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PloS One 2023Hospital inpatients are exposed to high levels of stress during hospitalisation that may increase susceptibility to major adverse health events post-hospitalisation... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Hospital inpatients are exposed to high levels of stress during hospitalisation that may increase susceptibility to major adverse health events post-hospitalisation (known as post-hospital syndrome). However, the existing evidence base has not been reviewed and the magnitude of this relationship remains unknown. Therefore, the aim of the current systematic review and meta-analysis was to: 1) synthesise existing evidence and to determine the strength of the relationship between in-hospital stress and patient outcomes, and 2) determine if this relationship differs between (i) in-hospital vs post-hospital outcomes, and (ii) subjective vs objective outcome measures.
METHODS
A systematic search of MEDLINE, EMBASE, PsychINFO, CINAHL, and Web of Science from inception to February 2023 was conducted. Included studies reported a measure of perceived and appraised stress while in hospital, and at least one patient outcome. A random-effects model was generated to pool correlations (Pearson's r), followed by sub-group and sensitivity analyses. The study protocol was preregistered on PROSPERO (CRD42021237017).
RESULTS
A total of 10 studies, comprising 16 effects and 1,832 patients, satisfied the eligibility criteria and were included. A small-to-medium association was found: as in-hospital stress increased, patient outcomes deteriorated (r = 0.19; 95% CI: 0.12-0.26; I2 = 63.6; p < 0.001). This association was significantly stronger for (i) in-hospital versus post-hospital outcomes, and (ii) subjective versus objective outcome measures. Sensitivity analyses indicated that our findings were robust.
CONCLUSIONS
Higher levels of psychological stress experienced by hospital inpatients are associated with poorer patient outcomes. However, more high-quality, larger scale studies are required to better understand the association between in-hospital stressors and adverse outcomes.
Topics: Humans; Outcome Assessment, Health Care; Hospitals; Hospitalization; Personal Satisfaction; Stress, Psychological
PubMed: 36893099
DOI: 10.1371/journal.pone.0282789 -
International Urogynecology Journal Jul 2021In evaluating the effectiveness of interventions in perineal trauma research, outcomes reported by patients should have a prominent focus. There is no international... (Review)
Review
INTRODUCTION AND HYPOTHESIS
In evaluating the effectiveness of interventions in perineal trauma research, outcomes reported by patients should have a prominent focus. There is no international consensus regarding the use of either patient-reported outcomes (PROs) or tools used to determine these outcomes (patient-reported outcome measures, PROMs). The objective was to evaluate the selection, reporting and geographical variations of PROs and PROMs in randomised controlled trials (RCTs) on perineal trauma.
METHODS
We performed a systematic review of RCTs in perineal trauma research evaluating outcome and outcome measure reporting. We identified PROs and PROMs and grouped PROs into domains and themes, a classification system based on a medical outcome taxonomy.
RESULTS
Of 48 included RCTs, 47 reported PROs. In total, we identified 51 PROs. Outcome reporting consistency was low, with 27 PROs reported only once. Nine PROs were reported more than five times, the most frequent being perineal pain, with no geographical variation in reporting. Four themes encompassing 12 domains were identified. The most frequently reported theme was "Clinical", with 25 PROs grouped within four domains. "Resource use" and "Adverse events" themes were rarely reported, with only five PROs. PROMs also exhibited variation. Most common were visual analogue scale (VAS; 100 mm), Cleveland Clinic Continence Score, The Faecal Incontinence Quality of Life scale, VAS (0-10) and the McGill Pain Questionnaire.
CONCLUSIONS
Significant heterogeneity in PROs and PROMs was observed among RCTs. Despite inconsistency, PROs are the most prevalent outcome in perineal trauma research. Patient-reported adverse events are underreported. Their use in determining the effectiveness and safety of interventions makes their integration important in perineal trauma core outcome sets. Identification and grouping of outcomes will assist future core outcome consensus studies.
Topics: Delivery, Obstetric; Female; Humans; Outcome Assessment, Health Care; Parturition; Patient Reported Outcome Measures; Perineum; Pregnancy
PubMed: 34143238
DOI: 10.1007/s00192-021-04820-z -
International Journal of Environmental... Jan 2023Studies with rural children are limited, and results are divergent regarding the information on movement behaviours. (Review)
Review
BACKGROUND
Studies with rural children are limited, and results are divergent regarding the information on movement behaviours.
PURPOSE
to (i) describe the physical activity and sedentary behaviour in children; (ii) synthetize the year and place of publication, methodological quality, and instruments used to measure physical activity and sedentary behaviour; and (iii) to analyse the relationship between physical activity, sedentary behaviour, and health outcomes in these children.
METHODS
We use the databases PubMed, Web of Science, SPORTDiscus, Scopus, Virtual Health Library, and SciELO, considering papers published until October 2021. A total of 12,196 studies were identified, and after the exclusion of duplicate, title and abstract screening, and the full-text assessment, a total of 68 were included in the study.
RESULTS
A cross-sectional design was dominant among the studies, with sample sizes ranging from 23 to 44,631 children of both sexes. One-third of the studies were conducted in North America and Europe, and most of them used device-based measurements. Inequalities were observed regarding sex, age, economic level, race, and physical activity domains within and between the places of residence. Sociodemographic characteristics were also related to health outcomes for children living in rural and urban areas.
CONCLUSION
It is necessary to increase the evidence on movement behaviours among children living in the countries of South America and Oceania, as well as to increase the level of evidence on the role of school for physical activity in children in rural areas, given the inconsistent findings.
Topics: Male; Female; Humans; Child; Cross-Sectional Studies; Exercise; Sedentary Behavior; Rural Population; Outcome Assessment, Health Care
PubMed: 36767880
DOI: 10.3390/ijerph20032514 -
Expert Review of Pharmacoeconomics &... Aug 2021: Despite the number of systematic reviews of how artificial intelligence is being used in different areas of medicine, there is no study on the scope of artificial...
: Despite the number of systematic reviews of how artificial intelligence is being used in different areas of medicine, there is no study on the scope of artificial intelligence methods used in outcomes research, the cornerstone of health technology assessment (HTA). This systematic scoping review aims to systematically capture the scope of artificial intelligence methods used in outcomes research to enhance decision-makers' knowledge and broaden perspectives for health technology assessment and adoption.: The review identified 370 studies, consisted of artificial intelligence methods applied to adult patients who underwent any health/medical intervention and reported therapeutic, preventive, or prognostic outcomes. Artificial intelligence was mainly used for the prediction/prognosis of more frequently reported outcomes, efficacy/effectiveness, among morbidity outcomes. The predictive analysis was common in neoplastic disorders. Neural networks algorithm was predominantly found in surgical method studies, but a mixture of artificial intelligence algorithms was applied to the studies with the rest of the interventions.: There are certain gaps in artificial intelligence applications used in outcomes research across therapeutic areas and further considerations are needed by decision-makers before incorporating artificial intelligence usage into HTA decision-making processes.
Topics: Adult; Algorithms; Artificial Intelligence; Decision Making; Humans; Neoplasms; Neural Networks, Computer; Outcome Assessment, Health Care; Prognosis; Technology Assessment, Biomedical
PubMed: 33554681
DOI: 10.1080/14737167.2021.1886083 -
Advances in Nutrition (Bethesda, Md.) Nov 2023Improving diet quality while simultaneously maintaining planetary health is of critical interest globally. Despite the shared motivation, advancement remains slow, and... (Review)
Review
Improving diet quality while simultaneously maintaining planetary health is of critical interest globally. Despite the shared motivation, advancement remains slow, and the research community continues to operate in silos, focusing on certain pairings (diet-climate), or with a discipline-specific lens of a sustainable diet, rather than examining their totality. This review aimed to summarize the literature on adherence to a priori defined dietary patterns in consideration of diet quality, metabolic risk factors for noncommunicable diseases (NCDs), environmental impacts, and affordability. A methodology using PRISMA guidelines was followed, and searches were performed in 7 databases as of October 2022. The Appraisal tool for Cross-Sectional Studies (AXIS) and the National Institutes of Health (NIH) quality assessment tool for observational cohort studies were employed for quality appraisal. The evidence was narratively synthesized according to the characteristics of the diet quality metrics. The review includes 24 studies published between 2017-2023. Thirteen distinct diet quality scores were identified, with those measuring adherence to national dietary guidelines the most reported. Thirteen distinct environmental impact indicators were identified, with greenhouse gas emissions (n=23) reported most. All studies reported on body mass index, and 7 studies assessed the cost of adherence. Our results are consistent with previous findings that healthier diets can reduce environmental impacts; however, incongruities between population and planetary health can occur. Hence, the "sustainability" of dietary patterns is dependent on the choice of indicators selected. Further, healthy, lower impact diets can increase financial cost, but may also provide a protective role against the risk of obesity. Given the Global Syndemic, strategies to reduce obesity prevalence should emphasize the win-win opportunities for population and planetary health through dietary change. Research should identify diets that address multiple environmental concerns to curtail burdens potentially transferring, and harmonize this with sociocultural and equity dimensions. This review was registered at PROSPERO as CRD42021238055.
Topics: United States; Humans; Cross-Sectional Studies; Diet; Obesity; Costs and Cost Analysis; Outcome Assessment, Health Care
PubMed: 37532100
DOI: 10.1016/j.advnut.2023.07.007 -
The Journal of Hand Surgery, European... Jun 2020This systematic review summarizes the outcome reporting standards in Dupuytren's disease treatment research. A search of Ovid Medline, Ovid Embase, and CINAHL was... (Meta-Analysis)
Meta-Analysis
This systematic review summarizes the outcome reporting standards in Dupuytren's disease treatment research. A search of Ovid Medline, Ovid Embase, and CINAHL was conducted. Randomized controlled trials, cohort studies, and case series published between 1997 and 2017, investigating treatment of Dupuytren's disease with fasciectomy, fasciotomy, or collagenase, were eligible for inclusion. Range of motion was the most commonly reported outcome, appearing in 77% of included studies. Outcomes, such as range of motion, recurrence, and clinical success, were frequently defined, however many different definitions were used. We identified 37 unique measurement methods for range of motion, 28 for recurrence, and 25 for clinical success. Most outcomes were assessed at multiple time points, and only a few studies reported results according to established clinical significance thresholds. Development of a core outcome set will help standardize outcome reporting, and ensure future research in this field is relevant, interpretable, and amenable to systematic review and/or meta-analysis.
Topics: Dupuytren Contracture; Fasciotomy; Humans; Neoplasm Recurrence, Local; Outcome Assessment, Health Care; Range of Motion, Articular; Treatment Outcome
PubMed: 32009497
DOI: 10.1177/1753193420903624 -
BJOG : An International Journal of... May 2023A core outcome set could address inconsistent outcome reporting and improve evidence for stillbirth care research, which have been identified as an important research... (Review)
Review
BACKGROUND
A core outcome set could address inconsistent outcome reporting and improve evidence for stillbirth care research, which have been identified as an important research priority.
OBJECTIVES
To identify outcomes and outcome measurement instruments reported by studies evaluating interventions after the diagnosis of a stillbirth.
SEARCH STRATEGY
Amed, BNI, CINAHL, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase, MEDLINE, PsycINFO, and WHO ICTRP from 1998 to August 2021.
SELECTION CRITERIA
Randomised and non-randomised comparative or non-comparative studies reporting a stillbirth care intervention.
DATA COLLECTION AND ANALYSIS
Interventions, outcomes reported, definitions and outcome measurement tools were extracted.
MAIN RESULTS
Forty randomised and 200 non-randomised studies were included. Fifty-eight different interventions were reported, labour and birth care (52 studies), hospital bereavement care (28 studies), clinical investigations (116 studies), care in a multiple pregnancy (2 studies), psychosocial support (28 studies) and care in a subsequent pregnancy (14 studies). A total of 391 unique outcomes were reported and organised into 14 outcome domains: labour and birth; postpartum; delivery of care; investigations; multiple pregnancy; mental health; emotional functioning; grief and bereavement; social functioning; relationship; whole person; subsequent pregnancy; subsequent children and siblings and economic. A total of 242 outcome measurement instruments were used, with 0-22 tools per outcome.
CONCLUSIONS
Heterogeneity in outcome reporting, outcome definition and measurement tools in care after stillbirth exists. Considerable research gaps on specific intervention types in stillbirth care were identified. A core outcome set is needed to standardise outcome collection and reporting for stillbirth care research.
Topics: Child; Female; Humans; Pregnancy; Outcome Assessment, Health Care; Parturition; Psychosocial Support Systems; Stillbirth
PubMed: 36655361
DOI: 10.1111/1471-0528.17390 -
Waste Management (New York, N.Y.) May 2021Informal waste picking is a common way for people to earn an income, especially in low-income countries; unfortunately, there are various occupational hazards and health... (Review)
Review
Informal waste picking is a common way for people to earn an income, especially in low-income countries; unfortunately, there are various occupational hazards and health outcomes associated with waste picking. This study focused on comprehensively identifying and exploring occupational hazards and health outcomes associated with informal waste picking. A systematic review of available relevant and peer-reviewed literature was completed to exhaustively analyze the full scope of these hazards and outcomes associated with informal waste picking; 58 papers were included. The results from this study provided insight and information related to the most common occupational hazards and negative health outcomes associated with informal waste pickers outlined in available literature. The most common reported occupational hazards were physical (77.6%), social (70.7%), biological (65.5%), chemical and safety (53.4%), ergonomic (34.5%) and mechanic (25.9%). Health outcomes appeared to include epidermal (50.0%), communicable disease (46.6%), musculoskeletal (44.8%), respiratory disease (41.4%), non-communicable diseases (39.7%), physiological (34.5%), gastrointestinal (31.0%) and waterborne diseases (17.2%). Physical hazards were often associated with slips, trips, and falls, which makes sense because of the unstable environment where waste pickers work. Health outcomes related to these hazards included bruises, cuts, and lacerations. This information also aligns with health outcomes, as epidermal outcomes were most reported in waste pickers (50.0% of data). It is clear that moving forward, additional research related to these occupational hazards and health outcomes associated with informal waste picking is needed to help create change in this affected population, as well as finding effective solutions to mitigate these hazards and outcomes. These hazards can be mitigated by simple, common control measures, like providing safety equipment, reducing hazards from the outside environment (e.g., less time in sun, breaks, etc.), and placing barriers between waste pickers and the hazards (e.g., covered stations, flat ground, etc.) or more complex engineering, administrative or work controls. Because of the breadth of health problems faced by workers, more research is needed to correctly assess health outcomes (e.g. use of health practitioners) in waste pickers across time to ensure accurate data and a focused answer to the far-reaching problem.
Topics: Humans; Income; Occupational Health; Outcome Assessment, Health Care; Recycling; Refuse Disposal
PubMed: 33794442
DOI: 10.1016/j.wasman.2021.03.006 -
Ageing Research Reviews Jan 2023Polypharmacy is a prevalent issue in older adults, associated with a wide range of adverse health outcomes, amplified in those with frailty. This review aims to... (Meta-Analysis)
Meta-Analysis Review
Polypharmacy is a prevalent issue in older adults, associated with a wide range of adverse health outcomes, amplified in those with frailty. This review aims to synthesize current literature on the prevalence and health outcomes of polypharmacy and hyperpolypharmacy in older adults with frailty. A systematic search was carried out within ten databases till December 2021. Data was extracted using a piloted data extraction form, and methodological quality was assessed using JBI critical appraisal checklists. Meta-analyses were conducted for prevalence, and narrative synthesis was conducted for the health outcomes of polypharmacy and hyperpolypharmacy in older adults with frailty. Heterogeneity was assessed using Chi and I statistics, with sensitivity and subgroup analyses performed to explore sources of heterogeneity. Sixty-six studies were included for this review. The overall pooled prevalence of polypharmacy and hyperpolypharmacy was 59% and 22% respectively. When stratifying the studies by setting, WHO regions, in eighteen frailty assessment instruments, and by its year of publication, subgroup analysis found the highest rates of prevalence in the hospital setting (71%), in the European region (68%), when Reported Edmonton Frail Scale was used (96%), and in studies published in 2015 (86%). Additionally, frail older adults with polypharmacy were less likely to experience an improvement in frailty states, had higher risks of mortality, were more likely to suffer adverse hospital-related outcomes, and required additional assistance compared to those without polypharmacy. Therefore, the high prevalence and poorer health outcomes urges the healthcare providers and health policymakers to develop and implement preventative and restorative measures targeted at the adverse outcomes associated with polypharmacy and hyperpolypharmacy in older adults with frailty.
Topics: Humans; Aged; Frailty; Polypharmacy; Prevalence; Frail Elderly; Outcome Assessment, Health Care
PubMed: 36455791
DOI: 10.1016/j.arr.2022.101811 -
Clinical Rehabilitation Mar 2022In clinical practice and research, standardised sets of data and outcomes are routinely collected to facilitate data comparison, benchmarking and quality improvement.... (Review)
Review
OBJECTIVE
In clinical practice and research, standardised sets of data and outcomes are routinely collected to facilitate data comparison, benchmarking and quality improvement. Most existing data sets are condition-specific and cannot be applied to all patients in a given clinical setting. This review aimed to determine whether the development of a minimum data set for subacute rehabilitation is feasible by collating and comparing existing rehabilitation minimum data sets and core outcome sets.
DATA SOURCES
Published literature was identified through database searches (Scopus, PubMed, EMBASE, CINAHL and the COMET Initiative) in September 2021. Additional data sets were identified through a grey literature search.
REVIEW METHODS
This review was conducted in alignment with the PRISMA-ScR recommendations. Datasets were included if they were published in English, designed for adults, and intended for use in subacute rehabilitation. Data were extracted and taxonomically organised to identify commonalities. Items present in ≥50% of data sets were considered common.
RESULTS
Twenty minimum data sets and seven core outcome sets were included. There were 29 common minimum data set domains, with 19 relating to , seven relating to , two relating to and one relating to . Four common domains were identified within the Core Outcome Set analysis, which all related to , specifically (86%) (57%) (86%) and (100%).
CONCLUSION
Common item domains in conditions requiring subacute rehabilitation have been identified, suggesting that development of a dataset for subacute rehabilitation may be feasible.
Topics: Adult; Humans; Medicine; Outcome Assessment, Health Care; Quality of Life
PubMed: 34873966
DOI: 10.1177/02692155211060468