-
Journal of Advanced Nursing Mar 2015To report quantitative evidence for the accuracy of the defining characteristics of ineffective airway clearance in different settings and populations. (Meta-Analysis)
Meta-Analysis Review
AIM
To report quantitative evidence for the accuracy of the defining characteristics of ineffective airway clearance in different settings and populations.
BACKGROUND
Defining characteristics are tests used by nurses to clinically indicate the presence or absence of a particular nursing diagnosis. A few studies have reported the accuracy of certain defining characteristics of ineffective airway clearance, but these studies address specific populations with particular needs.
DESIGN
A systematic review with meta-analysis was conducted to provide a synthesis and critical appraisal of the included studies.
DATA SOURCES
The electronic databases CINAHL, PubMed, Scopus and LILACS were searched using a systematic search strategy for studies published in any year. The last search was performed on 31 July 2013.
REVIEW METHODS
Using the recommendations from Cochrane Collaboration for Systematic Reviews of Diagnostic Test Accuracy and the Standards for Reporting of Diagnostic Accuracy (STARD), a systematic review was conducted using studies investigating the presence of ineffective airway clearance and its defining characteristics. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool was used to evaluate the quality of the studies.
RESULTS
Seven papers met the search criteria. The studies were developed in different clinical settings and most of them fulfilled QUADAS criteria. Summary measures indicated the following defining characteristics with higher accuracy values: adventitious breath sounds, changes in respiratory rate, difficult vocalizing, diminished breath sounds, dyspnoea, ineffective cough, orthopnoea and restlessness.
CONCLUSION
This systematic review showed that the variability in clinical indicators of ineffective airway clearance is related to differences in the clinical settings and patients.
Topics: Adolescent; Adult; Child; Child, Preschool; Cough; Dyspnea; Female; Humans; Infant; Male; Middle Aged; Mucociliary Clearance; Nursing Diagnosis; Respiratory Rate; Respiratory Sounds; Respiratory Tract Diseases; Young Adult
PubMed: 25169072
DOI: 10.1111/jan.12518 -
The British Journal of Social Psychology Oct 2023The role of empathy in morality is a subject of ongoing scientific debate due to the lack of systematic reviews and meta-analyses on this topic. To address this gap, we... (Meta-Analysis)
Meta-Analysis
The role of empathy in morality is a subject of ongoing scientific debate due to the lack of systematic reviews and meta-analyses on this topic. To address this gap, we conducted a PRISMA-based systematic quantitative review to investigate the role of empathy in moral judgements, decision-making, and inclinations using trolley problems and variants, which are popular types of moral dilemmas that explore utilitarianism and deontology. We searched for articles in four databases (PsycINFO, Pubmed, WorldWideScience, and Scopus) and performed citation searches. Out of 661 records, we selected 34 that studied the associations between empathy and moral judgements, moral decision-making, and/or moral inclinations. Six meta-analyses and systematic reviews of these records consistently showed small to moderate associations between affective empathy and these moral parameters, particularly in personal moral dilemmas involving intentional harm (although some approaches highlighted more complex associations between these parameters). Regarding other empathy domains, most studies found limited or insignificant links between cognitive empathy domains and moral judgements, decision-making, and inclinations. We discuss the nuances and implications of these results.
Topics: Humans; Empathy; Decision Making; Judgment; Morals; Ethical Theory
PubMed: 37314211
DOI: 10.1111/bjso.12654 -
Drugs & Aging Oct 2023Managing hypertension in frail older patients is challenging. Several institutions and organizations have published up-to-date hypertension guidelines suggesting frailty...
BACKGROUND
Managing hypertension in frail older patients is challenging. Several institutions and organizations have published up-to-date hypertension guidelines suggesting frailty screening among older hypertensive patients, with new recommendations for blood pressure-lowering treatment among the frail population. However, the quality of current hypertension guidelines and the consistency of antihypertension treatment recommendations for frail older patients and their supporting evidence remain unknown.
OBJECTIVE
In this review, we aimed to systematically collect guidelines with antihypertension treatment recommendations for frail older patients, examine and compare these recommendations, and critically assess reporting and methodology quality of these guidelines.
METHODS
A literature search was conducted on two databases and three major websites of guideline development organizations. The AGREE instrument and RIGHT checklist were used to evaluate the methodology and reporting quality of the guidelines, respectively. The consistency of recommendations within the guidelines were compared using descriptive analysis.
RESULTS
We identified 13 hypertension guidelines. The overall methodology quality scores (range 23.35-79.07%) and reporting rates (range 10/35-29/35) varied among these guidelines. Four guidelines provided an explicit definition of frailty. Considering treatment tolerability or increased likelihood of adverse effects while using pharmacotherapy in frail older patients was mentioned in all guidelines. Ten guidelines recommended adjusting blood pressure targets or specific pharmacotherapy programs. Four guidelines recommended using clinical judgment when prescribing. However, the specific recommendations lacked clarity and unity without sufficient evidence.
CONCLUSIONS
There were considerable variations in methodology and reporting quality across the 13 included hypertension guidelines. Furthermore, the depth and breadth of antihypertension treatment recommendations for frail older patients were varied and inconsistent. Further trials exploring optimal treatment are urgently required to promote the development of specific guidelines for managing frail older hypertensive patients.
Topics: Aged; Humans; Blood Pressure; Databases, Factual; Frail Elderly; Frailty; Hypertension; Practice Guidelines as Topic
PubMed: 37594718
DOI: 10.1007/s40266-023-01053-1 -
Annual Review of Nutrition 2014Decisions related to a spectrum of nutrition-related public health and clinical concerns must consider many factors and are best informed by evaluating the totality and... (Review)
Review
Decisions related to a spectrum of nutrition-related public health and clinical concerns must consider many factors and are best informed by evaluating the totality and quality of the evidence. Systematic review (SR) is a structured process to evaluate, compare, and synthesize relevant evidence for the SR-specific question(s). Applications of SR are exemplified here through the discussion of four case studies: research agendas, nutrient reference intakes, dietary guidance, and practice guidelines. Concerns that SR cannot be effectively applied to nutrition evidence because of the lack of an unexposed comparator and the complex homeostasis in nutrition are discussed. Central to understanding the applicability of SR is its flexibility in defining key inclusion criteria and rigorous elements as appropriate for the SR-specific question(s). Through the reduction of bias and random error by explicit, reproducible, comprehensive, and rigorous examination of all of the evidence, SR informs the scientific judgment needed for sound evidence-based public health nutrition.
Topics: Animals; Decision Support Techniques; Evidence-Based Medicine; Health Promotion; Humans; Meta-Analysis as Topic; Nutrition Policy; Practice Guidelines as Topic; Public Health; Review Literature as Topic
PubMed: 24819324
DOI: 10.1146/annurev-nutr-080508-141240 -
Frontiers in Psychology 2022The literature suggests that the moral sense is based on innate abilities. In fact, it has been shown that children show the capacity for moral discernment, emotions and...
The literature suggests that the moral sense is based on innate abilities. In fact, it has been shown that children show the capacity for moral discernment, emotions and prosocial motivations from an early age. However, the moral sense is a complex construct of an evolutionary and social nature that evolves under the influence of interpersonal relationships. The emergence and development of moral sense is a challenge that has prompted many research studies with the aim of achieving a clear comprehension of moral development. However, success has been scarce, and studies relevant to this subject are limited. Thus, a systematic review of studies relevant to this topic was conducted to clearly establish how moral sense emerges and develops. An Ovid search was conducted to retrieve relevant items for this systematic review. The databases that were electronically visited are Cross-reference, Google Scholar and PubMed. Strict inclusion and exclusion criteria were imposed on the retrieved items to retain only relevant resources. Twenty-six studies were found valid for inclusion in this systematic review. The results of these studies were presented differently: In order to effectively analyze the selected papers and bring out the results more clearly, a categorization of the approaches adopted in the studies was carried out. The approaches identified were: "Natural Moral Sense," "Social Relationships and Moral Development," and "Environmental Factors and Moral Development." The evidence that emerged from the analysis of the papers was collected to produce a general basic model that explains moral development while also serving as a link between the various studies. First, moral sense is found to be innate in humans; individuals can naturally respond morally to various dilemmas. As seen among children and young infants, moral sense naturally exists. Second, it can be socially nurtured through social interactions and exposure to various environmental factors. Various research studies were reviewed in this systematic review to obtain a consensus on how moral sense emerges and develops. From the systematic review, the moral sense is found to be innate. However, moral development is fostered by social interactions and environmental factors.
PubMed: 35615195
DOI: 10.3389/fpsyg.2022.887537 -
Schizophrenia Research Feb 2020Voice atypicalities have been a characteristic feature of schizophrenia since its first definitions. They are often associated with core negative symptoms such as flat... (Meta-Analysis)
Meta-Analysis Review
Voice atypicalities have been a characteristic feature of schizophrenia since its first definitions. They are often associated with core negative symptoms such as flat affect and alogia, and with the social impairments seen in the disorder. This suggests that voice atypicalities may represent a marker of clinical features and social functioning in schizophrenia. We systematically reviewed and meta-analyzed the evidence for distinctive acoustic patterns in schizophrenia, as well as their relation to clinical features. We identified 46 articles, including 55 studies with a total of 1254 patients with schizophrenia and 699 healthy controls. Summary effect sizes (Hedges'g and Pearson's r) estimates were calculated using multilevel Bayesian modeling. We identified weak atypicalities in pitch variability (g = -0.55) related to flat affect, and stronger atypicalities in proportion of spoken time, speech rate, and pauses (g's between -0.75 and -1.89) related to alogia and flat affect. However, the effects were mostly modest (with the important exception of pause duration) compared to perceptual and clinical judgments, and characterized by large heterogeneity between studies. Moderator analyses revealed that tasks with a more demanding cognitive and social component showed larger effects both in contrasting patients and controls and in assessing symptomatology. In conclusion, studies of acoustic patterns are a promising but, yet unsystematic avenue for establishing markers of schizophrenia. We outline recommendations towards more cumulative, open, and theory-driven research.
Topics: Aphasia; Bayes Theorem; Humans; Schizophrenia; Speech; Voice
PubMed: 31839552
DOI: 10.1016/j.schres.2019.11.031 -
Canadian Journal of Pain = Revue... 2023Graded Motor Imagery (GMI) is a non-invasive and inexpensive therapy used to treat Phantom Limb Pain (PLP) by sequentially activating motor networks in such a way that... (Review)
Review
INTRODUCTION
Graded Motor Imagery (GMI) is a non-invasive and inexpensive therapy used to treat Phantom Limb Pain (PLP) by sequentially activating motor networks in such a way that movement and pain are unpaired. The objective of this systematic review was to critically appraise relevant data on the efficacy of GMI and its components for reducing PLP and disability in amputees.
METHODS
We searched 11 electronic databases for controlled trials investigating GMI and its components in amputees with PLP from inception until February 2023. Two reviewers independently screened studies and extracted relevant data. Study-level data were entered using the inverse variance function of the Review Manager 5 and pooled with the random effects model.
RESULTS
Eleven studies with varying risk of bias were eligible. No eligible study considered left/right judgement tasks in isolation. Studies showed no effect for imagined movements, but positive effects were seen for GMI [weighted mean difference: -21.29 (95%CI: -31.55, -11.02), I= 0%] and mirror therapy [weighted mean difference: -8.55 (95%CI: -14.74, -2.35, I= 61%]. A comparison of mirror therapy versus sham showed no difference [weighted mean difference: -4.43 (95%CI: -16.03, 7.16), I= 51%].
CONCLUSION
Our findings suggest that GMI and mirror therapy may be effective for reducing PLP. However, this conclusion was drawn from a limited body of evidence, and the certainty of the evidence was very low. Therefore, rigorous, high-quality trials are needed to address the gap in the literature and inform practice.
PubMed: 37214633
DOI: 10.1080/24740527.2023.2188899 -
Cognition Aug 2024Absolute pitch is the name given to the rare ability to identify a musical note in an automatic and effortless manner without the need for a reference tone. Those... (Review)
Review
Absolute pitch is the name given to the rare ability to identify a musical note in an automatic and effortless manner without the need for a reference tone. Those individuals with absolute pitch can, for example, name the note they hear, identify all of the tones of a given chord, and/or name the pitches of everyday sounds, such as car horns or sirens. Hence, absolute pitch can be seen as providing a rare example of absolute sensory judgment in audition. Surprisingly, however, the intriguing question of whether such an ability presents unique features in the domain of sensory perception, or whether instead similar perceptual skills also exist in other sensory domains, has not been explicitly addressed previously. In this paper, this question is addressed by systematically reviewing research on absolute pitch using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) method. Thereafter, we compare absolute pitch with two rare types of sensory experience, namely synaesthesia and eidetic memory, to understand if and how these phenomena exhibit similar features to absolute pitch. Furthermore, a common absolute perceptual ability that has been often compared to absolute pitch, namely colour perception, is also discussed. Arguments are provided supporting the notion that none of the examined abilities can be considered like absolute pitch. Therefore, we conclude by suggesting that absolute pitch does indeed appear to constitute a unique kind of absolute sensory judgment in humans, and we discuss some open issues and novel directions for future research in absolute pitch.
Topics: Humans; Pitch Perception; Judgment; Synesthesia; Color Perception; Music
PubMed: 38761646
DOI: 10.1016/j.cognition.2024.105805 -
Journal of Speech, Language, and... Sep 2022Systematic review and meta-analysis are regarded as standard and valuable tools for providing an objective and reproducible synthesis of research findings in the... (Meta-Analysis)
Meta-Analysis
PURPOSE
Systematic review and meta-analysis are regarded as standard and valuable tools for providing an objective and reproducible synthesis of research findings in the literature. Their increasing popularity has led to heightened expectations for comprehensiveness and rigor in conducting scientific reviews and analyses. The purpose of this tutorial is to provide an overview and guidance on how to address the key elements for conducting a high-quality systematic review with meta-analysis.
METHOD
This tutorial describes practical guidelines to conduct systematic review and meta-analysis for researchers who are interested in learning and applying the method. Drawing on previous meta-analytic reviews of second-language learning as illustrative examples, it discusses the methodological choices and judgment calls in each step of the review and analysis process. As a hands-on tutorial, it uses a published data set concerning the role of talker variability in speech training studies as a running example to elucidate the statistical process and interpret the results of meta-analysis with freely available R software.
RESULTS/CONCLUSIONS
This tutorial provides a walk-through of the methodological choices, controversial issues, and common practices in conducting systematic reviews and meta-analyses. The data set and R codes are offered as publicly accessible supplementary materials (https://osf.io/e9bkf/) for replication and practice, which we hope will motivate more applications in the speech, language, and hearing sciences field as well as behavioral and social sciences research in general.
Topics: Hand; Humans; Research Design; Software
PubMed: 36001816
DOI: 10.1044/2022_JSLHR-21-00607 -
The Korean Journal of Internal Medicine Sep 2019About 21% of adults with osteoarthritis (OA) are diagnosed with concomitant depression in addition to chronic pain. Duloxetine, an anti-depressant medication, has been... (Meta-Analysis)
Meta-Analysis
About 21% of adults with osteoarthritis (OA) are diagnosed with concomitant depression in addition to chronic pain. Duloxetine, an anti-depressant medication, has been recently approved for managing Knee OA. We performed a systematic review to ascertain the efficacy and safety of duloxetine for OA. We searched MEDLINE, EMBASE, Web of Science, Google Scholar, and the Cochrane Database from inception to December 2018. Randomized clinical trials (RCTs) assessing the efficacy and/or safety of duloxetine versus placebo in OA patients were included. Data extraction and quality assessment were undertaken by two independent reviewers. Seven RCTs (n = 2,102 participants) met our inclusion criteria, and five RCTs (n = 1,713) were eligible for meta-analysis. The results of our analyses indicate that duloxetine has statistically significant, moderate benefits on pain, function, and quality of life in knee OA patients for up to 13 weeks. Reported incidences of gastrointestinal adverse events were three to four times higher in participants who received duloxetine versus placebo. Duloxetine may be an effective treatment option for individuals with knee OA, but use of the drug is associated with a significantly higher risk of adverse events. Patient preferences and clinicians' judgment must be considered before the initiation of duloxetine.
Topics: Aged; Antirheumatic Agents; Duloxetine Hydrochloride; Female; Humans; Male; Middle Aged; Osteoarthritis, Knee; Quality of Life; Remission Induction; Risk Factors; Treatment Outcome
PubMed: 30871298
DOI: 10.3904/kjim.2018.460