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Medicine May 2016Presently, there is no recommendation on how to assess functional status of chronic obstructive pulmonary disease (COPD) patients. This study aimed to summarize and... (Review)
Review
Presently, there is no recommendation on how to assess functional status of chronic obstructive pulmonary disease (COPD) patients. This study aimed to summarize and systematically evaluate these measures.Studies on measures of COPD patients' functional status published before the end of January 2015 were included using a search filters in PubMed and Web of Science, screening reference lists of all included studies, and cross-checking against some relevant reviews. After title, abstract, and main text screening, the remaining was appraised using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) 4-point checklist. All measures from these studies were rated according to best-evidence synthesis and the best-rated measures were selected.A total of 6447 records were found and 102 studies were reviewed, suggesting 44 performance-based measures and 14 patient-reported measures. The majority of the studies focused on internal consistency, reliability, and hypothesis testing, but only 21% of them employed good or excellent methodology. Their common weaknesses include lack of checks for unidimensionality, inadequate sample sizes, no prior hypotheses, and improper methods. On average, patient-reported measures perform better than performance-based measures. The best-rated patient-reported measures are functional performance inventory (FPI), functional performance inventory short form (FPI-SF), living with COPD questionnaire (LCOPD), COPD activity rating scale (CARS), University of Cincinnati dyspnea questionnaire (UCDQ), shortness of breath with daily activities (SOBDA), and short-form pulmonary functional status scale (PFSS-11), and the best-rated performance-based measures are exercise testing: 6-minute walk test (6MWT), endurance treadmill test, and usual 4-meter gait speed (usual 4MGS).Further research is needed to evaluate the reliability and validity of performance-based measures since present studies failed to provide convincing evidence. FPI, FPI-SF, LCOPD, CARS, UCDQ, SOBDA, PFSS-11, 6MWT, endurance treadmill test, and usual 4MGS performed well and are preferable to assess functional status of COPD patients.
Topics: Activities of Daily Living; Dyspnea; Humans; Psychometrics; Pulmonary Disease, Chronic Obstructive; Reproducibility of Results; Surveys and Questionnaires; Walk Test
PubMed: 27196472
DOI: 10.1097/MD.0000000000003672 -
Journal of Thrombosis and Haemostasis :... Jun 2017Essentials The widely recommended CHA2DS2-VASc shows conflicting results in contemporary validation studies. We performed a systematic review and meta-analysis of 19... (Meta-Analysis)
Meta-Analysis Review
UNLABELLED
Essentials The widely recommended CHA2DS2-VASc shows conflicting results in contemporary validation studies. We performed a systematic review and meta-analysis of 19 studies validating CHA2DS2-VASc. There was high heterogeneity in stroke risks for different CHA2DS2-VASc scores. This was not explained by differences between setting of care, or by performing meta-regression.
SUMMARY
Background The CHA2DS2-VASc decision rule is widely recommended for estimating stroke risk in patients with atrial fibrillation (AF), although validation studies show ambiguous and conflicting results. Objectives To: (i) review existing studies validating CHA2DS2-VASc in AF patients who are not (yet) anticoagulated; (ii) meta-analyze estimates of stroke risk per score; and (iii) explore sources of heterogeneity across the validation studies. Methods We performed a systematic literature review and random effects meta-analysis of studies externally validating CHA2DS2-VASc in AF patients not receiving anticoagulants. To explore between-study heterogeneity in stroke risk, we stratified studies to the clinical setting in which patient enrollment started, and performed meta-regression. Results In total, 19 studies were evaluated, with over two million person-years of follow-up. In studies recruiting AF patients in hospitals, stroke risks for scores of 0, 1 and 2 were 0.4% (approximate 95% prediction interval [PI] 0.2-3.2%), 1.2% (95% PI 0.1-3.8%), and 2.2% (95% PI 0.03-7.8%), respectively. These were consistently higher than those in studies recruiting patients from the open general population, with risks of 0.2% (95% PI 0.0-0.9%), 0.7% (95% PI 0.3-1.2%) and 1.5% (95% PI 0.4-3.3%) for scores of 0, 1, and 2, respectively. Heterogeneity, as reflected by the wide PIs, could not be fully explained by meta-regression. Conclusions Studies validating CHA2DS2-VASc show high heterogeneity in predicted stroke risks for different scores.
Topics: Aged; Anticoagulants; Atrial Fibrillation; Blood Coagulation; Cardiology; Female; Humans; Male; Middle Aged; Practice Guidelines as Topic; Regression Analysis; Risk Assessment; Risk Factors; Stroke; Thrombolytic Therapy; Validation Studies as Topic
PubMed: 28375552
DOI: 10.1111/jth.13690 -
Journal of Clinical Ultrasound : JCU Jun 2022To perform a systematic review and meta-analysis of published literature investigating the use of lung ultrasound (LUS) on COVID-19 patients, in emergency point of care... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To perform a systematic review and meta-analysis of published literature investigating the use of lung ultrasound (LUS) on COVID-19 patients, in emergency point of care settings, and to determine its diagnostic value compared with lung computed tomography (LCT) diagnostic performance. Whilst using the real-time polymerase chain reaction test as the 'gold standard'.
METHODS
Literature searches were performed on MEDLINE, Embase, Web of Science, and PubMed databases for eligible studies. The LUS and LCT pooled diagnostic performance were measured using DerSimonian-Laird random effect method.
RESULT
Out of a total of 158 studies, 16 met the eligibility criteria and were included in this review. The pooled sensitivity, specificity, positive and negative likelihood ratios were 86.9%, 62.4%, 2.4 and 0.19, respectively for LUS and 93.5%, 72.6%, 3.3 and 0.05, respectively for LCT.
CONCLUSION
The lung ultrasound (LUS) demonstrated acceptable sensitivity but poor specificity when used independently to diagnose COVID-19 pneumonia patients in emergency departments, while the lung computed tomography showed higher performance. Thus, LUS can be used to supplement existing diagnostic tools and possibly for the triage of patients.
Topics: COVID-19; Emergency Service, Hospital; Humans; Lung; Point-of-Care Systems; Ultrasonography
PubMed: 35261033
DOI: 10.1002/jcu.23184 -
Insights Into Imaging Mar 2022We systematically reviewed the current literature evaluating the ability of fully-automated deep learning (DL) and semi-automated traditional machine learning (TML)... (Review)
Review
Comparative performance of fully-automated and semi-automated artificial intelligence methods for the detection of clinically significant prostate cancer on MRI: a systematic review.
OBJECTIVES
We systematically reviewed the current literature evaluating the ability of fully-automated deep learning (DL) and semi-automated traditional machine learning (TML) MRI-based artificial intelligence (AI) methods to differentiate clinically significant prostate cancer (csPCa) from indolent PCa (iPCa) and benign conditions.
METHODS
We performed a computerised bibliographic search of studies indexed in MEDLINE/PubMed, arXiv, medRxiv, and bioRxiv between 1 January 2016 and 31 July 2021. Two reviewers performed the title/abstract and full-text screening. The remaining papers were screened by four reviewers using the Checklist for Artificial Intelligence in Medical Imaging (CLAIM) for DL studies and Radiomics Quality Score (RQS) for TML studies. Papers that fulfilled the pre-defined screening requirements underwent full CLAIM/RQS evaluation alongside the risk of bias assessment using QUADAS-2, both conducted by the same four reviewers. Standard measures of discrimination were extracted for the developed predictive models.
RESULTS
17/28 papers (five DL and twelve TML) passed the quality screening and were subject to a full CLAIM/RQS/QUADAS-2 assessment, which revealed a substantial study heterogeneity that precluded us from performing quantitative analysis as part of this review. The mean RQS of TML papers was 11/36, and a total of five papers had a high risk of bias. AUCs of DL and TML papers with low risk of bias ranged between 0.80-0.89 and 0.75-0.88, respectively.
CONCLUSION
We observed comparable performance of the two classes of AI methods and identified a number of common methodological limitations and biases that future studies will need to address to ensure the generalisability of the developed models.
PubMed: 35347462
DOI: 10.1186/s13244-022-01199-3 -
International Journal of Environmental... Sep 2022: Firefighting is a strenuous occupation, which necessitates that firefighters stay in good physical condition and maintain adequate cardiovascular and musculoskeletal... (Meta-Analysis)
Meta-Analysis Review
Effects of Cardiovascular Disease Risk Factors, Musculoskeletal Health, and Physical Fitness on Occupational Performance in Firefighters-A Systematic Review and Meta-Analysis.
: Firefighting is a strenuous occupation, which necessitates that firefighters stay in good physical condition and maintain adequate cardiovascular and musculoskeletal fitness to perform their duties with minimal health and safety risks. The aim of this review is to determine the effects of cardiovascular disease risk factors, musculoskeletal health, and physical fitness on the occupational performance of firefighters. PubMed/Medline, SCOPUS, Web of Science, EBSCOHost, and ScienceDirect were searched without time-restriction. The appraisal tool for cross-sectional studies and the Critical Appraisal Skills Programme toolkit were used to conduct the methodological assessment. Data were analyzed using Review Manager 5.3, and MedCalc statistical software. Age had a moderate effect on occupational performance (Z = 5.15, < 0.001), whereas gender had a large effect size on occupational performance (Z = 4.24, < 0.001). A significant moderate negative correlation was found between cardiorespiratory fitness and occupational performance (R = -0.584, < 0.001). Significant low negative correlations were found between upper body endurance (R = -0.344, < 0.001), abdominal endurance (R = -0.308, < 0.001), grip strength (R = -0.421, < 0.001), upper body strength (R = -0.318, < 0.001), and lower body strength (R = -0.216, = 0.020) and occupational performance. Aged firefighters with poor body composition and lower levels of physical fitness performed worse on all occupational performance tasks.
Topics: Aged; Cardiovascular Diseases; Cross-Sectional Studies; Firefighters; Humans; Occupational Health; Physical Fitness; Risk Factors
PubMed: 36231242
DOI: 10.3390/ijerph191911946 -
Sports Medicine - Open Dec 2019The sport of strongman is becoming increasingly popular, catering for females, lightweight, and Masters competitors, with strongman exercises also being used by strength... (Review)
Review
BACKGROUND
The sport of strongman is becoming increasingly popular, catering for females, lightweight, and Masters competitors, with strongman exercises also being used by strength and conditioning coaches for a range of athletic groups. Thus, a systematic review was conducted to examine researchers' current understanding of the biomechanics of strongman exercises, with a view to improve strongman athlete performance, provide biomechanical evidence supporting the transferability of strongman exercises to strength and conditioning/rehabilitation programs, and identify gaps in the current knowledge of the biomechanics of strongman exercises.
METHODS
A two-level search term strategy was used to search five databases for studies relevant to strongman exercises and biomechanics.
RESULTS
Eleven articles adherent to the inclusion criteria were returned from the search. The studies provided preliminary biomechanical analysis of various strongman exercises including the key biomechanical performance determinants of the farmer's walk, heavy sled pull, and tire flip. Higher performing athletes in the farmer's walk and heavy sled pull were characterized by a greater stride length and stride rate and reduced ground contact time, while higher performing athletes in the tire flip were characterized by a reduced second pull phase time when compared with lower performing athletes. Qualitative comparison of carrying/walking, pulling and static lifting strongman, traditional weight training exercises (TWTE), and common everyday activities (CEA), like loaded carriage and resisted sprinting, were discussed to further researchers' understanding of the determinants of various strongman exercises and their applications to strength and conditioning practice. A lack of basic quantitative biomechanical data of the yoke walk, unilateral load carriage, vehicle pull, atlas stone lift and tire flip, and biomechanical performance determinants of the log lift were identified.
CONCLUSIONS
This review has demonstrated the likely applicability and benefit of current and future strongman exercise biomechanics research to strongman athletes and coaches, strength and conditioning coaches considering using strongman exercises in a training program, and tactical operators (e.g., military, army) and other manual labor occupations. Future research may provide a greater understanding of the biomechanical determinants of performance, potential training adaptations, and risks expected when performing and/or incorporating strongman exercises into strength and conditioning or injury rehabilitation programs.
PubMed: 31820223
DOI: 10.1186/s40798-019-0222-z -
Archivos Espanoles de Urologia Dec 2021Nowadays, Robotic assistedkidney transplantation (RAKT) is considered a lessinvasive alternative to the Open Kidney Transplantation(OKT) with several advantages such as...
OBJECTIVES
Nowadays, Robotic assistedkidney transplantation (RAKT) is considered a lessinvasive alternative to the Open Kidney Transplantation(OKT) with several advantages such as image magnification,3D vision and articulated instruments and with arelatively short learning curve for an experienced surgeon.RAKT has shown comparable outcomes with theOKT literature data in terms of surgical and functionalresults. RAKT may decrease the complication rate, meanhospital stay, postoperative pain, and also improve aestheticoutcomes. The aim of this study was to perform asystematic review of the literature on this novel approachof KT.
MATERIALS AND METHODS
A systematic review was performed in accordance with the Preferred ReportingItems for Systematic Reviews and Meta-Analyses (PRISMA)statement. The search was conducted using the databases PubMed/Medline, including as outcomes: (1) indications, (2) step-by-step technique for RAKT, (3) RAKT in special cases (4) surgical and functional outcomes,and (5) future perspectives in RAKT.
RESULTS
The indications for RAKT are expanding, sothat including obese recipients, graft with multiple vesselsand graft from deceased donor. To date, the two absolute contraindications to RAKT are patients unfitfor pneumoperitoneum and presenting advanced atheromatic plaques where vessel clamping could result challenging. As far as the outcomes, the surgical and functional results are in line with the OKT experience.Complication rate is low in RAKT, particularly in terms of arterial and venous thrombosis (1%), lymphocele (3%),ureteral stricture (2%), and wound infection (0.3%). Arobotic assisted kidney auto-transplantation (RAKAT) has been recently described, as novel approach in case of complex proximal benign ureteral stenosis. Despite great advances in this field, some limits still need to be approached such as the modality to main tain the graft to a constant low temperature ( <20 ºC) and to find the proper location of arteriotomy in advanced atheromatic disease without the tactile feedback.
CONCLUSION
The present review has confirmed that RAKT is as safe and feasible as OKT with comparable surgical and functional results. Complication rate is lower in RAKT than OKT and the indications are expanding quickly. Furthermore, new technologies are being introduced in order to improve the surgical performances and to expand more the indications for robotic surgery.However, a prospective randomized study in order to compare RAKT versus OKT is still required.
Topics: Humans; Kidney Transplantation; Operative Time; Prospective Studies; Robotic Surgical Procedures; Robotics; Treatment Outcome
PubMed: 34851312
DOI: No ID Found -
International Journal of Environmental... Mar 2021Since the accelerating development of technology applied to team sports and its subsequent high amount of information available, the need for data mining leads to the... (Review)
Review
Training Design, Performance Analysis, and Talent Identification-A Systematic Review about the Most Relevant Variables through the Principal Component Analysis in Soccer, Basketball, and Rugby.
Since the accelerating development of technology applied to team sports and its subsequent high amount of information available, the need for data mining leads to the use of data reduction techniques such as Principal Component Analysis (PCA). This systematic review aims to identify determinant variables in soccer, basketball and rugby using exploratory factor analysis for, training design, performance analysis and talent identification. Three electronic databases (PubMed, Web of Science, SPORTDiscus) were systematically searched and 34 studies were finally included in the qualitative synthesis. Through PCA, data sets were reduced by 75.07%, and 3.9 ± 2.53 factors were retained that explained 80 ± 0.14% of the total variance. All team sports should be analyzed or trained based on the high level of aerobic capacity combined with adequate levels of power and strength to perform repeated high-intensity actions in a very short time, which differ between team sports. Accelerations and decelerations are mainly significant in soccer, jumps and landings are crucial in basketball, and impacts are primarily identified in rugby. Besides, from these team sports, primary information about different technical/tactical variables was extracted such as (a) soccer: occupied space, ball controls, passes, and shots; (b) basketball: throws, rebounds, and turnovers; or (c) rugby: possession game pace and team formation. Regarding talent identification, both anthropometrics and some physical capacity measures are relevant in soccer and basketball. Although overall, since these variables have been identified in different investigations, further studies should perform PCA on data sets that involve variables from different dimensions (technical, tactical, conditional).
Topics: Athletic Performance; Basketball; Football; Principal Component Analysis; Soccer
PubMed: 33807971
DOI: 10.3390/ijerph18052642 -
BMC Pregnancy and Childbirth Dec 2015The concept of neonatal near miss has been proposed as a tool for assessment of quality of care in neonates who suffered any life-threatening condition. However, there... (Review)
Review
BACKGROUND
The concept of neonatal near miss has been proposed as a tool for assessment of quality of care in neonates who suffered any life-threatening condition. However, there are no internationally agreed concepts or criteria for defining or identifying neonatal near miss. The purpose of this study was to perform a systematic review of studies and markers that are able to identify neonatal near miss cases and predict neonatal mortality.
METHODS
Electronic searches were performed in the Medline, Embase and Scielo databases, with no time or language restriction, until December 2014. The term "neonatal near miss" was used alone or in combination with terms related to neonatal morbidity/mortality and neonatal severity scores. Study selection criteria involved three steps: title, abstract and full text of the articles. Two researchers performed study selection and data extraction independently. Heterogeneity of study results did not permit the performance of meta-analysis.
RESULTS
Following the inclusion and exclusion criteria adopted, only four articles were selected. Preterm and perinatal asphyxia were used as near miss markers in all studies. Health indicators on neonatal morbidity and mortality were extracted or estimated. The neonatal near miss rate was 2.6 to 8 times higher than the neonatal mortality rate.
CONCLUSIONS
Pragmatic and management criteria are used to help develop the neonatal near miss concept. The most severe cases are identified and mortality is predicted with these criteria. Furthermore, the near miss concept can be used as a tool for evaluating neonatal care. It is the first step in building management strategies to reduce mortality and long-term sequelae.
Topics: Asphyxia Neonatorum; Female; Humans; Infant; Infant Mortality; Infant, Newborn; Morbidity; Near Miss, Healthcare; Pregnancy; Prognosis; World Health Organization
PubMed: 26625905
DOI: 10.1186/s12884-015-0758-y -
Sports Medicine (Auckland, N.Z.) Aug 2012Core stability training, operationally defined as training focused to improve trunk and hip control, is an integral part of athletic development, yet little is known... (Review)
Review
BACKGROUND
Core stability training, operationally defined as training focused to improve trunk and hip control, is an integral part of athletic development, yet little is known about its direct relation to athletic performance.
OBJECTIVE
This systematic review focuses on identification of the association between core stability and sports-related performance measures. A secondary objective was to identify difficulties encountered when trying to train core stability with the goal of improving athletic performance.
DATA SOURCES
A systematic search was employed to capture all articles related to athletic performance and core stability training that were identified using the electronic databases MEDLINE, CINAHL and SPORTDiscus™ (1982-June 2011).
STUDY SELECTION
A systematic approach was used to evaluate 179 articles identified for initial review. Studies that performed an intervention targeted toward the core and measured an outcome related to athletic or sport performances were included, while studies with a participant population aged 65 years or older were excluded. Twenty-four in total met the inclusionary criteria for review.
STUDY APPRAISAL AND SYNTHESIS METHODS
Studies were evaluated using the Physical Therapy Evidence Database (PEDro) scale. The 24 articles were separated into three groups, general performance (n = 8), lower extremity (n = 10) and upper extremity (n = 6), for ease of discussion.
RESULTS
In the majority of studies, core stability training was utilized in conjunction with more comprehensive exercise programmes. As such, many studies saw improvements in skills of general strengths such as maximum squat load and vertical leap. Surprisingly, not all studies reported measurable increases in specific core strength and stability measures following training. Additionally, investigations that targeted the core as the primary goal for improved outcome of training had mixed results.
LIMITATIONS
Core stability is rarely the sole component of an athletic development programme, making it difficult to directly isolate its affect on athletic performance. The population biases of some studies of athletic performance also confound the results.
CONCLUSIONS
Targeted core stability training provides marginal benefits to athletic performance. Conflicting findings and the lack of a standardization for measurement of outcomes and training focused to improve core strength and stability pose difficulties. Because of this, further research targeted to determine this relationship is necessary to better understand how core strength and stability affect athletic performance.
Topics: Athletic Performance; Databases, Bibliographic; Female; Humans; Male; Physical Education and Training; Resistance Training
PubMed: 22784233
DOI: 10.2165/11633450-000000000-00000