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Journal of Refractive Surgery... Jun 2012To evaluate uncorrected distance visual acuity (UDVA) as well as uncorrected near visual acuity (UNVA) as outcomes in treating presbyopic cataract patients to assist... (Review)
Review
PURPOSE
To evaluate uncorrected distance visual acuity (UDVA) as well as uncorrected near visual acuity (UNVA) as outcomes in treating presbyopic cataract patients to assist clinicians and ophthalmologists in their decision-making process regarding available interventions.
METHODS
Medline, Embase, and Evidence Based Medicine Reviews were systematically reviewed to identify studies reporting changes in UDVA and UNVA after cataract surgery in presbyopic patients. Strict inclusion/exclusion criteria were used to exclude any studies not reporting uncorrected visual acuity in a presbyopic population with cataracts implanted with multifocal intraocular lenses (IOLs). Relevant outcomes (UDVA and UNVA) were identified from the studies retrieved through the systematic review process.
RESULTS
Twenty-nine studies were identified that reported uncorrected visual acuities, including one study that reported uncorrected intermediate visual acuity. Nine brands of multifocal IOLs were identified in the search. All studies identified in the literature search reported improvements in UDVA and UNVA following multifocal IOL implantation. The largest improvements in visual acuity were reported using the Rayner M-Flex lens (Rayner Intraocular Lenses Ltd) (UDVA, binocular: 1.05 logMAR, monocular: 0.92 logMAR; UNVA, binocular and monocular: 0.83 logMAR) and the smallest improvements were reported using the Acri.LISA lens (Carl Zeiss Meditec) (UDVA, 0.21 decimal; UNVA, 0.51 decimal).
CONCLUSIONS
The results of this systematic review show the aggregate of studies reporting a beneficial increase in UDVA and UNVA with the use of multifocal IOLs in cataract patients with presbyopia, hence providing evidence to support the hypothesis that multifocal IOLs increase UDVA and UNVA in cataract patients.
Topics: Cataract Extraction; Distance Perception; Humans; Lens Implantation, Intraocular; Presbyopia; Visual Acuity
PubMed: 22692525
DOI: 10.3928/1081597X-20120518-06 -
The Journal of International Advanced... Dec 2020Summarise outcomes following cochlear implantation (CI) in patients with post-meningitis deafness. Systematic review and narrative synthesis. Databases searched:...
Summarise outcomes following cochlear implantation (CI) in patients with post-meningitis deafness. Systematic review and narrative synthesis. Databases searched: Medline, Pubmed, Embase, Web of Science, Cochrane Collection and ClinicalTrials.gov. No limits placed on language or year of publication. Studies with a minimum of 20 individuals with post-meningitis deafness were included. Review conducted in accordance with the PRISMA statement. Searches identified 906 abstracts and 291 full texts. Of these, 19 studies met the inclusion criteria, reporting outcomes in 610 patients with 650 implants. Audiological outcomes improved across all studies following cochlear implantation. 7 studies demonstrated a statistically significant difference between pre and post-CI outcomes. Patients with no cochlear ossification, full electrode insertion, shorter duration of deafness and no neurological sequelae generally appeared to perform best. A total of 31 minor and 19 major complications were reported, with 15 cases of reimplantation. The methodological quality of the included studies was sufficient, predominantly consisting of cohort studies. 15 studies were OCEBM grade III and 4 studies were OCEBM grade IV. All studies had a minimum of 20 individuals with post-meningitic deafness and used multi-channel cochlear implant devices. Audiological outcomes following cochlear implantation in meningitis are satisfactory, providing functional levels of speech perception and intelligibility. Improvement in hearing is dependent on the amount of cochlear ossification, duration of deafness prior to implantation, electrode insertion depth and presence of neurological sequalae. Cochlear implantation in meningitis patients can be challenging due to the presence of ossification and inaccuracies of pre-operative imaging. Therefore, early and bilateral implantation is recommended in all patients with post-meningitis hearing loss to improve the likelihood of full electrode insertion.
Topics: Adult; Child, Preschool; Cochlear Implantation; Cochlear Implants; Cohort Studies; Deafness; Humans; Infant; Infant, Newborn; Meningitis; Prospective Studies; Retrospective Studies; Speech Perception; Treatment Outcome
PubMed: 33136024
DOI: 10.5152/iao.2020.9040 -
The Cochrane Database of Systematic... Mar 2011Demographic data in North America, Europe, Asia, Australia and New Zealand suggest a rapid growth in the number of persons over the age of 65 years as the baby boomer... (Review)
Review
BACKGROUND
Demographic data in North America, Europe, Asia, Australia and New Zealand suggest a rapid growth in the number of persons over the age of 65 years as the baby boomer generation passes retirement age. As older adults make up an increasing proportion of the population, they are an important consideration when designing future evidence-based traffic safety policies, particularly those that lead to restrictions or cessation of driving. Research has shown that cessation of driving among older drivers can lead to negative emotional consequences such as loss of independence and depression. Those older adults who continue to drive tend to do so less frequently than other demographic groups and are more likely to be involved in a road traffic crash, probably due to what is termed the 'low mileage bias'. There is universal agreement among researchers that vision plays a significant role in driving performance, and that there are age-related visual changes. Vision testing of all drivers, and in particular of older drivers, is therefore an important road safety issue. The components of visual function essential for driving are acuity, field, depth perception and contrast sensitivity, which are currently not fully measured by licensing agencies. Furthermore, it is not known how effective vision screening tools are, and current vision screening regulations and cut-off values required to pass a licensing test vary from country to country. There is, therefore, a need to develop evidence-based tools for vision screening for driving, thereby increasing road safety.
OBJECTIVES
To assess the effects of vision screening interventions for older drivers to prevent road traffic injuries and fatalities.
SEARCH STRATEGY
We searched the Cochrane Injuries Group's Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 2), MEDLINE (Ovid), TRANSPORT (Ovid), IBSS (International Bibliography of Social Sciences), ASSIA: Applied Social Sciences Index and Abstracts, ISI Web of Science: Social Sciences Citation Index (SSCI), ISI Web of Science: Conference Proceedings Citation Index-Science (CPCI-S) and PubMed. We also searched the Internet and checked the reference lists of relevant papers to identify any further studies. The searches were conducted up to the first week of June 2010.
SELECTION CRITERIA
Randomised controlled trials (RCTs) and controlled before and after studies comparing vision screening to non-screening of drivers aged 55 years and older, and which assessed the effect on road traffic crashes, injuries, fatalities and any involvement in traffic law violations, were included.
DATA COLLECTION AND ANALYSIS
Two authors independently screened the reference lists for eligible articles and independently assessed the articles for inclusion against the criteria. Two authors independently extracted data using a standardised extraction form.
MAIN RESULTS
No studies were found which met the inclusion criteria for this review.
AUTHORS' CONCLUSIONS
Most countries require a vision screening test for the renewal of an individual's driver's license. There is, however insufficient evidence to assess the effects of vision screening tests on subsequent motor vehicle crash reduction. There is a need to develop valid and reliable tools of vision screening that can predict driving performance.
Topics: Accidents, Traffic; Aged; Automobile Driving; Humans; Vision Screening
PubMed: 21412894
DOI: 10.1002/14651858.CD006252.pub3 -
Journal of the American Academy of... Oct 2008The question regarding the use of amplification with implantation is timely and relevant in today's clinical settings where an increased number of adults with measurable... (Review)
Review
BACKGROUND
The question regarding the use of amplification with implantation is timely and relevant in today's clinical settings where an increased number of adults with measurable hearing are receiving cochlear implants due to the expanding implant criteria, especially among individuals seeking bilateral implantation.
PURPOSE
To review the evidence available to answer the clinical question: "Does amplification in the ear opposite of a cochlear implant provide improved communication function for adult users?"
RESEARCH DESIGN
A systematic review of the evidence that met the search criteria related to the use of amplification in adult implant users. All types of experiments were included with the exception of expert opinion. This systematic review ranked the levels of evidence related to these studies and distinguished the levels of evidence from judgments about the grade and strength of recommendations for the stated clinical question.
STUDY SAMPLE
Fifty-two articles were initially reviewed with a final 11 articles meeting the search criteria and identified for in-depth analysis.
DATA COLLECTION AND ANALYSIS
Several electronic databases and textbooks were searched to locate the evidence related to bimodal stimulation. Each article was reviewed using a check sheet and assigned a ranking for level of evidence (Levels 1-6) based on the type of research design that was used and a grade of evidence (A-D) based on the quality, relevance, and extensiveness of the study. Finally the level and grade were collapsed into only three categories to indicating the strength of the recommendations coming from each study and were classified as either strong (I), moderate (II), or weak (III).
RESULTS
Several trends about bimodal stimulation were observed, which include (1) significantly better speech understanding in the bimodal condition for many participants; (2) in noise, the largest bimodal benefits in speech recognition; (3) variable findings on localization tasks; and (4) overall significant improvement in functional ability based on self-assessments. The preponderance of evidence received grades of B or C.
CONCLUSIONS
The evidence available indicates "moderate" (II) strength in support of bimodal stimulation for adult implant users. Clinicians should encourage their clients to consider bimodal fittings. Additional research is needed about optimal time frame for introducing bimodal fittings as well as establishing a clinical profile of patients who may benefit most from this intervention compared to bilateral implantation.
Topics: Adult; Auditory Perception; Cochlear Implantation; Cochlear Implants; Evidence-Based Medicine; Hearing Aids; Hearing Loss; Humans; Research Design; Treatment Outcome
PubMed: 19418706
DOI: 10.3766/jaaa.19.9.2 -
The Cochrane Database of Systematic... Nov 2017Strabismus (misalignment of the eyes) is a risk factor for impaired visual development both of visual acuity and of stereopsis. Detection of strabismus in the community... (Review)
Review
BACKGROUND
Strabismus (misalignment of the eyes) is a risk factor for impaired visual development both of visual acuity and of stereopsis. Detection of strabismus in the community by non-expert examiners may be performed using a number of different index tests that include direct measures of misalignment (corneal or fundus reflex tests), or indirect measures such as stereopsis and visual acuity. The reference test to detect strabismus by trained professionals is the cover‒uncover test.
OBJECTIVES
To assess and compare the accuracy of tests, alone or in combination, for detection of strabismus in children aged 1 to 6 years, in a community setting by non-expert screeners or primary care professionals to inform healthcare commissioners setting up childhood screening programmes.Secondary objectives were to investigate sources of heterogeneity of diagnostic accuracy.
SEARCH METHODS
We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 12) (which contains the Cochrane Eyes and Vision Trials Register) in the Cochrane Library, the Health Technology Assessment Database (HTAD) in the Cochrane Library (2016, Issue 4), MEDLINE Ovid (1946 to 5 January 2017), Embase Ovid (1947 to 5 January 2017), CINAHL (January 1937 to 5 January 2017), Web of Science Conference Proceedings Citation Index-Science (CPCI-S) (January 1990 to 5 January 2017), BIOSIS Previews (January 1969 to 5 January 2017), MEDION (to 18 August 2014), the Aggressive Research Intelligence Facility database (ARIF) (to 5 January 2017), the ISRCTN registry (www.isrctn.com/editAdvancedSearch); searched 5 January 2017, ClinicalTrials.gov (www.clinicaltrials.gov); searched 5 January 2017 and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched 5 January 2017. We did not use any date or language restrictions in the electronic searches for trials. In addition, orthoptic journals and conference proceedings without electronic listings were searched.
SELECTION CRITERIA
All prospective or retrospective population-based test accuracy studies of consecutive participants were included. Studies compared a single or combination of index tests with the reference test. Only those studies with sufficient data for analysis were included specifically to calculate sensitivity and specificity and determine diagnostic accuracy.Participants were aged 1 to 6 years. Studies reporting participants outside this range were included if subgroup data were available.Permitted settings included population-based vision screening programmes or opportunistic screening programmes, such as those performed in schools.
DATA COLLECTION AND ANALYSIS
We used standard methodological procedures expected by Cochrane. In brief, two review authors independently assessed titles and abstracts for eligibility and extracted the data, with a third senior author resolving any disagreement. We analysed data primarily for specificity and sensitivity.
MAIN RESULTS
One study from a total of 1236 papers, abstracts and trials was eligible for inclusion with a total number of participants of 335 of which 271 completed both the screening test and the gold standard test. The screening test using an automated photoscreener had a sensitivity of 0.46 (95% confidence interval (CI) 0.19 to 0.75) and specificity of 0.97 (CI 0.94 to 0.99). The overall number affected by strabismus was low at 13 (4.8%).
AUTHORS' CONCLUSIONS
There is very limited data in the literature to ascertain the accuracy of tests for detecting strabismus in the community as performed by non-expert screeners. A large prospective study to compare methods would be required to determine which tests have the greatest accuracy.
Topics: Blinking; Child; Child, Preschool; Depth Perception; Fundus Oculi; Humans; Infant; Prospective Studies; Retrospective Studies; Sensitivity and Specificity; Strabismus; Vision Screening; Visual Acuity
PubMed: 29105728
DOI: 10.1002/14651858.CD011221.pub2 -
Journal of Surgical Education 2015To systematically review literature pertaining to microsurgical skill assessment tools to determine those specific to, and validated for, microsurgery training. (Review)
Review
OBJECTIVES
To systematically review literature pertaining to microsurgical skill assessment tools to determine those specific to, and validated for, microsurgery training.
DESIGN
Multiple databases were searched with preset terms. The search dates included all years up to May 2014. The eligibility criteria included the presence of statistical comparison with a control group and the presence of a measure of validation. The articles and their references were independently reviewed by 2 assessors. Each assessment tool was evaluated for content, construct, face, and criterion validities as well observation/expectant bias and interrater/intrarater reliability. For individual studies, we screened for expectant and selection bias.
RESULTS
Of the 261 articles reviewed, 10 articles and 1 abstract were included. Those excluded were predominantly assessment tools that did not evaluate microsurgical skill or articles where no assessment tool was described. The assessment tools identified in this review include a self-assessment tool where trainees rate their skill confidence from 1 to 5, stereoscopic visual acuity as a predictor for microsurgical performance, an objective motion-tracking electronic device--the Imperial College of Surgical Assessment Device, and 6 global rating scales. Content, construct, and face validities were consistently demonstrated in addition to observation/expectant bias and interrater reliability. Criterion validity was only demonstrated for half of the instruments and intrarater reliability for only 1.
CONCLUSIONS
Overall, 10 articles and 1 abstract described validated methods. Reliability and validity were demonstrated by 6 global rating scales (University of Western Ontario microsurgical skills acquisition, structured assessment of microsurgery skills, and video-based objective structured assessment of technical skill). Motion analysis using the Imperial College of Surgical Assessment Device is a valid objective measure of skill.
Topics: Clinical Competence; Depth Perception; Humans; Internship and Residency; Microsurgery; Reproducibility of Results; Task Performance and Analysis
PubMed: 25086464
DOI: 10.1016/j.jsurg.2014.06.009 -
International Journal of Medical... May 2019Health information exchange (HIE), the ability for health information technology (HIT) to share patient data, can improve the efficiency and effectiveness of healthcare;...
BACKGROUND
Health information exchange (HIE), the ability for health information technology (HIT) to share patient data, can improve the efficiency and effectiveness of healthcare; however, this ability may cause patient concern about their ability to control who can access their health records (i.e., privacy). These concerns may affect a patient's candor in their therapeutic patient-provider relationships, thereby undermining their care. While patient privacy concerns are often cited as a barrier to HIT implementation, the patient privacy perspective is not well understood. The purpose of this systematic review is to provide an in-depth exploration of the patient privacy perspective toward HIE, its antecedents, and its outcomes.
MATERIALS AND METHODS
A systematic review was conducted on seven health sciences and interdisciplinary databases. Empirical studies that assessed the patient perception of privacy in context of interoperable HIT were included. All included articles were independently screened, extracted, and analyzed by two reviewers. The results were extracted and categorized based on the dimensions outlined in the Antecedent Privacy Concern Outcomes macro-model (APCO).
RESULTS
Of the 1713 unique citations, 59 articles met the inclusion criteria which consisted of 39 (66.1%) quantitative studies, 15 (25.4%) qualitative studies, and 5 (8.5%) mixed methods studies. Fourteen articles (23.7%) were specifically focused on understanding privacy. The patient privacy perspective was operationalized in different ways, with privacy concern being the most common measure (25.4%). The percentage of participants expressing privacy concern ranged from 15% to 74%, depending on the study. Perceived quality of care was associated with lower privacy concerns. Privacy concerns were associated with privacy protective behaviours; however, the perceived benefit of HIE may mitigate the effects of privacy concern.
CONCLUSION
Using the APCO as a guide, this review found that the patient privacy perspective is dynamic, complex, and still not well understood. There may be an oversimplification of the patient privacy perspective and its impact given the paucity of privacy-focused research. The evidence suggests patient perceptions of healthcare and the value of HIE are important factors in mitigating privacy concerns and its effects. More in-depth privacy studies are required to further illuminate the nuances of the patient perspective and provide policy-makers with greater insights on the privacy barrier.
Topics: Health Information Exchange; Humans; Male; Patients; Perception; Privacy
PubMed: 30914173
DOI: 10.1016/j.ijmedinf.2019.01.014 -
International Journal of Dental Hygiene Aug 2008To review the available literature, considering the effect of instrumentation with the Vector ultrasonic scaler on human teeth in vitro and in vivo compared to... (Comparative Study)
Comparative Study Review
AIM
To review the available literature, considering the effect of instrumentation with the Vector ultrasonic scaler on human teeth in vitro and in vivo compared to conventional ultrasonic instruments and/or hand instrumentation. The assessed effects are calculus removal, time of instrumentation, root surface aspects, cell attachment, patients' perception, bleeding upon probing, pocket depth, clinical attachment loss and microbiological effects.
MATERIALS AND METHODS
MEDLINE-PubMed and the Cochrane Central register of controlled trials (CENTRAL) were searched up through January 2008 to identify appropriate studies.
RESULTS
Independent screening of the titles and abstracts of 270 MEDLINE-PubMed and 15 Cochrane papers resulted in 15 suitable publications. The studies differed in design and outcome, so this review summarizes the outcomes in a descriptive manner. Comparisons are presented against conventional ultrasonic system and scaling and root planing.
CONCLUSION
The Vector ultrasonic scaler provided comparable clinical and microbiological periodontal healing results as scaling and root planing and conventional ultrasonic system in moderately deep pockets. The Vector ultrasonic scaler may be used as a gentle root debridement device for supportive periodontal therapy, as an alternative to other conventional ultrasonic system. The operator should however consider the extra time needed for instrumentation.
Topics: Dental Calculus; Dental Scaling; Equipment Design; Humans; Patient Satisfaction; Periodontal Diseases; Time Factors; Tooth; Tooth Root; Ultrasonic Therapy
PubMed: 18768018
DOI: 10.1111/j.1601-5037.2008.00319.x -
Frontiers in Psychology 2021Deterrence by punishment aims to prevent a crime; however, it is not always successful. Restrictive deterrence explains the continuous criminal activities that occur...
Deterrence by punishment aims to prevent a crime; however, it is not always successful. Restrictive deterrence explains the continuous criminal activities that occur despite deterrence; offenders enact various strategies to avoid detection, which is more typical among drug offenders given that they have a high frequency of offending and exposure to punishment. This systematic review provides an in-depth understanding of restrictive deterrence of drug offenders. Two prominent themes, "restrictive deterrence strategy" and "deterrability and restrictive deterrence," depict drug offenders' restrictive deterrence and effectively fit within the certainty-severity framework of punishment. Future studies should investigate restrictive deterrence strategies in the after-arrest context, the facilitative effect of perception of risk on strategy development, and facilitators or inhibitors affecting the diffusion of restrictive deterrence strategies.
PubMed: 34512482
DOI: 10.3389/fpsyg.2021.727142 -
Chronic Respiratory Disease Aug 2013The aim of this study was to give an in-depth consideration of the chronic obstructive pulmonary disease (COPD) patients' subjective view of the impact of pulmonary... (Review)
Review
The aim of this study was to give an in-depth consideration of the chronic obstructive pulmonary disease (COPD) patients' subjective view of the impact of pulmonary rehabilitation (PR) on their lives. A systematic review in PubMed, Embase, CINAHL and PsychInfo databases yielded 3306 articles, of which 387 were duplicates, 263 remained after screening abstract and title; of them, 4 were excluded (editorial or due to lacking of full text) remaining a total of 259 for full text reading. Among these, eight studies met the inclusion criteria and were finally included. The meta-ethnography approach synthesized an understanding of the studies, which focused on constructing interpretations and developed a 'line-of-argument' synthesis. The psychosocial support of PR contributes to the patients' strength and desire for participation and the health education leads to illness-perception learning. Both psychosocial support and health education develop patients' empowerment, while PR promotes opportunities to health transitions. The empowerment experienced by the patients in taking advantage of these opportunities leads to positive impacts over time. If they do not exploit these occasions, negative impacts arise in their life, which make the treatment assistance or follow-up more difficult. The COPD patients' feedback revealed that PR promotes a better 'way of life', well-being and important behavioural changes towards health promotion.
Topics: Health Knowledge, Attitudes, Practice; Humans; Patient Acceptance of Health Care; Power, Psychological; Pulmonary Disease, Chronic Obstructive; Qualitative Research
PubMed: 23897930
DOI: 10.1177/1479972313493796