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Sports Medicine (Auckland, N.Z.) Dec 2023Resting metabolic rate (RMR) prediction equations are often used to calculate RMR in athletes; however, their accuracy and precision can vary greatly. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Resting metabolic rate (RMR) prediction equations are often used to calculate RMR in athletes; however, their accuracy and precision can vary greatly.
OBJECTIVE
The aim of this systematic review and meta-analysis was to determine which RMR prediction equations are (i) most accurate (average predicted values closest to measured values) and (ii) most precise (number of individuals within 10% of measured value).
DATA SOURCES
A systematic search of PubMed, CINAHL, SPORTDiscus, Embase, and Web of Science up to November 2021 was conducted.
ELIGIBILITY CRITERIA
Randomised controlled trials, cross-sectional observational studies, case studies or any other study wherein RMR, measured by indirect calorimetry, was compared with RMR predicted via prediction equations in adult athletes were included.
ANALYSIS
A narrative synthesis and random-effects meta-analysis (where possible) was conducted. To explore heterogeneity and factors influencing accuracy, subgroup analysis was conducted based on sex, body composition measurement method, athlete characteristics (athlete status, energy availability, body weight), and RMR measurement characteristics (adherence to best practice guidelines, test preparation and prior physical activity).
RESULTS
Twenty-nine studies (mixed sports/disciplines n = 8, endurance n = 5, recreational exercisers n = 5, rugby n = 3, other n = 8), with a total of 1430 participants (822 F, 608 M) and 100 different RMR prediction equations were included. Eleven equations satisfied criteria for meta-analysis for accuracy. Effect sizes for accuracy ranged from 0.04 to - 1.49. Predicted RMR values did not differ significantly from measured values for five equations (Cunningham (1980), Harris-Benedict (1918), Cunningham (1991), De Lorenzo, Ten-Haaf), whereas all others significantly underestimated or overestimated RMR (p < 0.05) (Mifflin-St. Jeor, Owen, FAO/WHO/UNU, Nelson, Koehler). Of the five equations, large heterogeneity was observed for all (p < 0.05, I range: 80-93%) except the Ten-Haaf (p = 0.48, I = 0%). Significant differences between subgroups were observed for some but not all equations for sex, athlete status, fasting status prior to RMR testing, and RMR measurement methodology. Nine equations satisfied criteria for meta-analysis for precision. Of the nine equations, the Ten-Haaf was found to be the most precise, predicting 80.2% of participants to be within ± 10% of measured values with all others ranging from 40.7 to 63.7%.
CONCLUSION
Many RMR prediction equations have been used in athletes, which can differ widely in accuracy and precision. While no single equation is guaranteed to be superior, the Ten-Haaf (age, weight, height) equation appears to be the most accurate and precise in most situations. Some equations are documented as consistently underperforming and should be avoided. Choosing a prediction equation based on a population of similar characteristics (physical characteristics, sex, sport, athlete status) is preferable. Caution is warranted when interpreting RMR ratio of measured to predicted values as a proxy of energy availability from a single measurement.
PROSPERO REGISTRATION
CRD42020218212.
Topics: Adult; Humans; Basal Metabolism; Cross-Sectional Studies; Athletes; Sports; Body Composition; Body Mass Index
PubMed: 37632665
DOI: 10.1007/s40279-023-01896-z -
Complementary Therapies in Clinical... Aug 2023The purpose of this systematic review is to ascertain the impact of inhalation aromatherapy on stress and anxiety in clinical settings. (Review)
Review
OBJECTIVE
The purpose of this systematic review is to ascertain the impact of inhalation aromatherapy on stress and anxiety in clinical settings.
METHODS
A search strategy was developed using various databases. Randomised Controlled Trials (RCTs) as well as single and double-blind pilot clinical studies (non-RCT) using inhalation aromatherapy with an essential oil blend or a single essential oil were examined. All studies included a control intervention and use of a validated measurement tool. The time period under review was years 2000-2021. Due to the high level of heterogeneity and element of bias, a narrative synthesis was conducted.
RESULTS
The search strategy initially retrieved 628 studies and through application of the selection criteria and the removal of duplicates, 76 studies were selected for review with a total of 6539 patients. In 42% of the RCTs, physiological measures including vital signs and/or salivary cortisol were used in addition to questionnaires. Over 70% of the studies reported a positive effect on anxiety levels in the aromatherapy intervention groups compared with the control. However, in many cases this is limited by the absence of safety data, imprecise reporting of plant species and dosage of essential oil.
CONCLUSION
Inhalation aromatherapy has the potential to reduce stress and anxiety with data emerging to further support this result across a wide modality of clinical treatments. However, there is a clear need for the development of standard protocols for research in this area, generating measurable results which will create the opportunity for more rigorous evidence-based outcomes.
Topics: Humans; Aromatherapy; Oils, Volatile; Anxiety; Anxiety Disorders; Administration, Inhalation; Randomized Controlled Trials as Topic
PubMed: 37031643
DOI: 10.1016/j.ctcp.2023.101750 -
Frontiers in Medicine 2023Vitiligo is a multifaceted autoimmune depigmenting disorder affecting around 0.5 to 2.0% of individuals globally. Standardizing diagnosis and therapy tracking can be...
UNLABELLED
Vitiligo is a multifaceted autoimmune depigmenting disorder affecting around 0.5 to 2.0% of individuals globally. Standardizing diagnosis and therapy tracking can be arduous, as numerous clinical evaluation methods are subject to interobserver variability and may not be validated. Therefore, there is a need for diagnostic tools that are objective, dependable, and preferably non-invasive.
AIMS
This systematic review provides a comprehensive overview of the non-invasive objective skin measurement methods that are currently used to evaluate the diagnosis, severity, and progression of vitiligo, as well as the advantages and limitations of each technique.
METHODS
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was used for the systematic review. Scopus, Embase, Cochrane Library, and Web of Science databases were comprehensively searched for non-invasive imaging and biophysical skin measuring methods to diagnose, evaluate the severity of, or monitor the effects of vitiligo treatment. The risk of bias in included articles was assessed using the QUADAS-2 quality assessment scale.
RESULTS
An extensive literature search resulted in 64 studies for analysis, describing eight imaging techniques (reflectance confocal microscopy, computer-aided imaging analysis, optical coherence tomography, infrared photography, third-harmonic generation microscopy, multiphoton microscopy, ultraviolet light photography, and visible light/digital photograph), and three biophysical approaches (dermoscopy, colorimetry, spectrometry) used in diagnosing and assessing vitiligo. Pertinent information about functionality, mechanisms of action, sensitivity, and specificity was obtained for all studies, and insights into the strengths and limitations of each diagnostic technique were addressed. Methodological study quality was adequate; however, statistical analysis was not achievable because of the variety of methods evaluated and the non-standardized reporting of diagnostic accuracy results.
CONCLUSIONS
The results of this systematic review can enhance clinical practice and research by providing a comprehensive overview of the spectrum of non-invasive imaging and biophysical techniques in vitiligo assessment. Studies with larger sample sizes and sound methodology are required to develop verified methods for use in future practice and research.
SYSTEMATIC REVIEW REGISTRATION
(PROSPERO) database, (CRD42023395996).
PubMed: 37575985
DOI: 10.3389/fmed.2023.1200963 -
European Respiratory Review : An... Sep 2023A proportion of coronavirus disease 2019 (COVID-19) survivors experience persistent dyspnoea without measurable impairments in lung function. We performed a systematic... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
A proportion of coronavirus disease 2019 (COVID-19) survivors experience persistent dyspnoea without measurable impairments in lung function. We performed a systematic review and meta-analysis to determine relationships between dyspnoea and imaging abnormalities over time in post-COVID-19 patients.
METHODS
Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we analysed studies published prior to 15 September 2022 and indexed by Google Scholar, PubMed and LitCOVID which assessed chest imaging in adults ≥3 months after COVID-19. Demographic, chest imaging, spirometric and post-COVID-19 symptom data were extracted. The relationships between imaging abnormalities and dyspnoea, sex and age were determined using a random effects model and meta-regression.
RESULTS
47 studies were included in the meta-analysis (n=3557). The most prevalent computed tomography (CT) imaging abnormality was ground-glass opacities (GGOs) (44.9% (95% CI 37.0-52.9%) at any follow-up time-point). Occurrence of reticulations significantly decreased between early and late follow-up (p=0.01). The prevalence of imaging abnormalities was related to the proportion of patients with dyspnoea (p=0.012). The proportion of females was negatively correlated with the presence of reticulations (p=0.001), bronchiectasis (p=0.001) and consolidations (p=0.025). Age was positively correlated with imaging abnormalities across all modalities (p=0.002) and imaging abnormalities present only on CT (p=0.001) (GGOs (p=0.004) and reticulations (p=0.001)). Spirometric values improved during follow-up but remained within the normal range at all time-points.
CONCLUSIONS
Imaging abnormalities were common 3 months after COVID-19 and their occurrence was significantly related to the presence of dyspnoea. This suggests that CT imaging is a sensitive tool for detecting pulmonary abnormalities in patients with dyspnoea, even in the presence of normal spirometric measurements.
Topics: Adult; Female; Humans; COVID-19; SARS-CoV-2; Lung; Dyspnea; Lung Diseases
PubMed: 37558261
DOI: 10.1183/16000617.0253-2022 -
BMJ Open Sep 2023Co-production is promoted as an effective way of improving the quality of health and social care but the diversity of measures used in individual studies makes their... (Review)
Review
BACKGROUND
Co-production is promoted as an effective way of improving the quality of health and social care but the diversity of measures used in individual studies makes their outcomes difficult to interpret.
OBJECTIVE
The objective is to explore how empirical studies in health and social care have described the outcomes of co-production projects and how those outcomes were measured.
DESIGN AND METHODS
A scoping review forms the basis for this systematic review. Search terms for the concepts (co-produc* OR coproduc* OR co-design* OR codesign*) and contexts (health OR 'public service* OR "public sector") were used in: CINAHL with Full Text (EBSCOHost), Cochrane Central Register of Controlled trials (Wiley), MEDLINE (EBSCOHost), PsycINFO (ProQuest), PubMed (legacy) and Scopus (Elsevier). There was no date limit. Papers describing the process, original data and outcomes of co-production were included. Protocols, reviews and theoretical, conceptual and psychometric papers were excluded. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed. The Mixed Methods Appraisal Tool underpinned the quality of included papers.
RESULTS
43 empirical studies were included. They were conducted in 12 countries, with the UK representing >50% of all papers. No paper was excluded due to the Mixed Methods Quality Appraisal screening and 60% of included papers were mixed methods studies. The extensive use of self-developed study-specific measures hampered comparisons and cumulative knowledge-building. Overall, the studies reported positive outcomes. Co-production was reported to be positively experienced and provided important learning.
CONCLUSIONS
The lack of common approaches to measuring co-production is more problematic than the plurality of measurements itself. Co-production should be measured from three perspectives: outputs of co-production processes, the experiences of participating in co-production processes and outcomes of co-production. Both self-developed study-specific measures and established measures should be used. The maturity of this research field would benefit from the development and use of reporting guidelines.
Topics: Humans; Social Support; Empirical Research; Knowledge; Learning; MEDLINE
PubMed: 37739472
DOI: 10.1136/bmjopen-2023-073808 -
Journal of the International Society of... Dec 2023Reference values of body fat for competitive volleyball players are lacking, making it difficult to interpret measurement results. This review systematically summarized... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Reference values of body fat for competitive volleyball players are lacking, making it difficult to interpret measurement results. This review systematically summarized published data on the relative body fat of volleyball players and calculated potential differences between sex, measurement method, and competitive level.
METHODS
The protocol followed the Preferred Reported Items for Systematic Reviews and Meta-Analysis guidelines. The literature search was conducted using five electronic databases to retrieve all relevant publications from January 1, 2010, to July 1, 2021. The 63 studies including 2607 players that met the inclusion criteria were analyzed using random-effects models. Data were reported as pooled mean body fat with 95% confidence intervals.
RESULTS
Body fat for males and females was 12.8% (11.9-13.8%) and 22.8% (21.9-23.7%), respectively. Body fat was 18.3% (16.3-20.4%) measured via skinfolds, 18.4% (15.6-21.2%) via bioelectrical impedance analysis, 24.2% (20.4-28.0%) via dual-energy x-ray absorptiometry and 21.6% (17.4-25.8%) via densitometry. Regional, national, and international-level players had body fat values of 19.5% (17.8-21.2%), 20.3% (18.6-22.0%), and 17.9% (15.7-20.4%), respectively. When the meta-regression was adjusted for the variables sex, measurement method, and competitive level, a significant difference between sex ( < 0.001), dual-energy x-ray absorptiometry and skinfolds ( = 0.02), and national and international-level players ( = 0.02) was found. However, sensitivity analysis revealed that findings regarding measurement method and competitive level were not robust and should, therefore, be interpreted with caution.
CONCLUSIONS
Despite the limitations of published data, this meta-analysis provided pooled values for body fat of male and female volleyball players for different competitive levels and measurement methods.
Topics: Humans; Male; Female; Volleyball; Body Composition; Anthropometry; Adipose Tissue; Absorptiometry, Photon
PubMed: 37578094
DOI: 10.1080/15502783.2023.2246414 -
Annals of Internal Medicine Jan 2024Severe maternal morbidity and mortality are worse in the United States than in all similar countries, with the greatest effect on Black women. Emerging research suggests... (Review)
Review
BACKGROUND
Severe maternal morbidity and mortality are worse in the United States than in all similar countries, with the greatest effect on Black women. Emerging research suggests that disrespectful care during childbirth contributes to this problem.
PURPOSE
To conduct a systematic review on definitions and valid measurements of respectful maternity care (RMC), its effectiveness for improving maternal and infant health outcomes for those who are pregnant and postpartum, and strategies for implementation.
DATA SOURCES
Systematic searches of Ovid Medline, CINAHL, Embase, Cochrane Central Register of Controlled Trials, PsycInfo, and SocINDEX for English-language studies (inception to July 2023).
STUDY SELECTION
Randomized controlled trials and nonrandomized studies of interventions of RMC versus usual care for effectiveness studies; additional qualitative and noncomparative validation studies for definitions and measurement studies.
DATA EXTRACTION
Dual data abstraction and quality assessment using established methods, with resolution of disagreements through consensus.
DATA SYNTHESIS
Thirty-seven studies were included across all questions, of which 1 provided insufficient evidence on the effectiveness of RMC to improve maternal outcomes and none studied RMC to improve infant outcomes. To define RMC, authors identified 12 RMC frameworks, from which 2 main concepts were identified: and frameworks. Disrespect and abuse components focused on recognizing birth mistreatment; rights-based frameworks incorporated aspects of reproductive justice, human rights, and antiracism. Five overlapping framework themes include freedom from abuse, consent, privacy, dignity, communication, safety, and justice. Twelve tools to measure RMC were validated in 24 studies on content validity, construct validity, and internal consistency, but lack of a gold standard limited evaluation of criterion validity. Three tools specific for RMC had at least 1 study demonstrating consistency internally and with an intended construct relevant to U.S. settings, but no single tool stands out as the best measure of RMC.
LIMITATIONS
No studies evaluated other health outcomes or RMC implementation strategies. The lack of definition and gold standard limit evaluation of RMC tools.
CONCLUSION
Frameworks for RMC are well described but vary in their definitions. Tools to measure RMC demonstrate consistency but lack a gold standard, requiring further evaluation before implementation in U.S. settings. Evidence is lacking on the effectiveness of implementing RMC to improve any maternal or infant health outcome.
PRIMARY FUNDING SOURCE
Agency for Healthcare Research and Quality. (PROSPERO: CRD42023394769).
Topics: Infant; Pregnancy; Female; Humans; Maternal Health Services; Respect; Obstetrics; Delivery, Obstetric; Postpartum Period; Quality of Health Care
PubMed: 38163377
DOI: 10.7326/M23-2676 -
Inquiry : a Journal of Medical Care... 2024Shipping is considered a demanding environment that can significantly impact seafarers' well-being and mental health. This review aims to examine existing literature on... (Review)
Review
Shipping is considered a demanding environment that can significantly impact seafarers' well-being and mental health. This review aims to examine existing literature on the resilience of seafarers, with a focus on the measurement methods used. Furthermore, this study intends to gain a comprehensive understanding of the current state of research in the field of seafarers' resilience, examining the variations in defining and conceptualizing resilience across different studies and contexts. The review identified 99 studies published between 2003 and 2023, with ten studies being included in the final analysis. These studies employed various measurement methods and provided definitions of resilience. Five questionnaires were identified, with the Dispositional Resilience Scale-15 (DRS-15) being the most commonly used. Two of the selected studies had a longitudinal follow-up, while eight were cross-sectional. Four studies related to tankers, and an additional four studies focused on naval vessels, while two studies did not specify the vessel type. The publications were distributed in the period between 2003 and 2013 (two papers) and between 2013 and 2023 (eight papers). The identified themes encompassed shipboard stressors (three papers), sleep problems (two papers), occupational groups or attitudes (two papers), experiences in war (two papers), and intervention measures (one paper), highlighting the multidimensional nature of resilience within the maritime field. This review suggests a research gap, as it reveals that the topic of resilience in seafaring has been sparsely represented. Despite an increasing interest in recent years, research remains limited, particularly in the civilian maritime sector. Therefore, this review highlights the importance of understanding and promoting resilience among seafarers. While the variety of questionnaires used was limited, achieving consensus and standardization in resilience measurement is essential for more comparable and consistent research findings. Recognizing resilience as a crucial resource can promote the development of targeted interventions and support systems, enhancing seafarers' well-being and mental health.
Topics: Humans; Mental Health; Occupational Health; Resilience, Psychological; Ships; Surveys and Questionnaires
PubMed: 38240089
DOI: 10.1177/00469580231221288 -
Journal of Medical Internet Research Aug 2023The prevalence of Parkinson disease (PD) is becoming an increasing concern owing to the aging population in the United Kingdom. Wearable devices have the potential to... (Review)
Review
BACKGROUND
The prevalence of Parkinson disease (PD) is becoming an increasing concern owing to the aging population in the United Kingdom. Wearable devices have the potential to improve the clinical care of patients with PD while reducing health care costs. Consequently, exploring the features of these wearable devices is important to identify the limitations and further areas of investigation of how wearable devices are currently used in clinical care in the United Kingdom.
OBJECTIVE
In this scoping review, we aimed to explore the features of wearable devices used for PD in hospitals in the United Kingdom.
METHODS
A scoping review of the current research was undertaken and reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. The literature search was undertaken on June 6, 2022, and publications were obtained from MEDLINE or PubMed, Embase, and the Cochrane Library. Eligible publications were initially screened by their titles and abstracts. Publications that passed the initial screening underwent a full review. The study characteristics were extracted from the final publications, and the evidence was synthesized using a narrative approach. Any queries were reviewed by the first and second authors.
RESULTS
Of the 4543 publications identified, 39 (0.86%) publications underwent a full review, and 20 (0.44%) publications were included in the scoping review. Most studies (11/20, 55%) were conducted at the Newcastle upon Tyne Hospitals NHS Foundation Trust, with sample sizes ranging from 10 to 418. Most study participants were male individuals with a mean age ranging from 57.7 to 78.0 years. The AX3 was the most popular device brand used, and it was commercially manufactured by Axivity. Common wearable device types included body-worn sensors, inertial measurement units, and smartwatches that used accelerometers and gyroscopes to measure the clinical features of PD. Most wearable device primary measures involved the measured gait, bradykinesia, and dyskinesia. The most common wearable device placements were the lumbar region, head, and wrist. Furthermore, 65% (13/20) of the studies used artificial intelligence or machine learning to support PD data analysis.
CONCLUSIONS
This study demonstrated that wearable devices could help provide a more detailed analysis of PD symptoms during the assessment phase and personalize treatment. Using machine learning, wearable devices could differentiate PD from other neurodegenerative diseases. The identified evidence gaps include the lack of analysis of wearable device cybersecurity and data management. The lack of cost-effectiveness analysis and large-scale participation in studies resulted in uncertainty regarding the feasibility of the widespread use of wearable devices. The uncertainty around the identified research gaps was further exacerbated by the lack of medical regulation of wearable devices for PD, particularly in the United Kingdom where regulations were changing due to the political landscape.
Topics: Humans; Male; Aged; Middle Aged; Female; Parkinson Disease; Artificial Intelligence; Aging; Commerce; Hospitals
PubMed: 37594791
DOI: 10.2196/42950 -
The Journal of Clinical Endocrinology... Aug 2023Adrenal medullary hyperplasia (AMH) is a rare, incompletely described disorder of the adrenal medulla that is associated with catecholamine excess. (Meta-Analysis)
Meta-Analysis
CONTEXT
Adrenal medullary hyperplasia (AMH) is a rare, incompletely described disorder of the adrenal medulla that is associated with catecholamine excess.
OBJECTIVE
To increase knowledge about AMH by reviewing the reported cases of this disorder.
DESIGN
Systematic review and meta-analysis of the genotype/phenotype relationship in all reported cases of AMH.
SETTING
Literature review and analysis.
PATIENTS OR OTHER PARTICIPANTS
All cases of AMH published to date.
MAIN OUTCOME MEASURE(S)
Characteristics of AMH cases and genotype-phenotype relationships.
RESULTS
A total of 66 patients, median age of 48 years, were identified from 29 reports. More than one-half were male (n = 39, 59%). The majority had unilateral (73%, n = 48) disease; 71% (n = 47) were sporadic and 23% (n = 15) were associated with the MEN2. Most (91%, n = 60) displayed signs and symptoms of excess catecholamine secretion, particularly hypertension. Elevated catecholamine concentrations (86%, n = 57) and adrenal abnormalities on imaging were common (80%, n = 53). More than one-half (58%, n = 38) had concurrent tumors: pheochromocytoma (42%, n = 16/38); medullary thyroid cancer (24%, n = 9/38); and adrenocortical adenoma (29%, n = 11/38). Most (88%, n = 58) underwent adrenalectomy with 45/58 achieving symptom resolution. Adrenalectomy was less common in patients under 40 years and those with bilateral disease (both P < .05).
CONCLUSION
AMH may be sporadic or associated with MEN2, most have catecholamine excess and imaging abnormalities. Unilateral involvement is more common. Most reported patients have been treated with adrenalectomy, which is usually curative with regard to catecholamine hypersecretion.
Topics: Male; Humans; Female; Hyperplasia; Adrenal Gland Neoplasms; Pheochromocytoma; Adrenal Medulla; Adrenalectomy; Catecholamines
PubMed: 36896586
DOI: 10.1210/clinem/dgad121