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Journal of the American Academy of... Oct 2013Although there has been a dramatic increase in the number of evidence-based practices (EBPs) to improve child and adolescent mental health, the poor uptake of these EBPs... (Review)
Review
OBJECTIVE
Although there has been a dramatic increase in the number of evidence-based practices (EBPs) to improve child and adolescent mental health, the poor uptake of these EBPs has led to investigations of factors related to their successful dissemination and implementation. The purpose of this systematic review was to identify key findings from empirical studies examining the dissemination and implementation of EBPs for child and adolescent mental health.
METHOD
Of 14,247 citations initially identified, 73 articles drawn from 44 studies met inclusion criteria. The articles were classified by implementation phase (exploration, preparation, implementation, and sustainment) and specific implementation factors examined. These factors were divided into outer (i.e., system level) and inner (i.e., organizational level) contexts.
RESULTS
Few studies used true experimental designs; most were observational. Of the many inner context factors that were examined in these studies (e.g., provider characteristics, organizational resources, leadership), fidelity monitoring and supervision had the strongest empirical evidence. Albeit the focus of fewer studies, implementation interventions focused on improving organizational climate and culture were associated with better intervention sustainment as well as child and adolescent outcomes. Outer contextual factors such as training and use of specific technologies to support intervention use were also important in facilitating the implementation process.
CONCLUSIONS
The further development and testing of dissemination and implementation strategies is needed to more efficiently move EBPs into usual care.
Topics: Adolescent; Child; Evidence-Based Practice; Humans; Information Dissemination; Mental Health
PubMed: 24074468
DOI: 10.1016/j.jaac.2013.07.012 -
BMJ Open Jul 2015Globally, an estimated 380 million people live with diabetes today--80% in low-income and middle-income countries. The Middle East, Western Pacific, Sub-Saharan Africa... (Meta-Analysis)
Meta-Analysis Review
Effectiveness of community-based peer-led diabetes self-management programmes (COMP-DSMP) for improving clinical outcomes and quality of life of adults with diabetes in primary care settings in low and middle-income countries (LMIC): a systematic review and meta-analysis.
INTRODUCTION
Globally, an estimated 380 million people live with diabetes today--80% in low-income and middle-income countries. The Middle East, Western Pacific, Sub-Saharan Africa and South-East Asia remain the most affected regions where economic development has transformed lifestyles, people live longer and there is an increase in the adult population. Although peer support has been used in different conditions with varied results, yet there is limited evidence to date supporting its effectiveness, particularly for individuals with diabetes. In this review, we will focus on community-based peer-led diabetes self-management programmes (COMP-DSMP) and examine the implementation strategies and diabetes-related health outcomes associated with them in LMIC primary healthcare settings.
METHODS AND ANALYSIS
In accordance with reporting equity-focused systematic reviews PRISMA-P (preferred reporting items for systematic review and meta-analysis protocols 2015 checklist) guidelines, a systematic review with meta-analysis of randomised controlled trials (RCTs), non-randomised controlled trials, quasi-randomised controlled trials (CCTs) that involve contact with an individual or group of peers (paid or voluntary). Electronic searches will be performed in The Cochrane Library, MEDLINE, PubMed, SCOUPS, CINAHL and PsycINFO Database for the period January up to July 2000 along with manual searches in the reference lists of relevant papers. The analyses will be performed based on baseline data from RCTs, CCTs and preintervention and postintervention means or proportions will be reported for both intervention and control groups, and the absolute change from baseline will be calculated, together with 95% CIs. For dichotomous outcomes, the relative risk of the outcome will be presented compared to the control group. The risk difference will be calculated, which is the absolute difference in the proportions in each treatment group.
ETHICS AND DISSEMINATION
Ethics is not required for this study, given that this is a protocol for a systematic review, which utilises published data. The findings of this study will be widely disseminated through peer-reviewed publications and conference presentations.
TRIAL REGISTRATION NUMBER
PROSPERO (2014:CRD42014007531).
Topics: Blood Glucose; Blood Glucose Self-Monitoring; Developing Countries; Diabetes Mellitus; Glycated Hemoglobin; Health Knowledge, Attitudes, Practice; Humans; Medication Adherence; Motor Activity; Peer Group; Primary Health Care; Quality of Life; Residence Characteristics; Self Care; Self Efficacy; Treatment Outcome
PubMed: 26179646
DOI: 10.1136/bmjopen-2015-007635 -
Pain Physician 2009In recent years, progress and innovations in healthcare are measured by evidence-based medicine (EBM), systematic reviews, and meta-analyses. A systematic review is... (Review)
Review
In recent years, progress and innovations in healthcare are measured by evidence-based medicine (EBM), systematic reviews, and meta-analyses. A systematic review is defined as, "the application of scientific strategies that limit bias by the systematic assembly, critical appraisal, and synthesis of all relevant studies on a specific topic." In contrast, meta-analysis is the statistical pooling of data across studies to generate pooled estimates of effects. Meta-analysis usually is the final step in a systematic review. Systematic reviews and meta-analyses are labor intensive, requiring expertise in both the subject matter and review methodology, and also must follow the rules of EBM which suggest that a formal set of rules must complement medical training and common sense for clinicians to interpret the results of clinical research effectively. While expertise in the subject matter is crucial, expertise in review methods is also particularly important. Despite an explosion of systematic reviews and meta-analyses, the empiric research on the quality of systematic reviews has shown that not all systematic reviews are truly systematic, having highly variable quality, deficiencies in methodologic assessment of the quality of the included manuscripts, and bias. Even then, systematic review of the literature is currently the best, least biased and most rational way to organize, cull, evaluate, and integrate the research evidence from among the expanding medical and healthcare literature. However, a dangerous discrepancy between the experts and the evidence continues to persist in part because multiple instruments are available to assess the quality of systematic reviews or meta-analyses. Steps in conducting systematic reviews include planning, conducting, reporting, and disseminating the results. The Quality of Reporting of Meta-analysis (QUOROM) statement provides a checklist and a flow diagram. The checklist describes the preferred way to present the abstract, introduction, methods, results, and discussion sections of the report of an analysis. This review describes various aspects of systematic reviews and meta-analyses of randomized trials with a special focus on interventional pain management.
Topics: Evidence-Based Medicine; Humans; Pain Management; Practice Guidelines as Topic; Randomized Controlled Trials as Topic
PubMed: 19165297
DOI: No ID Found -
Dissemination and implementation research on community-based cancer prevention: a systematic review.American Journal of Preventive Medicine Apr 2010An extensive array of effective interventions for the prevention of cancer exists, suggesting that evidence is ready for widespread use. However, few of these approaches... (Review)
Review
CONTEXT
An extensive array of effective interventions for the prevention of cancer exists, suggesting that evidence is ready for widespread use. However, few of these approaches have been extensively utilized in real-world settings. Further, little is known on how to best disseminate and implement evidence-based interventions for the primary prevention of cancer in community settings.
EVIDENCE ACQUISITION
A systematic review of the dissemination and implementation literature was conducted between 2006 and 2008 in the topic areas of smoking, healthy diet, physical activity, and sun protection. English-language peer-reviewed articles published between 1980 and 2008 that met the inclusion criteria were classified by suitability of study design (i.e., greatest, moderate, least); quality of execution (i.e., good, fair, limited); and effectiveness (i.e., substantial, some, or little/no evidence of effectiveness) and were abstracted for dissemination- and implementation-related content.
EVIDENCE SYNTHESIS
Twenty-five unique dissemination and implementation studies were identified. The majority of included studies were conducted in the U.S., in schools, and with children as the ultimate target population, had the least suitability of study design, had fair or limited execution, and used a theoretic framework, active dissemination and implementation approaches, and multimodal strategies. There was considerable heterogeneity across studies in reported mediators, moderators, and outcomes.
CONCLUSIONS
Key implications from this review include the need for uniform language, studies targeting various populations and settings, valid and reliable measures, triangulation of and more practice-based evidence, standardized reporting criteria, and active and multimodal strategies.
Topics: Community Health Services; Evidence-Based Practice; Health Services Research; Humans; Information Dissemination; Neoplasms; Primary Prevention; United States
PubMed: 20307814
DOI: 10.1016/j.amepre.2009.12.035 -
Frontiers in Veterinary Science 2022Staphylococci other than Staphylococcus aureus (SOSA) in animals are becoming more pathogenic and antibiotic resistant and can potentially disseminate to humans....
INTRODUCTION
Staphylococci other than Staphylococcus aureus (SOSA) in animals are becoming more pathogenic and antibiotic resistant and can potentially disseminate to humans. However, there is little synthesized information regarding SOSA from animals in Africa. This systematic review provides a comprehensive overview of the epidemiology and antimicrobial resistance of SOSA in companion animals (pets) and livestock in Africa.
METHOD
This systematic review (PROSPERO-CRD42021252303) was conducted according to the PRISMA guidelines, and 75 eligible studies from 13 countries were identified until August 2022. Three electronic databases (Pubmed, Scopus and Web of Science) were employed.
RESULTS
The frequently isolated SOSA were , and . Thirty (40%) studies performed antibiotic susceptibility testing (AST). Penicillin (58%) and tetracycline (28%) resistance were most common across all SOSA with high rates of resistance to aminoglycosides, fluoroquinolones, and macrolides in some species. Resistance to last-resort antibiotics such as linezolid and fusidic acid were also reported. Limited data on strain typing and molecular resistance mechanisms precluded analysis of the clonal diversity of SOSA on the continent.
CONCLUSION
The findings of this review indicate that research on livestock-associated SOSA in Africa is lacking in some regions such as Central and Western Africa, furthermore, research on companion animals and more advanced methods for identification and strain typing of SOSA need to be encouraged.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/, identifier: CRD42021252303.
PubMed: 36583033
DOI: 10.3389/fvets.2022.1059054 -
International Journal of Evidence-based... Jun 2010To synthesis the literature relevant to guideline dissemination and implementation strategies for healthcare teams and team-based practice. (Review)
Review
AIM
To synthesis the literature relevant to guideline dissemination and implementation strategies for healthcare teams and team-based practice.
METHODS
Systematic approach utilising Joanna Briggs Institute methods. Two reviewers screened all articles and where there was disagreement, a third reviewer determined inclusion.
RESULTS
Initial search revealed 12,083 of which 88 met the inclusion criteria. Ten dissemination and implementation strategies identified with distribution of educational materials the most common. Studies were assessed for patient or practitioner outcomes and changes in practice, knowledge and economic outcomes. A descriptive analysis revealed multiple approaches using teams of healthcare providers were reported to have statistically significant results in knowledge, practice and/or outcomes for 72.7% of the studies.
CONCLUSION
Team-based care using practice guidelines locally adapted can affect positively patient and provider outcomes.
Topics: Cooperative Behavior; Guideline Adherence; Humans; Information Dissemination; Interprofessional Relations; Patient Care Team; Practice Guidelines as Topic
PubMed: 20923511
DOI: 10.1111/j.1744-1609.2010.00166.x -
BMJ Open Jul 2014Venous thromboembolism (VTE) is a major disease associated with short-term and long-term morbidity and mortality. Patients with a VTE provoked by surgery or... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Venous thromboembolism (VTE) is a major disease associated with short-term and long-term morbidity and mortality. Patients with a VTE provoked by surgery or immobilisation are at low risk of recurrence and do not require long-term anticoagulation; those with a VTE and metastatic cancer are at high risk of recurrence and require lifetime thromboprophylaxis. In those at intermediate risk of recurrence, it remains controversial whether prolonging anticoagulation and thus incurring treatment burden and bleeding risk is warranted.
METHODS AND ANALYSIS
We will conduct a systematic review and meta-analysis of randomised controlled trials enrolling patients with VTE at intermediate risk of recurrence and evaluating short-term anticoagulation (12 weeks to 9 months initial therapy) versus longer term anticoagulation (at least 6 months additional anticoagulation beyond the course of treatment in the shorter arm). Anticoagulation could consist of vitamin K antagonists or new oral anticoagulants. Outcomes of interest include recurrent non-fatal thrombosis (deep venous thrombosis and pulmonary embolism), major non-fatal bleeding and mortality. We will systematically search CINAHL, EMBASE, MEDLINE and the Cochrane Central Registry of Controlled Trials. Teams of two reviewers will, independently and in duplicate, screen titles and abstracts and complete full text reviews to determine eligibility, and subsequently abstract data and assess risk of bias in eligible trials. We will conduct meta-analyses to establish the effect of short-term versus long-term anticoagulation on the outcomes of interest and evaluate confidence in estimates (quality of evidence) using the GRADE (grading of recommendations, assessment, development and evaluation) approach.
ETHICS AND DISSEMINATION
Our review will facilitate evidence-based management of patients with unprovoked or recurrent VTE. For purposes of privacy and confidentiality, the systematic review will be limited to studies with deidentified data. The study will be disseminated by peer-review publication and conference presentation.
TRIAL REGISTRATION NUMBER
PROSPERO (CRD42014007620).
Topics: Anticoagulants; Humans; Recurrence; Time Factors; Venous Thromboembolism
PubMed: 24996916
DOI: 10.1136/bmjopen-2014-005674 -
Thrombosis Research May 2021Coronavirus disease 2019 (COVID-19) is a novel infectious disease, with significant morbidity and mortality. This meta-analysis is to evaluate the prevalence of... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Coronavirus disease 2019 (COVID-19) is a novel infectious disease, with significant morbidity and mortality. This meta-analysis is to evaluate the prevalence of disseminated intravascular coagulation (DIC) in COVID-19 patients and to determine the association of DIC with the severity and prognosis of COVID-19.
METHODS
We searched the PubMed, EMBASE, and China National Knowledge Infrastructure (CNKI) database until August 12, 2020. The meta-analysis was performed using Stata 16.0 software.
RESULTS
14 studies were included in our meta-analysis. The pooled analysis revealed that the incidence of COVID-19 patients developing DIC was 3% (95%: 1%-5%, P < 0.001). In addition, deaths were more likely to be associated with DIC (Log OR = 2.46, 95% CI: 0.94-3.99, P < 0.001) with statistical significance.
CONCLUSIONS
DIC is associated with the severity and poor prognosis of COVID-19 patients. Therefore, attention should be paid to coagulation dysfunction in COVID-19 patients. Monitoring of coagulation indicators may improve the prognosis of COVID-19 inpatients.
Topics: COVID-19; China; Disseminated Intravascular Coagulation; Humans; Incidence; SARS-CoV-2
PubMed: 33631519
DOI: 10.1016/j.thromres.2021.02.010 -
Research Synthesis Methods Jun 2018Rating the quality of a body of evidence is an increasingly common component of research syntheses on intervention effectiveness. This study sought to identify and... (Review)
Review
INTRODUCTION
Rating the quality of a body of evidence is an increasingly common component of research syntheses on intervention effectiveness. This study sought to identify and examine existing systems for rating the quality of a body of evidence on the effectiveness of health and social interventions.
METHODS
We used a multicomponent search strategy to search for full-length reports of systems for rating the quality of a body of evidence on the effectiveness of health and social interventions published in English from 1995 onward. Two independent reviewers extracted data from each eligible system on the evidence domains included, as well as the development and dissemination processes for each system.
RESULTS
Seventeen systems met our eligibility criteria. Across systems, we identified 13 discrete evidence domains: study design, study execution, consistency, measures of precision, directness, publication bias, magnitude of effect, dose-response, plausible confounding, analogy, robustness, applicability, and coherence. We found little reporting of rigorous procedures in the development and dissemination of evidence rating systems.
CONCLUSION
We identified 17 systems for rating the quality of a body of evidence on intervention effectiveness across health and social policy. Existing systems vary greatly in the domains they include and how they operationalize domains, and most have important limitations in their development and dissemination. The construct of the quality of the body of evidence was defined in a few systems largely extending the Grading of Recommendations Assessment, Development, and Evaluation approach. Grading of Recommendations Assessment, Development, and Evaluation was found to be unique in its comprehensive guidance, rigorous development, and dissemination strategy.
Topics: Data Collection; Health Policy; Health Promotion; Health Services Research; Humans; Public Health; Public Policy; Publication Bias; Randomized Controlled Trials as Topic; Research Design
PubMed: 29346709
DOI: 10.1002/jrsm.1290 -
The Cochrane Database of Systematic... Jun 2011Disseminated intravascular coagulation (DIC) is an acquired syndrome characterized by systemic intravascular activation of coagulation, leading to deposition of fibrin... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Disseminated intravascular coagulation (DIC) is an acquired syndrome characterized by systemic intravascular activation of coagulation, leading to deposition of fibrin in the bloodstream, that may occur in patients with acute and chronic leukemia.
OBJECTIVES
To assess the clinical effectiveness and safety of any pharmacological intervention for treating DIC in acute or chronic leukemia.
SEARCH STRATEGY
The search strategy included the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 12), MEDLINE (1950 to 28 October 2010), EMBASE (1980 to 10 October 2010), LILACS (1982 to 19 August 2010) and African Index Medicus (1993 to 19 August 2010). There was no language restriction. We sought additional randomized controlled trials (RCTs) from the World Health Organization (WHO) Clinical Trials Registry Platform and by using the reference lists of primary studies found.
SELECTION CRITERIA
RCTs assessing the effectiveness of interventions for treating disseminated intravascular coagulation (DIC) in patients with acute and chronic leukemia.
DATA COLLECTION AND ANALYSIS
Two review authors independently performed study selection, risk of bias assessment and data extraction.
MAIN RESULTS
Four RCTs (126 participants) met the inclusion criteria. These trials evaluated the human activated protein C, recombinant human soluble thrombomodulin, tranexamic acid and dermatan sulphate. Included RCTs reported data on mortality and bleeding. The included RCTs were classified as: 1) including patients with or without leukemia, and 2) only including patients with leukemia. However, data were not reported for the leukemia subgroup. We were not able to pool results from studies due to the inconsistency in the measurement and reporting of mortality and bleeding data. The included studies were at high risk of bias.
AUTHORS' CONCLUSIONS
We found four RCTs which reported mortality and bleeding data. It is not possible to determine whether human activated protein C, recombinant human soluble thrombomodulin, tranexamic acid and dermatan sulphate are effective or harmful for patients presenting with DIC related to acute or chronic leukemia. The effects of these interventions need to be tested in sufficiently powered RCTs. Outcome measures should include in-hospital mortality from any cause, overall mortality, incidence of resolution of respiratory failure, renal failure, shock and safety. The definition of bleeding should be standardized in these patients.
Topics: Acute Disease; Anticoagulants; Chronic Disease; Dermatan Sulfate; Disseminated Intravascular Coagulation; Humans; Leukemia; Protein C; Randomized Controlled Trials as Topic; Thrombomodulin; Tranexamic Acid
PubMed: 21678379
DOI: 10.1002/14651858.CD008562.pub2