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Psychological Assessment Jun 2017We know surprisingly little about the interrater reliability of forensic psychological opinions, even though courts and other authorities have long called for known... (Meta-Analysis)
Meta-Analysis Review
We know surprisingly little about the interrater reliability of forensic psychological opinions, even though courts and other authorities have long called for known error rates for scientific procedures admitted as courtroom testimony. This is particularly true for opinions produced during routine practice in the field, even for some of the most common types of forensic evaluations-evaluations of adjudicative competency and legal sanity. To address this gap, we used meta-analytic procedures and study space methodology to systematically review studies that examined the interrater reliability-particularly the field reliability-of competency and sanity opinions. Of 59 identified studies, 9 addressed the field reliability of competency opinions and 8 addressed the field reliability of sanity opinions. These studies presented a wide range of reliability estimates; pairwise percentage agreements ranged from 57% to 100% and kappas ranged from .28 to 1.0. Meta-analytic combinations of reliability estimates obtained by independent evaluators returned estimates of κ = .49 (95% CI: .40-.58) for competency opinions and κ = .41 (95% CI: .29-.53) for sanity opinions. This wide range of reliability estimates underscores the extent to which different evaluation contexts tend to produce different reliability rates. Unfortunately, our study space analysis illustrates that available field reliability studies typically provide little information about contextual variables crucial to understanding their findings. Given these concerns, we offer suggestions for improving research on the field reliability of competency and sanity opinions, as well as suggestions for improving reliability rates themselves. (PsycINFO Database Record
Topics: Humans; Insanity Defense; Mental Competency; Reproducibility of Results
PubMed: 28594221
DOI: 10.1037/pas0000388 -
Value in Health : the Journal of the... May 2022As healthcare systems continue to respond to the COVID-19 pandemic, cost-effectiveness evidence will be needed to identify which tests and treatments for COVID-19 offer...
OBJECTIVES
As healthcare systems continue to respond to the COVID-19 pandemic, cost-effectiveness evidence will be needed to identify which tests and treatments for COVID-19 offer value for money. We sought to review economic evaluations of diagnostic tests and treatments for COVID-19, critically appraising the methodological approaches used and reporting cost-effectiveness estimates, using a "living" systematic review approach.
METHODS
Key databases (including MEDLINE, EconLit, Embase) were last searched on July 12, 2021. Gray literature and model repositories were also searched. Only full economic evaluations published in English were included. Studies were quality assessed and data were extracted into standard tables. Results were narratively summarized. The review was completed by 2 reviewers independently, with disagreements resolved through discussion with a senior reviewer.
RESULTS
Overall, 3540 records were identified, with 13 meeting the inclusion criteria. After quality assessment, 6 were excluded because of very severe limitations. Of the 7 studies included, 5 were cost-utility analyses and 2 were cost-effectiveness analyses. All were model-based analyses. A total of 5 evaluated treatments (dexamethasone, remdesivir, hypothetical) and 2 evaluated hypothetical testing strategies. Cost-effectiveness estimates were sensitive to the treatment effect on survival and hospitalization, testing speed and accuracy, disease severity, and price.
CONCLUSIONS
Presently, there are few economic evaluations for COVID-19 tests and treatments. They suggest treatments that confer a survival benefit and fast diagnostic tests may be cost effective. Nevertheless, studies are subject to major evidence gaps and take inconsistent analytical approaches. The evidence may improve for planned updates of this "living" review.
Topics: COVID-19; Cost-Benefit Analysis; Humans; Pandemics
PubMed: 35181207
DOI: 10.1016/j.jval.2022.01.001 -
The American Journal of Sports Medicine Jul 2019The early recognition and management of patients with hip lesions, such as femoroacetabular impingement (FAI) and early hip osteoarthritis (OA), may preempt significant... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The early recognition and management of patients with hip lesions, such as femoroacetabular impingement (FAI) and early hip osteoarthritis (OA), may preempt significant hip morbidity. The identification of reliable biomarkers may help guide decision making in an efficient and cost-effective manner.
PURPOSE
To determine the biomarkers that have been associated with FAI as well as identify serum, synovial, and urinary analytes that have shown clinical utility in the prediction or identification of hip OA.
STUDY DESIGN
Systematic review and meta-analysis.
METHODS
The terms "hip arthroscopy," "femoroacetabular impingement," "labral tear," "osteoarthritis," and "biomarker" were searched in PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar, yielding 276 articles. After screening, 7 articles were included. Pooled estimates were calculated utilizing a fixed-effects inverse-variance model weighted for individual study size.
RESULTS
A total of 1747 patients with a mean age of 37.5 ± 4.5 years (76.4% female) were identified. Forty-three unique biomarkers were assessed. Although general proinflammatory cytokines IL-1 and TNF-α exhibited inconsistent trends in arthritic hips, IL-6 demonstrated a consistent increase (+84.8% [95% CI, 81.9%-87.6%]; < .05). A significant difference was found in levels of the fibronectin-aggrecan complex (FAC) in patients with OA compared with controls (0.08 ± 0.40 vs 1.15 ± 0.35 μg/mL, respectively; < .001). It was the only specific analyte to show a significant difference between those with and without OA. In the setting of FAI, cartilage oligomeric matrix protein (COMP) was significantly increased in athletes after adjusting for concurrent knee and hip OA. A statistically significant difference was present in FAI-positive hips (9.0 ± 0.1 [95% CI, 8.8-9.3]) compared with controls (8.4 ± 0.1 [95% CI, 8.2-8.4]) ( < .05). Other biomarkers, such as CXCL3, which exhibited statistically significant differences compared with controls, did not control for underlying factors such as age and concomitant lesions.
CONCLUSION
COMP and FAC are specific biomarkers with potential utility in the diagnosis and management of FAI and hip OA, given their ability to differentiate between controls and patients with hip lesions. Further research is necessary to identify their ability in determining disease severity, predicting the response to treatment, and establishing an association with the risk of long-term OA.
Topics: Adult; Arthroscopy; Athletes; Biomarkers; Cartilage Oligomeric Matrix Protein; Female; Femoracetabular Impingement; Hip Joint; Humans; Male; Osteoarthritis, Hip
PubMed: 30388026
DOI: 10.1177/0363546518803360 -
Sensors (Basel, Switzerland) Feb 2023This paper reviews recent advances in sensor technologies for non-destructive testing (NDT) and structural health monitoring (SHM) of civil structures. The article is... (Review)
Review
This paper reviews recent advances in sensor technologies for non-destructive testing (NDT) and structural health monitoring (SHM) of civil structures. The article is motivated by the rapid developments in sensor technologies and data analytics leading to ever-advancing systems for assessing and monitoring structures. Conventional and advanced sensor technologies are systematically reviewed and evaluated in the context of providing input parameters for NDT and SHM systems and for their suitability to determine the health state of structures. The presented sensing technologies and monitoring systems are selected based on their capabilities, reliability, maturity, affordability, popularity, ease of use, resilience, and innovation. A significant focus is placed on evaluating the selected technologies and associated data analytics, highlighting limitations, advantages, and disadvantages. The paper presents sensing techniques such as fiber optics, laser vibrometry, acoustic emission, ultrasonics, thermography, drones, microelectromechanical systems (MEMS), magnetostrictive sensors, and next-generation technologies.
PubMed: 36850802
DOI: 10.3390/s23042204 -
Cost Effectiveness and Resource... Apr 2022This study aims to synthesize the empirical economic evidence of pharmaceutical therapies for people with dementia. (Review)
Review
OBJECTIVES
This study aims to synthesize the empirical economic evidence of pharmaceutical therapies for people with dementia.
STUDY DESIGN
Systematic review and meta-analysis. Literature evaluating the costs and effects of drug therapies for dementia was indexed until December 2021. Quality of study was assessed using the Cochrane Risk of Bias Tool and Consensus on Health Economic Criteria list. Cost data were standardized to 2020 US dollars and analyzed from healthcare service and societal perspectives. Random-effects models were used to synthesize economic and clinical data, based on mean differences (MDs) and standardized MDs.
RESULTS
Ten unique studies were identified from 11,771 records. Acetylcholinesterase inhibitors (AChEIs) and memantine improved dementia-related symptoms, alongside nonsignificant savings in societal cost (AChEIs: MD-2002 [- 4944 ~ 939]; memantine: MD-6322 [- 14355 ~ 1711]). Despite decreases in cost, antidepressants of mirtazapine and sertraline and second-generation antipsychotics were limited by their significant side effects on patients' cognitive and activity functions. Subgroup analysis indicated that the impacts of AChEIs on cost were affected by different analytical perspectives, follow-up periods, and participant age.
CONCLUSIONS
AChEIs and memantine are cost-effective with improvements in dementia-related symptoms and trends of cost-savings. More empirical evidence with non-industrial sponsorships and rigorous design in different settings is warranted.
PubMed: 35443684
DOI: 10.1186/s12962-022-00354-3 -
Clinical Trials (London, England) Dec 2022Self-management interventions are increasingly being developed and researched to improve long-term condition outcomes. To understand and interpret findings, it is... (Review)
Review
BACKGROUND/AIMS
Self-management interventions are increasingly being developed and researched to improve long-term condition outcomes. To understand and interpret findings, it is essential that fidelity of intervention delivery and participant engagement are measured and reported. Before developing fidelity checklists to assess treatment fidelity of interventions, current recommendations suggest that a synthesis of fidelity measures reported in the literature is completed. Therefore, here we aim to identify what the current measures of fidelity of intervention delivery and engagement for self-management interventions for long-term conditions are and whether there is treatment fidelity.
METHODS
Four databases (MEDLINE, PubMed, CINAHL Plus and ScienceDirect) and the journal implementation science were systematically searched to identify published reports from inception to December 2020 for experimental studies measuring fidelity of intervention delivery and/or participant engagement in self-management interventions for long-term conditions. Data on fidelity of delivery and engagement measures and the findings were extracted and synthesised.
RESULTS
Thirty-nine articles were identified as eligible, with 25 studies measuring fidelity of delivery, 19 reporting engagement and 5 measuring both. For fidelity of delivery, measures included structured checklists, participant completed measures and researcher observations/notes. These were completed by researchers, participants and intervention leaders. Often there was little information around the development of these measures, particularly when the measure had been developed by the researchers, rather than building on others work. Eighteen of 25 studies reported there was fidelity of intervention delivery. For engagement, measures included data analytics, participant completed measures and researcher observations. Ten out of 19 studies reported participants were engaged with the intervention.
CONCLUSION
In complex self-management interventions, it is essential to assess whether treatment fidelity of each core component of interventions is delivered, as outlined in the protocol, to understand which components are having an effect. Treatment fidelity checklists comparing what was planned to be delivered, with what was delivered should be developed with pre-defined cut-offs for when fidelity has been achieved. Similarly, when measuring engagement, while data analytics continue to rise with the increase in digital interventions, clear cut-offs for participant use and content engaged with to be considered an engagement participant need to be pre-determined.
Topics: Humans; Self-Management; Checklist; Data Science; Databases, Factual; MEDLINE
PubMed: 36017707
DOI: 10.1177/17407745221118555 -
Endocrinology, Diabetes & Metabolism May 2023Adipose tissue is the source of a broad array of signalling molecules (adipokines), which mediate interorgan communication and regulate metabolic homeostasis.... (Review)
Review
INTRODUCTION
Adipose tissue is the source of a broad array of signalling molecules (adipokines), which mediate interorgan communication and regulate metabolic homeostasis. Alterations in adipokine levels have been causally implicated in various metabolic disorders, including changes in bone mass. Osteoporosis is the commonest progressive metabolic bone disease, characterized by elevated risk of fragility fractures as a result of a reduced bone mass and microarchitectural deterioration. The effects of different adipokines on bone mass have been studied in an attempt to identify novel modulators of bone mass or diagnostic biomarkers of osteoporosis.
METHODS
In this review, we sought to aggregate and assess evidence from independent studies that quantify specific adipokines and their effect on bone mineral density (BMD).
RESULTS
A literature search identified 57 articles that explored associations between different adipokines and BMD. Adiponectin and leptin were the most frequently studied adipokines, with most studies demonstrating that adiponectin levels are associated with decreased BMD at the lumbar spine and femoral neck. Conversely, leptin levels are associated with increased BMD at these sites. However, extensive heterogeneity with regards to sample size, characteristics of study subjects, ethnicity, as well as direction and magnitude of effect at specific skeletal anatomical sites was identified. The broad degree of conflicting findings reported in this study can be attributed several factors. These include differences in study design and ascertainment criteria, the analytic challenges of quantifying specific adipokines and their isoforms, pre-analytical variables (in particular patient preparation) and confounding effects of co-existing disease.
CONCLUSIONS
This review highlights the biological relevance of adipokines in bone metabolism and reinforces the need for longitudinal research to elucidate the causal relationship of adipokines on bone mass.
Topics: Humans; Adipokines; Bone Density; Leptin; Adiponectin; Osteoporosis
PubMed: 36759562
DOI: 10.1002/edm2.408 -
Frontiers in Psychiatry 2020Web-based interventions have been introduced as novel and effective treatments for mental disorders and, in recent years, specifically for the bereaved. However, a...
BACKGROUND
Web-based interventions have been introduced as novel and effective treatments for mental disorders and, in recent years, specifically for the bereaved. However, a systematic summary of the effectiveness of online interventions for people experiencing bereavement is still missing.
OBJECTIVE
A systematic literature search was conducted by four reviewers who reviewed and meta-analytically summarized the evidence for web-based interventions for bereaved people.
METHODS
Systematic searches (PubMed, Web of Science, PsycInfo, PsycArticles, Medline, and CINAHL) resulted in seven randomized controlled trials ( = 1,257) that addressed adults having experienced bereavement using internet-based interventions. We used random effects models to summarize treatment effects for between-group comparisons (treatment control at post) and stability over time (post follow-up).
RESULTS
All web-based interventions were based on cognitive behavioral therapy (CBT). In comparison with control groups, the interventions showed moderate ( = .54) to large effects ( = .86) for symptoms of grief and posttraumatic stress disorder (PTSD), respectively. The effect for depression was small ( = .44). All effects were stable over time. A higher number of treatment sessions achieved higher effects for grief symptoms and more individual feedback increased effects for depression. Other moderators ( dropout rate, time since loss, exposure) did not significantly reduce moderate degrees of heterogeneity between the studies.
LIMITATIONS
The number of includable studies was low in this review resulting to lower power for moderator analyses in particular.
CONCLUSIONS
Overall, the results of web-based bereavement interventions are promising, and its low-threshold approach might reduce barriers to bereavement care. Nonetheless, future research should further examine potential moderators and specific treatment components ( exposure, feedback) and compare interventions with active controls.
PubMed: 32670101
DOI: 10.3389/fpsyt.2020.00525 -
International Journal of Dentistry 2021The majority of human maxillary first molars is usually described as having three roots, but different morphologies were documented in several studies and case reports.... (Review)
Review
OBJECTIVES
The majority of human maxillary first molars is usually described as having three roots, but different morphologies were documented in several studies and case reports. One very rare and less investigated anatomical anomaly is the occurrence of four radicular structures in the upper first molars. This communication aimed to define the prevalence of four-rooted maxillary first molars on a meta-analytical basis. The external and internal morphology of these teeth was described by the collection of published case reports.
MATERIALS AND METHODS
Six electronic databases were accessed to collect case reports dealing with four-rooted maxillary first molars, as well as population-based cone-beam computed tomography (CBCT) studies. Afterward, the publications were selected according to predefined inclusion/exclusion criteria and evaluated using the Joanna Briggs Institute Critical Appraisal tool. The teeth of the chosen case reports were then independently analyzed by two dental professionals according to different dental classifications. Furthermore, the population studies were meta-analyzed to calculate the global and regional prevalence of four-rooted maxillary molars.
RESULTS
Included were forty-nine population-based CBCT studies containing 26663 maxillary first molars. Upon these data, the global incidence of four-rooted maxillary molars was meta-analytically determined as 0.047% (95%-CI:0.011-0.103%). In combination with the case reports, it was pointed out that this anomaly is distributed worldwide. Furthermore, forty-eight case reports were included containing fifty-three maxillary molars with four roots. The analyzed teeth exhibited Versiani´s pulpal chamber floor Types A and B. The majority of four-rooted maxillary first molars were classified as Type I regarding Christie's configuration. But, also 7.54% of the altered teeth could not be described by this classification. 62.34% exhibited four root canals, but also variations with five, six, or seven canals were identified. Furthermore, a significant difference was found in the occurrence rate between male and female patients.
CONCLUSION
Due to the worldwide occurrence, dental professionals should be aware of this rare anomaly to avoid treatment errors, especially during endodontic or surgical therapies.
PubMed: 33542735
DOI: 10.1155/2021/8845442 -
Developmental Neurorehabilitation Jan 2018A systematic review was conducted to identify effective intervention strategies for communication in individuals with Down syndrome. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
A systematic review was conducted to identify effective intervention strategies for communication in individuals with Down syndrome.
METHODS
We updated and extended previous reviews by examining: (1) participant characteristics; (2) study characteristics; (3) characteristics of effective interventions (e.g., strategies and intensity); (4) whether interventions are tailored to the Down syndrome behavior phenotype; and (5) the effectiveness (i.e., percentage nonoverlapping data and Cohen's d) of interventions.
RESULTS
Thirty-seven studies met inclusion criteria. The majority of studies used behavior analytic strategies and produced moderate gains in communication targets. Few interventions were tailored to the needs of the Down syndrome behavior phenotype.
CONCLUSION
The results suggest that behavior analytic strategies are a promising approach, and future research should focus on replicating the effects of these interventions with greater methodological rigor.
Topics: Adolescent; Child; Down Syndrome; Female; Humans; Infant; Language; Male; Neurological Rehabilitation
PubMed: 27537068
DOI: 10.1080/17518423.2016.1212947