; p = 0.004). Other outcome indicators such as visual analogue scale (VAS) scores and American Orthopedic Foot and Ankle Society (AOFAS) scores were difficult to be included in the comparison.
CONCLUSIONS
Based on the relatively low quality and small amount of available evidence, the meta-analysis conducted produces a hypothesis that the frequency of adverse events in surgical treatment of Morton's neuroma, dorsal approach and plantar approach may be the same, but the types are different. More high-level evidence is needed to further verify this hypothesis.
Topics: Humans; Morton Neuroma; Consensus; Lower Extremity; Orthopedics; Software
PubMed: 37674248
DOI: 10.1186/s13047-023-00660-w -
European Journal of Surgical Oncology :... May 2024Clinical decision-making in gastrointestinal surgery is complex due to the unpredictability of tumoral behavior and postoperative complications. Artificial intelligence... (Review)
Review
BACKGROUND
Clinical decision-making in gastrointestinal surgery is complex due to the unpredictability of tumoral behavior and postoperative complications. Artificial intelligence (AI) could aid in clinical decision-making by predicting these surgical outcomes. The current status of AI-based clinical decision-making within gastrointestinal surgery is unknown in recent literature. This review aims to provide an overview of AI models used for clinical decision-making within gastrointestinal surgery.
METHODS
A systematic literature search was performed in databases PubMed, EMBASE, Cochrane, and Web of Science. To be eligible for inclusion, studies needed to use AI models for clinical decision-making involving patients undergoing gastrointestinal surgery. Studies reporting on reviews, children, and study abstracts were excluded. The Probast risk of bias tool was used to evaluate the methodological quality of AI methods.
RESULTS
Out of 1073 studies, 10 articles were eligible for inclusion. AI models have been used to make clinical decisions between surgical procedures, selection of chemotherapy, selection of postoperative follow up programs, and implementation of a temporary ileostomy. Most studies have used a Random Forest or Gradient Boosting model with AUCs up to 0.97. All studies involved a retrospective study design, in which external validation was performed in one study.
CONCLUSIONS
This review shows that AI models have the potentiality to select the most optimal treatments for patients undergoing gastrointestinal surgery. Clinical benefits could be gained if AI models were used for clinical decision-making. However, prospective studies and randomized controlled trials will reveal the definitive role of AI models in clinical decision-making.
PubMed: 38755062
DOI: 10.1016/j.ejso.2024.108385 -
Cureus Dec 2023This article introduces a concise 10-step guide tailored for researchers engaged in systematic reviews within the field of medicine and health, aligning with the...
This article introduces a concise 10-step guide tailored for researchers engaged in systematic reviews within the field of medicine and health, aligning with the imperative for evidence-based healthcare. The guide underscores the importance of integrating research evidence, clinical proficiency, and patient preferences. It emphasizes the need for precision in formulating research questions, utilizing tools such as PICO(S)(Population Intervention Comparator Outcome), PEO (Population Exposure Outcome), SPICE (setting, perspective, intervention/exposure/interest, comparison, and evaluation), and SPIDER (expectation, client group, location, impact, professionals, service and evaluation), and advocates for the validation of research ideas through preliminary investigations. The guide prioritizes transparency by recommending the documentation and registration of protocols on various platforms. It highlights the significance of a well-organized literature search, encouraging the involvement of experts to ensure a high-quality search strategy. The critical stages of screening titles and abstracts are navigated using different tools, each characterized by its specific advantages. This diverse approach aims to enhance the effectiveness of the systematic review process. In conclusion, this 10-step guide provides a practical framework for the rigorous conduct of systematic reviews in the domain of medicine and health. It addresses the unique challenges inherent in this field, emphasizing the values of transparency, precision, and ongoing efforts to improve primary research practices. The guide aims to contribute to the establishment of a robust evidence base, facilitating informed decision-making in healthcare.
PubMed: 38299136
DOI: 10.7759/cureus.51422 -
Medicine Jan 2024Dental decision-making represents the establishment of a common understanding between the dental professional and the recipient of the intervention, which determines...
Dental decision-making represents the establishment of a common understanding between the dental professional and the recipient of the intervention, which determines oral healthcare and dental treatment policies. Dental decision-making for persons with dementia can be challenging, and there have been no systematic reviews on this topic. Therefore, this systematic narrative review aimed to identify the current state of dental decision-making in persons with dementia. Literature search was performed using PubMed, Web of Science, Cochrane Library, CINAHL, and Google Scholar databases. Through the process of research selection, 7 articles with a high risk of bias were included in this study. This review clarified that there is limited information on the dental decision-making processes for persons with dementia. In conclusion, although this may be difficult due to different medical and socioeconomic conditions, the dilemma between the need to establish evidence for dental decision-making and medical ethics that prioritize a patient-centered position should be discussed globally in the future.
Topics: Humans; Decision Making; Delivery of Health Care; Narration; Dementia
PubMed: 38241530
DOI: 10.1097/MD.0000000000036555 -
International Journal of Environmental... Mar 2024(1) Background: Access to abortion care is a crucial reproductive health right. Refugees and migrants may have restricted access to and utilisation of abortion care,... (Review)
Review
(1) Background: Access to abortion care is a crucial reproductive health right. Refugees and migrants may have restricted access to and utilisation of abortion care, associated with histories of displacement, precarious migrant and citizenship status and difficulty navigating unfamiliar host country healthcare systems. However, there is limited evidence on the abortion experiences and perspectives of refugees and migrants. Moreover, existing research has not been synthesised to identify trends informing sexual and reproductive care access among this marginalised population. This systematic review aimed to address this gap in the cumulative evidence on refugee and migrant experiences and perspectives of abortion in host countries. (2) Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched the following databases for studies on refugee and migrant abortion attitudes, decision making and experiences: Embase, Medline, CINAHL, Web of Science, Sociological Abstracts, and Scopus. We also searched the grey literature on the same. Inclusion criteria specified qualitative studies involving migrant and/or refugee populations, examining their abortion experiences, attitudes or perspectives, written in English, published between January 2000 and December 2022. Two reviewers screened titles, abstracts and full-text articles, resulting in 27 articles included in the review, following consensus checks by two co-authors. The included studies were assessed for methodological quality using the Critical Appraisal Skills Programme tool. (3) Results: Abortion was stigmatised and generally considered impermissible and undesirable. However, participants discussed socioculturally determined 'exceptions' to this, positing circumstances where abortion was acceptable. There were striking differences in experiences between participants in higher-income settings and those in lower- and middle-income settings. Difficulties accessing care were ubiquitous but were heightened in lower-resource settings and among participants with precarious citizenship, financial and legal statuses. (4) Conclusions: The findings highlight the need for an international convention to guide policy and programming that acknowledges the specific abortion requirements of migrant and refugee communities, with attention to their financial, legal and social precarity.
Topics: Female; Pregnancy; Humans; Refugees; Delivery of Health Care; Sexual Behavior; Qualitative Research; Reproductive Health; Transients and Migrants
PubMed: 38541311
DOI: 10.3390/ijerph21030312