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International Journal of Environmental... May 2021Evidence has suggested that parental age at birth is a risk factor of offspring attention deficit/hyperactivity disorder (ADHD). We conducted a meta-analysis of... (Meta-Analysis)
Meta-Analysis Review
Evidence has suggested that parental age at birth is a risk factor of offspring attention deficit/hyperactivity disorder (ADHD). We conducted a meta-analysis of observational studies investigating the association between parental age and offspring ADHD. We conducted a systematic search that followed the recommended guidelines for performing meta-analyses on PUBMED, EMBASE, and Web of Science up to 8 April 2021. We calculated pooled risk estimates from individual age with and without adjusting for possible confounding factors. Dose-response analysis for parental age and ADHD risk was performed. Eleven studies were selected in this meta-analysis, which included 111,101 cases and 4,417,148 participants. Compared with the reference points, the lowest parental age category was associated with an increased risk of ADHD in the offspring, with adjusted odds ratios (ORs) of 1.49 (95% confidence intervals (95%CI) 1.19-1.87) and 1.75 (95%CI 1.31-2.36) for the mother and father, respectively. The highest parental age was statistically insignificant, with adjusted ORs of 1.11 (95%CI 0.79-1.55) and 0.93 (95%CI 0.70-1.23) for mother and father separately. Dose-response analysis indicated a non-linear relationship of parental age with offspring ADHD, with the lowest ADHD risk at 31-35 years old. The results of this meta-analysis support an association between young parental age and the risk of ADHD. More high-quality studies are needed to establish whether the association with parental age is causal.
Topics: Adult; Attention Deficit Disorder with Hyperactivity; Fathers; Female; Humans; Infant, Newborn; Male; Mothers; Odds Ratio; Risk Factors
PubMed: 34066379
DOI: 10.3390/ijerph18094939 -
The American Journal on Addictions Jul 2024Probability discounting (PD), which refers to the process of adjusting the value of future probabilities when making decisions, is a method of measuring impulsive... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVES
Probability discounting (PD), which refers to the process of adjusting the value of future probabilities when making decisions, is a method of measuring impulsive decision-making; however, the relationship between PD and nicotine remains unclear. The current study aimed at investigating the significance of PD in individuals who smoke.
METHODS
According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched the PubMed, Embase, PsycINFO, and Web of Science databases for articles comparing individuals who smoke and their tobacco-naïve controls using PD task as outcome measure from inception to May 2023. The main outcome was an overall difference in PD function, while subgroup analysis and meta-regression were conducted to examine the analysis methods and the moderators of PD.
RESULTS
Fourteen studies in total involving 384 individuals who smoke and 493 controls (mean age = 24.32 years, range = 15.1-38.05 years) were analyzed. The effect of smoking on PD was significant (g = 0.51, p = .02). The discounting parameter from the equation, compared to the area under the curve, was more sensitive to estimating PD function (p = .01). Regression analysis showed positive correlations of PD with female percentage, age, and the number of probability options (all p < .04), but not with the number of choices at each probability and maximum reward magnitude (all p > .07). There was no significant publication bias across the eligible studies (p = .09).
CONCLUSION AND SCIENTIFIC SIGNIFICANCE
Our findings, which are the first to demonstrate a smaller PD (i.e., prone to risk-taking) in individuals who smoke, shed light on the appropriate analysis method, gender effect, age, and probability options on the PD function.
Topics: Adolescent; Adult; Female; Humans; Male; Young Adult; Decision Making; Delay Discounting; Impulsive Behavior; Probability; Smoking
PubMed: 38290762
DOI: 10.1111/ajad.13521 -
BJOG : An International Journal of... Nov 2020Interpregnancy interval (IPI) <6 months is a potentially modifiable risk factor for adverse perinatal health outcomes. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Interpregnancy interval (IPI) <6 months is a potentially modifiable risk factor for adverse perinatal health outcomes.
OBJECTIVE
This systematic review evaluated the international literature on the risk of perinatal death associated with IPI.
SEARCH STRATEGY
Two independent reviewers screened titles and abstracts identified in MEDLINE, EMBASE and Scopus from inception to 4 April 2019 (Prospero Registration #CRD42018092792).
SELECTION CRITERIA
Studies were included if they provided a description of IPI measurement and perinatal death, including stillbirth and neonatal death.
DATA COLLECTION AND ANALYSIS
A narrative review was performed for all included studies. Random effects meta-analysis was used to compare unadjusted odds of perinatal death associated with IPI <6 months and IPI ≥6 months. Analyses were performed by outcome of the preceding pregnancy and study location.
MAIN RESULTS
Of the 624 unique articles identified, 26 met the inclusion criteria. The pooled unadjusted odds ratio of perinatal death for IPI <6 months was 1.34 (95% CI 1.17-1.53) following a previous live birth, 0.85 (95% CI 0.73-0.99) following a previous miscarriage and 1.07 (95% CI 0.84-1.36) following a previous stillbirth compared with IPI ≥6 months. However, few high-income country studies reported an association after adjustment. Fewer studies evaluated the impact of long IPI on perinatal death and what evidence was available showed mixed results.
CONCLUSIONS
Results suggest a possible association between short IPI and risk of perinatal death following a live birth, particularly in low- to middle-income countries.
TWEETABLE ABSTRACT
Short IPI <6 months after a live birth was associated with greater risk of perinatal death than IPI ≥6 months.
Topics: Birth Intervals; Female; Humans; Infant, Newborn; Perinatal Death; Pregnancy; Risk Assessment; Risk Factors
PubMed: 32378279
DOI: 10.1111/1471-0528.16303 -
Medical Decision Making : An... Oct 2022Analyzing and communicating uncertainty is essential in medical decision making. To judge whether risks are acceptable, policy makers require information on the expected...
PURPOSE
Analyzing and communicating uncertainty is essential in medical decision making. To judge whether risks are acceptable, policy makers require information on the expected outcomes but also on the uncertainty and potential losses related to the chosen strategy. We aimed to compare methods used to represent the impact of uncertainty in decision problems involving many strategies, enhance existing methods, and provide an open-source and easy-to-use tool.
METHODS
We conducted a systematic literature search to identify methods used to represent the impact of uncertainty in cost-effectiveness analyses comparing multiple strategies. We applied the identified methods to probabilistic sensitivity analysis outputs of 3 published decision-analytic models comparing multiple strategies. Subsequently, we compared the following characteristics: type of information conveyed, use of a fixed or flexible willingness-to-pay threshold, output interpretability, and the graphical discriminatory ability. We further proposed adjustments and integration of methods to overcome identified limitations of existing methods.
RESULTS
The literature search resulted in the selection of 9 methods. The 3 methods with the most favorable characteristics to compare many strategies were 1) the cost-effectiveness acceptability curve (CEAC) and cost-effectiveness acceptability frontier (CEAF), 2) the expected loss curve (ELC), and 3) the incremental benefit curve (IBC). The information required to assess confidence in a decision often includes the average loss and the probability of cost-effectiveness associated with each strategy. Therefore, we proposed the integration of information presented in an ELC and CEAC into a single heat map.
CONCLUSIONS
This article presents an overview of methods presenting uncertainty in multiple-strategy cost-effectiveness analyses, with their strengths and shortcomings. We proposed a heat map as an alternative method that integrates all relevant information required for health policy and medical decision making.
HIGHLIGHTS
To assess confidence in a chosen course of action, decision makers require information on both the probability and the consequences of making a wrong decision.This article contains an overview of methods for presenting uncertainty in multiple-strategy cost-effectiveness analyses.We propose a heat map that combines the probability of cost-effectiveness from the cost-effectiveness acceptability curve (CEAC) with the consequences of a wrong decision from the expected loss curve.Collapsing of the CEAC can be reduced by relaxing the CEAC, as proposed in this article.Code in Microsoft Excel and R is provided to easily analyze data using the methods discussed in this article.
Topics: Cost-Benefit Analysis; Health Policy; Humans; Probability; Uncertainty
PubMed: 35587181
DOI: 10.1177/0272989X221100112 -
Journal of Preventive Medicine and... Mar 2021As a fundamental dimension of quality, the patient safety and healthcare workers safety in the healthcare environment depend on the ability of each healthcare workers... (Review)
Review
INTRODUCTION
As a fundamental dimension of quality, the patient safety and healthcare workers safety in the healthcare environment depend on the ability of each healthcare workers (whether administrators or technicians) to reduce the probability of error. This review focused on nursing students. The aim was to assess level and determinants of knowledge about risk assessment, risk prevention and risk management of nursing students.
METHODS
A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Two reviewers searched the bibliographic databases Pubmed, Scopus and Cinahl to collect all the available articles in English and Italian issued between 2015 and August 2019. To obtain an exhaustive query of search, the following keywords were combined through Boolean operators AND and OR: Clinical Risk Assessment, Nursing Education, Nursing Student*, Patient Safety. The authors assessed the quality of the evidence by using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) method.
RESULTS
Twelve papers are included. Although the literature on the nursing student's error is limited, their frequencies are worrying. Some authors have created a model of prevention of clinical error based on three level. However, the majority of nursing students don't feel confident with a patient safety. Many authors shown that patient safety education was delivery by lecture, laboratory or simulation sessions.
CONCLUSIONS
This review underlines the need to revise the nursing curriculum on patient safety and the need to think what educational methodology is the better for the student to create a safe care.
Topics: Delivery of Health Care; Health Knowledge, Attitudes, Practice; Humans; Patient Safety; Risk Assessment; Risk Management; Students, Nursing
PubMed: 34322627
DOI: 10.15167/2421-4248/jpmh2021.62.1.1698 -
Helicobacter Apr 2023To assess the region-specific relative risk of cardia/non-cardia gastric cancer (CGC/NCGC) associated with Helicobacter pylori (H. pylori) and quantify its contribution... (Meta-Analysis)
Meta-Analysis Review
Cardia and non-cardia gastric cancer risk associated with Helicobacter pylori in East Asia and the West: A systematic review, meta-analysis, and estimation of population attributable fraction.
OBJECTIVES
To assess the region-specific relative risk of cardia/non-cardia gastric cancer (CGC/NCGC) associated with Helicobacter pylori (H. pylori) and quantify its contribution to gastric cancer burden using population attributable fraction (PAF).
METHODS
PubMed, EMBASE, Web of Science, and Cochrane Central databases were searched by two reviewers until April 20, 2022. The association between H. pylori infection and NCGC/CGC was assessed using pooled odds ratios (ORs) with 95% confidence intervals (CIs). PAF was calculated using the formula of H. pylori prevalence and the pooled OR.
RESULTS
One hundred and eight studies were included. A significant association was observed between H. pylori infection and NCGC in East Asia (OR, 4.36; 95% CI: 3.54-5.37) and the West (OR, 4.03; 95% CI: 2.59-6.27). Regarding CGC, a significant association was found only in East Asia (OR, 2.86; 95% CI: 2.26-3.63), not in the West (OR, 0.80; 95% CI: 0.61-1.05). For studies with a follow-up time of ≥10 years, pooled ORs for NCGC and CGC in East Asia were 5.58 (95% CI: 4.08-7.64) and 3.86 (95% CI: 2.69-5.55), respectively. Pooled OR for NCGC was 6.80 (95% CI: 3.78-12.25) in the West. PAFs showed that H. pylori infection accounted for 71.2% of NCGC, 60.7% of CGC in East Asia, and 73.2% of NCGC in the West.
CONCLUSIONS
Gastric cancer burden associated with H. pylori infection exhibits important geographical differences. Prolonged follow-up period could overcome the underestimation of the magnitude of the association between H. pylori infection and CGC/NCGC. Customized strategies for H. pylori screening and eradication should be implemented to prevent gastric cancer.
Topics: Humans; Stomach Neoplasms; Helicobacter pylori; Risk; Helicobacter Infections; Asia, Eastern; Risk Factors
PubMed: 36645649
DOI: 10.1111/hel.12950 -
Journal of the American Heart... Sep 2023Current recommendations support a personalized sequential approach for cardiac rhythm monitoring to detect atrial fibrillation after embolic stroke of undetermined... (Review)
Review
Current recommendations support a personalized sequential approach for cardiac rhythm monitoring to detect atrial fibrillation after embolic stroke of undetermined source. Several risk stratification scores have been proposed to predict the likelihood of atrial fibrillation after embolic stroke of undetermined source. This systematic review aimed to provide a comprehensive overview of the field by identifying risk scores proposed for this purpose, assessing their characteristics and the cohorts in which they were developed and validated, and scrutinizing their predictive performance. We identified 11 risk scores, of which 4 were externally validated. The most frequent variables included were echocardiographic markers and demographics. The areas under the curve ranged between 0.70 and 0.94. The 3 scores with the highest area under the curve were the Decryptoring (0.94 [95% CI, 0.88-1.00]), newly diagnosed atrial fibrillation (0.87 [95% CI, 0.79-0.94]), and AF-ESUS (Atrial Fibrillation in Embolic Stroke of Undetermined Source) (0.85 [95% CI, 0.80-0.87]), of which only the latter was externally validated. Risk stratification scores can guide a personalized approach for cardiac rhythm monitoring after embolic stroke of undetermined source.
Topics: Humans; Atrial Fibrillation; Embolic Stroke; Echocardiography; Risk Factors; Risk Assessment
PubMed: 37681521
DOI: 10.1161/JAHA.123.030479 -
International Journal of Molecular... Nov 2022Cardiovascular disease (CVD) continues as the most important cause of mortality. Better risk screening and prediction are needed to reduce the cardiovascular disease... (Meta-Analysis)
Meta-Analysis Review
Cardiovascular disease (CVD) continues as the most important cause of mortality. Better risk screening and prediction are needed to reduce the cardiovascular disease burden. The aim of the study was to assess the role of serum biomarkers in the prediction of CVD among asymptomatic middle-aged adults with no prior CVD history. A systematic review and meta-analysis were carried out using literature from PubMed and following PRISMA reporting guidelines. Twenty-five studies met our inclusion criteria and were included in the systematic review. The most commonly studied biomarker was high-sensitivity C reactive protein (hs-CRP) (10 studies), which showed that higher hs-CRP levels are associated with an increased risk of subsequent CVD events and mortality. In addition, several less-studied biomarkers (N-terminal pro-brain natriuretic peptide (NT-proBNP), fibrinogen, gamma-glutamyl transferase (GGT), and others) also showed significant associations with greater future risk of CVD. A meta-analysis was possible to perform for hs-CRP and NT-proBNP, which showed statistically significant results for the ability of hs-CRP (hazard ratio (HR) 1.19, (95% CI: 1.09−1.30), p < 0.05) and NT-proBNP (HR 1.22, (1.13−1.32), p < 0.05) to predict incident CVD among middle-aged adults without a prior CVD history or symptoms. Several serum biomarkers, particularly hs-CRP and NT-proBNP, have the potential to improve primary CVD risk prevention among asymptomatic middle-aged adults.
Topics: Middle Aged; Adult; Humans; Cardiovascular Diseases; C-Reactive Protein; Risk Factors; Natriuretic Peptide, Brain; Peptide Fragments; Biomarkers; Proportional Hazards Models
PubMed: 36362325
DOI: 10.3390/ijms232113540 -
Psychiatry Research Nov 2023Assessing and managing suicide behaviors is highly relevant to individuals with schizophrenia spectrum disorders. Our study aims to assess the association between... (Meta-Analysis)
Meta-Analysis Review
Assessing and managing suicide behaviors is highly relevant to individuals with schizophrenia spectrum disorders. Our study aims to assess the association between adverse childhood experiences and suicidal behaviors in individuals with schizophrenia spectrum disorders. We included observational studies comparing the probability of suicide behaviors in adults with schizophrenia spectrum disorders exposed and unexposed to adverse childhood experiences. Odds ratio estimates were obtained by pooling data using a random-effects pairwise meta-analysis. Standardized criteria were used to assess the strength of the association of the pooled estimate. We found 21 eligible studies reporting outcomes for 6257 individuals from 11 countries. The primary outcome revealed an association between any suicidal behavior and adverse childhood experiences, which resulted "highly suggestive" according to validated Umbrella Criteria. Similarly, a positive association was confirmed for suicidal ideation and suicide attempt and for any subtype of adverse childhood experience. This meta-analysis showed that exposure to adverse childhood experiences strongly increases the probability of suicide behaviors in people with schizophrenia spectrum disorders.
Topics: Adult; Humans; Suicidal Ideation; Schizophrenia; Adverse Childhood Experiences; Suicide, Attempted; Probability
PubMed: 37769371
DOI: 10.1016/j.psychres.2023.115488 -
Nutrition Reviews Jul 2022The importance and benefits of breastfeeding in children are well recognized, and it may improve motor development. Motor skills are fundamental to childhood... (Meta-Analysis)
Meta-Analysis
CONTEXT
The importance and benefits of breastfeeding in children are well recognized, and it may improve motor development. Motor skills are fundamental to childhood development. Although some studies report a positive association between breastfeeding and motor development in children, others have suggested that these differences could be influenced by confounding variables.
OBJECTIVE
To estimate the degree to which breastfeeding duration and exclusivity is associated with motor development in children. Thus, a systematic review of the literature and a meta-analysis was conducted.
DATA SOURCES
MEDLINE (via PubMed), Embase, the Cochrane Database of Systematic Reviews, and the Web of Science databases were systematically searched from inception to June 2021.
DATA EXTRACTION
The most adjusted relative risks (RRs) or odds ratios (ORs) and their corresponding 95% confidence intervals (95% CIs) reported by included studies were used. The "breastfeeding duration" category defined by each study was used as the reference category. Additionally, subgroup analyses were performed based on the duration of breastfeeding.
DATA ANALYSIS
Eighteen published studies were included in the systematic review and 14 studies in the meta-analysis. The results showed that the effect size (ES) for exclusively breastfed vs never breastfed children was 0.86 (95% CI: 0.32, 1.41, I2 = 90.3%), and the ES for children breastfed for any length vs never breastfed children was 0.95 (95% CI: 0.80, 1.10, I2 = 88.0%). The remaining groups studied did not show significant differences in outcomes.
CONCLUSIONS
Although our data suggest that breastfeeding may improve motor development in children, more studies are needed because publication bias has been detected. Nevertheless, our results support the promotion of breastfeeding.
Topics: Breast Feeding; Child; Child Development; Female; Humans; Motor Skills; Odds Ratio; Risk
PubMed: 35325229
DOI: 10.1093/nutrit/nuac013