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Health Information and Libraries Journal Sep 2009Systematic review articles support the advance of science and translation of research evidence into healthcare practice. Inaccurate retrieval from medline could limit... (Review)
Review
BACKGROUND
Systematic review articles support the advance of science and translation of research evidence into healthcare practice. Inaccurate retrieval from medline could limit access to reviews.
OBJECTIVE
To determine the quality of indexing systematic reviews and meta-analyses in medline.
METHODS
The Clinical Hedges Database, containing the results of a hand search of 161 journals, was used to test medline indexing terms for their ability to retrieve systematic reviews that met predefined methodologic criteria (labelled as 'pass' review articles) and reviews that reported a meta-analysis.
RESULTS
The Clinical Hedges Database contained 49 028 articles; 753 were 'pass' review articles (552 with a meta-analysis). In total 758 review articles (independent of whether they passed) reported a meta-analysis. The search strategy that retrieved the highest number of 'pass' systematic reviews achieved a sensitivity of 97.1%. The publication type 'meta analysis' had a false positive rate of 5.6% (95% CI 3.9 to 7.6), and false negative rate of 0.31% (95% CI 0.26 to 0.36) for retrieving systematic reviews that reported a meta-analysis.
CONCLUSIONS
Inaccuracies in indexing systematic reviews and meta-analyses in medline can be partly overcome by a 5-term search strategy. Introducing a publication type for systematic reviews of the literature could improve retrieval performance.
Topics: Abstracting and Indexing; Evidence-Based Medicine; Humans; Information Storage and Retrieval; Meta-Analysis as Topic; Review Literature as Topic; Sensitivity and Specificity; Subject Headings
PubMed: 19712212
DOI: 10.1111/j.1471-1842.2008.00823.x -
International Journal of Environmental... Mar 2023With the advancement of spatial analysis approaches, methodological research addressing the technical and statistical issues related to joint spatial and spatiotemporal... (Review)
Review
With the advancement of spatial analysis approaches, methodological research addressing the technical and statistical issues related to joint spatial and spatiotemporal models has increased. Despite the benefits of spatial modelling of several interrelated outcomes simultaneously, there has been no published systematic review on this topic, specifically when such models would be useful. This systematic review therefore aimed at reviewing health research published using joint spatial and spatiotemporal models. A systematic search of published studies that applied joint spatial and spatiotemporal models was performed using six electronic databases without geographic restriction. A search with the developed search terms yielded 4077 studies, from which 43 studies were included for the systematic review, including 15 studies focused on infectious diseases and 11 on cancer. Most of the studies (81.40%) were performed based on the Bayesian framework. Different joint spatial and spatiotemporal models were applied based on the nature of the data, population size, the incidence of outcomes, and assumptions. This review found that when the outcome is rare or the population is small, joint spatial and spatiotemporal models provide better performance by borrowing strength from related health outcomes which have a higher prevalence. A framework for the design, analysis, and reporting of such studies is also needed.
Topics: Bayes Theorem; Incidence; Research Design; Databases, Factual
PubMed: 37047911
DOI: 10.3390/ijerph20075295 -
British Journal of Anaesthesia Mar 2024We aimed to evaluate the comparative effectiveness and safety of various i.v. pharmacologic agents used for procedural sedation and analgesia (PSA) in the emergency... (Meta-Analysis)
Meta-Analysis Review
Pharmacological agents for procedural sedation and analgesia in the emergency department and intensive care unit: a systematic review and network meta-analysis of randomised trials.
BACKGROUND
We aimed to evaluate the comparative effectiveness and safety of various i.v. pharmacologic agents used for procedural sedation and analgesia (PSA) in the emergency department (ED) and ICU. We performed a systematic review and network meta-analysis to enable direct and indirect comparisons between available medications.
METHODS
We searched Medline, EMBASE, Cochrane, and PubMed from inception to 2 March 2023 for RCTs comparing two or more procedural sedation and analgesia medications in all patients (adults and children >30 days of age) requiring emergent procedures in the ED or ICU. We focused on the outcomes of sedation recovery time, patient satisfaction, and adverse events (AEs). We performed frequentist random-effects model network meta-analysis and used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to rate certainty in estimates.
RESULTS
We included 82 RCTs (8105 patients, 78 conducted in the ED and four in the ICU) of which 52 studies included adults, 23 included children, and seven included both. Compared with midazolam-opioids, recovery time was shorter with propofol (mean difference 16.3 min, 95% confidence interval [CI] 8.4-24.3 fewer minutes; high certainty), and patient satisfaction was better with ketamine-propofol (mean difference 1.5 points, 95% CI 0.3-2.6 points, high certainty). Regarding AEs, compared with midazolam-opioids, respiratory AEs were less frequent with ketamine (relative risk [RR] 0.55, 95% CI 0.32-0.96; high certainty), gastrointestinal AEs were more common with ketamine-midazolam (RR 3.08, 95% CI 1.15-8.27; high certainty), and neurological AEs were more common with ketamine-propofol (RR 3.68, 95% CI 1.08-12.53; high certainty).
CONCLUSION
When considering procedural sedation and analgesia in the ED and ICU, compared with midazolam-opioids, sedation recovery time is shorter with propofol, patient satisfaction is better with ketamine-propofol, and respiratory adverse events are less common with ketamine.
Topics: Adult; Child; Humans; Propofol; Midazolam; Ketamine; Network Meta-Analysis; Pain; Analgesics, Opioid; Analgesia; Emergency Service, Hospital; Intensive Care Units; Conscious Sedation; Randomized Controlled Trials as Topic
PubMed: 38185564
DOI: 10.1016/j.bja.2023.11.050 -
International Journal of Stroke :... Feb 2009Systematic reviews followed by a meta-analysis are carried out in medical research to combine the results of two or more related studies. Stroke trials have struggled to... (Review)
Review
BACKGROUND
Systematic reviews followed by a meta-analysis are carried out in medical research to combine the results of two or more related studies. Stroke trials have struggled to show beneficial effects and meta-analysis should be used more widely throughout the research process to either speed up the development of useful interventions, or halt more quickly research with hazardous or ineffective interventions.
SUMMARY OF REVIEW
This review summarises the clinical research process and illustrates how and when systematic reviews may be used throughout the development programme. Meta-analyses should be performed after observational studies, preclinical studies in experimental stroke, and after phase I, II, and III clinical trials and phase IV clinical surveillance studies. Although meta-analyses most commonly work with summary data, they may be performed to assess relationships between variables (meta-regression) and, ideally, should utilise individual patient data. Meta-analysis techniques may also work with ordered categorical outcome data (ordinal meta-analysis) and be used to perform indirect comparisons where original trial data do not exist.
CONCLUSION
Systematic review/meta-analyses are powerful tools in medical research and should be used throughout the development of all stroke and other interventions.
Topics: Animals; Clinical Trials as Topic; Humans; Meta-Analysis as Topic; Review Literature as Topic; Stroke
PubMed: 19236494
DOI: 10.1111/j.1747-4949.2009.00235.x -
Zoonoses and Public Health Jun 2014This article is the second article in a series of six focusing on systematic reviews in animal agriculture and veterinary medicine. This article addresses the strengths... (Review)
Review
This article is the second article in a series of six focusing on systematic reviews in animal agriculture and veterinary medicine. This article addresses the strengths and limitations of study designs commonly used in animal agriculture and veterinary research to assess interventions (preventive or therapeutic treatments) and discusses the appropriateness of their use in systematic reviews of interventions. Different study designs provide different evidentiary value for addressing questions about the efficacy of interventions. Experimental study designs range from in vivo proof of concept experiments to randomized controlled trials (RCTs) under real-world conditions. The key characteristic of experimental design in intervention studies is that the investigator controls the allocation of individuals or groups to different intervention strategies. The RCT is considered the gold standard for evaluating the efficacy of interventions and, if there are well-executed RCTs available for inclusion in a systematic review, that review may be restricted to only this design. In some instances, RCTs may not be feasible or ethical to perform, and there are fewer RCTs published in the veterinary literature compared to the human healthcare literature. Therefore, observational study designs, where the investigator does not control intervention allocation, may provide the only available evidence of intervention efficacy. While observational studies tend to be relevant to real-world use of an intervention, they are more prone to bias. Human healthcare researchers use a pyramid of evidence diagram to describe the evidentiary value of different study designs for assessing interventions. Modifications for veterinary medicine are presented in this article.
Topics: Agriculture; Animals; Evidence-Based Medicine; Meta-Analysis as Topic; Randomized Controlled Trials as Topic; Research Design; Review Literature as Topic; Veterinary Medicine
PubMed: 24905992
DOI: 10.1111/zph.12127 -
Medicina (Kaunas, Lithuania) Nov 2022: Pregnancies that occur with an intrauterine device (IUD) in situ are at increased risk for developing severe conditions which may affect the fetus and the mother. The... (Review)
Review
: Pregnancies that occur with an intrauterine device (IUD) in situ are at increased risk for developing severe conditions which may affect the fetus and the mother. The incidence of such adverse consequences significantly drops after device removal. A scoping review of the literature was performed to highlight the risks, benefits, and outcomes of hysteroscopic removal of intrauterine devices in early pregnancy. : PubMed, Scopus, and Web of Science were searched. The review included all reports from 1990 to October 2022. The research strategy adopted included different combinations of the following terms: ("hysteroscopy") AND ("pregnancy") AND ("intrauterine device" or "IUD") AND ("intrauterine system" or "IUS"). A scoping review of the hysteroscopic removal of IUDs during pregnancy was performed. All studies identified were listed by citation, title, authors, and abstract. Duplicates were identified by an independent manual screening performed by two researchers and then removed. For the eligibility process, two authors independently screened the titles and abstracts of all non-duplicated papers and excluded those not pertinent to the topic. : PRISMA guidelines were followed. Nine manuscripts were detected, accounting for 153 patients. Most IUD removals occurred during the first trimester of pregnancy. Most of the time, the procedure was safe and without consequences. : This review highlights the safety and efficacy of operative hysteroscopy as a method of IUD removal in early pregnancy. We recommend using a 3 to 5 mm hysteroscope, avoiding cervical dilation, and maintaining low infusion pressure during the procedure to avoid potential damage to the gestational sac and IUD fragment displacement. Heating the distension media to 30 °C should be considered.
Topics: Female; Pregnancy; Humans; Hysteroscopy; Research Design; Fetus
PubMed: 36422228
DOI: 10.3390/medicina58111688 -
Australian Endodontic Journal : the... Dec 2021This systematic review and meta-analysis was sought to assess whether intentional foraminal enlargement (IFE) is responsible for extrusion of a larger quantity of debris... (Meta-Analysis)
Meta-Analysis Review
This systematic review and meta-analysis was sought to assess whether intentional foraminal enlargement (IFE) is responsible for extrusion of a larger quantity of debris from extracted human teeth with fully formed apexes. Following the recommendations of Preferred Reporting Items for Systematic Review and Meta-Analysis - PRISMA, electronic and manual searches were performed to identify studies that evaluated the extrusion of debris, comparing different apical limits of instrumentation (with/without IFE). The quality of the studies selected was evaluated, and statistical analysis was conducted. To perform the meta-analysis, just 3 papers could be used. The heterogeneity was high, however; there was no statistically significant difference in relation to the extrusion of debris in teeth either submitted or not submitted to IFE. The general risk of bias was moderate. In conclusion, IFE is not responsible for extrusion of a larger quantity of debris from extracted human teeth with fully formed apexes.
Topics: Electronics; Humans; Research Design
PubMed: 34146366
DOI: 10.1111/aej.12539 -
Journal of Robotic Surgery Oct 2022Abdominal sacrocolpopexy is considered as the gold standard treatment for pelvic organ prolapse. Sacrocolpopexy can be performed using open (OSC), laparoscopic (LSC),... (Meta-Analysis)
Meta-Analysis
Abdominal sacrocolpopexy is considered as the gold standard treatment for pelvic organ prolapse. Sacrocolpopexy can be performed using open (OSC), laparoscopic (LSC), and robotic-assisted (RSC) approaches. The aim of this study is to compare the outcomes between these three approaches for managing pelvic organ prolapse by conducting a systematic review and network meta-analysis. A systematic search was performed in different databases from their earliest records to April 2021 with no restriction on languages. Only randomized controlled trials that compared the outcomes between OSC, LSC, and RSC were included in this study. A total of 6 studies with 486 participants were included in this study. Operative time was significantly shorter in OSC than in RSC and LSC. The probability rank showed less estimated blood loss in RSC and lowest overall postoperative complications in LSC. Probability scores also showed best anatomical outcomes for postoperative points C and Bp in RSC and for point Ba in LSC. Despite significantly longer operative time, RSC and LSC may provide better anatomical outcomes, less estimated blood loss, and less overall postoperative complications than OSC. However, this study did not find significant differences between RSC and LSC in efficacy and safety.
Topics: Humans; Laparoscopy; Network Meta-Analysis; Pelvic Organ Prolapse; Postoperative Complications; Randomized Controlled Trials as Topic; Robotic Surgical Procedures; Treatment Outcome
PubMed: 34779989
DOI: 10.1007/s11701-021-01329-x -
Contemporary Clinical Trials Nov 2015Individual participant data (IPD) systematic reviews and meta-analyses are often considered to be the gold standard for meta-analysis. In the ten years since the first... (Review)
Review
INTRODUCTION
Individual participant data (IPD) systematic reviews and meta-analyses are often considered to be the gold standard for meta-analysis. In the ten years since the first review into the methodology and reporting practice of IPD reviews was published much has changed in the field. This paper investigates current reporting and statistical practice in IPD systematic reviews.
METHODS
A systematic review was performed to identify systematic reviews that collected and analysed IPD. Data were extracted from each included publication on a variety of issues related to the reporting of IPD review process, and the statistical methods used.
RESULTS
There has been considerable growth in the use of "one-stage" methods to perform IPD meta-analyses. The majority of reviews consider at least one covariate other than the primary intervention, either using subgroup analysis or including covariates in one-stage regression models. Random-effects analyses, however, are not often used. Reporting of review methods was often limited, with few reviews presenting a risk-of-bias assessment. Details on issues specific to the use of IPD were little reported, including how IPD were obtained; how data was managed and checked for consistency and errors; and for how many studies and participants IPD were sought and obtained.
CONCLUSION
While the last ten years have seen substantial changes in how IPD meta-analyses are performed there remains considerable scope for improving the quality of reporting for both the process of IPD systematic reviews, and the statistical methods employed in them. It is to be hoped that the publication of the PRISMA-IPD guidelines specific to IPD reviews will improve reporting in this area.
Topics: Data Accuracy; Data Interpretation, Statistical; Humans; Meta-Analysis as Topic; Research Design; Review Literature as Topic
PubMed: 26091948
DOI: 10.1016/j.cct.2015.06.012 -
Best Practice & Research. Clinical... Dec 2011Meta-analysis uses numerical tools to pool data and to estimate a summary effect size for the comparison of two interventions from a set of randomised controlled trials... (Review)
Review
Meta-analysis uses numerical tools to pool data and to estimate a summary effect size for the comparison of two interventions from a set of randomised controlled trials identified in a systematic review. An effect size is a single number that expresses the difference in outcome from the interventions. The most commonly used effect sizes for dichotomous outcomes, for example, mortality, are the odds ratio and the relative risk. The results of a meta-analysis are usually presented in a complex figure, known as a forest plot, which shows both the individual studies and the summary statistics. Sensitivity analyses are performed to clarify the effect of the experimental design bias on the effect size. Clinical and statistical heterogeneity of the included studies are explored by the additional tools of fixed effect versus random effects models and subgroup analyses.
Topics: Anesthesiology; Biomedical Research; Humans; Meta-Analysis as Topic; Probability; Randomized Controlled Trials as Topic; Research Design
PubMed: 22099918
DOI: 10.1016/j.bpa.2011.08.005