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Digital Health 2024Wearable technology is used in healthcare to monitor the health of individuals. This study presents an updated systematic literature review of the use of wearable... (Review)
Review
BACKGROUND
Wearable technology is used in healthcare to monitor the health of individuals. This study presents an updated systematic literature review of the use of wearable technology in promoting child and adolescent health, accompanied by recommendations for future research.
METHODS
This review focuses on studies involving children and adolescents aged between 2 and 18 years, regardless of their health condition or disabilities. Studies that were published from 2016 to 2024, and which met the inclusion criteria, were extracted from four academic databases (i.e. PubMed, Cochrane, Embase, and Web of Science) using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) protocol. Data on intervention purposes, interventions deployed, intervention duration, measurements, and the main outcomes of the studies were collected.
RESULTS
A total of 53 studies involving 14,852 participants were reviewed. They focused on various aspects, including the ownership and use of wearable devices ( = 3), the feasibility ( = 22), effectiveness ( = 4), and adherence ( = 2) of intervention strategies, or a combination of multiple aspects ( = 22). Among the interventions deployed, Fitbit was the most frequently used, featuring in 26 studies, followed by ActiGraph ( = 11). In intervention studies, the majority of studies focused on pre-morbidity prevention ( = 26) and the treatment of illnesses ( = 20), with limited attention given to postoperative monitoring ( = 4).
CONCLUSIONS
The use of wearable technology by children and adolescents has proven to be both feasible and effective for health promotion. This systematic review summarizes existing research by exploring the use of wearable technology in promoting health across diverse youth populations, including healthy and unhealthy individuals. It examines health promotion at various stages of the disease continuum, including pre-disease prevention, in-disease treatment, and postoperative monitoring. Additionally, the review provides directions for future research.
PubMed: 38868368
DOI: 10.1177/20552076241260507 -
PLoS Neglected Tropical Diseases Jun 2024Despite its well-regarded vector control program, Singapore remains susceptible to dengue epidemics. To assist evaluation of dengue interventions, we aimed to synthesize...
BACKGROUND
Despite its well-regarded vector control program, Singapore remains susceptible to dengue epidemics. To assist evaluation of dengue interventions, we aimed to synthesize current data on the epidemiologic and economic burden of dengue in Singapore.
METHODOLOGY
We used multiple databases (PubMed, Embase, Cochrane, international/national repositories, surveillance) to search for published and gray literature (2000-2022). We included observational and cost studies, and two interventional studies, reporting Singapore-specific data on our co-primary outcomes, dengue incidence and dengue-related costs. Quality was assessed using the Newcastle-Ottawa Scale and an adapted cost-of-illness evaluation checklist. We performed a narrative synthesis and grouped studies according to reported outcomes and available stratified analyses.
FINDINGS
In total, 333 reports (330 epidemiological, 3 economic) were included. Most published epidemiological studies (89%) and all economic studies were of good quality. All gray literature reports were from the Ministry of Health or National Environment Agency. Based predominantly on surveillance data, Singapore experienced multiple outbreaks in 2000-2021, attaining peak incidence rate in 2020 (621.1 cases/100,000 person-years). Stratified analyses revealed the highest incidence rates in DENV-2 and DENV-3 serotypes and the 15-44 age group. Among dengue cases, the risk of hospitalization has been highest in the ≥45-year-old age groups while the risks of dengue hemorrhagic fever and death have generally been low (both <1%) for the last decade. Our search yielded limited data on deaths by age, severity, and infection type (primary, secondary, post-secondary). Seroprevalence (dengue immunoglobulin G) increases with age but has remained <50% in the general population. Comprising 21-63% indirect costs, dengue-related total costs were higher in 2010-2020 (SGD 148 million) versus the preceding decade (SGD 58-110 million).
CONCLUSION
Despite abundant passive surveillance data, more stratified and up-to-date data on the epidemiologic and economic burden of dengue are warranted in Singapore to continuously assess prevention and management strategies.
Topics: Singapore; Humans; Dengue; Cost of Illness; Incidence; Dengue Virus; Hospitalization; Adult
PubMed: 38857260
DOI: 10.1371/journal.pntd.0012240 -
Translational Lung Cancer Research May 2024We previously demonstrated in a meta-analysis there was no difference in risk ratio (RR) of lung cancer detected by low-dose computed tomography (LDCT) screening among...
Race, age at diagnosis and histological characteristics of lung cancer in never-smokers (LCINS) and ever-smokers in low-dose computed tomography (LDCT) screening: a systematic review and meta-analysis.
BACKGROUND
We previously demonstrated in a meta-analysis there was no difference in risk ratio (RR) of lung cancer detected by low-dose computed tomography (LDCT) screening among female never-smokers (NS) and male ever-smokers (ES) in Asia. LDCT screening significantly decreased lung cancer death among Asian NS compared to Asian ES (RR =0.27, P<0.001).
METHODS
We investigated if race, age at diagnosis, and histology further differentiate lung cancer diagnosed by LDCT among in NS and ES using the 14 studies from our previous meta-analysis.
RESULTS
Twelve publications reported relevant data utilized in this study. From five Asian and one international studies, Asian ES had similar risk of lung cancer diagnosed at baseline screening as Asian NS [RR =0.96; 95% confidence interval (CI): 0.74-1.24] but among non-Asian ES had a 4.56 times significantly higher risk than non-Asian NS (RR =4.56; 95% CI: 2.85-7.28). The baseline incidence of lung cancer in never-smoker (LCINS) was approximately 2.3 times higher among Asian NS than non-Asian NS (0.62% 0.27%, P=0.001). Asian ES had about half the baseline incidence of lung cancer diagnosed as non-Asian ES (0.65% 1.26%). LCINS was diagnosed at 1.98 years younger than ES (95% CI: -3.38 to -0.58) (four studies) and exhibited a higher proportion of adenocarcinoma (ADC) (96.58% 70.37%).
CONCLUSIONS
Among normal-risk individuals, LCINS had a significantly higher likelihood of being diagnosed among Asians than non-Asians, predominantly manifesting as ADC and diagnosed approximately 2 years younger than ES suggesting that the age limit to initiate lung cancer screening in NS may be set lower compared to LDCT lung cancer screening among ES.
PubMed: 38854936
DOI: 10.21037/tlcr-23-816 -
Breast Disease 2024Breast self-examination (BSE) is an important tool for early detection of breast cancer and can contribute to increased awareness and familiarity with breast tissue.... (Review)
Review
INTRODUCTION
Breast self-examination (BSE) is an important tool for early detection of breast cancer and can contribute to increased awareness and familiarity with breast tissue. This study aimed to review factors that influenced BSE in preventing breast cancer.
METHODS
In the initial stage of searching for journal articles, 186 journals were obtained, then screening was carried out within a time span of 2019-2024 and using Indonesian and English 54 journals. Of the 12 journals reviewed, the results showed that 4 journals reviewed had conducted pre and post-BSE practices, and 8 journal reviews conducted BSE practices conducted by students and health workers.
RESULTS
Several factors play an important role in implementing BSE, namely age, knowledge, history of exposure to information, family history, ethnicity, and attitude. Overall, the study shows that the need to create awareness and educate women, especially rural women, on the importance of BSE as a preventive measure for breast cancer is paramount.
CONCLUSIONS
Factors influencing the implementation of BSE can be a barrier or an enhancement in breast cancer prevention.
Topics: Female; Humans; Breast Neoplasms; Breast Self-Examination; Early Detection of Cancer; Health Knowledge, Attitudes, Practice; Indonesia
PubMed: 38820008
DOI: 10.3233/BD-249001 -
Future Science OA 2024This meta-analysis aims to shed light on any primacy the -carotid (TC-TAVR) access may have over the -femoral access (TF-TAVR) for those undergoing transcatheter aortic... (Review)
Review
This meta-analysis aims to shed light on any primacy the -carotid (TC-TAVR) access may have over the -femoral access (TF-TAVR) for those undergoing transcatheter aortic valve replacement (TAVR). PubMed/MEDLINE and Cochrane Library were searched, from inception to March 2023 retrieving seven adjusted studies with a total of 6609 patients, of which 5048 underwent TF-TAVR while 1561 underwent TC-TAVR. No divergence in risk of mortality, major bleeding or stroke/transient ischemic attack in TC-TAVR when compared with TF-TAVR was found. In TC-TAVR, the risk of vascular complications was low (OR: 0.51, 95% CI: 0.32-0.83, p = 0.003) as compared with TF-TAVR. As of this analysis, the viability of TC-TAVR as first alternative to TF-TAVR is plausible.
PubMed: 38817364
DOI: 10.2144/fsoa-2023-0101 -
Journal of Comparative Effectiveness... May 2024This systematic literature review aims to summarize the efficacy/effectiveness of treatments, including eribulin (ERI)-based and anti-human epidermal growth factor... (Review)
Review
This systematic literature review aims to summarize the efficacy/effectiveness of treatments, including eribulin (ERI)-based and anti-human epidermal growth factor receptor 2 (HER2) treatments in advanced/metastatic HER2+ breast cancer. Three databases from 2016 to September 2021 were searched for clinical trials and observational studies in patients receiving first-line (1L) standard of care (SOC), second-line (2L) SOC or third-line or subsequent lines (3L+). 2692 citations were screened, and 38 studies were included. Eleven studies were randomized-controlled trials (RCTs; 5 in 1L, 6 in 3L+), 6 were single-arm trials (5 in 1L, 1 in 3L+) and 21 were observational studies (13 in 1L, 6 in 2L, 4 in 3L+ [note that studies with subgroups for 1L, 2L, 3L+ are double-counted]). Longer overall survival (OS) was associated with 1L and 2L treatment, and for 3L+ studies that included ERI, ERI or trastuzumab (Tmab) + ERI led to longer OS than treatments of physician's choice (median OS of 11, 10 and 8.9 months, respectively). Progression-free survival was 9 months in Tmab + pertuzumab (Pmab) + ERI, 4 months in Tmab + ERI and 3.3 months in ERI. Available treatments provide a wide range of efficacy. However, later lines lack standardization and conclusions on comparative effectiveness are limited by differing trial designs. Thus, the chance of prolonged survival with new agents warrants further research.
PubMed: 38808626
DOI: 10.57264/cer-2023-0153 -
Orthopaedic Surgery Jul 2024Total knee arthroplasty (TKA) is a common surgery for osteoarthritis, with increasing prevalence expected in the near future. This systematic review and meta-analysis... (Meta-Analysis)
Meta-Analysis Comparative Study Review
Computerized Versus Traditional Approaches for Total Knee Arthroplasty: A Quantitative Analysis of Knee Society Score and Western Ontario and McMaster Universities Osteoarthritis Index.
Total knee arthroplasty (TKA) is a common surgery for osteoarthritis, with increasing prevalence expected in the near future. This systematic review and meta-analysis compared the effectiveness of computerized TKA versus traditional TKA, focusing on postoperative outcomes measured by the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and the Knee Society score (KSS). A search on PubMed and Cochrane databases on November 14, 2023 for retrospective randomized controlled trials (RCTs) yielded data on WOMAC and KSS. The search strategy was predefined, and methodological quality of studies was critically appraised. Two researchers extracted data. Unpaired t-testing assessed the mean monthly changes in KSS and WOMAC for computer-aided versus traditional TKA. Review Manager 5.3 was used for data synthesis and analysis. Out of 729 records, five RCTs enrolling 339 patients were eligible and analyzed using a random effects meta-analysis. The mean monthly ΔKSS score differed significantly between the traditional and computerized groups (11.47 ± 8.76 vs. 9.26 ± 6.05, respectively; p < 0.01). However, the pooled mean difference estimate showed no significant differences (D = 0.20, 95% CI = -0.53 to 0.93, p = 0.59), with high heterogeneity (I = 85%, p < 0.001). The mean monthly ΔWOMAC score also differed significantly (-14.18 ± 21.54 vs. -18.43 ± 20.65, respectively; p < 0.05), but again, no significant differences were found in the pooled estimate (D = 0.17, 95% CI = -0.46 to 0.79, p = 0.60), with moderate heterogeneity (I = 28%, p = 0.24).There is no significant difference in KSS or WOMAC outcomes between traditional and computerized TKA. The study suggests the need for further research with longer follow-up periods, more timepoints, and a broader range of patient outcome measures to fully evaluate the advantages and disadvantages of each method.
Topics: Humans; Arthroplasty, Replacement, Knee; Osteoarthritis, Knee; Surgery, Computer-Assisted
PubMed: 38798039
DOI: 10.1111/os.14103 -
PLoS Neglected Tropical Diseases May 2024Toxoplasmosis is a serious endemic zoonotic disease caused by the protozoan parasite Toxoplasma gondii. Toxoplasma infection during pregnancy can result in congenital... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Toxoplasmosis is a serious endemic zoonotic disease caused by the protozoan parasite Toxoplasma gondii. Toxoplasma infection during pregnancy can result in congenital transmission and serious fetal and neonatal complications. This systematic review and meta-analysis aimed to assess the pooled seroprevalence of T. gondii infection and its determinants among pregnant women in African countries.
METHODS
All articles reporting the seroprevalence of toxoplasmosis among pregnant women in African countries and published from 2010 to 2023 were searched using various databases. The pooled prevalence of toxoplasmosis was calculated using a random-effect model. The variation between the included studies was assessed using a funnel plot and I2 heterogeneity statistics. To identify the sources of heterogeneity, sub-group analysis was further conducted by country, diagnostic method, and sub-African region. The association of prevalence rates with the socio-economic level and geoclimatic parameters was also explored.
RESULTS
In total, 29,383 pregnant women from 60 articles were included for analysis. The pooled T. gondii seroprevalence was 42.89% with high heterogeneity (I2 = 99.4%, P < 0.001). Sub-group analysis revealed variation by country (ranging from 2.62% in Namibia to 80.28% in Congo), diagnostic method used (from 8.66% in studies using a rapid diagnostic test to 55.69% in those using an agglutination test), and sub-African region (from 4.14% in regions of Southern Africa to 53.96 in Central Africa). Cat ownership (OR = 1.58) and the consumption of raw meat (OR = 1.50) and raw vegetables (OR = 1.48) had a statistically significant combined effect on T. gondii seroprevalence. No association was found between T. gondii prevalence and the level of income of the country or geoclimatic parameters.
CONCLUSION
The prevalence of toxoplasmosis infection among pregnant women in Africa is high, particularly in Central and Eastern Africa. The determinants of prevalence are multifactorial. Therefore, efforts should be made to increase the awareness of women concerning the risk factors for toxoplasmosis.
Topics: Humans; Female; Seroepidemiologic Studies; Pregnancy; Toxoplasmosis; Toxoplasma; Africa; Pregnancy Complications, Parasitic; Antibodies, Protozoan; Animals; Prevalence; Pregnant Women
PubMed: 38781272
DOI: 10.1371/journal.pntd.0012198 -
Frontiers in Psychiatry 2024Online mental healthcare has gained significant attention due to its effectiveness, accessibility, and scalability in the management of mental health symptoms. Despite...
INTRODUCTION
Online mental healthcare has gained significant attention due to its effectiveness, accessibility, and scalability in the management of mental health symptoms. Despite these advantages over traditional in-person formats, including higher availability and accessibility, issues with low treatment adherence and high dropout rates persist. Artificial intelligence (AI) technologies could help address these issues, through powerful predictive models, language analysis, and intelligent dialogue with users, however the study of these applications remains underexplored. The following mixed methods review aimed to supplement this gap by synthesizing the available evidence on the applications of AI in online mental healthcare.
METHOD
We searched the following databases: MEDLINE, CINAHL, PsycINFO, EMBASE, and Cochrane. This review included peer-reviewed randomized controlled trials, observational studies, non-randomized experimental studies, and case studies that were selected using the PRISMA guidelines. Data regarding pre and post-intervention outcomes and AI applications were extracted and analyzed. A mixed-methods approach encompassing meta-analysis and network meta-analysis was used to analyze pre and post-intervention outcomes, including main effects, depression, anxiety, and study dropouts. We applied the Cochrane risk of bias tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) to assess the quality of the evidence.
RESULTS
Twenty-nine studies were included revealing a variety of AI applications including triage, psychotherapy delivery, treatment monitoring, therapy engagement support, identification of effective therapy features, and prediction of treatment response, dropout, and adherence. AI-delivered self-guided interventions demonstrated medium to large effects on managing mental health symptoms, with dropout rates comparable to non-AI interventions. The quality of the data was low to very low.
DISCUSSION
The review supported the use of AI in enhancing treatment response, adherence, and improvements in online mental healthcare. Nevertheless, given the low quality of the available evidence, this study highlighted the need for additional robust and high-powered studies in this emerging field.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=443575, identifier CRD42023443575.
PubMed: 38774435
DOI: 10.3389/fpsyt.2024.1356773 -
Human Vaccines & Immunotherapeutics Dec 2024Herpes zoster (HZ) is a painful rash which typically affects older adults. This is of concern in Asia-Pacific given its aging population. As HZ epidemiology and burden... (Review)
Review
Herpes zoster (HZ) is a painful rash which typically affects older adults. This is of concern in Asia-Pacific given its aging population. As HZ epidemiology and burden are evolving, this systematic literature review aimed to update the current understanding of HZ burden and associated costs for selected Asia-Pacific locales. MEDLINE and Embase were searched for English articles of HZ studies conducted in Australia, China, Hong Kong, Japan, Korea, New Zealand, Singapore, and Taiwan. Eligible outcomes included HZ incidence and prevalence, occurrence of HZ-related complications, healthcare resource utilization, costs, and HZ-associated quality of life outcomes. This paper focused on HZ data in the general adult population ( = 90 articles). Substantial HZ-related disease and economic burden were observed in these locales, consistent with global trends. These findings reinforce the increasing burden of HZ and need for preventive strategies, which may include raising awareness and encouraging timely vaccination.
Topics: Humans; Asia; Australia; Cost of Illness; Herpes Zoster; Incidence; New Zealand; Prevalence; Quality of Life; Adult
PubMed: 38767209
DOI: 10.1080/21645515.2024.2344983