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Stroke Oct 2023Evidence of efficacy of repetitive transcranial magnetic stimulation (rTMS) for stroke recovery is hampered by an unexplained variability of reported effect sizes and an... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Evidence of efficacy of repetitive transcranial magnetic stimulation (rTMS) for stroke recovery is hampered by an unexplained variability of reported effect sizes and an insufficient understanding of mechanisms of action. We aimed to (1) briefly summarize evidence of efficacy, (2) identify critical factors to explain the reported variation in effects, and (3) provide mechanism-based recommendations for future trials.
METHODS
We performed a systematic review of the literature according to Cochrane and PRISMA Protocols. We included trials with ≥10 patients per treatment group. We classified outcome measures according to the International Classification of Functioning, Disability, and Health. Meta-analysis was done when at least 3 trials were reported on the same construct. In case of significant summary effect sizes with significant heterogeneity, we used sensitivity analyses to test for correlations and differences between found individual effect sizes and possible effect modifiers such as patient-, repetitive transcranial magnetic stimulation-, and trial characteristics.
RESULTS
We included 57 articles (N=2595). Funnel plots showed no publication bias. We found significant effect sizes at the level of body function (upper limb synergies, muscle strength, language functioning, global cognitive functioning, visual/spatial inattention) with repetitive transcranial magnetic stimulation within or beyond 3 months after stroke. We also found significant effect sizes at the level of activities. We found no subgroup differences or significant correlations between individual summary effect sizes and any tested possible effect modifier.
CONCLUSIONS
Repetitive transcranial magnetic stimulation holds the potential to benefit a range of motor and cognitive outcomes after stroke, but the evidence of efficacy is challenged by unexplained heterogeneity across many small sampled trials. We propose large trials with the collection of individual patient data on baseline severity and brain network integrity with sufficiently powered subgroup analyses, as well as protocolized time-locked training of the target behavior. Additional neurophysiological and biomechanical data may help in understanding mechanisms and identifying biomarkers of treatment efficacy.
REGISTRATION
URL: https://www.
CLINICALTRIALS
gov; Unique identifier: CRD42022300330.
Topics: Humans; Transcranial Magnetic Stimulation; Stroke; Brain; Cognition; Language
PubMed: 37747964
DOI: 10.1161/STROKEAHA.123.043159 -
Journal of Optometry 2023To analyse the scientific evidence about the efficacy of Syntonic phototherapy for producing changes in visual function. (Review)
Review
PURPOSE
To analyse the scientific evidence about the efficacy of Syntonic phototherapy for producing changes in visual function.
MATERIAL AND METHODS
A systematic review was performed to obtain studies on the effects of Syntonic phototherapy on vision. A search in health science databases (Medline, Scopus, Web of Science and PsycINFO) for studies published between 1980 and 2022 was conducted in accordance with the principles of Cochrane approach. The search identified 197 articles. Only clinical studies which used the Syntonic phototherapy as a vision therapy for any visual condition were included. Clinical cases and case series were excluded. Following the inclusion criteria, 8 clinical studies met inclusion, 5 of them being pseudo-experimental studies with an equivalent control group and 3 pre-post pseudo-experimental studies. GRADE tool was used to assess the certainty of the evidence of the studies. The GRADE evidence profile for the studies through the Soft table was made to analyse data.
RESULTS
The studies analysed seven outcomes: visual symptoms, functional visual fields, visual acuity, contrast sensitivity, deviation (phoria/tropia), stereopsis and reading abilities. Finding table about results (Soft Table) showed that for all outcomes reviewed, all studies yielded very low certainty of evidence. Results revealed a lack of scientific evidence of the efficacy of Syntonic optometric phototherapy to produce changes in the visual function.
CONCLUSION
This systematic review found no consistent evidence for the efficacy of Syntonic phototherapy to cause changes in visual function. There is no scientific evidence to support its clinical use for treating any type of visual anomalies.
Topics: Humans; Phototherapy; Visual Acuity; Vision Disorders; Contrast Sensitivity; Vision, Low
PubMed: 37230932
DOI: 10.1016/j.optom.2023.03.002 -
Journal of Medical Internet Research Nov 2023The application of artificial intelligence (AI) in the delivery of health care is a promising area, and guidelines, consensus statements, and standards on AI regarding... (Review)
Review
BACKGROUND
The application of artificial intelligence (AI) in the delivery of health care is a promising area, and guidelines, consensus statements, and standards on AI regarding various topics have been developed.
OBJECTIVE
We performed this study to assess the quality of guidelines, consensus statements, and standards in the field of AI for medicine and to provide a foundation for recommendations about the future development of AI guidelines.
METHODS
We searched 7 electronic databases from database establishment to April 6, 2022, and screened articles involving AI guidelines, consensus statements, and standards for eligibility. The AGREE II (Appraisal of Guidelines for Research & Evaluation II) and RIGHT (Reporting Items for Practice Guidelines in Healthcare) tools were used to assess the methodological and reporting quality of the included articles.
RESULTS
This systematic review included 19 guideline articles, 14 consensus statement articles, and 3 standard articles published between 2019 and 2022. Their content involved disease screening, diagnosis, and treatment; AI intervention trial reporting; AI imaging development and collaboration; AI data application; and AI ethics governance and applications. Our quality assessment revealed that the average overall AGREE II score was 4.0 (range 2.2-5.5; 7-point Likert scale) and the mean overall reporting rate of the RIGHT tool was 49.4% (range 25.7%-77.1%).
CONCLUSIONS
The results indicated important differences in the quality of different AI guidelines, consensus statements, and standards. We made recommendations for improving their methodological and reporting quality.
TRIAL REGISTRATION
PROSPERO International Prospective Register of Systematic Reviews (CRD42022321360); https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=321360.
Topics: Humans; Artificial Intelligence; Consensus; Databases, Factual; Medicine; Guidelines as Topic
PubMed: 37991819
DOI: 10.2196/46089 -
Neuroscience and Biobehavioral Reviews Oct 2023Methamphetamine use typically starts in adolescence, and early onset is associated with worse outcomes. Yet, health, functional, and cognitive outcomes associated with... (Meta-Analysis)
Meta-Analysis Review
Methamphetamine use typically starts in adolescence, and early onset is associated with worse outcomes. Yet, health, functional, and cognitive outcomes associated with methamphetamine use in young people are not well understood. The aim of this study was to comprehensively assess the evidence on health, functional, and cognitive outcomes in young people (10-25 years-old) who use methamphetamine. Sixty-six studies were included. The strongest association observed was with conduct disorder, with young people who use methamphetamine some 13 times more likely to meet conduct disorder criteria than controls. They were also more likely to have justice system involvement and to perpetrate violence against others. Educational problems were consistently associated with youth methamphetamine use. The cognitive domain most reliably implicated was inhibitory control. Key limitations in the literature were identified, including heterogenous measurement of exposure and outcomes, lack of adequate controls, and limited longitudinal evidence. Outcomes identified in the present review - suggesting complex and clinically significant behavioural issues in this population - are informative for the development of future research and targeted treatments.
Topics: Adolescent; Humans; Child; Young Adult; Adult; Methamphetamine; Violence; Cognition
PubMed: 37678571
DOI: 10.1016/j.neubiorev.2023.105380 -
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 Neurodevelopmental Disorders Aug 2023Subtle abnormalities in children's intelligence, motor skills, and psychology from various assisted reproductive treatments (ARTs) might be underdiagnosed. Understanding... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Subtle abnormalities in children's intelligence, motor skills, and psychology from various assisted reproductive treatments (ARTs) might be underdiagnosed. Understanding the prognosis of intelligence, motor skills, and psychology in children from ART would provide parents with reasonable expectations and enable them to plan relevant support to achieve the optimum potential in ART children.
METHODS
We searched PubMed, EMBASE, Ovid, Google Scholar, and Scopus databases until April 13, 2021, to identify relevant studies. Thirty-four studies met the inclusion and exclusion criteria. The meta-analysis employed a standardized mean difference model. The outcome of this study is to compare intelligence quotient (IQ), motoric ability, and behavioral problems between all ARTs, in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) to naturally conceived (NC) children. Subdomains of intelligence based on the Cattell, Horn, and Carroll Model (CHC Model) of cognitive architecture, including fluid reasoning, short-term and working memory, processing speed, visual-spatial ability, long-term memory retrieval, and crystalized intelligence (knowledge), were evaluated and summarized in details. Motor skill was stratified into two domains: gross motoric and fine motoric. Behavioral problem was categorized as externalizing and internalizing behavior.
RESULTS
Meta-analysis showed that verbal intelligence score in IVF toddlers is significantly lower than NC toddlers (p = 0.02); conversely, ICSI toddlers scored significantly higher verbal intelligence score compared to NC toddlers (p = 0.005). Toddlers born after ART had significantly lower non-verbal intelligence score (p = 0.047). IVF toddlers scored significantly lower fine motor score (p = 0.01) compared to naturally conceived toddlers. Based on parent's CBCL, NC toddlers had higher total (p = 0.01) and externalizing behavior (p = 0.001) scores compared to ART toddlers. Evaluation of full scale IQ and all domains of intelligence in preschool and primary school children revealed that no significant differences exist between ART and NC children. Based on preschool and primary school parents' CBCL, IVF children had significantly lower externalizing behavior score compared to NC children (p = 0.04). Meta-analyses of studies on young adolescents revealed that ART young adolescents scored higher academically than their NC counterparts, including on mathematics (p < 0.00001) and reading or language (p < 0.00001).
CONCLUSIONS
Despite differences in certain aspects, this finding suggests that ART is unlikely to cause negative impacts on children's neurodevelopment.
Topics: Adolescent; Humans; Male; Child, Preschool; Child; Semen; Intelligence; Problem Behavior; Language; Memory, Short-Term
PubMed: 37608302
DOI: 10.1186/s11689-023-09490-0 -
Frontiers in Public Health 2023Shared decision-making (SDM) facilitates the participation of healthcare professionals and patients in treatment decisions. We conducted a scoping review to assess SDM's...
BACKGROUND
Shared decision-making (SDM) facilitates the participation of healthcare professionals and patients in treatment decisions. We conducted a scoping review to assess SDM's current status in mainland China, referencing the Ottawa Decision Support Framework (ODSF).
METHODS
Our review encompassed extensive searches across six English and four Chinese databases, and various gray literature until April 30, 2021. Results were synthesized using thematic analysis.
RESULTS
Out of the 60 included studies, we identified three key themes based on the ODSF framework: decisional needs, decision support, and decisional outcomes. However, there appears to be a lack of comprehensive understanding of concepts related to decisional needs in China. Only a few studies have delved into feasibility, preference, choice, and outcome factors in the SDM process. Another challenge emerges from an absence of uniform standards for developing patient decision aids (PDAs). Furthermore, regarding health outcome indicators, their predominant focus remains on physiological needs.
CONCLUSION
SDM is in its infancy in mainland China. It is important to explore the concept and expression of decisional needs in the context of Chinese culture. Subsequent studies should focus on constructing a scientifically rigorous and systematic approach for the development of PDAs, and considering the adaptation of SDM steps to the clinical context in China during SDM implementation. Concurrently, The focus on health outcomes in Chinese SDM studies, driven by the unique healthcare resource landscape, underscores the necessity of prioritizing basic needs within limited resources.
SYSTEMATIC REVIEW REGISTRATION
https://inplasy.com/?s=202130021.
Topics: Humans; Asian People; China; Databases, Factual; Health Personnel; Decision Making, Shared; Delivery of Health Care; Decision Support Systems, Clinical
PubMed: 37744479
DOI: 10.3389/fpubh.2023.1162993 -
Journal of Attention Disorders Dec 2023To evaluate if children and adolescents with a diagnosis of ASD or ADHD have distinct executive function (EF) profiles. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To evaluate if children and adolescents with a diagnosis of ASD or ADHD have distinct executive function (EF) profiles.
METHODS
Peer-reviewed articles comparing ASD, ADHD, and typically developing individuals under 19 years of age were identified. The domains evaluated were: working memory, response inhibition, planning, cognitive flexibility, attention, processing speed, and visuospatial abilities.
RESULTS
Fifty-eight articles met inclusion criteria. Analyses were performed on 45 performance metrics from 24 individual tasks. No differences in EF were found between individuals diagnosed with ASD and ADHD. Individuals diagnosed with ASD and ADHD exhibited worse performance in attention, flexibility, visuospatial abilities, working memory, processing speed, and response inhibition than typically developing individuals. Groups did not differ in planning abilities.
CONCLUSION
Children and adolescents with ASD and ADHD have similar EF profiles. Further research is needed to determine if comorbidity accounts for the commonality in executive dysfunction between each disorder.
Topics: Child; Adolescent; Humans; Executive Function; Attention Deficit Disorder with Hyperactivity; Autism Spectrum Disorder; Memory, Short-Term; Comorbidity
PubMed: 37565325
DOI: 10.1177/10870547231190494 -
BMC Public Health Jul 2023Latin dance is a well-liked physical activity. It has gained increasing attention as an exercise intervention for improving physical and mental health outcomes. This...
BACKGROUND
Latin dance is a well-liked physical activity. It has gained increasing attention as an exercise intervention for improving physical and mental health outcomes. This systematic review examines the effects of Latin dance on physical and mental health.
METHODS
Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) were used to report the data for this review. To gather research from the literature, we used recognized academic and scientific databases such SportsDiscus with Full Text, PsycINFO, Cochrane, Scopus, PubMed, and Web of Science. The systematic review only included 22 studies out of the 1,463 that matched all inclusion criteria. The PEDro scale was used to rate each study's quality. 22 research received scores between 3 and 7.
RESULTS
Latin dance has been demonstrated to promote physical health by helping people lose weight, improve cardiovascular health, increase muscle strength and tone, and improve flexibility and balance. Furthermore, Latin dance can benefit mental health by reducing stress, improving mood, social connection, and cognitive function.
CONCLUSIONS
Finding from this systematic review provide substantial evidence that Latin dance has effect on physical and mental health. Latin dance has the potential to be a powerful and pleasurable public health intervention.
SYSTEMATIC REVIEW REGISTRATION
CRD42023387851, https://www.crd.york.ac.uk/prospero .
Topics: Humans; Mental Health; Affect; Cognition; Databases, Factual
PubMed: 37434149
DOI: 10.1186/s12889-023-16221-6 -
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