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Obesity Reviews : An Official Journal... Dec 2021Although the deleterious effects of obesity have been well documented in terms of morbidity and mortality, less is known about what it is like to live with this complex... (Review)
Review
Although the deleterious effects of obesity have been well documented in terms of morbidity and mortality, less is known about what it is like to live with this complex and chronic disease. This study systematically reviewed and synthesized peer-reviewed studies relating to the lived experience of patients with obesity. A total of 12,388 records were screened, resulting in the inclusion of 32 final studies. Meta-ethnographic synthesis of these 32 studies generated five "third-order constructs" or themes: the development of obesity; a life limited; stigma, judgment, shame, and blame; treatment and; experiences of specific or minority groups. These constructs describe, from the patient's perspective, the factors associated with the development and maintenance of obesity; the effects of the disease on their day-to-day lives; the impact of the stigma and judgment many patients are subjected to; and their experience of accessing, or trying to access, treatment for their healthcare needs. This synthesis reveals the dearth of studies that focus solely on the experience of the patient and highlights the tendency for participant-informed, rather than participatory, methods in obesity research. It concludes with a call for further participatory research into the experiences of people living with obesity.
Topics: Chronic Disease; Delivery of Health Care; Humans; Obesity; Qualitative Research
PubMed: 34402150
DOI: 10.1111/obr.13334 -
Journal of Medical Internet Research Oct 2022When investigating voice disorders a series of processes are used when including voice screening and diagnosis. Both methods have limited standardized tests, which are... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
When investigating voice disorders a series of processes are used when including voice screening and diagnosis. Both methods have limited standardized tests, which are affected by the clinician's experience and subjective judgment. Machine learning (ML) algorithms have been used as an objective tool in screening or diagnosing voice disorders. However, the effectiveness of ML algorithms in assessing and diagnosing voice disorders has not received sufficient scholarly attention.
OBJECTIVE
This systematic review aimed to assess the effectiveness of ML algorithms in screening and diagnosing voice disorders.
METHODS
An electronic search was conducted in 5 databases. Studies that examined the performance (accuracy, sensitivity, and specificity) of any ML algorithm in detecting pathological voice samples were included. Two reviewers independently selected the studies, extracted data from the included studies, and assessed the risk of bias. The methodological quality of each study was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool via RevMan 5 software (Cochrane Library). The characteristics of studies, population, and index tests were extracted, and meta-analyses were conducted to pool the accuracy, sensitivity, and specificity of ML techniques. The issue of heterogeneity was addressed by discussing possible sources and excluding studies when necessary.
RESULTS
Of the 1409 records retrieved, 13 studies and 4079 participants were included in this review. A total of 13 ML techniques were used in the included studies, with the most common technique being least squares support vector machine. The pooled accuracy, sensitivity, and specificity of ML techniques in screening voice disorders were 93%, 96%, and 93%, respectively. Least squares support vector machine had the highest accuracy (99%), while the K-nearest neighbor algorithm had the highest sensitivity (98%) and specificity (98%). Quadric discriminant analysis achieved the lowest accuracy (91%), sensitivity (89%), and specificity (89%).
CONCLUSIONS
ML showed promising findings in the screening of voice disorders. However, the findings were not conclusive in diagnosing voice disorders owing to the limited number of studies that used ML for diagnostic purposes; thus, more investigations are needed. While it might not be possible to use ML alone as a substitute for current diagnostic tools, it may be used as a decision support tool for clinicians to assess their patients, which could improve the management process for assessment.
TRIAL REGISTRATION
PROSPERO CRD42020214438; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=214438.
Topics: Algorithms; Humans; Machine Learning; Supervised Machine Learning; Voice Disorders
PubMed: 36239999
DOI: 10.2196/38472 -
International Forum of Allergy &... Sep 2023Despite the significant morbidity associated with chronic rhinosinusitis (CRS) in individuals with asthma (CRSwA), there is a paucity of codified, evidence-based... (Review)
Review
BACKGROUND
Despite the significant morbidity associated with chronic rhinosinusitis (CRS) in individuals with asthma (CRSwA), there is a paucity of codified, evidence-based management strategies for CRS in this population.
METHODS
Using PubMed, Embase, and Cochrane Review Databases, a systematic review was performed covering management strategies for CRSwA. A total of 5903 articles were screened, and 70 were included for full-text analysis. After application of exclusion criteria, 53 articles comprised the qualitative synthesis. The level of evidence was graded and benefit-harm assessments, as well as value judgment and recommendations, were provided RESULTS: Strong evidence confirms the benefit of oral and topical medications on sinonasal-specific outcomes in individuals with CRSwA; there is low-grade evidence demonstrating that these agents improve lung function and/or asthma control. Moderate to strong evidence suggests that endoscopic sinus surgery (ESS) improves both sinonasal- and asthma-specific quality of life. Although there is insufficient to low evidence to indicate that ESS improves pulmonary function in this population, data indicate a positive impact of this intervention on asthma control. Biologic medications strongly improve both subjective and objective sinonasal- and asthma-specific outcomes.
CONCLUSION
Evidence supports managing CRS in individuals with CRSwA in a stepwise fashion, starting with traditional nonbiologic oral and topical medication, and escalating to second-line treatments, such as ESS and biologics. Optimal treatment of individuals who have CRSwA often requires concurrent, directed management of asthma, as not all CRS interventions impact asthma status.
Topics: Humans; Quality of Life; Rhinitis; Sinusitis; Asthma; Chronic Disease; Endoscopy
PubMed: 36579899
DOI: 10.1002/alr.23130 -
Journal of Orthopaedic Surgery and... Dec 2022In the emergency room, clinicians spend a lot of time and are exposed to mental stress. In addition, fracture classification is important for determining the surgical...
BACKGROUND
In the emergency room, clinicians spend a lot of time and are exposed to mental stress. In addition, fracture classification is important for determining the surgical method and restoring the patient's mobility. Recently, with the help of computers using artificial intelligence (AI) or machine learning (ML), diagnosis and classification of hip fractures can be performed easily and quickly. The purpose of this systematic review is to search for studies that diagnose and classify for hip fracture using AI or ML, organize the results of each study, analyze the usefulness of this technology and its future use value.
METHODS
PubMed Central, OVID Medline, Cochrane Collaboration Library, Web of Science, EMBASE, and AHRQ databases were searched to identify relevant studies published up to June 2022 with English language restriction. The following search terms were used [All Fields] AND (", "[MeSH Terms] OR (""[All Fields] AND "bone"[All Fields]) OR "bone fractures"[All Fields] OR "fracture"[All Fields]). The following information was extracted from the included articles: authors, publication year, study period, type of image, type of fracture, number of patient or used images, fracture classification, reference diagnosis of fracture diagnosis and classification, and augments of each studies. In addition, AI name, CNN architecture type, ROI or important region labeling, data input proportion in training/validation/test, and diagnosis accuracy/AUC, classification accuracy/AUC of each studies were also extracted.
RESULTS
In 14 finally included studies, the accuracy of diagnosis for hip fracture by AI was 79.3-98%, and the accuracy of fracture diagnosis in AI aided humans was 90.5-97.1. The accuracy of human fracture diagnosis was 77.5-93.5. AUC of fracture diagnosis by AI was 0.905-0.99. The accuracy of fracture classification by AI was 86-98.5 and AUC was 0.873-1.0. The forest plot represented that the mean AI diagnosis accuracy was 0.92, the mean AI diagnosis AUC was 0.969, the mean AI classification accuracy was 0.914, and the mean AI classification AUC was 0.933. Among the included studies, the architecture based on the GoogLeNet architectural model or the DenseNet architectural model was the most common with three each. Among the data input proportions, the study with the lowest training rate was 57%, and the study with the highest training rate was 95%. In 14 studies, 5 studies used Grad-CAM for highlight important regions.
CONCLUSION
We expected that our study may be helpful in making judgments about the use of AI in the diagnosis and classification of hip fractures. It is clear that AI is a tool that can help medical staff reduce the time and effort required for hip fracture diagnosis with high accuracy. Further studies are needed to determine what effect this causes in actual clinical situations.
Topics: Humans; Artificial Intelligence; Hip Fractures; Machine Learning; Databases, Factual; Emergency Service, Hospital
PubMed: 36456982
DOI: 10.1186/s13018-022-03408-7 -
Healthcare (Basel, Switzerland) Dec 2020The current review aims to investigate the barriers to and facilitators of the adherence to clinical practice guidelines (CPGs) in the Middle East and North Africa... (Review)
Review
The current review aims to investigate the barriers to and facilitators of the adherence to clinical practice guidelines (CPGs) in the Middle East and North Africa (MENA) region. English language studies published between January 2010 and May 2019 were searched on PubMed, Embase, and EBSCO. The barriers were categorized as clinician-related factors, such as lack of awareness of familiarity with the CPGs, and external factors, such as patients, guidelines, and environmental factors. The search identified 295 titles, out of which 15 were included. Environmental factors, specifically lack of time, resources, incentives, availability, and costs of treatment or diagnostic tests, training, and dissemination plans were the most commonly identified barriers. The familiarity with or awareness of healthcare professionals about the guideline, guideline characteristics, lack of agreement with the guidelines and preference in clinical judgment, physician self-efficacy, and motivation were reported to a lesser extent. Few studies reported on the compliance of facilitators with the guidelines including disseminating and advertising guideline materials, education and training on the guidelines, regulatory and financial incentives, and support from institutions. The review highlights that the studies on barriers to and facilitators of compliance with CPGs in the MENA region are limited in number and quality.
PubMed: 33333843
DOI: 10.3390/healthcare8040564 -
Medicine Aug 2020COVID-19 is a global public health emergency. At present, there is no highly effective medicine for the prevention and treatment of 2019-nCoV. Western medicine for... (Meta-Analysis)
Meta-Analysis
BACKGROUND
COVID-19 is a global public health emergency. At present, there is no highly effective medicine for the prevention and treatment of 2019-nCoV. Western medicine for COVID-19 is mainly based on symptomatic support therapy. Chinese herbal medicine has been used to prevent infectious diseases for thousands of years in China. Western medicine routine treatment combined with Chinese herbal medicine is an alternative clinical option but lacks evidence-based medical evidence. The systematic review protocol aims to formulate a research plan that can evaluate the efficacy and safety of western medicine routine treatment combined with Chinese herbal medicine for COVID-19.
METHODS
We will search the following eight databases: Cochrane Library, PubMed, Embase, Medline, CNKI, Wanfang, VIP, and CBM. The search time is up to the end of July 2020. Two authors will independently complete literature screening, data extraction, and risk of bias assessment. In case of disagreement, the third author will assist in the judgment. The primary outcome will be the clinical cure rate. The secondary outcome will be accounting symptoms, fever time, time of virus nucleic acid turning negative, check the condition by drawing blood, pneumonia absorption rate, patient hospitalization time, severe conversion rate and case fatality rate, adverse reactions, and adverse events. Revman 5.3 will be used for systematic reviews and meta-analysis. The report of the protocol will follow the PRISMA-P statement, and the report of the systematic review and meta-analysis will follow the PRISMA statement.
RESULTS
We will provide evidence-based medical evidence of the efficacy and safety of western medicine routine treatment combined with Chinese herbal medicine for COVID-19. The findings will be published in peer-reviewed journals.
REGISTRATION DETAILS
CRD42020190106.
Topics: Anti-Infective Agents; Antiviral Agents; COVID-19; China; Combined Modality Therapy; Coronavirus Infections; Drugs, Chinese Herbal; Female; Humans; Male; Medicine, Chinese Traditional; Pandemics; Patient Safety; Pneumonia, Viral; Severe Acute Respiratory Syndrome; Survival Analysis; Treatment Outcome; United States
PubMed: 32769922
DOI: 10.1097/MD.0000000000021616 -
Journal of Cosmetic Dermatology Oct 2022Recent developments in surgical techniques and grading schemas to treat temporal hollowing necessitate critically assessing their efficacy. This systematic review... (Review)
Review
BACKGROUND
Recent developments in surgical techniques and grading schemas to treat temporal hollowing necessitate critically assessing their efficacy. This systematic review presents the currently available protocols for temporal hollowing, aimed toward improving the clinical approach, for the benefit of the surgeon and patient.
METHODS
A search was conducted in PubMed, EMBASE, and Google Scholar in September 2021 using the keywords "temporal hollowing" and "temporal augmentation." Inclusion criteria were English-written articles published in peer-reviewed journals that reported an outcome relating to the cause, classification, or procedure used to prevent or correct hollowing in humans.
RESULTS
Of the 413, 966 publications retrieved, 24 met the study inclusion criteria. Twenty-one publications discussed the etiology of temporal hollowing, 12 discussed a classification or grading system for temporal hollowing, and 19 discussed a procedure to prevent or correct temporal hollowing. The most commonly reported etiology for temporal hollowing was iatrogenic (63%). For classifying temporal hollowing severity, visual analogue scales (25%) were most commonly used. Mesh (26%) and autologous fat grafts (26%) were the most popular procedures used to prevent or correct temporal hollowing.
DISCUSSION
We presented the spectrum of temporal hollowing grading schemas and treatment modalities currently published in the field. The use, by a majority of publications, of a grading system based on the subjective judgment of the examiner (either alone or adjunct to imaging results) suggests the need for a more standardized measurement tool. Future studies should investigate a universally applicable temporal hollowing classification system and its impact on treatment outcomes.
Topics: Humans; Adipose Tissue; Plastic Surgery Procedures; Treatment Outcome; Transplantation, Autologous
PubMed: 35467073
DOI: 10.1111/jocd.15021 -
Pain Management Nursing : Official... Aug 2022The objective of this systematic review was to identify and describe the psychometric properties of neonatal pain scales that were translated into Brazilian Portuguese... (Review)
Review
OBJECTIVES
The objective of this systematic review was to identify and describe the psychometric properties of neonatal pain scales that were translated into Brazilian Portuguese and to verify the methodological quality of these translation, transcultural adaptations and validation.
DESIGN
The present study is a systematic review. A systematic search in the literature included studies of development, validation, and transcultural adaptation of neonatal pain scales to Brazilian Portuguese. The instruments must have been developed for health care professionals to evaluate neonatal pain and stress in full-term and preterm newborns.
DATA SOURCES
The search strategy was conducted in PubMed, Web of Science, Scopus, and Scielo databases following The PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). REVIEW /ANALYSIS METHODS: A total of 1,479 publications were identified and 5 fulfilled the inclusion criteria, with 4 instruments evaluated. For the methodological quality analysis of the measurement properties of the instruments the Consensus-based Standards for Health Measurement Instruments (COSMIN) Risk of Bias checklist was used. The psychometric properties verified were internal consistency, content validity, reliability, and construct validity.
RESULTS
Three instruments reviewed were inadequate and one was doubtful.
CONCLUSIONS
The neonatal pain scales wich were cross culturally adapted to Brazilian Portuguese were shown to be of low methodological quality based on COSMIM checklist. Caution should be considered for clinical decisions about pain management judgment coming from these instruments.
Topics: Brazil; Humans; Infant, Newborn; Pain; Psychometrics; Reproducibility of Results; Surveys and Questionnaires; Translating
PubMed: 35078712
DOI: 10.1016/j.pmn.2021.12.003 -
Frontiers in Psychology 2021Cognitive biases can adversely affect human judgment and decision making and should therefore preferably be mitigated, so that we can achieve our goals as effectively as...
Cognitive biases can adversely affect human judgment and decision making and should therefore preferably be mitigated, so that we can achieve our goals as effectively as possible. Hence, numerous bias mitigation interventions have been developed and evaluated. However, to be effective in practical situations beyond laboratory conditions, the bias mitigation effects of these interventions should be retained over time and should transfer across contexts. This systematic review provides an overview of the literature on retention and transfer of bias mitigation interventions. A systematic search yielded 52 studies that were eligible for screening. At the end of the selection process, only 12 peer-reviewed studies remained that adequately studied retention over a period of at least 14 days (all 12 studies) or transfer to different tasks and contexts (one study). Eleven of the relevant studies investigated the effects of bias mitigation training using game- or video-based interventions. These 11 studies showed considerable overlap regarding the biases studied, kinds of interventions, and decision-making domains. Most of them indicated that gaming interventions were effective after the retention interval and that games were more effective than video interventions. The study that investigated transfer of bias mitigation training (next to retention) found indications of transfer across contexts. To be effective in practical circumstances, achieved effects of cognitive training should lead to enduring changes in the decision maker's behavior and should generalize toward other task domains or training contexts. Given the small number of overlapping studies, our main conclusion is that there is currently insufficient evidence that bias mitigation interventions will substantially help people to make better decisions in real life conditions. This is in line with recent theoretical insights about the "hard-wired" neural and evolutionary origin of cognitive biases.
PubMed: 34456780
DOI: 10.3389/fpsyg.2021.629354 -
Cureus Oct 2021St. John's wort (SJW) has been researched and clinically used for treating various psychiatric disorders, including depression. Few clinical trials have studied its use... (Review)
Review
St. John's wort (SJW) has been researched and clinically used for treating various psychiatric disorders, including depression. Few clinical trials have studied its use in smoking cessation. This systematic review provides comprehensive evidence of the studies conducted to date. Five databases were searched for randomized controlled trials (RCTs) that evaluated the effectiveness of SJW for smoking cessation in adults. The trials included the use of SJW alone, or along with nicotine replacement therapy, chromium, or behavioral therapies. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to report this systematic review. Overall, four RCTs met the eligibility criteria, and the risk of bias analysis was conducted using the Cochrane criteria. Abstinence, along with other physical symptoms, were measured as outcomes at the end of the follow-up period. Studies reported variable abstinence rates and a decrease in cravings at the end of 12-14 weeks. However, there was minimal to no difference reported between the intervention and placebo groups in all of the clinical trials. One of the studies reported minimal physical side effects. Overall, SJW was well tolerated. Quality analysis of the included studies showed low concerns in two studies while the other two studies showed high concerns in the risk of bias judgment. More clinical trials with larger sample sizes should be conducted in the future to evaluate the effectiveness of the use of SJW for smoking cessation.
PubMed: 34796061
DOI: 10.7759/cureus.18769