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Journal of the Association For Research... Feb 2023Identifying risk factors for tinnitus could facilitate not only the recommendations for prevention measures, but also identifying potential pathways for new... (Meta-Analysis)
Meta-Analysis
AIMS/HYPOTHESIS
Identifying risk factors for tinnitus could facilitate not only the recommendations for prevention measures, but also identifying potential pathways for new interventions. This study reports the first comprehensive systematic review of analytical observational studies able to provide information about causality (i.e., case-control and cohort designs).
METHODS
A literature search of four electronic databases identified epidemiological studies published on tinnitus and different exposures. Independent raters screened all studies, extracted data, and evaluated study quality using the Newcastle-Ottawa Scale. Reported relative risks (RR), hazard ratios (HR), odds ratios (OR), and prevalence ratios (PR) with 95% confidence intervals (CI) were used to compute crude estimates of RR for tinnitus risk factors.
RESULTS
From 2389 records identified, a total of 374 articles were read as full text (24 reviews, 301 cross-sectional studies, 42 cohort studies, and 7 case-control studies). However, from 49 case-control and cohort studies, only 25 adequately reported risk ratios. Using the findings from these studies, positive causal associations were found for various hearing-related factors (i.e., unspecified hearing loss, sensorineural hearing loss, occupational noise exposure, ototoxic platinum therapy, and otitis media). Evidence was also found for a number of non-otological risk factors including temporo-mandibular joint disorder, depression, chronic obstructive pulmonary disease, and hyperlipidemia. Negative associations indicating preventative effects were found for diabetes and high alcohol consumption. No associations were found for low alcohol consumption, body mass index, head injury, heart failure, hypertension, leisure noise exposure, migraine, rheumatoid arthritis, sex, smoking, stroke, and whiplash. However, with the exception of unspecified hearing loss, these findings resulted from pooling no more than 4 studies, illustrating that the vast majority of the associations still remain inconclusive.
CONCLUSIONS
These systematic review and meta-analysis confirm a number of otological and non-otological risk factors for tinnitus. By highlighting major gaps in knowledge, our synthesis can help provide direction for future research that will shed light on the pathophysiology, improve management strategies, and inform more effective preventions.
Topics: Humans; Tinnitus; Cross-Sectional Studies; Hearing Loss; Risk Factors; Hearing Loss, Sensorineural; Observational Studies as Topic
PubMed: 36380120
DOI: 10.1007/s10162-022-00874-y -
Clinical and Translational Radiation... Jan 2023To assess the literature on men's preferences and perceptions regarding prostate cancer radiation therapy. (Review)
Review
PURPOSE
To assess the literature on men's preferences and perceptions regarding prostate cancer radiation therapy.
METHODS
A scoping review was undertaken as per JBI guidelines. Searches were conducted in PubMed, CINAHL, Scopus and Science Direct with search terms including "prostate cancer," "radiotherapy," "radiation therapy," "radiation oncology," "patient preferences," "patient perceptions" and "patient experience." The resultant studies were mapped and grouped according to the emergent themes and pathway stages.
RESULTS
A total of 779 titles and abstracts were screened by two independent reviewers. Fifty-two full-text studies were reviewed, with 27 eligible for inclusion. There were 4 pre-treatment, 13 during treatment and 10 post-treatment studies covering broad themes of information needs (n = 3), preferences and decisions (n = 6), general experiences (n = 8), side effects (n = 6), and support (n = 4). There were a mix of methodologies, including 11 qualitative, 14 quantitative (including four preference studies), one mixed methods and one narrative review.
CONCLUSION
There were only four preference studies, with the remaining 23 reporting on perceptions. Overall, there is a paucity of literature regarding patient preferences and perceptions of prostate cancer radiation therapy, particularly when considering how many clinical and technical studies are published in the area. This highlights opportunities for future research.
PubMed: 36345391
DOI: 10.1016/j.ctro.2022.10.007 -
Age and Ageing Sep 2022our aim was to assess the effectiveness of medication review and deprescribing interventions as a single intervention in falls prevention. (Meta-Analysis)
Meta-Analysis
BACKGROUND
our aim was to assess the effectiveness of medication review and deprescribing interventions as a single intervention in falls prevention.
DESIGN
systematic review and meta-analysis.
DATA SOURCES
Medline, Embase, Cochrane CENTRAL, PsycINFO until 28 March 2022.
ELIGIBILITY CRITERIA
randomised controlled trials of older participants comparing any medication review or deprescribing intervention with usual care and reporting falls as an outcome.
STUDY RECORDS
title/abstract and full-text screening by two reviewers.
RISK OF BIAS
Cochrane Collaboration revised tool.
DATA SYNTHESIS
results reported separately for different settings and sufficiently comparable studies meta-analysed.
RESULTS
forty-nine heterogeneous studies were included.
COMMUNITY
meta-analyses of medication reviews resulted in a risk ratio (RR) of 1.05 (95% confidence interval, 0.85-1.29, I2 = 0%, 3 studies(s)) for number of fallers, in an RR = 0.95 (0.70-1.27, I2 = 37%, 3 s) for number of injurious fallers and in a rate ratio (RaR) of 0.89 (0.69-1.14, I2 = 0%, 2 s) for injurious falls.
HOSPITAL
meta-analyses assessing medication reviews resulted in an RR = 0.97 (0.74-1.28, I2 = 15%, 2 s) and in an RR = 0.50 (0.07-3.50, I2 = 72% %, 2 s) for number of fallers after and during admission, respectively.
LONG-TERM CARE
meta-analyses investigating medication reviews or deprescribing plans resulted in an RR = 0.86 (0.72-1.02, I2 = 0%, 5 s) for number of fallers and in an RaR = 0.93 (0.64-1.35, I2 = 92%, 7 s) for number of falls.
CONCLUSIONS
the heterogeneity of the interventions precluded us to estimate the exact effect of medication review and deprescribing as a single intervention. For future studies, more comparability is warranted. These interventions should not be implemented as a stand-alone strategy in falls prevention but included in multimodal strategies due to the multifactorial nature of falls.PROSPERO registration number: CRD42020218231.
Topics: Deprescriptions; Exercise; Hospitals; Humans; Medication Review
PubMed: 36153749
DOI: 10.1093/ageing/afac191 -
Osteoarthritis and Cartilage Jan 2023In order to facilitate data pooling between studies, we explored harmonisation of patient-reported outcome measures (PROMs) in people with knee pain due to... (Meta-Analysis)
Meta-Analysis
Harmonising knee pain patient-reported outcomes: a systematic literature review and meta-analysis of Patient Acceptable Symptom State (PASS) and individual participant data (IPD).
OBJECTIVE
In order to facilitate data pooling between studies, we explored harmonisation of patient-reported outcome measures (PROMs) in people with knee pain due to osteoarthritis or knee trauma, using the Patient Acceptable Symptom State scores (PASS) as a criterion.
METHODS
We undertook a systematic literature review (SLR) of PASS scores, and performed individual participant data (IPD) analysis of score distributions from concurrently completed PROM pairs. Numerical rating scales (NRS), visual analogue scales, KOOS and WOMAC pain questionnaires were standardised to 0 to 100 (worst) scales. Meta-regression explored associations of PASS. Bland Altman plots compared PROM scores within individuals using IPD from WebEx, KICK, MenTOR and NEKO studies.
RESULTS
SLR identified 18 studies reporting PASS in people with knee pain. Pooled standardised PASS was 27 (95% CI: 21 to 35; n = 6,339). PASS was statistically similar for each standardised PROM. Lower PASS was associated with lower baseline pain (β = 0.49, P = 0.01) and longer time from treatment initiation (Q = 6.35, P = 0.04). PASS scores were lowest in ligament rupture (12, 95% CI: 11 to 13), but similar between knee osteoarthritis (31, 95% CI: 26 to 36) and meniscal tear (27, 95% CI: 20 to 35). In IPD, standardised PROMs each revealed similar group mean scores, but scores within individuals diverged between PROMs (LoA between -7 to -38 and +25 to 52).
CONCLUSION
Different standardised PROMs give similar PASS thresholds in group data. PASS thresholds may be affected more by patient and treatment characteristics than between PROMs. However, different PROMs give divergent scores within individuals, possibly reflecting different experiences of pain.
Topics: Humans; Patient Reported Outcome Measures; Knee Joint; Osteoarthritis, Knee; Knee Injuries; Pain
PubMed: 36089231
DOI: 10.1016/j.joca.2022.08.011 -
Trials Sep 2022Single-sided deafness (SSD) has functional, psychological, and social consequences. Interventions for adults with SSD include hearing aids and auditory implants....
The Core Rehabilitation Outcome Set for Single-Sided Deafness (CROSSSD) study: International consensus on outcome measures for trials of interventions for adults with single-sided deafness.
BACKGROUND
Single-sided deafness (SSD) has functional, psychological, and social consequences. Interventions for adults with SSD include hearing aids and auditory implants. Benefits and harms (outcome domains) of these interventions are until now reported inconsistently in clinical trials. Inconsistency in reporting outcome measures prevents meaningful comparisons or syntheses of trial results. The Core Rehabilitation Outcome Set for Single-Sided Deafness (CROSSSD) international initiative used structured communication techniques to achieve consensus among healthcare users and professionals working in the field of SSD. The novel contribution is a set of core outcome domains that experts agree are critically important to assess in all clinical trials of SSD interventions.
METHODS
A long list of candidate outcome domains compiled from a systematic review and published qualitative data, informed the content of a two-round online Delphi survey. Overall, 308 participants from 29 countries were enrolled. Of those, 233 participants completed both rounds of the survey and scored each outcome domain on a 9-point scale. The set of core outcome domains was finalised via a web-based consensus meeting with 12 participants. Votes involved all stakeholder groups, with an approximate 2:1 ratio of professionals to healthcare users participating in the Delphi survey, and a 1:1 ratio participating in the consensus meeting.
RESULTS
The first round of the survey listed 44 potential outcome domains, organised thematically. A further five outcome domains were included in Round 2 based on participant feedback. The structured voting at round 2 identified 17 candidate outcome domains which were voted on at the consensus meeting. Consensus was reached for a core outcome domain set including three outcome domains: spatial orientation, group conversations in noisy social situations, and impact on social situations. Seventy-seven percent of the remaining Delphi participants agreed with this core outcome domain set.
CONCLUSIONS
Adoption of the internationally agreed core outcome domain set would promote consistent assessment and reporting of outcomes that are meaningful and important to all relevant stakeholders. This consistency will in turn enable comparison of outcomes reported across clinical trials comparing SSD interventions in adults and reduce research waste. Further research will determine how those outcome domains should best be measured.
Topics: Adult; Consensus; Deafness; Delphi Technique; Humans; Outcome Assessment, Health Care; Research Design; Treatment Outcome
PubMed: 36076299
DOI: 10.1186/s13063-022-06702-1 -
Applied Network Science 2022Network analysis is a useful tool to analyse the interactions and structure of graphs that represent the relationships among entities, such as sectors within an urban... (Review)
Review
UNLABELLED
Network analysis is a useful tool to analyse the interactions and structure of graphs that represent the relationships among entities, such as sectors within an urban system. Connecting entities in this way is vital in understanding the complexity of the modern world, and how to navigate these complexities during an event. However, the field of network analysis has grown rapidly since the 1970s to produce a vast array of available metrics that describe different graph properties. This diversity allows network analysis to be applied across myriad research domains and contexts, however widespread applications have produced polysemic metrics. Challenges arise in identifying which method of network analysis to adopt, which metrics to choose, and how many are suitable. This paper undertakes a structured review of literature to provide clarity on behind metric selection and suggests a way forward for applied network analysis. It is essential that future studies explicitly report the rationale behind metric choice and describe how the mathematics relates to target concepts and themes. An exploratory metric analysis is an important step in identifying the most important metrics and understanding redundant ones. Finally, where applicable, one should select an optimal number of metrics that describe the network both locally and globally, so as to understand the interactions and structure as holistically as possible.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s41109-022-00476-w.
PubMed: 35854964
DOI: 10.1007/s41109-022-00476-w -
International Journal of Environmental... May 2022Epidemiological studies of the neurological health of former professional soccer players are being undertaken to identify whether heading the ball is a risk factor for... (Review)
Review
Epidemiological studies of the neurological health of former professional soccer players are being undertaken to identify whether heading the ball is a risk factor for disease or premature death. A quantitative estimate of exposure to repeated sub-concussive head impacts would provide an opportunity to investigate possible exposure-response relationships. However, it is unclear how to formulate an appropriate exposure metric within the context of epidemiological studies. We have carried out a systematic review of the scientific literature to identify the factors that determine the magnitude of head impact acceleration during experiments and from observations during playing or training for soccer, up to the end of November 2021. Data were extracted from 33 experimental and 27 observational studies from male and female amateur players including both adults and children. There was a high correlation between peak linear and angular accelerations in the observational studies (p < 0.001) although the correlation was lower for the experimental data. We chose to rely on an analysis of maximum or peak linear acceleration for this review. Differences in measurement methodology were identified as important determinants of measured acceleration, and we concluded that only data from accelerometers fixed to the head provided reliable information about the magnitude of head acceleration from soccer-related impacts. Exposures differed between men and women and between children and adults, with women on average experiencing higher acceleration but less frequent impacts. Playing position appears to have some influence on the number of heading impacts but less so on the magnitude of the head acceleration. Head-to-head collisions result in high levels of exposure and thus probably risk causing a concussion. We concluded, in the absence of evidence to the contrary, that estimates of the cumulative number of heading impacts over a playing career should be used as the main exposure metric in epidemiological studies of professional players.
Topics: Acceleration; Adult; Athletes; Brain Concussion; Child; Female; Head; Humans; Male; Risk Factors; Soccer
PubMed: 35564889
DOI: 10.3390/ijerph19095488 -
Interventions for social isolation in older adults who have experienced a fall: a systematic review.BMJ Open Mar 2022The objective of our systematic review was to identify the effective interventions to prevent or mitigate social isolation and/or loneliness in older adults who...
OBJECTIVES
The objective of our systematic review was to identify the effective interventions to prevent or mitigate social isolation and/or loneliness in older adults who experienced a fall.
DESIGN
Systematic review.
DATA SOURCES
MEDLINE, Embase, the Cochrane Central Register of Controlled Trials and Ageline were searched (from inception to February 2020).
METHODS
Studies were eligible if they described any intervention for social isolation in older adults living in a community setting who experienced a fall, and reported outcomes related to social isolation or loneliness.Two independent reviewers screened citations, abstracted data and appraised risk of bias using the Cochrane risk of bias tool. The results were summarised descriptively.
RESULTS
After screening 4069 citations and 55 full-text articles, four studies were included. The four studies varied in study design, including a randomised controlled trial, non-randomised controlled trial, an uncontrolled before-after study and a quasiexperimental study. Interventions varied widely, and included singing in a choir, a patient-centred, interprofessional primary care team-based approach, a multifactorial assessment targeting fall risk, appropriate medication use, loneliness and frailty, and a community-based care model that included comprehensive assessments and multilevel care coordination. Outcome measures varied and included scales for loneliness, social isolation, social interaction, social networks and social satisfaction. Mixed results were found, with three studies reporting no differences in social isolation or loneliness after the intervention. Only the multifactorial assessment intervention demonstrated a small positive effect on loneliness compared with the control group after adjustment (B=-0.18, 95% CI -0.35 to -0.02).
CONCLUSIONS
Few studies examined the interventions for social isolation or loneliness in older adults who experienced a fall. More research is warranted in this area.
PROSPERO REGISTRATION NUMBER
CRD42020198487.
Topics: Aged; Humans; Accidental Falls; Bias; Loneliness; Research Design; Social Isolation; Controlled Clinical Trials as Topic
PubMed: 35264363
DOI: 10.1136/bmjopen-2021-056540 -
Journal of Lasers in Medical Sciences 2021Photobiomodulation or low-level laser therapy (LLLT;<0.5 W) has been used as a non-invasive treatment for various medical indications. Short (visible; 635-650 nm) and... (Review)
Review
Photobiomodulation or low-level laser therapy (LLLT;<0.5 W) has been used as a non-invasive treatment for various medical indications. Short (visible; 635-650 nm) and longer (invisible; 810-850 nm and 915-980 nm) near-infrared wavelengths have been commonly used, but power setting deficiencies or incorrect wavelength settings can cause negative outcomes. The 1064 nm wavelength as the longest wavelength is a relative newcomer in high-powered (>0.5 W) laser photobiomodulation therapy (HPL-PBMT) with unique biophysical characteristics. A comprehensive search of 2016-2021 PubMed, Google Scholar, and Cochrane databases for "photobiomodulation" restricted to clinical trials for patients with a medical diagnosis was done. "1064 nm" content was identified and restricted to high-powered lasers (>0.5 watt). Cohen's was calculated for the effect size and the difference was determined as a measure of relative 1064 nm HPL-PBMT efficacy. The 22 independent studies meeting inclusion criteria focused on knee arthropathies, spine, shoulder/elbow, wound, gynecological, or osteoporosis with evaluation of pain, function, quality of life, range of motion (ROM), and anatomy. Pain was reduced with statistical significance (<0.05) in 90% of study assessments (n=20) and 100% of studies focused on the knee (n=6). Of 18 studies assessing functional outcome measures, 100% demonstrated statistically significant improvements. Follow-up assessments up to 6 months in 5 knee arthritis studies revealed long-term pain reduction after cessation of treatment. Improvements in wound healing, bone mineral density, and knee cartilage thickness were demonstrated. The largest effect sizes observed were pain reduction in knee arthritis (average Cohen's effect size=2.46). These studies have established that 1064 nm HPL-PBMT can effectively reduce pain, increase ROM, increase functional scores, and increase the quality of life for knee osteoarthritis and spinal disorders, with limitations. More studies are needed for clinical validation of single-trial data detecting changes in musculoskeletal conditions, cartilage thickness and bone density.
PubMed: 35155171
DOI: 10.34172/jlms.2021.86 -
Frontiers in Aging Neuroscience 2021Possession of one or two e4 alleles of the apolipoprotein E () gene is associated with cognitive decline and dementia risk. Some evidence suggests that physical activity...
INTRODUCTION
Possession of one or two e4 alleles of the apolipoprotein E () gene is associated with cognitive decline and dementia risk. Some evidence suggests that physical activity may benefit carriers of the e4 allele differently.
METHOD
We conducted a systematic review and meta-analysis of studies which assessed differences in the association between physical activity and: lipid profile, Alzheimer's disease pathology, brain structure and brain function in healthy adults. Searches were carried out in PubMed, SCOPUS, Web of Science and PsycInfo.
RESULTS
Thirty studies were included from 4,896 papers screened. Carriers of the e4 allele gained the same benefit from physical activity as non-carriers on most outcomes. For brain activation, e4 carriers appeared to gain a greater benefit from physical activity on task-related and resting-state activation and resting-state functional connectivity compared to non-carriers. analysis identified possible compensatory mechanisms allowing e4 carriers to maintain cognitive function.
DISCUSSION
Though there is evidence suggesting physical activity may benefit e4 carriers differently compared to non-carriers, this may vary by the specific brain health outcome, perhaps limited to brain activation. Further research is required to confirm these findings and elucidate the mechanisms.
PubMed: 35153725
DOI: 10.3389/fnagi.2021.815439