TY - JOUR AB - Background: Exercise is a key component of rehabilitation for soft tissue injuries of the shoulder; however its effectiveness remains unclear. Objective: Determine the effectiveness of exercise for shoulder pain. Methods: We searched seven databases from 1990 to 2015 for randomized controlled trials (RCTs), cohort and case control studies comparing exercise to other interventions for shoulder pain. We critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network (SIGN) criteria. We synthesized findings from scientifically admissible studies using best-evidence synthesis methodology. Results: We retrieved 4853 articles. Eleven RCTs were appraised and five had a low risk of bias. Four studies addressed subacromial impingement syndrome. One study addressed nonspecific shoulder pain. For variable duration subacromial impingement syndrome: 1) supervised strengthening leads to greater short-term improvement in pain and disability over wait listing; and 2) supervised and home-based strengthening and stretching leads to greater short-term improvement in pain and disability compared to no treatment. For persistent subacromial impingement syndrome: 1) supervised and home-based strengthening leads to similar outcomes as surgery; and 2) home-based heavy load eccentric training does not add benefits to home-based rotator cuff strengthening and physiotherapy. For variable duration low-grade nonspecific shoulder pain, supervised strengthening and stretching leads to similar short-term outcomes as corticosteroid injections or multimodal care. Conclusion: The evidence suggests that supervised and home-based progressive shoulder strengthening and stretching are effective for the management of subacromial impingement syndrome. For low-grade nonspecific shoulder pain, supervised strengthening and stretching are equally effective to corticosteroid injections or multimodal care. Systematic review registration number: CRD42013003928. © 2015 Elsevier Ltd. AU - Abdulla, S. Y. AU - Southerst, D. AU - Côté, P. AU - Shearer, H. M. AU - Sutton, D. AU - Randhawa, K. AU - Varatharajan, S. AU - Wong, J. J. AU - Yu, H. AU - Marchand, A. A. AU - Chrobak, K. AU - Woitzik, E. AU - Shergill, Y. AU - Ferguson, B. AU - Stupar, M. AU - Nordin, M. AU - Jacobs, C. AU - Mior, S. AU - Carroll, L. J. AU - van der Velde, G. AU - Taylor-Vaisey, A. DA - 2015-1-1 IS - 5 KW - Physical Therapy Modalities Shoulder Pain Case-Control Studies Soft Tissue Injuries Shoulder PY - 2015 SN - 1356-689X DO - http://dx.doi.org/10.1016/j.math.2010.08.005 SP - 646-656 ST - Is exercise effective for the management of subacromial impingement syndrome and other soft tissue injuries of the shoulder? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration T2 - Manual Therapy TI - Is exercise effective for the management of subacromial impingement syndrome and other soft tissue injuries of the shoulder? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration VL - 20 ID - 17 ER - TY - JOUR AB - Background: Hearing loss is one of the leading causes of disability worldwide, with greater than 20% of Canadian adults having measurable hearing loss in at least one ear. Patients with hearing loss experience impaired quality of life, and emotional and financial consequences that affect themselves and their families. Sudden sensorineural hearing loss (SSNHL) is a common but difficult to treat form of hearing loss that has a sudden onset of ≤ 72 h associated with various etiologies, with the majority of cases being idiopathic. Some patients may partially or completely recover hearing ability, but for 32 to 65% of patients whose hearing does not recover, feelings of social isolation elevate the risk of anxiety and depression. Hearing loss is also associated with poorer functional status, including difficulty with sound localization and hearing in noise. There exists a wide range of therapeutic options; however, treatment of idiopathic SSNHL is controversial because some patients recover spontaneously. The planned systematic review and network meta-analysis (NMA) will assess the relative effects of competing treatments for management of idiopathic SSNHL in adults. Methods: Electronic search strategies were developed by an experienced medical information specialist in consultation with the review team. We will search MEDLINE, Embase, and the Cochrane Library with no date or language restrictions. Key clinical trial registries will also be searched for in-progress and completed trials. Two reviewers will independently screen the literature using pre-specified eligibility criteria, and assess the quality of included studies using the Cochrane Risk of Bias tool. Disagreements will be resolved through consensus or third party adjudication. Bayesian NMAs will be pursued to compare interventions in terms of their effects on hearing (including audiometric thresholds and speech recognition scores), extent of hearing recovery, quality of life, and incidence of harms (including vestibular dysfunction, incidence of infections, and withdrawals due to adverse events). Discussion: This systematic review and NMA will offer new and informative evaluations of current therapies for SSNHL. The results will inform clinicians as to the relative benefits of the currently available interventions for managing this difficult condition, provide optimal clinical treatment strategies, establish evidence gaps, and identify promising treatments for evaluation in future trials. Systematic review registration: PROSPERO registration number: CRD 42017073756. © 2018 The Author(s). AU - Ahmadzai, N. AU - Kilty, S. AU - Wolfe, D. AU - Bonaparte, J. AU - Schramm, D. AU - Fitzpatrick, E. AU - Lin, V. AU - Cheng, W. AU - Skidmore, B. AU - Moher, D. AU - Hutton, B. DA - 2018-1-1 IS - 1 KW - Hearing Loss, Sensorineural Quality of Life visual analog scale vestibular disorder tissue oxygenation speech discrimination speech audiometry sound detection sensitivity analysis priority journal perception deafness outcome assessment numeric rating scale multiple sclerosis meta analysis Meniere disease medical record review hyperbaric oxygen therapy human functional status epilepsy cerebellum disease basilar type migraine Article apheresis valaciclovir retinol recombinant plasminogen activator prostaglandin E1 prostacyclin prednisone prednisolone pentoxifylline nifedipine naftidrofuryl methylprednisolone mannitol magnesium sulfate magnesium aspartate hydrocortisone hetastarch Ginkgo biloba extract fludiazepam diazepam dextran 40 dexamethasone cortisone carbogen brimapitide betamethasone batroxobin alpha tocopherol aciclovir Systematic review Sensorineural hearing loss Network meta-analysis PY - 2018 SN - 2046-4053 ST - A protocol for a network meta-analysis of interventions to treat patients with sudden sensorineural hearing loss T2 - Systematic Reviews TI - A protocol for a network meta-analysis of interventions to treat patients with sudden sensorineural hearing loss VL - 7 ID - 124 ER - TY - JOUR AB - Objectives to assess FRC FPDs longevity through systematically reviewing contemporary clinical evidence. Population investigated comprised patients requiring replacement of a single missing anterior/posterior tooth. Intervention was FRC FPDs. No control/comparison selected. Outcome was longevity of FRC FPDs. The focus question was: ‘What is the longevity of FRC FPDs used to replace one anterior or posterior tooth in patients?’ Data Randomised, non-randomised, controlled, prospective and retrospective clinical studies were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses were applied. The Overall Strength of Clinical Recommendation (OSCR) was assessed using the Strength of Recommendation Taxonomy system. Survival of FPDs was assessed using the Kaplan-Meier method. Analysis of FPD-survival according to location and occurrence of different failures was performed using Logrank and Chi-square testing. Sources PubMed, MEDLINE, and Web of Science databases were searched between January 2007 and December 2015. Study selection Nine studies were included, involving placement of 592 FRC FPDs in 463 patients. Follow-up periods ranged between 2 months and 8 years. Kaplan-Meier overall survival probability was 94.5% (95% C.I: 92.5%–96.5%) at 4.8 years. There was no significant difference in survival probability of anterior versus posterior FRC FPDs (P = 0.278). Veneering material fracture/delamination occurred significantly more than other types of failures (Ps < 0.05). A meta-analysis could not be performed. OSCR was moderate. Conclusions FRC FPDs demonstrated high overall survival with predictable performance outcomes. However, long-term performance remains unclear. Clinical significance FRC FPDs are viable medium-term management alternatives for replacing single anterior or posterior teeth in patients. © 2016 Elsevier Ltd AU - Ahmed, K. E. AU - Li, K. Y. AU - Murray, C. A. DA - 2017-1-1 KW - Longevity Treatment Outcome Survival Analysis Randomized Controlled Trials as Topic Non-Randomized Controlled Trials as Topic Humans Glass Denture, Partial, Fixed, Resin-Bonded Denture, Partial, Fixed Denture Retention Denture Design Dental Veneers Dental Restoration Failure Dental Bonding Dental Abutments Databases, Factual Composite Resins resin-bonded fixed partial denture randomized controlled trial (topic) procedures human fixed partial denture factual database denture dental veneer dental restoration dental abutment controlled clinical trial (topic) chemistry resin glass fiber Survival Review Fixed partial dentures Fiber-reinforced Composite Bridges PY - 2017 SP - 1-11 ST - Longevity of fiber-reinforced composite fixed partial dentures (FRC FPD)—Systematic review T2 - Journal of Dentistry TI - Longevity of fiber-reinforced composite fixed partial dentures (FRC FPD)—Systematic review VL - 61 ID - 90 ER - TY - JOUR AB - BACKGROUND: Prophylactic immunoglobulin has been used with varying efficacy to reduce complications in hematopoietic stem cell transplant recipients. STUDY DESIGN AND METHODS: A systematic review and meta-analysis was conducted of randomized controlled trials that assessed clinical outcomes (overall survival, transplant-related mortality, graft-versus-host disease [GVHD], veno-occlusive disease [VOD], interstitial pneumonitis, disease relapse, cytomegalovirus [CMV] infection and disease, non-CMV infection) of immunoglobulin prophylaxis versus placebo in hematopoietic stem cell transplant recipients. MEDLINE, EMBASE, EBM Reviews, and the Cochrane Central Register of Controlled Trials were searched up to June 2017. Quality of included studies and outcomes were evaluated via Risk of Bias assessment and Grading of Recommendations, Assessment, Development and Evaluation criteria, respectively. RESULTS: Of 899 citations screened, 27 studies (n = 3934) were included. Immunoglobulin prophylaxis had no impact on survival (risk ratio [RR], 0.94; 95% confidence interval [CI], 0.88-1.01; 11 studies, n = 1962) but decreased risk of acute GVHD (RR, 0.78; 95% CI, 0.65-0.94; eight studies, n = 1097) and CMV disease (RR, 0.52; 95% CI, 0.28-0.97; two studies, n = 167). Meta-analysis revealed increased risk of VOD (RR, 3.04; 95% CI, 1.10-8.41; three studies, n = 384) and disease relapse (RR, 1.26; 95% CI, 1.07-1.49; seven studies, n = 1647). Other outcomes were small in sample size or nonsignificant. Results should be interpreted cautiously given the low quality of studies and evidence of outcomes. CONCLUSION: Immunoglobulin prophylaxis did not have a significant effect on survival. Positive clinical effects were shown for acute GVHD and CMV disease and negative effects against VOD and disease relapse. No studies examined the effect of immunoglobulin treatment in hypogammaglobulinemic patients despite current guidelines, warranting further studies in this population. © 2018 AABB AD - Department of Medicine, University of Ottawa, Ottawa, Canada Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada Blood and Marrow Transplant Program, The Ottawa Hospital, Ottawa, Canada School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada Learning Services, The Ottawa Hospital, Ottawa, Canada Renal Transplantation, Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa, Canada Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Canada Division of Infectious Diseases, Department of Medicine, University of Ottawa, Ottawa, Canada Department of Medicine, University of Calgary, Calgary, Canada AU - Ahn, H. AU - Tay, J. AU - Shea, B. AU - Hutton, B. AU - Shorr, R. AU - Knoll, G. A. AU - Cameron, D. W. AU - Cowan, J. C2 - 29770447 DB - Scopus DO - 10.1111/trf.14656 IS - 10 KW - immunoglobulin placebo cytomegalovirus infection drug efficacy graft infection graft survival graft versus host reaction hematopoietic stem cell transplantation human interstitial pneumonia meta analysis overall survival quality control randomized controlled trial (topic) relapse Review risk reduction sample size systematic error systematic review treatment outcome vein occlusion mortality premedication procedures survival analysis Cytomegalovirus Infections Graft vs Host Disease Humans Immunoglobulins Randomized Controlled Trials as Topic LA - English M3 - Review PY - 2018 SP - 2437-2452 ST - Effectiveness of immunoglobulin prophylaxis in reducing clinical complications of hematopoietic stem cell transplantation: a systematic review and meta-analysis T2 - Transfusion TI - Effectiveness of immunoglobulin prophylaxis in reducing clinical complications of hematopoietic stem cell transplantation: a systematic review and meta-analysis VL - 58 ID - 347 ER - TY - JOUR AB - Introduction Due to the many advantages of open source software (OSS), including reduced cost of licensing, more flexibility in terms of customisation and redistribution, better quality and no vendor lock-in, OSS in healthcare is increasingly gaining importance. Various open source health information technologies (OS-HITs) are continuously being designed and developed for different areas of healthcare to increase organisational efficiencies and quality of care at minimum costs. The objective of this scoping review is to identify the kinds of existing OS-HITs, their characteristics (e.g. functions) and capabilities (e.g. advantages/disadvantages) for various healthcare stakeholders (physicians and patients) and healthcare sectors (e.g. clinical, administrative). Methods We will conduct a scoping review to identify the range of available OS-HITs in international literature from 1980 to September 2018. Searches will be conducted in six major international databases, namely: Cumulative Index to Nursing and Allied Health Literature Plus, Excerpta Medica Database, Global Health, Library Information Science and Technology Abstracts, Medline and Web of Science to identify relevant published research. We will also search the Google search engine and Google Scholar for on-going and unpublished work and the grey literature. Searches will be peer-reviewed by two independent reviewers and will not be limited by methodology or language. Next, selected references will be tabulated for study characteristics by author affiliation, country of origin, the name of OS-HIT, healthcare area/sector, system requirements, stakeholders, complete solution and web link. Furthermore, functions, benefits/advantages, disadvantages and outcomes (e.g. usability) of OS-HITs will be extracted. Narrative and interpretative synthesis of data will be undertaken. Results We will report our findings in a peer-reviewed journal. Copyright © 2018 The Author(s). AD - Centre for Health Informatics, Department of Health and Hospital Management, Institute of Business Management, Korangi Creek, Karachi, 75190, Pakistan Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, Medical School, University of Edinburgh, United Kingdom AU - Akhlaq, A. AU - McKinstry, B. AU - Sheikh, A. C2 - 30672406 DB - Scopus DO - 10.14236/jhi.v25i4.1022 IS - 4 KW - Health information technology Open source Systematic scoping review adult Cinahl Embase female global health grey literature health care cost human information science language male medical information Medline narrative physician review search engine synthesis systematic review Web of Science LA - English M3 - Review PY - 2018 SP - 230-238 ST - The characteristics and capabilities of the available open source health information technologies supporting healthcare: A scoping review protocol T2 - Journal of Innovation in Health Informatics TI - The characteristics and capabilities of the available open source health information technologies supporting healthcare: A scoping review protocol VL - 25 ID - 348 ER - TY - JOUR AB - Background: Daily iron-folic acid supplementation reduces anemia and various adverse obstetric outcomes such as preterm delivery, low birthweight, hemorrhage, and perinatal and maternal morbidity and mortality. However, its supplementation has not been successful that attributed to several determinants including poor adherence. Therefore, we aimed to conduct a systematic review and meta-analysis on the prevalence and determinants of adherence to prenatal iron-folic acid supplementation in low- and middle-income countries. In addition, we will develop a conceptual framework in the context of low- and middle-income countries (LMIC). Methods/design: We will search PubMed, MEDLINE, EMBASE, EBSCO, Web of Science, SCOPUS, WHO Global Index Medicus, and African Journals Online (AJOL) databases to retrieve relevant literatures. Observational (i.e., case-control, cohort, cross-sectional, survey, and surveillance reports) and quasi-randomized and randomized controlled trial studies conducted in LMIC will be included. The Newcastle-Ottawa Scale (NOS) and Joanna Briggs Institute (JBI) critical appraisal checklist will be used to assess the quality of observational and randomized controlled trial studies respectively. The pooled prevalence and odds ratio of determinants of adherence will be generated using a weighted inverse-variance meta-analysis model. Statistical heterogeneity among studies will be assessed by Cochran's Q χ 2 statistics and Higgins (I 2 statistics) method. The result will be presented using forest plots and Harvest plots when necessary. Furthermore, we will perform Jackknife sensitivity and subgroup analysis. Data will be analyzed using comprehensive meta-analysis software (version 2). Discussion: Contemporary evidence about the prevalence and determinants of adherence in LMIC will be synthesized to generate up-to-date knowledge. To our knowledge, this is the first systematic review. It would have substantial implications for researchers, clinicians, and policymakers for optimizing maternal and child health outcomes in LMIC. Systematic review registration: The protocol has been registered on International Prospective Register of Systematic Review (PROSPERO), University of York Center for Reviews and Dissemination ( https://www.crd.york.ac.uk/ ), registration number CRD42017080245. © 2018 The Author(s). AD - Debre Berhan University, Institute of Medicine and Health Science, Debre Berhan, Ethiopia University of Newcastle, Research Centre for Generational Health and Ageing, Hunter Medical Research Institute, Callaghan, Australia Wollaga University, College of Medicine and Health Science, Nekemte, Ethiopia Hawassa University, College of Medicine and Health Science, School of Public Health, Hawassa, Ethiopia Oregon State University, School of Biological and Population Health Sciences, Corvallis, United States University of Groningen, Department of Epidemiology, University Medical Center Groningen, Groningen, Netherlands Debre Berhan University, Department of Midwifery, Institute of Medicine and Health Science, P.O. Box 445, Debre Berhan, Ethiopia AU - Akibu, M. AU - Tekelab, T. AU - Amano, A. AU - Besho, M. AU - Grutzmacher, S. AU - Tadese, M. AU - Habtewold, T. D. C2 - 30045772 C7 - 107 DB - Scopus DO - 10.1186/s13643-018-0774-x IS - 1 KW - Folate Folic acid Iron Medication adherence Patient compliance Pregnancy Prenatal care Prenatal Nutritional Physiological Phenomena trace element Article data analysis data extraction data synthesis dietary compliance human low income country meta analysis middle income country Newcastle-Ottawa scale prevalence priority journal quality control randomized controlled trial (topic) sensitivity analysis systematic review vitamin supplementation administration and dosage deficiency developing country dietary supplement female iron intake medication compliance newborn pregnancy complication pregnancy outcome Developing Countries Dietary Supplements Humans Infant, Newborn Iron, Dietary Micronutrients Pregnancy Complications LA - English M3 - Article PY - 2018 ST - Adherence to prenatal iron-folic acid supplementation in low- and middle-income countries (LMIC): A protocol for systematic review and meta-analysis T2 - Systematic Reviews TI - Adherence to prenatal iron-folic acid supplementation in low- and middle-income countries (LMIC): A protocol for systematic review and meta-analysis VL - 7 ID - 349 ER - TY - JOUR AB - Introduction Renal replacement therapy (RRT) is a complex and expensive form of life-sustaining therapy, reserved for our most acutely ill patients. While a number of randomised trials have evaluated the optimal timing to start RRT among critically ill patients in the intensive care unit (ICU), there has been a paucity of trials providing guidance on when and under what circumstances to ideally liberate a patient from RRT. We are conducting a systematic review and meta-analysis to identify clinical and biochemical markers that predict kidney recovery and successful liberation from acute RRT among critically ill patients with acute kidney injury. Methods and analysis Our comprehensive search strategy was developed in consultation with a research librarian and independently peer-reviewed by a second librarian. We will search electronic databases: Ovid Medline, Ovid Embase and Wiley Cochrane Library. Selected grey literature sources will also be searched. Our search strategies will focus on concepts related to RRT (ie, intermittent haemodialysis, slow low-efficiency dialysis, continuous renal replacement therapy), intensive care (ie, involving any ICU setting) and discontinuation of therapy (ie, either clinical, physiological and biochemical parameters of weaning acute RRT) from 1990 to October 10, 2017. Citation screening, selection, quality assessment and data abstraction will be performed in duplicate. Studies will, where possible, be pooled in statistical meta-analysis. When deemed sufficiently clinically homogenous, and we have four or more studies reporting, sensitivities and specificities will be pooled simultaneously using a hierarchical summary receiver operator characteristic curve and bivariate analysis. Ethics and dissemination Our systematic review will synthesise the literature on clinical and biochemical markers that predict liberation from RRT. Research ethics approval is not required. Trial registration number CRD42018074615. © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. AD - Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada Alberta Strategy for Patient Oriented Research (SPOR) SUPPORT Unit Knowledge Translation Platform, University of Alberta, Edmonton, AB, Canada Alberta Research Center for Health Evidence (ARCHE), University of Alberta, Edmonton, AB, Canada AU - Al Saadon, A. AU - Katulka, R. AU - Sebastianski, M. AU - Featherstone, R. AU - Vandermeer, B. AU - Gibney, R. T. N. AU - Rewa, O. G. AU - Bagshaw, S. M. C2 - 30478115 C7 - e023306 DB - Scopus DO - 10.1136/bmjopen-2018-023306 IS - 11 KW - acute renal failure dialysis biochemical marker acute kidney failure Article biochemical analysis bivariate analysis Cochrane Library continuous renal replacement therapy convalescence critically ill patient Embase hemodialysis hemodialysis weaning human intensive care meta analysis outcome assessment prediction quality control receiver operating characteristic renal replacement therapy sensitivity and specificity slow low efficiency dialysis systematic review treatment withdrawal critical illness procedures time factor Humans Time Factors LA - English M3 - Article PY - 2018 ST - Determining the optimal time for liberation from renal replacement therapy in critically ill patients: Protocol for a systematic review and meta-analysis (DOnE RRT) T2 - BMJ Open TI - Determining the optimal time for liberation from renal replacement therapy in critically ill patients: Protocol for a systematic review and meta-analysis (DOnE RRT) VL - 8 ID - 350 ER - TY - JOUR AB - Background This report was produced for the Canadian Task Force on Preventive Health Care to provide guidelines on screening for abdominal aortic aneurysm (AAA) with ultrasound scan. Purpose The aim of this systematic review is to examine the evidence on benefits and harms of AAA screening. Search strategy This systematic review considered studies from the most recent United States Preventive Services Task Force review on AAA screening and passed through the screening process with citations identified in our search up to April 2015 (PROSPERO Registration #CRD42015019047). Results For benefits of one-time AAA screening in men compared with controls, pooled analyses from four randomized controlled trials with moderate quality evidence showed significant reductions in AAA-related mortality and AAA rupture rate up to 13 to 15 years of follow-up with 42% reduction (risk ratio [RR], 0.58; 95% confidence interval [CI], 0.39-0.88; number needed to screen = 212) and 38% reduction (RR, 0.62; 95% CI, 0.45-0.86; number needed to screen = 200), respectively. The effect of on all-cause mortality was marginally significant for longer follow-up. The Chichester trial examined the benefits of one-time AAA screening in women and found no significant differences between screening and control arms for up to 10 years of follow-up (RR, 0.88; 95% CI, 0.72-1.07). For consequences of one-time AAA screening in men compared with controls, there was a significant increase in the total number of AAA-related procedures over a follow-up of 13 to 15 years (2.16 times more likely) compared with controls. For harms of one-time AAA screening, no significant differences were observed in 30-day postoperative mortality for elective and emergency operations with compared control groups. Evidence from the Multicenter Aneurysm Screening Study trial using 13-year follow-up data showed that one-time AAA screening with ultrasound scan was potentially associated with an overdiagnosis of 45% (95% CI, 42%-47%) among screen-detected men. Conclusions Population-based screening for AAA with ultrasound scan in asymptomatic men aged 65 years and older showed statistically significant reductions in AAA-related mortality and rupture and, hence, avoids unnecessary AAA-related deaths. The current evidence showed no benefit of one-time AAA screening in woman. Limited evidence is available on the benefits of repeat AAA screening and targeted screening approaches based on risk factors for AAA. Future research should explore the differential benefits of AAA screening based on risk factors that increase risk for developing AAA. © 2016 Society for Vascular Surgery AU - Ali, M. U. AU - Fitzpatrick-Lewis, D. AU - Miller, J. AU - Warren, R. AU - Kenny, M. AU - Sherifali, D. AU - Raina, P. C2 - 27871502 DB - Scopus DO - 10.1016/j.jvs.2016.05.101 IS - 6 KW - abdominal aorta aneurysm asymptomatic disease cardiovascular mortality diagnostic error echography emergency surgery human priority journal randomized controlled trial (topic) Review risk reduction screening surgical mortality systematic review age aged Aortic Aneurysm, Abdominal diagnostic imaging evidence based medicine female male mass screening meta analysis middle aged mortality odds ratio patient selection predictive value procedures prognosis risk factor sex difference time factor unnecessary procedure very elderly Age Factors Aged, 80 and over Asymptomatic Diseases Evidence-Based Medicine Humans Predictive Value of Tests Risk Factors Sex Factors Time Factors Ultrasonography Unnecessary Procedures M3 - Review PY - 2016 SP - 1855-1868 ST - Screening for abdominal aortic aneurysm in asymptomatic adults T2 - Journal of Vascular Surgery TI - Screening for abdominal aortic aneurysm in asymptomatic adults VL - 64 ID - 313 ER - TY - JOUR AB - Background: Fluid therapy is a mainstay during the resuscitation of critically ill children. After initial stabilization, excessive fluid accumulation may lead to complications of fluid overload, which has been independently associated with increased risk for mortality and major morbidity in critically ill children. Objectives: Perform an evidence synthesis to describe the methods used to measure fluid balance, define fluid overload, and evaluate the association between fluid balance and outcomes in critically ill children. Design: Systematic review and meta-analysis. Measurements: Fluid balance, fluid accumulation, and fluid overload as defined by authors. Methods: We will search Ovid MEDLINE, Ovid EMBASE, Cochrane Library, and ProQuest, Dissertations and Theses. In addition, we will search www.clinicaltrials.gov, World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and the proceedings of selected key conferences for ongoing and completed studies. Search strategy will be done in consultation with a research librarian. Clinical trials and observational studies (from database inception to present) in patients (<25 years) admitted to pediatric intensive care units (PICUs) reporting fluid balance, fluid accumulation, or fluid overload, and associated outcomes will be included. Language will not be restricted. Two reviewers will independently screen studies and extract data. Primary outcome is mortality, and secondary outcomes encompass critical care resource utilization. Quality of evidence and risk of bias will be assessed using the Newcastle-Ottawa Scale (NOS). Results will be synthesized qualitatively and pooled for meta-analysis if possible. Limitations: Quality of the included studies; lack of randomized trials; high degrees of expected heterogeneity; and variations in definitions of fluid balance and fluid overload between studies. Conclusion: We will comprehensively appraise and summarize the evidence of the association between fluid balance and outcomes in critically ill children, and in doing so attempt to harmonize definitions related to fluid balance, accumulation, and overload. Systematic review registration: PROSPERO: CRD42016036209. © The Author(s) 2017. AU - Alobaidi, R. AU - Morgan, C. AU - Basu, R. K. AU - Stenson, E. AU - Featherstone, R. AU - Majumdar, S. R. AU - Bagshaw, S. M. DA - 2017-1-1 KW - Child Fluid Therapy Only Child Water-Electrolyte Balance Critical Illness systematic review severity of illness index resuscitation renal replacement therapy priority journal pediatric intensive care unit organ dysfunction score meta analysis information retrieval hypervolemia human fluid balance critically ill patient clinical outcome artificial ventilation Article Pediatric Mortality Fluid overload PY - 2017 SP - 1-6 ST - Associations between fluid balance and outcomes in critically ill children: A protocol for a systematic review and meta-analysis T2 - Canadian Journal of Kidney Health and Disease TI - Associations between fluid balance and outcomes in critically ill children: A protocol for a systematic review and meta-analysis VL - 4 ID - 162 ER - TY - JOUR AB - IMPORTANCE After initial resuscitation, critically ill children may accumulate fluid and develop fluid overload. Accruing evidence suggests that fluid overload contributes to greater complexity of care and worse outcomes. OBJECTIVE To describe the methods to measure fluid balance, define fluid overload, and evaluate the association between fluid balance and outcomes in critically ill children. DATA SOURCES Systematic search of MEDLINE, EMBASE, Cochrane Library, trial registries, and selected gray literature from inception to March 2017. STUDY SELECTION Studies of children admitted to pediatric intensive care units that described fluid balance or fluid overload and reported outcomes of interest were included. No language restrictions were applied. DATA EXTRACTION AND SYNTHESIS All stageswere conducted independently by 2 reviewers. Data extracted included study characteristics, population, fluid metrics, and outcomes. Risk of bias was assessed using the Newcastle-Ottawa Scale. Narrative description of fluid assessment methods and fluid overload definitions was done. When feasible, pooled analyses were performed using random-effects models. MAIN OUTCOMES AND MEASURES Mortalitywas the primary outcome. Secondary outcomes included treatment intensity, organ failure, and resource use. RESULTS A total of 44 studies (7507 children)were included in this systematic review and meta-analysis. Of those, 27 (61%)were retrospective cohort studies, 13 (30%)were prospective cohort studies, 3 (7%)were case-control studies, and 1 study (2%)was a secondary analysis of a randomized trial. The proportion of children with fluid overload varied by case mix and fluid overload definition (median, 33%; range, 10%-83%). Fluid overload, however defined, was associated with increased in-hospital mortality (17 studies [n = 2853]; odds ratio [OR], 4.34 [95%CI, 3.01-6.26]; I2 = 61%). Survivors had lower percentage fluid overload than nonsurvivors (22 studies [n = 2848]; mean difference, -5.62 [95%CI, -7.28 to -3.97]; I2 = 76%). After adjustment for illness severity, therewas a 6%increase in odds of mortality for every 1% increase in percentage fluid overload (11 studies [n = 3200]; adjustedOR, 1.06 [95%CI, 1.03- 1.10]; I2 = 66%). Fluid overloadwas associated with increased risk for prolonged mechanical ventilation (>48 hours) (3 studies [n = 631];OR, 2.14 [95%CI, 1.25-3.66]; I2 = 0%) and acute kidney injury (7 studies [n = 1833];OR, 2.36 [95%CI, 1.27-4.38]; I2 = 78%). CONCLUSIONS AND RELEVANCE Fluid overload is common and is associated with substantial morbidity and mortality in critically ill children. Additional research should now ideally focus on interventions aimed to mitigate the potential for harm associated with fluid overload. © 2018 American Medical Association. All rights reserved. AU - Alobaidi, R. AU - Morgan, C. AU - Basu, R. K. AU - Stenson, E. AU - Featherstone, R. AU - Majumdar, S. R. AU - Bagshaw, S. M. DA - 2018-1-1 IS - 3 KW - Case-Control Studies Child Only Child Water-Electrolyte Balance Critical Illness systematic review survivor Review respiratory failure prognosis priority journal pediatric intensive care unit Newcastle-Ottawa scale multiple organ failure length of stay hypervolemia human hospital mortality health care utilization fluid balance disease severity critically ill patient clinical outcome childhood mortality all cause mortality acute kidney failure PY - 2018 SP - 257-268 ST - Association between fluid balance and outcomes in critically ill children: A systematic review and meta-analysis T2 - JAMA Pediatrics TI - Association between fluid balance and outcomes in critically ill children: A systematic review and meta-analysis VL - 172 ID - 126 ER - TY - JOUR AB - Purpose: The purpose of this review was to develop recommendations for non-invasive management of pain due to osteoporotic vertebral compression fractures (OVCF) that could be applied in medically underserved areas and low- and middle-income countries. Methods: We conducted a systematic review and best evidence synthesis of systematic reviews on the non-invasive management of OVCF. Eligible reviews were critically appraised using the Scottish Intercollegiate Guidelines Network criteria. Low risk of bias systematic reviews and high-quality primary studies that were identified in the reviews were used to develop recommendations. Results: From 6 low risk of bias systematic reviews and 14 high-quality primary studies we established that for acute pain management, in addition to rest and analgesic medication, orthoses may provide temporary pain relief, in addition to early mobilization. Calcitonin can be considered as a supplement to analgesics; however, cost is of concern. Once acute pain control is achieved, exercise can be effective for improving function and quality of life. Conclusion: The findings from this study will help to inform the GSCI care pathway and model of care for use in medically underserved areas and low- and middle-income countries. Conservative management of acute pain and recovery of function in adults with OVCF should include early mobilization, exercise, spinal orthosis for pain relief, and calcitonin for analgesic-refractory acute pain. Graphical Abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.]. © 2018, Springer-Verlag GmbH Germany. AU - Ameis, A. AU - Randhawa, K. AU - Yu, H. AU - Côté, P. AU - Haldeman, S. AU - Chou, R. AU - Hurwitz, E. L. AU - Nordin, M. AU - Wong, J. J. AU - Shearer, H. M. AU - Taylor-Vaisey, A. IS - Supp 6 KW - Calcitonin Low Back Pain Pain Management Early Ambulation PY - 2018 SP - 861-869 ST - The Global Spine Care Initiative: a review of reviews and recommendations for the non-invasive management of acute osteoporotic vertebral compression fracture pain in low- and middle-income communities T2 - European Spine Journal TI - The Global Spine Care Initiative: a review of reviews and recommendations for the non-invasive management of acute osteoporotic vertebral compression fracture pain in low- and middle-income communities VL - 27 ID - 272 ER - TY - JOUR AB - Background: Researchers and organizations often use evidence from randomized controlled trials (RCTs) to determine the efficacy of a treatment or intervention under ideal conditions. Studies of observational designs are often used to measure the effectiveness of an intervention in 'real world' scenarios. Numerous study designs and modifications of existing designs, including both randomized and observational, are used for comparative effectiveness research in an attempt to give an unbiased estimate of whether one treatment is more effective or safer than another for a particular population. A systematic analysis of study design features, risk of bias, parameter interpretation, and effect size for all types of randomized and non-experimental observational studies is needed to identify specific differences in design types and potential biases. This review summarizes the results of methodological reviews that compare the outcomes of observational studies with randomized trials addressing the same question, as well as methodological reviews that compare the outcomes of different types of observational studies. Objectives: To assess the impact of study design (including RCTs versus observational study designs) on the effect measures estimated. To explore methodological variables that might explain any differences identified. To identify gaps in the existing research comparing study designs. Search methods: We searched seven electronic databases, from January 1990 to December 2013. Along with MeSH terms and relevant keywords, we used the sensitivity-specificity balanced version of a validated strategy to identify reviews in PubMed, augmented with one term ("review" in article titles) so that it better targeted narrative reviews. No language restrictions were applied. Selection criteria: We examined systematic reviews that were designed as methodological reviews to compare quantitative effect size estimates measuring efficacy or effectiveness of interventions tested in trials with those tested in observational studies. Comparisons included RCTs versus observational studies (including retrospective cohorts, prospective cohorts, case-control designs, and cross-sectional designs). Reviews were not eligible if they compared randomized trials with other studies that had used some form of concurrent allocation. Data collection and analysis: In general, outcome measures included relative risks or rate ratios (RR), odds ratios (OR), hazard ratios (HR). Using results from observational studies as the reference group, we examined the published estimates to see whether there was a relative larger or smaller effect in the ratio of odds ratios (ROR). Within each identified review, if an estimate comparing results from observational studies with RCTs was not provided, we pooled the estimates for observational studies and RCTs. Then, we estimated the ratio of ratios (risk ratio or odds ratio) for each identified review using observational studies as the reference category. Across all reviews, we synthesized these ratios to get a pooled ROR comparing results from RCTs with results from observational studies. Main results: Our initial search yielded 4406 unique references. Fifteen reviews met our inclusion criteria; 14 of which were included in the quantitative analysis. The included reviews analyzed data from 1583 meta-analyses that covered 228 different medical conditions. The mean number of included studies per paper was 178 (range 19 to 530). Eleven (73%) reviews had low risk of bias for explicit criteria for study selection, nine (60%) were low risk of bias for investigators' agreement for study selection, five (33%) included a complete sample of studies, seven (47%) assessed the risk of bias of their included studies, Seven (47%) reviews controlled for methodological differences between studies, Eight (53%) reviews controlled for heterogeneity among studies, nine (60%) analyzed similar outcome measures, and four (27%) were judged to be at low risk of reporting bias. Our primary quantitative analysis, including 14 reviews, showed tha the ooled ROR comparing effects from RCTs with effects from observational studies was 1.08 (95% confidence interval (CI) 0.96 to 1.22). Of 14 reviews included in this analysis, 11 (79%) found no significant difference between observational studies and RCTs. One review suggested observational studies had larger effects of interest, and two reviews suggested observational studies had smaller effects of interest. Similar to the effect across all included reviews, effects from reviews comparing RCTs with cohort studies had a pooled ROR of 1.04 (95% CI 0.89 to 1.21), with substantial heterogeneity (I2 = 68%). Three reviews compared effects of RCTs and case-control designs (pooled ROR: 1.11 (95% CI 0.91 to 1.35)). No significant difference in point estimates across heterogeneity, pharmacological intervention, or propensity score adjustment subgroups were noted. No reviews had compared RCTs with observational studies that used two of the most common causal inference methods, instrumental variables and marginal structural models. Authors' conclusions: Our results across all reviews (pooled ROR 1.08) are very similar to results reported by similarly conducted reviews. As such, we have reached similar conclusions; on average, there is little evidence for significant effect estimate differences between observational studies and RCTs, regardless of specific observational study design, heterogeneity, or inclusion of studies of pharmacological interventions. Factors other than study design per se need to be considered when exploring reasons for a lack of agreement between results of RCTs and observational studies. Our results underscore that it is important for review authors to consider not only study design, but the level of heterogeneity in meta-analyses of RCTs or observational studies. A better understanding of how these factors influence study effects might yield estimates reflective of true effectiveness. © 2014 The Cochrane Collaboration. AU - Anglemyer, A. AU - Horvath, H. T. AU - Bero, L. DA - 2014-1-1 IS - 4 KW - Bias (Epidemiology) Randomized Controlled Trials as Topic Outcome Assessment (Health Care) Observational Study as Topic Meta-Analysis as Topic Humans procedures observational study comparative study systematic review (topic) systematic review study design statistical analysis Review randomized controlled trial (topic) quantitative analysis prospective study propensity score priority journal outcome assessment observational method methodology meta analysis (topic) intermethod comparison human healthcare outcome evidence based medicine drug therapy clinical research clinical outcome clinical effectiveness bibliographic database PY - 2014 ST - Healthcare outcomes assessed with observational study designs compared with those assessed in randomized trials T2 - Cochrane Database of Systematic Reviews TI - Healthcare outcomes assessed with observational study designs compared with those assessed in randomized trials VL - 2014 ID - 239 ER - TY - JOUR AB - Objectives This review was commissioned by WHO, South Africa-Country office because of an exponential increase in medical litigation claims related to patient safety in obstetrical care in the country. A rapid review was conducted to examine the effectiveness of quality improvement (QI) strategies on maternal and newborn patient safety outcomes, risk of litigation and burden of associated costs. Design A rapid review of the literature was conducted to provide decision-makers with timely evidence. Medical and legal databases (eg, MEDLINE, Embase, LexisNexis Academic, etc) and reference lists of relevant studies were searched. Two reviewers independently performed study selection, abstracted data and appraised risk of bias. Results were summarised narratively. Interventions We included randomised clinical trials (RCTs) of QI strategies targeting health systems (eg, team changes) and healthcare providers (eg, clinician education) to improve the safety of women and their newborns. Eligible studies were limited to trials published in English between 2004 and 2015. Primary and secondary outcome measures RCTs reporting on patient safety outcomes (eg, stillbirths, mortality and caesarean sections), litigation claims and associated costs were included. Results The search yielded 4793 citations, of which 10 RCTs met our eligibility criteria and provided information on over 500 000 participants. The results are presented by QI strategy, which varied from one study to another. Studies including provider education alone (one RCT), provider education in combination with audit and feedback (two RCTs) or clinician reminders (one RCT), as well as provider education with patient education and audit and feedback (one RCT), reported some improvements to patient safety outcomes. None of the studies reported on litigation claims or the associated costs. Conclusions Our results suggest that provider education and other QI strategy combinations targeting healthcare providers may improve the safety of women and their newborns during childbirth. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. AD - Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada Toronto Health Economics and Technology Assessment, University of Toronto, Toronto, ON, Canada WHO Kobe Center, World Health Organization, Kobe, Japan Department of Geriatric Medicine, University of Toronto, Toronto, ON, Canada Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada AU - Antony, J. AU - Zarin, W. AU - Pham, B. AU - Nincic, V. AU - Cardoso, R. AU - Ivory, J. D. AU - Ghassemi, M. AU - Barber, S. L. AU - Straus, S. E. AU - Tricco, A. C. C2 - 29982200 C7 - e020170 DB - Scopus DO - 10.1136/bmjopen-2017-020170 IS - 7 KW - knowledge synthesis medical malpractice obstetrics patient safety quality improvement review cesarean section childbirth drug safety Embase female health care personnel human law suit legal database major clinical study malpractice Medline mortality newborn patient education randomized controlled trial stillbirth synthesis total quality management perinatal care pregnancy randomized controlled trial (topic) Humans Infant, Newborn Randomized Controlled Trials as Topic LA - English M3 - Review PY - 2018 ST - Patient safety initiatives in obstetrics: A rapid review T2 - BMJ Open TI - Patient safety initiatives in obstetrics: A rapid review VL - 8 ID - 351 ER - TY - JOUR AB - This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effects of the use of collaborative writing applications on process outcomes (including the behaviour of healthcare professionals) and patient outcomes To critically appraise and summarise current evidence on the resource use, costs, and cost-effectiveness associated with collaborative writing applications to improve professional practices and patient outcomes To explore the effects of different collaborative writing application features (e.g., open versus closed) and different implementation factors (e.g., the presence of a moderator) on process outcomes and patient outcomes © 2014 The Cochrane Collaboration. AU - Archambault, P. M. AU - van de Belt, T. H. AU - Faber, M. J. AU - Plaisance, A. AU - Kuziemsky, C. AU - Gagnon, M. P. AU - Turgeon, A. AU - Aubin, K. AU - Poitras, J. AU - Horsley, T. AU - Lapointe, J. AU - Brand, K. AU - Witteman, W. AU - Lachaine, J. AU - Légaré, F. C7 - Cd011388 DB - Scopus DO - 10.1002/14651858.CD011388 IS - 11 KW - Article clinical protocol cost effectiveness analysis evidence based medicine experimental design health care cost health care planning health care utilization health personnel attitude human priority journal process design professional practice sensitivity analysis software systematic review treatment outcome writing M3 - Article PY - 2014 ST - Collaborative writing applications in healthcare: Effects on professional practice and healthcare outcomes T2 - Cochrane Database of Systematic Reviews TI - Collaborative writing applications in healthcare: Effects on professional practice and healthcare outcomes VL - 2014 ID - 316 ER - TY - JOUR AB - Background: Collaborative writing applications (eg, wikis and Google Documents) hold the potential to improve the use of evidence in both public health and health care. The rapid rise in their use has created the need for a systematic synthesis of the evidence of their impact as knowledge translation (KT) tools in the health care sector and for an inventory of the factors that affect their use. Objective: Through the Levac six-stage methodology, a scoping review was undertaken to explore the depth and breadth of evidence about the effective, safe, and ethical use of wikis and collaborative writing applications (CWAs) in health care. Methods: Multiple strategies were used to locate studies. Seven scientific databases and 6 grey literature sources were queried for articles on wikis and CWAs published between 2001 and September 16, 2011. In total, 4436 citations and 1921 grey literature items were screened. Two reviewers independently reviewed citations, selected eligible studies, and extracted data using a standardized form. We included any paper presenting qualitative or quantitative empirical evidence concerning health care and CWAs. We defined a CWA as any technology that enables the joint and simultaneous editing of a webpage or an online document by many end users. We performed qualitative content analysis to identify the factors that affect the use of CWAs using the Gagnon framework and their effects on health care using the Donabedian framework. Results: Of the 111 studies included, 4 were experimental, 5 quasi-experimental, 5 observational, 52 case studies, 23 surveys about wiki use, and 22 descriptive studies about the quality of information in wikis. We classified them by theme: patterns of use of CWAs (n=26), quality of information in existing CWAs (n=25), and CWAs as KT tools (n=73). A high prevalence of CWA use (ie, more than 50%) is reported in 58% (7/12) of surveys conducted with health care professionals and students. However, we found only one longitudinal study showing that CWA use is increasing in health care. Moreover, contribution rates remain low and the quality of information contained in different CWAs needs improvement. We identified 48 barriers and 91 facilitators in 4 major themes (factors related to the CWA, users' knowledge and attitude towards CWAs, human environment, and organizational environment). We also found 57 positive and 23 negative effects that we classified into processes and outcomes. Conclusions: Although we found some experimental and quasi-experimental studies of the effectiveness and safety of CWAs as educational and KT interventions, the vast majority of included studies were observational case studies about CWAs being used by health professionals and patients. More primary research is needed to find ways to address the different barriers to their use and to make these applications more useful for different stakeholders. © Patrick M Archambault, Tom H van de Belt, Francisco J Grajales III, Marjan J Faber, Craig E Kuziemsky, Susie Gagnon, Andrea Bilodeau, Simon Rioux, Willianne LDM Nelen, Marie-Pierre Gagnon, Alexis F Turgeon, Karine Aubin, Irving Gold, Julien Poitras, Gunther Eysenbach, Jan AM Kremer, France Légaré. AU - Archambault, P. M. AU - Van De Belt, T. H. AU - Grajales Iii, F. J. AU - Faber, M. J. AU - Kuziemsky, C. E. AU - Gagnon, S. AU - Bilodeau, A. AU - Rioux, S. AU - Nelen, W. L. D. M. AU - Gagnon, M. P. AU - Turgeon, A. F. AU - Aubin, K. AU - Gold, I. AU - Poitras, J. AU - Eysenbach, G. AU - Kremer, J. A. M. AU - Légaré, F. C2 - 24103318 C7 - 2787 DB - Scopus DO - 10.2196/jmir.2787 IS - 10 KW - Collaborative authoring Collaborative writing applications Crowdsourcing Ehealth Evidence-based medicine Google Docs Google Knol Internet Knowledge management Knowledge translation Medical informatics Participatory med Web 2.0 Wiki Wikipedia cooperation evidence based medicine health care delivery human review telehealth writing Cooperative Behavior Delivery of Health Care Humans M3 - Review PY - 2013 ST - Wikis and collaborative writing applications in health care: A scoping review T2 - Journal of Medical Internet Research TI - Wikis and collaborative writing applications in health care: A scoping review VL - 15 ID - 319 ER - TY - JOUR AB - Background: Collaborative writing applications (CWAs), such as wikis and Google Documents, hold the potential to improve the use of evidence in both public health and healthcare. Although a growing body of literature indicates that CWAs could have positive effects on healthcare, such as improved collaboration, behavioural change, learning, knowledge management, and adaptation of knowledge to local context, this has never been assessed systematically. Moreover, several questions regarding safety, reliability, and legal aspects exist. Objectives: The objectives of this review were to (1) assess the effects of the use of CWAs on process (including the behaviour of healthcare professionals) and patient outcomes, (2) critically appraise and summarise current evidence on the use of resources, costs, and cost-effectiveness associated with CWAs to improve professional practices and patient outcomes, and (3) explore the effects of different CWA features (e.g. open versus closed) and different implementation factors (e.g. the presence of a moderator) on process and patient outcomes. Search methods: We searched CENTRAL, MEDLINE, Embase, and 11 other electronic databases. We searched the grey literature, two trial registries, CWA websites, individual journals, and conference proceedings. We also contacted authors and experts in the field. We did not apply date or language limits. We searched for published literature to August 2016, and grey literature to September 2015. Selection criteria: We included randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs), controlled before-and-after (CBA) studies, interrupted time series (ITS) studies, and repeated measures studies (RMS), in which CWAs were used as an intervention to improve the process of care, patient outcomes, or healthcare costs. Data collection and analysis: Teams of two review authors independently assessed the eligibility of studies. Disagreements were resolved by discussion, and when consensus was not reached, a third review author was consulted. Main results: We screened 11,993 studies identified from the electronic database searches and 346 studies from grey literature sources. We analysed the full text of 99 studies. None of the studies met the eligibility criteria; two potentially relevant studies are ongoing. Authors' conclusions: While there is a high number of published studies about CWAs, indicating that this is an active field of research, additional studies using rigorous experimental designs are needed to assess their impact and cost-effectiveness on process and patient outcomes. © 2017 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. AU - Archambault, P. M. AU - van de Belt, T. H. AU - Kuziemsky, C. AU - Plaisance, A. AU - Dupuis, A. AU - McGinn, C. A. AU - Francois, R. AU - Gagnon, M. P. AU - Turgeon, A. F. AU - Horsley, T. AU - Witteman, W. AU - Poitras, J. AU - Lapointe, J. AU - Brand, K. AU - Lachaine, J. AU - Légaré, F. C2 - 28489282 C7 - Cd011388 DB - Scopus DO - 10.1002/14651858.CD011388.pub2 IS - 5 KW - collaborative writing application cost effectiveness analysis decision making health care cost health care planning human intervention study patient care practice guideline priority journal professional practice Review self concept social network systematic review cooperation data mining database management system procedures social media standards treatment outcome writing Cooperative Behavior Database Management Systems Humans Outcome and Process Assessment (Health Care) M3 - Review PY - 2017 ST - Collaborative writing applications in healthcare: Effects on professional practice and healthcare outcomes T2 - Cochrane Database of Systematic Reviews TI - Collaborative writing applications in healthcare: Effects on professional practice and healthcare outcomes VL - 2017 ID - 415 ER - TY - JOUR AB - Purpose: During the last two decades, many clinical trials and systematic reviews (SRs) have evaluated the clinical outcomes of immediate implant placement and its effects on soft and hard tissue. Despite the increased popularity and knowledge of immediate implant placement, the evidence about its benefits is still not conclusive. The aim of this review was to assess the quality of published SRs with meta-analyses of immediate implant placement and provide an overview of the key findings. Materials and Methods: Searches of MEDLINE, EMBASE, the Cochrane Library, and the Database of Abstracts of Reviews of Effects were performed to include SRs with meta-analysis of immediate implant placement. Two independent reviewers assessed the methodologic quality of SRs using A MeaSurement Tool to Assess Reviews (AMSTAR), the 2003 checklist of Glenny et al, and the Critical Appraisal Skills Program (CASP). Results: A total of 742 articles were found; 5 were included. All included SRs were published after 2007. Implant survival rate was the most commonly reported outcome. There was insufficient information in the primary studies, and hence in the SRs, about other outcomes and any adverse events. However, the methodologic quality of the SRs was considered to be high. Conclusion: There is a general consensus among the included SRs that it is still premature to draw definite conclusions about the potential benefits of immediate implant placement because of the limited number of well-designed controlled clinical trials. Improvements in future SRs are still required and can be achieved by following established quality criteria, namely researching the unpublished literature and literature not in English and by reporting the quality assessment of primary studies and any sources of bias. � 2016 by Quintessence Publishing Co Inc. AU - Atieh, M. A. AU - Duncan, W. J. AU - Faggion, C. M., Jr. DA - 2016-1-1 IS - 2 KW - Survival Rate Tooth Socket Tooth Extraction Survival Analysis Humans Evidence-Based Dentistry Dental Implants Dental Implantation, Endosseous tooth implantation tooth implant surgery standards procedures meta analysis human evidence based dentistry Review Meta-analysis Evidence-based practice PY - 2016 SP - 338-351 ST - Quality assessment of systematic reviews on oral implants placed immediately into fresh extraction sockets T2 - International Journal of Oral and Maxillofacial Implants TI - Quality assessment of systematic reviews on oral implants placed immediately into fresh extraction sockets VL - 31 ID - 192 ER - TY - JOUR AB - Objectives: Clinical ethics consultation as a mechanism for supporting patients, family, and staff during ethically challenging situations has become standard of care. Despite this, there is a lack of consensus about the effectiveness of clinical ethics consultation consultation in the ICU. We performed a systematic review of outcomes associated with clinical ethics consultation within adult ICUs. Data Sources: We searched MEDLINE, PubMed, Cochrane CENTRAL, Embase, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature from 1984 to May 2017. Study Selection: Two reviewers independently screened articles, assessed eligibility, extracted data, and assessed risk of bias using the Cochrane Collaboration Risk of Bias tool and the Newcastle-Ottawa Scale. Pooled estimates of effect were calculated where possible. We screened 3,970 abstracts and reviewed 325 full-text articles of which 16 met all eligibility criteria. Data Extraction: We examined changes in processes and outcomes as a result of clinical ethics consultation in the ICU. Categories of outcomes included user perception, clinical decision, or conflict resolution and resource utilization. Data Synthesis: The use of clinical ethics consultation in the ICU was associated with positive user experience (383/435 found clinical ethics consultation helpful), although stress and disagreement with clinical ethics consultation recommendations was greater in a subset (113/431 surrogates and providers). Consensus for a clinical decision was more frequently achieved with clinical ethics consultation (odds ratio, 4.09; 95% CI, 1.01-16.55; p = 0.05). Clinical ethics consultation was associated with lower resource utilization including significantly decreased ICU length of stay (mean difference, -4.65 d; 95% CI, -8.86 to -0.44; p = 0.03). Conclusions: Our review identified outcome-based assessment as the predominant measure used to report effectiveness of clinical ethics consultation consultations. In particular, clinical ethics consultation decreased ICU length of stay and increased family and healthcare provider satisfaction. However, using outcome measures as the primary endpoint may not reflect the original intent of the clinical ethics consultation service. Based on our review, we propose a list of process measures that may better capture the key domains of a quality clinical ethics consultation. Copyright © 2018 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved. AD - Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada Division of Palliative Care Medicine, Department of Oncology, University of Calgary, Calgary, AB, Canada Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada Hotchkiss Brain Institute, Calgary, AB, Canada O'Brien Institute for Public Health, Calgary, AB, Canada AU - Au, S. S. AU - Couillard, P. AU - Roze Des Ordons, A. AU - Fiest, K. M. AU - Lorenzetti, D. L. AU - Jette, N. C2 - 29394183 DB - Scopus DO - 10.1097/CCM.0000000000002999 IS - 5 KW - communication ethics consultation family intensive care units adult Cinahl Cochrane Library conflict consensus controlled study data extraction data synthesis Embase ethics female health care personnel human intensive care unit length of stay male Medline meta analysis Newcastle-Ottawa scale perception PsycINFO review risk assessment satisfaction stress systematic review clinical decision making Clinical Decision-Making Humans LA - English M3 - Review PY - 2018 SP - 799-808 ST - Outcomes of ethics consultations in adult ICUs: A systematic review and meta-analysis T2 - Critical Care Medicine TI - Outcomes of ethics consultations in adult ICUs: A systematic review and meta-analysis VL - 46 ID - 352 ER - TY - JOUR AB - Extreme prematurity is the leading cause of death among children under 5 years of age. Currently, there is no treatment for bronchopulmonary dysplasia (BPD), the most common complication of extreme prematurity. Experimental studies in animal models of BPD suggest that mesenchymal stromal cells (MSCs) are lung protective. To date, no systematic review and meta-analysis has evaluated the preclinical evidence of this promising therapy. Our protocol was registered with Collaborative Approach to Meta-Analysis and Review of Animal Data from Experimental Studies prior to searching MEDLINE (1946 to June 1, 2015), Embase (1947 to 2015 Week 22), Pubmed, Web of Science, and conference proceedings (1990 to present) for controlled comparative studies of neonatal animal models that received MSCs or cell free MSC-derived conditioned media (MSC-CM). Lung alveolarization was the primary outcome. We used random effects models for data analysis and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. We screened 990 citations; 25 met inclusion criteria. All used hyperoxia-exposed neonatal rodents to model BPD. MSCs significantly improved alveolarization (Standardized mean difference of −1.330, 95% confidence interval [CI −1.724, −0.94, I2 69%]), irrespective of timing of treatment, source, dose, or route of administration. MSCs also significantly ameliorated pulmonary hypertension, lung inflammation, fibrosis, angiogenesis, and apoptosis. Similarly, MSC-CM significantly improved alveolarization, angiogenesis, and pulmonary artery remodeling. MSCs, tested exclusively in hyperoxic rodent models of BPD, show significant therapeutic benefit. Unclear risk of bias and incomplete reporting in the primary studies highlights nonadherence to reporting standards. Overall, safety and efficacy in other species/large animal models may provide useful information for guiding the design of clinical trials. Stem Cells Translational Medicine 2017;6:2079–2093. © 2017 The Authors Stem Cells Translational Medicine published by Wiley Periodicals, Inc. on behalf of AlphaMed Press AU - Augustine, S. AU - Avey, M. T. AU - Harrison, B. AU - Locke, T. AU - Ghannad, M. AU - Moher, D. AU - Thébaud, B. DA - 2017-1-1 IS - 12 KW - Child Mesenchymal Stromal Cells Only Child Infant, Newborn Lung Animal Shells Stromal Cells Animals Cause of Death Mesoderm systematic review survival pulmonary hypertension prematurity preclinical study pneumonia nonhuman meta analysis mesenchymal stroma cell mesenchymal stem cell transplantation lung injury lung dysplasia hyperoxia histopathology fibrosis exercise data analysis Article apoptosis angiogenesis Stem cells Preterm birth Meta-analysis Animal model PY - 2017 SN - 2157-6580 (electronic) 2157-6564 SP - 2079-2093 ST - Mesenchymal Stromal Cell Therapy in Bronchopulmonary Dysplasia: Systematic Review and Meta-Analysis of Preclinical Studies T2 - Stem Cells Translational Medicine TI - Mesenchymal Stromal Cell Therapy in Bronchopulmonary Dysplasia: Systematic Review and Meta-Analysis of Preclinical Studies VL - 6 ID - 137 ER - TY - JOUR AB - BACKGROUND: The frequency of cryopreserving blood stem or progenitor products from unrelated donors is not known and the underlying reasons are poorly documented. Greater insight is needed to develop policies on cryopreservation that balance donor safety with patient needs. STUDY DESIGN AND METHODS: Cryopreservation requests between January 1, 2014, and May 31, 2016, at the OneMatch Stem Cell and Marrow Network at Canadian Blood Services were reviewed and a systematic review of the literature was performed. RESULTS: Thirty products of 719 (4.2%) unrelated donor collections facilitated by OneMatch were cryopreserved. Patient-related reasons were most common and included the need to delay transplant for continued antimicrobial treatment (six patients), patient too deconditioned to proceed with scheduled transplant (five patients), and/or need for more treatment for relapsed disease (three patients). Donor-related issues leading to cryopreservation requests were less common (five cases), mainly due to lack of donor availability after attempting to reschedule. Cryopreservation of a product that was never infused occurred infrequently (two cases, 7%). In our systematic review of the literature, 993 cases were identified in 32 published reports. Both patient-related and donor-related reasons were cited but not specifically reported, precluding quantitative insight regarding the relative frequency of causes. The impact of cryopreservation on hematopoietic engraftment appears negligible when compared to controls in a subset of studies; however, reporting of outcomes was inconsistent. CONCLUSION: Future studies with standard outcome measures are needed to clarify the impact of cryopreservation on engraftment and other transplant outcomes. International guidelines that consider the ethical framework surrounding requests for donor product cryopreservation are needed. © 2017 AABB AU - Aziz, J. AU - Morris, G. AU - Rizk, M. AU - Shorr, R. AU - Mercer, D. AU - Young, K. AU - Allan, D. DA - 2017-1-1 IS - 11 KW - Efficiency Tissue Donors Adult Unrelated Donors Practice Guidelines as Topic Humans Hematopoietic Stem Cell Transplantation Graft Survival Cryopreservation Canada utilization trends standards procedures treatment indication systematic review risk factor relapse practice guideline patient related factor immunosuppressive treatment human hematopoietic cell transplantatio health care policy health care concepts donor related factor donor availability deconditioning data extraction cell viability cell transplantation blood storage Article antifungal therapy unclassified drug chemical compound CD34 antigen adult unrelated hematopoietic cell donor product PY - 2017 SN - 0041-1132 SP - 2782-2789 ST - Cryopreservation of adult unrelated donor products in hematopoietic cell transplantation: the OneMatch experience and systematic review of the literature T2 - Transfusion TI - Cryopreservation of adult unrelated donor products in hematopoietic cell transplantation: the OneMatch experience and systematic review of the literature VL - 57 ID - 72 ER - TY - JOUR AB - Background: Care transitions from the hospital to home are critical to the sustainability of our health care system. Ineffective care transitions can be caused by high incidences of post-discharge adverse events, by poor communication with patients, and/or by inadequate information transfer between providers from the hospital to home. Any one of these can lead to fragmented care, high readmission rates, increased visits to the emergency department, and ultimately poor patient outcomes. Despite the ongoing improvement efforts of health care organizations, the efficacy of person- and family-centered care transition interventions on the quality of care and on the patient experience are not known. The aim of this systematic review is to critically analyze the body of evidence regarding the effectiveness of person- and family-centered care transition interventions on the quality of care, and the experience of patients. Methods: We will conduct a systematic review using the Cochrane Handbook's guidelines and will adhere to a standardized reporting format: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive search strategy will be conducted in the following databases: MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and the Cochrane Consumers and Communication Group. Following a two-step screening process, data including the full reference, objectives, target population, description of the intervention and control intervention, outcome measures, design, length of post-intervention follow-up period, and the study results will be extracted, synthesized, and reported. Risk of bias and quality of the studies will also be assessed. Discussion: This systematic review will summarize and present the evidence base for person- and family-centered care transition interventions. This review will also inform further research and will lay the groundwork for more empirical studies on person- and family-centered care transitions. Specifically, the results of this systematic review may inform the development of measures to monitor safe and effective person- and family-centered transitions from the hospital to home. These results may also be important for policy makers, decision-makers, clinicians, and patients/families who are involved in navigating the health care system. Systematic review registration: PROSPERO CRD42017067990 © 2017 The Author(s). AU - Backman, C. AU - Chartrand, J. AU - Dingwall, O. AU - Shea, B. DA - 2017-1-1 IS - 1 KW - Patient-Centered Care Patient Transfer Patient Discharge Humans Hospitals Family psychology procedures patient transport patient care hospital discharge hospital therapy effect systematic review (topic) systematic review risk assessment randomized controlled trial (topic) priority journal patient satisfaction outcome assessment human hospital readmission health care quality follow up family centered care client centered therapy attitude to health Article Systematic review protocol Person- and family-centered care Care transitions PY - 2017 SN - 2046-4053 ST - Effectiveness of person- and family-centered care transition interventions: A systematic review protocol T2 - Systematic Reviews TI - Effectiveness of person- and family-centered care transition interventions: A systematic review protocol VL - 6 ID - 83 ER - TY - JOUR AB - Background: With age, the acuity of the five senses (i.e., hearing, sight, taste, smell, touch) is reduced. These types of sensory changes can affect day-to-day activities, making it more difficult for individuals to communicate and to interact with the world around them. The five senses allow us to receive information from the environment in the form of sound, light, smell, taste, and touch. As an older person's senses decline, they need more stimulation to be aware of these sensations. In long-term care settings, appropriate sensory practices are needed to address the diminishing senses of older adults. The objective of this mixed-methods systematic review is to examine the relationship between the sensory practices and the quality of life of residents living in long-term care settings and to develop an aggregated synthesis of mixed-methods studies to derive recommendations for policy, practice, and research. Methods: We will conduct a mixed-methods systematic review in accordance with the Cochrane Handbook. A search strategy has been developed with an expert health sciences librarian and peer reviewed using Peer Review for Electronic Search Strategies (PRESS). Seven databases: MEDLINE (Ovid), PubMed (non-MEDLINE-Ovid), CINAHL (EBSCO), Embase (Ovid), Ageline, PsycINFO (Ovid), and Cochrane Central Register of Controlled Trials (CENTRAL) will be searched for studies that meet the inclusion criteria. Two reviewers will independently screen the results of the literature search using a two-step process. Eligible studies will undergo a quality assessment and data extraction. Disagreements will be resolved through consultation with a third reviewer. We will assess the quality of individual studies using the Mixed Methods Appraisal Tool (MMAT). The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) will be used to summarize the strength of the quantitative evidence, and the Confidence in the Evidence from Reviews of Qualitative research (CERQual) tool to assess confidence in the qualitative syntheses. Discussion: This systematic review will summarize evidence-based knowledge for sensory practices, identify gaps in the literature, and inform an audit program for assessing the presence of sensory practices in the long-term care setting. The results will be relevant to policy makers, decision-makers, clinicians, and residents/families in long-term care settings. Systematic review registration: PROSPERO registration # CRD42017032330. © 2018 The Author(s). AD - University of Ottawa, School of Nursing, Faculty of Health Sciences, 451, Smyth Road, RGN 3239, Ottawa, ON K1H 8M5, Canada University of Ottawa, School of Nursing, Faculty of Health Sciences, 451, Smyth Road, Ottawa, ON K1J 8M5, Canada University of Ottawa, School of Epidemiology and Public Health, 501, Smyth Road, Ottawa, ON K1H 8L6, Canada AU - Backman, C. AU - Crick, M. AU - Cho-Young, D. AU - Scharf, M. AU - Shea, B. C2 - 30075811 C7 - 115 DB - Scopus DO - 10.1186/s13643-018-0783-9 IS - 1 KW - Long-term care Quality of life Senses Systematic review aged article Cinahl Cochrane Library consultation controlled clinical trial (topic) data extraction Embase female human librarian long term care male Medline peer review PsycINFO qualitative research quality control quantitative analysis registration resident sensation synthesis aging daily life activity physiology psychology sensory feedback Activities of Daily Living Feedback, Sensory Humans LA - English M3 - Article PY - 2018 ST - What is the impact of sensory practices on the quality of life of long-term care residents? A mixed-methods systematic review protocol T2 - Systematic Reviews TI - What is the impact of sensory practices on the quality of life of long-term care residents? A mixed-methods systematic review protocol VL - 7 ID - 353 ER - TY - JOUR AB - Objectives: To determining attitudes and practice regarding breast cancer early detection techniques (breast self-examination (BSE), clinical breast examination (CBE) and mammography) among Iranian woman. Methods: International (PubMed, ISI, and Google Scholar) and national (SID and Magiran) databases were reviewed up to September 2017 to identify articles related to the attitudes and practices of Iranian women concerning breast cancer screening behavior with reference to BSE, CBE and mammography. The screening steps, analysis of quality of the studies and extraction of the papers were performed by two reviewers. Results: Of the 532 studies included initially, 21 performed on 10,521 people were considered eligible. Subjects with a positive attitude toward BSE in various studies were 13.5% to 94.0% with an average of 47.6%. Positive attitudes to CBE and mammography were found in 21.0% and 26.4%, respectively. Participant performance of BSE ranged from 2.6% to 84.7%, with an average of 21.9%. The respective figures for CBE and mammography were 15.8% and 16.7%. Conclusion: Considering the poor performance and low rates for positive attitudes, it is suggested that educational programs should be conducted across the country. AU - Badakhsh, M. AU - Balouchi, A. AU - Taheri, S. AU - Bouya, S. AU - Ahmadidarehsima, S. AU - Aminifard, M. DA - 2018-1-1 IS - 1 KW - Mammography Breast Neoplasms Systematic reviews Iran Early detection of cancer Breast self-examination Attitude PY - 2018 SN - 1513-7368 SP - 9-16 ST - Attitude and practice regarding breast cancer early detection among Iranian women: A systematic review T2 - Asian Pacific Journal of Cancer Prevention TI - Attitude and practice regarding breast cancer early detection among Iranian women: A systematic review VL - 19 ID - 63 ER - TY - JOUR AB - Background: Patient feedback is considered integral to quality improvement and professional development. However, while popular across the educational continuum, evidence to support its efficacy in facilitating positive behaviour change in a postgraduate setting remains unclear. This review therefore aims to explore the evidence that supports, or refutes, the impact of patient feedback on the medical performance of qualified doctors. Methods: Electronic databases PubMed, EMBASE, Medline and PsycINFO were systematically searched for studies assessing the impact of patient feedback on medical performance published in the English language between 2006-2016. Impact was defined as a measured change in behaviour using Barr's (2000) adaptation of Kirkpatrick's four level evaluation model. Papers were quality appraised, thematically analysed and synthesised using a narrative approach. Results: From 1,269 initial studies, 20 articles were included (qualitative (n=8); observational (n=6); systematic review (n=3); mixed methodology (n=1); randomised control trial (n=1); and longitudinal (n=1) design). One article identified change at an organisational level (Kirkpatrick level 4); six reported a measured change in behaviour (Kirkpatrick level 3b); 12 identified self-reported change or intention to change (Kirkpatrick level 3a), and one identified knowledge or skill acquisition (Kirkpatrick level 2). No study identified a change at the highest level, an improvement in the health and wellbeing of patients. The main factors found to influence the impact of patient feedback were: specificity; perceived credibility; congruence with physician self-perceptions and performance expectations; presence of facilitation and reflection; and inclusion of narrative comments. The quality of feedback facilitation and local professional cultures also appeared integral to positive behaviour change. Conclusion: Patient feedback can have an impact on medical performance. However, actionable change is influenced by several contextual factors and cannot simply be guaranteed. Patient feedback is likely to be more influential if it is specific, collected through credible methods and contains narrative information. Data obtained should be fed back in a way that facilitates reflective discussion and encourages the formulation of actionable behaviour change. A supportive cultural understanding of patient feedback and its intended purpose is also essential for its effective use. © 2018 The Author(s). AD - Collaboration for the Advancement of Medical Education Research and Assessment (CAMERA), Faculty of Medicine and Dentistry, University of Plymouth, Drake Circus, Plymouth, PL4 8AA, United Kingdom Improvement Science London, University College London, London, United Kingdom Research Department of Primary Care and Population Health, University College London, London, United Kingdom AU - Baines, R. AU - Regan De Bere, S. AU - Stevens, S. AU - Read, J. AU - Marshall, M. AU - Lalani, M. AU - Bryce, M. AU - Archer, J. C2 - 30064413 C7 - 173 DB - Scopus DO - 10.1186/s12909-018-1277-0 IS - 1 KW - Behaviour change Doctors Impact Medical education Patient feedback Systematic review adult article behavior change Embase English (language) expectation female human male Medline narrative perception PsycINFO randomized controlled trial (topic) skill wellbeing constructive feedback job performance medical staff patient-reported outcome standards total quality management Formative Feedback Humans Patient Reported Outcome Measures Quality Improvement Work Performance LA - English M3 - Article PY - 2018 ST - The impact of patient feedback on the medical performance of qualified doctors: A systematic review T2 - BMC Medical Education TI - The impact of patient feedback on the medical performance of qualified doctors: A systematic review VL - 18 ID - 354 ER - TY - JOUR AB - Background: There is international interest in the active involvement of patients and the public. However, consensus on how best to optimize its application is currently unavailable. Objective: To identify and assess the underlying principles of patient and public involvement (PPI) in health and social care services, research, education and regulation across medicine, dentistry and nursing. Design: A four-phase methodology: (i) an extensive systematic review of published and grey literature; (ii) inductive thematic analysis of review findings; (iii) development of best practice principles; and (iv) consensus testing of identified principles using a modified Delphi methodology. Setting and participants: Twelve systematic reviews and 88 grey literature publications were reviewed leading to the unique identification of 13 principles later assessed by 18 PPI experts. Results: Essential consensus (>75% agreement) was obtained for nine principles reviewed. Working in equal partnership and sharing information achieved the highest consensus rates: 16/17 essential 94.1%; 1/17 desirable 5.8%. The four remaining principles that failed to reach essential consensus were categorized as desirable by expert respondents. No principles were considered irrelevant. No alternatives were suggested. Discussion: Expert respondents suggest essential principles must be achieved to optimize PPI best practice. To advance PPI practice, desirable principles should also be aspired to wherever possible. Conclusions: This study's innovative approach advances existing knowledge by providing previously unavailable consensus about PPI best practice. Research findings hold important theoretical and practical implications for educators, regulators, researchers and practitioners looking to effectively work together. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd AU - Baines, R. L. AU - Regan de Bere, S. DA - 2018-1-1 IS - 1 KW - qualitative patient and public involvement health care delphi PY - 2018 SN - 1369-6513 SP - 327-335 ST - Optimizing patient and public involvement (PPI): Identifying its “essential” and “desirable” principles using a systematic review and modified Delphi methodology T2 - Health Expectations TI - Optimizing patient and public involvement (PPI): Identifying its “essential” and “desirable” principles using a systematic review and modified Delphi methodology VL - 21 ID - 128 ER - TY - JOUR AB - Objectives: The purpose of this study was to systematically review the literature to describe the knowledge, attitude and practice of CAM by nurses. Methods: Three databases were searched for relevant studies from launch through September of 2017 and included MEDLINE, Scopus and Web of science. Results: The average knowledge of CAM therapies by nurses was 62.2% with attitude about use averaging 65.7%. Close to two-thirds (65.9%) reported use of CAM therapies with patients. The primary reasons nurses suggested use of CAM were for stress and anxiety reduction and health improvement. Conclusion: Current evidence demonstrates the need for nurse education programs to integrate and strengthen CAM content into existing curricula. Similarly, documentation of the nature and extent of nurse use of CAM therapies in the clinical setting, as well as patient-reported use and preferences for CAM therapies, would provide valuable prospective data. © 2018 Elsevier Ltd AU - Balouchi, A. AU - Mahmoudirad, G. AU - Hastings-Tolsma, M. AU - Shorofi, S. A. AU - Shahdadi, H. AU - Abdollahimohammad, A. DA - 2018-1-1 KW - Web of Science systematic review stress Scopus review prospective study nursing education Medline male human female documentation averaging anxiety alternative medicine adult Nurses Knowledge Complementary therapies Attitude PY - 2018 SP - 146-157 ST - Knowledge, attitude and use of complementary and alternative medicine among nurses: A systematic review T2 - Complementary Therapies in Clinical Practice TI - Knowledge, attitude and use of complementary and alternative medicine among nurses: A systematic review VL - 31 ID - 55 ER - TY - JOUR AB - Introduction The US Food and Drug Administration has withdrawn the bowel cleansing kit HalfLytely (PEG 3500) with 10 mg bisacodyl tablets due to an increased risk of ischaemic colitis compared with the same kit with only 5 mg bisacodyl. This is of interest in Canada given that the bowel cleansing kit Bi-Peglyte (PEG 3500) with 15 mg bisacodyl is currently approved for use. The objective is to assess the comparative safety of various bowel cleansers with or without bisacodyl, with a primary interest inpolyethylene glycol (PEG)-based and sodium-picosulfate-based products. Methods and analysis Given the existing volume of the literature, the review will be conducted in two stages. Stage 1 will consist of a scoping exercise by searching MEDLINE, Embase and the Cochrane Library (up to 21 November 2017) to identify randomised controlled trials, quasirandomised studies and non-randomised studies in which any bowel cleanser regimens were compared among persons undergoing colonoscopy. The outcomes will be mapped to establish a listing of the studies and their comparisons and outcomes currently available in the literature. From this, a data synthesis plan will be determined. In stage 2, a systematic review with meta-analyses will be pursued, focused on the bowel cleanser comparisons and outcomes of interest identified in stage 1. Two reviewers will screen, extract and quality assess the articles. Outcomes of interest include ischaemic colitis, electrolyte imbalances and their consequences, seizures, bowel perforation and patient tolerability. If sufficient data exist and studies are of sufficient homogeneity, network meta-analyses (NMAs) will be performed. Ethics and dissemination Ethics approval was not necessary due to study design. Updating the safety profile of bowel cleansers among the generally healthy population undergoing colonoscopy is pertinent given recent approval changes. This will be the first NMA within this population. Policy considerations may be reconsidered to minimise risk during bowel cleanser use. PROSPERO registration number CRD42018084720. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. AD - Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada Department of Clinical Psychology, McGill University, Montreal, QC, Canada Department of Medicine, Division of Gastroenterology, Ottawa Hospital, Ottawa, ON, Canada Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada Department of Pharmacy, Ottawa Hospital, Ottawa, ON, Canada School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada AU - Barbeau, P. AU - Wolfe, D. AU - Yazdi, F. AU - Rice, D. B. AU - Dube, C. AU - Kanji, S. AU - Rostom, A. AU - Skidmore, B. AU - Moher, D. AU - Hutton, B. C2 - 29950476 C7 - e021892 DB - Scopus DO - 10.1136/bmjopen-2018-021892 IS - 6 KW - bisacodyl bowel cleansers colonoscopy ischemic colitis network meta-analysis polyethylene glycol sodium picosulfate systematic review bicarbonate plus bisacodyl plus macrogol 3350 plus potassium chloride plus sodium chloride bowel cleanser laxative macrogol 3350 picosulfate sodium unclassified drug citric acid macrogol organometallic compound picoline derivative bibliographic database Canada clinical outcome comorbidity comparative effectiveness comparative study follow up food and drug administration health care policy human medical information meta analysis outcome assessment patient safety peer review population practice guideline Review risk factor colon drug effect patient satisfaction procedures Cathartics Citrates Humans Organometallic Compounds Picolines Polyethylene Glycols Systematic Reviews as Topic LA - English M3 - Review PY - 2018 ST - Comparative safety of bowel cleansers: Protocol for a systematic review and network meta-analysis T2 - BMJ Open TI - Comparative safety of bowel cleansers: Protocol for a systematic review and network meta-analysis VL - 8 ID - 355 ER - TY - JOUR AB - Background: Pressure ulcers are a serious, common, lifelong, and costly secondary complication of spinal cord injury (SCI). Community-dwelling people with a SCI can prevent them with appropriate skin care (i.e. pressure relieving activities, skin checks). Adherence to skin care remains suboptimal however, and self-management interventions that focus on improving this have been designed. Little is known on their content, effectiveness, or theoretical basis. The aim of the proposed systematic review is to synthesize the literature on self-management interventions to improve skin care in people with a SCI. Specific objectives are to describe these interventions in relation to their content, effectiveness, theory base, and adherence to reporting guidelines for intervention description. Methods: The search strategy will combine an electronic search of nine bibliographic databases (MEDLINE, Embase, PsycInfo, CENTRAL, CINAHL, Rehabdata, CIRRIE, PEDro, ERIC) and two trial registers with a manual search of relevant reference lists. Predefined eligibility criteria will be applied in a two-phase selection process involving title and abstract screening, followed by full-text screening. A data extraction spreadsheet will be applied to included papers. Intervention content will be coded using two taxonomies (behaviour change taxonomy; PRISMS self-management support taxonomy). A validated tool (Theory Coding Scheme) and the Template for Intervention Description and Replication (TIDieR) will be used to examine theoretical basis and assess adherence to reporting guidelines for intervention description. A small number of heterogeneous studies are likely to be included in this review therefore a narrative synthesis is planned. Discussion: This systematic review will help identify the gaps and priorities to guide future research activities in this area. Systematic review registration: PROSPERO CRD42016033191 © 2016 The Author(s). AU - Baron, J. AU - Swaine, J. AU - Presseau, J. AU - Aspinall, A. AU - Jaglal, S. AU - White, B. AU - Wolfe, D. AU - Grimshaw, J. DA - 2016-1-1 IS - 1 KW - Spinal Cord Injuries Skin Care Self-Management Pressure Ulcer Humans spinal cord injury procedures decubitus complication systematic review self care research randomized controlled trial (topic) quality control publication priority journal practice guideline performance outcome assessment meta analysis knowledge intervention study human health care personnel feedback system Article Skin Self-care Pressure ulcers Bed sores PY - 2016 SN - 2046-4053 ST - Self-management interventions to improve skin care for pressure ulcer prevention in people with spinal cord injuries: A systematic review protocol T2 - Systematic Reviews TI - Self-management interventions to improve skin care for pressure ulcer prevention in people with spinal cord injuries: A systematic review protocol VL - 5 ID - 121 ER - TY - JOUR AB - Study design: Systematic review. Objectives: To review the content and effectiveness of skin care self-management interventions for people with SCI. Setting: International. Methods: We searched electronic bibliographic databases, trial registers, and relevant reference lists. Eligibility criteria for the reviews of intervention content and effectiveness were identical with the exception of study design. The review of intervention content included non-randomized and randomized controlled trials (RCTs). The review of effectiveness included RCTs. A Behavior Change Technique (BCT) taxonomy of 93 BCTs was used to code intervention content. Intervention effects on outcomes of interest are summarized descriptively. Effect sizes were calculated, and the Cochrane risk of bias tool applied. Results: In all, 15 studies testing 17 interventions were included in the review of intervention content. Interventions in these studies included 28 BCTs. The most common were “instructions on how to perform behavior” (16 interventions), “credible source” (12 interventions), and “social support (unspecified)” (9 interventions). Ten RCTs were included in the review of intervention effectiveness and they measured knowledge, self-efficacy, and skills relating to skin care/pressure ulcer (PU) prevention, skin care behaviors, skin status (PU prevalence, severity, and time to PU), and health-care utilization for skin problems. Evidence to support intervention effects on these outcomes was limited, particularly for clinical outcomes. Risk of bias assessments was often inconclusive due to poor reporting. Conclusions: There is potential to design SCI skin care interventions that include currently untested BCTs. Further research and better consistency in outcome measurements and reporting are required to synthesize evidence on effectiveness. © 2018, The Author(s). AD - Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, Australia Institute for Health Research, University of Notre Dame Australia, Fremantle, WA, Australia Rick Hansen Institute, Vancouver, BC, Canada Vancouver General Hospital, Vancouver, BC, Canada Department of Physical Therapy, University of Toronto, Toronto, ON, Canada Toronto Rehabilitation Institute, Toronto, ON, Canada School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada Parkwood Institute Research, Lawson Health Research Institute, London, ON, Canada University of Western Ontario, London, ON, Canada Department of Medicine, University of Ottawa, Ottawa, ON, Canada AU - Baron, J. S. AU - Sullivan, K. J. AU - Swaine, J. M. AU - Aspinall, A. AU - Jaglal, S. AU - Presseau, J. AU - White, B. AU - Wolfe, D. AU - Grimshaw, J. M. C2 - 29802393 DB - Scopus DO - 10.1038/s41393-018-0138-3 IS - 9 KW - behavior change behavior therapy body position body positioning skill training clinical effectiveness clinical outcome decubitus disease severity education program effect size feedback system health behavior health care utilization health education human knowledge outcome assessment prevalence priority journal randomized controlled trial (topic) Review risk assessment self care self concept skin care social support spinal cord injury statistical bias systematic review taxonomy telehealth treatment outcome wheelchair skill training complication procedures Humans Pressure Ulcer Randomized Controlled Trials as Topic Self-Management Spinal Cord Injuries LA - English M3 - Review PY - 2018 SP - 823-836 ST - Self-management interventions for skin care in people with a spinal cord injury: part 1—a systematic review of intervention content and effectiveness T2 - Spinal Cord TI - Self-management interventions for skin care in people with a spinal cord injury: part 1—a systematic review of intervention content and effectiveness VL - 56 ID - 356 ER - TY - JOUR AB - Background: Despite advances in treatment, acute myocardial infarction (MI) is still associated with significant morbidity and mortality, especially in patients with extensive damage and scar formation. Based on some promising preclinical studies, there is interest in the use of mesenchymal stromal cells (MSCs) to promote cardiac repair after acute MI. However, there is a need for a systematic review of this evidence to summarize the efficacy and safety of MSCs in preclinical models of MI. This will better inform the translation of MSC therapy for acute MI and guide the design of a future clinical trial. Methods/design: A systematic literature search of MEDLINE, Embase, and BIOSIS Previews will be conducted. We will identify comparative preclinical studies (randomized and non-randomized) of myocardial infarction that include animals given MSC therapy versus a vehicle/placebo. The primary outcome will be left ventricular ejection fraction. Secondary and tertiary outcomes will include death, infarct size, measures of cardiac function, biochemical outcomes, and MSC retention and differentiation. Risk of bias will be assessed using the Cochrane Risk of Bias Tool. Subgroup analyses will be performed to measure how various sources of preclinical study heterogeneity affect the direction and magnitude of the primary outcome. We will meta-analyze data using inverse variance random effects modeling. Discussion: This systematic review of preclinical evidence will provide a summary of the efficacy and safety of MSCs in animal models of MI. The results will help determine whether sufficient evidence exists to conduct a clinical trial in humans and inform its design. © 2017 The Author(s). AU - Barron, C. C. AU - Lalu, M. M. AU - Stewart, D. J. AU - Fergusson, D. AU - Yang, H. AU - Moher, D. AU - Liu, P. AU - Mazer, D. AU - Devereaux, P. J. AU - McIntyre, L. DA - 2017-1-1 IS - 1 KW - Animal Shells Animals Mesenchymal Stromal Cells Stromal Cells Mesoderm Myocardial Infarction Humanism Humanities Humans treatment outcome therapy effect systematic review (topic) stem cell transplantation risk assessment priority journal patient safety mesenchymal stroma cell internal validity inflammation human heart left ventricle ejection fraction heart infarction size heart function external validity death construct validity clinical trial (topic) cell differentiation capillary density biochemical analysis Article acute heart infarction Systematic review protocol Preclinical Perioperative myocardial infarction Mesenchymal stem cells PY - 2017 SN - 2046-4053 ST - Assessment of safety and efficacy of mesenchymal stromal cell therapy in preclinical models of acute myocardial infarction: A systematic review protocol T2 - Systematic Reviews TI - Assessment of safety and efficacy of mesenchymal stromal cell therapy in preclinical models of acute myocardial infarction: A systematic review protocol VL - 6 ID - 139 ER - TY - JOUR AB - In order to understand the effect of endurance running on inflammation, it is necessary to quantify the extent to which acute and chronic running affects inflammatory mediators. The aim of this study was to summarize the literature on the effects of endurance running on inflammation mediators. Electronic searches were conducted on PubMED and Science Direct with no limits of date and language of publication. Randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) investigating the acute and chronic effects of running on inflammation markers in runners were reviewed by two researchers for eligibility. The modified Downs and Black checklist for the assesssments of the methodological quality of studies was subsequently used. Fifty-one studies were finally included. There were no studies with elite athletes. Only two studies were chronic interventions. Results revealed that acute and chronic endurance running may affect anti- and pro-inflammatory markers but methodological differences between studies do not allow comparisons or generalization of the results. The information provided in this systematic review would help practitioners for better designing further studies while providing reference values for a better understanding of inflammatory responses after different running events. Further longitudinal studies are needed to identify the influence of training load parameters on inflammatory markers in runners of different levels and training background. © 2017 Barros, Nascimento, Prestes, Nóbrega, Córdova, Sousa and Boullosa. AU - Barros, E. S. AU - Nascimento, D. C. AU - Prestes, J. AU - Nóbrega, O. T. AU - Córdova, C. AU - Sousa, F. AU - Boullosa, D. A. DA - 2017-1-1 KW - Longitudinal Studies systematic review running runner Review randomized controlled trial (topic) physical performance outcome assessment methodology meta analysis medical parameters inflammation immune response human endurance training disease marker competition clinical assessment tool Marathon Immunology Half-marathon Athletes PY - 2017 SN - 1664-042X ST - Acute and chronic effects of endurance running on inflammatory markers: A systematic review T2 - Frontiers in Physiology TI - Acute and chronic effects of endurance running on inflammatory markers: A systematic review VL - 8 ID - 140 ER - TY - JOUR AB - Background: Total joint replacement (TJR) procedures have been one of the most rewarding interventions for treating patients suffering from joint disease. However, developing a periprosthetic joint infection (PJI) is a serious complication that is associated with the highest burden of cost and reduction in patients' quality of life compared to other complications following TJRs. One of the main challenges facing clinicians who are treating PJIs is accurately diagnosing infection in a timely fashion. Multiple orthopedic associations have published clinical guidelines for diagnosing PJI which are based solely on consensus approaches, expert opinions, and narrative reviews. We believe that a higher quality of scientific rigor is necessary to establish a diagnostic guideline that represents current evidence more accurately and that identifies important knowledge gaps in PJI diagnosis. Therefore, we will conduct a systematic review on diagnostic performance of blood markers, synovial fluids, and tissue tests for diagnosing PJI. Methods/design: Electronic search strategies will be developed and tested by an experienced medical information specialist in consultation with the review team, and gray literature will be searched using the checklist from CADTH's Grey Matters Light. Two reviewers will independently screen the literature for inclusion using the prespecified eligibility criteria. Non-English language and animal-only studies will be excluded. Quality assessment and data extractions by reviewers will be verified, and disagreements will be resolved through consensus or third party adjudication. We will assess the quality of individual studies using the QUADAS-2 tool and use GRADE to summarize the strength of body of evidence. Analyses of evidence will be conducted in accordance with the Cochrane Handbook for Diagnostic Test Accuracy Reviews. Discussion: We will conduct a systemic review of tests (blood markers, synovial fluids, and tissue testing) for diagnosing PJI in patients' knee, hip, and shoulder joint replacements. This will be the first scientifically rigorous and comprehensive systematic review in the field and may feed into an evidence-based clinical practice guideline. We will compare the findings of this review with the consensus-based guides and discuss the differences, similarities, and knowledge gaps. Systematic review registration: PROSPERO CRD42015023768 © 2015 Beaule et al. AU - Beaule, P. E. AU - Shea, B. AU - Abedlbary, H. AU - Ahmadzai, N. AU - Skidmore, B. AU - Mallick, R. AU - Hutton, B. AU - Bunting, A. C. AU - Moran, J. AU - Ward, R. AU - Moher, D. DA - 2015-1-1 IS - 1 KW - Synovial Membrane Synovial Fluid Review Literature as Topic Research Design Prosthesis-Related Infections Practice Guidelines as Topic Humans Evidence-Based Medicine Early Diagnosis C-Reactive Protein Blood Sedimentation Biomarkers Arthroplasty, Replacement synovium replacement arthroplasty practice guideline pathology microbiology methodology metabolism literature evidence based medicine erythrocyte sedimentation rate blood adverse effects tissue culture technique test strip systematic review randomized controlled trial (topic) priority journal polymerase chain reaction periprosthetic joint infection neutrophil leukocyte count joint prosthesis human Gram staining diagnostic accuracy data extraction blood culture Article C reactive protein biological marker unclassified drug tumor necrosis factor alpha toll like receptor 2 procalcitonin neutrophil gelatinase associated lipocalin leukocyte elastase 2 lactoferrin interleukin 6 intercellular adhesion molecule 1 esterase CD64 antigen bactericidal permeability increasing protein alpha interferon Shoulder Knee Joint replacement Hip LA - English PY - 2015 SN - 2046-4053 ST - A protocol for a systematic review of the diagnostic accuracy of blood markers, synovial fluid, and tissue testing in periprosthetic joint infections (PJI) T2 - Systematic Reviews TI - A protocol for a systematic review of the diagnostic accuracy of blood markers, synovial fluid, and tissue testing in periprosthetic joint infections (PJI) VL - 4 ID - 14 ER - TY - JOUR AB - Purpose: The objective of this study was to identify the most appropriate cadaver perfusion techniques for surgical training through a systematic review with a description of the protocols used. Methods: The search strategy included PubMed and reference tracking. Studies were identified by searching the electronic Medline databases. The search concepts included perfusion, cadavers and simulation training, and the protocol used is reported. This resulted in a qualitative review of 12 articles out of 250 articles consulted. We collected all the important data from these 12 articles. Results: Regarding the characteristics of the studies and the declotting or perfusion techniques, the results were heterogeneous. Indeed, in several studies, a good deal of information was unclear or insufficiently precise, making it unfeasible to summarize the data. The methods used were not sufficiently explicit and detailed. However, a majority of the fresh cadavers used tap water for declotting. Perfusion, type of fluid, number of pumps, pressure, pulsatility, and arterial or venous approaches differed greatly. Only two studies fulfilled five of our six realism criteria for surgical simulation. Conclusions: This systematic review provided an overview of all the different cadaver perfusion techniques. It could be used to establish a reference method of a simulation model. © 2018, Springer-Verlag France SAS, part of Springer Nature. AD - Department of Medical Evaluation, Grenoble Alpes University Hospital, Boulevard de la Chantourne, La Tronche, 38700, France Laboratoire d’Anatomie Des Alpes Françaises, Faculty of Medicine, Grenoble Alpes University, Place du commandant Nal, Domaine de La Merci, La Tronche Cedex, 38700, France GIPSA-Lab, Dpt. Parole et Cognition, UMR 5216, Grenoble Campus, 11 rue des Mathématiques, BP46, Saint Martin d’Hères Cedex, 38402, France AU - Bellier, A. AU - Chanet, A. AU - Belingheri, P. AU - Chaffanjon, P. C2 - 29511810 DB - Scopus DO - 10.1007/s00276-018-1997-1 IS - 4 KW - Cadavers Perfusion Revascularization Simulation Surgical training tap water preservation solution Article cadaver human Medline perfusion pressure priority journal simulation training systematic review tissue perfusion dissection education organ preservation procedures surgery Humans Organ Preservation Solutions Specialties, Surgical LA - English M3 - Article PY - 2018 SP - 439-448 ST - Techniques of cadaver perfusion for surgical training: a systematic review T2 - Surgical and Radiologic Anatomy TI - Techniques of cadaver perfusion for surgical training: a systematic review VL - 40 ID - 357 ER - TY - JOUR AB - Introduction The 30-item Geriatric Depression Scale (GDS-30) and the shorter GDS-15, GDS-5 and GDS-4 are recommended as depression screening tools for elderly individuals. Existing meta-analyses on the diagnostic accuracy of the GDS have not been able to conduct subgroup analyses, have included patients already identified as depressed who would not be screened in practice and have not accounted for possible bias due to selective reporting of results from only better-performing cut-offs in primary studies. Individual participant data meta-analysis (IPDMA), which involves a standard systematic review, then a synthesis of individual participant data, rather than summary results, could address these limitations. The objective of our IPDMA is to generate accuracy estimates to detect major depression for all possible cut-offs of each version of the GDS among studies using different reference standards, separately and among participant subgroups based on age, sex, dementia diagnosis and care settings. In addition, we will use a modelling approach to generate individual participant probabilities for major depression based on GDS scores (rather than a dichotomous cut-off) and participant characteristics (eg, sex, age, dementia status, care setting). Methods and analysis Individual participant data comparing GDS scores to a major depression diagnosis based on a validated structured or semistructured diagnostic interview will be sought via a systematic review. Data sources will include Medline, Medline In-Process & Other Non-Indexed Citations, PsycINFO and Web of Science. Bivariate random-effects models will be used to estimate diagnostic accuracy parameters for each cut-off of the different versions of the GDS. Prespecified subgroup analyses will be conducted. Risk of bias will be assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Ethics and dissemination The findings of this study will be of interest to stakeholders involved in research, clinical practice and policy. PROSPERO registration number CRD42018104329. © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. AD - Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, QC, Canada Department of Medicine, McGill University, Montreal, QC, Canada Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada Department of Psychiatry, McGill University, Montreal, QC, Canada Department of Family Medicine, McGill University, Montreal, QC, Canada Schulich Library of Science and Engineering, McGill University, Montreal, QC, Canada Stanford Prevention Research Center, Department of Medicine, Department of Health Research and Policy, Stanford School of Medicine, Stanford, CA, United States Department of Statistics, Stanford University School of Humanities and Sciences, Stanford, United States Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada Department of Psychiatry, University of Calgary, Calgary, Canada Department of Clinical, Neuro and Developmental Psychology and Amsterdam Public Health Research Institute, VU University Amsterdam, Amsterdam, Netherlands Hull York Medical School and Department of Health Sciences, University of York, York, United Kingdom Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada Department of Psychiatry, University of Alberta, Edmonton, Canada Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, United States Department of Psychology, McGill University, Montreal, Canada Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada AU - Benedetti, A. AU - Wu, Y. AU - Levis, B. AU - Wilchesky, M. AU - Boruff, J. AU - Ioannidis, J. P. A. AU - Patten, S. B. AU - Cuijpers, P. AU - Shrier, I. AU - Gilbody, S. AU - Ismail, Z. AU - McMillan, D. AU - Mitchell, N. AU - Ziegelstein, R. C. AU - Thombs, B. D. C2 - 30518594 C7 - e026598 DB - Scopus DO - 10.1136/bmjopen-2018-026598 IS - 12 KW - depression gds geriatric depression scale individual participant data meta-analysis aged Article bibliographic database comorbidity dementia diagnostic accuracy diagnostic test accuracy study false positive result Geriatric Depression Scale 15 Geriatric Depression Scale 30 Geriatric Depression Scale 4 Geriatric Depression Scale 5 human major depression medical research meta analysis mini international neuropsychiatric interview Patient Health Questionnaire 9 quality control risk factor screening test semi structured interview sensitivity and specificity statistical bias systematic review aging geriatric assessment meta analysis (topic) procedures psychological rating scale psychology Depressive Disorder, Major Humans Meta-Analysis as Topic Psychiatric Status Rating Scales Systematic Reviews as Topic LA - English M3 - Article PY - 2018 ST - Diagnostic accuracy of the Geriatric Depression Scale-30, Geriatric Depression Scale-15, Geriatric Depression Scale-5 and Geriatric Depression Scale-4 for detecting major depression: Protocol for a systematic review and individual participant data meta-analysis T2 - BMJ Open TI - Diagnostic accuracy of the Geriatric Depression Scale-30, Geriatric Depression Scale-15, Geriatric Depression Scale-5 and Geriatric Depression Scale-4 for detecting major depression: Protocol for a systematic review and individual participant data meta-analysis VL - 8 ID - 358 ER - TY - JOUR AB - Objective: Little is known about the trustworthiness of clinical practice guidelines (PGs) relevant to child and youth depression or anxiety. To address this gap, we used systematic review methods to identify all available relevant PGs, quality appraise them, and make recommendations regarding which PGs are trustworthy and should be used by clinicians. Methods: Prespecified inclusion criteria identified eligible PGs. Two independent trained reviewers applied the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool. Using three AGREE II domain scores (stakeholder involvement, rigor of development [clinical validity/trustworthiness], and editorial independence), PG quality was designated as (1) minimum (≥50%) and (2) high (≥70%). Results: Of 25 eligible PGs, five met minimum quality criteria (depression, n = 4; anxiety, n = 1); three out of five met high-quality criteria (depression, n = 2; anxiety, n = 1). Among the five minimum quality PGs, developers included government (n = 2), independent expert groups (n = 2), and other (n = 1). No PGs developed by specialty societies achieved minimum or high-quality ratings; eight of 25 PGs were up-to-date. Conclusions: Trustworthy PGs are available to support clinical decisions about depression and anxiety in children and youth, but are few in number. Many existing PGs (up to 80%) may not be clinically valid. Clinicians who implement the high-quality PGs identified here can increase the number of children and youth who receive effective interventions for depression and anxiety, minimize harm, and avoid wasted resources. Clinicians, service planners, youth, and their families should encourage PG developers to increase the pool of high-quality PGs using internationally recognized PG development standards. © 2018 Wiley Periodicals, Inc. AU - Bennett, K. AU - Courtney, D. AU - Duda, S. AU - Henderson, J. AU - Szatmari, P. DB - Scopus DO - 10.1002/da.22752 IS - 6 M3 - Review PY - 2018 SP - 530-540 ST - An appraisal of the trustworthiness of practice guidelines for depression and anxiety in children and youth T2 - Depression and Anxiety TI - An appraisal of the trustworthiness of practice guidelines for depression and anxiety in children and youth VL - 35 ID - 335 ER - TY - JOUR AB - Background: Internet-based interventions are emerging as an alternative way of delivering accessible healthcare for various conditions including hearing and balance disorders. A comprehensive review regarding the evidence-base of Internet-based interventions for auditory-related conditions is required to determine the existing evidence of their efficacy and effectiveness. The objective of the current protocol is to provide the methodology for a systematic review regarding the effects of Internet-based interventions for adults with hearing loss, tinnitus and vestibular disorders. Method: This protocol was developed according to the Preferred Reporting Items for Systematic reviews and Meta-analyses for Protocols (PRISMA-P) 2015 guidelines. Electronic database searches will include EBSCOhost, PubMed and Cochrane Central Register performed by two researchers. This will be complemented by searching other resources such as the reference lists for included studies to identify studies meeting the eligibility for inclusion with regard to study designs, participants, interventions, comparators and outcomes. The Cochrane risk of bias tool (RoB 2) for randomised trials will be used for the bias assessments in the included studies. Criteria for conducting meta-analyses were defined. Discussion: The result of this systematic review will be of value to establish the effects of Internet-based interventions for hearing loss, tinnitus and vestibular disorders. This will be of importance to guide future planning of auditory intervention research and clinical services by healthcare providers, researchers, consumers and stakeholders. © 2018 The Author(s). AD - Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, CB1 1PT, United Kingdom Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, United States Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India Audiology India, Mysore, Karnataka, India National Institute for Health Research, Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, United Kingdom Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, United Kingdom Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institute, Stockholm, Sweden AU - Beukes, E. W. AU - Manchaiah, V. AU - Baguley, D. M. AU - Allen, P. M. AU - Andersson, G. C2 - 30470247 C7 - 205 DB - Scopus DO - 10.1186/s13643-018-0880-9 IS - 1 KW - eHealth Hearing loss Internet interventions Protocol Self-help Systematic review Tinnitus Vestibular disorders adult Beck Anxiety Inventory Depression Anxiety Stress Scale dizziness hearing impairment Hospital Anxiety and Depression Scale human insomnia Internet outcome assessment prevalence priority journal prospective study quality of life questionnaire randomized controlled trial (topic) Review vertigo vestibular disorder procedures telemedicine Humans Vestibular Diseases LA - English M3 - Review PY - 2018 ST - Internet-based interventions for adults with hearing loss, tinnitus and vestibular disorders: A protocol for a systematic review 11 Medical and Health Sciences 1117 Public Health and Health Services T2 - Systematic Reviews TI - Internet-based interventions for adults with hearing loss, tinnitus and vestibular disorders: A protocol for a systematic review 11 Medical and Health Sciences 1117 Public Health and Health Services VL - 7 ID - 359 ER - TY - JOUR AB - This systematic review explores the sociodemographic factors associated with the utilization of bariatric surgery among eligible patients. Electronic databases were searched for population-based studies that explored the relationship between sociodemographic characteristics of patients eligible for bariatric surgery to those who actually received the procedure. Twelve retrospective cohort studies were retrieved, of which the results of 9 studies were pooled using a random effects model. Patients who received bariatric surgery were significantly more likely to be white versus non-white (OR 1.54; 95 % CI 1.08, 2.19), female versus male (OR 2.80; 95 % CI 2.46, 3.22), and have private versus government or public insurance (OR 2.51; 95 % CI 1.04, 6.05). Prospective cohort studies are warranted to further determine the relative effect of these factors, adjusting for confounding factors. © 2015, Springer Science+Business Media New York. AU - Bhogal, S. K. AU - Reddigan, J. I. AU - Rotstein, O. D. AU - Cohen, A. AU - Glockler, D. AU - Tricco, A. C. AU - Smylie, J. K. AU - Glazer, S. A. AU - Pennington, J. AU - Conn, L. G. AU - Jackson, T. D. DA - 2015-1-1 IS - 5 KW - Bariatrics Cohort Studies Socioeconomic Factors Prospective Studies Obesity, Morbid Male Humans Health Services Accessibility Female Bariatric Surgery utilization socioeconomics prospective study meta analysis human health care delivery Systematic review Sociodemographic disparities Obesity Meta-analysis Inequity PY - 2015 SP - 888-899 ST - Inequity to the Utilization of Bariatric Surgery: a Systematic Review and Meta-Analysis T2 - Obesity Surgery TI - Inequity to the Utilization of Bariatric Surgery: a Systematic Review and Meta-Analysis VL - 25 ID - 206 ER - TY - JOUR AB - Background: Out-of-hospital cardiac arrest (OHCA) is a significant cause of death in developed countries. The majority of OHCA patients are elderly (=65 years), and it was documented that they were less likely than younger patients to receive the evidence-based interventions, even though the improvement in survival in the elderly age group was higher than in younger population. Our goal is to investigate any disparity in the provision of post-arrest care for the elderly with OHCA and a sustained return of spontaneous circulation (ROSC). Methods/design: Eight relevant, electronic databases will be systematically searched to identify eligible studies. The searches will be supplemented with gray literature searching of theses, dissertations, and hand searching of pertinent journals. Two independent reviewers will screen the titles and abstracts and select studies for full text analysis using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) method, and both will extract information from the selected studies employing a form based on the Data Extraction Template for Cochrane Reviews. A team of three reviewers will assess the quality of the studies with the modified Downs and Black scale. Statistical methods for evidence synthesis, such as meta-analysis and meta-regression, will be applied to compare and combine the evidence regarding the association between age and intervention provision/utilization, adjusting for a number of significant confounders, such as patient characteristics and co-morbidities and availability of intervention techniques, as well as study specific characteristics. The strength of evidence from the selected studies will be assessed using a modified Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) system. Discussion: The findings obtained from this systematic review should inform whether disparity exists in the provision of post-arrest care for the elderly (= 65 years old) with OHCA or not. Addressing this problem has a potential to substantially increase the number of > 65-year-old, long-term survivors. The results of our review might also point to the gaps in the published literature that specifically examines disparity in provision of care for this population. This systematic review was designed in accordance with the Preferred Reporting Guidelines for Systematic reviews and Meta-analyses (PRISMA statement), while the protocol follows the Preferred Reporting items for Systematic review and Meta-analysis protocols (PRISMA-P) statement. � 2016 Bielecki et al. AU - Bielecki, J. M. AU - Wong, J. AU - Mitsakakis, N. AU - Shah, P. S. AU - Krahn, M. D. AU - Rac, V. E. DA - 2016-1-1 IS - 1 KW - Developing Countries Review Literature as Topic Research Design Out-of-Hospital Cardiac Arrest Humans Hospitalization Healthcare Disparities Aged methodology literature systematic review (topic) risk assessment return of spontaneous circulation randomized controlled trial (topic) priority journal percutaneous coronary intervention patient care out of hospital cardiac arrest modified Downs and Black scale meta analysis (topic) human hospital admission health care utilization health care disparity coronary artery bypass graft comorbidity assessment of humans Article angiocardiography Post-resuscitation interventions OHCA Elderly Disparity PY - 2016 SN - 2046-4053 ST - Disparities in a provision of in-hospital post-arrest interventions for out-of-hospital cardiac arrest (OHCA) in the elderly population-protocol for a systematic review T2 - Systematic Reviews TI - Disparities in a provision of in-hospital post-arrest interventions for out-of-hospital cardiac arrest (OHCA) in the elderly population-protocol for a systematic review VL - 5 ID - 194 ER - TY - JOUR AB - Background: Antimalarial drugs affect the central nervous system, but it is difficult to differentiate the effect of these drugs from that of the malaria illness. We conducted a systematic review to determine the association between anti-malarial drugs and mental and neurological impairment in humans. Methods: We systematically searched online databases, including Medline/PubMed, PsychoInfo, and Embase, for articles published up to 14th July 2016. Pooled prevalence, heterogeneity and factors associated with prevalence of mental and neurological manifestations were determined using meta-analytic techniques. Results: Of the 2,349 records identified in the initial search, 51 human studies met the eligibility criteria. The median pooled prevalence range of mental and neurological manifestations associated with antimalarial drugs ranged from 0.7% (dapsone) to 48.3% (minocycline) across all studies, while it ranged from 0.6% (pyrimethamine) to 42.7% (amodiaquine) during treatment of acute malaria, and 0.7% (primaquine/dapsone) to 55.0% (sulfadoxine) during prophylaxis. Pooled prevalence of mental and neurological manifestations across all studies was associated with an increased number of antimalarial drugs (prevalence ratio= 5.51 (95%CI, 1.05-29.04); P=0.045) in a meta-regression analysis. Headaches (15%) and dizziness (14%) were the most common mental and neurological manifestations across all studies. Of individual antimalarial drugs still on the market, mental and neurological manifestations were most common with the use of sulphadoxine (55%) for prophylaxis studies and amodiaquine (42.7%) for acute malaria studies. Mefloquine affected more domains of mental and neurological manifestations than any other antimalarial drug. Conclusions: Antimalarial drugs, particularly those used for prophylaxis, may be associated with mental and neurological manifestations, and the number of antimalarial drugs taken determines the association. Mental and neurological manifestations should be assessed following the use of antimalarial drugs. Copyright: © 2017 Bitta MA et al. AU - Bitta, M. A. AU - Kariuki, S. M. AU - Mwita, C. AU - Gwer, S. AU - Mwai, L. AU - Newton, C. R. J. C. DA - 2017-1-1 KW - Dapsone Prevalence Humanism Humanities Antimalarials Humans PY - 2017 SN - 2398-502X ST - Antimalarial drugs and the prevalence of mental and neurological manifestations: A systematic review and meta-analysis T2 - Wellcome Open Research TI - Antimalarial drugs and the prevalence of mental and neurological manifestations: A systematic review and meta-analysis VL - 2 ID - 164 ER - TY - JOUR AB - Our objective was to systematically review the data interrogating the association between gestational weight gain (GWG) and maternal and child health among women with twin gestations. We identified 15 articles of twin gestations that studied GWG in relation to a maternal, perinatal or child health outcome and controlled for gestational age at delivery and prepregnancy body mass index. A positive association between GWG and fetal size was consistently found. Evidence on preterm birth and pregnancy complications was inconsistent. The existing studies suffer from serious methodological weaknesses, including not properly accounting for the strong correlation between gestational duration and GWG and not controlling for chorionicity. In addition, serious perinatal outcomes were not studied, and no research is available on the association between GWG and outcomes beyond birth. Our systematic review underscores that GWG in twin gestations is a neglected area of research. Rigorous studies are needed to inform future evidence-based guidelines. © 2014 Nature America, Inc. AU - Bodnar, L. M. AU - Pugh, S. J. AU - Abrams, B. AU - Himes, K. P. AU - Hutcheon, J. A. DA - 2014-1-1 IS - 4 KW - Child Women's Health Only Child Child Welfare Weight Gain Twins Premature Birth Pregnancy, Multiple Pregnancy Outcome Pregnancy Infant Welfare Infant Humans Fetus Female Body Mass Index physiology pathophysiology multiple pregnancy twin pregnancy systematic review self report review prenatal period prematurity pregnancy complication preeclampsia maternal welfare human gestational age gestation period fetus size fetus growth child health body size body mass nutrition infants birth PY - 2014 SP - 252-263 ST - Gestational weight gain in twin pregnancies and maternal and child health: A systematic review T2 - Journal of Perinatology TI - Gestational weight gain in twin pregnancies and maternal and child health: A systematic review VL - 34 ID - 245 ER - TY - JOUR AB - Background: With over 230 million surgical procedures performed annually worldwide, better application of evidence in anesthesia and perioperative medicine may reduce widespread variation in clinical practice and improve patient care. However, a comprehensive summary of the complete available evidence has yet to be conducted. This scoping review aims to map the existing literature investigating perioperative anesthesia interventions and their potential impact on patient mortality, to inform future knowledge translation and ultimately improve perioperative clinical practice. Methods: Searches were conducted in MEDLINE, EMBASE, CINAHL, and the Cochrane Library databases from inception to March 2015. Study inclusion criteria were adult patients, surgical procedures requiring anesthesia, perioperative intervention conducted/organized by a professional with training in anesthesia, randomized controlled trials (RCTs), and patient mortality as an outcome. Studies were screened for inclusion, and data was extracted in duplicate by pairs of independent reviewers. Data were extracted, tabulated, and reported thematically. Results: Among the 10,505 publications identified, 369 RCTs (n = 147,326 patients) met the eligibility criteria. While 15 intervention themes were identified, only 7 themes (39 studies) had a significant impact on mortality: pharmacotherapy (n = 23), nutritional (n = 3), transfusion (n = 4), ventilation (n = 5), glucose control (n = 1), medical device (n = 2), and dialysis (n = 1). Conclusions: By mapping intervention themes, this scoping review has identified areas requiring further systematic investigation given their potential value for reducing patient mortality as well as areas where continued investment may not be cost-effective given limited evidence for improving survival. This is a key starting point for future knowledge translation to optimize anesthesia practice. © 2018 The Author(s). AU - Boet, S. AU - Etherington, N. AU - Nicola, D. AU - Beck, A. AU - Bragg, S. AU - Carrigan, I. D. AU - Larrigan, S. AU - Mendonca, C. T. AU - Miao, I. AU - Postonogova, T. AU - Walker, B. AU - De Wit, J. AU - Mohamed, K. AU - Balaa, N. AU - Lalu, M. M. AU - McIsaac, D. I. AU - Moher, D. AU - Stevens, A. AU - Miller, D. DA - 2018-1-1 %J Systematic Reviews IS - 1 KW - Physician's Practice Patterns PY - 2018 SN - 2046-4053 ST - Anesthesia interventions that alter perioperative mortality: A scoping review T2 - Systematic Reviews TI - Anesthesia interventions that alter perioperative mortality: A scoping review VL - 7 ID - 271 ER - TY - JOUR AB - Background: Non-technical skills, such as communication or leadership, are integral to clinical competence in anaesthesia. There is a need for valid and reliable tools to measure anaesthetists' non-technical performance for both initial and continuing professional development. This systematic review aims to summarise the measurement properties of existing assessment tools to determine which tool is most robust. Methods: Embase (via OVID), Medline and Medline in Process (via OVID), and reference lists of included studies and previously published relevant systematic reviews were searched (through August 2017). Quantitative studies investigating the measurement properties of tools used to assess anaesthetists' intraoperative non-technical skills, either in a clinical or simulated environment, were included. Pairs of independent reviewers determined eligibility and extracted data. Risk of bias was assessed using the COSMIN checklist. Results: The search yielded 978 studies, of which 14 studies describing seven tools met the inclusion criteria. Of these, 12 involved simulated crisis settings only. The measurement properties of the Anaesthetists' Non-Technical Skills (ANTS) tool were most commonly assessed (n=9 studies), with studies of two types of validity (content, concurrent) and two types of reliability (internal consistency, interrater). Most of these studies, however, were at serious risk of bias. Conclusions: Though there are seven tools for assessing the non-technical skills of anaesthetists, only ANTS has been extensively investigated with regard to its measurement properties. ANTS appears to have acceptable validity and reliability for assessing non-technical skills of anaesthetists in both simulated and clinical settings. Future research should consider additional clinical contexts and types of measurement properties. © 2018 British Journal of Anaesthesia AU - Boet, S. AU - Larrigan, S. AU - Martin, L. AU - Liu, H. AU - Sullivan, K. J. AU - Etherington, N. DA - 2018-1-1 %J British Journal of Anaesthesia IS - 6 KW - Bias (Epidemiology) PY - 2018 SN - 0007-0912 SP - 1218-1226 ST - Measuring non-technical skills of anaesthesiologists in the operating room: a systematic review of assessment tools and their measurement properties T2 - British Journal of Anaesthesia TI - Measuring non-technical skills of anaesthesiologists in the operating room: a systematic review of assessment tools and their measurement properties VL - 121 ID - 270 ER - TY - JOUR AB - Background: Three formulations of botulinum toxin are available for facial rhytides. It is unclear which formulation offers the greatest balance of benefits and harms. The objective of this study was to conduct a systematic review with meta-analyses to compare formulations of botulinum toxin for reduction of facial rhytides at the glabella. Methods: The authors' protocol was registered with the International Prospective Register of Systematic Reviews (CRD4201200377). A systematic literature search was performed identifying double-blind studies. The authors assessed 1-, 3-, and 4-month follow-up. The authors performed pairwise meta-analyses using random effects models to compare response rates among the three botulinum formulations and a network meta-analysis. Results: A total of 18 studies (3082 patients) were included. At 30-, 90-, and 120-day follow-up, all medications with available data showed statistically significantly increased treatment response versus placebo. Only high-dose onabotulinum toxin (compared to standard-dose onabotulinum toxin) offered additional benefit at 30 days. Exploratory analysis using network meta-analysis mostly suggested insuf-ficient evidence of incremental benefits when comparing specific formulations. Conclusions: Evidence supporting benefits versus placebo of the different formulations was clear over time. Comparisons between active formulations were rare and typically based on single trials of small to moderate sample size. The data suggest some gains with high-dose onabotulinum toxin (relative to standard dose), whereas exploratory indirect comparisons between active formulations were largely associated with inconclusive findings. Future studies should undertake head-to-head comparisons of the different formulations and ensure longer follow-up to best inform the accumulating evidence base. © 2016 by the American Society of Plastic Surgeons. AU - Bonaparte, J. P. AU - Ellis, D. AU - Quinn, J. G. AU - Rabski, J. AU - Hutton, B. DA - 2016-1-1 IS - 4 KW - Botulinum Toxins Skin Aging Outcome Assessment (Health Care) Neuromuscular Agents Models, Statistical Humans Cosmetic Techniques Botulinum Toxins, Type A statistical model outcome assessment meta analysis human esthetic surgery cutaneous parameters comparative study muscle relaxant agent botulinum toxin A PY - 2016 SP - 1125-1140 ST - A comparative assessment of three formulations of botulinum toxin type a for facial rhytides: A systematic review with meta-analyses T2 - Plastic and Reconstructive Surgery TI - A comparative assessment of three formulations of botulinum toxin type a for facial rhytides: A systematic review with meta-analyses VL - 137 ID - 191 ER - TY - JOUR AB - Objective: To conduct a systematic review to identify and describe the scope and nature of the research evidence on the effectiveness of interventions to improve health care quality or reduce disparities in the care of disadvantaged populations with osteoarthritis (OA) as an example of a common chronic disease. Methods: We searched electronic databases from 1950 through February 2010 and grey literature for relevant articles using any study design. Studies with interventions designed explicitly to improve health care quality or reduce disparities in the care of disadvantaged adult populations with OA and including an evaluation were eligible. We used the PROGRESS-Plus framework to identify disadvantaged population subgroups. Results: Of 4,701 citations identified, 10 met the inclusion criteria. Eight were community based and 6 targeted race/ethnicity/culture. All 10 studies evaluated interventions aimed at people with OA; 2 studies also targeted the health care system. No studies targeted health care providers. Nine of 10 studies evaluated arthritis self-management interventions; all showed some benefit. Only 1 study compared the difference in effect between the PROGRESS-Plus disadvantaged population and the relevant comparator group. Conclusion: There are few studies evaluating the effectiveness of interventions to improve health care quality in disadvantaged populations with OA. Further research is needed to evaluate interventions aimed at health care providers and the health care system, as well as other patient-level interventions. Gap intervention research is also needed to evaluate whether interventions are effective in reducing documented health care inequities. © 2011, American College of Rheumatology. AU - Borkhoff, C. M. AU - Wieland, M. L. AU - Myasoedova, E. AU - Ahmad, Z. AU - Welch, V. AU - Hawker, G. A. AU - Li, L. C. AU - Buchbinder, R. AU - Ueffing, E. AU - Beaton, D. AU - Cardiel, M. H. AU - Gabriel, S. E. AU - Guillemin, F. AU - Adebajo, A. O. AU - Bombardier, C. AU - Hajjaj-Hassouni, N. AU - Tugwell, P. C2 - 20842715 DB - Scopus DO - 10.1002/acr.20349 IS - 1 KW - article chronic disease clinical effectiveness conceptual framework data base data extraction ethnicity evidence based practice health care disparity health care quality health care system human intervention study osteoarthritis population research study design systematic review economics health service review standard vulnerable population Health Services Needs and Demand Humans Quality of Health Care Vulnerable Populations M3 - Article PY - 2011 SP - 39-52 ST - Reaching those most in need: A scoping review of interventions to improve health care quality for disadvantaged populations with osteoarthritis T2 - Arthritis Care and Research TI - Reaching those most in need: A scoping review of interventions to improve health care quality for disadvantaged populations with osteoarthritis VL - 63 ID - 324 ER - TY - JOUR AB - Objective: This scoping review investigates how knowledge and skills are assessed in the information literacy (IL) instruction for students in physical therapy, occupational therapy, or speech-language pathology, regardless of whether the instruction was given by a librarian. The objectives were to discover what assessment measures were used, determine whether these assessment methods were tested for reliability and validity, and provide librarians with guidance on assessment methods to use in their instruction in evidence-based practice contexts. Methods: A scoping review methodology was used. A systematic search strategy was run in Ovid MEDLINE and adapted for CINAHL; EMBASE; Education Resources Information Center (ERIC) (EBSCO); Library and Information Science Abstracts (LISA); Library, Information Science & Technology Abstracts (LISTA); and Proquest Theses and Dissertations from 1990 to January 16, 2017. Forty articles were included for data extraction. Results: Three major themes emerged: types of measures used, type and context of librarian involvement, and skills and outcomes described. Thirty-four measures of attitude and thirty-seven measures of performance were identified. Course products were the most commonly used type of performance measure. Librarians were involved in almost half the studies, most frequently as instructor, but also as author or assessor. Information literacy skills such as question formulation and database searching were described in studies that did not involve a librarian. Conclusion: Librarians involved in instructional assessment can use rubrics such as the Valid Assessment of Learning in Undergraduate Education (VALUE) when grading assignments to improve the measurement of knowledge and skills in course-integrated IL instruction. The Adapted Fresno Test could be modified to better suit the real-life application of IL knowledge and skills. © 2018, Medical Library Association. All rights reserved. AU - Boruff, J. T. AU - Harrison, P. DA - 2018-1-1 IS - 1 KW - Occupational Therapy Speech-language pathology Physical therapy Information Literacy Evidence-based practice Communication sciences and disorders Assessment Allied health PY - 2018 SN - 1536-5050 (Print) 1536-5050 (Linking) SP - 15-37 ST - Assessment of knowledge and skills in information literacy instruction for rehabilitation sciences students: A scoping review T2 - Journal of the Medical Library Association TI - Assessment of knowledge and skills in information literacy instruction for rehabilitation sciences students: A scoping review VL - 106 ID - 66 ER - TY - JOUR AB - Parenting a child with autism spectrum disorder (ASD) can be stressful, and accessing services can add to this stress. Self-efficacy, agency and advocacy are important for parents when accessing and using services. To develop insight into parental advocacy, a meta-synthesis was undertaken to consolidate the literature focussing on parents' experiences of advocating for their child with ASD. A qualitative meta-synthesis was conducted. Fifteen databases were systematically searched by using key terms related to ASD, children, parents/carers, advocacy and qualitative studies. Twenty-four studies were identified and appraised using an adapted version of the Critical Appraisal Skills Programme tool. Data were synthesized into themes through the steps of review, meta-aggregation, integration and interpretation. Two overarching concepts emerged, illustrating both the challenging nature of advocacy and the associated personal and societal benefits. These two concepts are supported by eight themes: a life-long, all-encompassing challenge; advocacy as a parental coping strategy; advocacy involving working to create a future; balancing roles and needs; isolation versus support; personal impacts of advocacy; benefits of advocacy; and the barriers to advocacy. The experience of advocacy for parents with a child with ASD is complex and intensive, presenting both personal and societal benefits, as well as challenges for parents. In supporting individuals with ASD and family well-being, service providers need to have an understanding of the advocating role of parents and ensure that opportunities exist for their voices to be heard during service delivery. � 2016 John Wiley & Sons Ltd AU - Boshoff, K. AU - Gibbs, D. AU - Phillips, R. L. AU - Wiles, L. AU - Porter, L. DA - 2016-1-1 IS - 6 KW - Nuclear Family Autistic Disorder Only Child Child Development Disorders, Pervasive Social Support Qualitative Research Parents Parenting Humans Child Advocacy Child Autism Spectrum Disorder Attitude to Health Adaptation, Psychological psychology parent meta analysis human coping behavior child parent relation autism meta-synthesis experience advocacy PY - 2016 SP - 784-797 ST - Parents' voices: ‘why and how we advocate’. A meta-synthesis of parents' experiences of advocating for their child with autism spectrum disorder T2 - Child: Care, Health and Development TI - Parents' voices: ‘why and how we advocate’. A meta-synthesis of parents' experiences of advocating for their child with autism spectrum disorder VL - 42 ID - 170 ER - TY - JOUR AB - Background: Advocacy has been described by parents of children with autism as an important coping strategy, enabling them to move forward by redirecting emotions into actions. A key factor in the development of collaborative and constructive partnerships between service providers and parents is having an understanding of how parents engage in advocacy and the support needed to do so. This meta-synthesis was undertaken to consolidate in-depth qualitative data from parents' perspectives of the process that they use to advocate for their children with autism. Methods: A qualitative meta-synthesis was conducted, whereby 15 databases were systematically searched. Thirty-one studies were identified and appraised using an adapted version of the Critical Appraisal Skills Programme tool. Data were synthesized into themes through the steps of review, meta-aggregation, integration, and interpretation. Results: The voices of 1,662 parents are presented describing the process of advocacy in the stages of seeking a diagnosis, seeking self-education, and taking action. Taking action includes 2 subthemes: seeking, access, and use of support services and community engagement and educating others. Conclusions: Results highlight the significant impact that positive experiences with first-line professionals have during the diagnosis process and how these experiences lay the foundation for all future relationships with other service providers. Important implications arise from this meta-synthesis for service providers in supporting parents' advocacy and hence building constructive relationships with families with a child with autism. © 2017 John Wiley & Sons Ltd AU - Boshoff, K. AU - Gibbs, D. AU - Phillips, R. L. AU - Wiles, L. AU - Porter, L. DA - 2018-1-1 IS - 1 KW - Nuclear Family Only Child Child Autistic Disorder parents meta-synthesis experience autism advocacy PY - 2018 SP - 147-160 ST - Parents' voices: “Our process of advocating for our child with autism.” A meta-synthesis of parents' perspectives T2 - Child: Care, Health and Development TI - Parents' voices: “Our process of advocating for our child with autism.” A meta-synthesis of parents' perspectives VL - 44 ID - 133 ER - TY - JOUR AB - Background and purpose: Aromatherapy, a CAM therapy, is a natural way of treating the mind, body and soul of individuals. The purpose of this study was to systematically review the literature to determine the effect of aromatherapy on hemodialysis complications. Methods: In this systematic review, international (PubMed, Google Scholar, Web of Science, CINHAL, EMBASE and Scopus) and national databases (SID and Magiran) were searched from inception of the databases to 30 December 2017. Results: The results showed that aromatherapy reduced some of the complications of hemodialysis, including anxiety, fatigue, pruritus, pain of arteriovenous fistula puncture, sleep quality, depression, stress and headache. In one case, it improved the quality of life of hemodialysis patients. Conclusion: Considering the complications and heavy costs of managing complications in patients undergoing hemodialysis, it appears that aromatherapy can be used as an inexpensive, fast-acting and effective treatment to reduce complications in hemodialysis patients. © 2018 Elsevier Ltd AU - Bouya, S. AU - Ahmadidarehsima, S. AU - Badakhsh, M. AU - Balouchi, A. AU - koochakzai, M. DA - 2018-1-1 KW - Renal Dialysis Systematic review Hemodialysis complications Aromatherapy PY - 2018 SP - 130-138 ST - Effect of aromatherapy interventions on hemodialysis complications: A systematic review T2 - Complementary Therapies in Clinical Practice TI - Effect of aromatherapy interventions on hemodialysis complications: A systematic review VL - 32 ID - 46 ER - TY - JOUR AB - The aim of this study was to determine the prevalence of CKD in the Iranian general population. In this systematic review and meta-analysis study, international (PubMed, Web of Science, Scopus, and Google scholar) and national databases (SID, Magiran) were searched until December 30, 2017. The quality of the studies was evaluated using the Hoy instrument. Out of 1170 initial studies, 9 studies with a total of 70 605 participants were included in the final stage of this study. Based on the results of the random effect method (95% CI), the overall prevalence of chronic kidney disease in 70 605 people was 15.14% (I 2 = 99.77%). The prevalence of CKD in female patients (18.80%) was 1.7 times higher than in male patients (10.83). The results of the present study indicate a higher than the global average prevalence of CKD in Iran and the need for additional attention of policy makers on better planning for control and implementation of screening programs in high-risk populations, such as patients with hypertension and diabetes. © 2018 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy AD - Internal Medicine and Nephrology, Clinical Immunology Research Center, Ali-Ebne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran Student Research Committee, Nursing and Midwifery School, Iran University of Medical Sciences, Tehran, Iran Department of Nursing, Zabol University of Medical Sciences, Zabol, Iran Student Research Committee, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran Pediatric Department, Zabol University of Medical Sciences, Zabol, Iran AU - Bouya, S. AU - Balouchi, A. AU - Rafiemanesh, H. AU - Hesaraki, M. C2 - 29974630 DB - Scopus DO - 10.1111/1744-9987.12716 IS - 6 KW - Iran Prevalence Renal failure Systematic review age distribution Article chronic kidney failure high risk population human meta analysis priority journal sex difference adolescent adult aged child female male middle aged very elderly young adult Aged, 80 and over Humans Renal Insufficiency, Chronic LA - English M3 - Article PY - 2018 SP - 594-599 ST - Prevalence of Chronic Kidney Disease in Iranian General Population: A Meta-Analysis and Systematic Review T2 - Therapeutic Apheresis and Dialysis TI - Prevalence of Chronic Kidney Disease in Iranian General Population: A Meta-Analysis and Systematic Review VL - 22 ID - 360 ER - TY - JOUR AB - Introduction: Urinary Tract Infections (UTIs) are the most common infections in children worldwide, however, data from Iran is not very well studied. Aim: The aim of the present study was to evaluate the prevalence of UTIs in Iranian children. Materials and Methods: From the beginning of databases to November 2017, International {PubMed, Web of Science (WOS) and Google scholar} and National {Scientific Information Database (SID), Magiran} databases were searched for related observational studies that were conducted in Iran including only on Iranian children and published in English and Persian languages. The quality of the articles was evaluated using the Hoy D tool. Results: Out of 515 initial studies, 14 and 6 studies were included in systematic review and meta-analysis, respectively. The overall prevalence of UTI in 3926 children was 4.92% (95% CI:2.32, 7.52; I2=93.58%). The prevalence of UTI in male and female children was 2.59% and 4.78%, and the difference was non-significant. Conclusion: Considering the prevalence of UTIs in Iranian children, it is recommended that studies should be conducted in the field of research at the national level to determine the precise incidence and risk factors for UTIs in children. © 2018, Journal of Clinical and Diagnostic Research. All rights reserved. AD - Department of Nephrology, Zahedan University of Medical Sciences, Zahedan, Iran Department of Midwifery, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Nursing, Zabol University of Medical Science, Zabol, Iran Department of Paediatrics, Zabol University of Medical Science, Zabol, Iran AU - Bouya, S. AU - Koochakzai, M. AU - Rafiemanesh, H. AU - Balouchi, A. AU - Hesaraki, M. DB - Scopus DO - 10.7860/JCDR/2018/36845.11864 IS - 8 KW - Asymptomatic bacteriuria Infectious disease Paediatrics data extraction data synthesis health care human Iran meta analysis methodology prevalence quality control Review screening systematic review urinary tract infection LA - English M3 - Review PY - 2018 SP - SE01-SE04 ST - The prevalence of urinary tract infections in iranian children: A meta-analysis and systematic review T2 - Journal of Clinical and Diagnostic Research TI - The prevalence of urinary tract infections in iranian children: A meta-analysis and systematic review VL - 12 ID - 361 ER - TY - JOUR AB - Purpose: Quality of life is the most important psychological factor affecting breast cancer patients. This study aimed to examine the health related quality of life of breast cancer patients in Iran. Methods: International (PubMed, Web of science, Scopus and Google scholar) and national (SID, Magiran) databases were searched for related studies to September 2017. The quality of the articles was evaluated using the Hoy tool. Results: Out of 232 initial studies, 18 studies performed on 2263 people were included in the final stage of the study. Based on the EORTC-QLQ-C30 and random effect method, the pooled mean score of quality of life in 1073 people was 57.88 (95% CI 48.26–67.41, I2 = 97.90%) and the pooled mean score of quality of life based on WHOQOL-BREF in 357 people was 66.79 (95% CI 45.96–87.62, I2 = 99.50%). Conclusion: According to the results of the study, a moderate level of quality of life in women with breast cancer was indicated. Therefore, the use of multidimensional approaches can improve their quality of life. © 2018, Springer Science+Business Media, LLC, part of Springer Nature. AU - Bouya, S. AU - koochakzai, M. AU - Rafiemanesh, H. AU - Balouchi, A. AU - Taheri, S. AU - Badakhsh, M. AU - Didehvar, M. DA - 2018-1-1 IS - 2 KW - Breast Neoplasms Quality of Life Systematic review Iran Breast Cancer PY - 2018 SP - 205-212 ST - Health-related quality of life of Iranian breast cancer patients: a meta-analysis and systematic review T2 - Breast Cancer Research and Treatment TI - Health-related quality of life of Iranian breast cancer patients: a meta-analysis and systematic review VL - 170 ID - 47 ER - TY - JOUR AB - The purpose of this review was to systematically search and critically analyse the literature pertaining to behavioural outcomes of exercise interventions for individuals with autism spectrum disorder aged ≤16 years. This systematic review employed a comprehensive peer-reviewed search strategy, two-stage screening process and rigorous critical appraisal, which resulted in the inclusion of 13 studies. Results demonstrated that exercise interventions consisting individually of jogging, horseback riding, martial arts, swimming or yoga/dance can result in improvements to numerous behavioural outcomes including stereotypic behaviours, social-emotional functioning, cognition and attention. Horseback riding and martial arts interventions may produce the greatest results with moderate to large effect sizes, respectively. Future research with well-controlled designs, standardized assessments, larger sample sizes and longitudinal follow-ups is necessary, in addition to a greater focus on early childhood (aged 0-5 years) and adolescence (aged 12-16 years), to better understand the extent of the behavioural benefits that exercise may provide these populations. © The Author(s) 2016. AU - Bremer, E. AU - Crozier, M. AU - Lloyd, M. DA - 2016-1-1 IS - 8 KW - Autistic Disorder Only Child Treatment Outcome Humans Exercise Therapy Child Behavior Child Autism Spectrum Disorder Adolescent Behavior Adolescent psychology procedures kinesiotherapy autism yoga treatment duration therapy effect systematic review swimming stereotypy standardization social interaction sample size Review priority journal outcome assessment martial art longitudinal study juvenile jogging intelligence quotient human horseback riding follow up evidence based medicine emotionality effect size dance therapy communication skill cognition childhood attention adolescence youth stereotypic behaviour social-emotional functioning intervention exercise children PY - 2016 SN - --- - 1362-3613 - 1461-7005 SP - 899-915 ST - A systematic review of the behavioural outcomes following exercise interventions for children and youth with autism spectrum disorder T2 - Autism TI - A systematic review of the behavioural outcomes following exercise interventions for children and youth with autism spectrum disorder VL - 20 ID - 34 ER - TY - JOUR AB - Background: There is a significant worldwide increase in type 2 diabetes mellitus and gestational diabetes (T2DM/GDM) linked to a range of associated comorbidities and rising healthcare costs. It has been shown that an increase in physical activity, healthy nutrition, and weight loss may prevent or delay T2DM/GDM manifestation. Despite this, it remains a key challenge to reach various populations, in particular so-called vulnerable groups, mostly with a migration background and/or low socio-economic status. Methods/design: We will conduct a scoping review to identify barriers and facilitating factors in the prevention of T2DM/GDM in vulnerable groups. An electronic literature search will be performed in MEDLINE, EMBASE, PsycINFO, PSYNDEX, Social Science Citation Index, and CINAHL. Two reviewers will independently select studies for inclusion. Extracted data will be charted, categorized, and summarized. Discussion: The results will be used to inform the National education and communication strategy on diabetes mellitus in Germany. In particular, the results will be discussed in focus groups of experts to develop recommendations for developing preventive measures targeting vulnerable groups. Systematic review registration: PROSPERO does not register scoping reviews. © 2018 The Author(s). AD - Institute for Research in Operative Medicine (IFOM), Faculty of Health, Department of Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, Building 38, Cologne, 51109, Germany Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, Cologne, 50933, Germany AU - Breuing, J. AU - Pieper, D. AU - Neuhaus, A. L. AU - Heß, S. AU - Lütkemeier, L. AU - Haas, F. AU - Spiller, M. AU - Graf, C. C2 - 30580761 C7 - 245 DB - Scopus DO - 10.1186/s13643-018-0919-y IS - 1 KW - Barriers and facilitating factors Diabetes mellitus type 2 Prevention Vulnerable groups body weight loss comorbidity data analysis data extraction health care health care cost health promotion human information processing mental disease mortality non insulin dependent diabetes mellitus nutrition outcome assessment physical activity pregnancy diabetes mellitus priority journal Review risk factor social status female Germany migration poverty pregnancy vulnerable population Diabetes Mellitus, Type 2 Diabetes, Gestational Humans Transients and Migrants Vulnerable Populations LA - English M3 - Review PY - 2018 ST - Barriers and facilitating factors in the prevention of diabetes type II and gestational diabetes in vulnerable groups: Protocol for a scoping review T2 - Systematic Reviews TI - Barriers and facilitating factors in the prevention of diabetes type II and gestational diabetes in vulnerable groups: Protocol for a scoping review VL - 7 ID - 362 ER - TY - JOUR AB - Objective The purpose of this systematic review was to determine the effectiveness of exercise for the management of soft tissue injuries of the hip, thigh, and knee. Methods We conducted a systematic review and searched MEDLINE, EMBASE, PsycINFO, the Cochrane Central Register of Controlled Trials, and CINAHL Plus with Full Text from January 1, 1990, to April 8, 2015, for randomized controlled trials (RCTs), cohort studies, and case-control studies evaluating the effect of exercise on pain intensity, self-rated recovery, functional recovery, health-related quality of life, psychological outcomes, and adverse events. Random pairs of independent reviewers screened titles and abstracts and assessed risk of bias using the Scottish Intercollegiate Guidelines Network criteria. Best evidence synthesis methodology was used. Results We screened 9494 citations. Eight RCTs were critically appraised, and 3 had low risk of bias and were included in our synthesis. One RCT found statistically significant improvements in pain and function favoring clinic-based progressive combined exercises over a "wait and see" approach for patellofemoral pain syndrome. A second RCT suggests that supervised closed kinetic chain exercises may lead to greater symptom improvement than open chain exercises for patellofemoral pain syndrome. One RCT suggests that clinic-based group exercises may be more effective than multimodal physiotherapy in male athletes with persistent groin pain. Conclusion We found limited high-quality evidence to support the use of exercise for the management of soft tissue injuries of the lower extremity. The evidence suggests that clinic-based exercise programs may benefit patients with patellofemoral pain syndrome and persistent groin pain. Further high-quality research is needed. © 2016 National University of Health Sciences. AU - Brown, C. K. AU - Southerst, D. AU - Côté, P. AU - Shearer, H. M. AU - Randhawa, K. AU - Wong, J. J. AU - Yu, H. AU - Varatharajan, S. AU - Sutton, D. AU - Stern, P. J. AU - D'Angelo, K. AU - Dion, S. AU - Cox, J. AU - Goldgrub, R. AU - Stupar, M. AU - Carroll, L. J. AU - Taylor-Vaisey, A. DA - 2016-1-1 IS - 2 KW - Physical Therapy Modalities Case-Control Studies Soft Tissue Injuries Recovery of Function Lower Extremity Joints Humans Exercise Therapy lower limb joint injuries convalescence traffic accident thigh systematic review symptom sprain soft tissue injury randomized controlled trial (topic) physiotherapy patellofemoral pain syndrome outcome assessment knee injury kinesiotherapy inguinal region human hip injury closed kinetic chain exercise clinical effectiveness athlete Article Thigh Pain Knee Injuries Knee Hip Injuries Hip Exercise PY - 2016 SN - 0161-4754 DO - http://dx.doi.org/10.1016/j.jmpt.2012.01.001 SP - 110-120.e1 ST - The Effectiveness of Exercise on Recovery and Clinical Outcomes in Patients with Soft Tissue Injuries of the Hip, Thigh, or Knee: A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration T2 - Journal of Manipulative and Physiological Therapeutics TI - The Effectiveness of Exercise on Recovery and Clinical Outcomes in Patients with Soft Tissue Injuries of the Hip, Thigh, or Knee: A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration VL - 39 ID - 185 ER - TY - JOUR AB - Introduction As legislation addressing medical treatments continues to evolve, there are several circumstances (eg, abortion, assisted dying) in which health practitioners may choose to not provide legally available care options. It is not always clear what underlies practitioner choice, as some research has suggested non-participation in care provision is not always due to an ethical abstention but may represent other factors. This results in tension between a practitioner's right to refrain from practices deemed morally objectionable by the practitioner, and the care recipient's right to access legally available treatments. The aim of this systematic scoping review is to identify the current knowledge regarding all the factors influencing practitioner's choices when declining involvement in legally available healthcare options. Methods and analysis Arksey and O'Malley's scoping framework in concert with Levac et al's enhancements will guide the systematic scoping review methodological processes. English language documents from 1 January 1998 to current will be sought using Medline, CINAHL, JSTOR, EMBASE, ProQuest Dissertations and Theses Global, PsychINFO and Sociological Abstracts. MeSH headings, keywords and synonyms will be adjusted using an iterative search process. Theses and dissertations will be included in the search protocol; however, other grey literature will be accessed only as required. Two research team members will screen the abstracts and full articles against inclusion criteria. Article information will be extracted via a data collection tool and undergo thematic analysis. Descriptive summary (visual summary and study contextual information) and a presentation of analytical themes will align findings back to the research question. Ethics and dissemination Ethics approval is not required. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist will be used to support transparency and guide translation of findings. Findings will be disseminated through professional networks, in peer-reviewed journals and conferences via abstract and presentation. © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. AD - Faculty of Nursing, University of Regina, Saskatoon, SK, Canada Health Sciences Graduate Program, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada Departments of Respirology, Critical Care and Sleep Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada Departments of Community Health and Epidemiology and Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada Nursing Liaison Librarian, University of Regina Library, Saskatoon, SK, Canada AU - Brown, J. AU - Goodridge, D. AU - Thorpe, L. AU - Chipanshi, M. C2 - 30121617 C7 - e023901 DB - Scopus DO - 10.1136/bmjopen-2018-023901 IS - 8 KW - abstention choice conscientious objection medical ethics non-participation refusal to treat adult article checklist Cinahl Embase English (language) female human human experiment male Medical Subject Headings Medline patient abandonment PsycINFO recipient scientific literature systematic review tension thematic analysis decision making physician psychology Choice Behavior Conscientious Refusal to Treat Humans Physicians LA - English M3 - Article PY - 2018 ST - Factors contributing to practitioner choice when declining involvement in legally available care: A scoping protocol T2 - BMJ Open TI - Factors contributing to practitioner choice when declining involvement in legally available care: A scoping protocol VL - 8 ID - 363 ER - TY - JOUR AB - Background: Cancer survivors face a range of negative physical and psychological effects that can be mitigated by participating in physical activity. Despite this, most do not meet recommended levels. Health care providers may be in a unique position to promote participation in physical activity among cancer survivors. The aim of this systematic review and meta-analysis is to synthesize the findings from randomized controlled trials and controlled clinical trials investigating the effectiveness of health care provider-administered physical activity recommendations on participation in physical activity among cancer survivors. Methods/design: Ten electronic databases (CINAHL, CENTRAL, Education Source, EMBASE, LILACS, MEDLINE, OTSeeker, PEDro, PsycINFO, SPORTDiscus) will be searched to identify relevant studies. The electronic searches will be supplemented by scanning the reference lists of relevant articles retrieved during these searches to ensure all potentially relevant studies are identified. Two reviewers will independently screen all titles and abstracts resulting from the searches to identify potentially eligible studies. They will then screen the full-text articles passing the first screen to identify studies for inclusion using predetermined inclusion/exclusion criteria, extract data from studies meeting all criteria, and assess the risk of bias of these studies. Results will be summarized narratively and statistically. Discussion: By summarizing the best available evidence for the effectiveness of health care provider physical activity recommendations for increasing participation in physical activity among cancer survivors, the results of this systematic review and meta-analysis will help determine if making physical activity recommendations effectively changes cancer survivors behaviour. It will also help to identify knowledge gaps and highlight areas in need of additional research. © 2017 The Author(s). AU - Brunet, J. AU - Wurz, A. AU - O'Rielly, C. AU - Howell, D. AU - Bélanger, M. AU - Sussman, J. DA - 2017-1-1 IS - 1 KW - Motor Activity Survivors Review Literature as Topic Neoplasms Meta-Analysis as Topic Humans Exercise Therapy survivor statistics and numerical data standards psychology neoplasm meta analysis (topic) literature kinesiotherapy systematic review randomized controlled trial (topic) priority journal physical activity meta analysis human health care clinical outcome cancer survivor cancer diagnosis behavior change Article Health care providers Cancer Behaviour change PY - 2017 SN - 2046-4053 ST - The effectiveness of health care provider physical activity recommendations in cancer survivors: A systematic review and meta-analysis protocol T2 - Systematic Reviews TI - The effectiveness of health care provider physical activity recommendations in cancer survivors: A systematic review and meta-analysis protocol VL - 6 ID - 98 ER - TY - JOUR AB - Purpose Invasive bedside procedures are core competencies for internal medicine, yet no formal training guidelines exist. The authors conducted a scoping review and realist synthesis to characterize current training for lumbar puncture, arthrocentesis, paracentesis, thoracentesis, and central venous catheterization. They aimed to collate how educators justify using specific interventions, establish which interventions have the best evidence, and offer directions for future research and training. Method The authors systematically searched Medline, Embase, the Cochrane Library, and ERIC through April 2015. Studies were screened in three phases; all reviews were performed independently and in duplicate. The authors extracted information on learner and patient demographics, study design and methodological quality, and details of training interventions and measured outcomes. A three-step realist synthesis was performed to synthesize findings on each study’s context, mechanism, and outcome, and to identify a foundational training model. Results From an initial 6,671 studies, 149 studies were further reduced to 67 (45%) reporting sufficient information for realist synthesis. Analysis yielded four types of procedural skills training interventions. There was relative consistency across contexts and significant differences in mechanisms and outcomes across the four intervention types. The medical procedural service was identified as an adaptable foundational training model. Conclusions The observed heterogeneity in procedural skills training implies that programs are not consistently developing residents who are competent in core procedures. The findings suggest that researchers in education and quality improvement will need to collaborate to design training that develops a “competent core” of proceduralists using simulation and clinical rotations. Copyright © 2017 by the Association of American Medical Colleges AU - Brydges, R. AU - Stroud, L. AU - Wong, B. M. AU - Holmboe, E. S. AU - Imrie, K. AU - Hatala, R. DA - 2017-1-1 IS - 11 KW - Thoracentesis Spinal Puncture Paracentesis Internal Medicine Humans Clinical Competence Catheterization, Central Venous Arthrocentesis thoracocentesis lumbar puncture human education central venous catheterization PY - 2017 SN - 1040-2446 SP - 1632-1643 ST - Core competencies or a competent core? A scoping review and realist synthesis of invasive bedside procedural skills training in internal medicine T2 - Academic Medicine TI - Core competencies or a competent core? A scoping review and realist synthesis of invasive bedside procedural skills training in internal medicine VL - 92 ID - 165 ER - TY - JOUR AB - This is the protocol for a review and there is no abstract. The objectives are as follows: Our primary objective is to assess the effects of pharmacological interventions on the duration of delirium in critically ill patients with confirmed or documented high risk of delirium. Our secondary objectives are to assess: 1) the effects of pharmacological interventions on delirium-free and coma-free days, relapse, duration of mechanical ventilation, ICU and hospital length of stay, mortality, long-term outcomes (e.g. cognitive, discharge disposition, health-related quality of life); and 2) the safety of such delirium treatments in critically ill patients. © 2015 The Cochrane Collaboration. AU - Burry, L. AU - Mehta, S. AU - Williamson, D. R. AU - Hutton, B. AU - Ely, E. W. AU - Adhikari, N. K. J. AU - Egerod, I. AU - Fergusson, D. A. AU - Rose, L. DA - 2015-1-1 IS - 6 KW - Ventilators, Mechanical Length of Stay Delirium Critical Illness treatment duration systematic review (topic) relapse randomized controlled trial (topic) quality of life priority journal pharmaceutical care noise reduction music therapy mortality mobilization intensive care unit human hospital discharge high risk population drug safety drug efficacy disease duration critically ill patient cognition clinical protocol artificial ventilation Article aged adult propofol opiate neuroleptic agent melatonin ketamine cholinesterase inhibitor benzodiazepine derivative atypical antipsychotic agent antidepressant agent alpha 2 adrenergic receptor stimulating agent PY - 2015 ST - Pharmacological interventions for the treatment of delirium in critically ill patients T2 - Cochrane Database of Systematic Reviews TI - Pharmacological interventions for the treatment of delirium in critically ill patients VL - 2015 ID - 205 ER - TY - JOUR AB - Background: Delirium is characterized by acute changes in mental status including inattention, disorganized thinking, and altered level of consciousness, and is highly prevalent in critically ill adults. Delirium has adverse consequences for both patients and the healthcare system; however, at this time, no effective treatment exists. The identification of effective prevention strategies is therefore a clinical and research imperative. An important limitation of previous reviews of delirium prevention is that interventions were considered in isolation and only direct evidence was used. Our systematic review will synthesize all existing data using network meta-analysis, a powerful statistical approach that enables synthesis of both direct and indirect evidence. Methods: We will search Ovid MEDLINE, CINAHL, Embase, PsycINFO, and Web of Science from 1980 to March 2016. We will search the PROSPERO registry for protocols and the Cochrane Library for published systematic reviews. We will examine reference lists of pertinent reviews and search grey literature and the International Clinical Trials Registry Platform for unpublished studies and ongoing trials. We will include randomized and quasi-randomized trials of critically ill adults evaluating any pharmacological, non-pharmacological, or multi-component intervention for delirium prevention, administered in or prior to (i.e., peri-operatively) transfer to the ICU. Two authors will independently screen search results and extract data from eligible studies. Risk of bias assessments will be completed on all included studies. To inform our network meta-analysis, we will first conduct conventional pair-wise meta-analyses for primary and secondary outcomes using random-effects models. We will generate our network meta-analysis using a Bayesian framework, assuming a common heterogeneity parameter across all comparisons, and accounting for correlations in multi-arm studies. We will perform analyses using WinBUGS software. Discussion: This systematic review will address the existing knowledge gap regarding best practices for delirium prevention in critically ill adults by synthesizing evidence from trials of pharmacological, non-pharmacological, and multi-component interventions administered in or prior to transfer to the ICU. Use of network meta-analysis will clarify which delirium prevention strategies are most effective in improving clinical outcomes while causing least harm. The network meta-analysis is a novel approach and will provide knowledge users and decision makers with comparisons of multiple interventions of delirium prevention strategies. Systematic review registration: PROSPERO CRD42016036313 � 2016 The Author(s). AU - Burry, L. D. AU - Hutton, B. AU - Guenette, M. AU - Williamson, D. AU - Mehta, S. AU - Egerod, I. AU - Kanji, S. AU - Adhikari, N. K. AU - Moher, D. AU - Martin, C. M. AU - Rose, L. DA - 2016-1-1 IS - 1 KW - Registries Treatment Outcome Network Meta-Analysis Intensive Care Units Humans Delirium Critical Illness psychology systematic review sensitivity analysis quality of life assessment priority journal outcome assessment mortality meta analysis length of stay knowledge intervention study intensive care unit incidence human genetic heterogeneity drug mechanism demography conceptual framework clinical protocol clinical decision making artificial ventilation Article propofol neuroleptic agent midazolam melatonin cholinesterase inhibitor benzodiazepine alpha 2 adrenergic receptor stimulating agent Prevention PY - 2016 SN - 2046-4053 ST - Comparison of pharmacological and non-pharmacological interventions to prevent delirium in critically ill patients: A protocol for a systematic review incorporating network meta-analyses T2 - Systematic Reviews TI - Comparison of pharmacological and non-pharmacological interventions to prevent delirium in critically ill patients: A protocol for a systematic review incorporating network meta-analyses VL - 5 ID - 120 ER - TY - JOUR AB - Background: Evidence-based practice (EBP) gaps are widespread across health disciplines. Understanding factors supporting the uptake of evidence can inform the design of strategies to narrow these EBP gaps. Although research utilization (RU) and the factors associated with EBP have been reported in several health disciplines, to date this area has not been reviewed comprehensively in the chiropractic profession. The purpose of this review was to report on the current state of knowledge on EBP, RU, and knowledge translation (KT) in chiropractic. Methods: A scoping review using the Arksey and O'Malley framework was used to systematically select and summarize existing literature. Searches were conducted using a combination of keywords and MeSH terms from the earliest date available in each database to May 2015. Quantitative and thematic analyses of the selected literature were conducted. Results: Nearly 85 % (56/67) of the included studies were conducted in Canada, USA, UK or Australia. Thematic analysis for the three categories (EBP, RU, KT) revealed two themes related to EBP (attitudes and beliefs of chiropractors; implementation of EBP), three related to RU (guideline adherence; frequency and sources of information accessed; and perceived value of websites and search engines), and three related to KT (knowledge practice gaps; barriers and facilitators to knowledge use; and selection, tailoring, and implementation of interventions). EBP gaps were noted in the areas of assessment of activity limitation, determination of psychosocial factors influencing pain, general health indicators, establishing a prognosis, and exercise prescription. While most practitioners believed EBP and research to be important and a few studies suggested that traditional and online educational strategies could improve patient care, use of EBP and guideline adherence varied widely. Conclusion: Findings suggest that the majority of chiropractors hold favourable attitudes and beliefs toward EBP. However, much remains to be done for chiropractors to routinely apply evidence into clinical practice. Educational strategies aimed at practicing chiropractors can lead to more EBP and improved patient care. The chiropractic profession requires more robust dissemination and implementation research to improve guideline adherence and patient health outcomes. © 2016 The Author(s). AU - Bussières, A. E. AU - Al Zoubi, F. AU - Stuber, K. AU - French, S. D. AU - Boruff, J. AU - Corrigan, J. AU - Thomas, A. DA - 2016-1-1 IS - 1 KW - Guideline Adherence Translational Medical Research Manipulation, Chiropractic Humans Evidence-Based Practice translational research chiropractic manipulation research utilization protocol compliance professional knowledge practice guideline philosophy patient care methodology knowledge translation human health personnel attitude evidence based practice data analysis conceptual framework chiropractic Article Scoping review PY - 2016 ST - Evidence-based practice, research utilization, and knowledge translation in chiropractic: A scoping review T2 - BMC Complementary and Alternative Medicine TI - Evidence-based practice, research utilization, and knowledge translation in chiropractic: A scoping review VL - 16 ID - 176 ER - TY - JOUR AB - This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To evaluate the benefits and harms of immediate-release methylphenidate compared with placebo or other pharmacological interventions for treating attention deficit hyperactivity disorder (ADHD) in adults. © 2018 The Cochrane Collaboration. AD - Universidade Federal de Minas Gerais (UFMG), Faculty of Pharmacy, Rua Moacyr Froes, 39 - apto 304/ Bl 7, Belo Horizonte, Minas Gerais Country, 31515-215, Brazil University of York, Department of Health Sciences, York, YO10 5DD, United Kingdom Faculty of Pharmacy, Universidade Federal de Minas Gerais (UFMG), Centro de Estudos do Medicamento (Cemed), Department of Social Pharmacy, Av Antonia Carlos 6627-sala 1050-B2-Campus Pampulha, Belo Horizonte, Minas Gerais(MG), 31270-901, Brazil University of Alberta, Faculty of Medicine and Dentistry, 8215 112 St NW, Suite #1702, College Plaza, Edmonton, AB T6G 2C8, Canada AU - Cândido, R. C. F. AU - Golder, S. AU - Menezes de Padua, C. A. AU - Perini, E. AU - Junqueira, D. R. C7 - Cd013011 DB - Scopus DO - 10.1002/14651858.CD013011 IS - 4 KW - methylphenidate placebo adult adverse outcome Article attention deficit disorder case study clinical outcome clinical protocol drug efficacy drug formulation drug release drug safety human mental disease meta analysis outcome assessment parallel design priority journal risk benefit analysis side effect standardization symptom systematic review treatment duration treatment response LA - English M3 - Article PY - 2018 ST - Immediate-release methylphenidate for attention deficit hyperactivity disorder (ADHD) in adults T2 - Cochrane Database of Systematic Reviews TI - Immediate-release methylphenidate for attention deficit hyperactivity disorder (ADHD) in adults VL - 2018 ID - 364 ER - TY - JOUR AB - Introduction Finding cost-effective strategies to improve patient care in the emergency department (ED) is an increasing imperative given growing numbers of ED attendees. Encouraging evidence indicates that interdisciplinary teams including health and social care professionals (HSCPs) enhance patient care across a variety of healthcare settings. However, to date no systematic reviews of the effectiveness of early assessment and/or interventions carried by such teams in the ED exist. This systematic review aims to explore the impact of early assessment and/or intervention carried out by interdisciplinary teams including HSCPs in the ED on the quality, safety and cost-effectiveness of care, and to define the content of the assessment and/or intervention offered by HSCPs. Methods and analysis Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standardised guidelines, we will conduct a systematic review of randomised controlled trials (RCTs), non-RCTs, controlled before-after studies, interrupted time series and repeated measures studies that report the impact of early assessment and/or intervention provided to adults aged 18+ by interdisciplinary teams including HSCPs in the ED. Searches will be carried in Cumulative Index of Nursing and Allied Health Literature, Embase, Cochrane Library and MEDLINE from inception to March 2018. We will also hand-search the reference lists of relevant studies. Following a two-step screening process, two independent reviewers will extract data on the type of population, intervention, comparison, outcomes and study design. The quality of the studies will be appraised using the Cochrane Risk of Bias Tool. The findings will be synthesised in a narrative summary, and a meta-analysis will be conducted where appropriate. Ethics and dissemination Ethical approval will not be sought since it is not required for systematic reviews. The results of this review will be disseminated through publication in a peer-review journal and presented at relevant conferences. Trial registration number CRD42018091794. © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. AU - Cassarino, M. AU - Robinson, K. AU - Quinn, R. AU - Naddy, B. AU - O'Regan, A. AU - Ryan, D. AU - Boland, F. AU - Ward, M. E. AU - McNamara, R. AU - McCarthy, G. AU - Galvin, R. DA - 2018-1-1 %J BMJ Open IS - 7 KW - Emergency Service, Hospital Cost-Benefit Analysis PY - 2018 SN - 2044-6055 ST - Effectiveness of early assessment and intervention by interdisciplinary teams including health and social care professionals in the emergency department: Protocol for a systematic review T2 - BMJ Open TI - Effectiveness of early assessment and intervention by interdisciplinary teams including health and social care professionals in the emergency department: Protocol for a systematic review VL - 8 ID - 276 ER - TY - JOUR AB - Background Our aim was to assess the effect of adjuvant radiotherapy on recurrence and survival for elderly women (≥70) with early-stage hormone receptor-positive breast cancer treated with breast conserving surgery (BCS) and Tamoxifen. Materials and methods MEDLINE, EMBASE, and Evidence-Based Medicine Reviews were systematically searched through August 12, 2016 for randomized controlled trials (RCTs) comparing radiotherapy to no radiotherapy and presenting outcomes for women ≥70 years. Two investigators screened citations, abstracted results, and appraised studies using Cochrane Risk of Bias tool. Pooled risk ratios (RR) for breast, axillary, and distant recurrence, and overall survival were determined using weights from fixed-effects models. Results Four RCTs with low risk of bias were identified (2387 elderly women). Tamoxifen plus radiotherapy reduced breast recurrence compared to Tamoxifen alone from 60 to 10 (95% CI 6–20) per 1000 patients at 5 years (RR 0.18, 95% CI 0.10–0.34; 4 trials, 2387 patients). This effect was maintained at 10 years (RR 0.27, 95% CI 0.13–0.54; 2 trials, 891 patients). Radiotherapy minimally reduced axillary recurrence from 12 to 3 (95% CI 1–10) per 1000 at 5 years (RR 0.28, 95% CI 0.10–0.81; 3 trials, 2287 patients). Radiotherapy did not affect distant recurrence (RR 1.49, 95% CI 0.87–2.54; 3 trials, 2287 patients) or overall survival (RR 0.98, 95% CI 0.79–1.22; 3 trials, 2287 patients). Conclusion For elderly women (≥70), radiotherapy reduces the risk of breast and axillary recurrence, but does not impact distant recurrence or overall survival in early-stage breast cancer treated with BCS and Tamoxifen. The value of this risk reduction must be weighed by women and their physicians when considering the omission of adjuvant radiotherapy. © 2017 Elsevier B.V. AU - Chesney, T. R. AU - Yin, J. X. AU - Rajaee, N. AU - Tricco, A. C. AU - Fyles, A. W. AU - Acuna, S. A. AU - Scheer, A. S. DA - 2017-1-1 IS - 1 KW - Bias (Epidemiology) Evidence-Based Medicine Treatment Outcome Tamoxifen Radiotherapy, Adjuvant Mastectomy, Segmental Humans Female Breast Neoplasms Axilla Antineoplastic Agents, Hormonal Aged procedures systematic review risk reduction Review randomized controlled trial (topic) priority journal partial mastectomy overall survival outcome assessment meta analysis Medline human evidence based medicine Embase early cancer cancer survival cancer risk cancer recurrence cancer radiotherapy breast cancer adjuvant radiotherapy antineoplastic hormone agonists and antagonists Senior Radiotherapy Geriatric Endocrine therapy Elderly PY - 2017 SP - 1-9 ST - Tamoxifen with radiotherapy compared with Tamoxifen alone in elderly women with early-stage breast cancer treated with breast conserving surgery: A systematic review and meta-analysis T2 - Radiotherapy and Oncology TI - Tamoxifen with radiotherapy compared with Tamoxifen alone in elderly women with early-stage breast cancer treated with breast conserving surgery: A systematic review and meta-analysis VL - 123 ID - 153 ER - TY - JOUR AB - BACKGROUND: Integrating evidence from randomized controlled trials (RCTs) into patient care is needed to optimize patient outcomes. Transfusion support during allogeneic hematopoietic cell transplantation (alloHCT) is a cornerstone of essential supportive care, yet optimal transfusion practices remain unclear. STUDY DESIGN AND METHODS: A scoping review of RCTs in alloHCT was conducted and 14 full-length articles on transfusion practice were identified that reported clinical outcomes after alloHCT. RESULTS: Eight RCTs compared various interventions related to platelet (PLT) transfusion, addressing product storage duration, dosage, and threshold for transfusion. Restrictive prophylactic PLT transfusion strategies were successful at reducing PLT consumption without impacting clinical outcomes. One study, however, reported increased bleeding associated with a strategy whereby patients did not receive prophylactic PLT transfusions. One study of thrombopoietin was associated with reduced PLT transfusion events but no difference in clinical outcomes compared to placebo. Six RCTs examined the utility of recombinant erythropoietin (EPO) in reducing red blood cell (RBC) transfusion dependence. Four trials reported an increase in hemoglobin levels while five studies demonstrated a reduction in RBC utilization; however, clinical outcomes were variably reported and no differences were identified. There were no RCTs examining RBC transfusion strategies, plasma transfusion, or plasma-derived protein administration. CONCLUSION: Prophylactic PLT transfusion when PLTs are fewer than 10 × 109/L can prevent bleeding and is consistent with recent guidelines. Thrombopoietin and EPO can reduce transfusion requirements; however, potential safety concerns remain and the lack of improvement in clinical outcomes and high cost may limit use. Additional RCTs are needed, particularly with regard to RBC transfusion thresholds, to refine best practices after alloHCT. © 2016 AABB AU - Christou, G. AU - Iyengar, A. AU - Shorr, R. AU - Tinmouth, A. AU - Saidenberg, E. AU - Maze, D. AU - Tay, J. AU - Bredeson, C. AU - Allan, D. S. DA - 2016-1-1 IS - 10 KW - Hemoglobin A, Glycosylated Treatment Outcome Transplantation, Homologous Thrombopoietin Randomized Controlled Trials as Topic Pre-Exposure Prophylaxis Platelet Transfusion Humans Hemorrhage Hematopoietic Stem Cell Transplantation Erythropoietin utilization procedures allotransplantation thrombocyte transfusion Review randomized controlled trial (topic) priority journal human graft versus host reaction bleeding allogeneic stem cell transplantation allogeneic hematopoietic cell transplantation recombinant erythropoietin hemoglobin PY - 2016 SN - 0041-1132 SP - 2607-2614 ST - Optimal transfusion practices after allogeneic hematopoietic cell transplantation: a systematic scoping review of evidence from randomized controlled trials T2 - Transfusion TI - Optimal transfusion practices after allogeneic hematopoietic cell transplantation: a systematic scoping review of evidence from randomized controlled trials VL - 56 ID - 172 ER - TY - JOUR AB - Background: Recent reviews have synthesised the psychometric properties of measures developed to examine implementation science constructs in healthcare and mental health settings. However, no reviews have focussed primarily on the properties of measures developed to assess innovations in public health and community settings. This review identified quantitative measures developed in public health and community settings, examined their psychometric properties, and described how the domains of each measure align with the five domains and 37 constructs of the Consolidated Framework for Implementation Research (CFIR). Methods: MEDLINE, PsycINFO, EMBASE, and CINAHL were searched to identify publications describing the development of measures to assess implementation science constructs in public health and community settings. The psychometric properties of each measure were assessed against recommended criteria for validity (face/content, construct, criterion), reliability (internal consistency, test-retest), responsiveness, acceptability, feasibility, and revalidation and cross-cultural adaptation. Relevant domains were mapped against implementation constructs defined by the CFIR. Results: Fifty-one measures met the inclusion criteria. The majority of these were developed in schools, universities, or colleges and other workplaces or organisations. Overall, most measures did not adequately assess or report psychometric properties. Forty-six percent of measures using exploratory factor analysis reported >50 % of variance was explained by the final model; none of the measures assessed using confirmatory factor analysis reported root mean square error of approximation (<0.06) or comparative fit index (>0.95). Fifty percent of measures reported Cronbach's alpha of <0.70 for at least one domain; 6 % adequately assessed test-retest reliability; 16 % of measures adequately assessed criterion validity (i.e. known-groups); 2 % adequately assessed convergent validity (r > 0.40). Twenty-five percent of measures reported revalidation or cross-cultural validation. The CFIR constructs most frequently assessed by the included measures were relative advantage, available resources, knowledge and beliefs, complexity, implementation climate, and other personal resources (assessed by more than ten measures). Five CFIR constructs were not addressed by any measure. Conclusions: This review highlights gaps in the range of implementation constructs that are assessed by existing measures developed for use in public health and community settings. Moreover, measures with robust psychometric properties are lacking. Without rigorous tools, the factors associated with the successful implementation of innovations in these settings will remain unknown � 2016 The Author(s). AU - Clinton-McHarg, T. AU - Yoong, S. L. AU - Tzelepis, F. AU - Regan, T. AU - Fielding, A. AU - Skelton, E. AU - Kingsland, M. AU - Ooi, J. Y. AU - Wolfenden, L. DA - 2016-1-1 IS - 1 KW - Translational Medical Research Surveys and Questionnaires Reproducibility of Results Public Health Psychometrics Humans Feasibility Studies Diffusion of Innovation Community Health Services Clinical Coding translational research standards reproducibility questionnaire psychometry procedures mass communication community care coding workplace validation process university test retest reliability systematic review publication PsycINFO organization model Medline internal consistency instrument validation human feasibility study exploratory factor analysis Embase Cronbach alpha coefficient convergent validity confirmatory factor analysis climate Cinahl Psychometric Measure Implementation research Factor analysis PY - 2016 SN - 1748-5908 ST - Psychometric properties of implementation measures for public health and community settings and mapping of constructs against the Consolidated Framework for Implementation Research: A systematic review T2 - Implementation Science TI - Psychometric properties of implementation measures for public health and community settings and mapping of constructs against the Consolidated Framework for Implementation Research: A systematic review VL - 11 ID - 168 ER - TY - JOUR AB - Background: There is no standardized definition of what a predatory journal is, nor have the characteristics of these journals been delineated or agreed upon. In order to study the phenomenon precisely a definition of predatory journals is needed. The objective of this scoping review is to summarize the literature on predatory journals, describe its epidemiological characteristics, and to extract empirical descriptions of potential characteristics of predatory journals. Methods: We searched five bibliographic databases: Ovid MEDLINE, Embase Classic + Embase, ERIC, and PsycINFO, and Web of Science on January 2 nd, 2018. A related grey literature search was conducted March 27 th, 2018. Eligible studies were those published in English after 2012 that discuss predatory journals. Titles and abstracts of records obtained were screened. We extracted epidemiological characteristics from all search records discussing predatory journals. Subsequently, we extracted statements from the empirical studies describing empirically derived characteristics of predatory journals. These characteristics were then categorized and thematically grouped. Results: 920 records were obtained from the search. 344 of these records met our inclusion criteria. The majority of these records took the form of commentaries, viewpoints, letters, or editorials (78.44%), and just 38 records were empirical studies that reported empirically derived characteristics of predatory journals. We extracted 109 unique characteristics from these 38 studies, which we subsequently thematically grouped into six categories: journal operations, article, editorial and peer review, communication, article processing charges, and dissemination, indexing and archiving, and five descriptors. Conclusions: This work identified a corpus of potential characteristics of predatory journals. Limitations of the work include our restriction to English language articles, and the fact that the methodological quality of articles included in our extraction was not assessed. These results will be provided to attendees at a stakeholder meeting seeking to develop a standardized definition for what constitutes a predatory journal. © 2018 Cobey KD et al. AD - Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, K1H 8L6, Canada School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, K1G 5Z3, Canada Department of Psychology, School of Natural Sciences, University of Stirling, Stirling, FK9 4LA, United Kingdom Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Faculty of Medicine, University of Ottawa, Regenerative Medicine Program, Ottawa Hospital Research Institute, Ottawa, K1H 8L6, Canada Telfer School of Management, University of Ottawa, Ottawa, K1N 6N5, Canada AU - Cobey, K. D. AU - Lalu, M. M. AU - Skidmore, B. AU - Ahmadzai, N. AU - Grudniewicz, A. AU - Moher, D. C2 - 30135732 C7 - 1001 DB - Scopus DO - 10.12688/f1000research.15256.1 KW - Illegitimate journals Open access Peer review Predatory journals Predatory publishers Reporting quality Scholarly publishing article Embase empiricism English (language) extraction human human experiment Medline PsycINFO publishing systematic review Web of Science economics empirical research open access publishing standards Humans LA - English M3 - Article PY - 2018 ST - What is a predatory journal? A scoping review T2 - F1000Research TI - What is a predatory journal? A scoping review VL - 7 ID - 365 ER - TY - JOUR AB - Sedentary time (ST) is an important risk factor for a variety of health outcomes in older adults. Consensus is needed on future research directions so that collaborative and timely efforts can be made globally to address this modifiable risk factor. In this review, we examined current literature to identify gaps and inform future research priorities on ST and healthy ageing. We reviewed three primary topics:(1) the validity/reliability of self-report measurement tools, (2) the consequences of prolonged ST on geriatric-relevant health outcomes (physical function, cognitive function, mental health, incontinence and quality of life) and(3) the effectiveness of interventions to reduce ST in older adults. METHODS: A trained librarian created a search strategy that was peer reviewed for completeness. RESULTS: Self-report assessment of the context and type of ST is important but the tools tend to underestimate total ST. There appears to be an association between ST and geriatric-relevant health outcomes, although there is insufficient longitudinal evidence to determine a dose-response relationship or a threshold for clinically relevant risk. The type of ST may also affect health; some cognitively engaging sedentary behaviours appear to benefit health, while time spent in more passive activities may be detrimental. Short-term feasibility studies of individual-level ST interventions have been conducted; however, few studies have appropriately assessed the impact of these interventions on geriatric-relevant health outcomes, nor have they addressed organisation or environment level changes. Research is specifically needed to inform evidence-based interventions that help maintain functional autonomy among older adults.This consensus statement has been endorsed by the following societies: Academy of Geriatric Physical Therapy, Exercise & Sports Science Australia, Canadian Centre for Activity and Aging, Society of Behavioral Medicine, and the National Centre for Sport and Exercise Medicine. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. AU - Copeland, J. L. AU - Ashe, M. C. AU - Biddle, S. J. AU - Brown, W. J. AU - Buman, M. P. AU - Chastin, S. AU - Gardiner, P. A. AU - Inoue, S. AU - Jefferis, B. J. AU - Oka, K. AU - Owen, N. AU - Sardinha, L. B. AU - Skelton, D. A. AU - Sugiyama, T. AU - Dogra, S. DA - 2017-1-1 IS - 21 KW - Adult Geriatrics Self Report Sedentary Lifestyle Risk Factors Reproducibility of Results Humans Health Status Health Behavior Exercise Aging Aged risk factor reproducibility human sedentary measurement intervention functional aging/ageing PY - 2017 SN - 1473-0480 SP - 1539 ST - Sedentary time in older adults: a critical review of measurement, associations with health, and interventions T2 - British journal of sports medicine TI - Sedentary time in older adults: a critical review of measurement, associations with health, and interventions VL - 51 ID - 32 ER - TY - JOUR AB - CONTEXT AND OBJECTIVE: The age-stratified performance of the oncogenic HPV-DNA (human papillomavirus deoxyribonucleic acid) test for triage of low-grade squamous intraepithelial lesions (LSIL) requires investigation. The objective of this study was to evaluate and compare the age-stratified performance (cutoff point: 35 years) of oncogenic HPV-DNA testing and repeated cytological tests, for detecting cervical intraepithelial neoplasia grade 3 (CIN3), in order to triage for LSIL. DESIGN AND SETTING: Systematic review. Studies were identified in nine electronic databases and in the reference lists of the articles retrieved. METHODS: The eligibility criteria consisted of initial cytological findings of LSIL; subsequent oncogenic HPV-DNA testing and repeated cytological tests; and CIN3 detection. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS) guidelines were used for quality assessment. Qualitative information synthesis was performed. RESULTS: Out of 7,776 studies, 284 were identified as pertinent and three fulfilled the eligibility criteria. The CIN3 prevalence ranged from 6% to 12%. The HPV-DNA positivity rate ranged from 64% to 83%; sensitivity for CIN3 detection ranged from 95.2% to 100%; and specificity was available in two studies (27% and 52%). The sensitivity of repeated cytological tests, in relation to the threshold for atypical squamous cells of undetermined significance (ASCUS), was available in two studies (33% and 90.8%); and specificity was available in one study (53%). CONCLUSIONS: Currently, there is no scientific evidence available that would prove that colposcopic triage using oncogenic HPV-DNA testing to detect CIN3 performs better than repeated cytological tests, among women with LSIL aged 35 years and over. AU - Corrêa, F. M. AU - Russomano, F. B. AU - de Oliveira, C. A. DA - 2012-1-1 IS - 1 KW - DNA, A-Form DNA, B-Form DNA Colposcopes DNA-(Apurinic or Apyrimidinic Site) Lyase DNA (Cytosine-5-)-Methyltransferase Humanism Humanities Uterine Cervical Neoplasms Triage Sensitivity and Specificity Papillomavirus Infections Humans Female DNA Probes, HPV Colposcopy Cervical Intraepithelial Neoplasia Age Factors Adult uterine cervix carcinoma in situ systematic review review Quality Assessment of Diagnostic Accuracy Studies prevalence practice guideline Papilloma virus nonhuman low grade squamous intraepithelial lesion intermethod comparison human health care quality false positive result false negative result emergency health service DNA determination disease classification cytopathology clinical assessment tool age distribution virus DNA HPV sensitivity and specificity Cervical intraepithelial neoplasia triage colposcopy vaginal smears DNA probes PY - 2012 SN - 1516-3180 SP - 44-52 ST - Colposcopic triage methods for detecting cervical intraepithelial neoplasia grade 3 after cytopathological diagnosis of low-grade squamous intraepithelial lesion: A systematic review on diagnostic tests T2 - Sao Paulo Medical Journal TI - Colposcopic triage methods for detecting cervical intraepithelial neoplasia grade 3 after cytopathological diagnosis of low-grade squamous intraepithelial lesion: A systematic review on diagnostic tests VL - 130 ID - 260 ER - TY - JOUR AB - Background: Aerobic exercise reduces blood pressure (BP), but it is unknown whether a high-intensity training approach can elicit a greater BP reduction in populations with elevated BP. This systematic review compared the efficacy of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) for reducing BP in adults with pre- to established hypertension. Methods: Five electronic databases (MEDLINE, EMBASE, CENTRAL, PEDro, and SPORTDiscus) were searched for randomized trials comparing the chronic effects of HIIT versus MICT on BP in individuals with resting systolic BP ≥ 130 mmHg and/or diastolic BP ≥ 85 mmHg and/or under antihypertensive medication. Random-effects modelling was used to compare changes from pre- to post-intervention in resting and ambulatory BP between HIIT and MICT. Changes from pre- to post-intervention in maximal oxygen uptake (V˙ O2max) between HIIT and MICT were also meta-analyzed. Data were reported as weighted mean difference (MD) and 95% confidence interval (CI). Results: Ambulatory BP was excluded from the meta-analysis due to the limited number of studies (two studies). Comparing changes from pre- to post-intervention, no differences in resting systolic BP (MD − 0.22 mmHg [CI 95%, − 5.36 to 4.92], p = 0.93, I2 = 53%) and diastolic BP (MD − 0.38 mmHg [CI 95%, − 3.31 to 2.54], p = 0.74, I2 = 0%) were found between HIIT and MICT (seven studies; 164 participants). HIIT improved V˙ O2max to a greater magnitude than MICT (MD 2.13 ml/kg/min [CI 95%, 1.00 to 3.27], p < 0.01, I2 = 41%) with similar completion rates of the intervention and attendance at the exercise training sessions (nine studies; 245 participants). Limited data were available to compare the incidence of adverse events between HIIT and MICT. Conclusion: HIIT and MICT provided comparable reductions in resting BP in adults with pre- to established hypertension. HIIT was associated with greater improvements in V˙ O2max when compared to MICT. Future randomized trials should investigate the efficacy of HIIT versus MICT for reducing ambulatory BP in adults with pre- to established hypertension. Registration: PROSPERO registration (2016: CRD42016041885). © 2018, Springer International Publishing AG, part of Springer Nature. AD - Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil Health, Leisure & Human Performance Research Institute, Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada Institute of Cardiovascular Sciences, St-Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB, Canada National Institute of Science and Technology for Health Technology Assessment (IATS)-CNPq, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil University of Manitoba Libraries, Winnipeg, MB, Canada AU - Costa, E. C. AU - Hay, J. L. AU - Kehler, D. S. AU - Boreskie, K. F. AU - Arora, R. C. AU - Umpierre, D. AU - Szwajcer, A. AU - Duhamel, T. A. C2 - 29949110 DB - Scopus DO - 10.1007/s40279-018-0944-y IS - 9 KW - adult blood pressure complication energy metabolism high intensity interval training human hypertension oxygen consumption physiology procedures randomized controlled trial (topic) resistance training High-Intensity Interval Training Humans Randomized Controlled Trials as Topic LA - English M3 - Review PY - 2018 SP - 2127-2142 ST - Effects of High-Intensity Interval Training Versus Moderate-Intensity Continuous Training On Blood Pressure in Adults with Pre- to Established Hypertension: A Systematic Review and Meta-Analysis of Randomized Trials T2 - Sports Medicine TI - Effects of High-Intensity Interval Training Versus Moderate-Intensity Continuous Training On Blood Pressure in Adults with Pre- to Established Hypertension: A Systematic Review and Meta-Analysis of Randomized Trials VL - 48 ID - 366 ER - TY - JOUR AB - Background Diabetic neuropathic foot ulcers are a risk factor for lower leg amputation. Many experts recommend offloading with fibreglass total contact casting, removable cast walkers, and irremovable cast walkers as a way to treat these ulcers. Methods We completed a health technology assessment, which included an evaluation of clinical benefits and harms, value for money, and patient preferences for offloading devices. We performed a systematic literature search on August 17, 2016, to identify randomized controlled trials that compared fibreglass total contact casting, removable cast walkers, and irremovable cast walkers with other treatments (offloading or non-offloading) in patients with diabetic neuropathic foot ulcers. We developed a decision-analytic model to assess the cost-effectiveness of fibreglass total contact casting, removable cast walkers, and irremovable cast walkers, and we conducted a 5-year budget impact analysis. Finally, we interviewed people with diabetes who had lived experience with foot ulcers, asking them about the different offloading devices and the factors that influenced their treatment choices. Results We identified 13 randomized controlled trials. The evidence suggests that total contact casting, removable cast walkers, and irremovable cast walkers are beneficial in the treatment of neuropathic, noninfected foot ulcers in patients with diabetes but without severe peripheral arterial disease. Compared to removable cast walkers, ulcer healing was improved with total contact casting (moderate quality evidence; risk difference 0.17 [95% confidence interval 0.00–0.33]) and irremovable cast walkers (low quality evidence; risk difference 0.21 [95% confidence interval 0.01–0.40]). We found no difference in ulcer healing between total contact casting and irremovable cast walkers (low quality evidence; risk difference 0.02 [95% confidence interval −0.11–0.14]). The economic analysis showed that total contact casting and irremovable cast walkers were less expensive and led to more health outcome gains (e.g., ulcers healed and quality-adjusted life-years) than removable cast walkers. Irremovable cast walkers were as effective as total contact casting and were associated with lower costs. The 5-year budget impact of funding total contact casting, removable cast walkers, and irremovable cast walkers (device costs only at 100% access) would be $17 to $20 million per year. The patients we interviewed felt that wound healing was improved with total contact casting than with removable cast walkers, but that removable cast walkers were more convenient and came with a lower cost burden. They reported no experience or familiarity with irremovable cast walkers. Conclusions Ulcer healing improved with total contact casting, irremovable cast walkers, and removable cast walkers, but total contact casting and irremovable cast walkers had higher rates of ulcer healing than removable cast walkers. Increased access to offloading devices could result in cost savings for the health system because of fewer amputations. Patients with diabetic foot ulcers reported a preference for total contact casting over removable cast walkers, largely because they perceived wound healing to be improved with total contact casting. However, cost, comfort, and convenience are concerns for patients. © Queen’s Printer for Ontario, 2017. AU - Costa, Vania AU - Tu, Hong Anh AU - Wells, David AU - Weir, Mark AU - Holubowich, Corinne AU - Walter, Melissa AU - McKane, Jeanne AU - Ali, Arshia AU - Heft, Harrison AU - Soulodre, Claude AU - Laing, Ana AU - Kaulback, Kellee AU - Ng, Vivian AU - Thota, Anil AU - Mitchell, Andrée AU - Sikich, Nancy AU - Dhalla, Irfan DA - 2017-1-1 IS - 12 KW - Biomedical Technology Foot Leg Risk Factors Wound Healing Technology Assessment, Biomedical Amputation walker ulcer healing systematic review skin maceration removable cast walker personal experience orthopedic cast medical device complication medical decision making irremovable cast walker human fibreglass total contact cast falling diabetic neuropathy diabetic foot device infection device failure cost effectiveness analysis cost benefit analysis biomedical technology assessment Article abrasion glass fiber PY - 2017 SN - 1915-7398 SP - 1-124 ST - Fibreglass total contact casting, removable cast walkers, and irremovable cast walkers to treat diabetic neuropathic foot ulcers: A health technology assessment T2 - Ontario Health Technology Assessment Series TI - Fibreglass total contact casting, removable cast walkers, and irremovable cast walkers to treat diabetic neuropathic foot ulcers: A health technology assessment VL - 17 ID - 109 ER - TY - JOUR AB - Background: Transplantation improves survival and the quality of life of patients with end-stage organ failure. Infection, due to surgical issues, host factors such as diabetes, immunosuppression, and hypogammaglobulinemia, is a major post-transplant complication. Clinical outcomes of prophylaxis or treatment of hypogammaglobulinemia in solid organ transplant recipients are not well established and are in need of further study. Methods/design: We will conduct a systematic review of studies investigating clinically relevant outcomes of immunoglobulin use either as prophylaxis or treatment of hypogammaglobulinemia after solid organ transplantation. Both randomized and non-randomized studies (excluding case reports and case series of less than 20 subjects) will be included. Outcomes of interest will include the overall rate of infection, hospital admission, hospital length of stay, intensive care unit admission, 1-year all-cause mortality, incidence of acute organ rejection, allograft survival within 1 year, and adverse events. We will search MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, Transplant library, and the International Clinical Trials Registry Platform for randomized and non-randomized studies on adult solid organ transplant patients who received prophylactic immunoglobulin or immunoglobulin treatment. Two reviewers will conduct all screening and data collection independently. We will assess study level of risk of bias using the Cochrane Risk of Bias Assessment Tool for randomized controlled trials and for non-randomized studies. If meta-analysis of outcome data is deemed appropriate, we will use random effects models to combine data for continuous and dichotomous measures. Discussion: The results of this systematic review may inform guideline development for measuring immunoglobulin level and use of immunoglobulin in solid organ transplant patients and highlight areas for further research. Systematic review registration: PROSPERO CRD42015017620 © 2015 Cowan et al. AU - Cowan, J. AU - Hutton, B. AU - Fergusson, N. AU - Bennett, A. AU - Tay, J. AU - Cameron, D. W. AU - Knoll, G. A. DA - 2015-1-1 IS - 1 KW - Length of Stay Quality of Life Immunoglobulin Variable Region Immunoglobulin E Immunoglobulin A Immunoglobulin M Immunoglobulin D Immunoglobulin G Transplant Recipients Research Design Organ Transplantation Infection Immunosuppression Immunoglobulins Humans Hospitalization Graft Rejection Antibodies, Monoclonal Agammaglobulinemia Adult methodology immunosuppressive treatment graft recipient blood adverse effects systematic review randomized controlled trial (topic) priority journal mortality meta analysis intensive care unit immunoglobulin deficiency human hospital admission graft survival controlled clinical trial (topic) Article monoclonal antibody immunoglobulin Solid organ transplantation Hypogammaglobulinemia PY - 2015 SN - 2046-4053 ST - Clinical outcomes of immunoglobulin use in solid organ transplant recipients: Protocol for a systematic review and meta-analysis T2 - Systematic Reviews TI - Clinical outcomes of immunoglobulin use in solid organ transplant recipients: Protocol for a systematic review and meta-analysis VL - 4 ID - 195 ER - TY - JOUR AB - STUDY DESIGN: Systematic review. BACKGROUND: Little is known about the effectiveness of acupuncture therapies for musculoskeletal disorders. OBJECTIVE: To assess the effectiveness and safety of acupuncture therapies for musculoskeletal disorders of the extremities. METHODS: We searched MEDLINE, Embase, CINAHL, PsycINFO, and Cochrane Central Register of Controlled Trials from 1990 to 2015 for randomized controlled trials, cohort studies, and case-control studies. Eligible studies were appraised with Scottish Intercollegiate Guidelines Network criteria. A best-evidence synthesis was performed to synthesize results from included studies with a low risk of bias. A sensitivity analysis was conducted to determine the impact of excluding studies with a high risk of bias. RESULTS: The search revealed 5180 articles; 15 were included (10 with a low risk of bias, 5 with a high risk of bias). The studies with a low risk of bias suggested that (1) traditional needle acupuncture was superior to oral steroids (1 RCT, n = 77) and may be superior to vitamin B1/B6 supplements (1 RCT, n = 64) for carpal tunnel syndrome (CTS), and was superior to exercise for Achilles tendinopathy (1 RCT, n = 64). Traditional needle acupuncture did not provide important benefit over placebo for upper extremity pain (1 RCT, n = 128), or no intervention for patellofemoral pain (1 RCT, n = 75), and was inconclusive for shoulder pain (2 RCTs, n = 849), suggesting no important benefit; (2) electroacupuncture may be superior to placebo for shoulder injuries (1 RCT, n = 130) and may not be superior to night splinting for persistent CTS (1 RCT, n = 78); and (3) dry needling may be superior to placebo for plantar fasciitis (1 RCT, n = 84). Sensitivity analysis suggests that including studies with a high risk of bias might have impacted the evidence synthesis in support of managing shoulder pain with traditional needle acupuncture, and that would suggest traditional needle acupuncture may be effective for lateral epicondylitis and piriformis syndrome. CONCLUSION: Evidence for the effectiveness of acupuncture for musculoskeletal disorders of the extremities was inconsistent. Traditional needle acupuncture may be beneficial for CTS and Achilles tendinopathy, but not for nonspecific upper extremity pain and patellofemoral syndrome. Electroacupuncture may be effective for shoulder injuries and may show similar effectiveness to that of night wrist splinting for CTS. The effectiveness of dry needling for plantar fasciitis is equivocal. LEVEL OF EVIDENCE: Therapy, 1a-. © Copyright 2016 Journal of Orthopaedic & Sports Physical Therapy®. AU - Cox, J. AU - Varatharajan, S. AU - Côté, P. DA - 2016-1-1 IS - 6 KW - Tendinopathy Shoulder Needles Bias (Epidemiology) Case-Control Studies Upper Extremity Treatment Outcome Musculoskeletal System Musculoskeletal Diseases Lower Extremity Humans Evidence-Based Medicine Acupuncture Therapy upper limb standards procedures lower limb injuries human evidence based medicine adverse effects acupuncture Electroacupuncture Dry needling PY - 2016 SP - 409-429 ST - Effectiveness of acupuncture therapies to manage musculoskeletal disorders of the extremities: A systematic review T2 - Journal of Orthopaedic and Sports Physical Therapy TI - Effectiveness of acupuncture therapies to manage musculoskeletal disorders of the extremities: A systematic review VL - 46 ID - 179 ER - TY - JOUR AB - Introduction This systematic scoping review will explore the role of regulation on the care of older people living with depression in long-term care. Depression presents a significant burden to older people living in long-term care. Regulation in the long-term care sector has increased, but there are still concerns about quality of care in the sector. Methods and analysis Using Arksey and O'Malley's scoping review methodology as a guide, our scoping review will search several databases: Embase; MEDLINE (using the OVID platform); Psych info; Ageline; and CINAHL, alongside the grey literature. An expert librarian has assisted the research team, using the Peer Review of Electronic Search Strategies, to assess the search strategy. The research team has formulated search strategies and two reviewers will independently screen studies for final study selection. We will summarise extracted data in tabular format; use a narrative format to describe their relevance; and finally, identify knowledge gaps and topics for future research. Ethics and dissemination This scoping review will outline the scope of the existing literature related to the influence of regulation on the care of older people living with depression in long-term care. The scoping review findings will be disseminated through publication in a peer-reviewed journal. The findings will be useful to policy-makers, managers and clinicians working in the long-term care sector. © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. AD - Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, ON, Canada Telfer School of Management, University of Ottawa, Ottawa, ON, Canada AU - Crick, M. AU - Angus, D. E. AU - Backman, C. C2 - 30061441 C7 - e021985 DB - Scopus DO - 10.1136/bmjopen-2018-021985 IS - 7 KW - long-term care old age psychiatry older people regulation Cinahl clinician Embase ethics human librarian long term care manager Medline narrative peer review psychiatry PsycINFO publication review systematic review aged clinical protocol depression geriatric assessment geriatrics health care quality health services research multiple chronic conditions procedures psychology quality of life very elderly Aged, 80 and over Clinical Protocols Humans Quality Indicators, Health Care Systematic Reviews as Topic LA - English M3 - Review PY - 2018 ST - Exploring the role of regulation and the care of older people with depression living in long-term care? A systematic scoping review protocol T2 - BMJ Open TI - Exploring the role of regulation and the care of older people with depression living in long-term care? A systematic scoping review protocol VL - 8 ID - 367 ER - TY - JOUR AB - Background: The period following discharge from a pediatric emergency department (ED) can be a time of significant vulnerability for caregivers who provide ongoing care to their child when they return home. Discharge communication practice varies widely at the individual practitioner and departmental level. At present, there are no nationally accepted guidelines for discharge communication for children and/or their caregivers in the ED.The primary objective of this knowledge synthesis is to understand how and why discharge instructions work and under what conditions. We will also examine the contextual factors and barriers and facilitators associated with discharge communication across varied ED settings.Methods/Design: Using an integrated narrative approach, we will synthesize different types of evidence and explore relationships within and between included studies to develop a theory-based and knowledge user-informed discharge communication practice guideline. We will follow key principles for knowledge synthesis including: (1) involvement of a multidisciplinary team (for example, information specialists, statisticians, and content experts); (2) developing focused and answerable questions in collaboration with the knowledge users; (3) using a systematic method including specific tools and techniques appropriate for answering questions concerned with effectiveness and the implementation of interventions; and, (4) involving knowledge users throughout the process in an integrated knowledge translation approach.Discussion: This collaborative and narrative approach will be a determining factor in increasing the reliability, validity and relevance of the study findings for healthcare practice and policy decision-makers. © 2014 Curran et al. AU - Curran, J. A. AU - Murphy, A. AU - Newton, M. AU - Zemek, R. AU - Hartling, L. AU - Plint, A. AU - Chorney, J. AU - MacPhee, S. AU - Campbell, S. G. AU - Jabbour, M. AU - Boliver, D. AU - Petrie, D. AU - Colwell, R. AU - MacWilliams, K. AU - Nolan, A. DA - 2014-1-1 IS - 1 KW - Only Child Emergency Medical Services Practice Guidelines as Topic Patient Discharge Narration Humans Emergency Service, Hospital Communication Child Caregivers verbal communication interpersonal communication emergency health service education article theory professional knowledge priority journal practice guideline pediatrics patient education methodology human hospital management hospital discharge health care practice health care policy emergency care clinical decision making caregiver Narrative synthesis Emergency medicine Discharge instruction PY - 2014 SN - 2046-4053 ST - Discharge instructions for caregivers in the context of pediatric emergency care: A narrative synthesis protocol T2 - Systematic Reviews TI - Discharge instructions for caregivers in the context of pediatric emergency care: A narrative synthesis protocol VL - 3 ID - 241 ER - TY - JOUR AB - Background: Matrix metalloproteinases (MMPs) are a major group of enzymes that play essential roles in normal functioning of diverse tissues during growth, development, and aging. However, among the MMPs little is known regarding the role of exercise in MMP-9 and MMP-2 function in humans.Objective: The aim of this study was to provide a systematic comprehensive review of the literature examining the effect of different exercise interventions on MMP-9 and MMP-2 in human investigations.Data Sources: A comprehensive systematic database search was performed, including PubMed/MEDLINE, Scopus, ScienceDirect, and Web of Science.Study Selection: Both the acute and chronic effects of exercise were included for evaluation in this systematic review. Inclusion criteria included the use of any type of planned, structured, and repetitive movement and its effects on the MMP-2 and MMP-9 response (obtained from plasma samples), participants (humans only) of any age with or without diseases, sedentary participants and those involved in light, moderate, and vigorous activity, randomized controlled trials (RCTs) and clinical trials (CTs), full text article citations with no restrictions in terms of language, and scored at least 5/11 on the Physiotherapy Evidence Database (PEDro) quality scale.Study Appraisal and Synthesis Methods: The PEDro scale was used to appraise study quality of RCTs and CTs. Two reviewers independently reviewed the full texts of all potentially relevant articles for eligibility and disagreements were discussed and resolved.Results: Seven studies met the previously determined quality indicators and were reviewed; three were RCTs and four were CTs. In general, the quality of the studies ranged from 5 to 9 out of a maximum of 11 on the PEDro quality criteria scale. Results revealed that chronic aerobic training induces a decrease in MMP-9 and MMP-2 levels, possibly indicating a cardioprotective effect, while resistance exercise training displayed conflicting results.Conclusion: Alterations in MMP-9 and MMP-2 plasma concentrations may be valuable biomarkers to reflect the influence of exercise on the inflammatory state. Nevertheless, the limited evidence available regarding the effects of exercise on the MMP-9 and MMP-2 response in human participants suggests that further studies are needed to fully define the connection between the role of exercise on the MMP-9 and MMP-2 response. © 2014, Springer International Publishing Switzerland. AU - da Cunha Nascimento, D. AU - de Cassia Marqueti Durigan, R. AU - Tibana, R. A. AU - Durigan, J. L. Q. AU - Navalta, J. W. AU - Prestes, J. DA - 2015-1-1 IS - 2 KW - Physical Therapy Modalities Matrix Metalloproteinases Humans Humanism Humanities PY - 2015 SN - 0112-1642 SP - 269-278 ST - The Response of Matrix Metalloproteinase-9 and -2 to Exercise T2 - Sports Medicine TI - The Response of Matrix Metalloproteinase-9 and -2 to Exercise VL - 45 ID - 20 ER - TY - JOUR AB - Objective The purpose of this systematic review was to determine the effectiveness of passive physical modalities compared to other interventions, placebo/sham interventions, or no intervention in improving self-rated recovery, functional recovery, clinical outcomes and/or administrative outcomes (eg, time of disability benefits) in adults and/or children with soft tissue injuries and neuropathies of the wrist and hand. Methods We systematically searched MEDLINE, EMBASE, PsycINFO, and the Cochrane Central Register of Controlled Trials, accessed through Ovid Technologies, Inc, and CINAHL Plus with Full Text, accessed through EBSCO host, from 1990 to 2015. Our search strategies combined controlled vocabulary relevant to each database (eg, MeSH for MEDLINE) and text words relevant to our research question and the inclusion criteria. Randomized controlled trials, cohort studies, and case-control studies were eligible. Random pairs of independent reviewers screened studies for relevance and critically appraised relevant studies using the Scottish Intercollegiate Guidelines Network criteria. Studies with low risk of bias were synthesized following best evidence synthesis principles. Results We screened 6618 articles and critically appraised 11 studies. Of those, 7 had low risk of bias: 5 addressed carpal tunnel syndrome (CTS) and 2 addressed de Quervain disease. We found evidence that various types of night splints lead to similar outcomes for the management of CTS. The evidence suggests that a night wrist splint is less effective than surgery in the short term but not in the long term. Furthermore, a night wrist splint and needle electroacupuncture lead to similar outcomes immediately postintervention. Finally, low-level laser therapy and placebo low-level laser therapy lead to similar outcomes. The evidence suggests that kinesio tape or a thumb spica cast offers short-term benefit for the management of de Quervain disease. Our search did not identify any low risk of bias studies examining the effectiveness of passive physical modalities for the management of other soft tissue injuries or neuropathies of the wrist and hand. Conclusions Different night orthoses provided similar outcomes for CTS. Night orthoses offer similar outcomes to electroacupuncture but are less effective than surgery in the short term. This review suggests that kinesio tape or a thumb spica cast may offer short-term benefit for the management of de Quervain disease. © 2015 National University of Health Sciences. AU - D'Angelo, K. AU - Sutton, D. AU - Côté, P. AU - Dion, S. AU - Wong, J. J. AU - Yu, H. AU - Randhawa, K. AU - Southerst, D. AU - Varatharajan, S. AU - Cox, J. AU - Brown, C. AU - Menta, R. AU - Nordin, M. AU - Shearer, H. M. AU - Ameis, A. AU - Stupar, M. AU - Carroll, L. J. AU - Taylor-Vaisey, A. DA - 2015-1-1 IS - 7 KW - Case-Control Studies Bias (Epidemiology) Wrist Injuries Ultrasonic Therapy Soft Tissue Injuries Practice Guidelines as Topic Physical Therapy Modalities Orthotic Devices Ontario Male Low-Level Light Therapy Humans Hand Injuries Female Evidence-Based Medicine Cooperative Behavior Child Carpal Tunnel Syndrome Adult Accidents, Traffic utilization ultrasound therapy traffic accident procedures practice guideline orthosis evidence based medicine cooperation wrist neuropathy wrist disease treatment outcome systematic review splinting splint soft tissue injury skin irritation Review randomized controlled trial (topic) physiotherapy neuropathy low level laser therapy infection hypertrophic scar human hematoma hand neuropathy hand disease electroacupuncture disease duration De Quervain tenosynovitis complex regional pain syndrome type I comparative study cohort analysis case control study acupuncture needle Ultrasonography Review Literature as Topic Low-Level Laser Therapy De Quervain Disease PY - 2015 SN - 0161-4754 DO - http://dx.doi.org/10.1016/j.jmpt.2012.01.001 SP - 493-506 ST - The effectiveness of passive physical modalities for the management of soft tissue injuries and neuropathies of the wrist and hand: A systematic review by the Ontario protocol for traffic injury management (OPTIMa) collaboration T2 - Journal of Manipulative and Physiological Therapeutics TI - The effectiveness of passive physical modalities for the management of soft tissue injuries and neuropathies of the wrist and hand: A systematic review by the Ontario protocol for traffic injury management (OPTIMa) collaboration VL - 38 ID - 230 ER - TY - JOUR AB - Systematic reviews have gained popularity as a way to combine the increasing amount of research information. This study assessed the quality of systematic reviews and meta-analyses of sublingual immunotherapy (SLIT) for allergic rhinitis in children, published since 2000. Eligible reviews were identified by searching Medline/Pubmed, Embase, and the Cochrane Library, from 2000 through 2008. Methodological quality was assessed using the assessment of multiple systematic reviews instrument. Ten systematic reviews were included, one of which was published in the Cochrane Library. Eight reviews gave some details about the search strategy. None of the reviews included measures to avoid selection bias. In 60% of the reviews, the methodological quality of the included studies was (partly) assessed. Four reviews pooled the results of individual studies, neglecting clinical heterogeneity. Three of the 10 reviews provided information about sources of funding or grants from industry. Of the 10 reviews, the six reviews with the highest overall score scored 5-8 points, indicating moderate quality. Systematic reviews are useful to evaluate the efficacy of SLIT in children. Although more reviews have become available, the methodological quality could be improved. SLIT for children could be promising, but methodological flaws in the reviews and individual studies are too serious to draw definite conclusions. © 2011 John Wiley & Sons A/S. AU - de Bot, C. M. A. AU - Moed, H. AU - Berger, M. Y. AU - Röder, E. AU - van Wijk, R. G. AU - van der Wouden, J. C. DA - 2011-1-1 IS - 6 KW - Selection Bias Only Child Immunotherapy Rhinitis Review Literature as Topic Meta-Analysis as Topic Hypersensitivity Humans Desensitization, Immunologic Child Allergens Administration, Sublingual unspecified side effect systematic review symptom sublingual immunotherapy subcutaneous immunotherapy review priority journal oral immunotherapy methodology human financial management childhood disease allergic rhinitis immunologic agent Methodological quality Meta-analysis Children Assessment of multiple systematic reviews PY - 2011 SN - 0905-6157 (Print) SP - 548-558 ST - Sublingual immunotherapy in children with allergic rhinitis: Quality of systematic reviews T2 - Pediatric Allergy and Immunology TI - Sublingual immunotherapy in children with allergic rhinitis: Quality of systematic reviews VL - 22 ID - 262 ER - TY - JOUR AB - Aim: To review the evidence about the role of care providers in fall prevention in older adults aged ≥ 65 years, this includes their views, strategies, and approaches on falls prevention and effectiveness of nursing interventions. Background: Some fall prevention programmes are successfully implemented and led by nurses and it is acknowledged the vital role they play in developing plans for fall prevention. Nevertheless, there has not been a systematic review of the literature that describes this role and care providers' views on fall's prevention initiatives. Design: A convergent synthesis of qualitative, quantitative, and mixed methods studies. The eligibility criteria will be based on participants, interventions/exposure, comparisons, and outcomes for quantitative studies and on population, the phenomena of interest and the context, for qualitative studies. To extract data and assess study qualities members of the research team will work in pairs according to their expertise. The review will follow the guidelines for integrative reviews and the proposed methods will adhere to the PRISMA statement checklist complemented by the ENTREQ framework. As qualitative synthesis are emergent, all procedures and changes in procedure will be documented. Discussion: The review has a constructivist drive as studies that combine methods ought to be paradigmatic driven. Review questions are broad to allow issues emerge and have purposefully left the design flexible to allow for adjustments as the review progresses. The review seeks to highlight the roles that care providers play in fall prevention and their views on fall's prevention initiatives. © 2016 John Wiley & Sons Ltd AU - de la Cuesta-Benjumea, C. AU - Henriques, M. A. AU - Abad-Corpa, E. AU - Roe, B. AU - Orts-Cortés, M. I. AU - Lidón-Cerezuela, B. AU - Avendaño-Céspedes, A. AU - Oliver-Carbonell, J. L. AU - Sánchez-Ardila, C. DA - 2017-1-1 IS - 7 KW - Humans Aged Accidental Falls prevention and control falling systematic review synthesis quantitative study qualitative research practice guideline nursing intervention nurse human extract exposure Europe checklist aging adult review older people nursing library methods falls community and public health care giving ageing PY - 2017 SP - 1722-1734 ST - “Falls prevention among older people and care providers: protocol for an integrative review” T2 - Journal of Advanced Nursing TI - “Falls prevention among older people and care providers: protocol for an integrative review” VL - 73 ID - 149 ER - TY - JOUR AB - This systematic review examines the relationship between sympathetic and parasympathetic activity on the one hand and job stress and burnout on the other, and is registered at PROSPERO under CRD42016035918. Background: Previous research has shown that prolonged job stress may lead to burnout, and that differences in heart rate variability are apparent in people who have heightened job stress. Aims: In this systematic review, the associations between job stress or burnout and heart rate (variability) or skin conductance are studied. Besides, it was investigated which–if any–guidelines are available for ambulatory assessment and reporting of the results. Methods: We extracted data from relevant databases following the PRESS checklist and contacted authors for additional resources. Participants included the employed adult population comparing validated job stress and burnout questionnaires examining heart rate and electrodermal activity. Synthesis followed the PRISMA guidelines of reporting systematic reviews. Results: The results showed a positive association between job stress and heart rate, and a negative association between job stress and heart rate variability measures. No definite conclusion could be drawn with regard to burnout and psychophysiological measures. No studies on electrodermal activity could be included based on the inclusion criteria. Conclusions: High levels of job stress are associated with an increased heart rate, and decreased heart rate variability measures. Recommendations for ambulatory assessment and reporting (STROBE) are discussed in light of the findings. © 2018 de Looff et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. AD - Behavioural Science Institute, Radboud University, Nijmegen, Netherlands Wier, Specialized and Forensic Care, Fivoor, Den Dolder, Netherlands Expertcentre “De Borg”, Den Dolder, Netherlands Psychology of Conflict, Risk and Safety, University of Twente, Enschede, Netherlands Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands Trajectum, Specialized and Forensic Care, Zwolle, Netherlands AU - De Looff, P. C. AU - Cornet, L. J. M. AU - Embregts, P. J. C. M. AU - Nijman, H. L. I. AU - Didden, H. C. M. C2 - 30335812 C7 - e0205741 DB - Scopus DO - 10.1371/journal.pone.0205741 IS - 10 KW - adrenergic system burnout cholinergic system diagnosis electrodermal response heart rate human job satisfaction mental stress pathophysiology physiology questionnaire Burnout, Professional Galvanic Skin Response Humans Parasympathetic Nervous System Stress, Psychological Surveys and Questionnaires Sympathetic Nervous System LA - English M3 - Review PY - 2018 ST - Associations of sympathetic and parasympathetic activity in job stress and burnout: A systematic review T2 - PLoS ONE TI - Associations of sympathetic and parasympathetic activity in job stress and burnout: A systematic review VL - 13 ID - 368 ER - TY - JOUR AB - Background: Premature birth is defined as birth of before 37 completed weeks' gestation. Not all pregnant women showing symptoms of preterm labour will go on to deliver before 37weeks' gestation. Hence, addition of fetal fibronectin (fFN) testing to the diagnostic workup of women with suspected preterm labour may help to identify those women who do not require active management, and thus avoid unnecessary interventions, hospitalisations and associated costs. Objective: To assess the clinical effectiveness and cost-effectiveness of rapid fFN testing in predicting preterm birth (PTB) in symptomatic women. Data sources: Bibliographic databases (including EMBASE, Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials) were searched from 2000 to September/November 2011. Trial registers were also searched. Review methods: Systematic review methods followed published guidance; we assessed clinical effectiveness and updated a previous systematic review of test accuracy. Risk of bias was assessed using the Cochrane tool (randomised controlled trials; RCTs) and a modification of QUADAS-2 (diagnostic test accuracy studies; DTAs). Summary risk ratios or weighted mean difference were calculated using randomeffects models. Summary sensitivity and specificity used a bivariate summary receiver operating characteristic model. Heterogeneity was investigated using subgroup and sensitivity analyses. Health economic analysis focused on cost consequences. The time horizon was hospital admission for observation. A main structural assumption was that, compared with usual care, fFN testing doesn't increase adverse events or negative pregnancy outcomes. Results: Five RCTs and 15 new DTAs were identified. No RCT reported significant effects of fFN testing on maternal or neonatal outcomes. One study reported a subgroup analysis of women with negative fFN test observed >6 hours, which showed a reduction in length of hospital stay where results were known to clinicians. Combining data from new studies and the previous systematic review, the pooled estimates of sensitivity and specificity were: 76.7% and 82.7% for delivery within 7-10 days of testing; 69.1% and 84.4% for delivery <34 weeks' gestation; and 60.8% and 82.3% for delivery <37 weeks' gestation. Estimates were similar across all subgroups sensitivity analyses. The base-case cost analysis resulted in a cost saving of £23.87 for fFN testing compared with usual care. The fFN testing was cost-neutral at an approximate cost of £45. Probabilistic sensitivity analysis gave an incremental cost (saving) of -£25.59(97.5% confidence interval -£304.96 to £240.06), indicating substantial uncertainty. Sensitivity analyses indicated that admission rate had the largest impact on results. Conclusions: Fetal fibronectin testing has moderate accuracy for predicting PTB. The main potential role is likely to be reducing health-care resource usage by identifying women not requiring intervention. Evidence from RCTs suggests that fFN does not increase adverse outcomes and may reduce resource use. The base-case analysis showed a modest cost difference in favour of fFN testing, which is largely dependent on whether or not fFN testing reduces hospital admission. Currently, there are no high-quality studies and the existing trials were generally underpowered. Hence, there is a need for high-quality adequately powered trials using appropriate study designs to confirm the findings presented. © Queen's Printer and Controller of HMSO 2013. AU - Deshpande, S. N. AU - Van Asselt, A. D. I. AU - Tomini, F. AU - Armstrong, N. AU - Allen, A. AU - Noake, C. AU - Khan, K. AU - Severens, J. L. AU - Kleijnen, J. AU - Westwood, M. E. DA - 2013-1-1 %J Health Technology Assessment IS - 40 KW - Length of Stay Pregnancy Outcome Fibronectins Pregnancy PY - 2013 SP - 95-135 ST - Rapid fetal fibronectin testing to predict preterm birth in women with symptoms of premature labour: A systematic review and cost analysis T2 - Health Technology Assessment TI - Rapid fetal fibronectin testing to predict preterm birth in women with symptoms of premature labour: A systematic review and cost analysis VL - 17 ID - 306 ER - TY - JOUR AB - Objectives This study reviews the current state of the published peer-reviewed literature related to physician burnout and two quality of care dimensions. The purpose of this systematic literature review is to address the question, € How does physician burnout affect the quality of healthcare related to the dimensions of acceptability and safety' Design Using a multiphase screening process, this systematic literature review is based on publically available peer-reviewed studies published between 2002 and 2017. Six electronic databases were searched: (1) MEDLINE Current, (2) MEDLINE In-process, (3) MEDLINE Epub Ahead of Print, (4) PsycINFO, (5) Embase and (6) Web of Science. Setting Physicians practicing in civilian settings. Participants Practicing physicians who have completed training. Primary and secondary outcome measures Quality of healthcare related to acceptability (ie, patient satisfaction, physician communication and physician attitudes) and safety (ie, minimising risks or harm to patients). Results 4114 unique citations were identified. Of these, 12 articles were included in the review. Two studies were rated as having high risk of bias and 10 as having moderate risk. Four studies were conducted in North America, four in Europe, one in the Middle East and three in East Asia. Results of this systematic literature review suggest there is moderate evidence that burnout is associated with safety-related quality of care. Because of the variability in the way patient acceptability-related quality of care was measured and the inconsistency in study findings, the evidence supporting the relationship between burnout and patient acceptability-related quality of care is less strong. Conclusions The focus on direct care-related quality highlights additional ways that physician burnout affects the healthcare system. These studies can help to inform decisions about how to improve patient care by addressing physician burnout. Continued work looking at the relationship between dimensions of acceptability-related quality of care measures and burnout is needed to advance the field. © 2017 Article author(s). AU - Dewa, C. S. AU - Loong, D. AU - Bonato, S. AU - Trojanowski, L. DA - 2017-1-1 IS - 6 KW - Quality of Health Care Physicians Patient Satisfaction Patient Safety Medical Errors Humans Communication Burnout, Professional Attitude of Health Personnel psychology physician medical error interpersonal communication health personnel attitude health care quality Web of Science systematic review screening safety PsycINFO physician attitude patient care North America Middle East Medline male human health care system female Europe Embase doctor patient relation burnout quality of healthcare PY - 2017 SN - 2044-6055 ST - The relationship between physician burnout and quality of healthcare in terms of safety and acceptability: A systematic review T2 - BMJ Open TI - The relationship between physician burnout and quality of healthcare in terms of safety and acceptability: A systematic review VL - 7 ID - 91 ER - TY - JOUR AB - Background: There has been increasing interest in examining the relationship between physician wellbeing and quality of patient care. However, few reviews have specifically focused on resident burnout and quality of patient care. The purpose of this systematic literature review of the current scientific literature is to address the question, "How does resident burnout affect the quality of healthcare related to the dimensions of acceptability and safety?" Methods: This systematic literature review uses a multi-step screening process of publicly available peer-reviewed studies from five electronic databases: (1) Medline Current, (2) Medline In-process, (3) PsycINFO, (4) Embase, and (5) Web of Science. Results: The electronic literature search resulted in the identification of 4638 unique citations. Of these, 10 articles were included in the review. Studies were assessed for risk of bias. Of the 10 studies that met the inclusion criteria, eight were conducted in the US, one in The Netherlands, and one in Mexico. Eight of the 10 studies focused on patient safety. The results of these included studies suggest there is moderate evidence that burnout is associated with patient safety (i.e., resident self-perceived medical errors and sub-optimal care). There is less evidence that specific dimensions of burnout are related to acceptability (i.e., quality of care, communication with patients). Conclusions: The results of this systematic literature review suggest a relationship between patient safety and burnout. These results potentially have important implications for the medical training milieu because residents are still in training and at the same time are asked to teach students. The results also indicate a need for more evidence-based interventions that support continued research examining quality of care measures, especially as they relate to acceptability. © 2017 The Author(s). AU - Dewa, C. S. AU - Loong, D. AU - Bonato, S. AU - Trojanowski, L. AU - Rea, M. DA - 2017-1-1 IS - 1 KW - Quality of Health Care Web of Science systematic review student scientific literature risk assessment resident PsycINFO patient safety Netherlands Mexico Medline medical error medical education male human female Embase burnout adult Residents Quality of care PY - 2017 ST - The relationship between resident burnout and safety-related and acceptability-related quality of healthcare: A systematic literature review T2 - BMC Medical Education TI - The relationship between resident burnout and safety-related and acceptability-related quality of healthcare: A systematic literature review VL - 17 ID - 71 ER - TY - JOUR AB - Objective: To evaluate the effectiveness of passive physical modalities for the management of soft tissue injuries of the elbow. Methods: We systematically searched MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane Central Register of Controlled Trials from 1990 to 2015. Studies meeting our selection criteria were eligible for critical appraisal. Random pairs of independent reviewers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria. We included studies with a low risk of bias in our best evidence synthesis. Results: We screened 6618 articles; 21 were eligible for critical appraisal and 9 (reporting on 8 randomized controlled trials) had a low risk of bias. All randomized controlled trials with a low risk of bias focused on lateral epicondylitis. We found that adding transcutaneous electrical nerve stimulation to primary care does not improve the outcome of patients with lateral epicondylitis. We found inconclusive evidence for the effectiveness of: (1) an elbow brace for managing lateral epicondylitis of variable duration; and (2) shockwave therapy or low-level laser therapy for persistent lateral epicondylitis. Discussion: Our review suggests that transcutaneous electrical nerve stimulation provides no added benefit to patients with lateral epicondylitis. The effectiveness of an elbow brace, shockwave therapy, or low-level laser therapy for the treatment of lateral epicondylitis is inconclusive. We found little evidence to inform the use of passive physical modalities for the management of elbow soft tissue injuries. © Copyright 2016 Wolters Kluwer Health, Inc. All rights reserved. AU - Dion, S. AU - Wong, J. J. AU - Côte, P. AU - Yu, H. AU - Sutton, D. AU - Randhawa, K. AU - Southerst, D. AU - Varatharajan, S. AU - Stern, P. J. AU - Nordin, M. AU - Chung, C. AU - D'Angelo, K. AU - Dresser, J. AU - Brown, C. AU - Menta, R. AU - Ammendolia, C. AU - Shearer, H. M. AU - Stupar, M. AU - Ameis, A. AU - Mior, S. AU - Carroll, L. J. AU - Jacobs, C. AU - Taylor-Vaisey, A. DA - 2017-1-1 IS - 1 KW - Laser Therapy Tennis Elbow Soft Tissue Injuries Physical Therapy Modalities Humans Elbow Disease Management soft tissue injury physiotherapy injuries treatment outcome transcutaneous electrical nerve stimulation systematic review shock wave therapy Review randomized controlled trial (topic) PsycINFO priority journal primary medical care physical medicine Medline low level laser therapy information retrieval human Embase elbow brace Cochrane Library Cinahl Shockwave Therapy Passive Physical Modalities Lateral Epicondylitis Brace PY - 2017 SN - 0749-8047 SP - 71-86 ST - Are passive physical modalities effective for the management of common soft tissue injuries of the elbow? A systematic review by the Ontario protocol for traffic injury management (OPTIMa) Collaboration T2 - Clinical Journal of Pain TI - Are passive physical modalities effective for the management of common soft tissue injuries of the elbow? A systematic review by the Ontario protocol for traffic injury management (OPTIMa) Collaboration VL - 33 ID - 166 ER - TY - JOUR AU - Dodoo-Schittko, F. AU - Brandstetter, S. AU - Blecha, S. AU - Thomann-Hackner, K. AU - Brandl, M. AU - Knüttel, H. AU - Bein, T. AU - Apfelbacher, C. DA - 2017-1-1 IS - 7 KW - Respiratory Distress Syndrome, Adult Quality of Life systematic review lung parenchyma human Article adult respiratory distress syndrome PY - 2017 SP - 103-109 ST - Determinants of quality of life and return to work following acute respiratory distress syndrome - A systematic review T2 - Deutsches Arzteblatt International TI - Determinants of quality of life and return to work following acute respiratory distress syndrome - A systematic review VL - 114 ID - 101 ER - TY - JOUR AB - The purpose of this review was to synthesize evidence on the associations of physical activity, sedentary time, and fitness with stress, depression, and anxiety in post-secondary students. We conducted a systematic review of the literature and searched four databases from 2000 to 2016. In total, 1942 articles were screened, 22 were critically appraised, and five had low or moderate risk of bias; all were cross-sectional studies. Articles were critically appraised using the modified Hoy tool to assess risk of bias criteria for cross-sectional studies. Only studies with low or moderate risk of bias were included for analysis. We synthesized evidence from studies with low or moderate risk of bias using best-evidence synthesis. Based on the two low risk of bias studies, there is inconsistent evidence regarding the association between self-reported physical activity levels and depressive symptoms. Among American university students using tobacco, the odds of depressive symptoms was 0.65 (95% CI: 0.45, 0.92) for every 1-unit (log transformed) increase in exercise level. However, the second study found no statistically significant correlations between measures of physical activity and either depression or anxiety scores. Among the moderate risk of bias studies, meeting vigorous intensity physical activity guidelines was associated with lower odds of reporting poor mental health (OR: 0.80; 95% CI 0.72, 0.96) and perceived stress (OR: 0.77; 95% CI 0.69, 0.87), lower odds of having higher depressive symptoms (OR = 0.59; 95% CI 0.42, 0.82), and had higher odds of reporting depressive symptoms “some” (OR: 1.35; 95% CI: 1.17–1.54), and “more than a good bit of the time” (OR: 1.72; 95% CI: 1.47–2.01). Importantly, this review highlights a lack of strong evidence available in post-secondary students. Longitudinal research is needed to better understand the temporal association between sedentary time, physical activity, and fitness with stress, depression and anxiety in this population. © 2017 Elsevier Ltd AU - Dogra, S. AU - MacIntosh, L. AU - O'Neill, C. AU - D'Silva, C. AU - Shearer, H. AU - Smith, K. AU - Côté, P. DA - 2018-1-1 %J Mental Health and Physical Activity KW - Bias (Epidemiology) Motor Activity Anxiety Cross-Sectional Studies PY - 2018 SP - 146-156 ST - The association of physical activity with depression and stress among post-secondary school students: A systematic review T2 - Mental Health and Physical Activity TI - The association of physical activity with depression and stress among post-secondary school students: A systematic review VL - 14 ID - 279 ER - TY - JOUR AB - Background: Researchers and practitioners working in sports medicine and science require valid tests to determine the effectiveness of interventions and enhance understanding of mechanisms underpinning adaptation. Such decision making is influenced by the supportive evidence describing the validity of tests within current research. The objective of this study is to review the validity of lower body isometric multi-joint tests ability to assess muscular strength and determine the current level of supporting evidence. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed in a systematic fashion to search, assess and synthesize existing literature on this topic. Electronic databases such as Web of Science, CINAHL and PubMed were searched up to 18 March 2015. Potential inclusions were screened against eligibility criteria relating to types of test, measurement instrument, properties of validity assessed and population group and were required to be published in English. The Consensus-based Standards for the Selection of health Measurement Instruments (COSMIN) checklist was used to assess methodological quality and measurement property rating of included studies. Studies rated as fair or better in methodological quality were included in the best evidence synthesis. Results: Fifty-nine studies met the eligibility criteria for quality appraisal. The ten studies that rated fair or better in methodological quality were included in the best evidence synthesis. The most frequently investigated lower body isometric multi-joint tests for validity were the isometric mid-thigh pull and isometric squat. The validity of each of these tests was strong in terms of reliability and construct validity. The evidence for responsiveness of tests was found to be moderate for the isometric squat test and unknown for the isometric mid-thigh pull. No tests using the isometric leg press met the criteria for inclusion in the best evidence synthesis. Conclusions: Researchers and practitioners can use the isometric squat and isometric mid-thigh pull with confidence in terms of reliability and construct validity. Further work to investigate other validity components such as criterion validity, smallest detectable change and responsiveness to resistance exercise interventions may be beneficial to the current level of evidence. © 2017, The Author(s). AU - Drake, D. AU - Kennedy, R. AU - Wallace, E. DA - 2017-1-1 IS - 1 KW - Sports PY - 2017 SN - 2198-9761 ST - The Validity and Responsiveness of Isometric Lower Body Multi-Joint Tests of Muscular Strength: a Systematic Review T2 - Sports Medicine - Open TI - The Validity and Responsiveness of Isometric Lower Body Multi-Joint Tests of Muscular Strength: a Systematic Review VL - 3 ID - 136 ER - TY - JOUR AB - Background: The prevalence of menopause in women with or at risk of chronic kidney disease is increasing globally. Although international guidelines on menopause recommend the use of postmenopausal hormone therapy with or without selective estrogen receptor modulators for control of vasomotor symptoms, the effects of these treatments on kidney function and albuminuria are unclear. Furthermore, women with chronic kidney disease are at significantly increased risk of venous thromboembolism and malignancy, well-documented adverse effects of postmenopausal hormone therapy. Our study aims to establish the effect of these treatments on kidney function and albuminuria in women, as well as determine the safety of these treatments in the chronic kidney disease population. Methods: We will conduct a systematic review and meta-analysis addressing the effect and safety of postmenopausal hormone therapy and selective estrogen receptor modulators on kidney outcomes in women. We plan to search for published (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), tables of contents of relevant journals) and unpublished (ongoing studies, conference proceedings) studies in all languages examining the effect of postmenopausal hormone therapy, including selective estrogen receptor modulators, on kidney function and albuminuria, as well as the risk of adverse outcomes of these treatments in women with chronic kidney disease. Two independent investigators will screen identified abstracts and select studies that examine the effect of postmenopausal hormone therapy and selective estrogen receptor modulators on kidney outcomes in the general population or adverse outcomes in the chronic kidney disease population. Data on study population, intervention, outcomes, as well as study quality and risk of bias will be independently extracted from each eligible study. Along with descriptive presentation of data, outcome measures will be presented as meta-analyses using a random effects model. Planned subgroup analyses will be completed, and meta-regression will be performed if significant heterogeneity is noted. Discussion: By examining the effects of postmenopausal hormone therapy and selective estrogen receptor modulators on kidney function and albuminuria, the results of this systematic review and meta-analysis will inform management of postmenopausal women in the general population. Furthermore, it will evaluate the safety, including the risks of known adverse outcomes of postmenopausal hormone therapy and selective estrogen receptor modulators, in the already vulnerable chronic kidney disease population. Systematic review registration: PROSPERO CRD42016050651 © 2017 The Author(s). AU - Dumanski, S. M. AU - Ramesh, S. AU - James, M. T. AU - Metcalfe, A. AU - Nerenberg, K. AU - Seely, E. W. AU - Robertson, H. L. AU - Ahmed, S. B. DA - 2017-1-1 IS - 1 KW - Receptors, Estrogen Estrogen Receptor Modulators Kidney Diseases Selective Estrogen Receptor Modulators Renal Insufficiency, Chronic Postmenopause Humans Female Estrogen Replacement Therapy Albuminuria estrogen therapy drug effect complication chronic kidney failure venous thromboembolism systematic review sensitivity analysis risk assessment priority journal ovary carcinoma meta analysis hypertension human hormonal therapy estimated glomerular filtration rate endometrium cancer end stage renal disease disease course breast cancer Article adverse outcome selective estrogen receptor modulator Women SERM Menopause Kidney Hormone therapy PY - 2017 SN - 2046-4053 ST - The effect and safety of postmenopausal hormone therapy and selective estrogen receptor modulators on kidney outcomes in women: A protocol for systematic review and meta-analysis T2 - Systematic Reviews TI - The effect and safety of postmenopausal hormone therapy and selective estrogen receptor modulators on kidney outcomes in women: A protocol for systematic review and meta-analysis VL - 6 ID - 146 ER - TY - JOUR AB - Background: Perioperative pain management has recently been revolutionized with the recognition of novel mechanisms and introduction of newer drugs. Many randomized trials have studied the use of the gabapentinoid anti-epileptic, pregabalin, in acute pain. Published systematic reviews suggest that using pregabalin for perioperative pain management may decrease analgesic requirements and pain scores, at the expense of troublesome side effects. A major limitation of the extant reviews is the lack of rigorous investigation of clinical characteristics that would maximize the benefit harms ratio in favor of surgical patients. We posit that effects of pregabalin for perioperative pain management vary by the type of surgical pain model and propose this systematic review protocol to update previous systematic reviews and investigate the heterogeneity in findings across subgroups of surgical pain models.Methods/Design: Using a peer-reviewed search strategy, we will search key databases for clinical trials on perioperative pregabalin use in adults. The electronic searches will be supplemented by scanning the reference lists of included studies. No limits of language, country or year will be imposed. Outcomes will include pain; use of co-analgesia, particularly opioids; enhanced recovery; and drug-related harms. We will focus on the identification of surgical models and patient characteristics that have shown benefit and adverse effects from pregabalin.Two clinical experts will independently screen the studies for inclusion using eligibility criteria established a priori. Data extracted by the reviewers will then be verified. Publication bias will be assessed, as will risk of bias using the Cochrane Risk of Bias tool. Meta-analysis and meta-regression are planned if the studies are deemed statistically, methodologically and clinically homogenous. Evidence will be graded for its strength for a select number of outcomes.Discussion: We will explore the findings of perioperative clinical trials studying the use of pregabalin for acute pain. We will comment on the implications of the findings and provide further direction for the appropriate use of pregabalin in acute pain. This protocol will attempt to bridge the growing gap between clinical experience and emerging evidence, and has the potential to aid future guideline development in the perioperative use of pregabalin.Trial registration: PROSPERO registration number CRD42012002078. © 2012 Eipe et al.; licensee BioMed Central Ltd. AU - Eipe, N. AU - Penning, J. AU - Ansari, M. AU - Yazdi, F. AU - Ahmadzai, N. DA - 2012-1-1 IS - 1 KW - Pain Management visual disorder systematic review (topic) systematic review somnolence sleep disordered breathing single drug dose side effect seizure sedation scoring system risk respiratory arrest respiration depression randomized controlled trial (topic) publication postherpetic neuralgia perioperative period pain outcome assessment neuropathic pain nausea and vomiting mortality meta analysis (topic) low drug dose kidney disease incidence human fibromyalgia drug use drug megadose dizziness diabetic neuropathy decision making confusion clinical protocol clinical practice article anxiety disorder pregabalin placebo opiate gabapentin LA - English PY - 2012 SN - 2046-4053 ST - A protocol for a systematic review for perioperative pregabalin use T2 - Systematic Reviews TI - A protocol for a systematic review for perioperative pregabalin use VL - 1 ID - 24 ER - TY - JOUR AB - Background: Pediatric epilepsy, including treatment-resistant forms, has a major effect on the quality of life, morbidity, and mortality of affected children. Interest has been growing in the use of medical cannabis as a treatment for pediatric epilepsy, yet there has been no comprehensive review of the benefits and harms of cannabis use in this population. In this systematic review, we will search for, synthesize, and assess the published and gray literature in order to provide usable and relevant information to parents, clinicians, and policy makers. Methods: We will perform a living systematic review of studies involving the use of cannabis to treat pediatric epilepsy. We will search the published and gray literature for studies involving children with any type of epilepsy taking any form of cannabis. Studies will be selected for inclusion by two independent reviewers. The primary outcome is seizure freedom. Secondary outcomes are seizure frequency, quality of life (child, caregiver), quality and quantity of sleep, status epilepticus, tonic-clonic seizures, death (all-cause, sudden unexpected death in epilepsy), gastrointestinal adverse events (diarrhea, vomiting), and visits to the emergency room. The quality of each included study will be assessed. If data are sufficient in quantity and sufficiently similar, we will conduct pairwise random-effects meta-analysis. We will repeat the literature search every 6 months to identify studies published after the previous search date. Sequential meta-analysis will be performed as necessary to update the review findings. Discussion: Our review aims to provide a comprehensive and up-to-date summary of the available evidence to inform decisions about the use of cannabis in children with treatment-resistant epilepsy. The results of this review will be of use to parents, clinicians, and policy makers as they navigate this rapidly evolving area. Systematic review registration: PROSPERO CRD42018084755 © 2018 The Author(s). AU - Elliott, J. AU - DeJean, D. AU - Clifford, T. AU - Coyle, D. AU - Potter, B. AU - Skidmore, B. AU - Alexander, C. AU - Repetski, A. E. AU - McCoy, B. AU - Wells, G. A. DA - 2018-1-1 %J Systematic Reviews IS - 1 KW - Status Epilepticus Child Epilepsy Only Child Quality of Life Cannabis PY - 2018 SN - 2046-4053 ST - Cannabis for pediatric epilepsy: Protocol for a living systematic review T2 - Systematic Reviews TI - Cannabis for pediatric epilepsy: Protocol for a living systematic review VL - 7 ID - 275 ER - TY - JOUR AB - Introduction: Although dual antiplatelet therapy (DAPT) is routinely given to patients after percutaneous coronary intervention (PCI) with stenting, the optimal duration is unknown. Recent evidence indicates there may be benefits in extending the duration beyond 12 months but such decisions may increase the risk of bleeding. Our objective is to provide a comprehensive overview of the literature for clinicians and policymakers via an umbrella review assessing the optimal duration of DAPT. Methods and analysis: We will perform a comprehensive search of the published and grey literature for systematic reviews involving randomised controlled trials (RCTs) assessing the optimal duration of DAPT following PCI with stenting. The intervention of interest is extended DAPT (beyond 12 months) compared with short-term DAPT (6-12 months). Studies will be selected for inclusion by two reviewers, and the quality will be assessed. The primary outcomes of interest are all-cause mortality and cardiovascular mortality. Secondary outcomes will be bleeding (major, minor and gastrointestinal), urgent target vessel revascularisation, major adverse cardiovascular events, myocardial infarction, stroke and stent thrombosis. Outcomes will be assessed while on DAPT and after withdrawal of DAPT. Data will be summarised with respect to the number of included RCTs, number of participants, effect estimates and heterogeneity. Data will be reported separately based on patient demographics, procedural parameters (eg, stent types, lesion complexity and concurrent disease) and clinical presentation (eg, acute coronary syndromes, infarct type). Ethics and dissemination: Our umbrella review aims to provide a comprehensive overview of the benefits and harms associated with extending DAPT beyond 12 months following PCI with stenting. The results of this review will inform clinical and policy decisions regarding the optimal treatment duration and reimbursement of DAPT following PCI with stenting. Results will be disseminated through a peer-reviewed publication and conference presentations. Ethics approval is not required for this study. Trial registration number: CRD42016047735. AU - Elliott, J. AU - Kelly, S. E. AU - Bai, Z. AU - Liu, W. AU - Skidmore, B. AU - Boucher, M. AU - So, D. Y. F. AU - Wells, G. A. DA - 2017-1-1 %J BMJ Open IS - 4 KW - Stents PY - 2017 SN - 2044-6055 ST - Optimal duration of dual antiplatelet therapy following percutaneous coronary intervention: Protocol for an umbrella review T2 - BMJ Open TI - Optimal duration of dual antiplatelet therapy following percutaneous coronary intervention: Protocol for an umbrella review VL - 7 ID - 287 ER - TY - JOUR AB - Background: Chronic kidney disease (CKD) affects ∼10% of the adult population. The majority of patients with CKD are managed by primary care physicians, and despite the availability of effective treatment options, the use of evidence-based interventions for CKD in this setting remains suboptimal. Clinical pathways have been identified as effective tools to guide primary care physicians in providing evidence-based care. We aimed to describe the availability, characteristics and credibility of clinical pathways for adult CKD using a scoping review methodology. Methods: We searched Medline, Embase, CINAHL and targeted Internet sites from inception to 31 October 2014 to identify studies and resources that identified adult CKD clinical pathways for primary care settings. Study selection and data extraction were independently performed by two reviewers. Results: From 487 citations, 41 items were eligible for review: 7 published articles and 34 grey literature resources published between 2001 and 2014. Of the 41 clinical pathways, 32, 24 and 22% were from the UK, USA and Canada, respectively. The majority (66%, n = 31) of clinical pathways were static in nature (did not have an online interactive feature). The majority (76%) of articles/resources reported using one or more clinical practice guidelines as a resource to guide the clinical pathway content. Few articles described a dissemination and evaluation plan for the clinical pathway, but most reported the targeted end-users. Conclusions: Our scoping review synthesized available literature on CKD clinical pathways in the primary care setting. We found that existing clinical pathways are diverse in their design, content and implementation. These results can be used by researchers developing or testing new or existing clinical pathways and by practitioners and health system stakeholders who aimto implement CKD clinical pathways in clinical practice. © The Author 2016. AU - Elliott, M. J. AU - Gil, S. AU - Hemmelgarn, B. R. AU - Manns, B. J. AU - Tonelli, M. AU - Jun, M. AU - Donald, M. DB - Scopus DO - 10.1093/ndt/gfw208 IS - 5 M3 - Review PY - 2017 SP - 838-846 ST - A scoping review of adult chronic kidney disease clinical pathways for primary care T2 - Nephrology Dialysis Transplantation TI - A scoping review of adult chronic kidney disease clinical pathways for primary care VL - 32 ID - 344 ER - TY - JOUR AB - Background: Out-of-hospital cardiac arrest (OHCA) is associated with significant mortality or may have a poor neurological outcome. Various community-training programmes have improved practices like bystander cardiopulmonary resuscitation (CPR) and early defibrillation using automated external defibrillator (AED). Post-resuscitation care has also changed significantly in the millennium. Interventions like targeted temperature management (TTM), avoidance of hyperoxia and emergency cardiac catheterisation have given patients a chance of a better neurological outcome. Despite these timely interventions, it is still very difficult to predict neurological outcome. The European Resuscitation Council and European Society of Intensive Care Medicine (ERC-ESICM) published guidance in 2015 with a strong recommendation to delay prognostication for at least 72 h and with an emphasis to adapt a multimodal approach, which includes neurological examination, biomarkers, electroencephalogram (EEG) and radiological tests. These interventions not only have cost attached to them, but the unpredictability has a significant emotional impact on family members. Bispectral index (BIS) monitoring device acts on the principle of EEG and converts the waveform into an absolute number and also measures the burst suppression. We hypothesize that patients who have a low BIS value and high burst suppression within 24 h of presentation will have a poor neurological outcome. The primary objective of this review is to look at BIS monitor as a tool, which could help bring forward the timing of prognostication. Methods: Electronic databases will be systematically searched for randomised controlled trials and prospective or retrospective cohort studies with no language restrictions. The search will be supplemented with grey literature searches of thesis, dissertations and hand searching of relevant journals. Two independent reviewers will screen, select and perform analysis according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) method. The selected studies will be analysed using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system. Meta-analysis will be performed if suitable. Discussion: This review will synthesize the evidence on the use of BIS monitors within 24 h of achieving return of spontaneous circulation (ROSC) and may help in early prognostication. Systematic review registration: PROSPERO CRD 42016050224. © 2017 The Author(s). AU - Eveson, L. AU - Vizcaychipi, M. AU - Patil, S. DA - 2017-1-1 IS - 1 KW - Electroencephalography Neurologic Examination systematic review study design retrospective study resuscitation randomized controlled trial (topic) priority journal out of hospital cardiac arrest meta analysis human heart catheterization functional neuroimaging electroencephalogram defibrillation clinical examination brain injury bispectral index automated external defibrillator Article biological marker Prognostication Out-of-hospital cardiac arrest OHCA Burst suppression BIS PY - 2017 SN - 2046-4053 ST - Role of bispectral index monitoring and burst suppression in prognostication following out-of-hospital cardiac arrest: A systematic review protocol T2 - Systematic Reviews TI - Role of bispectral index monitoring and burst suppression in prognostication following out-of-hospital cardiac arrest: A systematic review protocol VL - 6 ID - 141 ER - TY - JOUR AB - Background Before 2012, few studies had addressed pregnancy outcomes following maternal influenza vaccination; however, the number of publications on this topic has increased recently. Objectives To review comparative studies evaluating fetal death or preterm birth associated with influenza vaccination during pregnancy. Search strategy We searched bibliographic databases from inception to April 2014. Selection criteria Experimental or observational studies assessing the relationship between influenza vaccination during pregnancy and fetal death or preterm birth. Data collection and analysis Two reviewers independently abstracted data from studies meeting the inclusion criteria. Main results We included one randomised clinical trial and 26 observational studies. Meta-analyses were not considered appropriate because of high clinical and statistical heterogeneity. Three studies of fetal death at any gestational age reported adjusted effect estimates in the range 0.56-0.79, and four of five studies of fetal death at <20 weeks reported adjusted estimates between 0.89 and 1.23, all with confidence intervals including 1.0. Adjusted effect estimates for four of five studies of fetal death at ≥20 weeks ranged from 0.44 to 0.77 (two with confidence intervals not crossing 1.0), whereas a fifth reported a non-significant effect in the opposite direction. Among 19 studies of preterm birth, there was no strong evidence suggesting any increased risk, and meta-regression did not explain the moderate between-study heterogeneity (I2 = 57%). Authors' conclusions Most studies reported no association between fetal death or preterm birth and influenza vaccination during pregnancy. Although several reported risk reductions, results may be biased by methodological shortcomings of observational studies of influenza vaccine effectiveness. © 2014 Royal College of Obstetricians and Gynaecologists. AU - Fell, D. B. AU - Platt, R. W. AU - Lanes, A. AU - Wilson, K. AU - Kaufman, J. S. AU - Basso, O. AU - Buckeridge, D. DA - 2015-1-1 %J BJOG: An International Journal of Obstetrics and Gynaecology IS - 1 KW - Age Factors Vaccines Pregnancy Outcome Fetal Death Influenza Vaccines Pregnancy Influenza, Human Vaccination PY - 2015 SN - 1470-0328 SP - 17-26 ST - Fetal death and preterm birth associated with maternal influenza vaccination: Systematic review T2 - BJOG: An International Journal of Obstetrics and Gynaecology TI - Fetal death and preterm birth associated with maternal influenza vaccination: Systematic review VL - 122 ID - 300 ER - TY - JOUR AB - Background: Although pregnant women are considered at high risk for severe influenza disease, comparative studies of maternal influenza and birth outcomes have not been comprehensively summarised. Objective: To review comparative studies evaluating maternal influenza disease and birth outcomes. Search strategy: We searched bibliographic databases from inception to December 2014. Selection criteria: Studies of preterm birth, small-for-gestational-age (SGA) birth or fetal death, comparing women with and without clinical influenza illness or laboratory-confirmed influenza infection during pregnancy. Data collection and analysis: Two reviewers independently abstracted data and assessed study quality. Main results: Heterogeneity across 16 studies reporting preterm birth precluded meta-analysis. In a subgroup of the highest-quality studies, two reported significantly increased preterm birth (risk ratios (RR) from 2.4 to 4.0) following severe 2009 pandemic H1N1 (pH1N1) influenza illness, whereas those assessing mild-to-moderate pH1N1 or seasonal influenza found no association. Five studies of SGA birth showed no discernible patterns with respect to influenza disease severity (pooled odds ratio 1.24; 95% CI 0.96–1.59). Two fetal death studies were of sufficient quality and size to permit meaningful interpretation. Both reported an increased risk of fetal death following maternal pH1N1 disease (RR 1.9 for mild-to-moderate disease and 4.2 for severe disease). Conclusions: Comparative studies of preterm birth, SGA birth and fetal death following maternal influenza disease are limited in number and quality. An association between severe pH1N1 disease and preterm birth and fetal death was reported by several studies; however, these limited data do not permit firm conclusions on the magnitude of any association. Tweetable abstract: Comparative studies are limited in quality but suggest severe pandemic H1N1 influenza increases preterm birth. © 2016 World Health Organization; licensed by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists. AU - Fell, D. B. AU - Savitz, D. A. AU - Kramer, M. S. AU - Gessner, B. D. AU - Katz, M. A. AU - Knight, M. AU - Luteijn, J. M. AU - Marshall, H. AU - Bhat, N. AU - Gravett, M. G. AU - Skidmore, B. AU - Ortiz, J. R. DA - 2017-1-1 %J BJOG: An International Journal of Obstetrics and Gynaecology IS - 1 KW - Pregnancy Odds Ratio Fetal Death Influenza, Human PY - 2017 SN - 1470-0328 SP - 48-59 ST - Maternal influenza and birth outcomes: systematic review of comparative studies T2 - BJOG: An International Journal of Obstetrics and Gynaecology TI - Maternal influenza and birth outcomes: systematic review of comparative studies VL - 124 ID - 292 ER - TY - JOUR AB - Taxane acute pain syndrome (TAPS) is characterized by myalgia and arthralgia starting 24 to 48 hours after taxane-based chemotherapy and lasting ≤ 7 days. Little is known about its incidence and predisposing factors in patients with prostate cancer. A systematic review was performed to identify studies reporting the incidence and risk factors for TAPS in patients receiving taxane-based chemotherapy for prostate cancer. Embase, Ovid Medline, and other nonindexed citations were searched from 1947 to July 7, 2015. Randomized trials and prospective observational studies reporting the outcomes for prostate cancer patients who had received taxane-based chemotherapy were assessed. Four reviewers independently screened the citations and full text reports for data collection. Of 980 citations, 5 studies (2710 patients) met the eligibility criteria. The incidence of myalgia and arthralgia was reported in 4 trials (14%, [29% and 38%], 44.2%, and 46%). TAPS was not reported with cabazitaxel chemotherapy. Clinical risk factors were identified in 4 studies, suggesting that TAPS was numerically more common in the castrate-resistant setting and when concurrent medications (eg, corticosteroids) were not used. Although the TAPS incidence has been poorly reported in clinical practice, the results of the present study suggest that arthralgia and myalgia are a common toxicity in patients with prostate cancer. An improved and universal definition of TAPS, patient-directed reporting of TAPS, and improved standardized assessments are needed to better identify patients at the greatest risk of experiencing TAPS and improving patient care. © 2016 Elsevier Inc. AU - Fernandes, R. AU - Mazzarello, S. AU - Hutton, B. AU - Shorr, R. AU - Ibrahim, M. F. K. AU - Jacobs, C. AU - Ong, M. AU - Clemons, M. DA - 2017-1-1 IS - 1 KW - Arthralgia Prostatitis Prostatism Risk Factors Prostate Prostatic Neoplasms Taxoids PY - 2017 SP - 1-6 ST - A Systematic Review of the Incidence and Risk Factors for Taxane Acute Pain Syndrome in Patients Receiving Taxane-Based Chemotherapy for Prostate Cancer T2 - Clinical Genitourinary Cancer TI - A Systematic Review of the Incidence and Risk Factors for Taxane Acute Pain Syndrome in Patients Receiving Taxane-Based Chemotherapy for Prostate Cancer VL - 15 ID - 16 ER - TY - JOUR AB - Background: Taxane acute pain syndrome (TAPS) is characterized by myalgias and arthralgias starting 24–48 h after taxane-based chemotherapy and lasting for 5–7 days. Relatively little is known about its incidence and impact on quality of life. Objectives: A systematic review was conducted evaluating the incidence of TAPS in breast cancer patients receiving taxane-based chemotherapy. Methods: Embase, Cochrane, and Ovid MEDLINE were searched from 1947 to July 2015. Data was sought from randomized controlled trials (RCTs), prospective and retrospective observational studies. Two reviewers independently screened citations and full text articles. Outcomes of interest were the incidence of TAPS and its impact on quality of life. Results: Of 980 citations identified, 51 relevant studies (27,007 patients) were included. Data came from RCTs (12,357 patients), retrospective (6566 patients) and prospective observational studies (6210 patients). Study sample sizes ranged from 14 to 4149 patients (median 152). Given the significance between study heterogeneity, a meta-analysis was not performed. The incidence of TAPS varied between taxanes: paclitaxel (median 13.1 %, range 0.9–86 %), docetaxel (median 10.5 %, range 3.6–70 %), and nab-paclitaxel (26 %, range 14–43 %). In the metastatic setting, median incidence was 30 % (range 5.4–73 %), compared with 11.3 % (range 0.9–86 %) in the adjuvant setting. Three out of eight studies assessing quality of life demonstrated pain interference with daily activities. Conclusions: The incidence of TAPS varies between taxanes, regimens, and disease settings. In order to identify patients at the greatest risk of TAPS, and hence optimize its prevention and management, standardized methods of diagnosing and measuring TAPS are needed. © 2016, Springer-Verlag Berlin Heidelberg. AU - Fernandes, R. AU - Mazzarello, S. AU - Hutton, B. AU - Shorr, R. AU - Majeed, H. AU - Ibrahim, M. F. K. AU - Jacobs, C. AU - Ong, M. AU - Clemons, M. DA - 2016-1-1 IS - 8 KW - Arthralgia Taxoids Quality of Life Middle Aged Humans Female Breast Neoplasms Antineoplastic Agents Acute Pain complication chemically induced taxane acute pain syndrome systematic review risk assessment Review randomized controlled trial (topic) priority journal phase 3 clinical trial (topic) phase 2 clinical trial (topic) phase 1 clinical trial (topic) pain outcome assessment metastasis meta analysis incidence human high risk patient daily life activity cancer patient cancer chemotherapy breast cancer taxoid antineoplastic agent taxane derivative paclitaxel docetaxel Taxane chemotherapy PY - 2016 SP - 3633-3650 ST - Taxane acute pain syndrome (TAPS) in patients receiving taxane-based chemotherapy for breast cancer—a systematic review T2 - Supportive Care in Cancer TI - Taxane acute pain syndrome (TAPS) in patients receiving taxane-based chemotherapy for breast cancer—a systematic review VL - 24 ID - 174 ER - TY - JOUR AB - CONTEXT: Permanent hearing loss affects 1 to 3 per 1000 children and interferes with typical communication development. Early detection through newborn hearing screening and hearing technology provide most children with the option of spoken language acquisition. However, no consensus exists on optimal interventions for spoken language development. OBJECTIVE: To conduct a systematic review of the effectiveness of early sign and oral language intervention compared with oral language intervention only for children with permanent hearing loss. DATA SOURCES: An a priori protocol was developed. Electronic databases (eg, Medline, Embase, CINAHL) from 1995 to June 2013 and gray literature sources were searched. Studies in English and French were included. STUDY SELECTION: Two reviewers screened potentially relevant articles. DATA EXTRACTION: Outcomes of interest were measures of auditory, vocabulary, language, and speech production skills. All data collection and risk of bias assessments were completed and then verified by a second person. Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) was used to judge the strength of evidence. Results: Eleven cohort studies metinclusion criteria, of which 8 included only children with severe to profound hearing loss with cochlear implants. Language development was the most frequently reported outcome. Other reported outcomes included speech and speech perception. LIMITATIONS: Several measures and metrics were reported across studies, and descriptions of interventions were sometimes unclear. Conclusions: Very limited, and hence insufficient, high-quality evidence exists to determine whethersign language in combination with oral language is more effective than oral language therapy alone. More research is needed to supplement the evidence base. © 2016 by the American Academy of Pediatrics. AU - Fitzpatrick, E. M. AU - Hamel, C. AU - Stevens, A. AU - Pratt, M. AU - Moher, D. AU - Doucet, S. P. AU - Neuss, D. AU - Bernstein, A. AU - Na, E. DA - 2016-1-1 %J Pediatrics IS - 1 KW - Language Child Only Child PY - 2016 ST - Sign language and spoken language for children with hearing loss: A systematic review T2 - Pediatrics TI - Sign language and spoken language for children with hearing loss: A systematic review VL - 137 ID - 296 ER - TY - JOUR AB - Background. Flax is a food and dietary supplement commonly used for menopausal symptoms. Flax is known for its lignan, α-linolenic acid, and fiber content, components that may possess phytogestrogenic, anti-inflammatory, and hormone modulating effects, respectively. We conducted a systematic review of flax for efficacy in improving menopausal symptoms in women living with breast cancer and for potential impact on risk of breast cancer incidence or recurrence. Methods. We searched MEDLINE, Embase, the Cochrane Library, and AMED from inception to January 2013 for human interventional or observational data pertaining to flax and breast cancer. Results. Of 1892 records, we included a total of 10 studies: 2 randomized controlled trials, 2 uncontrolled trials, 1 biomarker study, and 5 observational studies. Nonsignificant (NS) decreases in hot flash symptomatology were seen with flax ingestion (7.5 g/d). Flax (25 g/d) increased tumor apoptotic index (P <.05) and decreased HER2 expression (P <.05) and cell proliferation (Ki-67 index; NS) among newly diagnosed breast cancer patients when compared with placebo. Uncontrolled and biomarker studies suggest beneficial effects on hot flashes, cell proliferation, atypical cytomorphology, and mammographic density, as well as possible anti-angiogenic activity at doses of 25 g ground flax or 50 mg secoisolariciresinol diglycoside daily. Observational data suggests associations between flax and decreased risk of primary breast cancer (adjusted odds ratio [AOR] = 0.82; 95% confidence interval [CI] = 0.69-0.97), better mental health (AOR = 1.76; 95% CI = 1.05-2.94), and lower mortality (multivariate hazard ratio = 0.69; 95% CI = 0.50-0.95) among breast cancer patients. Conclusions. Current evidence suggests that flax may be associated with decreased risk of breast cancer. Flax demonstrates antiproliferative effects in breast tissue of women at risk of breast cancer and may protect against primary breast cancer. Mortality risk may also be reduced among those living with breast cancer. © The Author(s) 2014. AU - Flower, G. AU - Fritz, H. AU - Balneaves, L. G. AU - Verma, S. AU - Skidmore, B. AU - Fernandes, R. AU - Kennedy, D. AU - Cooley, K. AU - Wong, R. AU - Sagar, S. AU - Fergusson, D. AU - Seely, D. DA - 2014-1-1 IS - 3 KW - Biological Markers Humanism Humanities Menopause Humans Hot Flashes Glucosides Flax Female Dietary Supplements Cell Proliferation Butylene Glycols Breast Neoplasms Breast Density pathology drug effects dietary supplement chemistry systematic review symptomatology risk reduction review randomized controlled trial (topic) protein expression priority journal nonhuman nausea mental health menstrual irregularity menopausal syndrome mammography incidence human hot flush gastrointestinal symptom flatulence cell structure cancer risk cancer recurrence cancer patient cancer mortality breast cancer breast bloating apoptosis antiproliferative activity antiangiogenic activity abdominal disease secoisolariciresinol diglucoside glucoside butanediol unclassified drug secoisolariciresinol plant extract Ki 67 antigen flax extract epidermal growth factor receptor 2 biological marker phytoestrogen Linum usitatissimum integrative oncology complementary and alternative medicine (CAM) breast neoplasm PY - 2014 SN - 1534-7354 SP - 181-192 ST - Flax and breast cancer: A systematic review T2 - Integrative Cancer Therapies TI - Flax and breast cancer: A systematic review VL - 13 ID - 249 ER - TY - JOUR AB - Background: Healthcare professionals are important contributors to healthcare quality and patient safety, but their performance does not always follow recommended clinical practice. There are many approaches to influencing practice among healthcare professionals. These approaches include audit and feedback, reminders, educational materials, educational outreach visits, educational meetings or conferences, use of local opinion leaders, financial incentives, and organisational interventions. In this review, we evaluated the effectiveness of patient-mediated interventions. These interventions are aimed at changing the performance of healthcare professionals through interactions with patients, or through information provided by or to patients. Examples of patient-mediated interventions include 1) patient-reported health information, 2) patient information, 3) patient education, 4) patient feedback about clinical practice, 5) patient decision aids, 6) patients, or patient representatives, being members of a committee or board, and 7) patient-led training or education of healthcare professionals. Objectives: To assess the effectiveness of patient-mediated interventions on healthcare professionals' performance (adherence to clinical practice guidelines or recommendations for clinical practice). Search methods: We searched MEDLINE, Ovid in March 2018, Cochrane Central Register of Controlled Trials (CENTRAL) in March 2017, and ClinicalTrials.gov and the International Clinical Trials Registry (ICTRP) in September 2017, and OpenGrey, the Grey Literature Report and Google Scholar in October 2017. We also screened the reference lists of included studies and conducted cited reference searches for all included studies in October 2017. Selection criteria: Randomised studies comparing patient-mediated interventions to either usual care or other interventions to improve professional practice. Data collection and analysis: Two review authors independently assessed studies for inclusion, extracted data and assessed risk of bias. We calculated the risk ratio (RR) for dichotomous outcomes using Mantel-Haenszel statistics and the random-effects model. For continuous outcomes, we calculated the mean difference (MD) using inverse variance statistics. Two review authors independently assessed the certainty of the evidence (GRADE). Main results: We included 25 studies with a total of 12,268 patients. The number of healthcare professionals included in the studies ranged from 12 to 167 where this was reported. The included studies evaluated three types of patient-mediated interventions: 1) patient-reported health information interventions (for instance information obtained from patients about patients' own health, concerns or needs before a clinical encounter), 2) patient information interventions (for instance, where patients are informed about, or reminded to attend recommended care), and 3) patient education interventions (intended to increase patients' knowledge about their condition and options of care, for instance). For each type of patient-mediated intervention a separate meta-analysis was produced. Patient-reported health information interventions probably improve healthcare professionals' adherence to recommended clinical practice (moderate-certainty evidence). We found that for every 100 patients consulted or treated, 26 (95% CI 23 to 30) are in accordance with recommended clinical practice compared to 17 per 100 in the comparison group (no intervention or usual care). We are uncertain about the effect of patient-reported health information interventions on desirable patient health outcomes and patient satisfaction (very low-certainty evidence). Undesirable patient health outcomes and adverse events were not reported in the included studies and resource use was poorly reported. Patient information interventions may improve healthcare professionals' adherence to recommended clinical practice (low-certainty evidence). We found that for every 100 patients consulted or treated, 32 (95% CI 24 to 42) are in accordance with recommended cli ical practice compared to 20 per 100 in the comparison group (no intervention or usual care). Patient information interventions may have little or no effect on desirable patient health outcomes and patient satisfaction (low-certainty evidence). We are uncertain about the effect of patient information interventions on undesirable patient health outcomes because the certainty of the evidence is very low. Adverse events and resource use were not reported in the included studies. Patient education interventions probably improve healthcare professionals' adherence to recommended clinical practice (moderate-certainty evidence). We found that for every 100 patients consulted or treated, 46 (95% CI 39 to 54) are in accordance with recommended clinical practice compared to 35 per 100 in the comparison group (no intervention or usual care). Patient education interventions may slightly increase the number of patients with desirable health outcomes (low-certainty evidence). Undesirable patient health outcomes, patient satisfaction, adverse events and resource use were not reported in the included studies. Patient decision aid interventions may have little or no effect on healthcare professionals' adherence to recommended clinical practice (low-certainty evidence). We found that for every 100 patients consulted or treated, 32 (95% CI 24 to 43) are in accordance with recommended clinical practice compared to 37 per 100 in the comparison group (usual care). Patient health outcomes, patient satisfaction, adverse events and resource use were not reported in the included studies. Authors' conclusions: We found that two types of patient-mediated interventions, patient-reported health information and patient education, probably improve professional practice by increasing healthcare professionals' adherence to recommended clinical practice (moderate-certainty evidence). We consider the effect to be small to moderate. Other patient-mediated interventions, such as patient information may also improve professional practice (low-certainty evidence). Patient decision aids may make little or no difference to the number of healthcare professionals' adhering to recommended clinical practice (low-certainty evidence). The impact of these interventions on patient health and satisfaction, adverse events and resource use, is more uncertain mostly due to very low certainty evidence or lack of evidence. © 2018 The Cochrane Collaboration. AU - Fønhus, M. S. AU - Dalsbø, T. K. AU - Johansen, M. AU - Fretheim, A. AU - Skirbekk, H. AU - Flottorp, S. A. C2 - 30204235 C7 - Cd012472 DB - Scopus DO - 10.1002/14651858.CD012472.pub2 IS - 9 KW - clinical practice data analysis feedback system health care utilization human medical information patient decision making patient education patient information patient mediated intervention patient participation patient safety patient satisfaction patient-reported outcome priority journal professional practice protocol compliance Review risk assessment staff training systematic error systematic review decision support system health care quality meta analysis procedures professional-patient relationship randomized controlled trial (topic) standards statistics and numerical data total quality management Decision Support Techniques Humans Patient Education as Topic Patient Reported Outcome Measures Professional-Patient Relations Quality Improvement Quality of Health Care Randomized Controlled Trials as Topic M3 - Review PY - 2018 ST - Patient-mediated interventions to improve professional practice T2 - Cochrane Database of Systematic Reviews TI - Patient-mediated interventions to improve professional practice VL - 2018 ID - 308 ER - TY - JOUR AB - This article reports a systematic review of the literature examining therapists' views and experiences of utilizing treatment manuals. Key databases were searched and a thematic narrative analysis was conducted. Twelve articles were identified. The literature contains four distinct subthemes: (i) exposure to and use of manuals; (ii) therapists' beliefs about manuals; (iii) therapist characteristics, such as age/gender/training and (iv) characteristics of the work, such as client group. The analysis finds that clinicians who have used manuals appraise them positively, and view them as facilitating flexibility, allowing for therapeutic relationship and keeping therapy on track. The review is a helpful contribution to the literature and is a prompt to practitioners to consider their own views and exposure to manualized treatments and how this relates to generating the 'hard' outcome data that governments and service commissioners internationally find credible and persuasive. Practitioner points: The positive appraisal of manuals is increased through exposure to them in clinical practice or research settings. Clinicians may wish, therefore, to seek out opportunities to use manuals. Clinicians are rarely exposed to manuals, which presents a potential topic for training courses to address. © 2014 The Association for Family Therapy and Systemic Practice. AU - Forbat, L. AU - Black, L. AU - Dulgar, K. DA - 2015-1-1 IS - 4 KW - Psychotherapy Teaching/training Research Manuals Evidence-based practice PY - 2015 SN - 0163-4445 SP - 409-428 ST - What clinicians think of manualized psychotherapy interventions: Findings from a systematic review T2 - Journal of Family Therapy TI - What clinicians think of manualized psychotherapy interventions: Findings from a systematic review VL - 37 ID - 224 ER - TY - JOUR AB - Background Erythropoiesis-stimulating agents (ESAs) increase red blood cell production in patients with chemotherapy-induced anemia (CIA). In Europe, short-acting ESAs (epoetin alfa, epoetin beta, epoetin zeta, and epoetin theta) and a long-acting ESA (darbepoetin alfa) are available to treat CIA. Objective This systematic review aimed to determine potential dose efficiency associated with the use of different ESAs for the treatment of CIA according to European labeling. Methods A systematic review of ESA studies with starting doses according to European labeling was conducted according to published methodology. Measures of dose efficiency were defined as mean weekly doses to achieve target hemoglobin level or final dose and dose adjustments (dose increase, decrease, or withheld). Electronic databases and grey literature sources were searched up to July 2012. Data were selected for analysis using an evidence hierarchy and quantitatively analyzed to assess statistical homogeneity. Where pooling of data was not appropriate, a narrative summary with descriptive statistics (medians and ranges) was reported. Results Fifty-five studies met the inclusion criteria. Twenty-five studies considered to represent the highest level of evidence were extracted and included in the analysis. The analysis showed a high degree of statistical heterogeneity, often precluding meta-analysis. The patients included in the analysis were representative of those encountered in clinical practice, and patient characteristics were similar between the short-acting and the darbepoetin alfa groups. Mean weekly doses appeared ~30% lower with darbepoetin alfa versus short-acting ESAs (median, 136.5 μg or 27,300 IU [range, 21,560-38,260 IU] vs 38,230 IU [range, 31,634-42,714 IU], respectively), resulting in a mean weekly dose ratio of 1:280. Darbepoetin alfa patients appeared to need fewer dose increases compared with short-acting ESAs (pooled, 0.75%; I2 = 21% vs median 26.6% [range, 7.6%-44.6%]) and more dose decreases (median, 74% [range, 57%-75%] vs 22% [range, 2.8%-59%]). A similar percentage of darbepoetin alfa and short-acting ESA patients required a dose to be withheld (20% and 33% [2 studies] vs median 33.2% [range, 12.6%-51.1%]). Conclusions Statistical heterogeneity between studies was high, although clinically the studies represented medical practice. Without randomized clinical trials directly comparing darbepoetin alfa and short-acting ESAs, these findings are tentative and future research is warranted. This review shows that good-quality, reliable data from head-to-head trials are lacking. The best available evidence comes from prospective ESA-arm data. Mean weekly doses, dose increases, and dose decreases suggest a dose efficiency for darbepoetin alfa compared with short-acting ESAs. © 2014 The Authors. AU - Forbes, C. A. AU - Worthy, G. AU - Harker, J. AU - Kleijnen, J. AU - Kutikova, L. AU - Zelek, L. AU - Van Belle, S. DA - 2014-1-1 %J Clinical Therapeutics IS - 4 KW - Hematinics Erythrocytes Anemia PY - 2014 SP - 594-610.e4 ST - Dose efficiency of Erythropoiesis-Stimulating agents for the treatment of patients with chemotherapy-induced anemia: A systematic review T2 - Clinical Therapeutics TI - Dose efficiency of Erythropoiesis-Stimulating agents for the treatment of patients with chemotherapy-induced anemia: A systematic review VL - 36 ID - 301 ER - TY - JOUR AB - Background: Delirium is a syndrome characterized by acute fluctuations and alterations in attention and arousal. Critically ill patients are at particularly high risk, and those that develop delirium are more likely to experience poor clinical outcomes such as prolonged duration of ICU and hospital length of stay, and increased mortality. Melatonin and melatonin agonists (MMA) have the potential to decrease the incidence and severity of delirium through their hypnotic and sedative-sparing effects, thus improving health-related outcomes. The objective of this review is to synthesize the available evidence pertaining to the efficacy and safety of MMA for the prevention and treatment of ICU delirium. Methods: We will search Ovid MEDLINE, Web of Science, EMBASE, PsycINFO, the Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL to identify studies evaluating MMA in critically ill populations. We will also search http://apps.who.int/trialsearch for ongoing and unpublished studies and PROSPERO for registered reviews. We will not impose restrictions on language, date, or journal of publication. Authors will independently screen for eligible studies using pre-defined criteria; data extraction from eligible studies will be performed in duplicate. The Cochrane Risk of Bias Scale and the Newcastle-Ottawa Scale will be used to assess the risk of bias and quality of randomized and non-randomized studies, respectively. Our primary outcome of interest is delirium incidence, and secondary outcomes include duration of delirium, number of delirium- and coma-free days, use of physical and chemical (e.g., antipsychotics or benzodiazepines) restraints, duration of mechanical ventilation, ICU and hospital length of stay, mortality, long-term neurocognitive outcomes, hospital discharge disposition, and adverse events. We will use Review Manager (RevMan) to pool effect estimates from included studies. We will present results as relative risks with 95% confidence intervals for dichotomous outcomes and as mean differences, or standardized mean differences, for continuous outcomes. Discussion: Current guidelines make no pharmacological recommendations for either the prevention or treatment of ICU delirium. This systematic review will synthesize the available evidence on the efficacy and safety of MMA for this purpose, thus potentially informing clinical decision-making and improving patient outcomes. Systematic review registration:PROSPERO CRD42015024713. © 2016 The Author(s). AU - Foster, J. AU - Burry, L. D. AU - Thabane, L. AU - Choong, K. AU - Menon, K. AU - Duffett, M. AU - Cheung, A. AU - Guenette, M. AU - Chimunda, T. AU - Rose, L. DA - 2016-1-1 IS - 1 KW - Length of Stay Research Design Melatonin Hypnotics and Sedatives Humans Delirium Critical Illness Critical Care methodology intensive care treatment outcome systematic review search engine randomized controlled trial (topic) publication public health priority journal mortality hypnotic susceptibility human drug safety drug efficacy decision making cognition artificial ventilation Article abdominal cramp hypnotic sedative agent ramelteon melatonin receptor agonist melatonin derivative Treatment Prevention Melatonin agonists PY - 2016 SN - 2046-4053 ST - Melatonin and melatonin agonists to prevent and treat delirium in critical illness: A systematic review protocol T2 - Systematic Reviews TI - Melatonin and melatonin agonists to prevent and treat delirium in critical illness: A systematic review protocol VL - 5 ID - 116 ER - TY - JOUR AB - Introduction: Polymyxin-B immobilised haemoperfusion (PMX-HP) is a promising adjuvant strategy for the treatment of sepsis and septic shock. PMX-HP therapy works by clearing circulating endotoxin through binding to polymyxin-immobilised fibres during haemoperfusion. Small clinical trials have shown that PMX-HP therapy is associated with improved haemodynamic profile, oxygenation and survival. However, clear inferences have been largely inconclusive due to limitations in study design (eg, small, unblinded) and generalisability. We therefore propose to perform an up-to-date systematic review and evidence synthesis to describe the efficacy, safety and effectiveness of PMX-HP for adult patients with sepsis or septic shock. Methods and analysis: We will search the following databases from 1946 to 2016 MEDLINE (Ovid), EMBASE (Ovid), Cochrane Library, Health Technology Assessment Database (HTA), Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed and 'Igaku Chuo Zasshi' (ICHUSHI) for randomised controlled trials of PMX-HP in critically ill patients with sepsis or septic shock. There will be no language restrictions in the electronic search for studies. Two reviewers will extract data and appraise the quality of each study independently. The primary outcome will be the pooled risk ratio of 28-day all-cause mortality. Serious adverse events and changes in organ dysfunction scores will also be evaluated. The secondary outcomes will be 90-day all-cause mortality, changes in haemodynamic profile and endotoxin levels, and health services use. Ethics and dissemination: Our systematic review will synthesise the evidence on use of the PMX-HP as an adjuvant therapy in sepsis/septic shock to improve patient-centred, physiological and health services outcomes. Research ethics is not required for this review. The study will be disseminated by peer-reviewed publication and conference presentation. © 2016 Published by the BMJ Publishing Group Limited. AU - Fujii, T. AU - Ganeko, R. AU - Kataoka, Y. AU - Featherstone, R. AU - Bagshaw, S. M. AU - Furukawa, T. A. DA - 2016-1-1 IS - 11 KW - Sepsis Colistin Polymyxins Time Factors Shock, Septic Research Design Randomized Controlled Trials as Topic Polymyxin B Organ Dysfunction Scores Odds Ratio Mortality Humans Hemoperfusion Hemodynamics Endotoxins Critical Illness Anti-Bacterial Agents time factor septic shock procedures organ dysfunction score methodology blood systematic review Sequential Organ Failure Assessment Score Review randomized controlled trial (topic) meta analysis human drug safety drug efficacy critically ill patient clinical protocol clinical effectiveness adult adjuvant therapy endotoxin antiinfective agent polymyxin meta-analysis PY - 2016 SN - 2044-6055 ST - Polymyxin B-immobilised haemoperfusion and mortality in critically ill patients with sepsis/septic shock: A protocol for a systematic review and meta-analysis T2 - BMJ Open TI - Polymyxin B-immobilised haemoperfusion and mortality in critically ill patients with sepsis/septic shock: A protocol for a systematic review and meta-analysis VL - 6 ID - 169 ER - TY - JOUR AB - Purpose: Polymyxin B-immobilized hemoperfusion (PMX-HP) is an adjuvant therapy for sepsis or septic shock that clears circulating endotoxin. Prior trials have shown that PMX-HP improves surrogate endpoints. We aimed to conduct an evidence synthesis to evaluate the efficacy and safety of PMX-HP in critically ill adult patients with sepsis or septic shock. Methods: We searched for randomized controlled trials (RCTs) in MEDLINE, EMBASE, the Cochrane Library, the Health Technology Assessment Database, CINAHL, “Igaku Chuo Zasshi”, the National Institute of Health Clinical Trials Register, the World Health Organization International Clinical Trials Registry Platform, the University Hospital Medical Information Network Clinical Trials Registry, the reference lists of retrieved articles, and publications by manufacturers of PMX-HP. The primary outcomes were 28-day all-cause mortality, the number of patients with at least one serious adverse event, and organ dysfunction scores. The GRADE methodology for the certainty of evidence was used. Results: Six trials (857 participants; weighted mean age 62.5 years) proved eligible. Patient-oriented primary outcomes were assessed. The pooled risk ratio (RR) for 28-day mortality associated with PMX-HP was 1.03 [95% confidence interval (CI) 0.78–1.36; I2 = 25%; n = 797]. The pooled RR for adverse events was 2.17 (95% CI 0.68–6.94; I2 = 0%; n = 717). Organ dysfunction scores over 24–72 h after PMX-HP treatment did not change significantly (standardized mean difference − 0.26; 95% CI − 0.64 to 0.12; I2 = 78%; n = 797). The certainty of the body of evidence was judged as low for both benefit and harm using the GRADE methodology. Conclusions: There is currently insufficient evidence to support the routine use of PMX-HP to treat patients with sepsis or septic shock. Registration: PROSPERO International Prospective Register of Systematic Reviews (CRD42016038356). © 2017, Springer-Verlag GmbH Germany, part of Springer Nature and ESICM. AU - Fujii, T. AU - Ganeko, R. AU - Kataoka, Y. AU - Furukawa, T. A. AU - Featherstone, R. AU - Doi, K. AU - Vincent, J. L. AU - Pasero, D. AU - Robert, R. AU - Ronco, C. AU - Bagshaw, S. M. DA - 2018-1-1 IS - 2 KW - Polymyxin B Colistin Adult Shock, Septic Hemoperfusion Critical Illness Polymyxins systematic review sequential analysis septic shock Review patient safety outcome assessment organ dysfunction score mortality risk meta analysis human hospital mortality critically ill patient clinical outcome clinical effectiveness all cause mortality adverse outcome adverse drug reaction Sepsis Polymyxin B-immobilized hemoperfusion Meta-analysis PY - 2018 SP - 167-178 ST - Polymyxin B-immobilized hemoperfusion and mortality in critically ill adult patients with sepsis/septic shock: a systematic review with meta-analysis and trial sequential analysis T2 - Intensive Care Medicine TI - Polymyxin B-immobilized hemoperfusion and mortality in critically ill adult patients with sepsis/septic shock: a systematic review with meta-analysis and trial sequential analysis VL - 44 ID - 130 ER - TY - JOUR AB - Background. UK trauma services are currently undergoing reconfiguration, but the optimum management pathway for head-injured patients is uncertain. We therefore performed a systematic review to assess the effects of routine inter-hospital transfer and specialist neuroscience care on mortality and disability in patients with non-surgical severe traumatic brain injury injured nearest to a non-specialist acute hospital. Methods. A protocol was registered with PROSPERO (CRD42012002021) and review methodology followed Cochrane Collaboration recommendations. A peer reviewed search strategy was implemented in an exhaustive range of information sources, including all major bibliographic databases, between 1973 and July 2013. Selection of eligible studies, extraction of relevant data and bias assessment were then performed by two independent reviewers. In the absence of homogeneous effect estimates at low risk of bias a narrative synthesis was pre-specified. Results. Four cohort studies, including a total of 4688 patients, were identified as potentially eligible after screening and bias assessment. Confounding by indication, arising from selective transfer of less severely injured patients, was the main limitation of included studies, with overall risk of bias rated as high for both mortality and disability effect estimates. Adjusted odds ratios for mortality favoured secondary transfer, ranging from 1.92 (95% CI 1.25-2.95) to 2.09 (95% CI 1.59-2.74). No convincing association was observed between non-specialist care and unfavourable outcome with a conditional odds ratio of 1.13 (95% CI 0.36-3.6). Conclusions. There is limited evidence supporting a strategy of secondary transfer of severe non-surgical traumatic brain injury patients to specialist neuroscience centres. Randomised controlled trials powered to detect clinically plausible treatment effects should be considered to definitively investigate effectiveness. © 2014 The Neurosurgical Foundation. AU - Fuller, G. AU - Pallot, D. AU - Coats, T. AU - Lecky, F. DA - 2014-1-1 IS - 4 KW - Neurosciences Brain Bias (Epidemiology) Treatment Outcome Specialization Neurosurgical Procedures Humans Great Britain Clinical Trials as Topic Brain Injuries United Kingdom neurosurgery meta analysis clinical trial (topic) traumatic brain injury systematic review (topic) risk reduction risk assessment randomized controlled trial (topic) priority journal patient transport patient risk patient care outcome assessment observational study neuroscience narrative mortality meta analysis (topic) medical specialist human head injury Glasgow outcome scale disease association disability cohort analysis clinical effectiveness clinical assessment bibliographic database article Trauma systems Neurocritical care Craniocerebral trauma PY - 2014 SN - 0268-8697 1360-046X (electronic) SP - 452-460 ST - The effectiveness of specialist neuroscience care in severe traumatic brain injury: A systematic review T2 - British Journal of Neurosurgery TI - The effectiveness of specialist neuroscience care in severe traumatic brain injury: A systematic review VL - 28 ID - 40 ER - TY - JOUR AB - Context: The anti-inflammatory activity of long-chain n-3 polyunsaturated fatty acids (PUFAs) has been established in several chronic inflammatory diseases but has yet to be demonstrated in inflammatory lung diseases such as chronic obstructive pulmonary disease (COPD). Objective: The aim of this systematic review was to investigate, using PRISMA guidelines, the relationship between the intake of long-chain n-3 PUFAs and the prevalence, severity, and health outcomes of COPD. Data Sources: Eight health databases and the World Health Organization's international clinical trial registry were searched for relevant studies. Study Selection: Experimental or observational studies that were published in English and that assessed long-chain n-3 PUFA intake (by determining habitual consumption and/or tissue levels) in adults with COPD were included. Data Extraction: Publication demographics, participant characteristics, type of intervention or exposure, long-chain n-3 PUFA intake, pulmonary function, COPD mortality, and COPD severity were independently extracted from each article by 2 authors using a prospectively designed data extraction tool. Data Synthesis: All 11 of the studies included in the review were observational. Approximately equal numbers of studies reported significant (n=6, 5 inverse) relationships or no significant relationships (n=5) between either consumption of long-chain n-3 PUFAs or levels of long-chain n-3 PUFAS in tissue and a COPD outcome. Conclusions: Current evidence of a relationship between long-chain n-3 PUFA intake and COPD is limited and conflicting, with studies having wide methodological variation. Registration number: PROSPERO 2013:CRD42013004085. © 2015. AU - Fulton, A. S. AU - Hill, A. M. AU - Williams, M. T. AU - Howe, P. R. C. AU - Coates, A. M. DA - 2015-1-1 IS - 9 KW - Lung Diseases Lung Diseases, Obstructive Pulmonary Disease, Chronic Obstructive Prevalence Humans Fatty Acids, Unsaturated Fatty Acids, Omega-3 Chronic Disease world health organization systematic review publishing prospective study practice guideline observational study mortality lung function human fat intake disease severity chronic obstructive lung disease Article unsaturated fatty acid omega 3 fatty acid long chain fatty acid Polyunsaturated fatty acid long-chain n-3 fatty acid LCn-3 PUFA COPD Chronic obstructive pulmonary disease PY - 2015 SN - 0029-6643 SP - 612-623 ST - Paucity of evidence for a relationship between long-chain omega-3 fatty acid intake and chronic obstructive pulmonary disease: A systematic review T2 - Nutrition Reviews TI - Paucity of evidence for a relationship between long-chain omega-3 fatty acid intake and chronic obstructive pulmonary disease: A systematic review VL - 73 ID - 202 ER - TY - JOUR AB - Background: Biomedical journals are the main route for disseminating the results of health-related research. Despite this, their editors operate largely without formal training or certification. To our knowledge, no body of literature systematically identifying core competencies for scientific editors of biomedical journals exists. Therefore, we aimed to conduct a scoping review to determine what is known on the competency requirements for scientific editors of biomedical journals. Methods: We searched the MEDLINE®, Cochrane Library, Embase®, CINAHL, PsycINFO, and ERIC databases (from inception to November 2014) and conducted a grey literature search for research and non-research articles with competency-related statements (i.e. competencies, knowledge, skills, behaviors, and tasks) pertaining to the role of scientific editors of peer-reviewed health-related journals. We also conducted an environmental scan, searched the results of a previous environmental scan, and searched the websites of existing networks, major biomedical journal publishers, and organizations that offer resources for editors. Results: A total of 225 full-text publications were included, 25 of which were research articles. We extracted a total of 1,566 statements possibly related to core competencies for scientific editors of biomedical journals from these publications. We then collated overlapping or duplicate statements which produced a list of 203 unique statements. Finally, we grouped these statements into seven emergent themes: (1) dealing with authors, (2) dealing with peer reviewers, (3) journal publishing, (4) journal promotion, (5) editing, (6) ethics and integrity, and (7) qualities and characteristics of editors. Discussion: To our knowledge, this scoping review is the first attempt to systematically identify possible competencies of editors. Limitations are that (1) we may not have captured all aspects of a biomedical editor's work in our searches, (2) removing redundant and overlapping items may have led to the elimination of some nuances between items, (3) restricting to certain databases, and only French and English publications, may have excluded relevant publications, and (4) some statements may not necessarily be competencies. Conclusion: This scoping review is the first step of a program to develop a minimum set of core competencies for scientific editors of biomedical journals which will be followed by a training needs assessment, a Delphi exercise, and a consensus meeting. © 2016 Galipeau et al. AU - Galipeau, J. AU - Barbour, V. AU - Baskin, P. AU - Bell-Syer, S. AU - Cobey, K. AU - Cumpston, M. AU - Deeks, J. AU - Garner, P. AU - MacLehose, H. AU - Shamseer, L. AU - Straus, S. AU - Tugwell, P. AU - Wager, E. AU - Winker, M. AU - Moher, D. DA - 2016-1-1 IS - 1 KW - Quality Control Publishing Professional Competence Periodicals as Topic Peer Review, Research Humans Editorial Policies Databases, Factual Biomedical Research standards publication peer review medical research factual database skill PsycINFO organization needs assessment human exercise ethics editor consensus development consensus Cochrane Library Cinahl Scoping review Scientific editor Journal Competencies Biomedical PY - 2016 ST - A scoping review of competencies for scientific editors of biomedical journals T2 - BMC Medicine TI - A scoping review of competencies for scientific editors of biomedical journals VL - 14 ID - 183 ER - TY - JOUR AB - Objectives To investigate whether training in writing for scholarly publication, journal editing, or manuscript peer review effectively improves educational outcomes related to the quality of health research reporting. Study Design and Setting We searched MEDLINE, Embase, ERIC, PsycINFO, and the Cochrane Library for comparative studies of formalized, a priori-developed training programs in writing for scholarly publication, journal editing, or manuscript peer review. Comparators included the following: (1) before and after administration of a training program, (2) between two or more training programs, or (3) between a training program and any other (or no) intervention(s). Outcomes included any measure of effectiveness of training. Results Eighteen reports of 17 studies were included. Twelve studies focused on writing for publication, five on peer review, and none fit our criteria for journal editing. Conclusion Included studies were generally small and inconclusive regarding the effects of training of authors, peer reviewers, and editors on educational outcomes related to improving the quality of health research. Studies were also of questionable validity and susceptible to misinterpretation because of their risk of bias. This review highlights the gaps in our knowledge of how to enhance and ensure the scientific quality of research output for authors, peer reviewers, and journal editors. © 2015 The Authors. Published by Elsevier Inc. AU - Galipeau, J. AU - Moher, D. AU - Campbell, C. AU - Hendry, P. AU - Cameron, D. W. AU - Palepu, A. AU - Hébert, P. C. DA - 2015-1-1 IS - 3 KW - Writing Selection Bias Review Literature as Topic Research Report Publishing Peer Review, Research Humans Education Biomedical Research standards research medical research literature validity systematic review study design scientific literature risk assessment Review randomized controlled trial (topic) publication PsycINFO professional knowledge priority journal practice guideline peer review outcome assessment multicenter study (topic) Medline medical literature medical information human health program health education health care quality editor data extraction Cochrane Library clinical evaluation clinical effectiveness bibliographic database Manuscript Journalology Author PY - 2015 SP - 257-265 ST - A systematic review highlights a knowledge gap regarding the effectiveness of health-related training programs in journalology T2 - Journal of Clinical Epidemiology TI - A systematic review highlights a knowledge gap regarding the effectiveness of health-related training programs in journalology VL - 68 ID - 229 ER - TY - JOUR AB - Objectives Overcrowding is a serious and ongoing challenge in Canadian hospital emergency departments (EDs) that has been shown to have negative consequences for patient outcomes. The American College of Emergency Physicians recommends observation/short-stay units as a possible solution to alleviate this problem. However, the most recent systematic review assessing short-stay units shows that there is limited synthesized evidence to support this recommendation; it is over a decade old and has important methodologic limitations. The aim of this study was to conduct a more methodologically rigorous systematic review to update the evidence on the effectiveness and safety of short-stay units, compared with usual care, on hospital and patient outcomes. Methods A literature search was conducted using MEDLINE, the Cochrane Library, Embase, ABI/INFOM, and EconLit databases and gray literature sources. Randomized controlled trials of ED short-stay units (stay of 72 hours or less) were compared with usual care (i.e., not provided in a short-stay unit), for adult patients. Risk-of-bias assessments were conducted. Important decision-making (gradable) outcomes were patient outcomes, quality of care, utilization of and access to services, resource use, health system-related outcomes, economic outcomes, and adverse events. Results Ten reports of five studies were included, all of which compared short-stay units with inpatient care. Studies had small sample sizes and were collectively at a moderate risk of bias. Most outcomes were only reported by one study and the remaining outcomes were reported by two to four studies. No deaths were reported. Three of the four included studies reporting length of stay found a significant reduction among short-stay unit patients, and one of the two studies reporting readmission rates found a significantly lower rate for short-stay unit patients. All four economic evaluations indicated that short-stay units were a cost-saving intervention compared to inpatient care from both hospital and health care system perspectives. Results were mixed for outcomes related to quality of care and patient satisfaction. Conclusions Insufficient evidence exists to make conclusions regarding the effectiveness and safety of short-stay units, compared with inpatient care. © 2015 by the Society for Academic Emergency Medicine. AU - Galipeau, J. AU - Pussegoda, K. AU - Stevens, A. AU - Brehaut, J. C. AU - Curran, J. AU - Forster, A. J. AU - Tierney, M. AU - Kwok, E. S. H. AU - Worthington, J. R. AU - Campbell, S. G. AU - Moher, D. DA - 2015-1-1 IS - 8 KW - Bias (Epidemiology) Emergencies Treatment Outcome Randomized Controlled Trials as Topic Quality of Health Care Patient Safety Length of Stay Humans Health Services Accessibility Emergency Service, Hospital Crowding Canada statistics and numerical data organization and management health care delivery emergency health service economics crowding (area) wellbeing thorax pain systematic review support group social status social interaction short stay unit sample size randomized controlled trial (topic) priority journal personal needs percutaneous coronary intervention patient satisfaction patient information patient education patient care outcome assessment nuclear magnetic resonance multicenter study (topic) mental health intracardiac echocardiography human hospital readmission hospital patient hospital discharge hospital cost hospital care heart stress heart muscle revascularization heart infarction heart catheterization health status health service health care utilization health care system health care quality health care cost health care access follow up exercise test esophagoscopy emotionality emergency ward economic evaluation cost effectiveness analysis cost control cost benefit analysis coronary artery bypass graft congestive heart failure clinical effectiveness clinical decision making cerebrovascular accident cardioversion atrial fibrillation asthma Article angioplasty angiocardiography analgesia acute coronary syndrome PY - 2015 SN - 1069-6563 SP - 893-907 ST - Effectiveness and Safety of Short-stay Units in the Emergency Department: A Systematic Review T2 - Academic Emergency Medicine TI - Effectiveness and Safety of Short-stay Units in the Emergency Department: A Systematic Review VL - 22 ID - 222 ER - TY - JOUR AB - The purpose of this study is to evaluate accuracy of magnetic resonance imaging (MRI) for local staging of bladder cancer for four clinical scenarios (T-stage thresholds) considered against current standards for clinical staging and secondarily to identify sources for variability in accuracy. Systematic review of patients with bladder cancer undergoing T-staging MRI to evaluate the diagnostic accuracy using bivariate random-effects meta-analysis. Sub-group analysis was done to explore variability; risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 tool. The search identified 30 studies (5156 patients). Pooled accuracy at multiple T-stage thresholds: ≤T1 vs ≥T2 = sensitivity 87% (95% confidence interval [CI] 82–91), specificity 79% (95% CI 72–85); T-any vs T0 = sensitivity 65% (95% CI 23–92), specificity 90% (95% CI 83–94); ≤T2 vs ≥T3 = sensitivity 83% (95% CI 75–88), specificity 87% (95% CI 78–93); and 99%). Conclusion: Less than half of patients with HTN would not be identified by self-reporting in epidemiological studies. Self-reported HTN has important limitations and may represent an important source of bias in research depending on regional, socioeconomic, and cultural differences. © Copyright 2018 Wolters Kluwer Health, Inc. All rights reserved. AU - Gonçalves, V. S. S. AU - Andrade, K. R. C. AU - Carvalho, K. M. B. AU - Silva, M. T. AU - Pereira, M. G. AU - Galvao, T. F. DA - 2018-1-1 IS - 5 KW - systematic review sensitivity and specificity self report Review priority journal physical examination meta analysis hypertension human blood pressure measurement age self-report meta-analysis data accuracy PY - 2018 SP - 970-978 ST - Accuracy of self-reported hypertension: A systematic review and meta-analysis T2 - Journal of Hypertension TI - Accuracy of self-reported hypertension: A systematic review and meta-analysis VL - 36 ID - 56 ER - TY - JOUR AB - Background: Depression and anxiety remain under-diagnosed and under-treated in those with neurologic diseases such as dementia or Parkinson's Disease (PD). Our objectives were to first, to provide a synthesis of high quality guidelines available for the identification and management of depression or anxiety in those with dementia or PD. Second, to identify areas for improvement for future guidelines. Methods: We searched MEDLINE, PsycINFO, and EMBASE (2009 to July 24, 2015), grey literature (83 sources; July 24-Sept 6, 2015), and bibliographies of included studies. Included studies were evaluated for quality by four independent reviewers the AGREE II tool. Guideline characteristics, statements and recommendations relevant to depression or anxiety for dementia and PD were then extracted. (PROSPERO CRD: 42016014584) Results: 8121 citations were reviewed with 31 full text articles included for assessment with the AGREE II tool. 17 were of sufficient quality for inclusion. Mean overall quality scores were between 4.25 to 6.5. Domain scores were lowest in the areas of stakeholder involvement, applicability, and editorial independence. Recommendations for the screening and diagnosis of depression were found for PD and dementia. There was little evidence to guide diagnosis or management of anxiety. Non-pharmacologic therapies were recommended for dementia patients. Most advocated pharmacologic treatment for depression, for both PD and dementia, but did not specify an agent due to lack of evidence. Conclusions: The available recent high quality guidelines outline several recommendations for the management of comorbid depression or anxiety in PD or dementia. However there remain significant gaps in the evidence. © 2016 The Author(s). AU - Goodarzi, Z. AU - Mele, B. AU - Guo, S. AU - Hanson, H. AU - Jette, N. AU - Patten, S. AU - Pringsheim, T. AU - Holroyd-Leduc, J. C7 - 244 DB - Scopus DO - 10.1186/s12883-016-0754-5 IS - 1 M3 - Article PY - 2016 ST - Guidelines for dementia or Parkinson's disease with depression or anxiety: A systematic review T2 - BMC Neurology TI - Guidelines for dementia or Parkinson's disease with depression or anxiety: A systematic review VL - 16 ID - 346 ER - TY - JOUR AB - Objective. Shared-care decision-making between patients and clinicians involves making trade-offs between desirable and undesirable consequences of management strategies. Although patient values and preferences should provide the basis for these trade-offs, few guidelines consider the relevant evidence when formulating recommendations. To inform a guideline for use of opioids in patients with chronic noncancer pain, we conducted a systematic review of studies exploring values and preferences of affected patients toward opioid therapy. Methods. We searched MEDLINE, CINAHL, EMBASE, and PsycINFO from the inception of each database through October 2016. We included studies examining patient preferences for alternative approaches to managing chronic noncancer pain and studies that assessed how opioid-using chronic noncancer pain patients value alternative health states and their experiences with treatment. We compiled structured summaries of the results. Results. Pain relief and nausea and vomiting were ranked as highly significant outcomes across studies. When considered, the adverse effect of personality changes was rated as equally important. Constipation was assessed in most studies and was an important outcome, secondary to pain relief and nausea and vomiting. Of only two studies that evaluated addiction, both found it less important to patients than pain relief. No studies examined opioid overdose, death, or diversion. Conclusions. Our findings suggest that the adverse effects of opioids, especially nausea and vomiting, may reduce or eliminate any net benefit of opioid therapy unless pain relief is significant (>2 points on a 10-point scale). Further research should investigate patient values and preferences regarding opioid overdose, diversion, and death. © 2017 American Academy of Pain Medicine. All rights reserved. AD - Department of Health Sciences, McMaster University, Hamilton, Canada Michael G. DeGroote National Pain Centre, McMaster University, Hamilton, Canada Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada School of Medicine, University of Toronto, Toronto, Canada Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Canada University of British Columbia Medical Program, Vancouver, Canada McMaster Midwifery Education Program, McMaster University, Hamilton, Canada Department of Anesthesia, McMaster University, Hamilton, Canada AU - Goshua, A. AU - Craigie, S. AU - Guyatt, G. H. AU - Agarwal, A. AU - Li, R. AU - Bhullar, J. S. AU - Scott, N. AU - Chahal, J. AU - Pavalagantharajah, S. AU - Chang, Y. AU - Couban, R. AU - Busse, J. W. C2 - 29618109 DB - Scopus DO - 10.1093/pm/pnx274 IS - 12 KW - Chronic Pain Opioids Preferences Side Effects Trade-offs Values narcotic analgesic agent analgesia decision making human pain measurement patient preference physiology psychology Analgesics, Opioid Humans Pain Management LA - English M3 - Review PY - 2018 SP - 2469-2480 ST - Patient values and preferences regarding opioids for chronic noncancer pain: A systematic review T2 - Pain Medicine (United States) TI - Patient values and preferences regarding opioids for chronic noncancer pain: A systematic review VL - 19 ID - 370 ER - TY - JOUR AB - Background: The enhanced recovery after surgery (ERAS) programme is a multimodal evidence-based approach to surgical care which begins in the preoperative setting and extends through to patient discharge in the postoperative period. The primary components of ERAS include the introduction of preoperative patient education; reduction in perioperative use of nasogastric tubes and drains; the use of multimodal analgesia; goal-directed fluid management; early removal of Foley catheter; early mobilization, and early oral nutrition. The ERAS approach has gradually evolved to become the standard of care in colorectal surgery and is presently being used in other specialty areas such as vascular surgery. Currently there is little evidence available for the implementation of ERAS in this field. We plan to conduct a systematic review of this literature with a view to incorporating ERAS principles into the management of major elective vascular surgery procedures.Methods: We will search EMBASE (OVID, 1947 to June 2012), Medline (OVID, 1948 to June 2012), and Cochrane Central Register of Controlled Trials (Wiley, Issue 1, 2012). Searches will be performed with no year or language restrictions. For inclusion, studies must look at adult patients over 18 years. Major elective vascular surgery includes carotid, bypass, aneurysm and amputation procedures. Studies must have evaluated usual care against an ERAS intervention in the preoperative, perioperative or postoperative period of care. Primary outcome measures are length of stay, decreased complication rate, and patient satisfaction or expectations. Only randomized controlled trials will be included.Discussion: Most ERAS approaches have been considered in the context of colorectal surgery. Given the increasing use of multiple yet different aspects of this pathway in vascular surgery, it is timely to systematically review the evidence for their independent or combined outcomes, with a view to implementing them in this clinical setting. Results from this review will have important implications for vascular surgeons, anaesthetists, nurses, and other health care professionals when making evidenced-based decisions about the use of ERAS in daily practice. © 2012 Gotlib Conn et al.; licensee BioMed Central Ltd. AU - Gotlib Conn, L. AU - Rotstein, O. D. AU - Greco, E. AU - Tricco, A. C. AU - Perrier, L. AU - Soobiah, C. AU - Moloney, T. DA - 2012-1-1 IS - 1 KW - Length of Stay Postoperative Period Colorectal Surgery Vascular Surgical Procedures Review Literature as Topic Research Design Postoperative Care Humans Evidence-Based Medicine standard methodology literature evidence based medicine vascular surgery systematic review surgical risk postoperative complication patient satisfaction outcome assessment human health program enhanced recovery after surgery article nonsteroid antiinflammatory agent narcotic agent Fast-track ERAS PY - 2012 SN - 2046-4053 ST - Enhanced recovery after vascular surgery: Protocol for a systematic review T2 - Systematic Reviews TI - Enhanced recovery after vascular surgery: Protocol for a systematic review VL - 1 ID - 256 ER - TY - JOUR AB - Curcumin has demonstrated anti-inflammatory properties and has been investigated as an adjuvant therapy of ulcerative colitis (UC). The scope of this study was to systematically review and meta-analyze the efficacy of oral curcumin administration as an adjuvant therapy of UC. MEDLINE, Cochrane/CENTRAL, ClinicalTrials.gov, WHO-ICT Registry, EMBASE and grey literature were searched for relevant randomized controlled trials (RCTs). The primary outcome was clinical remission (attainment) and the secondary outcome was clinical response (maintenance/failure). Risk of bias was assessed with the Cochrane tool. Odds ratios (OR) were calculated with a Mantel-Haenszel (M-H) random effects model and with a beta-binomial (B-B) random effects model when zero events/cells occurred. Four RCTs met the criteria, but one was removed from the analyses due to inconsistency in protocol details. With the M-H method, treatment with curcumin was significantly superior to placebo in attaining remission in the per-protocol (PP) analysis (OR = 5.83, 95%CI = 1.24–27.43), but not in the intention-to-treat (ITT) analysis (OR = 4.33, 95%CI = 0.78–24.00). However, with the more accurate B-B method, both analyses were insignificant (for PP OR = 4.26, 95%CI = 0.59–31.00, for ITT OR = 3.80, 95%CI = 0.55–26.28). Based on the current available evidence, oral curcumin administration does not seem superior to placebo in attaining remission in patients with UC. Future RCTs should be planned more cautiously with sufficient size and adhere to the ITT analysis in all outcomes. © 2018 by the authors. Licensee MDPI, Basel, Switzerland. AD - Faculty of Medicine, School of Health Sciences, University of Thessaly, Mezourlo, Larissa, GR41110, Greece Department of Nutrition & Dietetics, Alexander Technological Educational Institute, Sindos, P.O. Box 141, Thessaloniki, GR57400, Greece Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, Thessaloniki, GR54124, Greece Laboratory of Clinical Pharmacology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, Thessaloniki, GR54124, Greece Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, GR41110, Greece Norwich Medical School, University of East Anglia, Bob Champion Building, James Watson Road, Norwich, NR4 7UQ, United Kingdom Division of Transplantation Immunology and Mucosal Biology, MRC Centre for Transplantation, King’s College London Medical School, London, SE5 9RS, United Kingdom AU - Grammatikopoulou, M. G. AU - Gkiouras, K. AU - Theodoridis, X. AU - Asteriou, E. AU - Forbes, A. AU - Bogdanos, D. P. C2 - 30424514 C7 - 1737 DB - Scopus DO - 10.3390/nu10111737 IS - 11 KW - Autoimmune diet Autoimmune disease Beta binomial Curcumin Diet Gastrointestinal disease IBD Inflammatory bowel disease Meta-analysis Nutraceutical Proctitis Proctocolitis Rare events RCT Turmeric Ulcerative colitis mesalazine antiinflammatory agent adjuvant therapy antiinflammatory activity bibliographic database clinical trial (topic) Curcuma longa human meta analysis outcome assessment patient compliance randomized controlled trial (topic) remission Review systematic review treatment outcome treatment response time female male oral drug administration Administration, Oral Anti-Inflammatory Agents Colitis, Ulcerative Humans LA - English M3 - Review PY - 2018 ST - Oral adjuvant curcumin therapy for attaining clinical remission in ulcerative colitis: A systematic review and meta-analysis of randomized controlled trials T2 - Nutrients TI - Oral adjuvant curcumin therapy for attaining clinical remission in ulcerative colitis: A systematic review and meta-analysis of randomized controlled trials VL - 10 ID - 371 ER - TY - JOUR AB - Objective The purpose of this review was to identify risk factors, prognostic factors, and comorbidities associated with common spinal disorders. Methods A scoping review of the literature of common spinal disorders was performed through September 2016. To identify search terms, we developed 3 terminology groups for case definitions: 1) spinal pain of unknown origin, 2) spinal syndromes, and 3) spinal pathology. We used a comprehensive strategy to search PubMed for meta-analyses and systematic reviews of case-control studies, cohort studies, and randomized controlled trials for risk and prognostic factors and cross-sectional studies describing associations and comorbidities. Results Of 3,453 candidate papers, 145 met study criteria and were included in this review. Risk factors were reported for group 1: non-specific low back pain (smoking, overweight/obesity, negative recovery expectations), non-specific neck pain (high job demands, monotonous work); group 2: Degenerative spinal disease (workers' compensation claim, degenerative scoliosis), and group 3: Spinal tuberculosis (age, imprisonment, previous history of tuberculosis), spinal cord injury (age, accidental injury), vertebral fracture from osteoporosis (type 1 diabetes, certain medications, smoking), and neural tube defects (folic acid deficit, anti-convulsant medications, chlorine, influenza, maternal obesity). A range of comorbidities was identified for spinal disorders. Conclusion Many associated factors for common spinal disorders identified in this study are modifiable. The most common spinal disorders are co-morbid with general health conditions, but there is a lack of clarity in the literature differentiating which conditions are merely comorbid versus ones that are risk factors. Modifiable risk factors present opportunities for policy, research, and public health prevention efforts on both the individual patient and community levels. Further research into prevention interventions for spinal disorders is needed to address this gap in the literature. © This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication. AU - Green, B. N. AU - Johnson, C. D. AU - Haldeman, S. AU - Griffith, E. AU - Clay, M. B. AU - Kane, E. J. AU - Castellote, J. M. AU - Rajasekaran, S. AU - Smuck, M. AU - Hurwitz, E. L. AU - Randhawa, K. AU - Yu, H. AU - Nordin, M. DA - 2018-1-1 IS - 6 KW - Tuberculosis Spinal Cord Injuries Smoke Case-Control Studies Cross-Sectional Studies Comorbidity Risk Factors PY - 2018 ST - A scoping review of biopsychosocial risk factors and co-morbidities for common spinal disorders T2 - PLoS ONE TI - A scoping review of biopsychosocial risk factors and co-morbidities for common spinal disorders VL - 13 ID - 50 ER - TY - JOUR AB - Objective: This systematic review and meta-analysis examined the association between maternal antenatal anxiety (AA) and a range of perinatal outcomes. Data Sources: Ovid MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, PsycINFO, CINAHL, Embase, and the Cochrane Library were searched to May 31, 2016, using controlled vocabulary and keywords (eg, prenatal, anxiety, preterm). Study Selection: Perinatal outcomes of women with and without AA (diagnosed or selfreported using validated scale) derived from English language, prospectively collected data were included. 1,458 abstracts were reviewed, 306 articles were retrieved, and 29 articles were included. Data Extraction: Two independent reviewers extracted data and assessed quality. Random-effects models were utilized for outcomes (≥ 3 studies). Subanalyses examined potential effect moderators including study quality and diagnostic versus self-reported anxiety among others. Results: Antenatal anxiety was associated with increased odds for preterm birth (pooled odds ratio [OR] = 1.54; 95% confidence interval [CI], 1.39 to 1.70, 16 studies) and spontaneous preterm birth (OR = 1.41; 95% CI, 1.13 to 1.75), lower mean birth weight (mean difference = -55.96 g; 95% CI, -93.62 to -18.31 g), increased odds for low birth weight (OR = 1.80; 95% CI, 1.48 to 2.18), earlier gestational age (mean difference = -0.13 wk; 95% CI, -0.22 to -0.04 wk), increased odds for being small for gestational age (OR = 1.48; 95% CI, 1.26 to 1.74), and smaller head circumference (mean difference = -0.25 cm; 95% CI, -0.45 to -0.06 cm). Heterogeneity between studies was not significant for most outcomes. Subanalyses for birth weight found women with diagnosed anxiety had infants with significantly lower birth weight (P < .03) compared to those identified with rating scales (although both subanalyses were significant [P < .01]). Associations between anxiety and preeclampsia, cesarean delivery, and Apgar scores were nonsignificant. Conclusions: Antenatal anxiety is associated with multiple adverse perinatal outcomes and is not benign. The impact of treating anxiety on these associations is unknown. © 2018 Physicians Postgraduate Press, Inc. AU - Grigoriadis, S. AU - Graves, L. AU - Peer, M. AU - Mamisashvili, L. AU - Tomlinson, G. AU - Vigod, S. N. AU - Dennis, C. L. AU - Steiner, M. AU - Brown, C. AU - Cheung, A. AU - Dawson, H. AU - Rector, N. A. AU - Guenette, M. AU - Richter, M. DA - 2018-1-1 %J Journal of Clinical Psychiatry IS - 5 KW - Infant Anxiety Pregnancy PY - 2018 ST - Maternal anxiety during pregnancy and the association with adverse perinatal outcomes: Systematic review and meta-analysis T2 - Journal of Clinical Psychiatry TI - Maternal anxiety during pregnancy and the association with adverse perinatal outcomes: Systematic review and meta-analysis VL - 79 ID - 274 ER - TY - JOUR AB - To systematically review and meta-analyze research investigating the association between maternal anxiety during pregnancy and outcomes for mother and baby following the immediate delivery period. MEDLINE, Medline In-Process & Other Non-Indexed Citations, PsycINFO, Embase, CINAHL, and the Cochrane library were searched. English-language, prospective studies providing data on outcomes following delivery in women with and without antenatal anxiety (defined by clinical diagnosis or score on validated scale) were included. Three-hundred-fifty-eight articles were retrieved and 13 were included. Titles and abstracts were screened; two reviewers independently reviewed full text articles, conducted quality assessments, extracted, and checked the data. Where available for > 2 studies, random effect meta-analysis was conducted and heterogeneity was quantified. Subanalyses explored moderators, regardless of heterogeneity, including type of anxiety assessment and timing, among others. There were two outcomes that were amenable to meta-analysis. Antenatal anxiety was significantly associated with postpartum depression (PPD) measured within 6 months postpartum (pooled odds ratio [OR] = 2.64, 95% CI 2.02–3.46; 8 studies), regardless of restricting analyses to those studies controlling for prenatal depression (2.45, 1.77–3.39; 6 studies). Associations were also significant when PPD was measured at 1–3 months (2.57, 1.94–3.40; 7 studies) and 6–10 months (4.42, 1.45–13.49; 3 studies). Maternal anxiety was also associated with reduced odds of breastfeeding (0.63, 0.53–0.74; 5 studies). Antenatal anxiety is associated with PPD up to the first 10 months, independent of prenatal depression, and with lower odds of breastfeeding. © 2018, Springer-Verlag GmbH Austria, part of Springer Nature. AU - Grigoriadis, S. AU - Graves, L. AU - Peer, M. AU - Mamisashvili, L. AU - Tomlinson, G. AU - Vigod, S. N. AU - Dennis, C. L. AU - Steiner, M. AU - Brown, C. AU - Cheung, A. AU - Dawson, H. AU - Rector, N. A. AU - Guenette, M. AU - Richter, M. DA - 2018-1-1 %J Archives of Women's Mental Health KW - Pregnancy Postpartum Period Anxiety PY - 2018 SN - 1434-1816 ST - A systematic review and meta-analysis of the effects of antenatal anxiety on postpartum outcomes T2 - Archives of Women's Mental Health TI - A systematic review and meta-analysis of the effects of antenatal anxiety on postpartum outcomes ID - 282 ER - TY - JOUR AB - We have performed a narrative synthesis. A literature search was conducted between January 2000 and June 2014 in 7 databases. The initial search identified 2717 articles; 319 underwent abstract screening, 67 underwent full-text screening, and 25 final articles were included. This review looked at early stage breast cancer in women only, excluding ductal carcinoma in situ and advanced breast cancer. A conceptual framework was created to organize the central constructs underlying women's choices: clinicopathologic factors, physician factors, and individual factors with subgroups of sociodemographic, geographic, and personal beliefs and preferences. This framework guided our review's synthesis and analysis. We found that larger tumor size and increasing stage was associated with increased rates of mastectomy. The results for age varied, but suggested that old and young extremes of diagnostic age were associated with an increased likelihood of mastectomy. Higher socioeconomic status was associated with higher breast conservation therapy (BCT) rates. Resident rural location and increasing distance from radiation treatment facilities were associated with lower rates of BCT. Individual belief factors influencing women's choice of mastectomy (mastectomy being reassuring, avoiding radiation, an expedient treatment) differed from factors influencing choice of BCT (body image and femininity, physician recommendation, survival equivalence, less surgery). Surgeon factors, including female gender, higher case numbers, and individual surgeon practice, were associated with increased BCT rates. The decision-making process for women with early stage breast cancer is complicated and affected by multiple factors. Organizing these factors into central constructs of clinicopathologic, individual, and physician factors may aid health-care professionals to better understand this process. © 2017 The Authors AD - Department of General Surgery, University of Saskatchewan, Saskatoon, SK, Canada Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada Leslie and Irene Dubé Library, University of Saskatchewan, Saskatoon, SK, Canada School of Physical Therapy, University of Saskatchewan, Saskatoon, SK, Canada College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada University of the Witwatersrand, Johannesburg, South Africa AU - Gu, J. AU - Groot, G. AU - Boden, C. AU - Busch, A. AU - Holtslander, L. AU - Lim, H. C2 - 29396079 DB - Scopus DO - 10.1016/j.clbc.2017.12.013 IS - 4 KW - Breast conserving surgery Decision-making Geography Oncology Treatment choice body image breast cancer cancer radiotherapy cancer staging conceptual framework demography female femininity human intermethod comparison mastectomy organ preservation partial mastectomy patient decision making Review risk factor rural area rural population social belief social status systematic review tumor volume age breast tumor decision making pathology professional-patient relationship psychology socioeconomics statistics and numerical data Age Factors Breast Neoplasms Choice Behavior Humans Mastectomy, Segmental Professional-Patient Relations Socioeconomic Factors LA - English M3 - Review PY - 2018 SP - e539-e554 ST - Review of Factors Influencing Women's Choice of Mastectomy Versus Breast Conserving Therapy in Early Stage Breast Cancer: A Systematic Review T2 - Clinical Breast Cancer TI - Review of Factors Influencing Women's Choice of Mastectomy Versus Breast Conserving Therapy in Early Stage Breast Cancer: A Systematic Review VL - 18 ID - 372 ER - TY - JOUR AB - Aims: To identify instruments that could assess the quality of dying and death and their psychometric properties. To assess the methodological quality of studies on measurement properties. Background: A high quality of death is regarded as a goal at the end of life and, therefore, an assessment of the end of life experience is essential. Many instruments have been developed to evaluate the quality of dying and death. The selection of the most appropriate measure to be used in clinical and research settings is crucial. Design: Psychometric systematic review. Data Sources: We systematically searched ProQuest Medline, SciELO and ProQuest PsycINFO from 1970 - May 2016. Review Methods: Identification and evaluation of instruments that assessed quality of dying and death. Papers were evaluated by two independent reviewers according to the COSMIN checklist with a 4-point scale. Results: A total of 19 studies were included in this review. Seven instruments were found that were specifically designed for assessing quality of dying and death. A retrospective carer proxy report to evaluate this construct was used in most of the papers. The methodological quality of the studies was fair for most of the psychometric characteristics analyzed. Conclusion: Many instruments have been developed to assess the quality of dying and death. The Quality of Dying and Death Questionnaire is the best available measure of the quality of dying and death. It is the only questionnaire identified in this review where all psychometric properties according to the COSMIN checklist have been evaluated. © 2018 John Wiley & Sons Ltd AD - Fundación Cudeca, Av. del Cosmos, s/n, 29631 Arroyo de la Miel, Málaga, Spain Departamento de Fisioterapia, Instituto de Investigación Biomédico de Málaga (IBIMA), Universidad de Málaga, C/ Arquitecto Francisco Peñalosa, Ampliación Campus Teatinos, 29071 Malaga, Spain School of Clinical Sciences, Faculty of Health at the Queensland University of TechnologyQLD, Australia AU - Gutiérrez Sánchez, D. AU - Pérez Cruzado, D. AU - Cuesta-Vargas, A. I. DB - Scopus DO - 10.1111/jan.13687 IS - 8 KW - end of life good death instruments nursing outcome measure psychometric properties psychometric systematic review quality of dying and death article checklist death human Medline PsycINFO questionnaire systematic review LA - English M3 - Review PY - 2018 SP - 1803-1818 ST - The quality of dying and death measurement instruments: A systematic psychometric review T2 - Journal of Advanced Nursing TI - The quality of dying and death measurement instruments: A systematic psychometric review VL - 74 ID - 373 ER - TY - JOUR AB - Objective: The objective of this review was to perform a rapid evidence summary to determine the prevalence of subaneurysmal aortic aneurysms, growth rates, and risk factors that modulate growth in average-risk men aged 65 years and older. Secondary objectives were to evaluate benefits and harms of lifelong ultrasound (US) surveillance and treatment outcomes for any large aneurysms that develop in the screened population. Methods: We searched multiple databases (eg, Ovid MEDLINE, Embase Classic and Embase, and the Cochrane Library) on February 16, 2016. Using a liberal accelerated method, two reviewers screened titles and abstracts for relevance and subsequently screened full-text studies. General study characteristics (eg, country, study design, number of participants) and data (eg, number of men with subaneurysmal aortas, quality of life [QoL], mortality) were extracted. One reviewer performed data extraction and risk of bias assessments, and a second reviewer verified 100% of studies. Any disagreements were resolved by consensus. Results: The search identified 37 relevant studies ranging in size from 3 to 52,690 participants. Prevalence of subaneurysmal aortas ranged from 1.14% to 8.53%, and 55% to 88% of these men progressed to a 3.0-cm aneurysm by 5 years of follow-up. Risk factors for growth included the infrarenal aortic diameter at age 65 years, having a subaneurysmal aorta at age 65 years, and current smoking. The 36-Item Short Form Health Survey was the most commonly used tool to measure QoL, and QoL was typically lower in people with abdominal aortic aneurysm. Anxiety and depression levels did not differ significantly between comparison groups in any studies. Four studies reported on the number of men whose aorta was subaneurysmal on initial US who went on to surgery. Overall, 10% (57/547) of men initially measuring in the subaneurysmal range progressed to abdominal aortic aneurysm >5.4 cm and received elective surgery; 1% (6/547) received emergency surgery because of a ruptured aorta. Among those who did, mortality rates were much lower for elective (9.5%) vs emergency surgery (50%). Risk of bias was usually low for studies measuring prevalence and moderate and high for studies measuring psychological harms of screening and harms and benefits of surgery. Overall, using the Grading of Recommendations Assessment, Development, and Evaluation framework as guidance, the quality of the evidence was generally very low. Conclusions: Because of the limited evidence and the low quality of the existing evidence, it is not possible to determine confidently whether men with abdominal aortas measuring 2.5 to 2.9 cm should be observed in a lifelong US surveillance program. © 2018 Society for Vascular Surgery AD - Ottawa Methods Centre, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada Department of Radiology, University of Ottawa, Ottawa, Ontario, Canada AU - Hamel, C. AU - Ghannad, M. AU - McInnes, M. D. F. AU - Marshall, J. AU - Earnshaw, J. AU - Ward, R. AU - Skidmore, B. AU - Garritty, C. C2 - 29477237 DB - Scopus DO - 10.1016/j.jvs.2017.11.074 IS - 4 KW - abdominal aortic aneurysm age aged diagnostic imaging echography human male mortality predictive value prognosis risk assessment risk factor sex factor time factor very elderly Age Factors Aged, 80 and over Aortic Aneurysm, Abdominal Humans Predictive Value of Tests Risk Factors Sex Factors Time Factors Ultrasonography LA - English M3 - Review PY - 2018 SP - 1298-1307 ST - Potential benefits and harms of offering ultrasound surveillance to men aged 65 years and older with a subaneurysmal (2.5-2.9 cm) infrarenal aorta T2 - Journal of Vascular Surgery TI - Potential benefits and harms of offering ultrasound surveillance to men aged 65 years and older with a subaneurysmal (2.5-2.9 cm) infrarenal aorta VL - 67 ID - 374 ER - TY - JOUR AB - Background: Chronic diseases, such as cardiovascular disease and type 2 diabetes, impose significant burden to public health. Most chronic diseases are associated with underlying preventable risk factors, such as elevated blood pressure, blood glucose, and lipids, physical inactivity, excessive sedentary behaviours, overweight and obesity, and tobacco usage. Sugar-sweetened beverages are known to be significant sources of additional caloric intake, and given recent attention to their contribution in the development of chronic diseases, a systematic review is warranted. We will assess whether the consumption of sugar-sweetened beverages in adults is associated with adverse health outcomes and what the potential moderating factors are. Methods/Design: Of interest are studies addressing sugar-sweetened beverage consumption, taking a broad perspective. Both direct consumption studies as well as those evaluating interventions that influence consumption (e.g. school policy, educational) will be relevant. Non-specific or multi-faceted behavioural, educational, or policy interventions may also be included subject to the level of evidence that exists for the other interventions/exposures. Comparisons of interest and endpoints of interest are pre-specified. We will include randomized controlled trials, controlled clinical trials, interrupted time series studies, controlled before-after studies, prospective and retrospective comparative cohort studies, case-control studies, and nested case-control designs. The MEDLINE®, Embase, The Cochrane Library, CINAHL, ERIC, and PsycINFO® databases and grey literature sources will be searched. The processes for selecting studies, abstracting data, and resolving conflicts are described. We will assess risk of bias using design-specific tools. To determine sets of confounding variables that should be adjusted for, we have developed causal directed acyclic graphs and will use those to inform our risk of bias assessments. Meta-analysis will be conducted where appropriate; parameters for exploring statistical heterogeneity and effect modifiers are pre-specified. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach will be used for determining the quality of evidence for outcomes. Systematic review registration: PROSPERO CRD42014009638. © 2014 Hamel et al. AU - Hamel, C. AU - Stevens, A. AU - Singh, K. AU - Ansari, M. T. AU - Myers, E. AU - Ziegler, P. AU - Hutton, B. AU - Sharma, A. AU - Bjerre, L. M. AU - Fenton, S. AU - Lau, D. C. W. AU - O'Hara, K. AU - Reid, R. AU - Salewski, E. AU - Shrier, I. AU - Willows, N. AU - Tremblay, M. AU - Moher, D. DA - 2014-1-1 IS - 1 KW - Bias (Epidemiology) Case-Control Studies Chronic Disease Sweetening Agents Research Design Renal Insufficiency, Chronic Obesity Neoplasms Metabolic Syndrome X Humans Health Education Gout Energy Intake Dietary Sucrose Diabetes Mellitus, Type 2 Dental Caries Cardiovascular Diseases Beverages sugar intake methodology meta analysis beverage adverse effects systematic review sugar sweetened beverage soft drink risk assessment quality of life public health priority journal non insulin dependent diabetes mellitus neoplasm mortality meta analysis (topic) information retrieval information processing hypertension human glucose blood level dyslipidemia decision making data synthesis chronic kidney disease cardiovascular disease caloric intake bibliographic database Article alcoholic beverage adverse outcome adult sweetening agent sugar Type 2 diabetes Sugar-sweetened beverage Metabolic syndrome Cancer PY - 2014 SN - 2046-4053 ST - Do sugar-sweetened beverages cause adverse health outcomes in adults? A systematic review protocol T2 - Systematic Reviews TI - Do sugar-sweetened beverages cause adverse health outcomes in adults? A systematic review protocol VL - 3 ID - 235 ER - TY - JOUR AB - Background: Delirium is an acute and reversible geriatric syndrome that represents a decompensation of cerebral function. Delirium is associated with adverse postoperative outcomes, but controversy exists regarding whether delirium is an independent predictor of mortality. Thus, we assessed the association between incident postoperative delirium and mortality in adult noncardiac surgery patients. Methods: A systematic search was conducted using Cochrane, MEDLINE/PubMed, Cumulative Index to Nursing and Allied Health Literature, and Embase. Screening and data extraction were conducted by two independent reviewers. Pooled-effect estimates calculated with a random-effects model were expressed as odds ratios with 95% CIs. Risk of bias was assessed using the Cochrane Risk of Bias Tool for Non-Randomized Studies. Results: A total of 34 of 4,968 screened citations met inclusion criteria. Risk of bias ranged from moderate to critical. Pooled analysis of unadjusted event rates (5,545 patients) suggested that delirium was associated with a four-fold increase in the odds of death (odds ratio = 4.12 [95% CI, 3.29 to 5.17]; I2 = 24.9%). A formal pooled analysis of adjusted outcomes was not possible due to heterogeneity of effect measures reported. However, in studies that controlled for prespecified confounders, none found a statistically significant association between incident postoperative delirium and mortality (two studies in hip fractures; n = 729) after an average follow-up of 21 months. Overall, as study risk of bias decreased, the association between delirium and mortality decreased. Conclusions: Few high-quality studies are available to estimate the impact of incident postoperative delirium on mortality. Studies that controlled for prespecified confounders did not demonstrate significant independent associations of delirium with mortality. Copyright © 2017, the American Society of Anesthesiologists, Inc. Wolters Kluwer Health, Inc. All Rights Reserved. AU - Hamilton, G. M. AU - Wheeler, K. AU - Di Michele, J. AU - Lalu, M. M. AU - McIsaac, D. I. DA - 2017-1-1 IS - 1 KW - Bias (Epidemiology) Surgical Procedures, Operative Postoperative Complications Odds Ratio Middle Aged Male Incidence Humans Female Delirium Aged, 80 and over Aged very elderly surgery statistics and numerical data postoperative complication mortality treatment outcome systematic review surgical patient surgical mortality Review priority journal postoperative delirium meta analysis human hospital mortality follow up Diagnostic and Statistical Manual of Mental Disorders adult PY - 2017 SN - 0003-3022 SP - 78-88 ST - A Systematic Review and Meta-analysis Examining the Impact of Incident Postoperative Delirium on Mortality T2 - Anesthesiology TI - A Systematic Review and Meta-analysis Examining the Impact of Incident Postoperative Delirium on Mortality VL - 127 ID - 88 ER - TY - JOUR AB - Background: Randomised controlled trials (RCTs) show that breastfeeding newborn infants during painful procedures reduces pain. Mechanisms are considered to be multifactorial and include sucking, skin-to-skin contact, warmth, rocking, sound and smell of the mother, and possibly endogenous opiates present in the breast milk. Objectives: To determine the effect of breastfeeding on procedural pain in infants beyond the neonatal period (first 28 days of life) up to one year of age compared to no intervention, placebo, parental holding, skin-to-skin contact, expressed breast milk, formula milk, bottle feeding, sweet-tasting solutions (e.g. sucrose or glucose), distraction, or other interventions. Search methods: We searched the following databases to 18 February 2016: the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library), MEDLINE including In-Process & Other Non-Indexed Citations (OVID), Embase (OVID), PsycINFO (OVID), and CINAHL (EBSCO); the metaRegister of Controlled Trials (mRCT), ClinicalTrials.gov (clinicaltrials.gov), and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) (apps.who.int/trialsearch/) for ongoing trials. Selection criteria: We included RCTs and quasi-RCTs involving infants aged 28 days postnatal to 12 months and receiving breastfeeding while undergoing a painful procedure. Comparators included, but were not limited to, oral administration of water, sweet-tasting solutions, expressed breast or formula milk, no intervention, use of pacifiers, positioning, cuddling, distraction, topical anaesthetics, and skin-to-skin care. Procedures included, but were not limited to: subcutaneous or intramuscular injection, venipuncture, intravenous line insertion, heel lance, and finger lance. We applied no language restrictions. Data collection and analysis: We used standard methodological procedures expected by Cochrane. Two review authors independently considered trials for inclusion in the review, assessed risk of bias, and extracted data. The main outcome measures were behavioural or physiological indicators and composite pain scores, as well as other clinically important outcomes reported by the authors of included studies. We pooled data for the most comparable outcomes and where data from at least two studies could be included. We used mean difference (MD) with 95% confidence interval (CI), employing a random-effects model for continuous outcomes measured on the same scales. For continuous outcomes measured on different scales, we pooled standardised mean differences (SMDs) and associated 95% CIs. For dichotomous outcomes, we planned to pool events between groups across studies using risk ratios (RRs) and 95% CIs. However, as insufficient studies reported dichotomous outcomes, we did not pool such events. We assessed the evidence using GRADE and created a 'Summary of findings' table. Main results: We included 10 studies with a total of 1066 infants. All studies were conducted during early childhood immunisation. As the breastfeeding intervention cannot be blinded, we rated all studies as being at high risk of bias for blinding of participants and personnel. We assessed nine studies as being at low risk of bias for incomplete outcome data. In addition, we rated nine studies as high risk for blinding of outcome assessment. We scored risk of bias related to random sequence generation, allocation concealment, and selective reporting as unclear for the majority of the studies due to lack of information. Our primary outcome was pain. Breastfeeding reduced behavioural pain responses (cry time and pain scores) during vaccination compared to no treatment, oral water, and other interventions such as cuddling, oral glucose, topical anaesthetic, massage, and vapocoolant. Breastfeeding did not consistently reduce changes in physiological indicators, such as heart rate. We pooled data for duration of cry from six studies (n = 547 infants). Breastfeeding compared to water or no treatment resulted in a 38-second reduction in cry time (MD -38, 95% CI -50 to 26; P < 0.00001). The quality of the evidence according to GRADE for this outcome was moderate, as most infants were 6 months or younger, and outcomes may be different for infants during their 12-month immunisation. We pooled data for pain scores from five studies (n = 310 infants). Breastfeeding was associated with a 1.7-point reduction in standardised pain scores (SMD -1.7, 95% CI -2.2 to -1.3); we considered this evidence to be of moderate quality as data were primarily from infants younger than 6 months of age. We could pool heart rate data following injections for only two studies (n = 186); we considered this evidence to be of low quality due to insufficient data. There were no differences between breastfeeding and control (MD -3.6, -23 to 16). Four of the 10 studies had more than two study arms. Breastfeeding was more effective in reducing crying duration or pain scores during vaccination compared to: 25% dextrose and topical anaesthetic cream (EMLA), vapocoolant, maternal cuddling, and massage. No included studies reported adverse events. Authors' conclusions: We conclude, based on the 10 studies included in this review, that breastfeeding may help reduce pain during vaccination for infants beyond the neonatal period. Breastfeeding consistently reduced behavioural responses of cry duration and composite pain scores during and following vaccinations. However, there was no evidence that breastfeeding had an effect on physiological responses. No studies included in this review involved populations of hospitalised infants undergoing other skin-breaking procedures. Although it may be possible to extrapolate the review results to this population, further studies of efficacy, feasibility, and acceptability in this population are warranted. © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. AU - Harrison, D. AU - Reszel, J. AU - Bueno, M. AU - Sampson, M. AU - Shah, V. S. AU - Taddio, A. AU - Larocque, C. AU - Turner, L. DA - 2016-1-1 %J Cochrane Database of Systematic Reviews IS - 10 KW - Meta-Analysis as Topic Injections, Intramuscular Opioid Peptides Milk Ejection Smell Bias (Epidemiology) Skin Breast Feeding Infant, Newborn Infant PY - 2016 ST - Breastfeeding for procedural pain in infants beyond the neonatal period T2 - Cochrane Database of Systematic Reviews TI - Breastfeeding for procedural pain in infants beyond the neonatal period VL - 2016 ID - 293 ER - TY - JOUR AB - Aim: This integrative study on safety in home care provides a synopsis of evidence in the Canadian and international literature. The objectives of this study were to: (i) develop/test a comprehensive search strategy to locate the literature on harmful incidents (previously called adverse events (AEs)) in the home care environment to track emerging evidence; (ii) determine what has been documented about AEs in the home care setting; and (iii) catalogue definitions of safety in home care by analysis of reported/published definitions. Methods: The review was characterised by a process of mapping and categorising existing literature in practice, health services and policy literature. Methods included a thorough search strategy determined by time/scope constraints, quality assessment of study sets relevant to design and graphic/tabular representation of the synthesis. This multi-step, iterative process used an explicit search and retrieval strategy based on Cochrane and Joanna Briggs Institute methodologies. A modified Problem, Intervention, Comparison, Outcome template was used to design the search. To facilitate concept clarification, key definitions relevant to patient safety and AEs in home care were catalogued. Results: Multiple runs on searches were performed for sensitivity and specificity using the Peer Review of Electronic Search Strategies methodology developed by the Canadian Agency for Drugs and Technologies in Health and additional other approaches. Ninety-two research studies published from 1993 to 2010 and representing 14 countries (the majority North American) met the inclusion criteria (i.e. addressing AEs within the context of home care). Studies varied in scope from one home healthcare agency/site to nationwide investigations that involved more than five million participants. Quantitative research methods included experimental, descriptive and retrospective designs. Qualitative research methods included focus groups, interviews and consensus workshops. The nature of AEs was categorised as types of patient injury/harm related to an AE, caregiver instigated injury/harm and organisational/services/staff injury/harm. Conclusions: There is an emerging evidence base about safety in home care. A predominant theme was the lack of conceptual clarity with the terms patient safety and AEs in the home care environment. An important finding was that innovative strategies/tools appear in the grey or peer-review literature as quality initiatives with/without evaluation elements. Traditionally, we do not concentrate heavily on the grey literature, but to advance the field, it may be necessary to place more emphasis on this source. A glaring limitation was the paucity of research on the occurrence of AEs and a lack of quality of research that documents prevalence estimates/incidence rates. Interventional research to evaluate risk reduction strategies was very limited and will advance only when tracking and documentation of various AEs improves. © 2013 The Authors International Journal of Evidence-Based Healthcare © 2013 The Joanna Briggs Institute. AU - Harrison, M. B. AU - Keeping-Burke, L. AU - Godfrey, C. M. AU - Ross-White, A. AU - McVeety, J. AU - Donaldson, V. AU - Blais, R. AU - Doran, D. M. DA - 2013-1-1 IS - 3 KW - Consensus Development Conferences as Topic Home Care Services Synthesis. Patient safety Home healthcare Harmful incident Adverse event LA - English PY - 2013 SN - 1744-1609 1744-1595 SP - 148-160 ST - Safety in home care: A mapping review of the international literature T2 - International Journal of Evidence-Based Healthcare TI - Safety in home care: A mapping review of the international literature VL - 11 ID - 2 ER - TY - JOUR AB - Background Simulation-based training is a widespread strategy to improve health-care quality. However, its effect on registered nurses has previously not been established in systematic reviews. The aim of this systematic review is to evaluate effect of simulation-based training on nurses' skills and knowledge. Methods We searched CDSR, DARE, HTA, CENTRAL, CINAHL, MEDLINE, Embase, ERIC, and SveMed + for randomised controlled trials (RCT) evaluating effect of simulation-based training among nurses. Searches were completed in December 2016. Two reviewers independently screened abstracts and full-text, extracted data, and assessed risk of bias. We compared simulation-based training to other learning strategies, high-fidelity simulation to other simulation strategies, and different organisation of simulation training. Data were analysed through meta-analysis and narrative syntheses. GRADE was used to assess the quality of evidence. Results Fifteen RCTs met the inclusion criteria. For the comparison of simulation-based training to other learning strategies on nurses' skills, six studies in the meta-analysis showed a significant, but small effect in favour of simulation (SMD − 1.09, CI − 1.72 to − 0.47). There was large heterogeneity (I2 85%). For the other comparisons, there was large between-study variation in results. The quality of evidence for all comparisons was graded as low. Conclusion The effect of simulation-based training varies substantially between studies. Our meta-analysis showed a significant effect of simulation training compared to other learning strategies, but the quality of evidence was low indicating uncertainty. Other comparisons showed inconsistency in results. Based on our findings simulation training appears to be an effective strategy to improve nurses' skills, but further good-quality RCTs with adequate sample sizes are needed. © 2017 Elsevier Ltd AU - Hegland, P. A. AU - Aarlie, H. AU - Strømme, H. AU - Jamtvedt, G. DA - 2017-1-1 KW - Quality of Health Care Simulation Training Nurses Humans Health Knowledge, Attitudes, Practice Clinical Competence procedures nurse attitude to health uncertainty total quality management systematic review synthesis skill sample size registered nurse narrative meta analysis Medline human Embase doctor patient relation controlled study Cinahl Skills Simulation Quality improvement Knowledge PY - 2017 SP - 6-20 ST - Simulation-based training for nurses: Systematic review and meta-analysis T2 - Nurse Education Today TI - Simulation-based training for nurses: Systematic review and meta-analysis VL - 54 ID - 148 ER - TY - JOUR AB - Purpose: Historically, cardiac surgery patients have often been managed with supraphysiologic intraoperative oxygen levels to protect against the risks of cellular hypoxia inherent in the un-physiologic nature of surgery and cardiopulmonary bypass. This may result in excessive reactive oxygen species generation and exacerbation of ischemia-reperfusion injury. In this review, we synthesize all available data from randomized controlled trials (RCTs) to investigate the impact that hyperoxia has on postoperative organ dysfunction, length of stay, and mortality during adult cardiac surgery. Source: We searched Medline, Embase, Scopus, and Cochrane Central Register of Controlled Trials databases using a high-sensitivity strategy for RCTs that compared oxygenation strategies for adult cardiac surgery. Our primary outcome was postoperative organ dysfunction defined by postoperative increases in myocardial enzymes, acute kidney injury, and neurologic dysfunction. Secondary outcomes were mortality, ventilator days, and length of stay in the hospital and intensive care unit. Principal findings: We identified 12 RCTs that met our inclusion criteria. Risk of bias was unclear to high in all but one trial. Significant heterogeneity in timing of the treatment period and the oxygenation levels targeted was evident and precluded meta-analysis. The large majority of trials found no difference between hyperoxia and normoxia for any outcome. Two trials reported reduced postoperative myocardial enzymes and one trial reported reduced mechanical ventilation time in the normoxia group. Conclusions: Hyperoxia had minimal impact on organ dysfunction, length of stay, and mortality in adult cardiac surgery. The current evidence base is small, heterogeneous, and at risk of bias. Trial registration: International Prospective Register of Systematic Reviews (PROSPERO) (CRD42017074712). Registered 17 August 2017. © 2018, Canadian Anesthesiologists' Society. AD - Department of Anesthesia, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada Department of Surgery, Section of Cardiac Surgery, University of Manitoba, Winnipeg, MB, Canada Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada George & Fay Yee Center for Healthcare Innovation, University of Manitoba/Winnipeg Regional Health Authority, Winnipeg, MB, Canada Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, MB, Canada University of Manitoba, St. Boniface Hospital, CR3008 - 369 Tache Avenue, Winnipeg, MB R2H 2A6, Canada AU - Heinrichs, J. AU - Lodewyks, C. AU - Neilson, C. AU - Abou-Setta, A. AU - Grocott, H. P. C2 - 29721817 DB - Scopus DO - 10.1007/s12630-018-1143-x IS - 8 KW - heart enzyme reactive oxygen metabolite acute kidney failure artificial ventilation cardiac patient cell hypoxia clinical outcome heart surgery human hyperoxia intensive care unit intraoperative period length of stay multiple organ failure neurologic disease patient care priority journal Review surgical mortality surgical patient systematic review adverse event cardiopulmonary bypass complication mortality outcome assessment postoperative complication randomized controlled trial (topic) statistical bias Bias Cardiac Surgical Procedures Humans Outcome Assessment (Health Care) Postoperative Complications Randomized Controlled Trials as Topic LA - English M3 - Review PY - 2018 SP - 923-935 ST - Répercussions de l’hyperoxie sur les résultats après une chirurgie cardiaque : revue systématique et synthèse narrative T2 - Canadian Journal of Anesthesia TI - The impact of hyperoxia on outcomes after cardiac surgery: a systematic review and narrative synthesis VL - 65 ID - 375 ER - TY - JOUR AB - Background: Contrast-induced acute kidney injury (CI-AKI) is defined as worsening of renal function after the administration of iodinated contrast material. In patients with cardiovascular disease, kidney disease, and/or diabetes, renin-angiotensin system blockers, non-steroidal anti-inflammatory drugs, diuretics, and metformin can increase the risk of CI-AKI when undergoing contrast imaging. Despite CI-AKI being the leading iatrogenic cause of acute kidney injury, there is a lack of sufficient scientific evidence supporting which drugs should be stopped, when they should be stopped, and when they should be resumed. The purpose of this systematic review is to assess (1) the effect of withholding medication before contrast procedures on the risk of CI-AKI and other clinical outcomes and (2) the incidence of adverse events occurring after withholding these drugs prior to contrast procedures. This protocol has been registered with PROSPERO, https://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42016033178. Methods: An information specialist will assist in searching MEDLINE, Embase, and the Cochrane Library databases to identify randomized controlled trials, observational studies, case reports, and case series. Relevant abstracts from professional society meetings and web-based registries of clinical trials will also be included. Studies included will compare patients aged ≥18 years instructed to continue taking the drugs of interest and those advised to stop taking them before undergoing contrast procedures. If these drugs are not withheld prior to contrast procedures, the studies must compare patients who are administered these drugs and those who are not before undergoing contrast procedures. Two reviewers will independently screen the titles and abstracts of the studies obtained from the search using pre-defined inclusion criteria and will then extract data from the full texts of selected studies. The quality of the studies will be assessed by two independent reviewers using the Cochrane Risk of Bias 2.0 tool for randomized trials and the Newcastle-Ottawa Scale for observational studies. Discussion: This systematic review will provide a synthesis of current evidence on the discontinuation of drugs prior to contrast procedures and its effect on CI-AKI and other clinical outcomes. These findings will provide clinicians with guidelines and serve as a strong research base for future studies in this field. Systematic review registration: PROSPERO CRD42016033178 © 2018 The Author(s). AU - Hiremath, S. AU - Kayibanda, J. F. AU - Chow, B. J. W. AU - Fergusson, D. AU - Knoll, G. A. AU - Shabana, W. AU - Lahey, B. AU - McBride, O. AU - Davis, A. AU - Akbari, A. DA - 2018-1-1 IS - 1 KW - Kidney Diseases Kidney Acute Kidney Injury systematic review screening renin angiotensin aldosterone system priority journal Newcastle-Ottawa scale mortality morbidity lactic acidosis kidney function human heart catheterization glomerulus filtration rate drug withdrawal contrast-enhanced ultrasound contrast induced nephropathy computer assisted tomography clinical outcome Article angiography renin inhibitor nonsteroid antiinflammatory agent metformin diuretic agent dipeptidyl carboxypeptidase inhibitor creatinine contrast medium Renin-angiotensin system blockade Non-steroidal anti-inflammatory drugs Diuretic Contrast-induced acute kidney injury Contrast nephropathy Contrast imaging Angiotensin receptor blockers Ace inhibitors PY - 2018 SN - 2046-4053 ST - Drug discontinuation before contrast procedures and the effect on acute kidney injury and other clinical outcomes: A systematic review protocol T2 - Systematic Reviews TI - Drug discontinuation before contrast procedures and the effect on acute kidney injury and other clinical outcomes: A systematic review protocol VL - 7 ID - 58 ER - TY - JOUR AB - Background: Research partnership approaches, in which researchers and stakeholders work together collaboratively on a research project, are an important component of research, knowledge translation, and implementation. Despite their growing use, a comprehensive understanding of the principles, strategies, outcomes, and impacts of different types of research partnerships is lacking. Generating high-quality evidence in this area is challenging due to the breadth and diversity of relevant literature. We established a Coordinated Multicenter Team approach to identify and synthesize the partnership literature and better understand the evidence base. This review protocol outlines an innovative approach to locating, reviewing, and synthesizing the literature on research partnerships. Methods: Five reviews pertaining to research partnerships are proposed. The Coordinated Multicenter Team developed a consensus-driven conceptual framework to guide the reviews. First, a review of reviews will comparatively describe and synthesize key domains (principles, strategies, outcomes, and impacts) for different research partnership approaches, within and beyond health (e.g., integrated knowledge translation, participatory action research). After identifying commonly used search terminology, three complementary scoping reviews will describe and synthesize these domains in the health research partnership literature. Finally, an umbrella review will amalgamate and reflect on the collective findings and identify research gaps and future directions. We will develop a collaborative review methodology, comprising search strategy efficiencies, terminology standardization, and the division of screening, extraction, and synthesis to optimize feasibility and literature capture. A series of synthesis and scoping manuscripts will emerge from this Coordinated Multicenter Team approach. Discussion: Comprehensively describing and differentiating research partnership terminology and its domains will address well-documented gaps in the literature. These efforts will contribute to and improve the quality, conduct, and reporting of research partnership literature. The collaborative review methodology will help identify and establish common terms, leverage efficiencies (e.g., expertise, experience, search and protocol design, resources) and optimize research feasibility and quality. Our approach allows for enhanced scope and inclusivity of all research user groups and domains, thereby contributing uniquely to the literature. This multicenter, efficiency and quality-focused approach may serve to inspire researchers across the globe in addressing similar domain challenges, as exist in this rapidly expanding field. © 2018 The Author(s). AU - Hoekstra, F. AU - Mrklas, K. J. AU - Sibley, K. M. AU - Nguyen, T. AU - Vis-Dunbar, M. AU - Neilson, C. J. AU - Crockett, L. K. AU - Gainforth, H. L. AU - Graham, I. D. DA - 2018-1-1 %J Systematic Reviews IS - 1 KW - synthesis standardization stakeholder engagement scientist review publication participatory research nomenclature multicenter study medical research human feasibility study extraction conceptual framework Research principles and strategies Research outcomes and impact Knowledge synthesis Integrated knowledge translation Community-based participatory research Collaborative research partnerships LA - English PY - 2018 SN - 2046-4053 ST - A review protocol on research partnerships: A Coordinated Multicenter Team approach T2 - Systematic Reviews TI - A review protocol on research partnerships: A Coordinated Multicenter Team approach VL - 7 ID - 269 ER - TY - JOUR AB - Introduction: Colorectal cancer (CRC) poses a serious health problem worldwide. While screening is effective in reducing CRC mortality, participation in screening tests is generally suboptimal and social inequities in participation are frequently reported. The goal of this review is to synthesise factors that influence an individual's decision to participate in CRC screening, and to explore how those factors vary by sex, ethnicity and socioeconomic status. Data sources: A primary search of Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, EMBASE, PsycINFO, and a secondary search of grey literature and articles taken from references of included articles (from inception to July 2013). Design: A systematic review and Meta-study synthesis of qualitative studies that address perceived benefits and barriers to participation in CRC screening tests among adults 50 years of age or older. Review methods: The two-staged Meta-study methodology by Paterson will be used to conduct this review. In stage 1, similarities/differences, patterns and themes will be identified across three levels of analysis while preserving the context of original studies. In stage 2, synthesis will extend beyond the analysis to generate new theory of the phenomenon through a process called Meta-synthesis. Discussion: This review offers to generate a framework to better understand benefits and barriers that affect decision-making to participate in CRC screening among different sectors of the population. This framework will be a relevant tool for policy makers in framing educational materials, for patient-centered communication, and for researchers interested in the science of equity. This review is registered in PROSPERO (registration number: CRD42013005025). AU - Honein-AbouHaidar, G. N. AU - Kastner, M. AU - Vuong, V. AU - Perrier, L. AU - Rabeneck, L. AU - Tinmouth, J. AU - Straus, S. AU - Baxter, N. N. DA - 2014-1-1 IS - 2 KW - Mass Screening Social Class Sex Factors Review Literature as Topic Research Design Patient Acceptance of Health Care Meta-Analysis as Topic Humans Early Detection of Cancer Colorectal Neoplasms utilization patient attitude methodology meta analysis (topic) meta analysis literature ethnology early cancer diagnosis systematic review social status sex difference screening test race difference qualitative research patient participation medical decision making interpersonal communication human data synthesis colorectal cancer cancer screening cancer diagnosis article PY - 2014 SN - 2044-6055 ST - Benefits and barriers to participation in colorectal cancer screening: A protocol for a systematic review and synthesis of qualitative studies T2 - BMJ Open TI - Benefits and barriers to participation in colorectal cancer screening: A protocol for a systematic review and synthesis of qualitative studies VL - 4 ID - 246 ER - TY - JOUR AB - Introduction In the UK, it is estimated that a disabling hearing loss (HL) affects 1 in 6 people. HL has functional, economic and social-emotional consequences for affected individuals. Intervention for HL focuses on improving access to the auditory signal using hearing aids or cochlear implants. However, even if sounds are audible and speech is understood, individuals with HL often report increased effort when listening. Listening effort (LE) may be measured using self-reported measures such as patient-reported outcome measures (PROMs). PROMs are validated questionnaires completed by patients to measure their perceptions of their own functional status and well-being. When selecting a PROM for use in research or clinical practice, it is necessary to appraise the evidence of a PROM's acceptability to patients, validity, responsiveness and reliability. Methods and analysis A systematic review of studies evaluating the measurement properties of PROMs available to measure LE in HL will be undertaken. MEDLINE, EMBASE, CINAHL, PsychINFO and Web of Science will be searched electronically. Reference lists of included studies, key journals and the grey literature will be hand-searched to identify further studies for inclusion. Two reviewers will independently complete title, abstract and full-text screening to determine study eligibility. Data on the characteristics of each study and each PROM will be extracted. Methodological quality of the included studies will be appraised using the COnsensus-based Standards for the selection of health Measurement INstruments, the quality of included PROMs appraised and the credibility of the evidence assessed. A narrative synthesis will summarise extracted data. Ethics and dissemination Ethical permission is not required, as this study uses data from published research. Dissemination will be through publication in peer-reviewed journals, conference presentations and the lead author's doctoral dissertation. Findings may inform the selection of PROMs used to measure LE in HL. © 2017 Article author(s). AU - Hughes, S. E. AU - Rapport, F. L. AU - Boisvert, I. AU - McMahon, C. M. AU - Hutchings, H. A. DA - 2017-1-1 IS - 5 KW - Fetal Membranes, Premature Rupture Severity of Illness Index Self Report Research Design Quality of Life Perception Patient Reported Outcome Measures Humans Hearing Loss psychology pathophysiology methodology hearing impairment Web of Science systematic review PsycINFO patient-reported outcome outcome assessment meta analysis (topic) Medline listening effort human hearing Embase clinical protocol clinical practice clinical evaluation clinical assessment Cinahl Article protocol patient-reported outcome measures audiology PY - 2017 SN - 2044-6055 ST - Patient-reported outcome measures (PROMs) for assessing perceived listening effort in hearing loss: Protocol for a systematic review T2 - BMJ Open TI - Patient-reported outcome measures (PROMs) for assessing perceived listening effort in hearing loss: Protocol for a systematic review VL - 7 ID - 94 ER - TY - JOUR AB - This is the protocol for a review and there is no abstract. The objectives are as follows: To examine which intervention (anterior or posterior spinal correction and fusion) has the best functional clinical outcome (in terms of pain, participant satisfaction and function), the best radiographic results and the lowest complication rates in people with AIS. © 2014 The Cochrane Collaboration. AU - Huitema, G. AU - Willems, P. C. AU - van Rhijn, L. AU - Kleijnen, J. AU - Shaffrey, C. I. C7 - Cd011280 DB - Scopus DO - 10.1002/14651858.CD011280 IS - 9 M3 - Article PY - 2014 ST - Anterior versus posterior spinal correction and fusion for adolescent idiopathic scoliosis T2 - Cochrane Database of Systematic Reviews TI - Anterior versus posterior spinal correction and fusion for adolescent idiopathic scoliosis VL - 2014 ID - 333 ER - TY - JOUR AB - Purpose: The purpose of this review was to synthesize literature on the burden of spinal disorders in rural communities to inform the Global Spine Care Initiative care pathway and model of care for their application in medically underserved areas and low- and middle-income countries. Methods: A systematic review was conducted. Inclusion criteria included all age groups with nonspecific low back pain, neck pain, and associated disorders, nonspecific thoracic spinal pain, musculoskeletal chest pain, radiculopathy, or spinal stenosis. Study designs included observational study design (case-control, cross-sectional, cohort, ecologic, qualitative) or review or meta-analysis. After study selection, studies with low or moderate risk of bias were qualitatively synthesized. Results: Of 1150 potentially relevant articles, 43 were eligible and included in the review. All 10 low and 18 moderate risk of bias studies were cross-sectional, 14 of which included rural residents only. All studies included estimates of low back pain prevalence, one included neck pain and one reported estimates for spinal disorders other than back or neck pain. The prevalence of low back pain appears greater among females and in those with less education, psychological factors (stress, anxiety, depression), and alcohol consumers. The literature is inconsistent as to whether back pain is more common in rural or urban areas. High risk of bias in many studies, lack of data on disability and other burden measures and few studies on conditions other than back and neck pain preclude a more comprehensive assessment of the individual and community-based burden of spinal disorders in less-developed communities. Conclusion: We identified few high-quality studies that may inform patients, providers, policymakers, and other stakeholders about spinal disorders and their burden on individuals and communities in most rural places of the developing world. These findings should be a call to action to devote resources for high-quality research to fill these knowledge gaps in medically underserved areas and low and middle-income countries. Graphical abstract: These slides can be retrieved under Electronic Supplementary Material. [Figure not available: see fulltext.]. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature. AD - Office of Public Health Studies, University of Hawai`i, Mānoa, Honolulu, HI, United States Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada Rehabilitation Centre, San Cristobal Clinic, Santiago Spine Group, Santiago, Chile Department of Sports Science and Clinical Biomechanics, University of Southern Denmark and Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, United States Department of Neurology, University of California, Irvine, CA, United States World Spine Care, Santa Ana, CA, United States AU - Hurwitz, E. L. AU - Randhawa, K. AU - Torres, P. AU - Yu, H. AU - Verville, L. AU - Hartvigsen, J. AU - Côté, P. AU - Haldeman, S. C2 - 29282539 DB - Scopus DO - 10.1007/s00586-017-5393-z KW - Back pain Global burden of disease Neck pain Spine alcohol consumption anxiety case control study clinical pathway cohort analysis community dwelling person cross-sectional study demography depression disease association ecology educational status evidence based practice global disease burden health behavior health care organization health care planning human low back pain low income country mental stress meta analysis (topic) middle income country musculoskeletal chest pain observational study prevalence priority journal psychological aspect publishing qualitative research quality control radiculopathy Review risk factor rural area rural population sex difference socioeconomics spinal pain spine disease systematic review thorax pain urban area vertebral canal stenosis workplace developing country occupational disease Developing Countries Humans Occupational Diseases Spinal Diseases Stress, Psychological LA - English M3 - Review PY - 2018 SP - 802-815 ST - The Global Spine Care Initiative: a systematic review of individual and community-based burden of spinal disorders in rural populations in low- and middle-income communities T2 - European Spine Journal TI - The Global Spine Care Initiative: a systematic review of individual and community-based burden of spinal disorders in rural populations in low- and middle-income communities VL - 27 ID - 376 ER - TY - JOUR AB - Background: Sedatives and analgesics are administered to provide sedation and manage agitation and pain in most critically ill mechanically ventilated patients. Various sedation administration strategies including protocolized sedation and daily sedation interruption are used to mitigate drug pharmacokinetic limitations and minimize oversedation, thereby shortening the duration of mechanical ventilation. At present, it is unclear which strategy is most effective, as few have been directly compared. Our review will use network meta-analysis (NMA) to compare and rank sedation strategies to determine their efficacy and safety for mechanically ventilated patients. Methods: We will search the following from 1980 to March 2016: Ovid MEDLINE, CINAHL, Embase, PsycINFO, and Web of Science. We will also search the Cochrane Library, gray literature, and the International Clinical Trials Registry Platform. We will use a validated randomized control trial search filter to identify studies evaluating any strategy to optimize sedation in mechanically ventilated adult patients. Authors will independently extract data from eligible studies in duplicate and complete the Cochrane Risk of Bias tool. Our outcomes of interest include duration of mechanical ventilation, time to first extubation, ICU and hospital length of stay, re-intubation, tracheostomy, mortality, total sedative and opioid exposure, health-related quality of life, and adverse events. To inform our NMA, we will first conduct conventional pair-wise meta-analyses using random-effects models. Where appropriate, we will perform Bayesian NMA using WinBUGS software. Discussion: There are multiple strategies to optimize sedation for mechanically ventilated patients. Current ICU guidelines recommend protocolized sedation or daily sedation interruption. Our systematic review incorporating NMA will provide a unified analysis of all sedation strategies to determine the relative efficacy and safety of interventions that may not have been compared directly. We will provide knowledge users, decision makers, and professional societies with ranking of multiple sedation strategies to inform future sedation guidelines. Systematic review registration: PROSPERO CRD42016037480 � 2016 The Author(s). AU - Hutton, B. AU - Burry, L. D. AU - Kanji, S. AU - Mehta, S. AU - Guenette, M. AU - Martin, C. M. AU - Fergusson, D. A. AU - Adhikari, N. K. AU - Egerod, I. AU - Williamson, D. AU - Straus, S. AU - Moher, D. AU - Ely, E. W. AU - Rose, L. DA - 2016-1-1 IS - 1 KW - Ventilators, Mechanical Hypnotics and Sedatives Respiration, Artificial Quality of Life Network Meta-Analysis Length of Stay Humans Critical Illness Conscious Sedation procedures tracheostomy systematic review sedation priority journal outcome assessment mortality rate meta analysis intensive care unit human hospitalization health care quality extubation critically ill patient artificial ventilation Article Sedation protocol Mechanical ventilation Intensive care Daily sedation interruption PY - 2016 SN - 2046-4053 ST - Comparison of sedation strategies for critically ill patients: A protocol for a systematic review incorporating network meta-analyses T2 - Systematic Reviews TI - Comparison of sedation strategies for critically ill patients: A protocol for a systematic review incorporating network meta-analyses VL - 5 ID - 119 ER - TY - JOUR AB - Background: Despite consensus recommendations for antiemetics in breast cancer patients receiving anthracycline and cyclophosphamide-based chemotherapy, control of chemotherapy-induced nausea and vomiting (CINV) remains sub-optimal. Objective: To inspect available evidence from randomized controlled trials (RCT) in this population to establish treatment comparisons that have been studied, outcomes that have been reported, and the extent of study heterogeneity. Review of this data helps identify challenges for a systematic review comparing antiemetic regimens, and to identify potential future trials. Methods: A search of Ovid MEDLINE�, Embase and Cochrane CENTRAL was performed. We sought RCTs comparing antiemetic regimens in breast cancer patients receiving anthracycline and cyclophosphamidebased chemotherapy. We extracted information related to study design, patient characteristics and interventions compared. Patterns of outcome reporting were studied. While performing network metaanalysis was also of interest, studies were judged highly heterogeneous and it was felt findings from such work would be of uncertain validity. Results: From 1062 citations, a total of 30 full texts were retained. Overall, 47 antiemetic regimens were evaluated using 15 different CINV endpoints. Treatment comparisons were diverse and many were informed by single small trials. Reporting of key endpoints was varied and all endpoints were not consistently available. Heterogeneity in patients, chemotherapies administered, and intervention doses were noted. Conclusions: Despite the availability of consensus recommendations for antiemetic use, we identified challenges in synthesizing the evidence base including high diversity in treatment comparisons, varied outcome reporting, and study heterogeneity. These represent challenges to identifying an optimal antiemetic regimen. Future antiemetic trials should incorporate more informed comparator selection, report patient-oriented outcomes in a standard fashion, and provide accessible data for these measures. � 2015 Published by Elsevier Ltd. AU - Hutton, B. AU - Clemons, M. AU - Mazzarello, S. AU - Kuchuk, I. AU - Skidmore, B. AU - Ng, T. DA - 2015-1-1 IS - 10 KW - Vomiting Nausea Humans Female Cyclophosphamide Clinical Decision-Making Breast Neoplasms Antineoplastic Combined Chemotherapy Protocols Antiemetics Anthracyclines clinical decision making chemically induced treatment response systematic review risk factor risk assessment randomized controlled trial (topic) outcome assessment human drug efficacy chemotherapy induced nausea and vomiting cancer patient cancer chemotherapy breast cancer Article antineoplastic agent antiemetic agent anthracycline steroid serotonin 3 antagonist ranitidine prochlorperazine palonosetron orphenadrine ondansetron metoclopramide granisetron dolasetron mesilate casopitant aprepitant alprazolam Clinical trials Chemotherapy PY - 2015 SP - 951-959 ST - Identifying an optimal antiemetic regimen for patients receiving anthracycline and cyclophosphamide-based chemotherapy for breast cancer - An inspection of the evidence base informing clinical decision-making T2 - Cancer Treatment Reviews TI - Identifying an optimal antiemetic regimen for patients receiving anthracycline and cyclophosphamide-based chemotherapy for breast cancer - An inspection of the evidence base informing clinical decision-making VL - 41 ID - 231 ER - TY - JOUR AB - Background: Patients undergoing renal transplant procedures require multi-agent immunosuppressive regimens both short term (induction phase) and long term (maintenance phase) to minimize the risk of organ rejection. There are several drug classes and agents for immunosuppression. Use of these agents may increase the risk of different harms including not only infections, but also malignancies including post-transplant lymphoproliferative disorder. There is a need to identify which regimens minimize the risk of such outcomes. The objective of this systematic review and network meta-analysis of randomized and observational studies is to explore whether certain modern regimens of immunosuppression used to prevent organ rejection in renal transplant patients are associated with an increased risk of post-transplant lymphoproliferative disorder and other malignancies. Methods/design: 'Modern' regimens were defined to be those evaluated in controlled studies beginning in 1990 or later. An electronic literature search of Medline, Embase and the Cochrane Central Register of Controlled Trials has been designed by an experienced information specialist and peer reviewed by a second information specialist. Study selection and data collection will be performed by two reviewers. The outcomes of interest will include post-transplant lymphoproliferative disorder and other incident forms of malignancy occurring in adult renal transplant patients. Network meta-analyses of data from randomized and observational studies will be performed where judged appropriate based on a review of the clinical and methodological features of included studies. A sequential approach to meta-analysis will be used to combine data from different designs. Discussion: Our systematic review will include both single-agent and multi-agent modern pharmacotherapy regimens in patients undergoing renal transplantation. It will synthesize malignancy outcomes. Our work will also add to the development of methods for network meta-analysis across study designs to assess treatment safety. © 2014 Hutton et al.; licensee BioMed Central Ltd. AN - rayyan-8956276 AU - Hutton, B. AU - Joseph, L. AU - Yazdi, F. AU - Tetzlaff, J. AU - Hersi, M. AU - Kokolo, M. AU - Fergusson, N. AU - Bennett, A. AU - Buenaventura, C. AU - Fergusson, D. AU - Tricco, A. AU - Strauss, S. AU - Moher, D. AU - Knoll, G. DA - 2014-1-1 IS - 1 KW - Immunosuppression Immune Tolerance Kidney Transplantation Risk Factors Randomized Controlled Trials as Topic Observational Study as Topic Neoplasms Lymphoproliferative Disorders Immunosuppressive Agents Humans risk factor chemically induced disorder treatment response risk assessment randomized controlled trial (topic) protocol compliance priority journal postoperative period outcome assessment observational study neoplasm monotherapy meta analysis lymphoproliferative disease information processing immunosuppressive treatment human evidence based medicine clinical trial (topic) clinical research clinical effectiveness bibliographic database Article immunosuppressive agent thymocyte antibody tacrolimus rapamycin prednisone OKT 3 mycophenolic acid 2 morpholinoethyl ester mycophenolic acid everolimus daclizumab cyclosporin belatacept basiliximab azathioprine alemtuzumab systematic review Renal transplant post-transplant lymphoproliferative disorder network meta-analysis malignancy PY - 2014 SN - 2046-4053 ST - Checking whether there is an increased risk of post-transplant lymphoproliferative disorder and other cancers with specific modern immunosuppression regimens in renal transplantation: Protocol for a network meta-analysis of randomized and observational studies T2 - Systematic Reviews TI - Checking whether there is an increased risk of post-transplant lymphoproliferative disorder and other cancers with specific modern immunosuppression regimens in renal transplantation: Protocol for a network meta-analysis of randomized and observational studies VL - 3 ID - 13 ER - TY - JOUR AB - Background: Medication errors represent a noteworthy source of harm to patients. In recent years, several systematic reviews have assessed the frequency and causes of these events, as well as other factors such as commonly associated drugs, their incidence in different specialties, and their consequences to patients. Despite this past literature, there remains a need to study discrepancies between these reviews and establish the current state of the evidence. The planned review will bring together, compare, and contract existing evidence related to the occurrence of medication errors in acute and continuing/long-term care settings. Methods: A systematic review of reviews will be performed. A literature search designed by an experienced information specialist will be carried out in Medline, Embase, and the Cochrane Library. We will seek systematic reviews and meta-analyses of primary research studies that evaluate one or more of the following aspects of the occurrence of preventable adverse drug events in hospitals and long-term care centers: the incidence of preventable adverse drug events, either overall or within subgroups of interest related to setting; drug or patient characteristics; cited consequences of these events to patients, including death, emergency room visits, or other outcomes; and established causes of the preventable adverse drug events. Two researchers will independently screen all abstracts and full texts for study selection and subsequently perform data extraction from all included studies. Quality of the reviews will be assessed using the assessing the methodological quality of systematic reviews (AMSTAR) tool. Where objectives from two or more reviews overlap, we will employ the Jadad framework to assess the causes of any noted discrepancies between reviews. An overall summary of results will be performed using tabular and graphical approaches and will be supplemented by narrative description. Discussion: This overview will help synthesize the broad degree of information available on this important topic. This review is being performed by members of the Drug Safety and Effectiveness Network along with collaboration from Health Canada, and its findings will be published in a peer-reviewed journal. The results may also inform future research in this area. Systematic review registration: PROSPERO CRD42016043220. © 2016 The Author(s). AU - Hutton, B. AU - Kanji, S. AU - McDonald, E. AU - Yazdi, F. AU - Wolfe, D. AU - Thavorn, K. AU - Pepper, S. AU - Chapman, L. AU - Skidmore, B. AU - Moher, D. DA - 2016-1-1 IS - 1 KW - Medical Errors Risk Factors Review Literature as Topic Research Design Patient Safety Patient Education as Topic Medication Errors Medication Adherence Medical Order Entry Systems Incidence Humans Evidence-Based Medicine Drug-Related Side Effects and Adverse Reactions Drug Prescriptions statistics and numerical data standards risk factor procedures prevention and control prescription physician order entry system patient education medication error medication compliance literature evidence based medicine adverse drug reaction study design quality control priority journal patient care outcome assessment methodology human data synthesis data extraction data collection method Article Systematic review Overview of reviews Adverse drug reactions Adverse drug events PY - 2016 SN - 2046-4053 ST - Incidence, causes, and consequences of preventable adverse drug events: Protocol for an overview of reviews T2 - Systematic Reviews TI - Incidence, causes, and consequences of preventable adverse drug events: Protocol for an overview of reviews VL - 5 ID - 167 ER - TY - JOUR AB - Introduction: Some have suggested the quality of reporting of network meta-analyses (a technique used to synthesize information to compare multiple interventions) is sub-optimal. We sought to review information addressing this claim. Objective: To conduct an overview of existing evaluations of quality of reporting in network meta-analyses and indirect treatment comparisons, and to compile a list of topics which may require detailed reporting guidance to enhance future reporting quality. Methods: An electronic search of Medline and the Cochrane Registry of methodologic studies (January 2004-August 2013) was performed by an information specialist. Studies describing findings from quality of reporting assessments were sought. Screening of abstracts and full texts was performed by two team members. Descriptors related to all aspects of reporting a network meta-analysis were summarized. Results: We included eight reports exploring the quality of reporting of network meta-analyses. From past reviews, authors found several aspects of network meta-analyses were inadequately reported, including primary information about literature searching, study selection, and risk of bias evaluations; statement of the underlying assumptions for network meta-analysis, as well as efforts to verify their validity; details of statistical models used for analyses (including information for both Bayesian and Frequentist approaches); completeness of reporting of findings; and approaches for summarizing probability measures as additional important considerations. Conclusions: While few studies were identified, several deficiencies in the current reporting of network meta-analyses were observed. These findings reinforce the need to develop reporting guidance for network meta-analyses. Findings from this review will be used to guide next steps in the development of reporting guidance for network meta-analysis in the format of an extension of the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analysis) Statement. © 2014 Hutton et al. AU - Hutton, B. AU - Salanti, G. AU - Chaimani, A. AU - Caldwell, D. M. AU - Schmid, C. AU - Thorlund, K. AU - Mills, E. AU - Catalá-López, F. AU - Turner, L. AU - Altman, D. G. AU - Moher, D. DA - 2014-1-1 IS - 3 KW - Review Literature as Topic Research Report Publishing Meta-Analysis as Topic Abstracting and Indexing as Topic standards research meta analysis (topic) literature documentation validity statistical model screening register quality control probability information processing Bayes theorem article PY - 2014 ST - The quality of reporting methods and results in network meta-analyses: An overview of reviews and suggestions for improvement T2 - PLoS ONE TI - The quality of reporting methods and results in network meta-analyses: An overview of reviews and suggestions for improvement VL - 9 ID - 240 ER - TY - JOUR AB - Background: Breast and prostate cancers are the most commonly diagnosed non-dermatologic malignancies in Canada. Agents including endocrine therapies (e.g., aromatase inhibitors, gonadotrophin-releasing hormone analogs, anti-androgens, tamoxifen) and chemotherapy have improved survival for both conditions. As endocrine manipulation is a mainstay of treatment, it is not surprising that hot flashes are a common and troublesome adverse effect. Hot flashes can cause chills, night sweats, anxiety, and insomnia, lessening patients' quality of life. These symptoms impact treatment adherence, worsening prognosis. While short-term estrogen replacement therapy is frequently used to manage hot flashes in healthy menopausal women, its use is contraindicated in breast cancer. Similarly, testosterone replacement therapy is contraindicated in prostate cancer. It is therefore not surprising that non-hormonal pharmacological treatments (anti-depressants, anti-epilectics, anti-hypertensives), physical/behavioral treatments (e.g., acupuncture, yoga/exercise, relaxation techniques, cognitive behavioral therapy), and natural health products (e.g., black cohosh, flax, vitamin E, ginseng) have been studied for control of hot flashes. There is a need to identify which interventions minimize the frequency and severity of hot flashes and their impact on quality of life. This systematic review and network meta-analysis of randomized studies will synthesize available evidence addressing this knowledge gap. Methods/design: An electronic search of Medline, Embase, AMED, PsycINFO, and the Cochrane Register of Controlled Trials has been designed by an information specialist and peer reviewed by a second information specialist. Study selection and data collection will be performed by two reviewers independently. Risk of bias assessments will be completed using the Cochrane Risk of Bias Scale. Outcomes of interest will include validated measures of hot flash severity, hot flash frequency, quality of life, and harms. Bayesian network meta-analyses will be performed where judged appropriate based on review of clinical and methodologic features of included studies. Discussion: Our review will include a broad range of interventions that patients with breast and prostate cancer have attempted to use to manage hot flashes. Our work will establish the extent of evidence underlying these interventions and will employ an inclusive approach to analysis to inform comparisons between them. Our findings will be shared with Cancer Care Ontario for consideration in the development of guidance related to supportive care in these patients. Systematic review registration: PROSPERO: CRD42015024286 © 2015 Hutton et al. AU - Hutton, B. AU - Yazdi, F. AU - Bordeleau, L. AU - Morgan, S. AU - Cameron, C. AU - Kanji, S. AU - Fergusson, D. AU - Tricco, A. AU - Straus, S. AU - Skidmore, B. AU - Hersi, M. AU - Pratt, M. AU - Mazzarello, S. AU - Brouwers, M. AU - Moher, D. AU - Clemons, M. DA - 2015-1-1 IS - 1 KW - Quality of Life Prognosis Relaxation Therapy Prostatitis Prostatism Behavior Therapy Estrogen Replacement Therapy Prostatic Neoplasms Prostate Hot Flashes Systematic review Prostate cancer Network meta-analysis Hot flash Breast cancer PY - 2015 SN - 2046-4053 ST - Comparison of physical interventions, behavioral interventions, natural health products, and pharmacologics to manage hot flashes in patients with breast or prostate cancer: Protocol for a systematic review incorporating network meta-analyses T2 - Systematic Reviews TI - Comparison of physical interventions, behavioral interventions, natural health products, and pharmacologics to manage hot flashes in patients with breast or prostate cancer: Protocol for a systematic review incorporating network meta-analyses VL - 4 ID - 15 ER - TY - JOUR AB - Background: De-escalation of bone-targeted agents, such as bisphosphonates and denosumab, from 4- to 12-weekly dosing is an increasingly used strategy in patients with bone metastases from breast cancer. It is unclear whether there is sufficient evidence to support de-escalation as a standard of care. Methods: A systematic review of randomized trials comparing standard 4-weekly administration of bone-targeted agents with de-escalated (Q12-weekly) dosing in breast cancer patients was carried out. Medline, PubMed and the Cochrane Register of Controlled Trials were searched from inception until November 2014 for relevant studies. Outcomes of interest included skeletal-related event (SRE) rates, bone pain, adverse events (AEs) and bone turnover biomarkers. Random-effects meta-analyses were carried out. Results: A total of nine citations representing seven unique studies were eligible. One study is ongoing with no reported data. Six studies reported data for at least one outcome of interest. Data were available comparing standard versus de-escalated therapy for pamidronate (1 study, 38 patients), zoledronate (3 studies, 1117 patients) and denosumab (2 studies, 284 patients). Meta-analysis of five trials reporting data for on-study SRE rates between standard (61/443 patients) and de-escalated (49/392 patients) arms produced a summary risk ratio of 0.90 (95% confidence interval 0.63-1.29). Meta-analyses of data for AEs and bone turnover biomarkers also showed no statistically significant differences between standard and de-escalated arms, though only limited numbers of patients and events were present for most analyses. Conclusion: In this systematic review of studies of bisphosphonates and denosumab, there appears to be no difference in SREs or pain with de-escalated therapy. While a large, hopefully definitive study is ongoing, the data presented so far are consistent with de-escalation of bone-targeting agents becoming a standard of care for patients with bone metastases from breast cancer. © The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. AU - Ibrahim, M. F. K. AU - Mazzarello, S. AU - Shorr, R. AU - Vandermeer, L. AU - Jacobs, C. AU - Hilton, J. AU - Hutton, B. AU - Clemons, M. DA - 2015-1-1 IS - 11 KW - Diphosphonates Biological Markers Standard of Care Humans Female Drug Administration Schedule Clinical Trials as Topic Breast Neoplasms Bone Neoplasms Bone Density Conservation Agents standards secondary procedures health care quality drug administration clinical trial (topic) Review priority journal patient care meta analysis major clinical study hypocalcemia human evidence based medicine drug therapy drug safety drug efficacy drug dose de escalation dosage schedule comparison cancer chemotherapy breast metastasis bone turnover bone pain bone metastasis aged adult bone density conservation agent zoledronic acid pamidronic acid denosumab skeletal-related event de-escalated treatment breast cancer Bisphosphonate biomarker PY - 2015 SP - 2205-2213 ST - Should de-escalation of bone-targeting agents be standard of care for patients with bone metastases from breast cancer? A systematic review and meta-analysis T2 - Annals of Oncology TI - Should de-escalation of bone-targeting agents be standard of care for patients with bone metastases from breast cancer? A systematic review and meta-analysis VL - 26 ID - 218 ER - TY - JOUR AB - Pituitary pars intermedia dysfunction (PPID) is caused by an age-related degenerative disease of dopaminergic neurones. Despite its importance in equine practice, available information regarding its epidemiology is limited. This systematic review aimed to assess published literature to evaluate available evidence regarding the clinical presentation, prevalence and risk factors for PPID in horses and ponies. Electronic database searches were undertaken using a range of terms, and English language publications published prior to August 2016 were included. Both authors independently reviewed screened papers for inclusion, extracted data, and assessed the quality of reporting using predefined criteria. Data were extracted using modified critically appraised topic data collection forms. Meta-analysis was not undertaken due to marked between-study variations. Following removal of duplicate records, of 358 published papers yielded by the search, 97 abstracts were screened for eligibility and 29 publications meeting inclusion criteria were included in the review. Most studies reviewed were case series or cross-sectional studies, with considerable variation in study populations and PPID case definition. Hypertrichosis and/or other hair coat abnormalities, laminitis and epaxial muscle wastage or muscle atrophy are the most frequently reported clinical signs, with prevalence of these signs increasing with increasing horse age. The most robust prevalence estimates for PPID were 21.2% in horses and ponies aged ≥15 years and 2.9% amongst the general equine population. Findings regarding breed and sex predispositions were equivocal and only increasing age has been identified as a significant risk factor for PPID. © 2018 AU - Ireland, J. L. AU - McGowan, C. M. DA - 2018-1-1 KW - Prevalence Cross-Sectional Studies Horses Risk Factors Laminitis Hypertrichosis Horse Geriatric Cushing's disease PY - 2018 SP - 22-33 ST - Epidemiology of pituitary pars intermedia dysfunction: A systematic literature review of clinical presentation, disease prevalence and risk factors T2 - Veterinary Journal TI - Epidemiology of pituitary pars intermedia dysfunction: A systematic literature review of clinical presentation, disease prevalence and risk factors VL - 235 ID - 54 ER - TY - JOUR AB - Background: Bariatric surgery is the only weight-loss treatment available that results in both sustained weight loss and improvements of obesity-related comorbidities. Individuals who meet the eligibility criteria for bariatric surgery are generally older, come from racial or ethnic minorities, are economically disadvantaged, and have low levels of education. However, the population who actually receives bariatric surgery does not reflect the individuals who need it the most. The objective is to conduct a systematic review of the literature exploring the inequities to the access of bariatric surgery.Methods/Design: EMBASE and Medline databases will be searched for observational studies that compared at least one of the PROGRESS-PLUS sociodemographic characteristics of patients eligible for bariatric surgery to those who actually received the procedure. Articles published in the year 1980 to present with no language restrictions will be included. For inclusion, studies must only include adults (≥18 years old) who meet National Institutes of Health (NIH) eligibility criteria for bariatric surgery defined as having either (1) a body mass index (BMI) of 40 kg/m2 or greater; or (2) BMI of 35 kg/m2 or greater with significant weight-related comorbidities. Eligible interventions will include malabsorptive, restrictive, and mixed bariatric procedures.Discussion: There appears to be inequities in access to bariatric surgery. In order to resolve the health inequity in the treatment of obesity, a synthesis of the literature is needed to explore and identify barriers to accessing bariatric surgery. It is anticipated that the results from this systematic review will have important implications for advancing solutions to minimize inequities in the utilization of bariatric surgery.http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42013004920. © 2014 Jackson et al. AU - Jackson, T. D. AU - Zhang, R. AU - Glockler, D. AU - Pennington, J. AU - Reddigan, J. I. AU - Rotstein, O. D. AU - Smylie, J. AU - Perrier, L. AU - Conn, L. G. DA - 2014-1-1 IS - 1 KW - Bariatrics Comorbidity Weight Loss Young Adult Socioeconomic Factors Obesity, Morbid Middle Aged Humans Healthcare Disparities Health Services Accessibility Bariatric Surgery Adult Adolescent statistics review morbid obesity health care delivery systematic review socioeconomics priority journal obesity income human health insurance health care utilization health care disparity health care cost health care access body mass Article age Sociodemographic disparities PY - 2014 SN - 2046-4053 ST - Health inequity in access to bariatric surgery: A protocol for a systematic review T2 - Systematic Reviews TI - Health inequity in access to bariatric surgery: A protocol for a systematic review VL - 3 ID - 242 ER - TY - JOUR AB - Purpose: Strong leadership has been shown to foster change, including loyalty, improved performance and decreased error rates, but there is a dearth of evidence on effectiveness of leadership development programs. To ensure a return on the huge investments made, evidence-based approaches are needed to assess the impact of leadership on health-care establishments. As a part of a pan-Canadian initiative to design an effective evaluative instrument, the purpose of this paper was to identify and summarize evidence on health-care outcomes/return on investment (ROI) indicators and metrics associated with leadership quality, leadership development programs and existing evaluative instruments. Design/methodology/approach: The authors performed a scoping review using the Arksey and O’Malley framework, searching eight databases from 2006 through June 2016. Findings: Of 11,868 citations screened, the authors included 223 studies reporting on health-care outcomes/ROI indicators and metrics associated with leadership quality (73 studies), leadership development programs (138 studies) and existing evaluative instruments (12 studies). The extracted ROI indicators and metrics have been summarized in detail. Originality/value: This review provides a snapshot in time of the current evidence on ROI indicators and metrics associated with leadership. Summarized ROI indicators and metrics can be used to design an effective evaluative instrument to assess the impact of leadership on health-care organizations. © 2018, Emerald Publishing Limited. AU - Jeyaraman, M. M. AU - Qadar, S. M. Z. AU - Wierzbowski, A. AU - Farshidfar, F. AU - Lys, J. AU - Dickson, G. AU - Grimes, K. AU - Phillips, L. A. AU - Mitchell, J. I. AU - Van Aerde, J. AU - Johnson, D. AU - Krupka, F. AU - Zarychanski, R. AU - Abou-Setta, A. M. DA - 2018-1-1 IS - 1 KW - Metronidazole Program Development systematic review leadership investment human health care organization Transformational leadership Organizational performance Leaders Hospitals Health services PY - 2018 SN - 1188-3669 SP - 77-97 ST - Return on investment in healthcare leadership development programs T2 - Leadership in Health Services TI - Return on investment in healthcare leadership development programs VL - 31 ID - 64 ER - TY - JOUR AB - Hypomagnesemia is a common side effect of treatment with epidermal growth factor receptor inhibitor. Guidelines recommend intravenous magnesium replacement to treat this toxicity; however, our systematic review has found little evidence to support this approach. Prospective studies are needed to define the best strategy to manage epidermal growth factor receptor inhibitor-induced hypomagnesemia. Background Despite occurring in 30% of patients, there are no evidence-based guidelines on the management of epidermal growth factor receptor inhibitor (EGFRI)-induced hypomagnesemia. Based on expert opinion, severe hypomagnesemia should be treated by intravenous magnesium replacement. A systematic review of published data of intervention on EGFRI-induced hypomagnesemia was performed. Methods Articles from 1960 to March 2015 were identified from Medline, Embase, Cochrane Central Register of Controlled Trials, and PubMed using a peer-reviewed systematic search strategy. Eligible studies included randomized controlled trials or observational studies that evaluated management of hypomagnesemia in adult patients treated with EGFRIs. Risk factors for severe hypomagnesemia were also assessed. The quality of included studies was rated using Jadad scores. Results A total of 1327 references were identified, and 6 studies, involving 486 patients, met inclusion criteria for analysis. There were no randomized controlled trials, and all included studies were of poor quality. From the studies included in this review, severity of EGFRI-induced hypomagnesemia was associated with length of EGFRI treatment, concomitant platinum chemotherapy, increasing age, and baseline magnesium concentration. In most patients with grade 3 or 4 hypomagnesemia, high-dose intravenous magnesium replacement did not achieve sustainable magnesium repletion beyond 72 hours. Oral magnesium supplementation was not effective or tolerable. Severe hypomagnesemia has been associated with tachycardia and mental alteration. After discontinuation of EGFRI therapy, hypomagnesemia generally resolves within weeks to months. Conclusions There is an absence of high-quality evidence for the management of EGFRI-induced hypomagnesemia. As hypomagnesemia is often refractory to frequent intravenous or oral replacement, there is a need for prospective trials of new interventions for this common toxicity. © 2016 Elsevier Inc. AU - Jiang, D. AU - Dennis, K. AU - Steinmetz, A. AU - Clemons, M. AU - Asmis, T. R. AU - Goodwin, R. A. AU - Vickers, M. M. DA - 2016-1-1 IS - 3 KW - Epidermal Growth Factor Receptor, Epidermal Growth Factor Neoplasms Magnesium Humans Antineoplastic Agents blood antagonists and inhibitors tachycardia systematic review risk factor risk assessment randomized controlled trial (topic) mental disease magnesium blood level hypomagnesemia human head and neck squamous cell carcinoma drug megadose drug efficacy disease severity diet supplementation colorectal cancer cancer chemotherapy Article age distribution advanced cancer epidermal growth factor receptor EGFR protein, human antineoplastic agent panitumumab epidermal growth factor receptor kinase inhibitor cetuximab Toxicity Monoclonal antibody EGFR PY - 2016 SN - 1533-0028 SP - e117-e123 ST - Management of Epidermal Growth Factor Receptor Inhibitor-Induced Hypomagnesemia: A Systematic Review T2 - Clinical Colorectal Cancer TI - Management of Epidermal Growth Factor Receptor Inhibitor-Induced Hypomagnesemia: A Systematic Review VL - 15 ID - 35 ER - TY - JOUR AB - OBJECTIVES: International trends in incidence and outcomes of biliary atresia (BA) are controversial and a wide range of estimates have been reported worldwide. We reviewed the population-based literature to assess international variation of BA incidence and outcomes, and to assess the evidence for seasonal variation in incidence, centralization of Kasai hepatoportoenterostomy, and newborn screening. METHODS: We conducted a systematic review (registration number CRD42011001441) of observational or interventional research within MEDLINE, EMBASE, and the Cochrane Database, which reported incidence, prevalence, or outcomes of infants with BA. Population-based studies, defined by inclusion of an entire population or representative sample, were included. Outcomes included overall survival, native liver survival (NLS), and time to Kasai hepatoportoenterostomy. Single-or multicenter studies were excluded unless those centers captured all potential patients within a jurisdiction. Two independent data extractors reviewed the abstracts and articles. RESULTS: A total of 40 studies were included following review of 3128 references. A wide range of incidence was reported internationally. Ten-year overall survival ranged from 66.7% to 89%. NLS ranged from 20.3% to 75.8% at 1 to 3 years and 24% to 52.8% at 10 years. Earlier age at Kasai was a predictor of improved NLS. Seasonality was reported in 11 studies, and 3 reported an increased incidence during the months of August to March. The evidence for centralization of Kasai to high-volume centers is promising but does not account for all case-mix, provider, or health system factors involved in volume-outcome relations. Stool color card screening resulted in earlier Kasai and improved NLS in Taiwan. CONCLUSIONS: Large, international studies could help fill the gaps in knowledge identified by this review. Copyright © 2013 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. AU - Jimenez-Rivera, C. AU - Jolin-Dahel, K. S. AU - Fortinsky, K. J. AU - Gozdyra, P. AU - Benchimol, E. I. DA - 2013-1-1 IS - 4 KW - Infant World Health Survival Analysis Seasons Referral and Consultation Prognosis Incidence Humans Child Biliary Atresia treatment outcome systematic review survival seasonal variation review priority journal overall survival native liver survival liver surgery Kasai hepatoportoenterostomy human bile duct atresia screening pediatrics outcomes liver transplantation epidemiology PY - 2013 SP - 344-354 ST - International incidence and outcomes of biliary atresia T2 - Journal of Pediatric Gastroenterology and Nutrition TI - International incidence and outcomes of biliary atresia VL - 56 ID - 253 ER - TY - JOUR AB - Background: Ambulatory electrocardiography (ECG) monitors are often used to detect cardiac arrhythmia. For patients with symptoms, an external cardiac loop recorder will often be recommended. The improved recording capacity of newer Holter monitors and similar devices, collectively known as long-term continuous ambulatory ECG monitors, suggests that they will perform just as well as, or better than, external loop recorders. This health technology assessment aimed to evaluate the effectiveness, cost-effectiveness, and budget impact of long-term continuous ECG monitors compared with external loop recorders in detecting symptoms of cardiac arrhythmia. Methods: Based on our systematic search for studies published up to January 15, 2016, we did not identify any studies directly comparing the clinical effectiveness of long-term continuous ECG monitors and external loop recorders. Therefore, we conducted an indirect comparison, using a 24-hour Holter monitor as a common comparator. We used a meta-regression model to control for bias due to variation in device-wearing time and baseline syncope rate across studies. We conducted a similar systematic search for cost-utility and cost-effectiveness studies comparing the two types of devices; none were found. Finally, we used historical claims data (2006-2014) to estimate the future 5-year budget impact in Ontario, Canada, of continued public funding for both types of long-term ambulatory ECG monitors. Results: Our clinical literature search yielded 7,815 non-duplicate citations, of which 12 cohort studies were eligible for indirect comparison. Seven studies assessed the effectiveness of long-term continuous monitors and five assessed external loop recorders. Both types of devices were more effective than a 24-hour Holter monitor, and we found no substantial difference between them in their ability to detect symptoms (risk difference 0.01; 95% confidence interval -0.18, 0.20). Using GRADE for network meta-analysis, we evaluated the quality of the evidence as low. Our budget impact analysis showed that use of the long-term continuous monitors has grown steadily in Ontario since they became publicly funded in 2006, particularly since 2011 when monitors that can record for 14 days or longer became funded, and the use of external cardiac loop recorders has correspondingly declined. The analysis suggests that, with these trends, continued public funding of both types of long-term ambulatory ECG testing will result in additional costs ranging from $130,000 to $370,000 per year over the next 5 years. Conclusions: Although both long-term continuous ambulatory ECG monitors and external cardiac loop recorders were more effective than a 24-hour Holter monitor in detecting symptoms of cardiac arrhythmia, we found no evidence to suggest that these two devices differ in effectiveness. Assuming that the use of long-term continuous monitors will continue to increase in the next 5 years, the public health care system in Ontario can expect to see added costs of $130,000 to $370,000 per year. © Queen’s Printer for Ontario, 2017. AU - Kabali, Conrad AU - Xie, Xuanqian AU - Higgins, Caroline AU - Zierler, Amy AU - Ali, Arshia AU - Soulodre, Claude AU - Laing, Ana AU - Kaulback, Kellee AU - Thota, Anil AU - Ng, Vivian AU - Mitchell, Andrée AU - Sikich, Nancy AU - Dhalla, Irfan DA - 2017-1-1 IS - 1 KW - Ontario Biomedical Technology Cost-Benefit Analysis Arrhythmias, Cardiac Technology Assessment, Biomedical Electrocardiography Electrocardiography, Ambulatory systematic review (topic) Note human Holter monitor heart arrhythmia health care cost funding faintness electrocardiography monitoring electrocardiograph cost utility analysis cost effectiveness analysis cohort analysis clinical effectiveness cardiovascular equipment cardiac loop recorder Canada ambulatory electrocardiography PY - 2017 SN - 1915-7398 SP - 1-56 ST - Ontario health technology assessment series: Long-term continuous ambulatory ECG monitors and external cardiac loop recorders for cardiac arrhythmia: A health technology assessm T2 - Ontario Health Technology Assessment Series TI - Ontario health technology assessment series: Long-term continuous ambulatory ECG monitors and external cardiac loop recorders for cardiac arrhythmia: A health technology assessm VL - 17 ID - 104 ER - TY - JOUR AB - Background: Interprofessional collaboration (IPC) is a core demand of policymakers, funding parties, and health care professionals in practice. Although the causal mechanism from increased IPC to improved patient outcomes seems to be intuitive, there is a lack of credible causal evidence concerning the effects not only on the objective but also on the subjective patient outcomes. The aim of the planned systematic review is to focus on the effect of IPC on patient-reported outcomes and experiences in inpatient care. Methods: A systematic literature review will be undertaken by searching the following electronic databases: PubMed, Web of Science/Social Science Citation Index, Cochrane Library (CENTRAL), Current Contents (LIVIVO), CINAHL, and EMBASE. Additional studies will be identified through forward and backward citation tracking, manually searching the Internet and Google Scholar, and consultation of experts. Data will be synthesized through narrative description, grouping, and thematic analysis of the extracted data. If heterogeneity for some studies and outcomes is sufficiently low, a quantitative meta-analysis of effect sizes and standard errors will be applied. Discussion: The systematic review will synthesize the evidence regarding the effectiveness of IPC and how it is perceived by patients in inpatient care. As the patients' perspective becomes increasingly relevant in the context of quality improvement, the results can help decision-makers in policy- and health care institutions to understand and develop strategies to ensure a high quality of care. Systematic review registration: PROSPERO registration number: CRD42017073900 ; date of registration in PROSPERO 07 August 2017. © 2018 The Author(s). AD - Witten/Herdecke University, Witten, Germany The Federal Joint Committee, Berlin, Germany Brandenburg Medical School Theodor Fontane, Neuruppin, Germany Institute for Research in Operative Medicine, Witten, Germany AU - Kaiser, L. AU - Bartz, S. AU - Neugebauer, E. A. M. AU - Pietsch, B. AU - Pieper, D. C2 - 30126451 C7 - 126 DB - Scopus DO - 10.1186/s13643-018-0797-3 IS - 1 KW - Collaboration Inpatient Interdisciplinary Interprofessional Patient-reported experiences Patient-reported outcomes Quality improvement Quality of care adult article Cinahl Cochrane Library consultation effect size Embase error female hospital patient human Internet male Medline meta analysis narrative outcome assessment patient-reported outcome quantitative analysis registration SciSearch sociology systematic review thematic analysis total quality management Web of Science clinical competence cooperation health care personnel health care quality psychology public relations Cooperative Behavior Health Personnel Humans Inpatients Interprofessional Relations Patient Reported Outcome Measures Quality of Health Care LA - English M3 - Article PY - 2018 ST - Interprofessional collaboration and patient-reported outcomes in inpatient care: Protocol for a systematic review T2 - Systematic Reviews TI - Interprofessional collaboration and patient-reported outcomes in inpatient care: Protocol for a systematic review VL - 7 ID - 377 ER - TY - JOUR AB - Objectives: Patients often suffer from disturbed sleep in hospital. Poor-quality sleep in hospitalised patients has been associated with significant morbidity and pharmacological sleep aids are often prescribed. The objective of this systematic review is to evaluate the comparative efficacy and safety of pharmacological interventions used for sleep in hospitalised patients. Setting/participants: We searched MEDLINE, Embase, the Cochrane database and grey literature for prospective studies that evaluated sleep in hospitalised adults after a pharmacological intervention. Primary and secondary outcome measures: Two reviewers assessed studies for inclusion and extracted data for efficacy outcomes, including sleep efficiency, sleep latency, sleep fragmentation and objectively measured sleep stage distribution. Risk of bias was assessed and meta-analyses were planned contingent upon homogeneity of the included studies. Results: After screening 1920 citations, 15 studies involving 861 patients were included. Medications studied included benzodiazepines, nonbenzodiazepine sedatives, melatonin, propofol and dexmedetomidine. Five studies were deemed to be of high quality. Heterogeneity and variable outcome reporting precluded meta-analysis in most cases. No consistent trends with respect to sleep efficiency, quality or interruptions were observed identifying a drug or drug class as superior to another or no treatment. Benzodiazepines appeared to be better than no treatment with respect to sleep latency, but this was not consistently demonstrated across all studies. Sleep stage distribution shows that sleep in hospital is dominated by stages N1 and N2. Conclusions: There is insufficient evidence to suggest that pharmacotherapy improves the quality or quantity of sleep in hospitalised patients suffering from poor sleep. No drug class or specific drug was identified as superior even when compared to placebo or no treatment. Although 15 studies were included, the quality of evidence was limited by their quality and size. Larger, better-designed trials in hospitalised adults are needed. AU - Kanji, S. AU - Mera, A. AU - Hutton, B. AU - Burry, L. AU - Rosenberg, E. AU - MacDonald, E. AU - Luks, V. DA - 2016-1-1 IS - 7 KW - Sleep Stages Benzodiazepines Adult systematic review somnolence sleep stage sleep quality sleep side effect Sedation Agitation Scale review respiration depression REM sleep randomized controlled trial (topic) pruritus prospective study polysomnography nasopharynx airway Mini Mental State Examination meta analysis human hospital patient evening dosage drug withdrawal drug safety drug hypersensitivity drug efficacy critically ill patient continuous infusion comparative study cohort analysis cognition case study bradycardia arousal alertness agitation zopiclone zolpidem zaleplon triazolam sedative agent propofol pregabalin oxazepam neuroleptic agent natural product midazolam melatonin receptor agonist melatonin lorazepam imidazopyridine derivative hypnotic sedative agent hypnotic agent gabapentin flunitrazepam dexmedetomidine brotizolam benzodiazepine derivative barbituric acid derivative antihistaminic agent antidepressant agent alpha 2 adrenergic receptor stimulating agent PY - 2016 SN - 2044-6055 ST - Pharmacological interventions to improve sleep in hospitalised adults: A systematic review T2 - BMJ Open TI - Pharmacological interventions to improve sleep in hospitalised adults: A systematic review VL - 6 ID - 1 ER - TY - JOUR AB - Introduction: Globally, health information technologies are now being used by nurses in a variety of settings. However, nurse leaders often do not have the necessary strategic and tactical informatics competencies to adequately ensure their effective adoption and use. Although informatics competencies and competency frameworks have been identified and developed, to date there has not been review or consolidation of the work completed in this area. In order to address this gap, a scoping review is being conducted. The objectives of this scoping review are to: (1) identify informatics competencies of relevance to nurse leaders, (2) identify frameworks or theories that have been used to develop informatics competencies for nurse leaders, (3) identify instruments used to assess the informatics competencies of nurse leaders and (4) examine the psychometric properties of identified instruments. Methods: Using the Arksey and O'Malley five-step framework, a literature review will be conducted using a scoping review methodology. The search will encompass academic and grey literature and include two primary databases and five secondary databases. Identified studies and documents will be independently screened for eligibility by two reviewers. Data from the studies and documents will be extracted and compiled into a chart. Qualitative data will be subject to a thematic analysis and descriptive statistics applied to the quantitative data. Ethics and dissemination: Ethical approval was not required for this study. Results: will be used to inform a future study designed to validate an instrument used to evaluate informatics competencies for nurse leaders within a Canadian context. © 2017 Article author(s). All rights reserved. AU - Kassam, I. AU - Nagle, L. AU - Strudwick, G. C7 - e018855 DB - Scopus DO - 10.1136/bmjopen-2017-018855 IS - 12 M3 - Review PY - 2017 ST - Informatics competencies for nurse leaders: Protocol for a scoping review T2 - BMJ Open TI - Informatics competencies for nurse leaders: Protocol for a scoping review VL - 7 ID - 329 ER - TY - JOUR AB - Purpose: Specialized palliative care (SPC) is currently underutilized or provided late in cancer care. The aim of this systematic review and meta-analysis is to critically evaluate the impact of SPC on patients’ health-related quality of life (HRQoL). Methods: Five databases were searched through June 2016. Randomized controlled trials (RCTs) and prospective studies using a pre- and post- assessment of HRQoL were included. The PRISMA reporting statement was followed. Criteria from available checklists were used to evaluate the studies’ quality. A meta-analysis followed using random-effect models separately for RCTs and non-RCTs. Results: Eleven studies including five RCTs and 2939 cancer patients published between 2001 and 2014 were identified. There was improved HRQoL in patients with cancer following SPC especially in symptoms like pain, nausea, and fatigue as well as improvement of physical and psychological functioning. Less or no improvements were observed in social and spiritual domains. In general, studies of inpatients showed a larger benefit from SPC than studies of outpatients whereas patients’ age and treatment duration did not moderate the impact of SPC. Methodological shortcomings of included studies include high attrition rates, low precision, and power and poor reporting of control procedures. Conclusions: The methodological problems and publication bias call for higher-quality studies to be designed, funded, and published. However, there is a clear message that SPC is multi-disciplinary and aims at palliation of symptoms and burden in line with current recommendations. © 2017, Springer-Verlag GmbH Germany. AU - Kassianos, A. P. AU - Ioannou, M. AU - Koutsantoni, M. AU - Charalambous, H. DA - 2018-1-1 %J IS - 1 KW - Palliative Care Quality of Life Specialized palliative care Meta-analysis Cancer PY - 2018 SP - 61-79 ST - The impact of specialized palliative care on cancer patients’ health-related quality of life: a systematic review and meta-analysis T2 - Supportive Care in Cancer TI - The impact of specialized palliative care on cancer patients’ health-related quality of life: a systematic review and meta-analysis VL - 26 ID - 265 ER - TY - JOUR AB - Introduction: More than half of older adults (age ≥ 65 yr) have 2 or more high-burden multimorbidity conditions (i.e., highly prevalent chronic diseases, which are associated with increased health care utilization; these include diabetes [DM], dementia, depression, chronic obstructive pulmonary disease [COPD], cardiovascular disease [CVD], arthritis, and heart failure [HF]), yet most existing interventions for managing chronic disease focus on a single disease or do not respond to the specialized needs of older adults. We conducted a systematic review and meta-analysis to identify effective multimorbidity interventions compared with a control or usual care strategy for older adults. Methods: We searched bibliometric databases for randomized controlled trials (RCTs) evaluating interventions for managing multiple chronic diseases in any language from 1990 to December 2017. The primary outcome was any outcome specific to managing multiple chronic diseases as reported by studies. Reviewer pairs independently screened citations and full-text articles, extracted data and assessed risk of bias. We assessed statistical and methodological heterogeneity and performed a meta-analysis of RCTs with similar interventions and components. Results: We included 25 studies (including 15 RCTs and 6 cluster RCTs) (12 579 older adults; mean age 67.3 yr). In patients with [depression + COPD] or [CVD + DM], care-coordination strategies significantly improved depressive symptoms (standardized mean difference -0.41; 95% confidence interval [CI] -0.59 to -0.22; I2 = 0%) and reduced glycosylated hemoglobin (HbA1c) levels (mean difference -0.51; 95% CI -0.90 to -0.11; I2 = 0%), but not mortality (relative risk [RR] 0.79; 95% CI 0.53 to 1.17; I2 = 0%). Among secondary outcomes, care-coordination strategies reduced functional impairment in patients with [arthritis + depression] (between-group difference -0.82; 95% CI -1.17 to -0.47) or [DM + depression] (between-group difference 3.21; 95% CI 1.78 to 4.63); improved cognitive functioning in patients with [DM + depression] (between-group difference 2.44; 95% CI 0.79 to 4.09) or [HF + COPD] (p = 0.006); and increased use of mental health services in those with [DM + (CVD or depression)] (RR 2.57; 95% CI 1.90 to 3.49; I2 = 0%). Interpretation: Subgroup analyses showed that older adults with diabetes and either depression or cardiovascular disease, or with coexistence of chronic obstructive pulmonary disease and heart failure, can benefit from care-coordination strategies with or without education to lower HbA1c, reduce depressive symptoms, improve health-related functional status, and increase the use of mental health services. © 2018 Joule Inc. or its licensors AD - Knowledge Translation and Implementation unit, North York General Hospital, Li Ka Shing Knowledge Institute of St. Michael's Hospital, United States Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ont, Canada Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom Family Practice Health Centre, Women's College Research Institute, Institute for Health System Solutions and Virtual Care, Women's College Hospital, Canada Department of Family and Community Medicine and Institute of Health Policy (Ivers), Management and Evaluation, University of Toronto, Toronto, Canada Regional Geriatric Program of Toronto (Liu), Sunnybrook Health Sciences, Geriatric Medicine, Toronto, Ont., Canada St. Peter's Hospital, Hamilton Health Sciences, Division of Geriatric Medicine, McMaster University, Hamilton, Ont., Canada Departments of Medicine and Community Health Sciences, University of Calgary, Foothills Hospital, Calgary, Canada Department of Medicine, University of Toronto, Toronto, Ont, Canada AU - Kastner, M. AU - Cardoso, R. AU - Lai, Y. AU - Treister, V. AU - Hamid, J. S. AU - Hayden, L. AU - Wong, G. AU - Ivers, N. M. AU - Liu, B. AU - Marr, S. AU - Holroyd-Leduc, J. AU - Straus, S. E. C2 - 30150242 DB - Scopus DO - 10.1503/cmaj.171391 IS - 34 KW - hemoglobin A1c arthritis bibliometrics cardiovascular disease chronic disease chronic obstructive lung disease depression diabetes mellitus disease burden follow up health care cost health care utilization heart failure intervention study mental health service multiple chronic conditions population research practice guideline prospective study quality of life Review risk assessment telemonitoring aged comorbidity cost of illness human meta analysis patient care randomized controlled trial (topic) Humans Mental Health Services Patient Care Management Physical Functional Performance Randomized Controlled Trials as Topic LA - English M3 - Article PY - 2018 SP - E1004-E1012 ST - effectiveness of interventions for managing multiple high-burden chronic diseases in older adults: A systematic review and meta-analysis T2 - CMAJ TI - effectiveness of interventions for managing multiple high-burden chronic diseases in older adults: A systematic review and meta-analysis VL - 190 ID - 378 ER - TY - JOUR AB - Introduction: Heart failure (HF) is a leading reason for hospitalisation and readmissions to hospital, particularly among individuals older than 65 years of age. The prognosis of patients with HF is grim, with high rates of mortality risk and hospital readmissions. The transition period early after hospital discharge represents a window of opportunity to positively influence patient outcomes using quality improvement (QI) strategies. However, little is known about which QI interventions exist for early events of HF after discharge, so the main objective of our study is to conduct a scoping review of the literature to determine which QI strategies are effective for reducing hospital readmissions and mortality for patients with HF who transition from the hospital back into independent living. We will also investigate which elements contribute to effective QI strategies. Methods and analysis: We will search the literature in MEDLINE, EMBASE, CINAHL and the Cochrane library for randomised controlled trials and systematic reviews evaluating QI interventions aimed at improving outcomes for patients with HF transitioning from the hospital back into the community. Two reviewers will independently apply our eligibility criteria at level 1 (abstract/title) and level 2 (full-text) screening; disagreements will be resolved through consensus. We will extract data in duplicate on study characteristics, population, setting, QI intervention and outcomes. We will synthesise results descriptively and explore QI elements to determine which aspect contributes to its impact. We will also consider synthesis of our data according to several conceptual frameworks such as Wagner's Chronic Care Model. Discussion and dissemination: The findings of this scoping review will be used to determine which elements should comprise a QI intervention aimed at facilitating the transition of newly admitted patients with HF back into the community. We will disseminate our findings through publications, presentations as well as through a stakeholder meeting to generate key messages most relevant to each. AU - Kastner, M. AU - Lillie, E. AU - Ashoor, H. AU - Perrier, L. AU - Cardoso, R. AU - Straus, S. AU - Lee, D. S. DA - 2015-1-1 IS - 11 KW - Quality Improvement Patient Readmission Middle Aged Male Independent Living Humans Heart Failure Female Aged total quality management self-directed learning self care Review patient education patient counseling motivational interviewing lifestyle modification human hospital readmission hospital discharge hospital admission health care personnel conceptual framework cardiovascular mortality cardiac patient bibliographic database PY - 2015 SN - 2044-6055 ST - Quality improvement strategies to optimise transition of patients with heart failure to independent living: Protocol for a scoping review T2 - BMJ Open TI - Quality improvement strategies to optimise transition of patients with heart failure to independent living: Protocol for a scoping review VL - 4 ID - 217 ER - TY - JOUR AB - Introduction: The burden of chronic disease is a global phenomenon, particularly among people aged 65 years and older. More than half of older adults have more than one chronic disease and their care is not optimal. Chronic disease management (CDM) tools have the potential to meet this challenge but they are primarily focused on a single disease, which fails to address the growing number of seniors with multiple chronic conditions. Methods and analysis: We will conduct a systematic review alongside a realist review to identify effective CDM tools that integrate one or more highburden chronic diseases affecting older adults and to better understand for whom, under what circumstances, how and why they produce their outcomes. We will search MEDLINE, EMBASE, CINAHL, AgeLine and the Cochrane Library for experimental, quasi-experimental, observational and qualitative studies in any language investigating CDM tools that facilitate optimal disease management in one or more high-burden chronic diseases affecting adults aged. 65 years. Study selection will involve calibration of reviewers to ensure reliability of screening and duplicate assessment of articles. Data abstraction and risk of bias assessment will also be performed independently. Analysis will include descriptive summaries of study and appraisal characteristics, effectiveness of each CDM tool (metaanalysis if appropriate); and a realist programme theory will be developed and refined to explain the outcome patterns within the included studies. Ethics and dissemination: Ethics approval is not required for this study. We anticipate that our findings, pertaining to gaps in care across highburden chronic diseases affecting seniors and highlighting specific areas that may require more research, will be of interest to a wide range of knowledge users and stakeholders. We will publish and present our findings widely, and also plan more active dissemination strategies such as workshops with our key stakeholders. Trial registration number: Our protocol is registered with PROSPERO (registration number CRD42014014489). © 2015 BMJ Open. AU - Kastner, M. AU - Perrier, L. AU - Hamid, J. AU - Tricco, A. C. AU - Cardoso, R. AU - Ivers, N. M. AU - Liu, B. AU - Marr, S. AU - Holroyd-Leduc, J. AU - Wong, G. AU - Graves, L. AU - Straus, S. E. DA - 2015-1-1 IS - 2 KW - Adult Translational Medical Research Research Design Reproducibility of Results Outcome Assessment (Health Care) Humans Health Services for the Aged Disease Management Chronic Disease Aged translational research reproducibility outcome assessment methodology evaluation study elderly care systematic review risk assessment reliability quasi experimental study qualitative research publication observational study Medline language knowledge human Embase Cochrane Library Cinahl calibration Article aging PY - 2015 SN - 2044-6055 ST - Effectiveness of knowledge translation tools addressing multiple high-burden chronic diseases affecting older adults: Protocol for a systematic review alongside a realist review T2 - BMJ Open TI - Effectiveness of knowledge translation tools addressing multiple high-burden chronic diseases affecting older adults: Protocol for a systematic review alongside a realist review VL - 5 ID - 226 ER - TY - JOUR AB - Osteoporosis is affecting over 200 million people worldwide. Despite available guidelines, care for these patients remains sub-optimal. We developed an osteoporosis tool to address the multiple dimensions of chronic disease management. Findings from its evaluation showed a significant increase from baseline in osteoporosis investigations and treatment, so we are revising this tool to include multiple chronic conditions including an update of evidence about osteoporosis. Our objectives were to conduct a systematic review of osteoporosis interventions in adults at risk for osteoporosis. We searched bibliometric databases for randomized controlled trials (RCTs) in any language evaluating osteoporosis disease management interventions in adults at risk for osteoporosis. Reviewer pairs independently screened citations and full-text articles, extracted data, and assessed risk of bias. Analysis included random effects meta-analysis. Primary outcomes were osteoporosis investigations and treatment, and fragility fractures. Fifty-five RCTs and one companion report were included in the analysis representing 165,703 patients. Our findings from 55 RCTs and 18 sub-group meta-analyses showed that complex implementation interventions with multiple components consisting of at least education + feedback + follow-up significantly increased the initiation of osteoporosis medications, and interventions with at least education + follow-up significantly increased the initiation of osteoporosis investigations. No significant impact was found for any type of intervention to reduce fracture. Complex interventions that include at least education + follow-up or feedback have the most potential for increasing osteoporosis investigations and treatment. Patient education appears to be an important component in osteoporosis disease management. © 2017, International Osteoporosis Foundation and National Osteoporosis Foundation. AU - Kastner, M. AU - Perrier, L. AU - Munce, S. E. P. AU - Adhihetty, C. C. AU - Lau, A. AU - Hamid, J. AU - Treister, V. AU - Chan, J. AU - Lai, Y. AU - Straus, S. E. DA - 2018-1-1 IS - 1 KW - Disease Management treatment planning systematic review risk factor risk assessment Review priority journal patient education outcome assessment osteoporosis meta analysis intervention study human fragility fracture follow up decision making clinical evaluation clinical decision support system bone density vitamin D calcium Meta-analysis Complex interventions Chronic disease management PY - 2018 SP - 5-17 ST - Complex interventions can increase osteoporosis investigations and treatment: a systematic review and meta-analysis T2 - Osteoporosis International TI - Complex interventions can increase osteoporosis investigations and treatment: a systematic review and meta-analysis VL - 29 ID - 134 ER - TY - JOUR AB - Background: A knowledge synthesis attempts to summarize all pertinent studies on a specific question, can improve the understanding of inconsistencies in diverse evidence, and can identify gaps in research evidence to define future research agendas. Knowledge synthesis activities in healthcare have largely focused on systematic reviews of interventions. However, a wider range of synthesis methods has emerged in the last decade addressing different types of questions (e.g., realist synthesis to explore mediating mechanisms and moderators of interventions). Many different knowledge synthesis methods exist in the literature across multiple disciplines, but locating these, particularly for qualitative research, present challenges. There is a need for a comprehensive manual for synthesis methods (quantitative/qualitative or mixed), outlining how these methods are related, and how to match the most appropriate knowledge synthesis method to answer a research question. The objectives of this scoping review are to: 1) conduct a systematic search of the literature for knowledge synthesis methods across multi-disciplinary fields; 2) compare and contrast the different knowledge synthesis methods; and, 3) map out the specific steps to conducting the knowledge syntheses to inform the development of a knowledge synthesis methods manual/tool. Methods. We will search relevant electronic databases (e.g., MEDLINE, CINAHL), grey literature, and discipline-based listservs. The scoping review will consider all study designs including qualitative and quantitative methodologies (excluding economic analysis or clinical practice guideline development), and identify knowledge synthesis methods across the disciplines of health, education, sociology, and philosophy. Two reviewers will pilot-test the screening criteria and data abstraction forms, and will independently screen the literature and abstract the data. A three-step synthesis process will be used to map the literature to our objectives. Discussion. This project represents the first attempt to broadly and systematically identify, define and classify knowledge synthesis methods (i.e., less traditional knowledge synthesis methods). We anticipate that our results will lead to an accepted taxonomy for less traditional knowledge synthesis methods, and to the development and implementation of a methods manual for these reviews which will be relevant to a wide range of knowledge users, including researchers, funders, and journal editors. © 2012 Kastner et al.; licensee BioMed Central Ltd. AU - Kastner, M. AU - Tricco, A. C. AU - Soobiah, C. AU - Lillie, E. AU - Perrier, L. AU - Horsley, T. AU - Welch, V. AU - Cogo, E. AU - Antony, J. AU - Straus, S. E. DA - 2012-1-1 KW - Review Literature as Topic Humans Guidelines as Topic Evidence-Based Practice practice guideline literature human evidence based practice article PY - 2012 SN - 1471-2288 ST - What is the most appropriate knowledge synthesis method to conduct a review? Protocol for a scoping review T2 - BMC Medical Research Methodology TI - What is the most appropriate knowledge synthesis method to conduct a review? Protocol for a scoping review VL - 12 ID - 257 ER - TY - JOUR AB - Objective: Lifestyle factors such as physical activity are known to reduce the risk of frailty. However, less is known about the frailty-sedentary behavior relationship. A systematic review was conducted to synthesize the available evidence concerning associations between sedentary behaviors and frailty levels in adults. Method: MEDLINE, Embase, Web of Science, CINAHL, SPORTDiscus, Scopus, and the World Health Organization Clinical Trials Registry were searched up to August 2017 for observational studies in adults >18 years for cohort studies. Included studies identified frailty as a specified outcome using a multi-component tool. Sedentary behavior was measured by self-report or objectively. Studies with statistical models adjusting for at least one covariate were included. Meta-analysis could not be performed due to the heterogeneity in frailty and sedentary behavior measures. Results: Six longitudinal and ten cross-sectional studies were identified (n = 14, 693 unique participants); sample sizes ranged from 26 to 5871. Studies were generally at a low to moderate risk of bias. Most studies (n = 9) used the Fried criteria to measure frailty. Five studies measured sedentary behavior by questionnaire, with three studies specifically measuring television viewing time. Seven studies measured sedentary time by accelerometry. Thirteen of sixteen studies observed a detrimental association between high amounts of sedentary behaviors and an increased prevalence of frailty or higher frailty levels. Six of seven studies adjusting for physical activity behaviors demonstrated an independent association between sedentary behaviors and frailty. All six longitudinal studies found a negative association between sedentary behaviors and frailty. Conclusions: Sedentary behaviors were associated with a higher prevalence of frailty or higher frailty levels. Longitudinal studies are needed that adjust for physical activity when determining the association between sedentary behaviors and frailty. The efficacy of sedentary behavior reduction outside of physical activity interventions to treat and reverse frailty should also be tested. © 2018 Elsevier Inc. AD - Health, Leisure & Human Performance Research Institute, Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Canada Institute of Cardiovascular Sciences, St. Boniface Hospital Research Centre, Winnipeg, Canada College of Nursing, Rady Faculty of Heath Sciences, University of Manitoba, Winnipeg, Canada University of Manitoba Libraries, Winnipeg, Canada Department of Surgery, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada Cardiac Sciences Program, St. Boniface Hospital, Winnipeg, Canada Seven Oaks Hospital Research Centre, Winnipeg, Canada AU - Kehler, D. S. AU - Hay, J. L. AU - Stammers, A. N. AU - Hamm, N. C. AU - Kimber, D. E. AU - Schultz, A. S. H. AU - Szwajcer, A. AU - Arora, R. C. AU - Tangri, N. AU - Duhamel, T. A. C2 - 30355522 DB - Scopus DO - 10.1016/j.exger.2018.10.010 KW - Frailty Sedentary behavior Systematic review accelerometry disease association health impact assessment human physical activity prevalence priority journal Review risk factor sedentary lifestyle sitting television viewing adult exercise self report Humans Risk Factors LA - English M3 - Review PY - 2018 SP - 1-12 ST - A systematic review of the association between sedentary behaviors with frailty T2 - Experimental Gerontology TI - A systematic review of the association between sedentary behaviors with frailty VL - 114 ID - 379 ER - TY - JOUR AB - Background: Although children have historically been excluded from clinical trials (CTs), many require medicines tested and approved in CTs, forcing health care providers to treat their pediatric patients based on extrapolated data. Unfortunately, traditional randomized CTs can be slow and resource-intensive, and they often require multi-center collaboration. However, an adaptive design (AD) framework for CTs could be used to increase the efficiency of pediatric CTs by incorporating prospectively planned modifications to CT methods without undermining the integrity or validity of the study. There are many possible adaptations, but each will have ethical, logistical, and statistical implications. It remains unclear which adaptations (or combinations thereof) will lead to real-world improvements in pediatric CT efficiency. This study will identify, evaluate, and synthesize the various regulatory, ethical, logistical, and statistical considerations and emerging issues of AD in CTs that could be used to evaluate the use of drugs in children. Methods/design: Following the development of a peer-reviewed search strategy, a systematic review on AD in CTs will be conducted. Data on regulatory, ethical, logistic, and statistical considerations as well as population and trial design characteristics will be synthesized. A mixed-methods study including surveys and focus groups with regulators, research ethics board members, biostatisticians, clinicians, and scientists, as well as representatives from patient groups and the public will evaluate the opportunities and challenges in applying AD in trials enrolling children and propose recommendations on best practices. Discussion: This study will deliver practical recommendations on the use of AD in pediatric CTs. Collaboration and consultation with national and global partners will ensure that our results meet the needs of researchers, regulators, and patients, both locally and globally, and that they remain current and relevant by engaging a wide variety of stakeholders. Overall, this research will enrich the knowledge base regarding if, how, and when AD can be used to answer research questions with fewer resources while still meeting the highest ethical standards and regulatory requirements for CTs. In turn, this will result in increased high-quality clinical research needed by health care providers so they have access to appropriate, population-specific evidence regarding the safe and effective use of medicines in children. © 2018 The Author(s). AD - Department of Pediatrics and Child Health, University of Manitoba, 405 Chown, 753 McDermot Ave., Winnipeg, MB R3E0T6, Canada Clinical Trials Platform, George and Fay Yee Centre for Healthcare Innovation, Winnipeg, MB, Canada Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada Department of Pediatrics, University of Alberta, Edmonton, AB, Canada Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, ON, Canada Data Science Platform, George and Fay Yee Centre for Healthcare Innovation, Winnipeg, MB, Canada Center for Ethics and Policy, Carnegie Mellon University, Pittsburgh, PA, United States Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, MB, Canada Department of Allergy and Immunology, British Columbia Children's Hospital, Vancouver, BC, Canada Vaccine and Drug Evaluation Centre, University of Manitoba, Winnipeg, MB, Canada Department of Statistics, University of Manitoba, Winnipeg, MB, Canada AU - Kelly, L. E. AU - Dyson, M. P. AU - Butcher, N. J. AU - Balshaw, R. AU - London, A. J. AU - Neilson, C. J. AU - Junker, A. AU - Mahmud, S. M. AU - Driedger, S. M. AU - Wang, X. C2 - 30340624 C7 - 572 DB - Scopus DO - 10.1186/s13063-018-2934-7 IS - 1 KW - Adaptive design Child health Clinical trials Extrapolation Research ethics child clinical protocol clinical trial (topic) ethics human information processing legislation and jurisprudence methodology translational research Clinical Protocols Clinical Trials as Topic Focus Groups Humans Research Design Translational Medical Research LA - English M3 - Article PY - 2018 ST - Considerations for adaptive design in pediatric clinical trials: Study protocol for a systematic review, mixed-methods study, and integrated knowledge translation plan T2 - Trials TI - Considerations for adaptive design in pediatric clinical trials: Study protocol for a systematic review, mixed-methods study, and integrated knowledge translation plan VL - 19 ID - 380 ER - TY - JOUR AB - Background: Many parents consider fever a disease in itself and feel disempowered when their child is ill. Numerous guidelines have been produced; however, their target audience remains healthcare professionals and not carers of children in general. A reliable source of information will decrease worry in parents and carers when managing a febrile child. Methods/Design: A systematic search will be conducted in nine electronic databases. Articles published in English, or with an abstract published in English, will be eligible for inclusion in the review. Unpublished literature, grey literature and consultation with experts in the area will be used to supplement database searching. Titles and abstracts of studies will be screened for inclusion in the study by two independent reviewers against pre-determined inclusion and exclusion criteria. A data extraction form will be designed and data will be extracted to provide detail of the included studies by a further two reviewers. Quality assessment of studies will be conducted by two additional independent reviewers and results will be used to moderate included studies. All disagreements will be resolved through discussion until consensus is reached. Thematic synthesis will be used to analyse results. Discussion: Correct management of fever in children is not well understood in the general population. Although carers can identify fever and febrile illness in children, determination of the severity of fever proves challenging. Research is needed to cohere existing evidence and identify knowledge gaps. It is envisaged that results of this review will contribute to the development of trustworthy, accessible guidelines for parents and carers of children with fever or febrile illness. Systematic review registration: PROSPERO CRD42014009812 © 2015 Kelly et al.; licensee BioMed Central. AU - Kelly, M. AU - Sahm, L. J. AU - Shiely, F. AU - O'Sullivan, R. AU - Brenner, M. AU - Larkin, P. AU - McCarthy, S. DA - 2015-1-1 IS - 1 KW - Child Only Child Q Fever Research Design Parents Infant Humans Health Personnel Health Knowledge, Attitudes, Practice Fever Clinical Protocols Clinical Competence Child, Preschool Caregivers Attitude of Health Personnel preschool child parent methodology health personnel attitude clinical protocol caregiver systematic review sensitivity analysis priority journal outcome assessment human health care personnel emergency ward controlled clinical trial (topic) attitude to illness attitude to health Article Knowledge Febrile illness Children Carers PY - 2015 SN - 2046-4053 ST - The knowledge, attitudes and beliefs of carers (parents, guardians, healthcare practitioners, crèche workers) around fever and febrile illness in children aged 5 years and under: Protocol for a qualitative systematic review T2 - Systematic Reviews TI - The knowledge, attitudes and beliefs of carers (parents, guardians, healthcare practitioners, crèche workers) around fever and febrile illness in children aged 5 years and under: Protocol for a qualitative systematic review VL - 4 ID - 213 ER - TY - JOUR AB - Vitamin D has reported anti-cancer and anti-inflammatory properties modulated through gene transcription and non-genomic signaling cascades. The purpose of this review was to summarize the available research on interactions and pharmacokinetics between vitamin D and the pharmaceutical drugs used in patients with cancer. Hypercalcemia was the most frequently reported side effect that occurred in high dose calcitriol. The half-life of 25(OH)D3 and/or 1,25(OH)2D3 was found to be impacted by cimetidine; rosuvastatin; prednisone and possibly some chemotherapy drugs. No unusual adverse effects in cancer patients; beyond what is expected from high dose 1,25(OH)2D3 supplementation, were revealed through this review. While sufficient evidence is lacking, supplementation with 1,25(OH)2D3 during chemotherapy appears to have a low risk of interaction. Further interactions with vitamin D3 have not been studied. © 2013 by the authors; licensee MDPI, Basel, Switzerland. AU - Kennedy, D. A. AU - Cooley, K. AU - Skidmore, B. AU - Fritz, H. AU - Campbell, T. AU - Seely, D. DA - 2013-1-1 IS - 1 KW - Tocopherols Vitamins Arachidonic Acid Biotin Riboflavin Ascorbic Acid Vitamin E Vitamin B Complex Folic Acid Vitamin A Vitamin U systematic review stomach ulcer solid tumor single drug dose side effect review prostate cancer peptic ulcer pancreas cancer myelodysplastic syndrome multiple myeloma multiple cycle treatment metastasis mental disease maximum tolerated dose malignant neoplastic disease hypophosphatemia hypocalcemia hyperlipidemia hyperglycemia hypercalcemia human gastrointestinal symptom feces impaction duodenum ulcer drug tolerability drug safety drug potentiation drug metabolism drug megadose drug half life drug efficacy drug effect drug dose increase drug dose escalation drug blood level drug bioavailability dose response digestive system ulcer continuous infusion constipation congestive heart failure colorectal cancer clinical effectiveness castration resistant prostate cancer cancer patient cancer combination chemotherapy bone marrow suppression asthenia area under the curve urolithiasis unspecified side effect treatment duration time to maximum plasma concentration thromboembolism androgen independent prostate cancer advanced cancer acute leukemia acute granulocytic leukemia zoledronic acid vitamin D unindexed drug thiazide diuretic agent rosuvastatin prednisone placebo paclitaxel mitoxantrone melphalan isotretinoin hydroxyurea gluconate calcium gefitinib fluoxymesterone fluoride sodium estramustine ergocalciferol docetaxel dexamethasone cytarabine cyclophosphamide cimetidine carmustine carboplatin calcitriol calcifediol antineoplastic agent alpha interferon alfacalcidol Pharmacokinetics Drug interactions PY - 2013 SN - 2072-6694 SP - 255-280 ST - Vitamin D: Pharmacokinetics and safety when used in conjunction with the pharmaceutical drugs used in cancer patients: A systematic review T2 - Cancers TI - Vitamin D: Pharmacokinetics and safety when used in conjunction with the pharmaceutical drugs used in cancer patients: A systematic review VL - 5 ID - 254 ER - TY - JOUR AB - IMPORTANCE Attrition of residents from general surgery training programs is relatively high; however, there are wide discrepancies in the prevalence and causes of attrition reported among surgical residents in previous studies. OBJECTIVE To summarize the estimate of attrition prevalence among general surgery residents. DATA SOURCES We searched the Medline, EMBASE, Cochrane, PsycINFO, and ERIC databases (January 1, 1946, to October 22, 2015) for studies reporting on the prevalence and causes of attrition in surgical residents, as well as the characteristics and destinations of residents who left general surgery training programs. Database searches were conducted on October 22, 2015. STUDY SELECTION Eligibility criteria included all studies reporting on the primary (attrition prevalence) or secondary (causes of attrition and characteristics and destination of residents who leave residency programs) outcomes in peer-reviewed journals. Commentaries, reviews, and studies reporting on preliminary surgery programs were excluded. Of the 41 full-text articles collected from the title/abstract screening, 22 studies (53.7%) met the selection criteria. DATA EXTRACTION AND SYNTHESIS Two reviewers independently collected and summarized the data.We calculated pooled estimates using random effects meta-analyses where appropriate. MAIN OUTCOME AND MEASURE Attrition prevalence of general surgery residents. RESULTS Overall, we included 22 studies that reported on residents (n = 19 821) from general surgery programs. The pooled estimate for the overall attrition prevalence among general surgery residents was 18%(95%CI, 14%-21%), with significant between-study variation (I2 = 96.8%; P < .001). Attrition was significantly higher among female compared with male (25%vs 15%, respectively; P = .008) general surgery residents, and most residents left after their first postgraduate year (48%; 95%CI, 39%-57%). Departing residents often relocated to another general surgery program (20%; 95%CI, 15%-24%) or switched to anesthesia (13%; 95%CI, 11%-16%) and other specialties. The most common reported causes of attrition were uncontrollable lifestyle (range, 12%-87.5%) and transferring to another specialty (range, 19%-38.9%). CONCLUSIONS AND RELEVANCE General surgery programs have relatively high attrition, with female residents more likely to leave their training programs than male residents. Residents most often relocate or switch to another specialty after the first postgraduate year owing to lifestyle-related issues. © 2017 American Medical Association. AU - Khoushhal, Z. AU - Hussain, M. A. AU - Greco, E. AU - Mamdani, M. AU - Verma, S. AU - Rotstein, O. AU - Tricco, A. C. AU - Al-Omran, M. DA - 2017-1-1 IS - 3 KW - Prevalence Work-Life Balance Sex Factors Personnel Turnover Life Style Internship and Residency Humans General Surgery Career Choice statistics and numerical data personnel management meta analysis medical education education decision making workload work systematic review surgical training specialization sex difference resident PsycINFO priority journal postgraduate education occupational health Medline lifestyle human eric database Embase education program Conference Paper Cochrane Library bibliographic database attrition anesthesiology PY - 2017 SP - 265-272 ST - Prevalence and causes of attrition among surgical residents a systematic review and meta-analysis T2 - JAMA Surgery TI - Prevalence and causes of attrition among surgical residents a systematic review and meta-analysis VL - 152 ID - 155 ER - TY - JOUR AB - Purpose Prognostic and treatment uncertainty make ductal carcinoma in situ (DCIS) complex to manage. The purpose of this study was to describe research that evaluated DCIS communication experiences, needs and interventions among DCIS patients or physicians. Methods MEDLINE, EMBASE, CINAHL and The Cochrane Library were searched from inception to February 2017. English language studies that evaluated patient or physician DCIS needs, experiences or behavioural interventions were eligible. Screening and data extraction were done in duplicate. Summary statistics were used to describe study characteristics and findings. Results A total of 51 studies published from 1997 to 2016 were eligible for review, with a peak of 8 articles in year 2010. Women with DCIS lacked knowledge about the condition and its prognosis, although care partners were more informed, desired more information and experienced decisional conflict. Many chose mastectomy or prophylactic mastectomy, often based on physician’s recommendation. Following treatment, women had anxiety and depression, often at levels similar to those with invasive breast cancer. Disparities were identified by education level, socioeconomic status, ethnicity and literacy. Physicians said that they had difficulty explaining DCIS and many referred to DCIS as cancer. Despite the challenges reported by patients and physicians, only two studies developed interventions designed to improve patient–physician discussion and decision-making. Conclusions As most women with DCIS undergo extensive treatment, and many experience treatment-related complications, the paucity of research on PE to improve and support informed decision-making for DCIS is profound. Research is needed to improve patient and provider discussions and decision-making for DCIS management. © The Author(s) 2017. This article is an open access publication. AU - Kim, C. AU - Liang, L. AU - Wright, F. C. AU - Look Hong, N. J. AU - Groot, G. AU - Helyer, L. AU - Meiers, P. AU - Quan, M. L. AU - Urquhart, R. AU - Warburton, R. AU - Gagliardi, A. R. DA - 2018-1-1 IS - 3 KW - Breast Neoplasms Carcinoma, Intraductal, Noninfiltrating Decision Making Supportive care Ductal carcinoma in situ Decision-making Communication PY - 2018 SP - 579-592 ST - Interventions are needed to support patient–provider decision-making for DCIS: A scoping review T2 - Breast Cancer Research and Treatment TI - Interventions are needed to support patient–provider decision-making for DCIS: A scoping review VL - 168 ID - 44 ER - TY - JOUR AB - Objective Active surveillance (AS) represents a fundamental shift in managing select cancer patients that initiates treatment only upon disease progression to avoid overtreatment. Given uncertain outcomes, patient engagement could support decision-making about AS. Little is known about how to optimize patient engagement for AS decision-making. This scoping review aimed to characterize research on patient and provider communication about AS, and associated determinants and outcomes. Methods MEDLINE, EMBASE, CINAHL, and The Cochrane Library were searched from 2006 to October 2016. English language studies that evaluated cancer patient or provider AS views, experiences or behavioural interventions were eligible. Screening and data extraction were done in duplicate. Summary statistics were used to describe study characteristics and findings. Results A total of 2,078 studies were identified, 1,587 were unique, and 1,243 were excluded based on titles/abstracts. Among 344 full-text articles, 73 studies were eligible: 2 ductal carcinoma in situ (DCIS), 4 chronic lymphocytic leukemia (CLL), 6 renal cell carcinoma (RCC) and 61 prostate cancer. The most influential determinant of initiating AS was physician recommendation. Others included higher socioeconomic status, smaller tumor size, comorbid disease, older age, and preference to avoid adverse treatment effects. AS patients desired more information about AS and reassurance about future treatment options, involvement in decision-making and assessment of illness uncertainty and supportive care needs during follow-up. Only three studies of prostate cancer evaluated interventions to improve AS communication or experience. Conclusions This study revealed a paucity of research on AS communication for DCIS, RCC and CLL, but generated insight on how to optimize AS discussions in the context of routine care or clinical trials from research on AS for prostate cancer. Further research is needed on AS for patients with DCIS, RCC and CLL, and to evaluate interventions aimed at patients and/or providers to improve AS communication, experience and associated outcomes. © 2018 Kim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. AU - Kim, C. AU - Wright, F. C. AU - Look Hong, N. J. AU - Groot, G. AU - Helyer, L. AU - Meiers, P. AU - Quan, M. L. AU - Urquhart, R. AU - Warburton, R. AU - Gagliardi, A. R. DA - 2018-1-1 IS - 2 KW - Decision Making Prostatitis Prostatism Prostate Prostatic Neoplasms Neoplasms Humans Disease Progression pathophysiology neoplasm disease exacerbation tumor volume systematic review social status renal cell carcinoma quality of life prostate cancer personal experience patient satisfaction patient preference patient education patient attitude medical information medical decision making intraductal carcinoma human health personnel attitude follow up disease surveillance comorbidity chronic lymphatic leukemia cancer patient Article age PY - 2018 ST - Patient and provider experiences with active surveillance: A scoping review T2 - PLoS ONE TI - Patient and provider experiences with active surveillance: A scoping review VL - 13 ID - 60 ER - TY - JOUR AB - Background: Mobile health (mHealth) interventions for smoking cessation have been shown to be associated with an increase in effectiveness. However, interventions using mobile phones to change people's behaviour are often perceived as complex interventions, and the interactions between several components within them may affect the outcome. Therefore, it is important to understand how we can improve the design of mHealth interventions using mobile phones as a medium to deliver services. Methods: Randomised controlled trials (RCTs) of mHealth interventions to support smoking cessation or uptake of smoking cessation services for smokers will be included in this systematic review. A search will be performed by searching MEDLINE, MEDLINE(R) In-Process & Other Non-Indexed Citations, EMBASE, PsycINFO, Web of Science, and CINAHL. A search for new publications will be conducted 3 months prior to submission for publication as mHealth is an emerging area of research. A random-effects meta-analysis model will be used to summarise the effectiveness of mHealth interventions. The risk ratio will be used for the primary outcome, self-reported or verified smoking abstinence, and any binary outcomes for uptake of smoking cessation services. The standardised mean difference using Hedges' g will be reported for continuous data. Heterogeneity will be assessed using I 2 statistics. Where feasible, meta-regression analysis using random-effects multilevel modelling will be conducted to examine the association of pre-specified characteristics (covariates) at the study level with the effectiveness of interventions. Publication bias will be explored using Egger's test for continuous outcomes and Harbord and Peters tests for dichotomous outcomes. The funnel plot will be used to evaluate the presence of publication bias. The Cochrane Risk of Bias Tool will be used to assess differences in risks of bias. Discussion: The results of this systematic review will provide future research with a foundation for designing and evaluating complex interventions that use mobile phones as a platform to deliver behaviour change techniques. Systematic review registration: PROSPERO CRD42016026918. © 2017 The Author(s). AU - Kingkaew, P. AU - Glidewell, L. AU - Walwyn, R. AU - Fraser, H. AU - Wyatt, J. C. DA - 2017-1-1 IS - 1 KW - Publication Bias Smoke Smoking Smoking Cessation Tobacco cessation Theory-based interventions Systematic review Protocol Mobile phones Mobile health Meta-analysis Complex interventions Behaviour change techniques PY - 2017 SN - 2046-4053 ST - Identifying effective components for mobile health behaviour change interventions for smoking cessation and service uptake: Protocol of a systematic review and planned meta-analysis T2 - Systematic Reviews TI - Identifying effective components for mobile health behaviour change interventions for smoking cessation and service uptake: Protocol of a systematic review and planned meta-analysis VL - 6 ID - 25 ER - TY - JOUR AB - Background: Goals for improving the quality of care for all Veterans and eliminating health disparities are outlined in the Veterans Health Administration Blueprint for Excellence, but the degree to which disparities in utilization, health outcomes, and quality of care affect Veterans is not well understood. Objectives: To characterize the research on health care disparities in the Veterans Health Administration by means of a map of the evidence. Research Design: We conducted a systematic search for research studies published from 2006 to February 2016 in MEDLINE and other data sources. We included studies of Veteran populations that examined disparities in 3 outcome categories: utilization, quality of health care, and patient health. Measures: We abstracted data on study design, setting, population, clinical area, outcomes, mediators, and presence of disparity for each outcome category. We grouped the data by population characteristics including race, disability status, mental illness, demographics (age, era of service, rural location, and distance from care), sex identity, socioeconomic status, and homelessness, and created maps illustrating the evidence. Results: We reviewed 4249 citations and abstracted data from 351 studies which met inclusion criteria. Studies examining disparities by race/ethnicity comprised by far the vast majority of the literature, followed by studies examining disparities by sex, and mental health condition. Very few studies examined disparities related to lesbian, gay, bisexual, or transgender identity or homelessness. Disparities findings vary widely by population and outcome. Conclusions: Our evidence maps provide a "lay of the land" and identify important gaps in knowledge about health disparities experienced by different Veteran populations. © 2017 Wolters Kluwer Health, Inc. All rights reserved. AU - Kondo, K. AU - Low, A. AU - Everson, T. AU - Gordon, C. D. AU - Veazie, S. AU - Lozier, C. C. AU - Freeman, M. AU - Motu'Apuaka, M. AU - Mendelson, A. AU - Friesen, M. AU - Paynter, R. AU - Friesen, C. AU - Anderson, J. AU - Boundy, E. AU - Saha, S. AU - Quiñones, A. AU - Kansagara, D. DA - 2017-1-1 IS - 9 KW - Bisexuality Veterans United States Department of Veterans Affairs United States Sex Factors Quality of Health Care Mental Disorders Humans Hospitals, Veterans Healthcare Disparities Ethnic Groups Continental Population Groups veteran sex difference public hospital psychology organization and management health care quality health care disparity government ethnology ethnic group ancestry group veterans health systematic review study design social status rural area Review research race publication priority journal population outcome assessment mental disease Medline LGBT people human homelessness health care utilization groups by age and sex ethnicity disability women rural LGBT homeless health disparities PY - 2017 SP - S9-S15 ST - Health Disparities in Veterans T2 - Medical Care TI - Health Disparities in Veterans VL - 55 ID - 161 ER - TY - JOUR AB - Norovirus (NoV) is considered the second leading cause of viral acute gastroenteritis (AGE). To our knowledge, there are no systematic reviews assessing the role of NoV in AGE in the Middle East and North Africa (MENA) region. Consequently, we conducted an extensive systematic literature review on articles studying NoV in the 24 countries of the MENA region during the past 15 years (2000-2015). The methods and reporting were set according to the 2015 PRISMA-P and based on the elements from the international prospective register of systematic reviews (PROSPERO). We retrieved 38 studies meeting our predefined inclusion criteria and were used to extract full data. Studies reporting on NoV were conducted in 15 out of the 24 countries of the region. The reported NoV infection rates in MENA countries ranged between 0.82% and 36.84%. The majority of studies were clinical observational studies assessing NoV rates mainly among children. Participants were recruited from in- and outpatient clinics. NoV infection was reported all year round with with peaks observed mainly during cold months. GII.4 was the predominant genotype detected in stool of participants as reported by 16 out of 25 studies (64%). Overall, there is an increasing recognition of NoV as an important causative agent of AGE across all age groups in the MENA region. Further studies are needed to assess the national and the regional burden of NoV among different age groups, its molecular diversity and seasonal variability. © 2017 The Author(s). AU - Kreidieh, K. AU - Charide, R. AU - Dbaibo, G. AU - Melhem, N. M. DA - 2017-1-1 IS - 1 KW - Africa, Northern Middle Aged virus identification systematic review seasonal variation Review reverse transcription polymerase chain reaction outpatient North Africa norovirus infection Norovirus nonhuman molecular epidemiology Middle East human hospital patient genotype data extraction acute gastroenteritis Seasonality Middle East and North Africa Diagnosis PY - 2017 ST - The epidemiology of Norovirus in the Middle East and North Africa (MENA) region: A systematic review T2 - Virology Journal TI - The epidemiology of Norovirus in the Middle East and North Africa (MENA) region: A systematic review VL - 14 ID - 70 ER - TY - JOUR AB - Objectives: Use systematic review and meta-analytic methodology to estimate the pooled incidence, prevalence, and proportion of delirium cases for each delirium subtype (hypoactive, hyperactive, and mixed) in an adult ICU population. Data Sources: We conducted a search of the MEDLINE, EMBASE, CINAHL, SCOPUS, Web of Science, and PsycINFO databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards from database inception until October 22, 2017, with no restrictions. Study Selection: We included original research conducted in adults admitted to any medical, surgical, or speciality ICU that reported incidence or prevalence estimates of delirium according to delirium subtype. Data Extraction: Data were extracted on sample size, population demographics, condition information, and reported delirium estimates. Data Synthesis: Forty-eight studies (27,342 patients; 4,550 with delirium) with an overall pooled prevalence of 31% (95% CI, 24-41; I2 = 99%) met inclusion criteria. The pooled incidence (n = 18 studies) of delirium subtypes were hyperactive (4% [95% CI, 2-6]; I2 = 92%]), hypoactive (11% [95% CI, 8-17; I2 = 97%]), and mixed (7% [95% CI, 4-11; I2 = 97%]). The pooled prevalence (n = 31 studies) of delirium subtypes were hyperactive (4% [95% CI, 3-6; I2 = 94%]), hypoactive (17% [95% CI, 13-22; I2 = 97%]), and mixed (10% [95% CI, 6-16; I2 = 99%]). The pooled prevalence of hypoactive delirium in study populations with a similarly high severity of illness or mechanically ventilated was higher (severity of illness: 29% [95% CI, 18-46%; I2 = 95%], 100% mechanically ventilated: 35% [95% CI, 23-55%; I2 = 93%]) compared with the pooled prevalence of hypoactive delirium. Conclusions: Despite significant heterogeneity between studies, these data show the majority of delirious ICU patients to have hypoactive delirium, a finding with potential monitoring, management, and prognostic implications. The prevalence of hypoactive delirium varies between-study populations and is higher in patients with greater severity of illness. Copyright © 2018 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved. AD - Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada Critical Care Strategic Clinical Network (CC SCN), Alberta Health Services, Calgary, AB, Canada Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada Tennessee Valley Veteran's Affairs Geriatric Research Education and Clinical Center (GRECC), Center for Health Services Research, Nashville, TN, United States Division of Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada AU - Krewulak, K. D. AU - Stelfox, H. T. AU - Leigh, J. P. AU - Wesley Ely, E. AU - Fiest, K. M. C2 - 30234569 DB - Scopus DO - 10.1097/CCM.0000000000003402 IS - 12 KW - Delirium Incidence Intensive care unit Prevalence Subtype Systematic review data base human priority journal publication bias quality control Review sample size adult aged artificial ventilation classification female male meta analysis middle aged severity of illness index very elderly Aged, 80 and over Humans Intensive Care Units Respiration, Artificial LA - English M3 - Review PY - 2018 SP - 2029-2035 ST - Incidence and prevalence of delirium subtypes in an adult ICU: A systematic review and meta-analysis T2 - Critical Care Medicine TI - Incidence and prevalence of delirium subtypes in an adult ICU: A systematic review and meta-analysis VL - 46 ID - 381 ER - TY - JOUR AB - Objectives: Physiotherapists promote physical activity as part of their practice. This study reviewed the behaviour change techniques physiotherapists use when promoting physical activity in experimental and observational studies. Design: Systematic review of experimental and observational studies. Methods: Twelve databases were searched using terms related to physiotherapy and physical activity. We included experimental studies evaluating the efficacy of physiotherapist-led physical activity interventions delivered to adults in clinic-based private practice and outpatient settings to individuals with, or at risk of, non-communicable diseases. Observational studies reporting the techniques physiotherapists use when promoting physical activity were also included. The behaviour change techniques used in all studies were identified using the Behaviour Change Technique Taxonomy. The behaviour change techniques appearing in efficacious and inefficacious experimental interventions were compared using a narrative approach. Results: Twelve studies (nine experimental and three observational) were retained from the initial search yield of 4141. Risk of bias ranged from low to high. Physiotherapists used seven behaviour change techniques in the observational studies, compared to 30 behaviour change techniques in the experimental studies. Social support (unspecified) was the most frequently identified behaviour change technique across both settings. Efficacious experimental interventions used more behaviour change techniques (n = 29) and functioned in more ways (n = 6) than did inefficacious experimental interventions (behaviour change techniques = 10 and functions = 1). Conclusions: Physiotherapists use a small number of behaviour change techniques. Less behaviour change techniques were identified in observational studies compared to experimental studies, suggesting physiotherapists use less BCTs clinically than experimentally. © 2017 Sports Medicine Australia AU - Kunstler, B. E. AU - Cook, J. L. AU - Freene, N. AU - Finch, C. F. AU - Kemp, J. L. AU - O'Halloran, P. D. AU - Gaida, J. E. DA - 2018-1-1 IS - 6 KW - Physical Therapy Modalities Motor Activity systematic review social support Review questionnaire private practice physiotherapy physiotherapist physical activity outpatient observational study human health promotion energy expenditure endurance training behavior change accelerometry Physical therapists Health behavior Exercise PY - 2018 SP - 609-615 ST - Physiotherapists use a small number of behaviour change techniques when promoting physical activity: A systematic review comparing experimental and observational studies T2 - Journal of Science and Medicine in Sport TI - Physiotherapists use a small number of behaviour change techniques when promoting physical activity: A systematic review comparing experimental and observational studies VL - 21 ID - 122 ER - TY - JOUR AB - Objective To conduct a systematic review to evaluate the efficacy of exercise interventions in improving outcomes across domains of functioning and disability in children and adolescents with juvenile idiopathic arthritis (JIA). Data Sources Seven electronic databases were systematically searched up to November 16, 2016. Study Selection Original data, analytic prospective design, physical therapy–led exercise intervention evaluation, children and adolescents with JIA, and assessment of functional, structural, activity, participation, or quality of life outcomes. Data Extraction Two authors screened search results, and discrepancies were resolved by consensus. Of 5037 potentially relevant studies, 9 randomized controlled trials and 1 cohort study were included and scored. Data Synthesis Study quality (Downs and Black quality assessment tool) and level of evidence (Oxford Centre of Evidence-Based Medicine model) were assessed and meta-analysis conducted where appropriate. Alternatively, a descriptive summary approach was chosen. All randomized controlled trials were moderate-quality intervention studies (level 2b evidence; median Downs and Black score, 20 out of 32; range, 15–27). Interventions included aquatic, strengthening, proprioceptive, aerobic, and Pilates exercises. Pediatric activity capacity (Child Health Assessment Questionnaire) improved with exercise (mean difference,.45; 95% confidence interval,.05–.76). Furthermore, descriptive summaries indicated improved activity capacity, body function and structure (pain and muscle strength), and quality of life outcomes. Conclusions Exercise therapy appears to be well tolerated and beneficial across clinically relevant outcomes in patients with JIA. The paucity of high-quality evidence and study heterogeneity limited the ability to provide conclusive, generalizing evidence for the efficacy of exercise therapy and to provide specific recommendations for clinical practice at this time. Future research evaluating exercise program implementation using validated outcomes and detailed adherence and safety assessment is needed to optimize clinical decision pathways in patients with JIA. © 2016 American Congress of Rehabilitation Medicine AU - Kuntze, G. AU - Nesbitt, C. AU - Whittaker, J. L. AU - Nettel-Aguirre, A. AU - Toomey, C. AU - Esau, S. AU - Doyle-Baker, P. K. AU - Shank, J. AU - Brooks, J. AU - Benseler, S. AU - Emery, C. A. DA - 2018-1-1 IS - 1 KW - Adolescent African Continental Ancestry Group Child Only Child Evidence-Based Medicine Treatment Outcome Patient Compliance Humans Exercise Therapy Arthritis, Juvenile procedures juvenile rheumatoid arthritis systematic review Review randomized controlled trial (topic) quality of life quality control prospective study pilates physiotherapy outcome assessment muscle strength meta analysis kinesiotherapy intervention study human evidence based medicine consensus clinical evaluation clinical effectiveness clinical assessment Child Health Assessment Questionnaire assessment of humans adverse outcome Rheumatology Rehabilitation Pediatrics PY - 2018 SP - 178-193.e1 ST - Exercise Therapy in Juvenile Idiopathic Arthritis: A Systematic Review and Meta-Analysis T2 - Archives of Physical Medicine and Rehabilitation TI - Exercise Therapy in Juvenile Idiopathic Arthritis: A Systematic Review and Meta-Analysis VL - 99 ID - 61 ER - TY - JOUR AB - Introduction Randomised controlled trials (RCTs) conducted using cohorts and routinely collected health data, including registries, electronic health records and administrative databases, are increasingly used in healthcare intervention research. The development of an extension of the CONsolidated Standards of Reporting Trials (CONSORT) statement for RCTs using cohorts and routinely collected health data is being undertaken with the goal of improving reporting quality by setting standards early in the process of uptake of these designs. To develop this extension to the CONSORT statement, a scoping review will be conducted to identify potential modifications or clarifications of existing reporting guideline items, as well as additional items needed for reporting RCTs using cohorts and routinely collected health data. Methods and analysis In separate searches, we will seek publications on methods or reporting or that describe protocols or results from RCTs using cohorts, registries, electronic health records and administrative databases. Data sources will include Medline and the Cochrane Methodology Register. For each of the four main types of RCTs using cohorts and routinely collected health data, separately, two investigators will independently review included publications to extract potential checklist items. A potential item will either modify an existing CONSORT 2010, Strengthening the Reporting of Observational Studies in Epidemiology or REporting of studies Conducted using Observational Routinely collected health Data item or will be proposed as a new item. Additionally, we will identify examples of good reporting in RCTs using cohorts and routinely collected health data. Ethics and dissemination The proposed scoping review will help guide the development of the CONSORT extension statement for RCTs conducted using cohorts and routinely collected health data. © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. AD - Behavioural Science Institute, Clinical Psychology, Radboud University, Nijmegen, Gelderland, Netherlands Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland Library Services, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada Department of Cardiology, Faculty of Health, Örebro University, Örebro, United Kingdom Section of Neonatal Medicine, Department of Medicine, Imperial College London, London, United Kingdom Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada Centre for Clinical Trials and Methodology, Barts Institute of Population Health Science, Queen Mary University, London, United Kingdom Department of Family Medicine, Western University, London, Canada Institute for Clinical Evaluative Sciences, Toronto, ON, Canada Department of Pediatrics and School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada Institute for Clinical Evaluative Sciences, Ottawa, ON, Canada Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada Sorbonne Paris Cité Epidemiology and Statistics Research Center, INSERM, UMR1153, Paris, France Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden Department of Psychology, McGill University, Montréal, QC, Canada Scleroderma Society of Ontario, Hamilton, ON, Canada Scleroderma Canada, Hamilton, ON, Canada Health E-Research Centre, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom Division of Pharmacoepidemiology and Clinical Pharmacology, Faculty of Science, Utrecht University, Utrecht, Netherlands Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada Department of Psychiatry, Dalhousie University, Halifax, NS, Canada Department of Epidemiology, University Medical Center Utrecht, Utrecht, Netherlands Department of Epidemiology, University of Utrecht, Utrecht, Netherlands NPEU Clinical Trials Unit, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom Department of Psychiatry, McGill University, Montreal, QC, Canada Departments of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada Department of Medicine, McGill University, Montreal, QC, Canada Departments of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada AU - Kwakkenbos, L. AU - Imran, M. AU - McCord, K. A. AU - Sampson, M. AU - Fröbert, O. AU - Gale, C. AU - Hemkens, L. G. AU - Langan, S. M. AU - Moher, D. AU - Relton, C. AU - Zwarenstein, M. AU - Benchimol, E. I. AU - Boutron, I. AU - Campbell, M. K. AU - Erlinge, D. AU - Jawad, S. AU - Ravaud, P. AU - Rice, D. B. AU - Sauve, M. AU - Van Staa, T. P. AU - Thabane, L. AU - Uher, R. AU - Verkooijen, H. M. AU - Juszczak, E. AU - Thombs, B. D. C2 - 30082372 C7 - e025266 DB - Scopus DO - 10.1136/bmjopen-2018-025266 IS - 8 KW - cohort consort randomized controlled trials rcts reporting guideline routinely collected health data article checklist controlled study electronic health record ethics human Medline observational study practice guideline publication randomized controlled trial (topic) administrative claims (health care) cohort analysis literature methodology register Administrative Claims, Healthcare Cohort Studies Electronic Health Records Guidelines as Topic Humans Randomized Controlled Trials as Topic Registries Research Design Review Literature as Topic LA - English M3 - Article PY - 2018 ST - Protocol for a scoping review to support development of a CONSORT extension for randomised controlled trials using cohorts and routinely collected health data T2 - BMJ Open TI - Protocol for a scoping review to support development of a CONSORT extension for randomised controlled trials using cohorts and routinely collected health data VL - 8 ID - 382 ER - TY - JOUR AB - Background: Cytomegalovirus (CMV) reactivation in critically ill patients is a well-recognized phenomenon with an incidence as high as 71%. A number of studies have investigated the association between CMV reactivation and outcomes in critically ill patients with conflicting results. We propose to conduct a systematic review and meta-analysis to determine the impact of CMV reactivation on patient-centered outcomes and measures of health resource utilization in immunocompetent critically ill patients. Methods: In consultation with a research librarian, a search strategy will be developed and electronic databases (i.e., Ovid MEDLINE, Ovid EMBASE, and the Cochrane Library including the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials (CENTRAL)) will be searched for original studies. Selected grey literature sources will be hand-searched. Search themes will include cytomegalovirus, intensive care unit, and sepsis. Citation screening, selection, quality assessment, and data abstraction will be performed in duplicate. Pooled effect estimates of the impact of CMV reactivation on selected patient-centered outcomes and measures of health resource utilization will be described. Discussion: This systematic review aims to explore the impact of CMV reactivation on patient-centered outcomes and health resource utilization in immunocompetent critically ill patients. Our results will help to better define the burden of disease associated with CMV reactivation. Indeed, evidence to date suggests increased mortality in this patient population. However, the relationship between CMV reactivation and health resource utilization remains less clear. Based on our results, future study on the impact of CMV treatment or prophylaxis on outcomes (including those other than mortality) may be warranted. Systematic review registration: PROSPERO CRD42016035446 © 2016 The Author(s). AU - Lachance, P. AU - Chen, J. AU - Featherstone, R. AU - Sligl, W. DA - 2016-1-1 IS - 1 KW - Virus Activation Viral Load Intensive Care Units Incidence Immunocompetence Humans Cytomegalovirus Infections Cytomegalovirus Critical Illness Clinical Protocols virus load physiology pathogenicity mortality immunology cytomegalovirus infection clinical protocol virus reactivation treatment outcome systematic review sepsis randomized controlled trial (topic) priority journal patient care nonhuman methodology meta analysis intensive care unit information processing human health care utilization disease association critically ill patient conference paper Article Protocol Meta-analysis PY - 2016 SN - 2046-4053 ST - Impact of cytomegalovirus reactivation on clinical outcomes in immunocompetent critically ill patients: Protocol for a systematic review and meta-analysis T2 - Systematic Reviews TI - Impact of cytomegalovirus reactivation on clinical outcomes in immunocompetent critically ill patients: Protocol for a systematic review and meta-analysis VL - 5 ID - 175 ER - TY - JOUR AB - Background. Electronic alerts (e-alerts) for acute kidney injury (AKI) in hospitalized patients are increasingly being implemented; however, their impact on outcomes remains uncertain. Methods. We performed a systematic review. Electronic databases and grey literature were searched for original studies published between 1990 and 2016. Randomized, quasi-randomized, observational and before-and-after studies that included hospitalized patients, implemented e-alerts for AKI and described their impact on one of care processes, patient-centred outcomes or resource utilizationmeasures were included. Results. Our search yielded six studies (n=10 165 patients). Ealerts were generally automated, triggered through electronic health records and not linked to clinical decision support. In pooled analysis, e-alerts did not improve mortality [odds ratio (OR) 1.05; 95% confidence intervals (CI), 0.84-1.31; n=3 studies; n=3425 patients; I2=0%] or reduce renal replacement therapy (RRT) use (OR 1.20; 95% CI, 0.91-1.57; n=2 studies; n=3236 patients; I2=0%). Isolated studies reported improvements in selected care processes. Pooled analysis found no significant differences in prescribed fluid therapy. Conclusions. In the available studies, e-alerts for AKI do not improve survival or reduce RRT utilization. The impact of ealerts on processes of care was variable. Additional research is needed to understand those aspects of e-alerts that are most likely to improve care processes and outcomes. © The Author 2017. AU - Lachance, P. AU - Villeneuve, P. M. AU - Rewa, O. G. AU - Wilson, F. P. AU - Selby, N. M. AU - Featherstone, R. M. AU - Bagshaw, S. M. DA - 2017-1-1 IS - 2 KW - Kidney Telecommunications Renal Replacement Therapy Humans Health Plan Implementation Fluid Therapy Acute Kidney Injury utilization telecommunication statistics and numerical data health care planning systematic review survival randomized controlled trial (topic) prescription observational study mortality human hospital patient health care utilization electronic medical record electronic device e-alert decision support system clinical outcome automation Article acute kidney failure Meta-analysis Electronic alert Clinical decision support PY - 2017 SN - 0931-0509 SP - 265-272 ST - Association between e-alert implementation for detection of acute kidney injury and outcomes: A systematic review T2 - Nephrology Dialysis Transplantation TI - Association between e-alert implementation for detection of acute kidney injury and outcomes: A systematic review VL - 32 ID - 158 ER - TY - JOUR AB - Introduction: Acute kidney injury (AKI) is a common complication in hospitalised patients. It imposes significant risk for major morbidity and mortality. Moreover, patients suffering an episode of AKI consume considerable health resources. Recently, a number of studies have evaluated the implementation of automated electronic alerts (e-alerts) configured from electronic medical records (EMR) and clinical information systems (CIS) to warn healthcare providers of early or impending AKI in hospitalised patients. The impact of e-alerts on care processes, patient outcomes and health resource use, however, remains uncertain. Methods and analysis: We will perform a systematic review to describe and appraise e-alerts for AKI, and evaluate their impact on processes of care, clinical outcomes and health services use. In consultation with a research librarian, a search strategy will be developed and electronic databases (ie, MEDLINE, EMBASE, CINAHL, Cochrane Library and Inspec via Engineering Village) searched. Selected grey literature sources will also be searched. Search themes will focus on e-alerts and AKI. Citation screening, selection, quality assessment and data abstraction will be performed in duplicate. The primary analysis will be narrative; however, where feasible, pooled analysis will be performed. Each e-alert will be described according to trigger, type of alert, target recipient and degree of intrusiveness. Pooled effect estimates will be described, where applicable. Ethics and dissemination: Our systematic review will synthesise the literature on the value of e-alerts to detect AKI, and their impact on processes, patient-centred outcomes and resource use, and also identify key knowledge gaps and barriers to implementation. This is a fundamental step in a broader research programme aimed to understand the ideal structure of e-alerts, target population and methods for implementation, to derive benefit. Research ethics approval is not required for this review. Systematic review registration number: CRD42016033033. © 2016, BMJ Publishing Group. All rights reserved. AU - Lachance, P. AU - Villeneuve, P. M. AU - Wilson, F. P. AU - Selby, N. M. AU - Featherstone, R. AU - Rewa, O. AU - Bagshaw, S. M. DA - 2016-1-1 IS - 5 KW - Kidney Review Literature as Topic Research Design Outcome and Process Assessment (Health Care) Meta-Analysis as Topic Humans Electronic Health Records Early Diagnosis Acute Kidney Injury treatment outcome methodology meta analysis (topic) literature electronic health record acute kidney failure urinalysis systematic review Review quality control patient care outcome assessment medical information system length of stay intensive care unit human hospital readmission hospital patient hospital mortality health care utilization electronic medical record automated electronic alert PY - 2016 SN - 2044-6055 ST - Impact of e-alert for detection of acute kidney injury on processes of care and outcomes: Protocol for a systematic review and meta-analysis T2 - BMJ Open TI - Impact of e-alert for detection of acute kidney injury on processes of care and outcomes: Protocol for a systematic review and meta-analysis VL - 6 ID - 187 ER - TY - JOUR AB - Preclinical and clinical evidence suggests that mesenchymal stem cells (MSCs) may be beneficial in treating both acute myocardial infarction (AMI) and ischemic heart failure (IHF). However, the safety profile and efficacy of MSC therapy is not well-known. We conducted a systematic review of clinical trials that evaluated the safety or efficacy of MSCs for AMI or IHF. Embase, PubMed/Medline, and Cochrane Central Register of Controlled Trials were searched from inception to September 27, 2017. Studies that examined the use of MSCs administered to adults with AMI or IHF were eligible. The Cochrane risk of bias tool was used to assess bias of included studies. The primary outcome was safety assessed by adverse events and the secondary outcome was efficacy which was assessed by mortality and left ventricular ejection fraction (LVEF). A total of 668 citations were reviewed and 23 studies met eligibility criteria. Of these, 11 studies evaluated AMI and 12 studies evaluated IHF. There was no association between MSCs and acute adverse events. There was a significant improvement in overall LVEF in patients who received MSCs (SMD 0.73, 95% CI 0.24–1.21). No significant difference in mortality was noted (Peto OR 0.68, 95% CI 0.38–1.22). Results from our systematic review suggest that MSC therapy for ischemic heart disease appears to be safe. There is a need for a well-designed adequately powered randomized control trial (with rigorous adverse event reporting and evaluations of cardiac function) to further establish a clear risk-benefit profile of MSCs. Stem Cells Translational Medicine 2018;7:857–866. © 2018 The Authors. Stem Cells Translational Medicine published by Wiley Periodicals, Inc. on behalf of AlphaMed Press AD - Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, ON, Canada Blueprint Translational Research Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada Regenerative Medicine Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada Division of Critical Care, The Ottawa Hospital, Ottawa, ON, Canada Population Health Research Institute, David Braley Cardiac, Vascular, and Stroke Research Institute, Departments of Medicine and Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada Department of Anesthesia, Li Ka Shing Knowledge Institute of St. Michael's Hospital, University of Toronto, Department of Physiology, Toronto, ON, Canada Department of Medicine, McMaster University, Hamilton, ON, Canada AU - Lalu, M. M. AU - Mazzarello, S. AU - Zlepnig, J. AU - Dong, Y. Y. R. AU - Montroy, J. AU - McIntyre, L. AU - Devereaux, P. J. AU - Stewart, D. J. AU - David Mazer, C. AU - Barron, C. C. AU - McIsaac, D. I. AU - Fergusson, D. A. C2 - 30255989 DB - Scopus DO - 10.1002/sctm.18-0120 IS - 12 KW - Myocardial infarction Myocardial ischemia Stem cells Systematic review acetic acid plus gluconate sodium plus magnesium chloride plus potassium chloride plus sodium chloride endoglin methoxy isobutyl isonitrile technetium tc 99m acute heart infarction allergy cardiologist chronic kidney failure clinical evaluation comorbidity assessment comparative study coronary artery bypass graft echocardiography efficacy parameters evidence based medicine fever gastrointestinal disease heart function heart left ventricle ejection fraction heart left ventricle enddiastolic volume heart left ventricle endsystolic volume heart left ventricle wall motion heart muscle ischemia heart stroke volume hematologic disease human immune system injury intervention study meta analysis neurologic examination New York Heart Association class nuclear magnetic resonance imaging outcome assessment performance pericardial effusion quality of life assessment Review risk assessment scintiangiography stem cell transplantation adult stem cell adverse event biological therapy cytology heart failure heart infarction heart left ventricle function mortality odds ratio quality of life transplantation Adult Stem Cells Cell- and Tissue-Based Therapy Humans Ventricular Function, Left LA - English M3 - Review PY - 2018 SP - 857-866 ST - Safety and Efficacy of Adult Stem Cell Therapy for Acute Myocardial Infarction and Ischemic Heart Failure (SafeCell Heart): A Systematic Review and Meta-Analysis T2 - Stem Cells Translational Medicine TI - Safety and Efficacy of Adult Stem Cell Therapy for Acute Myocardial Infarction and Ischemic Heart Failure (SafeCell Heart): A Systematic Review and Meta-Analysis VL - 7 ID - 383 ER - TY - JOUR AB - Background: Acute respiratory distress syndrome (ARDS) in humans is caused by an unchecked proinflammatory response that results in diffuse and severe lung injury, and it is associated with a mortality rate of 35 to 45%. Mesenchymal stromal cells (MSCs; 'adult stem cells') could represent a promising new therapy for this syndrome, since preclinical evidence suggests that MSCs may ameliorate lung injury. Prior to a human clinical trial, our aim is to conduct a systematic review to compare the efficacy and safety of MSC therapy versus controls in preclinical models of acute lung injury that mimic some aspects of the human ARDS. Methods/Design: We will include comparative preclinical studies (randomized and non-randomized) of acute lung injury in which MSCs were administered and outcomes compared to animals given a vehicle control. The primary outcome will be death. Secondary outcomes will include the four key features of preclinical acute lung injury as defined by the American Thoracic Society consensus conference (histologic evidence of lung injury, altered alveolar capillary barrier, lung inflammatory response, and physiological dysfunction) and pathogen clearance for acute lung injury models that are caused by infection. Electronic searches of MEDLINE, Embase, BIOSIS Previews, and Web of Science will be constructed and reviewed by the Peer Review of Electronic Search Strategies (PRESS) process. Search results will be screened independently and in duplicate. Data from eligible studies will be extracted, pooled, and analyzed using random effects models. Risk of bias will be assessed using the Cochrane risk of bias tool, and individual study reporting will be assessed according to the Animal Research: Reporting of In Vivo Experiments (ARRIVE) guidelines. Discussion: The results of this systematic review will comprehensively summarize the safety and efficacy of MSC therapy in preclinical models of acute lung injury. Our results will help translational scientists and clinical trialists to determine whether sufficient evidence exists to perform a human clinical trial. These results may also guide future acute lung injury preclinical and clinical research. � 2014 Lalu et al. AU - Lalu, M. M. AU - Moher, D. AU - Marshall, J. AU - Fergusson, D. AU - Mei, S. H. J. AU - Macleod, M. AU - Griffin, G. AU - Turgeon, A. F. AU - Rudnicki, M. AU - Fishman, J. AU - Avey, M. T. AU - Skidmore, B. AU - Grimshaw, J. M. AU - Stewart, D. J. AU - Singh, K. AU - McIntyre, L. DA - 2014-1-1 IS - 1 KW - Stromal Cells Mesoderm Respiratory Distress Syndrome, Adult Humanism Humanities Lung Treatment Outcome Mesenchymal Stromal Cells Mesenchymal Stem Cell Transplantation Humans Disease Models, Animal Animals Acute Lung Injury review physiology mesenchymal stroma cell disease model animal systematic review shock randomized controlled trial (topic) priority journal pathogen clearance nonhuman mortality lung function lung alveolus oxygen tension lung alveolus cell inflammation hypoxemia human histology drug safety drug efficacy disease severity death bronchoalveolar lavage fluid Article adult respiratory distress syndrome tumor necrosis factor prostaglandin E2 myeloperoxidase interleukin 8 interleukin 6 interleukin 1beta interleukin 10 gamma interferon chemokine receptor CXCR2 Systematic review protocol Preclinical Mesenchymal stem cells Acute respiratory distress syndrome PY - 2014 SN - 2046-4053 ST - Efficacy and safety of mesenchymal stromal cells in preclinical models of acute lung injury: A systematic review protocol T2 - Systematic Reviews TI - Efficacy and safety of mesenchymal stromal cells in preclinical models of acute lung injury: A systematic review protocol VL - 3 ID - 39 ER - TY - JOUR AB - Background About 15% to 25% of people with diabetes will develop a foot ulcer. These wounds are often resistant to healing; therefore, people with diabetes experience lower limb amputation at about 20 times the rate of people without diabetes. If an ulcer does not heal with standard wound care, other therapeutic interventions are offered, one of which is hyperbaric oxygen therapy (HBOT). However, the effectiveness of this therapy is not clearly known. The objectives of this health technology assessment were to assess the safety, clinical effectiveness, and cost-effectiveness of standard wound care plus HBOT versus standard wound care alone for the treatment of diabetic foot ulcers. We also investigated the preferences and perspectives of people with diabetic foot ulcers through lived experience. Methods We performed a review of the clinical and economic literature for the effectiveness and cost-effectiveness of hyperbaric oxygen therapy, as well as the budget impact of HBOT from the perspective of the Ministry of Health and Long-Term Care. We assessed the quality of the body of clinical evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. To better understand the preferences, perspectives, and values of patients with diabetic foot ulcers and their experience with HBOT, we conducted interviews and administered an online survey. Results Seven randomized controlled trials and one nonrandomized controlled trial met the inclusion criteria. Comparing standard wound care plus HBOT with standard wound care alone, we found mixed results for major amputation rates (GRADE quality of evidence: low), a significant difference in favour of standard wound care plus HBOT on ulcers healed (GRADE quality of evidence: low), and no difference in terms of adverse events (GRADE quality of evidence: moderate). There is a large degree of uncertainty associated with the evaluation of the cost-effectiveness of standard wound care plus HBOT. However, results appear to suggest that this treatment results in lower costs and better outcomes than standard wound care alone. Funding HBOT will result in a budget impact of $4 million per year in immediate treatment costs for the Ontario Ministry of Health and Long-Term Care. This cost decreases to $0.5 million per year when downstream costs are considered. There is a substantial daily burden of care and emotional weight associated with living with diabetic foot ulcers, both of which are compounded by concern regarding possible amputation. Patients feel that HBOT is an effective treatment and reported that they were satisfied with how their ulcers healed and that this improved their quality of life. Conclusions The evidence makes it difficult to draw any definitive conclusions on the clinical and cost effectiveness of standard wound care plus HBOT versus standard wound care alone for the treatment of diabetic foot ulcers. © Queen’s Printer for Ontario, 2017. AU - Lambrinos, Anna AU - Chan, Brian AU - Wells, David AU - Holubowich, Corinne AU - Stahl, Kara AU - Harrison, Susan AU - Betsch, Elizabeth Jean AU - Ali, Arshia AU - Brener, Stacey AU - Kaulback, Kellee AU - Laing, Ana AU - Soulodre, Claude AU - Weir, Mark AU - Mitchell, Andrée AU - Thota, Anil AU - Ng, Vivian AU - Williams, Laura AU - Sikich, Nancy AU - Dhalla, Irfan DA - 2017-1-1 IS - 5 KW - Oxygenators Long-Term Care Cost-Benefit Analysis Biomedical Technology Foot Ulcer Amputation Technology Assessment, Biomedical Hyperbaric Oxygenation Diabetic Foot wound care randomized controlled trial (topic) quality of life personal experience patient satisfaction patient safety non insulin dependent diabetes mellitus male major clinical study insulin dependent diabetes mellitus hyperbaric oxygen therapy hyperbaric chamber human health care cost funding foot amputation female cost effectiveness analysis controlled clinical trial (topic) comparative effectiveness Canada biomedical technology assessment Article aged adult oxygen PY - 2017 SN - 1915-7398 SP - 1-142 ST - Hyperbaric oxygen therapy for the treatment of diabetic foot ulcers: A health technology assessment T2 - Ontario Health Technology Assessment Series TI - Hyperbaric oxygen therapy for the treatment of diabetic foot ulcers: A health technology assessment VL - 17 ID - 112 ER - TY - JOUR AB - Background Pressure injuries (bedsores) are common and reduce quality of life. They are also costly and difficult to treat. This health technology assessment evaluates the effectiveness, cost-effectiveness, budget impact, and lived experience of adding electrical stimulation to standard wound care for pressure injuries. Methods We conducted a systematic search for studies published to December 7, 2016, limited to randomized and non-randomized controlled trials examining the effectiveness of electrical stimulation plus standard wound care versus standard wound care alone for patients with pressure injuries. We assessed the quality of evidence through Grading of Recommendations Assessment, Development, and Evaluation (GRADE). In addition, we conducted an economic literature review and a budget impact analysis to assess the cost-effectiveness and affordability of electrical stimulation for treatment of pressure ulcers in Ontario. Given uncertainties in clinical evidence and resource use, we did not conduct a primary economic evaluation. Finally, we conducted qualitative interviews with patients and caregivers about their experiences with pressure injuries, currently available treatments, and (if applicable) electrical stimulation. Results Nine randomized controlled trials and two non-randomized controlled trials were found from the systematic search. There was no significant difference in complete pressure injury healing between adjunct electrical stimulation and standard wound care. There was a significant difference in wound surface area reduction favouring electrical stimulation compared with standard wound care. The only study on cost-effectiveness of electrical stimulation was partially applicable to the patient population of interest. Therefore, the cost-effectiveness of electrical stimulation cannot be determined. We estimate that the cost of publicly funding electrical stimulation for pressure injuries would be $0.77 to $3.85 million yearly for the next 5 years. Patients and caregivers reported that pressure injuries were burdensome and reduced their quality of life. Patients and caregivers also noted that electrical stimulation seemed to reduce the time it took the wounds to heal. Conclusions While electrical stimulation is safe to use (GRADE quality of evidence: high) there is uncertainty about whether it improves wound healing (GRADE quality of evidence: low). In Ontario, publicly funding electrical stimulation for pressure injuries could result in extra costs of $0.77 to $3.85 million yearly for the next 5 years. © Queen’s Printer for Ontario, 2017. AU - Lambrinos, Anna AU - Falk, Lindsey AU - Ali, Arshia AU - Holubowich, Corinne AU - Walter, Melissa AU - Betsch, Elizabeth Jean AU - Singh, Tanveer AU - Kaulback, Kellee AU - Laing, Ana AU - Soulodre, Claude AU - Mitchell, Andree AU - Ng, Vivian AU - Thota, Anil AU - Sikich, Nancy AU - Dhalla, Irfan DA - 2017-1-1 IS - 14 KW - Wound Healing Biomedical Technology Cost-Benefit Analysis Technology Assessment, Biomedical Pressure Ulcer Quality of Life Electric Stimulation wound care therapy effect systematic review patient compliance Ontario human health care cost funding electrotherapy electrostimulation disease burden decubitus cost effectiveness analysis caregiver biomedical technology assessment Article PY - 2017 SN - 1915-7398 SP - 1-106 ST - Electrical stimulation for pressure injuries: A health technology assessment T2 - Ontario Health Technology Assessment Series TI - Electrical stimulation for pressure injuries: A health technology assessment VL - 17 ID - 76 ER - TY - JOUR AB - Background: A patient safety learning system (sometimes called a critical incident reporting system) refers to structured reporting, collation, and analysis of critical incidents. To inform a provincial working group’s recommendations for an Ontario Patient Safety Event Learning System, a systematic review was undertaken to determine design features that would optimize its adoption into the health care system and would inform implementation strategies. Methods: The objective of this review was to address two research questions: (a) what are the barriers to and facilitators of successful adoption of a patient safety learning system reported by health professionals and (b) what design components maximize successful adoption and implementation? To answer the first question, we used a published systematic review. To answer the second question, we used scoping study methodology. Results: Common barriers reported in the literature by health care professionals included fear of blame, legal penalties, the perception that incident reporting does not improve patient safety, lack of organizational support, inadequate feedback, lack of knowledge about incident reporting systems, and lack of understanding about what constitutes an error. Common facilitators included a non-accusatory environment, the perception that incident reporting improves safety, clarification of the route of reporting and of how the system uses reports, enhanced feedback, role models (such as managers) using and promoting reporting, legislated protection of those who report, ability to report anonymously, education and training opportunities, and clear guidelines on what to report. Components of a patient safety learning system that increased successful adoption and implementation were emphasis on a blame-free culture that encourages reporting and learning, clear guidelines on how and what to report, making sure the system is user-friendly, organizational development support for data analysis to generate meaningful learning outcomes, and multiple mechanisms to provide feedback through routes to reporters and the wider community (local meetings, email alerts, bulletins, paper contributions, etc.). Conclusions: The design of a patient safety learning system can be optimized by an awareness of the barriers to and facilitators of successful adoption and implementation identified by health care professionals. Evaluation of the effectiveness of a patient safety learning system is needed to refine its design. © Queen’s Printer for Ontario, 2017. AU - Lambrinos, Anna AU - Holubowich, Corinne AU - Betsch, Elizabeth AU - Soulodre, Claude AU - Kaulback, Kellee AU - Mitchell, Andrée AU - Sikich, Nancy AU - Rossi, Michelle AU - Dhalla, Irfan DA - 2017-1-1 IS - 3 KW - world health organization systematic review synthesis punishment practice guideline perception patient safety organizational development Ontario model manager learning human health care system fear education e-mail data analysis comparative effectiveness awareness adoption PY - 2017 SN - 1915-7398 SP - 1-23 ST - Patient safety learning systems: A systematic review and qualitative synthesis T2 - Ontario Health Technology Assessment Series TI - Patient safety learning systems: A systematic review and qualitative synthesis VL - 17 ID - 105 ER - TY - JOUR AB - Objective: This systematic review aimed to summarize research that assessed the associations between 20 m shuttle run test (20mSRT) performance and indicators of physiological, psychosocial and cognitive health among school-aged children and youth. Design: Systematic review. Methods: Five online databases were used to identify peer-reviewed studies published from 1980 to 2016. Studies were included if they matched these criteria: population (children and youth with a mean age of 5–17 years and/or in Grades 1–12), intervention/exposure (performance on the 20mSRT), and outcomes (health indicators: adiposity, cardiometabolic biomarkers, cognition, mental health, psychosocial health, self-esteem and physical self-perception, quality of life and wellbeing, bone health, musculoskeletal fitness, motor skill development, and injuries and/or harm). Narrative syntheses were applied to describe the results. A lack of homogeneity precluded a meta-analysis approach. Results: Overall, 142 studies that determined an association between 20mSRT performance and a health indicator were identified, representing 319,311 children and youth from 32 countries. 20mSRT performance was favourably associated with indicators of adiposity, and some indicators of cardiometabolic, cognitive, and psychosocial health in boys and girls. Fewer studies examined the relationship between 20mSRT performance and measures of quality of life/wellbeing, mental health and motor skill development, and associations were generally inconsistent. The quality of the evidence ranged from very low to moderate across health indicators. Conclusion and Implications: These findings support the use of the 20mSRT as a holistic indicator of population health in children and youth. © 2017 Sports Medicine Australia AU - Lang, J. J. AU - Belanger, K. AU - Poitras, V. AU - Janssen, I. AU - Tomkinson, G. R. AU - Tremblay, M. S. DA - 2018-1-1 %J Journal of Science and Medicine in Sport IS - 4 KW - Cognition Child Motor Skills Only Child Adolescent PY - 2018 SP - 383-397 ST - Systematic review of the relationship between 20 m shuttle run performance and health indicators among children and youth T2 - Journal of Science and Medicine in Sport TI - Systematic review of the relationship between 20 m shuttle run performance and health indicators among children and youth VL - 21 ID - 278 ER - TY - JOUR AB - Background: Percutaneous coronary intervention (PCI)-using a catheter to place a stent to keep blood vessels open-is increasingly used for high-risk patients who cannot undergo surgery. Cardiogenic shock (when the heart suddenly cannot pump enough blood) is associated with a high mortality rate. The percutaneous ventricular assist device can help control blood pressure and increase blood flow in these high-risk conditions. This health technology assessment examined the benefits, harms, and budget impact of the Impella percutaneous ventricular assist device in high-risk PCI and cardiogenic shock. We also analyzed cost-effectiveness of the Impella device in high-risk PCI. Methods: We performed a systematic search of the literature for studies examining the effects of the Impella percutaneous ventricular assist device in high-risk PCI and cardiogenic shock, and appraised the evidence according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria, focusing on hemodynamic stability, mortality, major adverse cardiac events, bleeding, and vascular complications. We developed a Markov decision-analytical model to assess the cost- effectiveness of Impella devices versus intra-aortic balloon pumps (IABPs), calculated incremental cost-effectiveness ratios (ICERs) using a 10-year time horizon, and conducted sensitivity analyses to examine the robustness of the estimates. The economic model was conducted from the perspective of the Ontario Ministry of Health and Long-Term Care. Results: Eighteen studies (one randomized controlled trial and 10 observational studies for high-risk PCI, and one randomized controlled trial and six observational studies for cardiogenic shock) were included in the clinical review. Compared with IABPs, Impella 2.5, one model of the device, improved hemodynamic parameters (GRADE low-very low) but showed no significant difference in mortality (GRADE low), major adverse cardiac events (GRADE low), bleeding (GRADE low), or vascular complications (GRADE low) in high-risk PCI and cardiogenic shock. No randomized controlled trials or prospective observational studies with a control group have studied Impella CP and Impella 5.0 (other models of the device) in patients undergoing high-risk PCI or patients with cardiogenic shock. The economic model predicted that treatment with the Impella device would have fewer quality-adjusted life-years (QALYs) and higher costs than IABP in high-risk PCI patients. These observations were consistent even when uncertainty in model inputs and parameters was considered. We estimated that adopting Impella would increase costs by $2.9 to $11.5 million per year. Conclusions: On the basis of evidence of low to very low quality, Impella 2.5 devices were associated with improved hemodynamic stability, but had mortality rates and safety profile similar to IABPs in high-risk PCI and cardiogenic shock. Our cost-effectiveness analysis indicated that Impella 2.5 is likely associated with greater costs and fewer quality-adjusted life years than IABP. © Queen’s Printer for Ontario, 2017. AU - Lee, Christine AU - Djalalov, Sandjar AU - Xie, Xuanqian AU - Holubowich, Corinne AU - Betsch, Elizabeth Jean AU - Mohamed, Merissa AU - Laing, Ana AU - Kaulback, Kellee AU - Soulodre, Claude AU - Mitchell, Andree AU - Ng, Vivian AU - Thota, Anil AU - Sikich, Nancy AU - Dhalla, Irfan DA - 2017-1-1 IS - 2 KW - Models, Economic Biomedical Technology Quality-Adjusted Life Years Ontario Cost-Benefit Analysis Stents Blood Vessels Hemodynamics Self-Help Devices Technology Assessment, Biomedical Heart-Assist Devices ventricular assist device randomized controlled trial (topic) quality of life prospective study percutaneous ventricular assist device percutaneous coronary intervention observational study Note mortality left ventricular assist device intraaortic balloon pump human high risk patient heart ventricle arrhythmia health care utilization health care cost cost effectiveness analysis controlled clinical trial (topic) cohort analysis cerebrovascular accident cardiogenic shock bleeding acute heart infarction PY - 2017 SN - 1915-7398 SP - 1-97 ST - Ontario health technology assessment series: Percutaneous ventricular assist devices: A health technology assessment T2 - Ontario Health Technology Assessment Series TI - Ontario health technology assessment series: Percutaneous ventricular assist devices: A health technology assessment VL - 17 ID - 108 ER - TY - JOUR AB - Background Retinitis pigmentosa is a group of inherited disorders characterized by the degeneration of the photoreceptors in the retina, resulting in progressive vision loss. The Argus II system is designed to restore partial functional vision in patients with profound vision loss from advanced retinitis pigmentosa. At present, it is the only treatment option approved by Health Canada for this patient population. In June 2016, Health Quality Ontario published a health technology assessment of the Argus II retinal prosthesis system for patients with advanced retinitis pigmentosa. Based on that assessment, the Ontario Health Technology Advisory Committee recommended against publicly funding the Argus II system for this population. It also recommended that Health Quality Ontario re-evaluate the evidence in 1 year. The objective of this report was to examine new evidence published since the 2016 health technology assessment. Methods We completed a health technology assessment, which included an evaluation of clinical benefits and harms, value for money, and patient preferences related to the Argus II system. We performed a systematic literature search for studies published since the 2016 Argus II health technology assessment. We developed a Markov decision-analytic model to assess the cost-effectiveness of the Argus II system compared with standard care, and we calculated incremental cost-effectiveness ratios over a 20-year time horizon. We also conducted a five-year budget impact analysis. Finally, we interviewed people with retinitis pigmentosa about their lived experience with vision loss, and with the Argus II system. Results Four publications from one multicentre international study were included in the clinical review. Patients showed significant improvements in visual function and functional outcomes with the Argus II system, and these outcomes were sustained up to a 5-year follow-up (moderate quality of evidence). The safety profile was generally acceptable. In the base case economic analysis, the Argus II system was cost-effective compared with standard care if the willingness to pay was more than $97,429 per quality-adjusted life-year. We estimated that funding the Argus II system would cost the province $0.71 to $0.78 million per year over 5 years, assuming 4 implants per year. People with lived experience spoke about the challenges of retinitis pigmentosa, including the gradual but persistent progression of the disease; its impact on their quality of life and their families; and the accessibility challenges they faced. Those who used the Argus II system spoke about its positive impact on their quality of life. Conclusions Based on evidence of moderate quality, the Argus II retinal prosthesis system improved visual function, real-life functional outcomes, and quality of life in patients with advanced retinitis pigmentosa. The Argus II system is expensive, but the cost to publicly fund it would be low, because of the small number of eligible patients. The Argus II system can only enable perception of light/dark and shapes/objects, but these advancements represent important gains for people with retinitis pigmentosa in terms of mobility and quality of life. © Queen’s Printer for Ontario, 2017. AU - Lee, Christine AU - Tu, Hong Anh AU - Wells, David AU - Holubowich, Corinne AU - McKane, Jeanne AU - Singh, Tanveer AU - Kaulback, Kellee AU - Lang, Ana AU - Soulodre, Claude AU - McDowell, Sarah AU - Mitchell, Andrée AU - Ng, Vivian AU - Thota, Anil AU - Lang, Amy AU - Sikich, Nancy AU - Dhalla, Irfan DA - 2017-1-1 IS - 13 KW - Retinitis Pigmentosa Biomedical Technology Prostheses and Implants Retina Technology Assessment, Biomedical vision systematic review retina detachment quality adjusted life year patient preference Ontario meta analysis human follow up cost effectiveness analysis biomedical technology assessment Article PY - 2017 SN - 1915-7398 SP - 1-62 ST - Retinal prosthesis system for advanced retinitis pigmentosa: A health technology assessment update T2 - Ontario Health Technology Assessment Series TI - Retinal prosthesis system for advanced retinitis pigmentosa: A health technology assessment update VL - 17 ID - 73 ER - TY - JOUR AB - Background: We performed a systematic review and meta-analysis to evaluate the efficacy and safety of high-flow oxygen via nasal cannulae (HFNC) compared to non-invasive ventilation (NIV) and/or standard oxygen in patients with acute, hypoxemic respiratory failure. Methods: We reviewed randomized controlled trials from CENTRAL, EMBASE, MEDLINE, Scopus and the International Clinical Trials Registry Platform (inception to February 2016), conference proceedings, and relevant article reference lists. Two reviewers independently screened and extracted trial-level data from trials investigating HFNC in patients with acute, hypoxemic respiratory failure. Internal validity was assessed in duplicate using the Cochrane Risk of Bias tool. The strength of evidence was assessed in duplicate using the Grading of Recommendations Assessment, Development and Evaluation framework. Our primary outcome was mortality. Secondary outcomes included dyspnea, PaO 2 :FiO 2 ratio, PaCO 2 , and pH. Safety outcomes included respiratory arrest, intubation, delirium, and skin breakdown. Results: From 2023 screened citations, we identified seven trials (1771 patients) meeting inclusion criteria. All trials were at high risk of bias due to lack of blinding. There was no evidence for a mortality difference in patients receiving HFNC vs. NIV and/or standard oxygen (RR 1.01, 95% CI 0.69 to 1.48, I 2 =63%, five trials, 1629 patients). In subgroup analyses of HFNC compared to NIV or standard oxygen individually, mortality differences were not observed. Measures of patient tolerability were heterogeneous. The PaO 2 :FiO 2 ratio at 6-12h was significantly lower in patients receiving oxygen via HFNC compared to NIV or standard oxygen for hypoxemic respiratory failure (MD -53.34, 95% CI -71.95 to -34.72, I 2 =61%, 1143 patients). There were no differences in pH, PaCO 2 , or rates of intubation or cardio-respiratory arrest. Delirium and skin breakdown were infrequently reported in included trials. Conclusions: In patients with acute hypoxemic respiratory failure HFNC was not associated with a difference in mortality compared to NIV or standard oxygen. Secondary outcomes including dyspnea, tolerance, and safety were not systematically reported. Residual heterogeneity and variable reporting of secondary outcomes limit the conclusions that can be made in this review. Prospective trials designed to evaluate the efficacy and safety of HFNC in patients with acute hypoxemic respiratory failure are required. © 2017 The Author(s). AU - Leeies, M. AU - Flynn, E. AU - Turgeon, A. F. AU - Paunovic, B. AU - Loewen, H. AU - Rabbani, R. AU - Abou-Setta, A. M. AU - Ferguson, N. D. AU - Zarychanski, R. C2 - 29037221 C7 - 202 DB - Scopus DO - 10.1186/s13643-017-0593-5 IS - 1 KW - Acute respiratory failure High flow Hypoxemic respiratory failure Nasal cannula Oxygen therapy Respiratory failure oxygen Article blood carbon dioxide tension bronchoscopy delirium dyspnea flow rate human hypoxemia intubation meta analysis mortality noninvasive ventilation outcome assessment oxygen tension pain threshold pH priority journal randomized controlled trial (topic) respiratory arrest risk factor sequential analysis systematic review adult respiratory distress syndrome cannula hypoxia procedures Humans Oxygen Inhalation Therapy Respiratory Distress Syndrome, Adult M3 - Article PY - 2017 ST - High-flow oxygen via nasal cannulae in patients with acute hypoxemic respiratory failure: A systematic review and meta-analysis T2 - Systematic Reviews TI - High-flow oxygen via nasal cannulae in patients with acute hypoxemic respiratory failure: A systematic review and meta-analysis VL - 6 ID - 310 ER - TY - JOUR AB - Introduction: Investigations of the dynamic function of female pelvic floor muscles (PFM) help us to understand the pathophysiology of stress urinary incontinence (SUI). Displacement measurements of PFM give insight into muscle activation and thus help to improve rehabilitation strategies. This systematic review (PROSPERO 2013: CRD42013006409) was performed to summarise the current evidence for PFM displacement during voluntary and involuntary activation in continent and incontinent women. Methods: MEDLINE, EMBASE, Cochrane and SPORTDiscus databases were searched using selected terminology reflecting the PICO approach. Screening of Google Scholar and congress abstracts added to further information. Original articles investigating PFM displacement were included if they reported on at least one of the aims of the review, e.g., method, test position, test activity, direction and quantification of displacement, as well as the comparison between continent and incontinent women. Titles and abstracts were screened by two reviewers. The papers included were reviewed by two individuals to ascertain whether they fulfilled the inclusion criteria and data were extracted on outcome parameters. Results: Forty-two predominantly observational studies fulfilled the inclusion criteria. A variety of measurement methods and calculations of displacement was presented. The sample was heterogeneous concerning age, parity and continence status. Test positions and test activities varied among the studies. Conclusions: The findings summarise the present knowledge of PFM displacement, but still lack deeper comprehension of the SUI pathomechanism of involuntary, reflexive activation during functional activities. We therefore propose that future investigations focus on PFM dynamics during fast and stressful impact tasks. © 2015, The International Urogynecological Association. AU - Leitner, M. AU - Moser, H. AU - Taeymans, J. AU - Kuhn, A. AU - Radlinger, L. DA - 2015-1-1 IS - 11 KW - Urinary Incontinence Urinary Incontinence, Stress Pelvic Floor Humans Female pelvis floor pathophysiology voluntary movement urine incontinence systematic review stress incontinence Review quality control priority journal pelvic floor muscle displacement pelvic floor disorder nomenclature meta analysis involuntary movement human Embase data extraction controlled clinical trial (topic) Stress urinary incontinence Diagnostics Activities of daily living PY - 2015 SP - 1587-1598 ST - Pelvic floor muscle displacement during voluntary and involuntary activation in continent and incontinent women: a systematic review T2 - International Urogynecology Journal TI - Pelvic floor muscle displacement during voluntary and involuntary activation in continent and incontinent women: a systematic review VL - 26 ID - 198 ER - TY - JOUR AB - BackgRound: The Public Health Agency of Canada reviewed sexual transmission of HIV between serodiscordant partners to support examination of the criminal justice system response to HIV nondisclosure by the Department of Justice of Canada. We sought to determine HIV transmission risk when an HIV-positive partner takes antiretroviral therapy, has a suppressed viral load or uses condoms. Methods: We conducted an overview and systematic review update by searching MEDLINE and other databases (Jan. 1, 2007, to Mar. 13, 2017; and Nov. 1, 2012, to Apr. 27, 2017, respectively). We considered reviews and studies about absolute risk of sexual transmission of HIV between serodiscordant partners to be eligible for inclusion. We used A Measurement Tool to Assess Systematic Reviews (AMSTAR) for review quality, Quality in Prognosis Studies (QUIPS) instrument for study risk of bias and then the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach to assess the quality of evidence across studies. We calculated HIV incidence per 100 person-years with 95% confidence intervals (CIs). We assigned risk categories according to potential for and evidence of HIV transmission. Results: We identified 12 reviews. We selected 1 review to estimate risk of HIV transmission for condom use without antiretroviral therapy (1.14 transmissions/ 100 person-years, 95% CI 0.56-2.04; low risk). We identified 11 studies with 23 transmissions over 10 511 person-years with antiretroviral therapy (0.22 transmissions/100 person-years, 95% CI 0.14-0.33; low risk). We found no transmissions with antiretroviral therapy and a viral load of less than 200 copies/mL across consecutive measurements 4 to 6 months apart (0.00 transmissions/ 100 person-years, 95% CI 0.00-0.28; negligible risk regardless of condom use). InteRpRetatIon: Based on high-quality evidence, there is a negligible risk of sexual transmission of HIV when an HIV-positive sex partner adheres to antiretroviral therapy and maintains a suppressed viral load of less than 200 copies/mL measured every 4 to 6 months. Sexual transmissions of HIV have occurred when viral load was more than 200 copies/mL with antiretroviral therapy or condoms alone were used, although the risk remains low. These findings will help to support patient and clinician decision-making, affect public health case management and contact tracing, and inform justice system responses to HIV nondisclosure. © 2018 Joule Inc. AD - Centre for Communicable Diseases and Infection Control, United States Public Health Agency of Canada, Department of Family Medicine, Canada School of Epidemiology and Public Health, United States University of Ottawa, ONT, Ottawa, Canada Department of Health Research Methods, McMaster University, ONT, Hamilton, Canada AU - LeMessurier, J. AU - Traversy, G. AU - Varsaneux, O. AU - Weekes, M. AU - Avey, M. T. AU - Niragira, O. AU - Gervais, R. AU - Guyatt, G. AU - Rodin, R. C2 - 30455270 DB - Scopus DO - 10.1503/cmaj.180311 IS - 46 KW - adult antiretroviral therapy case management clinician condom use contact examination controlled study criminal justice decision making female human Human immunodeficiency virus incidence male Medline nonhuman prognosis public health review risk assessment sexual transmission systematic review virus load blood condom Human immunodeficiency virus infection risk safe sex sustained virologic response anti human immunodeficiency virus agent Anti-HIV Agents Condoms HIV Infections Humans Viral Load LA - English M3 - Article PY - 2018 SP - E1350-E1360 ST - Risk of sexual transmission of human immunodeficiency virus with antiretroviral therapy, suppressed viral load and condom use: A systematic review T2 - CMAJ TI - Risk of sexual transmission of human immunodeficiency virus with antiretroviral therapy, suppressed viral load and condom use: A systematic review VL - 190 ID - 384 ER - TY - JOUR AB - Background: Stroke secondary prevention guidelines recommend medication prescription and adherence, active education and behavioural counselling regarding lifestyle risk factors. To impact on recurrent vascular events, positive behaviour/s must be adopted and sustained as a lifestyle choice, requiring theoretically informed behaviour change and self-management interventions. A growing number of systematic reviews have addressed complex interventions in stroke secondary prevention. Differing terminology, inclusion criteria and overlap of studies between reviews makes the mechanism/s that affect positive change difficult to identify or replicate clinically. Adopting a two-phase approach, this overview will firstly comprehensively summarise systematic reviews in this area and secondly identify and synthesise primary studies in these reviews which provide person-centred, theoretically informed interventions for stroke secondary prevention. Methods: An overview of reviews will be conducted using a systematic search strategy across the Cochrane Database of Systematic Reviews, PubMed and Epistomonikas. Inclusion criteria: systematic reviews where the population comprises individuals post-stroke or TIA and where data relating to person-centred risk reduction are synthesised for evidence of efficacy when compared to standard care or no intervention. Primary outcomes of interest include mortality, recurrent stroke and other cardiovascular events. In phase 1, two reviewers will independently (1) assess the eligibility of identified reviews for inclusion; (2) rate the quality of included reviews using the ROBIS tool; (3) identify unique primary studies and overlap between reviews; (4) summarise the published evidence supporting person-centred behavioural change and self-management interventions in stroke secondary prevention and (5) identify evidence gaps in this field. In phase 2, two independent reviewers will (1) examine person-centred, primary studies in each review using the Template for Intervention Description and Replication (TIDieR checklist), itemising, where present, theoretical frameworks underpinning interventions; (2) group studies employing theoretically informed interventions by the intervention delivered and by the outcomes reported (3) apply GRADE quality of evidence for each intervention by outcome/s identified from theoretically informed primary studies. Disagreement between reviewers at each process stage will be discussed and a third reviewer consulted. Discussion: This overview will comprehensively bring together the best available evidence supporting person-centred, stroke secondary prevention strategies in an accessible format, identifying current knowledge gaps. © 2018 The Author(s). AD - School of Public Health, Physiotherapy and Sports Science, University College Dublin, Health Sciences Centre, Belfield-Dublin 4, Ireland School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom Nursing, Midwifery and Allied Health Professionals Research Unit, Glasgow Caledonian University, Glasgow, United Kingdom AU - Lennon, O. AU - Blake, C. AU - Booth, J. AU - Pollock, A. AU - Lawrence, M. C2 - 30545406 C7 - 231 DB - Scopus DO - 10.1186/s13643-018-0888-1 IS - 1 KW - Behaviour change Lifestyle Overview Secondary prevention Self-management Stroke anticoagulant agent antihypertensive agent antilipemic agent antithrombocytic agent alcohol consumption behavior change bibliographic database cardiovascular disease cerebrovascular accident healthy diet human mental stress meta analysis (topic) mortality outcome assessment physical activity practice guideline priority journal quality control randomized controlled trial (topic) Review risk factor self care smoking smoking cessation stress management systematic review transient ischemic attack procedures risk reduction Humans Life Style Risk Reduction Behavior LA - English M3 - Review PY - 2018 ST - Interventions for behaviour change and self-management in stroke secondary prevention: Protocol for an overview of reviews T2 - Systematic Reviews TI - Interventions for behaviour change and self-management in stroke secondary prevention: Protocol for an overview of reviews VL - 7 ID - 385 ER - TY - JOUR AB - Background: "Clinical ethics consultation" (CEC) is the provision of consultative services by an individual or team with the aim of helping health professionals, patients, and their families grapple with difficult ethical issues arising during health care. There are almost 25,000 articles in the worldwide literature on CEC, but very few explicitly address measuring the quality of CEC. Many more address quality implicitly, however. This article describes a rigorous protocol for compiling the diverse literature on CEC, analyzing it with a quality measurement lens, and seeking a set of potential quality domains for CEC based on areas of existing, but hitherto unrecognized, consensus in the literature. Methods/design: This mixed-method systematic review will follow a sequential pattern: scoping review, qualitative synthesis, and then a quantitative synthesis. The scoping review will include categorizing all quality measures for CEC discussed in the literature, both quantitative and qualitative. The qualitative synthesis will generate a comprehensive analytic framework for understanding the quality of CEC and is expected to inform the quantitative synthesis, which will be a meta-analysis of studies reporting the effects of CEC on pre-specified clinical outcomes. Discussion: The literature on CEC is broad and diverse and has never been examined with specific regard to quality measurement. We propose a novel mixed-methods approach to compile and synthesize this literature and to derive a framework for assessing quality in CEC. Systematic review registration: PROSPERO CRD42015023282. © 2016 The Author(s). AU - Leslie, L. AU - Cherry, R. F. AU - Mulla, A. AU - Abbott, J. AU - Furfari, K. AU - Glover, J. J. AU - Harnke, B. AU - Wynia, M. K. DA - 2016-1-1 IS - 1 KW - Referral and Consultation Quality Assurance, Health Care Qualitative Research Humans Ethics, Clinical standards patient referral health care quality systematic review sensitivity analysis scientific literature randomized controlled trial (topic) quantitative study publication priority journal meta analysis medical ethics human data synthesis consultation Article Scoping review Mixed-method Health care ethics committees Ethics consultation Clinical ethics Bioethics PY - 2016 SN - 2046-4053 ST - Domains of quality for clinical ethics case consultation: A mixed-method systematic review T2 - Systematic Reviews TI - Domains of quality for clinical ethics case consultation: A mixed-method systematic review VL - 5 ID - 178 ER - TY - JOUR AB - Background Patients with advanced lung cancer commonly have bone metastases. Compared with other malignancies, the use of bone-targeted agents (e.g. bisphosphonates and denosumab) is less common in lung cancer patients. This may be due to the perception that bone-targeted agents are less effective in this population. Objective To perform a systematic review to evaluate data from randomized trials of bone-targeted agents in lung cancer patients with bone metastases. Methods A systematic search of Medline, Embase and the Cochrane Register of Controlled Trials through May 2015 was performed. Randomized trials of bone-targeted therapies in lung cancer patients with bone metastases were sought. Outcomes studied included skeletal related events (SREs), pain, quality of life, progression-free survival and overall survival. Random effects meta-analyses were planned if studies were judged homogeneous. Results Of 632 abstracts, 17 publications describing 13 studies were included. Sample sizes ranged between 50 and 1776. Of 3379 patients, 1903 had lung cancer, with subgroup data available for 8 of 13 studies. Patient demographics were comparable, but enrollment criteria and endpoints were heterogeneous across studies, precluding meta-analysis. Study-specific results suggested that bone-modifying agents reduce the incidence of SREs and bone pain in lung cancer patients. Three studies suggested a survival benefit. Conclusion Data from included trials suggests benefit of bone-targeted agents in lung cancer for the prevention of SREs and bone pain. There is a trend toward improvement in overall survival and progression-free survival, although further research is needed. Impact on quality of life and key subgroups for benefit both require future research. © 2016 Elsevier Ltd AU - LeVasseur, N. AU - Clemons, M. AU - Hutton, B. AU - Shorr, R. AU - Jacobs, C. DA - 2016-1-1 KW - Neoplasm Metastasis Lung Spinal Neoplasms Spinal Cord Compression Randomized Controlled Trials as Topic Lung Neoplasms Humans Fractures, Spontaneous Disease-Free Survival Diphosphonates Denosumab Carcinoma, Non-Small-Cell Lung Bone Neoplasms Bone Density Conservation Agents secondary pathology lung tumor disease free survival complication visual analog scale systematic review sex difference Review randomized controlled trial (topic) quality of life progression free survival overall survival outcome assessment non small cell lung cancer lung cancer human drug safety drug efficacy cancer survival bone pain bone metastasis age distribution bone density conservation agent bisphosphonic acid derivative zoledronic acid pamidronic acid ibandronic acid clodronic acid Bone targeted therapy Bone metastases Bisphosphonates PY - 2016 SP - 183-193 ST - Bone-targeted therapy use in patients with bone metastases from lung cancer: A systematic review of randomized controlled trials T2 - Cancer Treatment Reviews TI - Bone-targeted therapy use in patients with bone metastases from lung cancer: A systematic review of randomized controlled trials VL - 50 ID - 171 ER - TY - JOUR AB - Background: Guidelines support health care decision-making and high quality care and outcomes. However, their implementation is sub-optimal. Theory-informed, tailored implementation is associated with guideline use. Few guideline implementation studies published up to 1998 employed theory. This study aimed to describe if and how theory is now used to plan or evaluate guideline implementation among physicians. Methods: A scoping review was conducted. MEDLINE, EMBASE, and The Cochrane Library were searched from 2006 to April 2016. English language studies that planned or evaluated guideline implementation targeted to physicians based on explicitly named theory were eligible. Screening and data extraction were done in duplicate. Study characteristics and details about theory use were analyzed. Results: A total of 1244 published reports were identified, 891 were unique, and 716 were excluded based on title and abstract. Among 175 full-text articles, 89 planned or evaluated guideline implementation targeted to physicians; 42 (47.2%) were based on theory and included. The number of studies using theory increased yearly and represented a wide array of countries, guideline topics and types of physicians. The Theory of Planned Behavior (38.1%) and the Theoretical Domains Framework (23.8%) were used most frequently. Many studies rationalized choice of theory (83.3%), most often by stating that the theory described implementation or its determinants, but most failed to explicitly link barriers with theoretical constructs. The majority of studies used theory to inform surveys or interviews that identified barriers of guideline use as a preliminary step in implementation planning (76.2%). All studies that evaluated interventions reported positive impact on reported physician or patient outcomes. Conclusions: While the use of theory to design or evaluate interventions appears to be increasing over time, this review found that one half of guideline implementation studies were based on theory and many of those provided scant details about how theory was used. This limits interpretation and replication of those interventions, and seems to result in multifaceted interventions, which may not be feasible outside of scientific investigation. Further research is needed to better understand how to employ theory in guideline implementation planning or evaluation. © 2017 The Author(s). AU - Liang, L. AU - Bernhardsson, S. AU - Vernooij, R. W. M. AU - Armstrong, M. J. AU - Bussières, A. AU - Brouwers, M. C. AU - Gagliardi, A. R. AU - Alhabib, S. AU - Fleuren, M. AU - Fortino, M. AU - Mazza, D. AU - O'Rourke, N. AU - Willson, M. DA - 2017-1-1 IS - 1 KW - Planning Techniques Decision Making Practice Patterns, Physicians' Practice Guidelines as Topic Patient Care Planning Humans Guideline Adherence General Practice Diffusion of Innovation protocol compliance practice guideline mass communication clinical practice Theory of Planned Behavior theoretical model systematic review screening physician Medline interview human English (language) Embase data extraction controlled study consensus development Cochrane Library Theory Physicians Interventions Implementation Guidelines Evaluation Effectiveness PY - 2017 SN - 1748-5908 ST - Use of theory to plan or evaluate guideline implementation among physicians: A scoping review T2 - Implementation Science TI - Use of theory to plan or evaluate guideline implementation among physicians: A scoping review VL - 12 ID - 100 ER - TY - JOUR AB - Objectives Patient engagement (PE) improves patient, organisation and health system outcomes, but most research is based on primary care. The primary purpose of this study was to describe the characteristics of published empirical research that evaluated PE in hospital health service improvement. Design Scoping review. Methods Five databases were searched from 2006 to September 2016. English language studies that evaluated patient or provider beliefs, participation in PE, influencing factors or impact were eligible. Screening and data extraction were done in triplicate. PE characteristics, influencing factors and impact were extracted and summarised. Results From a total of 3939 search results, 227 studies emerged as potentially relevant; of these, 217 were not eligible, and 10 studies were included in the review. None evaluated behavioural interventions to promote or support PE. While most studies examined involvement in standing committees or projects, patient input and influence on decisions were minimal. Lack of skill and negative beliefs among providers were PE barriers. PE facilitators included careful selection and joint training of patients and providers, formalising patient roles, informal interaction to build trust, involving patients early in projects, small team size, frequent meetings, active solicitation of patient input in meetings and debriefing after meetings. Asking patients to provide insight into problems rather than solutions and deploying provider champions may enhance patient influence on hospital services. Conclusions Given the important role of PE in improving hospital services and the paucity of research on this topic, future research should develop and evaluate behavioural interventions for PE directed at patients and providers informed by the PE barriers and facilitators identified here. Future studies should also assess the impact on various individual and organisational outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. AD - Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada Beatrice Hunter Cancer Research Institute, Dalhousie University, Halifax, Canada Department of Medicine, University of Toronto, Toronto, ON, Canada Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada AU - Liang, L. AU - Cako, A. AU - Urquhart, R. AU - Straus, S. E. AU - Wodchis, W. P. AU - Baker, G. R. AU - Gagliardi, A. R. C2 - 29382676 C7 - e018263 DB - Scopus DO - 10.1136/bmjopen-2017-018263 IS - 1 KW - hospital care patient engagement quality improvement scoping review adult clinical evaluation data extraction empirical research English (language) female hospital service human joint male outcome assessment review skill systematic review total quality management trust decision making hospital planning organization and management patient participation Humans LA - English M3 - Review PY - 2018 ST - Patient engagement in hospital health service planning and improvement: A scoping review T2 - BMJ Open TI - Patient engagement in hospital health service planning and improvement: A scoping review VL - 8 ID - 386 ER - TY - JOUR AB - Introduction Management of early breast cancer in the elderly population is challenging due to different breast cancer biology and limited tolerance to aggressive treatments. The aim of this study is to evaluate whether the omission of axillary staging impacts breast cancer outcomes in elderly patients. Patients and Methods A systematic review and meta-analysis was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The electronic databases were searched in August 2014 using the following inclusion criteria: Population Elderly patients (≥ 70 years) with early stage (T1/T2, N0) breast cancer. Intervention Axillary staging with a sentinel node biopsy, axillary sampling or axillary node dissection. Control No axillary surgery. Outcomes Local-regional recurrence, disease-free survival, overall survival. Study design RCTs.Results Two RCTs met the eligibility criteria and were included. A meta-analysis of the included RCTs of 692 patients found that axillary staging reduced the risk of axillary recurrence compared to no axillary staging (RR 0.24, 95% CI: 0.06 to 0.95, I2 = 0%, p = 0.04). There were no differences observed in in-breast recurrence or distant recurrence (RR 1.20, 95% CI: 0.55 to 2.64, I2 = 62%, p = 0.65, RR 1.17, 95% CI: 0.75 to 1.82, I2 = 0%, p = 0.48, respectively). There were no differences observed in overall or breast-cancer specific mortality (RR 0.99, 95% CI: 0.79 to 1.24, I2 = 0%, p = 0.92, RR 1.07, 95% CI: 0.72 to 1.57, I2 = 0%, p = 0.75, respectively). Discussion Omission of axillary staging in elderly patients with clinically negative axillae results in increased regional recurrence but does not appear to impact survival. © 2016 Elsevier Ltd AU - Liang, S. AU - Hallet, J. AU - Simpson, J. S. AU - Tricco, A. C. AU - Scheer, A. S. DA - 2017-1-1 IS - 2 KW - Treatment Outcome Risk Recurrence Randomized Controlled Trials as Topic Neoplasm Staging Lymphatic Metastasis Lymph Node Excision Humans Female Early Detection of Cancer Disease-Free Survival Breast Neoplasms Axilla Aged Age Factors utilization recurrent disease randomized controlled trial (topic) pathology mortality lymph node metastasis early cancer diagnosis cancer staging breast tumor age systematic review risk reduction Review overall survival outcome assessment meta analysis lymph node dissection human early cancer disease free survival clinical evaluation cancer survival cancer recurrence breast cancer axillary lymph node Meta-analysis Elderly Axillary staging PY - 2017 SN - 1879-4068 SP - 140-147 ST - Omission of axillary staging in elderly patients with early stage breast cancer impacts regional control but not survival: A systematic review and meta-analysis T2 - Journal of Geriatric Oncology TI - Omission of axillary staging in elderly patients with early stage breast cancer impacts regional control but not survival: A systematic review and meta-analysis VL - 8 ID - 154 ER - TY - JOUR AB - Introduction Using specific tools to assess the measurement properties of health status instruments is recommended both to standardise the review process and to improve the methodological quality of systematic reviews. However, depending on the measurement standards on which these tools are developed, the approach to appraise the measurement properties of instruments may vary. For this reason, the present meta-review aims to: (1) identify systematic reviews assessing the measurement properties of instruments evaluating health-related quality of life (HRQoL); (2) identify the tools applied to assess the measurement properties of HRQoL instruments; (3) describe the characteristics of the tools applied to assess the measurement properties of HRQoL instruments; (4) identify the measurement standards on which these tools were developed or conform to and (5) compare the similarities and differences among the identified measurement standards. Methods and analysis A systematic review will be conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols Guidelines. Electronic search will be carried out on bibliographic databases, including PubMed, Cumulative Index to Nursing and Allied Health Literature, Psychological Information, SCOPUS, Web of Science, COSMIN database and ProQuest Dissertations & Theses Global, being limited by time (2008-2018) and language (English). Descriptive analyses of different aspects of tools applied to evaluate the measurement properties of HRQoL instruments will be presented; the different measurement standards will be described and some recommendations about the methodological and research applications will be made. Ethics and dissemination Ethical approval is not necessary for systematic review protocols. The results will be disseminated by its publication in a peer-reviewed journal and presented at a relevant conference. PROSPERO registration number CRD42017065232 © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. AD - Department of Psychobiology and Methodology of Health Science, Universitat Autònoma de Barcelona, Bellaterra, Spain Pediatric Area, PNP, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Spain AU - Lorente, S. AU - Vives, J. AU - Viladrich, C. AU - Losilla, J. M. C2 - 30037880 C7 - e022829 DB - Scopus DO - 10.1136/bmjopen-2018-022829 IS - 7 KW - health instruments measurement properties measurement standards meta-review quality of life article Cinahl ethics health status human human experiment language Medline meta analysis practice guideline publication registration Scopus systematic review Web of Science minimal clinically important difference outcome assessment Humans Outcome Assessment (Health Care) Systematic Reviews as Topic LA - English M3 - Article PY - 2018 ST - Tools to assess the measurement properties of quality of life instruments: A meta-review protocol T2 - BMJ Open TI - Tools to assess the measurement properties of quality of life instruments: A meta-review protocol VL - 8 ID - 387 ER - TY - JOUR AB - Background: Progressive, incurable cancer is associated with increased fatigue, increased muscle weakness, and reduced physical functioning, all of which negatively impact quality of life. Physical activity has demonstrated benefits on cancer-related fatigue and physical functioning in early-stage cancer patients; however, its impact on these outcomes in end-stage cancer has not been established. The aim of this systematic review is to determine the potential benefits, harms, and effects of physical activity interventions on quality of life outcomes in advanced cancer patients. Methods/design: A systematic review of peer-reviewed literature on physical activity in advanced cancer patients will be undertaken. Empirical quantitative studies will be considered for inclusion if they present interventional or observational data on physical activity in advanced cancer patients. Searches will be conducted in the following electronic databases: CINAHL; CIRRIE Database of International Rehabilitation Research; Cochrane Database of Systematic Reviews (CDSR); Database of Abstracts of Reviews of Effects (DARE); Cochrane Central Register of Controlled Trials (CENTRAL); EMBASE; MEDLINE; PEDro: the Physiotherapy Evidence Database; PQDT; PsycInfo; PubMed; REHABDATA; Scopus; SPORTDiscus; and Web of Science, to identify relevant studies of interest. Additional strategies to identify relevant studies will include citation searches and evaluation of reference lists of included articles. Titles, abstracts, and keywords of identified studies from the search strategies will be screened for inclusion criteria. Two independent reviewers will conduct quality appraisal using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies (EPHPP) and the Cochrane risk of bias tool. A descriptive summary of included studies will describe the study designs, participant and activity characteristics, and objective and patient-reported outcomes. Discussion: This systematic review will summarize the current evidence base on physical activity interventions in advanced cancer patients. The findings from this systematic review will identify gaps to be explored by future research studies and inform future practice guideline development of physical activity interventions in advanced cancer patients. Systematic review registration: PROSPERO CRD42015026281 © 2016 Lowe et al. AU - Lowe, S. S. AU - Tan, M. AU - Faily, J. AU - Watanabe, S. M. AU - Courneya, K. S. DA - 2016-1-1 %J Systematic Reviews IS - 1 KW - Physical Therapy Modalities Quality of Life Muscle Weakness Neoplasm Staging Motor Activity PY - 2016 SN - 2046-4053 ST - Physical activity in advanced cancer patients: A systematic review protocol T2 - Systematic Reviews TI - Physical activity in advanced cancer patients: A systematic review protocol VL - 5 ID - 295 ER - TY - JOUR AB - Aims A better understanding of pelvic floor muscle (PFM) activation and strength components is a prerequisite to get better insight in PFM contraction mechanisms and develop more specific PFM-training regimens for female stress urinary incontinence (SUI) patients. The aim of this systematic review (2012:CRD42012002547) was to evaluate and summarize existing studies investigating PFM activation and strength components influencing female continence and SUI. Methods PubMed, EMBASE, and Cochrane databases were systematically searched for literature from January 1980 to November 2013 for cross-sectional studies comparing female SUI patients with healthy controls and intervention studies with SUI patients reporting on the association between PFM activation and strength components and urine loss. Trial characteristics, evaluated PFM components, their definitions, measurement methods, study outcomes, as well as quality measures, based on the Cochrane risk of bias tool, were independently extracted. The high heterogeneity of the retrieved data made pooling of results impossible and therefore restricted the analysis to a systematic review. Results Cross-sectional studies showed group differences in favor of the continent women compared to SUI patients for PFM activation or PFM maximal strength, mean strength or sustained contraction. All intervention studies showed an improvement of PFM strength and decrease in urine loss in SUI patients after physical therapy. Conclusions Higher PFM activation and strength components influence female continence positively. This systematic review underscored the need for a standardized PFM components' terminology (similar to rehabilitation and training science), standardized test procedures and well matched diagnostic instruments. © 2014 Wiley Periodicals, Inc. AU - Luginbuehl, H. AU - Baeyens, J. P. AU - Taeymans, J. AU - Maeder, I. M. AU - Kuhn, A. AU - Radlinger, L. DA - 2015-1-1 IS - 6 KW - Cesarean Section Intervention Studies Urinary Incontinence Cross-Sectional Studies Urinary Incontinence, Stress Pelvic Floor Disorders Pelvic Floor Muscle, Skeletal Muscle Strength Humans Female stress incontinence skeletal muscle pelvis floor pelvic floor disorder pathophysiology meta analysis urinary tract function urinary continence systematic review systematic error study design selection bias risk assessment Review pretest posttest design physiotherapy pelvic floor muscle training muscle contraction medical terminology intervention study human electromyogram cross-sectional study comparative study pressure electromyography PY - 2015 SN - 0733-2467 SP - 498-506 ST - Pelvic floor muscle activation and strength components influencing female urinary continence and stress incontinence: A systematic review T2 - Neurourology and Urodynamics TI - Pelvic floor muscle activation and strength components influencing female urinary continence and stress incontinence: A systematic review VL - 34 ID - 203 ER - TY - JOUR AB - Background: There is little data on the effect of exercise on markers of airway inflammation in human asthmatics. The main objective of this review is to determine the effects of physical training on markers of airway inflammation in animal models of asthma.Methods: A peer reviewed search was applied to Medline, Embase, Web of Science, Cochrane, and DARE databases. Data extraction was performed in a blinded fashion.Results: From the initial 2336 studies, a total of 10 studies were selected for the final analysis. All were randomized controlled trials with low to moderate intensity training on ovalbumin-sensitized mice. In the exercised group of mice, there was a reduction in BAL eosinophils and Th-2 cytokines, no change in Th-1 cytokines, an increase in IL-10, and a reversal of airway remodeling. The data was not pooled owing to significant heterogeneity between studies, and a funnel plot test for publication bias was not performed because there were few studies reporting on any one outcome measure. The asthma models differed between studies in age and gender of mice, as well as in timing of physical training after sensitization. The risk of bias was unclear for some studies though this may not influence outcome measures. The accuracy of data extracted from graphics is unknown.Conclusions: Physical training improves airway inflammation in animal asthma models. © 2013 Luks et al.; licensee BioMed Central Ltd. AU - Luks, V. AU - Burkett, A. AU - Turner, L. AU - Pakhale, S. DA - 2013-1-1 IS - 1 KW - Inflammation Humanism Humanities Animal Shells Humans Pneumonia Physical Conditioning, Animal Ovalbumin Mice, Inbred BALB C Mice Male Immunoglobulin E Guinea Pigs Female Disease Models, Animal Cytokines Biological Markers Asthma Animals review physiology pathophysiology chemically induced disorder animal experiment mouse guinea pig disease model chemically induced blood Bagg albino mouse animal Th2 cell Th1 cell systematic review (topic) sensitization sedentary lifestyle respiratory tract inflammation regulatory T lymphocyte randomized controlled trial (topic) peer review outcome assessment nonhuman lung lavage kinesiotherapy exercise intensity eosinophil CD4+ CD25+ T lymphocyte article airway resistance airway remodeling cytokine biological marker vasculotropin vascular cell adhesion molecule 1 transforming growth factor beta tissue inhibitor of metalloproteinase 2 somatomedin C RANTES purinergic P2X7 receptor macrophage elastase interleukin 5 interleukin 4 interleukin 2 interleukin 13 interleukin 10 intercellular adhesion molecule 1 immunoglobulin enhancer binding protein glycoprotein gp 91 gamma interferon epidermal growth factor receptor eotaxin alpha chemokine 8 isoprostane 3 nitrotyrosine Systematic review Physical exercise Chronic airway inflammation Asthma therapy PY - 2013 ST - Effect of physical training on airway inflammation in animal models of asthma: A systematic review T2 - BMC Pulmonary Medicine TI - Effect of physical training on airway inflammation in animal models of asthma: A systematic review VL - 13 ID - 43 ER - TY - JOUR AB - Background: The number of caesarean sections (CS) is increasing globally, and repeat CS after a previous CS is a significant contributor to the overall CS rate. Vaginal birth after caesarean (VBAC) can be seen as a real and viable option for most women with previous CS. To achieve success, however, women need the support of their clinicians (obstetricians and midwives). The aim of this study was to evaluate clinician-centred interventions designed to increase the rate of VBAC. Methods: The bibliographic databases of The Cochrane Library, PubMed, PsychINFO and CINAHL were searched for randomised controlled trials, including cluster randomised trials that evaluated the effectiveness of any intervention targeted directly at clinicians aimed at increasing VBAC rates. Included studies were appraised independently by two reviewers. Data were extracted independently by three reviewers. The quality of the included studies was assessed using the quality assessment tool, 'Effective Public Health Practice Project'. The primary outcome measure was VBAC rates. Results: 238 citations were screened, 255 were excluded by title and abstract. 11 full-text papers were reviewed; eight were excluded, resulting in three included papers. One study evaluated the effectiveness of antepartum x-ray pelvimetry (XRP) in 306 women with one previous CS. One study evaluated the effects of external peer review on CS birth in 45 hospitals, and the third evaluated opinion leader education and audit and feedback in 16 hospitals. The use of external peer review, audit and feedback had no significant effect on VBAC rates. An educational strategy delivered by an opinion leader significantly increased VBAC rates. The use of XRP significantly increased CS rates. Conclusions: This systematic review indicates that few studies have evaluated the effects of clinician-centred interventions on VBAC rates, and interventions are of varying types which limited the ability to meta-analyse data. A further limitation is that the included studies were performed during the late 1980s-1990s. An opinion leader educational strategy confers benefit for increasing VBAC rates. This strategy should be further studied in different maternity care settings and with professionals other than physicians only. © Lundgren et al. AU - Lundgren, I. AU - Smith, V. AU - Nilsson, C. AU - Vehvilainen-Julkunen, K. AU - Nicoletti, J. AU - Devane, D. AU - Bernloehr, A. AU - van Limbeek, E. AU - Lalor, J. AU - Begley, C. DA - 2015-1-1 IS - 1 KW - Databases, Bibliographic Cesarean Section Vaginal Birth after Cesarean Randomized Controlled Trials as Topic Pregnancy Patient Education as Topic Obstetrics Midwifery Humans Female Decision Making Cesarean Section, Repeat Adult repeat cesarean section psychology procedures patient education midwife education X ray pelvimetry vaginal delivery systematic review randomized controlled trial (topic) quality control public health service peer review medical education medical audit human feedback system Article VBAC Interventions Clinicians PY - 2015 ST - Clinician-centred interventions to increase vaginal birth after caesarean section (VBAC): A systematic review T2 - BMC Pregnancy and Childbirth TI - Clinician-centred interventions to increase vaginal birth after caesarean section (VBAC): A systematic review VL - 15 ID - 215 ER - TY - JOUR AB - Objective To conduct a systematic review of the literature regarding assessment and treatment modalities in patients with persistent symptoms following sport-related concussion (SRC). Data sources We searched Medline, Embase, SPORTSDiscus, PsycINFO, CINAHL, Cochrane library and ProQuest Dissertation & Theses Global electronic databases. Study eligibility criteria Studies were included if they were original research, reported on SRC as the primary source of injury, included patients with persistent postconcussive symptoms (>10 days) and investigated the role of assessment or treatment modalities. Results Of 3225 articles identified in the preliminary search, 25 articles met the inclusion criteria. 11 articles were concerned with assessment and 14 articles with treatment of persistent symptoms following SRC. There were three randomised control trials and one quasi-experimental study. The remainder consisting of cross-sectional studies, historical cohorts and case series. Summary â € Persistent symptoms' following SRC can be defined as clinical recovery that falls outside expected time frames (ie, >10-14 days in adults and >4 weeks in children). It does not reflect a single pathophysiological entity, but describes a constellation of non-specific post-traumatic symptoms that may be linked to coexisting and/or confounding pathologies. A detailed multimodal clinical assessment is required to identify specific primary and secondary processes, and treatment should target specific pathologies identified. There is preliminary evidence supporting the use of symptom-limited aerobic exercise, targeted physical therapy and a collaborative approach that includes cognitive behavioural therapy. Management of patients with persistent symptoms is challenging and should occur in a multidisciplinary collaborative setting, with healthcare providers with experience in SRC. © © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. AU - Makdissi, M. AU - Schneider, K. J. AU - Feddermann-Demont, N. AU - Guskiewicz, K. M. AU - Hinds, S. AU - Leddy, J. J. AU - McCrea, M. AU - Turner, M. AU - Johnston, K. M. DA - 2017-1-1 IS - 12 KW - Cross-Sectional Studies Sports Randomized Controlled Trials as Topic Post-Concussion Syndrome Physical Therapy Modalities Humans Exercise Therapy Cognitive Therapy Brain Concussion Athletic Injuries randomized controlled trial (topic) physiotherapy kinesiotherapy human treatment concussion assessment PY - 2017 SN - 0306-3674 SP - 958-968 ST - Approach to investigation and treatment of persistent symptoms following sport-related concussion: A systematic review T2 - British Journal of Sports Medicine TI - Approach to investigation and treatment of persistent symptoms following sport-related concussion: A systematic review VL - 51 ID - 89 ER - TY - JOUR AB - Background Osteoarthritis is a chronic disorder and the most common form of arthritis. The joints most commonly affected are the hip and knee. The progression of osteoarthritis results in the breakdown of tissues and cartilage and the loss of joint function, causing symptoms such as pain, stiffness, reduced physical function, and limited movement. Although there is no cure for osteoarthritis, treatment options are available to manage symptoms and optimize quality of life. Clinical guidelines recommend education, exercise, and weight loss (when necessary) as the first line of treatment. Methods We conducted a health technology assessment, which included an evaluation of the effectiveness, safety, and cost-effectiveness of a structured education and neuromuscular exercise program for the management of hip and/or knee osteoarthritis. We also assessed the budget impact of publicly funding such a program, and we spoke with people with osteoarthritis to gain an understanding of their preferences and values. We performed a systematic review of the clinical and economic literature published between January 1, 2008, and October 4, 2017. We also performed a grey literature search of health technology assessment websites. We assessed the risk of bias of each study, and we assessed the quality of the body of evidence according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Working Group criteria. To evaluate the cost-effectiveness of a structured education and neuromuscular exercise program for adults with knee osteoarthritis, we conducted a cost–utility analysis from the perspective of the Ontario Ministry of Health and Long-Term Care. We also estimated the budget impact of publicly funding such a program in Ontario over the next 5 years. To contextualize the potential value of this type of program as a treatment option, we spoke with people with hip and/or knee osteoarthritis. Results Ten studies met our inclusion criteria for the clinical evidence review. Compared with usual care, a structured education and neuromuscular exercise program showed statistically significant short-term improvements in pain (GRADE low) and physical function (GRADE moderate), as well as statistically significant long-term improvements in performing activities of daily living (GRADE moderate) and in quality of life (GRADE moderate). The short-term improvements in pain and physical function appeared to be sustained into the medium term. Compared with patient education, a structured education and neuromuscular exercise program showed statistically significant short-term improvements in pain (GRADE low) and physical function (GRADE low) and sustained long-term improvement in physical function. Our primary economic evaluation showed that, compared with usual care, a group-based structured education and neuromuscular exercise program consisting of two educational sessions and 24 exercise sessions for the management of knee osteoarthritis was associated with an incremental cost of $719 (95% confidence interval [CI]: $410–$1,118) and an incremental quality-adjusted survival of 0.03 quality-adjusted life-years (QALYs) (95% CI: −0.006 to 0.06), resulting in an incremental cost-effectiveness ratio (ICER) of $23,967 per QALY gained. The budget impact of publicly funding a group-based structured education and neuromuscular exercise program consisting of two educational sessions and 24 exercise sessions would range from $21.4 million to $91.6 million per year over the next 5 years. The budget impact of publicly funding a program consisting of two educational sessions and 12 exercise sessions would range from $12.4 million to $53.2 million per year over the next 5 years. People with hip and/or knee osteoarthritis with whom we spoke reported on the negative impact of osteoarthritis on their physical functioning and quality of life. Those with experience of a structured education and neuromuscular exercise program reported favourably on the program, stating they felt that participation in the program had strengthened their muscles and reduced the negative impact of their symptoms. The cost of such programs was reported as a barrier to access. © Queen’s Printer for Ontario, 2018. AD - 130 Bloor Street West, 10th Floor, Toronto, ON M5S 1N5, Canada AU - Manoharan, A. AU - Xie, X. AU - Gajic-Veljanoski, O. AU - Wells, D. AU - Holubowich, C. AU - Stahl, Kara AU - Kolodziej, Paul AU - Soulodre, Claude AU - Laing, Ana AU - McDowell, Sarah AU - Ng, Vivian AU - Mitchell, Andrée AU - Lang, Amy AU - Sikich, Nancy AU - Dhalla, Irfan C2 - 30443280 DB - Scopus IS - 8 KW - Article biomedical technology assessment body weight loss body weight management budget clinical effectiveness confidence interval cost effectiveness analysis cost utility analysis daily life activity economic evaluation funding health care access health care cost health care quality health program hip osteoarthritis hip pain human knee osteoarthritis knee pain muscle exercise neuromuscular exercise program neuromuscular system Ontario pain patient education patient safety physical capacity practice guideline quality adjusted life year quality of life risk assessment systematic review arthralgia cost benefit analysis economics kinesiotherapy procedures Activities of Daily Living Cost-Benefit Analysis Exercise Therapy Humans Osteoarthritis, Knee Technology Assessment, Biomedical LA - English M3 - Article PY - 2018 SP - 1-110 ST - Structured education and neuromuscular exercise program for hip and/or knee osteoarthritis: A health technology assessment T2 - Ontario Health Technology Assessment Series TI - Structured education and neuromuscular exercise program for hip and/or knee osteoarthritis: A health technology assessment VL - 18 ID - 388 ER - TY - JOUR AB - Background: The objective of this systematic review and meta-analysis was to determine the effect of REBOA, compared to resuscitative thoracotomy, on mortality and among non-compressible torso hemorrhage trauma patients. Methods: Relevant articles were identified by a literature search in MEDLINE and EMBASE. We included studies involving trauma patients suffering non-compressible torso hemorrhage. Studies were eligible if they evaluated REBOA and compared it to resuscitative thoracotomy. Two investigators independently assessed articles for inclusion and exclusion criteria and selected studies for final analysis. We conducted meta-analysis using random effect models. Results: We included three studies in our systematic review. These studies included a total of 1276 patients. An initial analysis found that although lower in REBOA-treated patients, the odds of mortality did not differ between the compared groups (OR 0.42; 95% CI 0.17-1.03). Sensitivity analysis showed that the risk of mortality was significantly lower among patients who underwent REBOA, compared to those who underwent resuscitative thoracotomy (RT) (RR 0.81; 95% CI 0.68-0.97). Conclusion: Our meta-analysis, mainly from observational data, suggests a positive effect of REBOA on mortality among non-compressible torso hemorrhage patients. However, these results deserve further investigation. © 2017 The Author(s). AU - Manzano Nunez, R. AU - Naranjo, M. P. AU - Foianini, E. AU - Ferrada, P. AU - Rincon, E. AU - García-Perdomo, H. A. AU - Burbano, P. AU - Herrera, J. P. AU - García, A. F. AU - Ordoñez, C. A. DA - 2017-1-1 IS - 1 KW - Resuscitation Aorta Thoracotomy Traumatic shock Resuscitation strategies REBOA Non-compressible torso hemorrhage Injuries Endovascular procedures PY - 2017 SN - 1749-7922 ST - A meta-analysis of resuscitative endovascular balloon occlusion of the aorta (REBOA) or open aortic cross-clamping by resuscitative thoracotomy in non-compressible torso hemorrhage patients T2 - World Journal of Emergency Surgery TI - A meta-analysis of resuscitative endovascular balloon occlusion of the aorta (REBOA) or open aortic cross-clamping by resuscitative thoracotomy in non-compressible torso hemorrhage patients VL - 12 ID - 86 ER - TY - JOUR AB - BACKGROUND Serious complications related to groin access have been reported with the use of resuscitative endovascular balloon occlusion of the aorta (REBOA). We performed a systematic review and meta-analysis to estimate the incidence of complications related to groin access from the use of REBOA in adult trauma patients. METHODS We identified articles in MEDLINE and EMBASE. We reviewed all studies that involved adult trauma patients who underwent the placement of a REBOA and included only those that reported the incidence of complications related to groin access. A meta-analysis of proportions was performed. RESULTS We identified 13 studies with a total of 424 patients. REBOA was inserted most commonly by trauma surgeons or emergency room physicians. Information regarding puncture technique was reported in 12 studies and was available for a total of 414 patients. Percutaneous access and surgical cutdown were performed in 304 (73.4%) and 110 (26.5%) patients, respectively. Overall, complications related to groin access occurred in 5.6% of patients (n = 24/424). Lower limb amputation was required in 2.1% of patients (9/424), of which three cases (3/424 [0.7%]) were directly related to the vascular puncture from the REBOA insertion. A meta-analysis that used the logit transformation showed a 5% (95% CI 3%-9%) incidence of complications without significant heterogeneity (LR test: χ 2 = 0.73, p = 0.2, Tau-square = 0.2). In a second meta-analysis, we used the Freeman-Tukey double arcsine transformation and found an incidence of complications of 4% (95% CI 2%-7%) with low heterogeneity (I 2 = 16.3%). CONCLUSION We found that the incidence of complications related to groin access was of 4-5% based on a meta-analysis of 13 studies published worldwide. Currently, there are no benchmarks or quality measures as a reference to compare, and thus, further work is required to identify these benchmarks and improve the practice of REBOA in trauma surgery. © 2018 Wolters Kluwer Health, Inc. AD - Clinical Research Center, Fundación Valle Del Lili, Carrera 98 #18-49, Cali, Colombia Department of Surgery, Division of Trauma and Acute Care Surgery, Fundacion Valle Del Lili, Cali, Colombia Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States R Adams Cowley Shock Trauma Center, Baltimore, MD, United States Trauma and Acute Care Surgery Fellowship, Department of Surgery, Universidad Del Valle, Cali, Colombia Orebro University, Orebro, Sweden School of Medicine, ICESI University, Cali, Colombia Department of Trauma Critical Care, Broward General Level i Trauma Center, Fort Lauderdale, FL, United States AU - Manzano-Nunez, R. AU - Orlas, C. P. AU - Herrera-Escobar, J. P. AU - Galvagno, S. AU - Dubose, J. AU - Melendez, J. J. AU - Serna, J. J. AU - Salcedo, A. AU - Peña, C. A. AU - Angamarca, E. AU - Horer, T. AU - Salazar, C. J. AU - Lopez-Castilla, V. AU - Ruiz-Yucuma, J. AU - Rodriguez, F. AU - Parra, M. W. AU - Ordoñez, C. A. C2 - 29787536 DB - Scopus DO - 10.1097/TA.0000000000001978 IS - 3 KW - benchmarking endovascular procedures intraoperative complications REBOA Wounds and injuries artery dissection artery injury artery thrombosis blood vessel injury emergency physician false aneurysm human iatrogenic disease iliac artery incidence inguinal region leg amputation leg ischemia limb ischemia minimally invasive procedure peroperative complication priority journal resuscitative endovascular balloon occlusion of the aorta Review systematic review trauma surgeon vascular puncture adult aged amputation anatomy and histology aorta balloon occlusion complication devices endovascular surgery female hemorrhagic shock injuries injury lower limb male meta analysis middle aged mortality pathology procedures puncture resuscitation statistics and numerical data surgery very elderly Aged, 80 and over Groin Humans Lower Extremity Punctures Shock, Hemorrhagic LA - English M3 - Review PY - 2018 SP - 626-634 ST - A meta-analysis of the incidence of complications associated with groin access after the use of resuscitative endovascular balloon occlusion of the aorta in trauma patients T2 - Journal of Trauma and Acute Care Surgery TI - A meta-analysis of the incidence of complications associated with groin access after the use of resuscitative endovascular balloon occlusion of the aorta in trauma patients VL - 85 ID - 389 ER - TY - JOUR AB - Introduction Substance use disorders are chronic conditions that require a multidimensional treatment approach. Despite ongoing efforts to diversify such treatments, evidence continues to illuminate modest rates of treatment engagement and perceived barriers to treatment. Patient-centred care (PCC) is one approach that may strengthen the responsiveness of treatments for people with problematic substance use. The aim of this scoping review is to explore how the principles of PCC have been implemented and operationalised in healthcare settings for people with problematic substance use. Methods and analysis This scoping review follows the iterative stages of the Arksey and O'Malley framework. Both empirical (from Medline, Embase, PsycINFO, CINAHL and ISI Web of Science) and grey literature references will be considered if they focused on populations with problematic substance use and described or measured PCC or one of its principles in a health-oriented context. Two reviewers will independently screen references in two successive stages of title/abstract screening and then full-text screening for references meeting title/abstract criteria. A descriptive overview, tabular and/or graphical summaries, and a directed content analysis will be carried out on extracted data. This scoping review has been registered with Open Science Framework (https://osf.io/5swvd/). Ethics and dissemination This review will systematically examine the extent and nature of existing evidence of PCC in addiction research and clinical practice. Such evidence will contribute to the operationalisation of PCC for people with problematic substance use. A multidisciplinary team has been gathered to represent the needs of people with problematic substance use, healthcare providers and decision-makers. The team's knowledge users will be engaged throughout this review and will participate in dissemination activities (eg, workshops, presentations, publications, reports). © 2018 BMJ Publishing Group Limited. No commercial re-use. See rights and permissions. Published by BMJ. AD - School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada Centre for Health Evaluation and Outcome Sciences, Providence Health Care, St. Paul's Hospital, Vancouver, BC, Canada Canadian Association for People Who Use Drugs, Vancouver, BC, Canada Providence Crosstown Clinic, Providence Health Care, Vancouver, BC, Canada Northern Ontario School of Medicine, Sudbury, ON, Canada AU - Marchand, K. AU - Beaumont, S. AU - Westfall, J. AU - MacDonald, S. AU - Harrison, S. AU - Marsh, D. C. AU - Schechter, M. T. AU - Oviedo-Joekes, E. C2 - 30593556 C7 - e024588 DB - Scopus DO - 10.1136/bmjopen-2018-024588 IS - 12 KW - addiction treatment client-centered care patient-centered care person-centered care problematic substance use substance-related disorders addiction clinical practice health care personnel human knowledge multidisciplinary team patient care population Review substance use treatment outcome attitude to health decision making drug dependence interdisciplinary communication literature methodology Health Knowledge, Attitudes, Practice Humans Research Design Review Literature as Topic LA - English M3 - Review PY - 2018 ST - Patient-centred care for addiction treatment: A scoping review protocol T2 - BMJ Open TI - Patient-centred care for addiction treatment: A scoping review protocol VL - 8 ID - 390 ER - TY - JOUR AB - Objectives The objective of this study was to analyze the features of registry-based randomized trials (rRCTs). Study Design and Setting We systematically searched PubMed for rRCTs. Study selection was performed independently by two reviewers. We extracted all data in standardized tables and prepared descriptive summary statistics. Results The search resulted in 1,202 hits. We included 71 rRCTs. Most rRCTs were from Denmark and Sweden. Chronic conditions were considered in 82.2%. A preventive intervention was examined in 45.1%. The median of included patients was 2,000 (range: 69–246,079). Definition of the study population was mostly broad. Study procedures were regularly little standardized. The number of included and analyzed patients was the same in 82.1%. In half of the rRCTs, more than one registry was utilized. Various linkage techniques were used. In median, two outcomes were collected from the registry/ies. The median follow-up of the rRCTs was 5.3 years (range: 6 weeks to 27 years). Information on quality of registry data was reported in 11.3%. Conclusion rRCTs can provide valid (randomization, low lost-to-follow-up rates, generalizable) patient important long-term comparative-effectiveness data for relative little effort. Researchers planning an RCT should always check whether existing registries can be used for data collection. Reporting on data quality must be improved for use in evidence synthesis. © 2017 Elsevier Inc. AD - Institute for Research in Operative Medicine, Chair of Surgical Research, Faculty of Health, School of Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, Cologne, 51109, Germany AU - Mathes, T. AU - Buehn, S. AU - Prengel, P. AU - Pieper, D. C2 - 28951111 DB - Scopus DO - 10.1016/j.jclinepi.2017.09.017 KW - External validity Health registries Internal validity Patient registries Pragmatic trials Randomized controlled trials Registry-based randomized trials Study design abdominal aortic aneurysm Alzheimer disease Article asthma cancer prevention cancer screening chronic disease Crohn disease cystic fibrosis diabetes mellitus dietary supplement follow up heart disease human immunization infection kidney disease low back pain malignant neoplasm observational study osteoporosis outcome assessment pharmaceutical care primary prevention priority journal randomization randomized controlled trial (topic) register rheumatoid arthritis risk factor surgical technique systematic review total quality management Denmark methodology sample size Sweden Humans Observational Studies as Topic Pragmatic Clinical Trials as Topic Randomized Controlled Trials as Topic Registries Research Design LA - English M3 - Article PY - 2018 SP - 120-127 ST - Registry-based randomized controlled trials merged the strength of randomized controlled trails and observational studies and give rise to more pragmatic trials T2 - Journal of Clinical Epidemiology TI - Registry-based randomized controlled trials merged the strength of randomized controlled trails and observational studies and give rise to more pragmatic trials VL - 93 ID - 391 ER - TY - JOUR AB - Background: Because of the enormous social and economic burden of disease, the prevention of mild cognitive impairment and Alzheimer's-type dementia has become a major global public health priority. Studies show that cognitively stimulating activities during middle adulthood might have a protective effect on the brain by boosting the cognitive reserve. The aim of this review is to identify evidence investigating the effects of continuing education for the prevention of mild cognitive impairment and Alzheimer's-type dementia in late life. Methods: Our approach employs a two-stage design: First, we will conduct a systematic review to assess the preventive effects of continuing education on mild cognitive impairment and Alzheimer's-type dementia. Second, because we expect to find few studies, we will perform a review of systematic reviews on leisure activities that mimic formal continuing education to determine their effects on the prevention of mild cognitive impairment and Alzheimer's-type dementia. We will search electronic databases (e.g., MEDLINE, PsycINFO, EMBASE, CENTRAL, CINAHL, and Scopus) for published studies and gray literature databases (e.g., trial registries) for unpublished studies. Two authors will independently screen abstracts and full-texts using pre-defined eligibility criteria, select studies, extract data, and assess the quality of included studies or reviews. Outcomes of interest include the incidence of mild cognitive impairment or Alzheimer's-type dementia, quality of life, functional capacity, and psychological wellbeing. Intermediate outcomes are cognitive (test) performance, cognitive functioning, and social inclusion. The review team is a multidisciplinary group consisting of methodological experts and dementia, geriatrics, and continuing education researchers. Discussion: We anticipate that our review will highlight serious gaps in the current evidence. Results will build the basis for further research regarding the relation of continuing education and cognitive decline and dementia. Systematic review registration: PROSPERO CRD42017063944 © 2017 The Author(s). AU - Matyas, N. AU - Auer, S. AU - Gisinger, C. AU - Kil, M. AU - Keser Aschenberger, F. AU - Klerings, I. AU - Gartlehner, G. DA - 2017-1-1 IS - 1 KW - Cognition Leisure Activities Humans Education, Continuing Cognitive Dysfunction Alzheimer Disease psychology procedures leisure continuing education cognitive defect systematic review quality of life public health psychological well-being prophylaxis priority journal outcome assessment Mini Mental State Examination mild cognitive impairment human functional status cognitive function test Article Prevention Dementia Alzheimer PY - 2017 SN - 2046-4053 ST - Continuing education for the prevention of mild cognitive impairment and Alzheimer's-type dementia: A systematic review protocol T2 - Systematic Reviews TI - Continuing education for the prevention of mild cognitive impairment and Alzheimer's-type dementia: A systematic review protocol VL - 6 ID - 84 ER - TY - JOUR AB - Background: People with chronic diseases experience barriers to managing their diseases and accessing available health services. Patient navigator programs are increasingly being used to help people with chronic diseases navigate and access health services. Objective: The objective of this review was to summarize the evidence for patient navigator programs in people with a broad range of chronic diseases, compared to usual care. Methods: We searched MEDLINE, EMBASE, CENTRAL, CINAHL, PsycINFO, and Social Work Abstracts from inception to August 23, 2017. We also searched the reference lists of included articles. We included original reports of randomized controlled trials of patient navigator programs compared to usual care for adult and pediatric patients with any one of a defined set of chronic diseases. Results: From a total of 14,672 abstracts, 67 unique studies fit our inclusion criteria. Of these, 44 were in cancer, 8 in diabetes, 7 in HIV/AIDS, 4 in cardiovascular disease, 2 in chronic kidney disease, 1 in dementia and 1 in patients with more than one condition. Program characteristics varied considerably. Primary outcomes were most commonly process measures, and 45 of 67 studies reported a statistically significant improvement in the primary outcome. Conclusion: Our findings indicate that patient navigator programs improve processes of care, although few studies assessed patient experience, clinical outcomes or costs. The inability to definitively outline successful components remains a key uncertainty in the use of patient navigator programs across chronic diseases. Given the increasing popularity of patient navigators, future studies should use a consistent definition for patient navigation and determine which elements of this intervention are most likely to lead to improved outcomes. © 2018 McBrien et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. AU - McBrien, K. A. AU - Ivers, N. AU - Barnieh, L. AU - Bailey, J. J. AU - Lorenzetti, D. L. AU - Nicholas, D. AU - Tonelli, M. AU - Hemmelgarn, B. AU - Lewanczuk, R. AU - Edwards, A. AU - Braun, T. AU - Manns, B. C7 - e0191980 DB - Scopus DO - 10.1371/journal.pone.0191980 IS - 2 M3 - Review PY - 2018 ST - Patient navigators for people with chronic disease: A systematic review T2 - PLoS ONE TI - Patient navigators for people with chronic disease: A systematic review VL - 13 ID - 327 ER - TY - JOUR AB - Background and Purpose: The aim of this study is to provide a systematic overview of the past decade of literature on processes of triage for patients with spinal pain, outcomes measured and markers of effectiveness. Methods: A systematic search of the literature with narrative synthesis of findings was conducted. Studies in English language of any design concerning spinal triage programmes for adults with acute or chronic spinal complaints were considered for inclusion. Electronic database searches were conducted in OVID, Medline, Embase, CINAHL, Health Source Nursing, Scopus and Web of Science. Additional references were sourced through pearling reference lists, and expert input. Findings were synthesized descriptively. Results: Of 216 potentially relevant records, 21 papers (20 studies) were included. There was little commonality in triage activities/programmes and outcomes, although physiotherapists were common members of triage programmes. Positive outcomes were reported most commonly for wait times, with several studies also reporting high levels of patient and physician satisfaction. Outcomes such as surgical conversion rates and selection accuracy were less clear. Discussion: Spinal triage programmes have the potential to improve efficiency of care for outpatients with spinal complaints. The evidence gaps in health outcomes, service models and cost effectiveness should be addressed by more robust prospective research designs. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd. AU - McEvoy, C. AU - Wiles, L. AU - Bernhardsson, S. AU - Grimmer, K. DA - 2017-1-1 IS - 1 KW - Triage Professional Role Physical Therapists Patient Compliance Musculoskeletal Pain Low Back Pain Humans Evidence-Based Practice Ambulatory Care Facilities statistics and numerical data professional standard physiotherapist outpatient department human evidence based practice emergency health service spinal critical pathways PY - 2017 SN - 1358-2267 ST - Triage for Patients with Spinal Complaints: A Systematic Review of the Literature T2 - Physiotherapy Research International TI - Triage for Patients with Spinal Complaints: A Systematic Review of the Literature VL - 22 ID - 163 ER - TY - JOUR AB - The purpose of this study was to identify the patient populations at risk of medication-related osteonecrosis of the jaw (MRONJ) and determine which medical and dental comorbidities are significant risk factors for this disease. An electronic search of Embase, MEDLINE, Cochrane Central Register of Controlled Trials, WHO International Clinical Trials Registry Platform and ProQuest Dissertations and Theses Global was conducted to identify all human studies that reported risk factors for MRONJ. Only a qualitative analysis was performed due to significant heterogeneity in the collected data. The search strategy identified 2872 records, of which 219 studies were eligible for inclusion. A total of 4106 patients with MRONJ were identified, 39 different systemic diseases were implicated, and 14 medical and 11 dental risk factors were reported, although no statistical analysis of the significance of each of these factors was possible. The clinical reach of MRONJ may be wider than anticipated, and more data on the significance of each potential risk factor are needed to guide the identification and management of at-risk patients. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd AU - McGowan, K. AU - McGowan, T. AU - Ivanovski, S. DA - 2018-1-1 IS - 4 KW - Risk Factors Osteonecrosis Humanism Humanities Humans tooth extraction tobacco use systemic disease systematic review stem cell transplantation smoking Sjoegren syndrome sickle cell anemia sarcoidosis risk factor rheumatoid arthritis Review priority journal periodontal disease kidney transplantation kidney failure jaw osteonecrosis inflammatory bowel disease hypertension hyperlipidemia human gastroesophageal reflux gastritis diabetes mellitus Crohn disease corticosteroid therapy comorbidity cancer radiotherapy cancer immunotherapy cancer hormone therapy cancer chemotherapy bone marrow transplantation angina pectoris anemia alcohol consumption monoclonal antibody immunologic agent hormone DNA topoisomerase inhibitor corticosteroid antineoplastic antimetabolite antineoplastic antibiotic antimitotic agent alkylating agent preventative dentistry osteoporosis molecular targeted therapy cancer bone density conservation agents anti-neoplastic agents PY - 2018 SN - 1354-523X SP - 527-536 ST - Risk factors for medication-related osteonecrosis of the jaws: A systematic review T2 - Oral Diseases TI - Risk factors for medication-related osteonecrosis of the jaws: A systematic review VL - 24 ID - 51 ER - TY - JOUR AB - Background: This study is to perform a systematic review of existing guidance on quality of reporting and methodology for systematic reviews of diagnostic test accuracy (DTA) in order to compile a list of potential items that might be included in a reporting guideline for such reviews: Preferred Reporting Items for Systematic Reviews and Meta-Analyses of Diagnostic Test Accuracy (PRISMA-DTA). Methods: Study protocol published on EQUATOR website. Articles in full text or abstract form that reported on any aspect of reporting systematic reviews of diagnostic test accuracy were eligible for inclusion. We used the Ovid platform to search Ovid MEDLINE®, Ovid MEDLINE® In-Process & Other Non-Indexed Citations and Embase Classic+Embase through May 5, 2016. The Cochrane Methodology Register in the Cochrane Library (Wiley version) was also searched. Title and abstract screening followed by full-text screening of all search results was performed independently by two investigators. Guideline organization websites, published guidance statements, and the Cochrane Handbook for Diagnostic Test Accuracy were also searched. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Standards for Reporting Diagnostic Accuracy (STARD) were assessed independently by two investigators for relevant items. Results: The literature searched yielded 6967 results; 386 were included after title and abstract screening and 203 after full-text screening. After reviewing the existing literature and guidance documents, a preliminary list of 64 items was compiled into the following categories: title (three items); introduction (two items); methods (35 items); results (13 items); discussion (nine items), and disclosure (two items). Conclusion: Items on the methods and reporting of DTA systematic reviews in the present systematic review will provide a basis for generating a PRISMA extension for DTA systematic reviews. © 2017 The Author(s). AU - McGrath, T. A. AU - Alabousi, M. AU - Skidmore, B. AU - Korevaar, D. A. AU - Bossuyt, P. M. M. AU - Moher, D. AU - Thombs, B. AU - McInnes, M. D. F. DA - 2017-1-1 IS - 1 KW - Mass Screening systematic review quality control priority journal patient safety meta analysis medical society medical research information processing diagnostic accuracy data extraction bibliographic database Article PY - 2017 SN - 2046-4053 ST - Recommendations for reporting of systematic reviews and meta-analyses of diagnostic test accuracy: A systematic review T2 - Systematic Reviews TI - Recommendations for reporting of systematic reviews and meta-analyses of diagnostic test accuracy: A systematic review VL - 6 ID - 78 ER - TY - JOUR AB - The Acute Respiratory Distress Syndrome (ARDS) is a devastating clinical condition that is associated with a 30-40% risk of death, and significant long term morbidity for those who survive. Mesenchymal stromal cells (MSC) have emerged as a potential novel treatment as in pre-clinical models they have been shown to modulate inflammation (a major pathophysiological hallmark of ARDS) while enhancing bacterial clearance and reducing organ injury and death. A systematic search of MEDLINE, EMBASE, BIOSIS and Web of Science was performed to identify pre-clinical studies that examined the efficacy MSCs as compared to diseased controls for the treatment of Acute Lung Injury (ALI) (the pre-clinical correlate of human ARDS) on mortality, a clinically relevant outcome. We assessed study quality and pooled results using random effect meta-analysis. A total of 54 publications met our inclusion criteria of which 17 (21 experiments) reported mortality and were included in the metaanalysis. Treatment with MSCs, as compared to controls, significantly decreased the overall odds of death in animals with ALI (Odds Ratio 0.24, 95% Confidence Interval 0.18-0.34, I2 8%). Efficacy was maintained across different types of animal models and means of ALI induction; MSC origin, source, route of administration and preparation; and the clinical relevance of the model (timing of MSC administration, administration of fluids and or antibiotics). Reporting of standard MSC characterization for experiments that used human MSCs and risks of bias was generally poor, and although not statistically significant, a funnel plot analysis for overall mortality suggested the presence of publication bias. The results from our meta-analysis support that MSCs substantially reduce the odds of death in animal models of ALI but important reporting elements were sub optimal and limit the strength of our conclusions. © 2016 McIntyre et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. AU - McIntyre, L. A. AU - Moher, D. AU - Fergusson, D. A. AU - Sullivan, K. J. AU - Mei, S. H. J. AU - Lalu, M. AU - Marshall, J. AU - McLeod, M. AU - Griffin, G. AU - Grimshaw, J. AU - Turgeon, A. AU - Avey, M. T. AU - Rudnicki, M. A. AU - Jazi, M. AU - Fishman, J. AU - Stewart, D. J. DA - 2016-1-1 IS - 1 KW - Lung Injury Stromal Cells Mesoderm Lung Humanism Humanities Animal Shells Treatment Outcome Respiratory Distress Syndrome, Adult Mesenchymal Stromal Cells Mesenchymal Stem Cell Transplantation Humans Disease Models, Animal Animals Acute Lung Injury physiology mesenchymal stroma cell disease model animal United States umbilical cord systematic review severe combined immunodeficiency reperfusion injury rat rabbit osteoblast North America nonhuman New Zealand mouse mortality meta analysis male major clinical study Italy isograft human fluid therapy female Europe controlled study clinical effectiveness cell therapy cell lineage cell differentiation cartilage cell Canada Brazil bone marrow cell autologous stem cell transplantation Australia Asia Article animal model animal experiment animal cell allogeneic stem cell transplantation adult respiratory distress syndrome adipose tissue cell adipocyte antibiotic agent PY - 2016 ST - Efficacy of mesenchymal stromal cell therapy for acute lung injury in preclinical animal models: A systematic review T2 - PLoS ONE TI - Efficacy of mesenchymal stromal cell therapy for acute lung injury in preclinical animal models: A systematic review VL - 11 ID - 193 ER - TY - JOUR AB - Background: The majority of a child's language development occurs in the first 5 years of life when brain development is most rapid. There are significant long-term benefits to supporting all children's language and literacy development such as maximizing their developmental potential (i.e., cognitive, linguistic, social-emotional), when children are experiencing a critical period of development (i.e., early childhood to 9 years of age). A variety of people play a significant role in supporting children's language development, including parents, guardians, family members, educators, and/or speech-language pathologists. Speech-language pathologists and educators are the professionals who predominantly support children's language development in order for them to become effective communicators and lay the foundation for later developing literacy skills (i.e., reading and writing skills). Therefore, these professionals need formal and informal assessments that provide them information on a child's understanding and/or use of the increasingly complex aspects of language in order to identify and support the receptive and expressive language learning needs of diverse children during their early learning experiences (i.e., aged 1.5 to 9 years). However, evidence on what methods and tools are being used is lacking. Methods: The authors will carry out a scoping review of the literature to identify studies and map the receptive and expressive English language assessment methods and tools that have been published and used since 1980. Arksey and O'Malley's (2005) six-stage approach to conducting a scoping review was drawn upon to design the protocol for this investigation: (1) identifying the research question; (2) identifying relevant studies; (3) study selection; (4) charting the data; (5) collating, summarizing, and reporting the results; and (6) consultation. Discussion: This information will help these professionals identify and select appropriate assessment methods or tools that can be used to support development and/or identify areas of delay or difficulty and plan, implement, and monitor the progress of interventions supporting the development of receptive and expressive language skills in individuals with diverse language needs (e.g., typically developing children, children with language delays and disorders, children learning English as a second or additional language, Indigenous children who may be speaking dialects of English). Researchers plan to evaluate the effectiveness of the assessment methods or tools identified in the scoping review as an extension of this study. © 2017 The Author(s). AU - McIntyre, L. J. AU - Hellsten, L. A. M. AU - Bidonde, J. AU - Boden, C. AU - Doi, C. C7 - 70 DB - Scopus DO - 10.1186/s13643-017-0471-1 IS - 1 M3 - Article PY - 2017 ST - Receptive and expressive English language assessments used for young children: A scoping review protocol T2 - Systematic Reviews TI - Receptive and expressive English language assessments used for young children: A scoping review protocol VL - 6 ID - 345 ER - TY - JOUR AB - Background Frailty is an important prognostic factor for adverse outcomes and increased resource use in the growing population of older surgical patients. We identified and appraised studies that tested interventions in populations of frail surgical patients to improve perioperative outcomes. Methods We systematically searched Cochrane, CINAHL, EMBASE and Medline to identify studies that tested interventions in populations of frail patients having surgery. All phases of study selection, data extraction, and risk of bias assessment were done in duplicate. Results were synthesized qualitatively per a prespecified protocol (CRD42016039909). Results We identified 2 593 titles; 11 were included for final analysis, representing 1 668 participants in orthopedic, general, cardiac, and mixed surgical populations. Only one study was multicenter and risk of bias was moderate to high in all studies. Interventions were applied pre- and postoperatively, and included exercise therapy (n = 4), multicomponent geriatric care protocols (n = 5), and blood transfusion triggers (n = 1); no specific surgical techniques were compared. Exercise therapy, applied pre-, or post-operatively, was associated with significant improvements in functional outcomes and improved quality of life. Multicomponent protocols suffered from poor compliance and difficulties in implementation. Transfusion triggers had no significant impact on mortality or other outcomes. Conclusions Despite a growing literature that demonstrates strong independent associations between frailty and adverse outcomes, few interventions have been tested to improve the outcomes of frail surgical patients, and most available studies are at substantial risk of bias. Multicen-ter, low risk of bias, studies of perioperative exercise are needed, while substantial efforts are required to develop and test other interventions to improve the outcomes of frail people having surgery. © 2017 McIsaac et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. AU - McIsaac, D. I. AU - Jen, T. AU - Mookerji, N. AU - Patel, A. AU - Lalu, M. M. DA - 2017-1-1 IS - 12 KW - Bias (Epidemiology) Treatment Outcome Surgical Procedures, Operative Quality of Life Male Humans Frail Elderly Female Exercise Therapy Blood Transfusion Aged, 80 and over Aged very elderly surgery standards surgical patient Review preoperative period postoperative period perioperative period outcome assessment orthopedic surgery mortality kinesiotherapy human hip fracture heart surgery geriatric care geriatric assessment general surgery functional assessment fracture treatment elective surgery colorectal surgery clinical protocol PY - 2017 ST - Interventions to improve the outcomes of frail people having surgery: A systematic review T2 - PLoS ONE TI - Interventions to improve the outcomes of frail people having surgery: A systematic review VL - 12 ID - 69 ER - TY - JOUR AB - Objective: The US Agency for Healthcare Research and Quality funded an evidence report to address seven questions on multiple aspects of the effectiveness of medication management information technology (MMIT) and its components (prescribing, order communication, dispensing, administering, and monitoring). Materials and Methods: Medline and 11 other databases without language or date limitations to mid-2010. Randomized controlled trials (RCTs) assessing integrated MMIT were selected by two independent reviewers. Reviewers assessed study quality and extracted data. Senior staff checked accuracy. Results: Most of the 87 RCTs focused on clinical decision support and computerized provider order entry systems, were performed in hospitals and clinics, included primarily physicians and sometimes nurses but not other health professionals, and studied process changes related to prescribing and monitoring medication. Processes of care improved for prescribing and monitoring mostly in hospital settings, but the few studies measuring clinical outcomes showed small or no improvements. Studies were performed most frequently in the USA (n=63), Europe (n=16), and Canada (n=6). Discussion: Many studies had limited description of systems, installations, institutions, and targets of the intervention. Problems with methods and analyses were also found. Few studies addressed order communication, dispensing, or administering, non-physician prescribers or pharmacists and their MMIT tools, or patients and caregivers. Other study methods are also needed to completely understand the effects of MMIT. Conclusions: Almost half of MMIT interventions improved the process of care, but few studies measured clinical outcomes. This large body of literature, although instructive, is not uniformly distributed across settings, people, medication phases, or outcomes. AU - McKibbon, K. A. AU - Lokker, C. AU - Handler, S. M. AU - Dolovich, L. R. AU - Holbrook, A. M. AU - O'Reilly, D. AU - Tamblyn, R. AU - Hemens, B. J. AU - Basu, R. AU - Troyan, S. AU - Roshanov, P. S. DA - 2012-1-1 IS - 1 KW - Systems Integration Randomized Controlled Trials as Topic Outcome and Process Assessment (Health Care) Medication Therapy Management Medical Order Entry Systems Medical Informatics Humans Decision Support Systems, Clinical United States treatment outcome systematic review review prescription physician patient monitoring nurse medical information system information technology human health education health care management drug monitoring LA - English PY - 2012 SP - 22-30 ST - The effectiveness of integrated health information technologies across the phases of medication management: A systematic review of randomized controlled trials T2 - Journal of the American Medical Informatics Association TI - The effectiveness of integrated health information technologies across the phases of medication management: A systematic review of randomized controlled trials VL - 19 ID - 3 ER - TY - JOUR AB - Background Major depressive disorder and generalized anxiety disorder are among the most commonly diagnosed mental illnesses in Canada; both are associated with a high societal and economic burden. Treatment for major depressive disorder and generalized anxiety disorder consists of pharmacological and psychological interventions. Three commonly used psychological interventions are cognitive behavioural therapy (CBT), interpersonal therapy, and supportive therapy. The objectives of this report were to assess the effectiveness and safety of these types of therapy for the treatment of adults with major depressive disorder and/or generalized anxiety disorder, to assess the cost-effectiveness of structured psychotherapy (CBT or interpersonal therapy), to calculate the budget impact of publicly funding structured psychotherapy, and to gain a greater understanding of the experiences of people with major depressive disorder and/or generalized anxiety disorder. Methods We performed a literature search on October 27, 2016, for systematic reviews that compared CBT, interpersonal therapy, or supportive therapy with usual care, waitlist control, or pharmacotherapy in adult outpatients with major depressive disorder and/or generalized anxiety disorder. We developed an individual-level state-transition probabilistic model for a cohort of adult outpatients aged 18 to 75 years with a primary diagnosis of major depressive disorder to determine the cost-effectiveness of individual or group CBT (as a representative form of structured psychotherapy) versus usual care. We also estimated the 5-year budget impact of publicly funding structured psychotherapy in Ontario. Finally, we interviewed people with major depressive disorder and/or generalized anxiety disorder to better understand the impact of their condition on their daily lives and their experience with different treatment options, including psychotherapy. Results Interpersonal therapy compared with usual care reduced posttreatment major depressive disorder scores (standardized mean difference [SMD]: 0.24, 95% confidence interval [CI]: -0.47 to -0.02) and reduced relapse/recurrence in patients with major depressive disorder (relative risk [RR]: 0.41, 95% CI: 0.27-0.63). Supportive therapy compared with usual care improved major depressive disorder scores (SMD: 0.58, 95% CI: 0.45-0.72) and increased posttreatment recovery (odds ratio [OR]: 2.71, 95% CI: 1.19-6.16) in patients with major depressive disorder. CBT compared with usual care increased response (OR: 1.58, 95% CI: 1.11-2.26) and recovery (OR: 3.42, 95% CI: 1.98-5.93) in patients with major depressive disorder and decreased relapse/recurrence (RR: 0.68, 95% CI: 0.65-0.87]). For patients with generalized anxiety disorder, CBT improved symptoms posttreatment (SMD: 0.80, 95% CI: 0.67-0.93), improved clinical response posttreatment (RR: 0.64, 95% CI: 0.55-0.74), and improved quality-of-life scores (SMD: 0.44, 95% CI: 0.06-0.82). There was a significant difference in posttreatment recovery (OR: 1.98, 95% CI: 1.11-3.54) and mean major depressive disorder symptom scores (weighted mean difference: -3.07, 95% CI: -4.69 to -1.45) for patients who received individual versus group CBT. Details about the providers of psychotherapy were rarely reported in the systematic reviews we examined. In the base case probabilistic cost-utility analysis, compared with usual care, both group and individual CBT were associated with increased survival: 0.11 quality-adjusted life-years (QALYs) (95% credible interval [CrI]: 0.03-0.22) and 0.12 QALYs (95% CrI: 0.03-0.25), respectively. Group CBT provided by nonphysicians was associated with the smallest increase in discounted costs: $401 (95% CrI: -1,177 to 1,665). Group CBT provided by physicians, individual CBT provided by nonphysicians, and individual CBT provided by physicians were associated with the incremental costs of $1,805 (95% CrI: 65-3,516), $3,168 (95% CrI: 889-5,624), and $5,311 (95% CrI: 2,539-8,938), respectively. The corresponding incremental cost-effectiveness ratio (ICER) was lowest fo grou CBT provided by nonphysicians ($3,715/QALY gained) and highest for individual CBT provided by physicians ($43,443/QALY gained). In the analysis that ranked best strategies, individual CBT versus group CBT provided by nonphysicians yielded an ICER of $192,618 per QALY. The probability of group CBT provided by nonphysicians being cost-effective versus usual care was greater than 95% for all willingness-to-pay thresholds over $20,000 per QALY and was around 88% for individual CBT provided by physicians at a threshold of $100,000 per QALY. We estimated that adding structured psychotherapy to usual care over the next 5 years would result in a net budget impact of $68 million to $529 million, depending on a range of factors. We also estimated that to provide structured psychotherapy to all adults with major depressive disorder (alone or combined with generalized anxiety disorder) in Ontario by 2021, an estimated 500 therapists would be needed to provide group therapy, and 2,934 therapists would be needed to provide individual therapy. People with major depressive disorder and/or generalized anxiety disorder with whom we spoke reported finding psychotherapy effective, but they also reported experiencing a large number of barriers that prevented them from finding effective psychotherapy in a timely manner. Participants reported wanting more freedom to choose the type of psychotherapy they received. Conclusions Compared with usual care, treatment with CBT, interpersonal therapy, or supportive therapy significantly reduces depression symptoms posttreatment. CBT significantly reduces anxiety symptoms posttreatment in patients with generalized anxiety disorder. Compared with usual care, treatment with structured psychotherapy (CBT or interpersonal therapy) represents good value for money for adults with major depressive disorder and/or generalized anxiety disorder. The most affordable option is group structured psychotherapy provided by nonphysicians, with the selective use of individual structured psychotherapy provided by nonphysicians or physicians for those who would benefit most from it (i.e., patients who are not engaging well with or adhering to group therapy). AU - McMartin, Kristen AU - GajicVeljanoski, Olga AU - Wells, David AU - Higgins, Caroline AU - Walter, Melissa AU - Stahl, Kara AU - Heft, Harrison AU - Soulodre, Claude AU - Laing, Ana AU - Kaulback, Kellee AU - Mitchell, Andrée AU - Thota, Anil AU - Ng, Vivian AU - Sikich, Nancy AU - Dhalla, Irfan DA - 2017-1-1 IS - 15 KW - Cost-Benefit Analysis Odds Ratio Anxiety Technology Assessment, Biomedical Probability Quality-Adjusted Life Years Mentally Ill Persons Canada Depressive Disorder Anxiety Disorders Depressive Disorder, Major Psychotherapy treatment response systematic review (topic) systematic review survival supportive therapy scoring system relapse recurrent disease quality of life physician personalized medicine personal experience paramedical personnel outpatient Ontario major depression interview interpersonal therapy human health care cost group therapy funding evidence based medicine daily life activity cost utility analysis cost effectiveness analysis comparative study cognitive behavioral therapy budget biomedical technology assessment Article anxiety disorder anxiolytic agent antidepressant agent PY - 2017 SN - 1915-7398 SP - 1-167 ST - Psychotherapy for major depressive disorder and generalized anxiety disorder: A health technology assessment T2 - Ontario Health Technology Assessment Series TI - Psychotherapy for major depressive disorder and generalized anxiety disorder: A health technology assessment VL - 17 ID - 77 ER - TY - JOUR AB - BACKGROUND: Vitamin D deficiency may represent a modifiable risk factor to improve outcome in severe illness. The efficacy of high-dose regimens in rapid normalization of vitamin D levels is uncertain. METHODS: We conducted a systematic review of pediatric clinical trials administering high-dose vitamin D to evaluate 25-hydroxyvitamin D (25[OH]D) response and characteristics associated with final 25(OH)D levels by using Medline, Embase, and the Cochrane Central Register of Controlled Trials, including reference lists of systematic reviews and eligible publications. Uncontrolled and controlled trials reporting 25(OH)D levels after high-dose (≥1000 IU) ergocalciferol or cholecalciferol were selected. Two reviewers independently extracted and verified predefined data fields. RESULTS: We identified 88 eligible full-text articles. Two of 6 studies that administered daily doses approximating the Institute of Medicine's Tolerable Upper Intake Level (1000-4000 IU) to vitamin D-deficient populations achieved group 25(OH)D levels >75 nmol/L within 1 month. Nine of 10 studies evaluating loading therapy (>50 000 IU) achieved group 25(OH)D levels >75 nmol/L. In meta-regression, baseline 25(OH)D, regimen type, dose, age, and time factors were associated with final 25(OH)D levels. Adverse event analysis identified increased hypercalcemia risk with doses >400 000 IU, but no increased hypercalcemia or hypercalciuria with loading doses <400 000 IU (or 10 000 IU/kg). Few studies in adolescents evaluated loading dose regimens >300 000 IU. CONCLUSIONS: Rapid normalization of vitamin D levels is best achieved by using loading therapy that considers disease status, baseline 25(OH)D, and age (or weight). Loading doses >300 000 IU should be avoided until trials are conducted to better evaluate risk and benefit. Copyright © 2015 by the American Academy of Pediatrics. AU - McNally, J. D. AU - Iliriani, K. AU - Pojsupap, S. AU - Sampson, M. AU - O'Hearn, K. AU - McIntyre, L. AU - Fergusson, D. AU - Menon, K. DA - 2015-1-1 IS - 1 KW - Vitamin E Deficiency Vitamin A Deficiency Vitamin B Deficiency Risk Factors Tocopherols Avitaminosis Arachidonic Acid Biotin Riboflavin Ascorbic Acid Vitamin E Folic Acid Vitamin B Complex Vitamin A Vitamin U Vitamins Vitamin D Deficiency Vitamin D Time Factors Remission Induction Reference Values Infant, Newborn Infant Humans Child, Preschool Child Adolescent time remission reference value preschool child blood analogs and derivatives systematic review single drug dose randomized controlled trial (topic) newborn meta analysis loading drug dose hypercalciuria hypercalcemia human drug response drug megadose drug intermittent therapy controlled clinical trial (topic) Article vitamin 25-hydroxyvitamin D placebo ergocalciferol colecalciferol 25 hydroxyvitamin D PY - 2015 SP - e152-e166 ST - Rapid normalization of vitamin D levels: A meta-analysis T2 - Pediatrics TI - Rapid normalization of vitamin D levels: A meta-analysis VL - 135 ID - 232 ER - TY - JOUR AB - Background: Vitamin D deficiency (VDD) has been hypothesized not only to be common but also to represent a potentially modifiable risk factor for greater illness severity and clinical outcome during critical illness. The objective of this systematic review was to determine the frequency of VDD in pediatric critical illness and its association with clinical outcomes. Methods: MEDLINE, Embase, and CENTRAL were searched through December 12, 2016, with no date or language restrictions. The primary objective was to estimate the prevalence of VDD in the pediatric intensive care unit (PICU) and compare vitamin D status with healthy control populations. Secondary objectives were to evaluate whether VDD is associated with mortality, increased illness severity, PICU interventions, and patient clinical course. Random effects meta-analysis was used to calculate pooled VDD event rate, compare levels with those of control subjects, and evaluate for associations between VDD and clinical outcome. Results: Among 2700 citations, 17 studies meeting study eligibility were identified. The studies reported a total of 2783 critically ill children and had a median sample size of 120 (range 12-511). The majority of studies used a 25-hydroxyvitamin D [25(OH)D] level less than 50 nmol/L to define VDD, and the pooled VDD prevalence was 54.8 (95% CI 45.4-63.9). Average 25(OH)D levels were significantly lower in PICU patients than in healthy control subjects (pooled difference -17.3 nmol/L, 95% CI -14.0 to -20.6). In a meta-analysis calculation, we found that VDD was associated with increased mortality (OR 1.62, 95% CI 1.11-2.36), illness severity, and need for PICU interventions. Conclusions: Approximately 50% of critically ill children have VDD at the time of PICU admission, defined as a blood total 25(OH)D concentration under 50 nmol/L. VDD was further determined to be associated with greater illness severity, multiple organ dysfunction, and mortality in the PICU setting. Clinical trials are required to determine if optimization of vitamin D status improves patient outcome. Trial registration: PROSPERO, CRD42016026617. Registered on 11 January 2016. © 2017 The Author(s). AU - McNally, J. D. AU - Nama, N. AU - O'Hearn, K. AU - Sampson, M. AU - Amrein, K. AU - Iliriani, K. AU - McIntyre, L. AU - Fergusson, D. AU - Menon, K. DA - 2017-1-1 IS - 1 KW - Prevalence Child Tocopherols Only Child Vitamins Avitaminosis Arachidonic Acid Vitamin E Vitamin B Complex Biotin Riboflavin Ascorbic Acid Critical Illness Vitamin U Folic Acid Vitamin A vitamin D deficiency vitamin blood level ultraviolet radiation systematic review supplementation seasonal variation risk factor radiation exposure race difference priority journal pediatric intensive care unit nutritional status multiple organ failure mortality length of stay infection human hospital admission frequency failure to thrive disease severity disease association critically ill patient clinical outcome body mass artificial ventilation Article age 25 hydroxyvitamin D Vitamin D Pediatrics Nutrition Meta-analyses PY - 2017 SN - 1364-8535 ST - Vitamin D deficiency in critically ill children: A systematic review and meta-analysis T2 - Critical Care TI - Vitamin D deficiency in critically ill children: A systematic review and meta-analysis VL - 21 ID - 138 ER - TY - JOUR AB - Background A number of small studies have suggested a relationship between vitamin D status and severe acute lower respiratory tract infection (ALRI), including RSV - bronchiolitis. The objective of this study was to evaluate the relationship between vitamin D receptor (VDR) polymorphism and severe RSV-bronchiolitis through a systemic literature review and meta-analysis. Methods A comprehensive electronic literature search was conducted to identify all studies published before January 2013. Two reviewers independently screened all abstracts, followed by the full text of potential articles to evaluate eligibility. Study methodological quality was evaluated using the Newcastle Ottawa scale and individual component analysis. Meta-analysis evaluated associations at the allele and genotype levels. Results Of 803 studies identified from our literature search, three met eligibility criteria. Two VDR polymorphisms were included in more than one study: TaqI (rs731236) and FokI (rs2228570). All three reported a positive relationship between the FokI minor allele and disease with random effects meta-analyses demonstrating a statistically significant relationship (OR 1.52, CI: 1.12, 2.05). Genotype analysis was highly suggestive of a dominant or incomplete dominance model with combined odds ratios for fF (OR 1.73, CI: 0.92-3.36) and ff (OR 2.24, CI: 0.98-5.14) compared to the FF genotype. No association between TaqI and severe RSV-bronchiolitis was evident at the allele or genotype level. Conclusions Available literature supports an association between the FokI polymorphism and severe RSV disease. Determination of VDR receptor polymorphism status could help predict high-risk infants who might benefit from preventive measures. © 2013 Wiley Periodicals, Inc. AU - McNally, J. D. AU - Sampson, M. AU - Matheson, L. A. AU - Hutton, B. AU - Little, J. DA - 2014-1-1 IS - 8 KW - Arachidonic Acid Infant Biotin Riboflavin Vitamin B Complex Vitamins Ascorbic Acid Folic Acid Vitamin A Vitamin E Vitamin D Vitamin U Polymorphism, Genetic Bronchioles Bronchiolitis Severity of Illness Index Respiratory Syncytial Virus Infections Receptors, Calcitriol Polymorphism, Single Nucleotide Humans Genotype Genetic Predisposition to Disease Bronchiolitis, Viral Alleles viral bronchiolitis respiratory syncytial virus infection meta analysis genetics genetic predisposition vitamin D deficiency systematic review single nucleotide polymorphism review priority journal meta analysis (topic) lower respiratory tract infection infection risk human genetic risk genetic association DNA polymorphism disease severity allele VDR protein, human calcitriol receptor vitamin D receptor 25 hydroxyvitamin D risk factors pediatrics PY - 2014 SP - 790-799 ST - Vitamin D receptor (VDR) polymorphisms and severe RSV bronchiolitis: A systematic review and meta-analysis T2 - Pediatric Pulmonology TI - Vitamin D receptor (VDR) polymorphisms and severe RSV bronchiolitis: A systematic review and meta-analysis VL - 49 ID - 247 ER - TY - JOUR AB - Objective The purpose of this systematic review was to evaluate the effectiveness of exercise compared to other interventions, placebo/sham intervention, or no intervention in improving self-rated recovery, functional recovery, clinical, and/or administrative outcomes in individuals with musculoskeletal disorders and injuries of the elbow, forearm, wrist, and hand. Methods We searched MEDLINE, EMBASE, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials from 1990 to 2015. Paired reviewers independently screened studies for relevance and assessed the risk of bias using the Scottish Intercollegiate Guidelines Network criteria. We synthesized the evidence using the best evidence synthesis methodology. Results We identified 5 studies with a low risk of bias. Our review suggests that, for patients with persistent lateral epicondylitis, (1) adding concentric or eccentric strengthening exercises to home stretching exercises provides no additional benefits; (2) a home program of either eccentric or concentric strengthening exercises leads to similar outcomes; (3) home wrist extensor strengthening exercises lead to greater short-term improvements in pain reduction compared to "wait and see"; and (4) clinic-based, supervised exercise may be more beneficial than home exercises with minimal improvements in pain and function. For hand pain of variable duration, supervised progressive strength training added to advice to continue normal physical activity provides no additional benefits. Conclusion The relative effectiveness of stretching vs strengthening for the wrist extensors remains unknown for the management of persistent lateral epicondylitis. The current evidence shows that the addition of supervised progressive strength training does not provide further benefits over advice to continue normal physical activity for hand pain of variable duration. © 2015 National University of Health Sciences. AU - Menta, R. AU - Randhawa, K. AU - Côté, P. AU - Wong, J. J. AU - Yu, H. AU - Sutton, D. AU - Varatharajan, S. AU - Southerst, D. AU - Angelo, K. AU - Cox, J. AU - Brown, C. AU - Dion, S. AU - Mior, S. AU - Stupar, M. AU - Shearer, H. M. AU - Lindsay, G. M. AU - Jacobs, C. AU - Taylor-Vaisey, A. DA - 2015-1-1 IS - 7 KW - Recovery of Function Forearm PY - 2015 SN - 0161-4754 DO - http://dx.doi.org/10.1016/j.jmpt.2012.01.001 SP - 507-520 ST - The effectiveness of exercise for the management of musculoskeletal disorders and injuries of the elbow, forearm, wrist, and hand: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration T2 - Journal of Manipulative and Physiological Therapeutics TI - The effectiveness of exercise for the management of musculoskeletal disorders and injuries of the elbow, forearm, wrist, and hand: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration VL - 38 ID - 18 ER - TY - JOUR AB - Background: Achilles tendon ruptures are a common injury and are increasing in incidence. Several management strategies exist for both non-operative and operative care, with each strategy offering unique risks and benefits. Traditional pairwise meta-analyses have been performed to compare management strategies; however, all treatment options have never been integrated in a single analysis. Network meta-analysis (NMA) is a generalization of pairwise meta-analysis, which allows for the comparison of multiple interventions based on all available direct and indirect evidence. The objectives of this review are to synthesize the evidence on the management options for acute Achilles tendon rupture and identify which treatment gives the best functional outcomes. Methods: A systematic review with NMA is planned. An electronic literature search will be performed in conjunction with an experienced information specialist in MEDLINE, EMBASE, CINAHL, PEDro, and the Cochrane Central Register of Controlled Trials. We will include randomized controlled trials with a minimum 6-month follow-up. Two independent reviewers will screen citations for eligibility, extract study data, and perform risk of bias assessments. The primary outcome will be disease-specific functional outcome scores (AOFAS, Leppilahti, modified Leppilahti) at 1 year. Secondary outcomes will include complications (re-rupture, sural nerve injury, wound complications, deep infection, secondary surgeries), strength, range of motion, return to work, return to sport, and quality-of-life measures (including the SF-36 questionnaire). Traditional pairwise meta-analyses will be performed for all direct comparisons where evidence is available, and NMAs will subsequently be performed where possible to compare all management strategies. Discussion: The data generated from this review will provide health-care providers with a clear evidence synthesis of all Achilles tendon rupture management strategies. Additionally, these data will be incorporated into the development of a patient decision aid to assist patients and clinicians in making a preference-based decision when faced with an Achilles tendon rupture. Systematic review registration: PROSPERO CRD42018093033. © 2018 The Author(s). AD - Faculty of Medicine, University of Ottawa, 1053 Carling Ave., Ottawa, ON K1Y 4E9, Canada Faculty of Health Sciences, Centre for Practice-Changing Research, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada Department of Medicine, Centre for Practice-Changing Research Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada Clinical Epidemiology Program, Centre for Practice-Changing Research, Ottawa Hospital Research Institute, Ottawa, Canada Ottawa Hospital, Ottawa, Canada School of Epidemiology and Public Health, Ottawa, Canada AU - Meulenkamp, B. AU - Stacey, D. AU - Fergusson, D. AU - Hutton, B. AU - Mlis, R. S. AU - Graham, I. D. C2 - 30580763 C7 - 247 DB - Scopus DO - 10.1186/s13643-018-0912-5 IS - 1 KW - Achilles tendon rupture Network meta-analysis Orthopedics Physiotherapy Surgery Systematic review data extraction human immobilization meta analysis minimally invasive surgery nerve injury outcome assessment priority journal quality of life questionnaire randomized controlled trial (topic) range of motion Review risk assessment risk factor sensitivity analysis wound complication achilles tendon injuries postoperative complication procedures rupture Humans Physical Therapy Modalities Postoperative Complications Randomized Controlled Trials as Topic Surgical Procedures, Operative LA - English M3 - Review PY - 2018 ST - Protocol for treatment of Achilles tendon ruptures; A systematic review with network meta-analysis T2 - Systematic Reviews TI - Protocol for treatment of Achilles tendon ruptures; A systematic review with network meta-analysis VL - 7 ID - 392 ER - TY - JOUR AB - Background: Acute heart failure (AHF) accounts for a substantial proportion of Emergency Department (ED) visits and hospitalizations. Previous studies have shown that emergency physicians’ clinical gestalt is not sufficient to stratify patients with AHF into severe and requiring hospitalization vs nonsevere and safe to be discharged. Various prognostic algorithms have been developed to risk-stratify patients with AHF, however there is no consensus as to the best-performing risk assessment tool in the ED. Methods: A systematic review of Medline, PubMed, and Embase up to May 2016 was conducted using established methods. Major cardiology and emergency medicine conference proceedings from 2010 to 2016 were also screened. Two independent reviewers identified studies that evaluated clinical risk scores in adult (ED) patients with AHF, with risk prognostication for mortality or significant morbidity within 7-30 days. Studies included patients who were discharged or admitted. Results: The systematic review search generated 2950 titles that were screened according to title and abstract. Nine articles, describing 6 risk prediction tools met full inclusion criteria, however, prognostic performance and ease of bedside application is limited for most. Because of clinical heterogeneity in the prognostic tools and study outcomes, a meta-analysis was not performed. Conclusions: Several risk scores exist for predicting short-term mortality or morbidity in ED patients with AHF. No single risk tool is clearly superior, however, the Emergency Heart Failure Mortality Risk Grade might aid in prognostication of mortality and the Ottawa Heart Failure Risk Score might provide useful prognostic information in patients suitable for ED discharge. © 2017 Canadian Cardiovascular Society AD - Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada Health Sciences Library, University of Calgary, Calgary, Alberta, Canada Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada Department of Emergency Medicine, University of Calgary, Calgary, Alberta, Canada Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada AU - Michaud, A. M. AU - Parker, S. I. A. AU - Ganshorn, H. AU - Ezekowitz, J. A. AU - McRae, A. D. C2 - 29287944 DB - Scopus DO - 10.1016/j.cjca.2017.09.004 IS - 2 KW - acute heart failure adverse event cardiovascular mortality Embase emergency medicine emergency ward human Medline morbidity mortality risk prediction prognostic assessment Review risk assessment scoring system systematic review heart failure hospital emergency service meta analysis mortality Emergency Service, Hospital Humans LA - English M3 - Review PY - 2018 SP - 168-179 ST - Prediction of Early Adverse Events in Emergency Department Patients With Acute Heart Failure: A Systematic Review T2 - Canadian Journal of Cardiology TI - Prediction of Early Adverse Events in Emergency Department Patients With Acute Heart Failure: A Systematic Review VL - 34 ID - 393 ER - TY - JOUR AB - Objective: To describe the process of development, content, and methods of implementation of reporting guidelines for health research. Study Design and Setting: A systematic review of publications describing health research reporting guidelines developed using consensus. Results: Eighty-one reporting guidelines for health research were included in the review. The largest number of guidelines do not focus on a specific study type (n = 35; 43%), whereas those that do primarily refer to reporting of randomized controlled trials (n = 16; 35%). Most of the guidelines (n = 76; 94%) include a checklist of recommended reporting items, with a median of 21 checklist items (range: 5-64 items). Forty-seven (58%) reporting guidelines were classified as new guidance. Explanation documents were developed for 11 (14%) reporting guidelines. Reporting-guideline developers provided little information about the guideline development process. Developers of 50 (62%) reporting guidelines encouraged endorsement, most commonly by including guidelines in journal instructions to authors (n = 18; 36%). Conclusions: Reporting-guideline developers need to endeavor to maximize the quality of their product. Recently developed guidance is likely to facilitate more robust guideline development. Journal editors can be more confident in endorsing reporting guidelines that have followed these approaches. © 2011 Elsevier Inc. All rights reserved. AU - Moher, D. AU - Weeks, L. AU - Ocampo, M. AU - Seely, D. AU - Sampson, M. AU - Altman, D. G. AU - Schulz, K. F. AU - Miller, D. AU - Simera, I. AU - Grimshaw, J. AU - Hoey, J. DA - 2011-1-1 IS - 7 PY - 2011 SP - 718-742 ST - Describing reporting guidelines for health research: A systematic review T2 - Journal of Clinical Epidemiology TI - Describing reporting guidelines for health research: A systematic review VL - 64 ID - 11 ER - TY - JOUR AB - Tranexamic acid (TXA) is an effective hemostatic agent used for the reduction of blood loss and transfusion. However, the safety profile of TXA remains in question due to a potential increased risk of venous thromboembolism. By applying TXA topically as opposed to intravenously, systemic absorption may be reduced and unwanted side-effects mitigated. The objective of our review is to investigate the efficacy and safety of topically applied tranexamic acid compared to both placebo, and the intravenous administration. Cochrane Central Register of Controlled Trials, MEDLINE, Embase, ISI Web of Science, PubMed, and Clinicaltrials.gov were searched from inception to November, 2016. We included randomized controlled trials that compared topical tranexamic acid to either placebo (or standard care) or intravenous administration, in adult patients. Surgical and non-surgical trials were included. Abstract, full-text selection, data extraction and risk of bias assessment were all performed in duplicate. In total, 67 studies involving 6,034 patients met inclusion criteria. The majority of trials evaluated orthopedic procedures. Compared to placebo, the administration of topical TXA significantly reduced the odds of receiving a blood transfusion (pooled OR 0.28, 95% CI 0.20 to 0.38; P < 0.001) and significantly reduced mean blood loss (WMD -276.6, 95% CI -327.8 to -225.4; P < 0.0001). When compared to the intravenous administration, there was no difference between the two groups in terms of transfusion requirements (pooled OR 1.03, 95% CI 0.72 to 1.46; P=0.88) or blood loss (WMD -21.95, 95% CI -66.61 to 27.71; P=0.34). There was no difference in the odds of developing a venous thromboembolic complication between the topical TXA and control groups (pooled OR=0.78, 95% CI 0.47 to 1.29; P=0.33) or the topical and intravenous groups (pooled OR=0.75, 95% CI 0.39 to 1.46; P=0.40). The topical application of TXA effectively reduces both transfusion risk and blood loss compared to placebo, without increasing thromboembolic risks. There were no major differences between topical and intravenous tranexamic acid with respect to safety and efficacy, and both were superior to placebo with regards to blood loss and transfusion requirements. Further study of the topical application is required outside of the field of orthopedics. © 2018 Elsevier Inc. AD - Clinical Epidemiology Program, Centre for Practice Changing Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada University of Ottawa, School of Epidemiology, Community Medicine and Preventive Medicine, Ottawa, ON, Canada Division of Urology, Department of Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada AU - Montroy, J. AU - Hutton, B. AU - Moodley, P. AU - Fergusson, N. A. AU - Cheng, W. AU - Tinmouth, A. AU - Lavallée, L. T. AU - Fergusson, D. A. AU - Breau, R. H. DB - Scopus DO - 10.1016/j.tmrv.2018.02.003 IS - 3 KW - Blood transfusion Lysine analogue Surgery Topical Tranexamic acid Venous thromboembolism placebo bleeding cerebrovascular accident deep vein thrombosis drug absorption drug dose comparison drug efficacy drug safety heart infarction human lung embolism major clinical study meta analysis Review risk assessment systematic review LA - English M3 - Review PY - 2018 SP - 165-178 ST - The efficacy and safety of topical tranexamic acid: A systematic review and meta-analysis T2 - Transfusion Medicine Reviews TI - The efficacy and safety of topical tranexamic acid: A systematic review and meta-analysis VL - 32 ID - 394 ER - TY - JOUR AB - Importance: Many centers delivering infants at 22 to 25 weeks' gestation have limited data regarding their outcomes. Ameta-analysis of the 4- to 8-year neurodevelopmental outcomes and exploration of the limitations of meta-analysis would aid physicians and parents to plan care for these infants. OBJECTIVES: To determine the rate of moderate to severe and severe neurodevelopmental impairment by gestational age in extremely preterm survivors followed up between ages 4 and 8 years, as well as to determine whether there is a significant difference in impairment rates between the successive weeks of gestation of survivors. EVIDENCE REVIEW: A peer-reviewed search strategy obtained English-language publications from MEDLINE In-Process & Other Non-Indexed Citations, MEDLINE, and EMBASE. Personal files and reference lists from identified articles were searched. Contemporary cohorts were obtained by restriction to those published after 2004. Inclusion criteria were prospective cohort studies, follow-up rate of 65%or more, use of standardized testing or classification for impairment, reporting by gestation, and meeting prespecified definitions of impairment.We excluded randomized clinical trials, highly selective cohorts, consensus statements, and reviews. Of 1771 identified records, 89 full-text publications were assessed for eligibility. Using the full text of each publication, 2 authors independently followed a 2-step procedure. First, they determined that 9 studiesmet inclusion criteria. Next, they extracted data using a structured data collection form. Investigators were contacted for data clarification. RESULTS: All extremely preterm infant survivors have a substantial likelihood of developing moderate to severe impairment. Wide confidence intervals at the lower gestations (eg, at 22 weeks, 43%[95%CI, 21%-69%]; heterogeneity I2, 0%) and high heterogeneity at the higher gestations (eg, at 25 weeks, 24%[95%CI, 17%-32%]; I2, 66%) limit the results. There was a statistically significant absolute decrease in moderate to severe impairment between each week of gestation (6.5%[95%CI, 2%-11%]). CONCLUSIONS AND RELEVANCE: Knowledge of these data, including the limitations, should facilitate discussion during the shared decision-making process about care plans for these infants, particularly in centers without their own data. More prospective, high-quality, complete cohorts are needed. AU - Moore, G. P. AU - Lemyre, B. AU - Barrowman, N. AU - Daboval, T. DA - 2013-1-1 IS - 10 KW - Survivors Only Child Infant Pregnancy Male Infant, Newborn Infant, Low Birth Weight Infant, Extremely Premature Humans Gestational Age Female Developmental Disabilities Child, Preschool Child Development Child visual impairment systematic review survivor review publishing prospective study priority journal prematurity peer review outcome assessment neurologic disease neurodevelopmental impairment meta analysis Medline medical record human hearing impairment follow up Embase disease severity disease association developmental disorder consensus confidence interval cohort analysis clinical assessment cerebral palsy bibliographic database PY - 2013 SP - 967-974 ST - Neurodevelopmental outcomes at 4 to 8 years of children born at 22 to 25 weeks' gestational age: A meta-analysis T2 - JAMA Pediatrics TI - Neurodevelopmental outcomes at 4 to 8 years of children born at 22 to 25 weeks' gestational age: A meta-analysis VL - 167 ID - 41 ER - TY - JOUR AB - Introduction Preventable injuries lead to 200 000 hospital stays, 60 000 disabilities, and 13 000 deaths per year in Canada with direct costs of $20 billion. Overall, potentially unnecessary medical interventions are estimated to consume up to 30% of healthcare resources and may expose patients to avoidable harm. However, little is known about overuse for acute injury care. We aim to identify low-value clinical practices in injury care. Methods and analysis We will perform a scoping review of peer-reviewed and non-peer-reviewed literature to identify research articles, reviews, recommendations and guidelines that identify at least one low-value clinical practice specific to injury populations. We will search Medline, EMBASE, COCHRANE central, and BIOSIS/Web of Knowledge databases, websites of government agencies, professional societies and patient advocacy organisations, thesis holdings and conference proceedings. Pairs of independent reviewers will evaluate studies for eligibility and extract data from included articles using a prepiloted and standardised electronic data abstraction form. Low-value clinical practices will be categorised using an extension of the Agency for Healthcare Research and Quality conceptual framework and data will be presented using narrative synthesis. Ethics and dissemination Ethics approval is not required as original data will not be collected. This study will be disseminated in a peer-reviewed journal, international scientific meetings, and to knowledge users through clinical and healthcare quality associations. This review will contribute new knowledge on low-value clinical practices in acute injury care. Our results will support the development indicators to measure resource overuse and inform policy makers on potential targets for deadoption in injury care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. AU - Moore, L. AU - Boukar, K. M. AU - Tardif, P. A. AU - Stelfox, H. T. AU - Champion, H. AU - Cameron, P. AU - Gabbe, B. AU - Yanchar, N. AU - Kortbeek, J. AU - Lauzier, F. AU - Légaré, F. AU - Archambault, P. AU - Turgeon, A. F. DA - 2017-1-1 IS - 7 KW - Canada Length of Stay Wounds and Injuries Review Literature as Topic Research Design Medical Overuse Humans Critical Care utilization methodology literature intensive care injury health service systematic review Review randomized controlled trial (topic) practice guideline peer review patient care patient advocacy narrative meta analysis low value clinical practice information processing human health services research health care quality e-mail data base consultation conceptual framework clinical practice accident prevention Quality in health care Low-value clinical practise PY - 2017 SN - 2044-6055 ST - Low-value clinical practices in injury care: A scoping review protocol T2 - BMJ Open TI - Low-value clinical practices in injury care: A scoping review protocol VL - 7 ID - 147 ER - TY - JOUR AB - Background: Injury represents one of the greatest public health challenges of our time with over 5 million deaths and 100 million people temporarily or permanently disabled every year worldwide. The effectiveness of trauma systems in decreasing injury mortality and morbidity has been well demonstrated. However, the organisation of trauma care varies significantly across trauma systems and we know little about which components of trauma systems contribute to their effectiveness. The objective of the study described in this protocol is to systematically review evidence of the impact of trauma system components on clinically significant outcomes including mortality, function and disability, quality of life, and resource utilization. Methods: We will perform a systematic review of studies evaluating the association between at least one trauma system component (e.g. accreditation by a central agency, interfacility transfer agreements) and at least one injury outcome (e.g. mortality, disability, resource use). We will search MEDLINE, EMBASE, COCHRANE central, and BIOSIS/Web of Knowledge databases, thesis holdings, key injury organisation websites and conference proceedings for eligible studies. Pairs of independent reviewers will evaluate studies for eligibility and extract data from included articles. Methodological quality will be evaluated using elements of the ROBINS-I tool and the Cochrane risk of bias tool for non-randomized and randomized studies, respectively. Strength of evidence will be evaluated using the GRADE tool. Discussion: We expect to advance knowledge on the components of trauma systems that contribute to their effectiveness. This may lead to recommendations on trauma system structure that will help policy-makers make informed decisions as to where resources should be focused. The review may also lead to specific recommendations for future research efforts. Systematic review registration: This protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 28-06-2016. PROSPERO 2016:CRD42016041336 Available from http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42016041336. � 2017 The Author(s). AU - Moore, L. AU - Champion, H. AU - O'Reilly, G. AU - Leppaniemi, A. AU - Cameron, P. AU - Palmer, C. AU - Abu-Zidan, F. M. AU - Gabbe, B. AU - Gaarder, C. AU - Yanchar, N. AU - Stelfox, H. T. AU - Coimbra, R. AU - Kortbeek, J. AU - Noonan, V. AU - Gunning, A. AU - Leenan, L. AU - Gordon, M. AU - Khajanchi, M. AU - Shemilt, M. AU - Porgo, V. AU - Turgeon, A. F. DA - 2017-1-1 IS - 1 KW - Wounds and Injuries Tertiary Prevention Review Literature as Topic Research Design Quality-Adjusted Life Years Quality of Life Humans Health Resources Delivery of Health Care utilization quality adjusted life year organization and management methodology literature injury health care planning health care delivery economics complication sensitivity analysis randomized controlled trial (topic) quality control process development priority journal mortality human health care utilization health care system health care policy health care cost disability data synthesis bibliographic database Article adverse outcome Trauma system Organizational-level intervention Injury outcomes PY - 2017 SN - 2046-4053 ST - Impact of trauma system structure on injury outcomes: A systematic review protocol T2 - Systematic Reviews TI - Impact of trauma system structure on injury outcomes: A systematic review protocol VL - 6 ID - 160 ER - TY - JOUR AB - Introduction There is fragmented information about the different needs following a spinal cord injury (SCI). Expressed SCI needs can be met or unmet, they change along the rehabilitation continuum (eg, acute, rehabilitation and reintegration into the community) and can be different for traumatic and non traumatic SCI. The general objective of this scoping study is to evaluate and integrate the needs of individuals with traumatic and non-traumatic SCI, their family caregivers and those reported by rehabilitation professionals from the time of rehabilitation admission to community reintegration. The specific objectives are to: (A) synthesise the needs of individuals with SCI as perceived by themselves, their family caregivers and rehabilitation professionals using two theoretical models, (B) classify needs as met and unmet, (C) explore the evolution of met/unmet needs from the time of rehabilitation admission to community reintegration and (D) provide recommendations to improve SCI care. Methods and analysis (A) identifying the most frequent met and unmet needs reported by adults with traumatic and non-traumatic SCI, their family caregivers and their rehabilitation professionals from the time of rehabilitation admission to community reintegration; (B) identifying relevant studies with a search in electronic databases; (C) charting the data based on categories refined and adjusted with a stakeholder group; (D) collating, summarising and reporting the results using two analytical frameworks (Maslow's hierarchical model of human needs and the Ferrans et al's model of health-related quality of life) and (E) a stakeholder consultation phase. Ethics and dissemination The results of this scoping study will allow understanding SCI needs from the time of rehabilitation admission to community reintegration from the perspective of different stakeholders. An integrated master report combining the needs of individuals with SCI from the perspectives of different stakeholders from the time of rehabilitation admission to community reintegration will follow the consultation meetings. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. AU - Moreno, A. AU - Zidarov, D. AU - Raju, C. AU - Boruff, J. AU - Ahmed, S. DA - 2017-1-1 IS - 8 KW - Rehabilitation Humanism Humanities Spinal Cord Injuries Social Support Self Care Research Design Rehabilitation Centers Quality of Life Psychometrics Patient Satisfaction Patient Discharge Needs Assessment Humans Health Services Needs and Demand Health Personnel Family Disabled Persons Disability Evaluation Community Integration Caregivers spinal cord injury rehabilitation center psychometry psychology hospital discharge health service health care personnel disabled person disability caregiver theoretical model rehabilitation care methodology information dissemination human needs human health care quality ethics controlled study conceptual framework community reintegration clinical evaluation Article adult scoping study needs healthcare PY - 2017 SN - 2044-6055 ST - Integrating the perspectives of individuals with spinal cord injuries, their family caregivers and healthcare professionals from the time of rehabilitation admission to community reintegration: Protocol for a scoping study on SCI needs T2 - BMJ Open TI - Integrating the perspectives of individuals with spinal cord injuries, their family caregivers and healthcare professionals from the time of rehabilitation admission to community reintegration: Protocol for a scoping study on SCI needs VL - 7 ID - 85 ER - TY - JOUR AB - Introduction and hypothesis: Investigating the activity of the pelvic floor muscles (PFMs) in women during impact activities such as jumping, running or coughing may elucidate different aspects of PFM activation and therefore clarify the pathophysiology of stress urinary incontinence (SUI). A systematic review (PROSPERO 2016:CRD42016035624) was conducted to summarize current evidence on PFM activity during impact activities in both continent and incontinent women. Methods: PubMed, EMBASE, Cochrane, and SPORTDiscus databases were systematically searched for studies published up to December 2016. The PICO approach (patient, intervention, comparison, outcome) was used to construct the search queries. Original studies were included that investigated PFM activity during impact activities if they included terms related to muscle activity and measurement methods, test positions, activities performed and continence status. Two reviewers screened titles and abstracts independently to ascertain if the included studies fulfilled the inclusion criteria, and extracted data on outcome parameters. Results: The search revealed 28 studies that fulfilled the inclusion criteria, of which 26 were cross-sectional studies. They used different electromyography measurement methods, test activities, test positions, and comparisons with other structures. Ten studies compared continent and incontinent women. The timing of PFM activity in relation to the activity of other trunk muscles seems to be a crucial factor in maintaining continence. Women with SUI have delayed PFM activity. Conclusions: The findings of this systematic review suggest that impact activities causing involuntary and reflex PFM activity should be the subject of further study. This may help guide clinical studies to improve our understanding of how the PFMs react during impact activities and to determine best practices that can be included in rehabilitation programmes. © 2017, The International Urogynecological Association. AU - Moser, H. AU - Leitner, M. AU - Baeyens, J. P. AU - Radlinger, L. DA - 2018-1-1 IS - 2 KW - Cross-Sectional Studies Urinary Incontinence Pelvic Floor urine incontinence systematic review skeletal muscle Review priority journal pressure measurement pelvis floor muscle Newcastle-Ottawa scale muscle contraction human female electromyography electromyogram Stress urinary incontinence Pelvis Exercise Cough PY - 2018 SP - 179-196 ST - Pelvic floor muscle activity during impact activities in continent and incontinent women: a systematic review T2 - International Urogynecology Journal TI - Pelvic floor muscle activity during impact activities in continent and incontinent women: a systematic review VL - 29 ID - 129 ER - TY - JOUR AB - Background: Despite the existence of human papilloma virus (HPV) vaccines with demonstrated safety and effectiveness and funded HPV vaccination programs, coverage rates are persistently lower and cervical cancer burden higher among Canadian Indigenous peoples. Barriers and supports to HPV vaccination in Indigenous peoples have not been systematically documented, nor have interventions to increase uptake in this population. This protocol aims to appraise the literature in Canadian and global Indigenous peoples, relating to documented barriers and supports to vaccination and interventions to increase acceptability/uptake or reduce hesitancy of vaccination. Although HPV vaccination is the primary focus, we anticipate only a small number of relevant studies to emerge from the search and will, therefore, employ a broad search strategy to capture literature related to both HPV vaccination and vaccination in general in global Indigenous peoples. Methods: Eligible studies will include global Indigenous peoples and discuss barriers or supports and/or interventions to improve uptake or to reduce hesitancy, for the HPV vaccine and/or other vaccines. Primary outcomes are documented barriers or supports or interventions. All study designs meeting inclusion criteria will be considered, without restricting by language, location, or data type. We will use an a priori search strategy, comprised of key words and controlled vocabulary terms, developed in consultation with an academic librarian, and reviewed by a second academic librarian using the PRESS checklist. We will search several electronic databases from date of inception, without restrictions. A pre-defined group of global Indigenous websites will be reviewed for relevant gray literature. Bibliographic searches will be conducted for all included studies to identify relevant reviews. Data analysis will include an inductive, qualitative, thematic synthesis and a quantitative analysis of measured barriers and supports, as well as a descriptive synthesis and quantitative summary of measures for interventions. Discussion: To our knowledge, this study will contribute the first systematic review of documented barriers, supports, and interventions for vaccination in general and for HPV vaccination. The results of this study are expected to inform future research, policies, programs, and community-driven initiatives to enhance acceptability and uptake of HPV vaccination among Indigenous peoples. Systematic review registration: PROSPERO Registration Number: CRD42017048844. © 2018 The Author(s). AU - Mrklas, K. J. AU - MacDonald, S. AU - Shea-Budgell, M. A. AU - Bedingfield, N. AU - Ganshorn, H. AU - Glaze, S. AU - Bill, L. AU - Healy, B. AU - Healy, C. AU - Guichon, J. AU - Colquhoun, A. AU - Bell, C. AU - Richardson, R. AU - Henderson, R. AU - Kellner, J. AU - Barnabe, C. AU - Bednarczyk, R. A. AU - Letendre, A. AU - Nelson, G. S. DA - 2018-1-1 IS - 1 KW - Papillomavirus Vaccines Vaccines Poverty Humanities Humanism Humans systematic review scoring system quality control public health priority journal Human papillomavirus type 18 human health care planning genetic heterogeneity conceptual framework Canada Article Vaccination Uptake Supports Indigenous populations Human papillomavirus (HPV) Hesitancy Cancer prevention Barriers Acceptance PY - 2018 SN - 2046-4053 ST - Barriers, supports, and effective interventions for uptake of human papillomavirus- and other vaccines within global and Canadian Indigenous peoples: A systematic review protocol T2 - Systematic Reviews TI - Barriers, supports, and effective interventions for uptake of human papillomavirus- and other vaccines within global and Canadian Indigenous peoples: A systematic review protocol VL - 7 ID - 125 ER - TY - JOUR AB - Background. Due to inadequate UV exposure, intake of small quantities of vitamin D is recommended to prevent musculoskeletal disease. Both basic science and observational literature strongly suggest that higher doses may benefit specific populations and have non-musculoskeletal roles. Evaluating the evidence surrounding high dose supplementation can be challenging given a relatively large and growing body of clinical trial evidence spanning time, geography, populations and dosing regimens. Study objectives were to identify and summarize the clinical trial literature, recognize areas with high quality evidence, and develop a resource database that makes the literature more immediately accessible to end users. Methods. Medline (1946 to January 2015), Embase (1974 to January 2015), and Cochrane databases (January 2015), were searched for trials. All pediatric (0-18 years) trials administering doses higher than 400 IU (< 1 year) or 600 IU (≥1 year) were included. Data was extracted independently by two of the authors. An online searchable database of trials was developed containing relevant extracted information (http://www. cheori.org/en/pedvitaminddatabaseOverview). Sensitivity and utility were assessed by comparing the trials in the database with those from systematic reviews of vitamin D supplementation including children. Results. A total of 2,579 candidate papers were identified, yielding 169 trials having one or more arms meeting eligibility criteria. The publication rate has increased significantly from 1 per year (1970-1979) to 14 per year (2010-2015). Although 84% of the total trials focused on healthy children or known high risk populations (e.g., renal, prematurity), this proportion has declined in recent years due to the rise in trials evaluating populations and outcomes not directly related to the musculoskeletal actions of vitamin D (27% in 2010s). Beyond healthy children, the only pediatric populations with more than 50 participants from low risk of bias trials evaluating a clinically relevant outcome were prematurity and respiratory illness. Finally, we created and validated the online searchable database using 13 recent systematic reviews. Of the 38 high dose trials identified by the systematic review, 36 (94.7%) could be found within the database. When compared with the search strategy reported in each systematic review, use of the database reduced the number of full papers to assess for eligibility by 85.2% (±13.4%). Conclusion. The pediatric vitamin D field is highly active, with a significant increase in trials evaluating non-classical diseases and outcomes. Despite the large overall number there are few high quality trials of sufficient size to provide answers on clinical efficacy of high-dose vitamin D. An open access online searchable data should assist end users in the rapid and comprehensive identification and evaluation of trials relevant to their population or question of interest. © 2016 Nama et al. AU - Nama, N. AU - Menon, K. AU - Iliriani, K. AU - Pojsupap, S. AU - Sampson, M. AU - O'Hearn, K. AU - Zhou, L. AU - McIntyre, L. AU - Fergusson, D. AU - McNally, J. D. DA - 2016-1-1 IS - 2 KW - Tocopherols Musculoskeletal Diseases Vitamins Arachidonic Acid Biotin Riboflavin Ascorbic Acid Vitamin E Vitamin B Complex Folic Acid Vitamin A Vitamin U vitamin supplementation vitamin D deficiency validation process systematic review sensitivity analysis randomized controlled trial (topic) pediatrics meta analysis human geographic distribution evidence based emergency medicine drug overdose body surface Article vitamin D Online database High-dose PY - 2016 SN - 2167-8359 ST - A systematic review of pediatric clinical trials of high dose vitamin D T2 - PeerJ TI - A systematic review of pediatric clinical trials of high dose vitamin D VL - 2016 ID - 189 ER - TY - JOUR AB - Background Atrial fibrillation is a common cardiac arrhythmia, and 15% to 20% of those who have experienced stroke have atrial fibrillation. Treatment options to prevent stroke in people with atrial fibrillation include pharmacological agents such as novel oral anticoagulants or nonpharmacological devices such as the left atrial appendage closure device with delivery system (LAAC device). The objectives of this health technology assessment were to assess the clinical effectiveness and cost-effectiveness of the LAAC device versus novel oral anticoagulants in patients without contraindications to oral anticoagulants and versus antiplatelet agents in patients with contraindications to oral anticoagulants. Methods We performed a systematic review and network meta-analysis. We also conducted an economic literature review, economic evaluation, and budget impact analysis to assess the cost-effectiveness and budget impact of the LAAC device compared with novel oral anticoagulants and oral antiplatelet agents (e.g., aspirin). We also spoke with patients to better understand their preferences, perspectives, and values. Results Seven randomized controlled studies met the inclusion criteria for indirect comparison. Five studies assessed the effectiveness of novel oral anticoagulants versus warfarin, and two studies compared the LAAC device with warfarin. No studies were identified that compared the LAAC device with aspirin in patients in whom oral anticoagulants were contraindicated. Using the random effects model, we found that the LAAC device was comparable to novel oral anticoagulants in reducing stroke (odds ratio [OR] 0.85; credible interval [Cr.I] 0.63–1.05). Similarly, the reduction in the risk of all-cause mortality was comparable between the LAAC device and novel oral anticoagulants (OR 0.71; Cr.I 0.49–1.22). The LAAC device was found to be superior to novel oral anticoagulants in preventing hemorrhagic stroke (OR 0.45; Cr.I 0.29–0.79), whereas novel oral anticoagulants were found to be superior to the LAAC device in preventing ischemic stroke (OR 0.67; Cr.I 0.24–1.64). The body of clinical evidence was found to be of moderate quality as assed by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. Results from the economic evaluation indicate that the LAAC device is cost-effective compared with aspirin in patients with contraindications to oral anticoagulants. In patients without contraindications to oral anticoagulants, we found that the LAAC device is not cost-effective compared with novel oral anticoagulants. Publicly funding the LAAC device in patients with nonvalvular atrial fibrillation with contraindications to oral anticoagulants could result in additional funding of $1.1 million to $7.7 million over the first five years. Patients interviewed reported on the impact of living with nonvalvular atrial fibrillation and were supportive of the LAAC device as a treatment option. Conclusions Moderate-quality evidence suggests that the LAAC device is as effective as novel oral anticoagulants in preventing stroke in people with nonvalvular atrial fibrillation. However, our results indicate that the LAAC device is cost-effective only in patients with contraindications to oral anticoagulants. People with nonvalvular atrial fibrillation with whom we spoke reported positive support for the LAAC device. © Queen’s Printer for Ontario, 2017. AU - Nevis, Immaculate AU - Falk, Lindsey AU - Wells, David AU - Higgins, Caroline AU - Stahl, Kara AU - Singh, Tanveer AU - Laing, Ana AU - Kaulback, Kellee AU - Soulodre, Claude AU - Mitchell, Andrée AU - Ng, Vivian AU - Thota, Anil AU - Sikich, Nancy AU - Dhalla, Irfan DA - 2017-1-1 IS - 9 KW - Biomedical Technology Ontario Cost-Benefit Analysis Platelet Aggregation Inhibitors Anticoagulants Technology Assessment, Biomedical Atrial Fibrillation Review randomized controlled trial (topic) prophylaxis patient safety male major clinical study left atrial appendage closure device human female evidence based medicine cost effectiveness analysis comparative effectiveness cerebrovascular accident biomedical technology assessment aged adult warfarin rivaroxaban edoxaban dabigatran apixaban PY - 2017 SN - 1915-7398 SP - 1-106 ST - Ontario health technology assessment series: Left atrial appendage closure device with delivery system: A health technology assessment T2 - Ontario Health Technology Assessment Series TI - Ontario health technology assessment series: Left atrial appendage closure device with delivery system: A health technology assessment VL - 17 ID - 111 ER - TY - JOUR AB - Background: Urinary incontinence is involuntary leakage of urine and can affect people of all ages. Incidence rises as people age, often because of reduced mobility or conditions affecting the nervous system, such as dementia and stroke. Urinary incontinence can be a distressing condition and can harm a person’s physical, financial, social, and emotional well-being. People with urinary incontinence are susceptible to skin irritation, pressure sores, and urinary tract infections. Urinary incontinence is also associated with an increased risk of falls in older adults. This health technology assessment examined the effectiveness of, budget impact of, and patient values and preferences about electronic monitoring systems to assess urinary incontinence for residents of long-term care homes or geriatric hospital inpatients with complex conditions. Methods: A clinical evidence review of the published clinical literature was conducted to June 9, 2017. Critical appraisal of the clinical evidence included assessment of risk of bias and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria to reflect the certainty of the evidence. We calculated the funding required for an electronic urinary incontinence monitoring system in the first year of implementation (when facilities would buy the systems) and in subsequent years. We interviewed six people with urinary incontinence and two caregivers, who described ways urinary incontinence affected daily life. Results: We included one observational study in the clinical review. Most of the 31 participants in the observational study were female (78%) and required high levels of care, primarily because of cognitive impairment. The quality of evidence for all outcomes was very low owing to potential risk of bias and indirectness. We are consequently uncertain about how electronic monitoring systems affect management of urinary incontinence. For patients living in long-term care homes who are eligible for the technology, we estimated that an electronic monitoring system to assess urinary incontinence would cost $6.4 million in the first year of implementation and $1.6 million in subsequent years. Patients said urinary incontinence reduced their independence and social life and adversely affected their quality of life. Incontinence made them embarrassed and reduced their self-esteem. Several respondents mentioned how expensive supplies to manage incontinence were. Conclusions: The effectiveness of using the electronic monitoring system to assess urinary incontinence is uncertain because of the very low quality of the evidence. Introducing electronic monitoring systems would result in incremental costs, and there would be savings only if the systems substantially reduced incontinence. © Queen’s Printer for Ontario, 2018. AU - Nevis, Immaculate AU - Kabali, Conrad AU - Tu, Hong Anh AU - Ekanayake, Samanthika AU - Mistry, Jigna AU - Wells, David AU - Ali, Arshia AU - Walter, Melissa AU - Higgins, Caroline AU - Betsch, Elizabeth Jean AU - Heft, Harrison AU - Soulodre, Claude AU - Laing, Ana AU - Kaulback, Kellee AU - Mitchell, Andrée AU - McDowell, Sarah AU - Ng, Vivian AU - Thota, Anil AU - Sikich, Nancy AU - Dhalla, Irfan DA - 2018-1-1 IS - 3 KW - Home Care Services Biomedical Technology Bias (Epidemiology) Long-Term Care Technology Assessment, Biomedical Urinary Incontinence urine incontinence uncertainty social life self esteem quality of life patient preference patient care outcome assessment long term care human home care health care planning health care personnel health care facility health care cost geriatric hospital funding evidence based medicine disease assessment daily life activity consultation clinical effectiveness caregiver biomedical technology assessment Article PY - 2018 SN - 1915-7398 SP - 1-60 ST - Electronic monitoring systems to assess urinary incontinence: A health technology assessment T2 - Ontario Health Technology Assessment Series TI - Electronic monitoring systems to assess urinary incontinence: A health technology assessment VL - 18 ID - 52 ER - TY - JOUR AB - Objective Humanitarian surgery is often organized and delivered with short notice and limited time for developing unique strategies for providing care. While some surgical pathologies can be anticipated by the nature of the crisis, the role of foreign medical teams in treating the existing and unmet burden of surgical disease during crises is unclear. The purpose of this study was to examine published data from crises during the years 1990 through 2011 to understand the role of foreign medical teams in providing surgical care in these settings. Methods: A literature search was completed using PubMed, MEDLINE, and EMBASE databases to locate relevant manuscripts published in peer-reviewed journals. A qualitative review of the surgical activities reported in the studies was performed. Results: Of 185 papers where humanitarian surgical care was provided by a foreign medical team, only 11 articles met inclusion criteria. The reporting of surgical activities varied significantly, and pooled statistical analysis was not possible. The quality of reporting was notably poor, and produced neither reliable estimates of the pattern of surgical consultations nor data on the epidemiology of the burden of surgical diseases. The qualitative trend analysis revealed that the most frequent procedures were related to soft tissue or orthopedic surgery. Procedures such as caesarean sections, hernia repairs, and appendectomies also were common. As length of deployment increased, the surgical caseload became more reflective of the existing, unmet burden of surgical disease. Conclusion:s This review suggests that where foreign medical teams are indicated and requested, multidisciplinary surgical teams capable of providing a range of emergency and essential surgical, and rehabilitation services are required. Standardization of data collection and reporting tools for surgical care are needed to improve the reporting of surgical epidemiology in crisis-affected populations. © Copyright 2012 World Association for Disaster and Emergency Medicine. AU - Nickerson, J. W. AU - Chackungal, S. AU - Knowlton, L. AU - McQueen, K. AU - Burkle Jr, F. M. DA - 2012-1-1 %J Prehospital and Disaster Medicine IS - 2 KW - Emigrants and Immigrants PY - 2012 SP - 184-189 ST - Surgical care during humanitarian crises: A systematic review of published surgical caseload data from foreign medical teams T2 - Prehospital and Disaster Medicine TI - Surgical care during humanitarian crises: A systematic review of published surgical caseload data from foreign medical teams VL - 27 ID - 307 ER - TY - JOUR AB - Background: Fear of Childbirth (FOC) is a common problem affecting women's health and wellbeing, and a common reason for requesting caesarean section. The aims of this review were to summarise published research on prevalence of FOC in childbearing women and how it is defined and measured during pregnancy and postpartum, and to search for useful measures of FOC, for research as well as for clinical settings. Methods: Five bibliographic databases in March 2015 were searched for published research on FOC, using a protocol agreed a priori. The quality of selected studies was assessed independently by pairs of authors. Prevalence data, definitions and methods of measurement were extracted independently from each included study by pairs of authors. Finally, some of the country rates were combined and compared. Results: In total, 12,188 citations were identified and screened by title and abstract; 11,698 were excluded and full-text of 490 assessed for analysis. Of these, 466 were excluded leaving 24 papers included in the review, presenting prevalence of FOC from nine countries in Europe, Australia, Canada and the United States. Various definitions and measurements of FOC were used. The most frequently-used scale was the W-DEQ with various cut-offpoints describing moderate, severe/intense and extreme/phobic fear. Different 3-, 4-, and 5/6 point scales and visual analogue scales were also used. Country rates (as measured by seven studies using W-DEQ with ≥85 cut-offpoint) varied from 6.3 to 14.8%, a significant difference (chi-square = 104.44, d.f. = 6, p< 0.0001). Conclusions: Rates of severe FOC, measured in the same way, varied in different countries. Reasons why FOC might differ are unknown, and further research is necessary. Future studies on FOC should use the W-DEQ tool with a cut-offpoint of ≥85, or a more thoroughly tested version of the FOBS scale, or a three-point scale measurement of FOC using a single question as 'Are you afraid about the birth?' In this way, valid comparisons in research can be made. Moreover, validation of a clinical tool that is more focussed on FOC alone, and easier than the longer W-DEQ, for women to fill in and clinicians to administer, is required. © 2018 The Author(s). AU - Nilsson, C. AU - Hessman, E. AU - Sjöblom, H. AU - Dencker, A. AU - Jangsten, E. AU - Mollberg, M. AU - Patel, H. AU - Sparud-Lundin, C. AU - Wigert, H. AU - Begley, C. DA - 2018-1-1 IS - 1 KW - Pregnancy Women's Health visual analog scale validation process United States systematic review prevalence human female fear Europe childbirth cesarean section Canada bibliographic database Australia adult W-DEQ Request for caesarean section FOBS Fear of childbirth PY - 2018 ST - Definitions, measurements and prevalence of fear of childbirth: A systematic review T2 - BMC Pregnancy and Childbirth TI - Definitions, measurements and prevalence of fear of childbirth: A systematic review VL - 18 ID - 131 ER - TY - JOUR AB - Objective: to evaluate the effectiveness of women-centred interventions during pregnancy and birth to increase rates of vaginal birth after caesarean. Design: we searched bibliographic databases for randomised trials or cluster randomised trials on women-centred interventions during pregnancy and birth designed to increase VBAC rates in women with at least one previous caesarean section. Comparator groups included standard or usual care or an alternative treatment aimed at increasing VBAC rates. The methodological quality of included studies was assessed independently by two authors using the Effective Public Health Practice Project quality assessment tool. Outcome data were extracted independently from each included study by two review authors. Findings: in total, 821 citations were identified and screened by title and abstract; 806 were excluded and full text of 15 assessed. Of these, 12 were excluded leaving three papers included in the review. Two studies evaluated the effectiveness of decision aids for mode of birth and one evaluated the effectiveness of an antenatal education programme. The findings demonstrate that neither the use of decision aids nor information/education of women have a significant effect on VBAC rates. Nevertheless, decision-aids significantly decrease women's decisional conflict about mode of birth, and information programmes significantly increase their knowledge about the risks and benefits of possible modes of birth. Key conclusions: few studies evaluated women-centred interventions designed to improve VBAC rates, and all interventions were applied in pregnancy only, none during the birth. There is an urgent need to develop and evaluate the effectiveness of all types of women-centred interventions during pregnancy and birth, designed to improve VBAC rates. Implications for practice: decision-aids and information programmes during pregnancy should be provided for women as, even though they do not affect the rate of VBAC, they decrease women's decisional conflict and increase their knowledge about possible modes of birth. © 2015 Elsevier Ltd. AU - Nilsson, C. AU - Lundgren, I. AU - Smith, V. AU - Vehvilainen-Julkunen, K. AU - Nicoletti, J. AU - Devane, D. AU - Bernloehr, A. AU - van Limbeek, E. AU - Lalor, J. AU - Begley, C. DA - 2015-1-1 IS - 7 KW - Acquired Immunodeficiency Syndrome Cesarean Section Decision Support Techniques Vaginal Birth after Cesarean Randomized Controlled Trials as Topic Prenatal Care Pregnancy Patient-Centered Care Midwifery Maternal-Child Health Services Humans Female Europe randomized controlled trial (topic) patient care midwife maternal child health care human Women-centred intervention Vaginal birth after caesarean (VBAC) Systematic review Caesarean section (CS) PY - 2015 SN - 1532-3099 SP - 657-663 ST - Women-centred interventions to increase vaginal birth after caesarean section (VBAC): A systematic review T2 - Midwifery TI - Women-centred interventions to increase vaginal birth after caesarean section (VBAC): A systematic review VL - 31 ID - 219 ER - TY - JOUR AB - Background: The ability to reproduce experiments is a defining principle of science. Reproducibility of clinical research has received relatively little scientific attention. However, it is important as it may inform clinical practice, research agendas, and the design of future studies. Methods: We used scoping review methods to examine reproducibility within a cohort of randomized trials examining clinical critical care research and published in the top general medical and critical care journals. To identify relevant clinical practices, we searched the New England Journal of Medicine, The Lancet, and JAMA for randomized trials published up to April 2016. To identify a comprehensive set of studies for these practices, included articles informed secondary searches within other high-impact medical and specialty journals. We included late-phase randomized controlled trials examining therapeutic clinical practices in adults admitted to general medical-surgical or specialty intensive care units (ICUs). Included articles were classified using a reproducibility framework. An original study was the first to evaluate a clinical practice. A reproduction attempt re-evaluated that practice in a new set of participants. Results: Overall, 158 practices were examined in 275 included articles. A reproduction attempt was identified for 66 practices (42%, 95% CI 33-50%). Original studies reported larger effects than reproduction attempts (primary endpoint, risk difference 16.0%, 95% CI 11.6-20.5% vs. 8.4%, 95% CI 6.0-10.8%, P = 0.003). More than half of clinical practices with a reproduction attempt demonstrated effects that were inconsistent with the original study (56%, 95% CI 42-68%), among which a large number were reported to be efficacious in the original study and to lack efficacy in the reproduction attempt (34%, 95% CI 19-52%). Two practices reported to be efficacious in the original study were found to be harmful in the reproduction attempt. Conclusions: A minority of critical care practices with research published in high-profile journals were evaluated for reproducibility; less than half had reproducible effects. © 2018 The Author(s). AU - Niven, D. J. AU - McCormick, T. J. AU - Straus, S. E. AU - Hemmelgarn, B. R. AU - Jeffs, L. AU - Barnes, T. R. M. AU - Stelfox, H. T. DA - 2018-1-1 IS - 1 KW - Reproducibility of Results Intensive Care Units Humans Critical Care Biomedical Research reproducibility procedures medical research intensive care unit intensive care United States surgery reproduction randomized controlled trial male human experiment human female drug efficacy controlled study cohort analysis clinical research clinical practice clinical evaluation attributable risk article adult adoption Replication research ICU De-adoption PY - 2018 ST - Reproducibility of clinical research in critical care: A scoping review T2 - BMC Medicine TI - Reproducibility of clinical research in critical care: A scoping review VL - 16 ID - 127 ER - TY - JOUR AB - Introduction: Reducing unnecessary, low-value clinical practice (ie, de-adoption) is key to improving value for money in healthcare, especially among patients admitted to intensive care units (ICUs) where resource consumption exceeds other medical and surgical populations. Research suggests that low-value clinical practices are common in medicine, however systematically and objectively identifying them is a widely cited barrier to de-adoption. We will conduct a scoping review to identify low-value clinical practices in adult critical care medicine that are candidates for de-adoption. Methods and analysis: We will systematically search the literature to identify all randomised controlled trials or systematic reviews that focus on diagnostic or therapeutic interventions in adult patients admitted to medical, surgical or specialty ICUs, and are published in 3 general medical journals with the highest impact factor (New England Journal of Medicine, The Lancet, Journal of the American Medical Association). 2 investigators will independently screen abstracts and full-text articles against inclusion criteria, and extract data from included citations. Included citations will be classified according to whether or not they represent a repeat examination of the given research question (ie, replication research), and whether the results are similar or contradictory to the original study. Studies with contradictory results will determine clinical practices that are candidates for de-adoption. Ethics and dissemination: Our scoping review will use robust methodology to systematically identify a list of clinical practices in adult critical care medicine with evidence supporting their de-adoption. In addition to adding to advancing the study of de-adoption, this review may also serve as the launching point for clinicians and researchers in critical care to begin reducing the number of low-value clinical practices. Dissemination of these results to relevant stakeholders will include tailored presentations at local, national and international meetings, and publication of a manuscript. Ethical approval is not required for this study. AU - Niven, D. J. AU - McCormick, T. J. AU - Straus, S. E. AU - Hemmelgarn, B. R. AU - Jeffs, L. P. AU - Stelfox, H. T. DA - 2015-1-1 IS - 10 KW - Research Design Quality of Health Care Practice Patterns, Physicians' Intensive Care Units Humans Critical Care standards methodology intensive care unit intensive care health care quality clinical practice United States systematic review surgery scientist publication medicine medical society human extract ethics adult adoption PY - 2015 SN - 2044-6055 ST - Identifying low-value clinical practices in critical care medicine: Protocol for a scoping review T2 - BMJ Open TI - Identifying low-value clinical practices in critical care medicine: Protocol for a scoping review VL - 5 ID - 221 ER - TY - JOUR AB - Background: Low-value clinical practices are common in healthcare, yet the optimal approach to de-adopting these practices is unknown. The objective of this study was to systematically review the literature on de-adoption, document current terminology and frameworks, map the literature to a proposed framework, identify gaps in our understanding of de-adoption, and identify opportunities for additional research. Methods: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, the Cochrane Database of Abstracts and Reviews of Effects, and CINAHL Plus were searched from 1 January 1990 to 5 March 2014. Additional citations were identified from bibliographies of included citations, relevant websites, the PubMed 'related articles' function, and contacting experts in implementation science. English-language citations that referred to de-adoption of clinical practices in adults with medical, surgical, or psychiatric illnesses were included. Citation selection and data extraction were performed independently and in duplicate. Results: From 26,608 citations, 109 were included in the final review. Most citations (65 %) were original research with the majority (59 %) published since 2010. There were 43 unique terms referring to the process of de-adoption-the most frequently cited was "disinvest" (39 % of citations). The focus of most citations was evaluating the outcomes of de-adoption (50 %), followed by identifying low-value practices (47 %), and/or facilitating de-adoption (40 %). The prevalence of low-value practices ranged from 16 % to 46 %, with two studies each identifying more than 100 low-value practices. Most articles cited randomized clinical trials (41 %) that demonstrate harm (73 %) and/or lack of efficacy (63 %) as the reason to de-adopt an existing clinical practice. Eleven citations described 13 frameworks to guide the de-adoption process, from which we developed a model for facilitating de-adoption. Active change interventions were associated with the greatest likelihood of de-adoption. Conclusions: This review identified a large body of literature that describes current approaches and challenges to de-adoption of low-value clinical practices. Additional research is needed to determine an ideal strategy for identifying low-value practices, and facilitating and sustaining de-adoption. In the meantime, this study proposes a model that providers and decision-makers can use to guide efforts to de-adopt ineffective and harmful practices. © 2015 Niven et al. AU - Niven, D. J. AU - Mrklas, K. J. AU - Holodinsky, J. K. AU - Straus, S. E. AU - Hemmelgarn, B. R. AU - Jeffs, L. P. AU - Stelfox, H. T. DA - 2015-1-1 IS - 1 KW - Utilization Review Quality Improvement Practice Patterns, Physicians' Peer Review, Health Care Patient Safety Humans Decision Making total quality management standards peer review clinical practice systematic review randomized controlled trial (topic) publishing practice guideline percutaneous coronary intervention obesity medical research medical literature medical documentation medical decision making ischemic heart disease hypertension human health care quality gastric dysmotility evidence based medicine end stage renal disease diabetes mellitus de adoption congestive heart failure conceptual framework Article arthritis adaptation acute coronary syndrome zomepirac rosiglitazone nonsteroid antiinflammatory agent nesiritide lidocaine fenfluramine dexfenfluramine cyclooxygenase 2 inhibitor cisapride calcium channel blocking agent alpha adrenergic receptor blocking agent Withdrawal Reassess Obsolete Medical reversal Low-value Disinvestment De-implementation De-adoption Contradict Abandon PY - 2015 ST - Towards understanding the de-adoption of low-value clinical practices: A scoping review T2 - BMC Medicine TI - Towards understanding the de-adoption of low-value clinical practices: A scoping review VL - 13 ID - 199 ER - TY - JOUR AB - Background - Atrial fibrillation is an important cause of cardioembolic stroke. Oral anticoagulants (OAC) reduce stroke risk but increase the risk of serious bleeding. Left atrial appendage (LAA) procedures have been developed to isolate the LAA from circulating blood flow, as an alternative to OAC. We conducted a systematic review of the benefits and harms of surgical and percutaneous LAA exclusion procedures. Methods and Results - We searched multiple data sources, including Ovid MEDLINE, Cochrane, and Embase, through January 7, 2015. Of 2567 citations, 20 primary studies met prespecified inclusion criteria. We abstracted data on patient characteristics, stroke, mortality, and adverse effects. We assessed study quality and graded the strength of evidence using published criteria. Trials found low-strength evidence that percutaneous LAA exclusion confers similar risks of stroke and mortality as continued OAC, but this evidence was limited to the Watchman device in patients eligible for long-term OAC. Observational studies found moderate-strength evidence of serious harms with a variety of percutaneous LAA procedures. There is low-strength evidence that surgical LAA exclusion does not add significant harm during heart surgery for another indication, but evidence on stroke reduction is insufficient. Conclusions - There is limited evidence that the Watchman device may be noninferior to long-term OAC in selected patients. Data on effectiveness of LAA exclusion devices is lacking in patients ineligible for long-term OAC. Percutaneous LAA devices are associated with high rates of procedure-related harms. Although surgical LAA exclusion during heart surgery does not seem to add incremental harm, there is insufficient evidence of benefit. © 2016 American Heart Association, Inc. AU - Noelck, N. AU - Papak, J. AU - Freeman, M. AU - Paynter, R. AU - Low, A. AU - Motu'apuaka, M. AU - Kondo, K. AU - Kansagara, D. C2 - 27407055 DB - Scopus DO - 10.1161/CIRCOUTCOMES.115.002539 IS - 4 KW - anticoagulants atrial appendage atrial fibrillation hemorrhage stroke warfarin anticoagulant therapy bleeding cardioembolic stroke Cochrane Library comparative effectiveness Embase heart atrium appendage heart surgery human interventional cardiovascular procedure left atrial appendage closure device left atrial appendage exclusion procedure long term care Medline mortality percutaneous coronary intervention pericardial effusion priority journal randomized controlled trial (topic) Review systematic review aged devices evidence based medicine female heart catheterization male middle aged pathophysiology risk assessment risk factor time factor treatment outcome Cardiac Catheterization Cardiac Surgical Procedures Evidence-Based Medicine Humans Risk Factors Time Factors M3 - Review PY - 2016 SP - 395-405 ST - Effectiveness of left atrial appendage exclusion procedures to reduce the risk of stroke: A systematic review of the evidence T2 - Circulation: Cardiovascular Quality and Outcomes TI - Effectiveness of left atrial appendage exclusion procedures to reduce the risk of stroke: A systematic review of the evidence VL - 9 ID - 314 ER - TY - JOUR AB - Purpose: The purpose of this systematic literature review was to develop recommendations for the assessment of spine-related complaints in medically underserved areas with limited resources. Methods: We conducted a systematic review and best evidence synthesis of guidelines on the assessment of spine-related complaints. Independent reviewers critically appraised eligible guidelines using the Appraisal of Guidelines for Research and Evaluation-II criteria. Low risk of bias clinical practice guidelines was used to develop recommendations. In accordance with the mandate of the Global Spinal Care Initiative (GSCI), recommendations were selected that could be applied to medically underserved areas and low- and middle-income countries by considering the limited access and costs of diagnostic technologies. Results: We screened 3069 citations; 20 guidelines were eligible for critical appraisal. We used 13 that had a low risk of bias that targeted neck and back pain. Conclusions: When assessing patients with spine-related complaints in medically underserved areas and low- and middle-income countries, we recommend that clinicians should: (1) take a clinical history to determine signs or symptoms suggesting serious pathology (red flags) and psychological factors (yellow flags); (2) perform a physical examination (musculoskeletal and neurological); (3) do not routinely obtain diagnostic imaging; (4) obtain diagnostic imaging and/or laboratory tests when serious pathologies are suspected, and/or presence of progressive neurologic deficits, and/or disabling persistent pain; (5) do not perform electromyography or nerve conduction studies for diagnosis of intervertebral disc disease with radiculopathy; and (6) do not perform discography for the assessment of spinal disorders. This information can be used to inform the GSCI care pathway and model of care. Graphical abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.] © 2018, Springer-Verlag GmbH Germany, part of Springer Nature. AU - Nordin, M. AU - Randhawa, K. AU - Torres, P. AU - Yu, H. AU - Haldeman, S. AU - Brady, O. D. AU - Côté, P. AU - Torres, C. AU - Modic, M. AU - Mullerpatan, R. AU - Cedraschi, C. AU - Chou, R. AU - Acaroğlu, E. AU - Hurwitz, E. L. AU - Lemeunier, N. AU - Dudler, J. AU - Taylor-Vaisey, A. AU - Sönmez, E. DA - 2018-1-1 %J European Spine Journal KW - Spine Neck Pain Bias (Epidemiology) PY - 2018 SP - 816-827 ST - The Global Spine Care Initiative: a systematic review for the assessment of spine-related complaints in populations with limited resources and in low- and middle-income communities T2 - European Spine Journal TI - The Global Spine Care Initiative: a systematic review for the assessment of spine-related complaints in populations with limited resources and in low- and middle-income communities VL - 27 ID - 273 ER - TY - JOUR AB - Background: Mining is a hazardous occupation with elevated rates of lost-time injury and disability. OBJECTIVE: The purpose of this study is twofold: 1) To identify the type of lost-time injuries in the mining workforce, regardless of the kind of mining and 2) To examine the antecedent factors to the occupational injury (lost-time injuries). METHODS: We identified and extracted primary papers related to lost-time injuries in the mining sector by conducting a systematic search of the electronic literature in the eight health and related databases. RESULTS: We critically reviewed nine articles in the mining sector that examined lost-time injuries. Musculoskeletal injuries (hand, back, limbs, fractures, lacerations and muscle contusions), slips and falls were identified as types of lost-time injuries. The review identified the following antecedent factors related to lost-time injuries: the mining work environment (underground mining), being male, age, working with mining equipment, organizational size, falling objects, disease status, job training and lack of occupational safety management teams, recovery time, social supports, access to health services, pre-injury health status and susceptibility to injury. DISCUSSIONS: The mining sector is a hazardous environment that increases workers' susceptibility to occupational injuries. There is a need to create and implement monitoring systems of lost-time injuries to implement prevention programs. © 2018-IOS Press and the authors. All rights reserved. AU - Nowrouzi-Kia, B. AU - Gohar, B. AU - Casole, J. AU - Chidu, C. AU - Dumond, J. AU - McDougall, A. AU - Nowrouzi-Kia, B. DB - Scopus DO - 10.3233/WOR-182715 IS - 1 M3 - Review PY - 2018 SP - 49-61 ST - A systematic review of lost-time injuries in the global mining industry T2 - Work TI - A systematic review of lost-time injuries in the global mining industry VL - 60 ID - 332 ER - TY - JOUR AB - Background The mining industry is associated with high levels of accidents, injuries and illnesses. Lost-time injuries are useful measures of health and safety in mines, and the effectiveness of its safety programmes. Aims To identify the type of lost-time injuries in the US mining workforce and to examine predictors of these occupational injuries. Methods Primary papers on lost-time injuries in the US mining sector were identified through a literature search in eight health, geology and mining databases, using a systematic review protocol tailored to each database. The Critical Appraisal Skills Programme (CASP), Framework of Quality Assurance for Administrative Data Source and the Cochrane Collaboration 'Risk of bias' assessment tools were used to assess study quality. Results A total of 1736 articles were retrieved before duplicates were removed. Fifteen articles were ultimately included with a CASP mean score of 6.33 (SD 0.62) out of 10. Predictors of lost-time injuries included slips and falls, electric injuries, use of mining equipment, working in underground mining, worker's age and occupational experience. Conclusions This is the first systematic review of lost-time injuries in the US mining sector. The results support the need for further research on factors that contribute to workplace lost-time injuries as there is limited literature on the topic. Safety analytics should also be applied to uncover new trends and predict the likelihood of future incidents before they occur. New insights will allow employers to prevent injuries and foster a safer workplace environment by implementing successful occupational health and safety programmes. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. AU - Nowrouzi-Kia, B. AU - Sharma, B. AU - Dignard, C. AU - Kerekes, Z. AU - Dumond, J. AU - Li, A. AU - Larivière, M. DB - Scopus DO - 10.1093/occmed/kqx077 IS - 6 M3 - Article PY - 2017 SP - 442-447 ST - Systematic review: Lost-time injuries in the US mining industry T2 - Occupational Medicine TI - Systematic review: Lost-time injuries in the US mining industry VL - 67 ID - 336 ER - TY - JOUR AB - Background: Early mobilization and rehabilitation of patients in intensive care units (ICUs) may improve physical function, and reduce the duration of delirium, mechanical ventilation, and ICU length of stay. However, safety concerns are an important barrier to widespread implementation. Objectives: To synthesize safety data regarding patient mobilization and rehabilitation in the ICU, including falls, removal of endotracheal tubes, removal or dysfunction of intravascular catheters, removal of other catheters/tubes, cardiac arrest, hemodynamic changes, and desaturation. Data Sources: Systematic literature review, including searches of five databases. Eligible studies evaluated patients who received mobilization-related interventions in the ICU. Exclusion criteria included: (1) case series with fewer than 10 patients; (2) majority of patients under 18 years of age; and (3) data not reported to permit calculation of incidence of safety events. Data Extraction: Number of patients, mobilization/rehabilitation sessions, potential safety events, and events with negative consequences (e.g., requiring intervention or additional therapy). Synthesis: Heterogeneity was assessed by I2statistics, and bias assessed by the Newcastle-Ottawa Scale and Cochrane risk of bias assessment. The literature search identified 20,660 titles. There were 48 eligible publications evaluating 7,546 patients, with 583 potential safety events occurring in 22,351 mobilization/rehabilitation sessions. There was a total of 583 (2.6%) potential safety events with heterogeneity in the definitions for these events. For the safety event types that could be meta-analyzed, pooled incidences per 1,000 mobilization/rehabilitation sessions (95% confidence interval), were: hemodynamic changes, 3.8 (1.3-11.4), and desaturation, 1.9 (0.9-4.3). A total of 24 studies of 3,404 patients reported on any consequences of potential safety events (e.g., needing to increase dose of vasopressor due to mobility-related hypotension), with a frequency of 0.6% in 14,398 mobilization/rehabilitation sessions. Conclusions: Patient mobilization and physical rehabilitation in the ICU appears safe, with a low incidence of potential safety events, and only rare events having any consequences for patient management Heterogeneity in the definition of safety events across studies emphasizes the importance of implementing existing consensus-based definitions. Copyright © 2017 by the American Thoracic Society. AU - Nydahl, P. AU - Sricharoenchai, T. AU - Chandra, S. AU - Kundt, F. S. AU - Huang, M. AU - Fischill, M. AU - Needham, D. M. DA - 2017-1-1 IS - 5 KW - Hemodynamics Intensive Care Early Ambulation Respiration, Artificial Randomized Controlled Trials as Topic Patient Safety Length of Stay Intensive Care Units Humans Critical Illness Case Management statistics and numerical data randomized controlled trial (topic) organization and management intensive care unit artificial ventilation systematic review risk assessment Review rehabilitation care Newcastle-Ottawa scale mobilization meta analysis intravascular catheter incidence hypotension human heart arrest falling endotracheal tube drug dose increase catheter removal hypertensive agent Exercise Adverse effects PY - 2017 SN - 2325-6621 SP - 766-777 ST - Safety of patient mobilization and rehabilitation in the intensive care unit: Systematic review with meta-analysis T2 - Annals of the American Thoracic Society TI - Safety of patient mobilization and rehabilitation in the intensive care unit: Systematic review with meta-analysis VL - 14 ID - 96 ER - TY - JOUR AB - Background: With an ageing population and increasing numbers of people with life-limiting illness, there is a growing demand for palliative day services. There is a need to measure and demonstrate the quality of these services, but there is currently little agreement on which aspects of care should be used to do this. The aim of the scoping review will be to map the extent, range and nature of the evidence around models of delivery, care domains and existing quality indicators used to evaluate palliative day services. Methods: Electronic databases (MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials) will be searched for evidence using consensus development methods; randomised or quasi-randomised controlled trials; mixed methods; and prospective, longitudinal or retrospective case-control studies to develop or test quality indicators for evaluating palliative care within non-residential settings, including day hospices and community or primary care settings. At least two researchers will independently conduct all searches, study selection and data abstraction procedures. Meta-analyses and statistical methods of synthesis are not planned as part of the review. Results will be reported using numerical counts, including number of indicators in each care domain and by using qualitative approach to describe important indicator characteristics. A conceptual model will also be developed to summarise the impact of different aspects of quality in a palliative day service context. Methodological quality relating to indicator development will be assessed using the Appraisal of Indicators through Research and Evaluation (AIRE) tool. Overall strength of evidence will be assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. Final decisions on quality assessment will be made via consensus between review authors. Discussion: Identifying, developing and implementing evidence-based quality indicators is critical to the evaluation and continued improvement of palliative care. Review findings will be used to support clinicians and policymakers make decisions on which quality indicators are most appropriate for evaluating day services at the patient and service level, and to identify areas for further research. © 2017 The Author(s). AU - O'Connor, S. R. AU - Dempster, M. AU - McCorry, N. K. DA - 2017-1-1 IS - 1 KW - Case-Control Studies Quality Indicators, Health Care Review Literature as Topic Retrospective Studies Research Design Randomized Controlled Trials as Topic Quality of Health Care Prospective Studies Policy Making Palliative Care Humans Hospices Health Services Research Evidence-Based Practice Delivery of Health Care standards retrospective study randomized controlled trial (topic) prospective study methodology management literature hospice health care quality health care delivery evidence based practice total quality management systematic review quality of life quality control priority journal primary medical care practice guideline palliative therapy human hospice care consensus development clinical indicator Article ageism Quality indicators Quality improvement PY - 2017 SN - 2046-4053 ST - Identifying models of delivery, care domains and quality indicators relevant to palliative day services: A scoping review protocol T2 - Systematic Reviews TI - Identifying models of delivery, care domains and quality indicators relevant to palliative day services: A scoping review protocol VL - 6 ID - 93 ER - TY - JOUR AB - Background: Type 2 diabetes mellitus (T2DM), a highly prevalent chronic disease, puts a large burden on individual health and health care systems. Computer simulation models, used to evaluate the clinical and economic effectiveness of various interventions to handle T2DM, have become a well-established tool in diabetes research. Despite the broad consensus about the general importance of validation, especially external validation, as a crucial instrument of assessing and controlling for the quality of these models, there are no systematic reviews comparing such validation of diabetes models. As a result, the main objectives of this systematic review are to identify and appraise the different approaches used for the external validation of existing models covering the development and progression of T2DM. Methods: We will perform adapted searches by applying respective search strategies to identify suitable studies from 14 electronic databases. Retrieved study records will be included or excluded based on predefined eligibility criteria as defined in this protocol. Among others, a publication filter will exclude studies published before 1995. We will run abstract and full text screenings and then extract data from all selected studies by filling in a predefined data extraction spreadsheet. We will undertake a descriptive, narrative synthesis of findings to address the study objectives. We will pay special attention to aspects of quality of these models in regard to the external validation based upon ISPOR and ADA recommendations as well as Mount Hood Challenge reports. All critical stages within the screening, data extraction and synthesis processes will be conducted by at least two authors. This protocol adheres to PRISMA and PRISMA-P standards. Discussion: The proposed systematic review will provide a broad overview of the current practice in the external validation of models with respect to T2DM incidence and progression in humans built on simulation techniques. Systematic review registration: PROSPERO CRD42017069983. © 2017 The Author(s). AU - Ogurtsova, K. AU - Heise, T. L. AU - Linnenkamp, U. AU - Lhachimi, S. K. AU - Icks, A. DA - 2017-1-1 IS - 1 KW - Humanism Humanities Computer Simulation Humans systematic review (topic) screening risk factor priority journal non insulin dependent diabetes mellitus morbidity human glucose tolerance disease course Article Type 2 diabetes mellitus Systematic review Simulation External validation Diabetes models PY - 2017 SN - 2046-4053 ST - External validation of type 2 diabetes computer simulation models: Definitions, approaches, implications and room for improvement-a protocol for a systematic review T2 - Systematic Reviews TI - External validation of type 2 diabetes computer simulation models: Definitions, approaches, implications and room for improvement-a protocol for a systematic review VL - 6 ID - 67 ER - TY - JOUR AB - This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effects of the integrated community case management (iCCM) strategy for children younger than five years of age in low- and middle-income countries. © 2017 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. AU - Oliphant, N. P. AU - Daniels, K. AU - Odendaal, W. A. AU - Besada, D. AU - Manda, S. AU - Kinney, M. AU - White Johansen, E. AU - Lunze, K. AU - Johansen, M. AU - Doherty, T. C7 - Cd012882 DB - Scopus DO - 10.1002/14651858.CD012882 IS - 11 KW - Article caregiver case management child childhood disease clinical trial (topic) health care delivery health service human integrated community case management lowest income group middle income group outcome assessment preschool child priority journal systematic review (topic) world health organization M3 - Article PY - 2017 ST - Integrated community case management of childhood illness in low- and middle-income countries T2 - Cochrane Database of Systematic Reviews TI - Integrated community case management of childhood illness in low- and middle-income countries VL - 2017 ID - 309 ER - TY - JOUR AB - BACKGROUND We describe intraoperative and postdischarge outcomes of a case series after the prophylactic use of resuscitative endovascular balloon occlusion of the aorta (REBOA) during elective cesarean delivery in pregnant women with morbidly adherent placenta (MAP). We furthermore performed a systematic review and meta-analysis to investigate the safety and effectiveness of the use of REBOA during elective cesarean delivery in pregnant women with MAP. METHODS Descriptive case series of REBOA (December 2015 to June 2017) used during elective cesarean delivery in pregnant women with MAP. The systematic review was conducted following PRISMA guidelines. We included studies involving pregnant women with a diagnosis of MAP who underwent an elective cesarean delivery with prophylactic REBOA placement. A meta-analysis was performed to assess the overall amount of transfusions and intraoperative hemorrhage of REBOA compared to NO-REBOA cases. RESULTS A total of 12 patients with MAP underwent elective cesarean delivery with REBOA deployment. The median (interquartile range) of packed red blood cells transfused during the first 24 hours following surgery was two units (0-3.5). The median (interquartile range) of intraoperative blood loss was 1,500 mL (900-2,750). At 28 days, all patients were alive, and no adverse outcomes were observed. Four articles were included in the systematic review and meta-analysis. These articles included a total of 441 patients. Quantitative synthesis (meta-analysis) found that the use of REBOA as prophylaxis for the prevention of major hemorrhage was associated with a lower amount of intraoperative hemorrhage (in milliliters) (weighted mean difference, -1,384.66; 95% confidence interval, -2,141.74 to -627.58) and lower requirements of blood products transfusions (in units) (weighted mean difference, -2.42; 95% confidence interval, -3.90 to -0.94). CONCLUSION We provide clinical data supporting the use of REBOA in the management of pregnant women with MAP undergoing elective cesarean delivery. Our findings demonstrate the feasibility of REBOA as a prophylactic intervention to improve outcomes in women at risk of catastrophic postpartum hemorrhage. © 2018 Wolters Kluwer Health, Inc. AU - Ordoñez, C. A. AU - Manzano-Nunez, R. AU - Parra, M. W. AU - Rasmussen, T. E. AU - Nieto, A. J. AU - Herrera-Escobar, J. P. AU - Fernandez, P. AU - Naranjo, M. P. AU - García, A. F. AU - Carvajal, J. A. AU - Burgos, J. M. AU - Rodriguez, F. AU - Escobar-Vidarte, M. F. DA - 2018-1-1 IS - 5 KW - Aorta systematic review Review resuscitative endovascular balloon occlusion of the aorta prophylaxis priority journal pregnant woman placenta disorder operative blood loss morbidly adherent placenta meta analysis human female erythrocyte transfusion clinical article cesarean section case study balloon occlusion adult REBOA postpartum hemorrhage Placenta accreta endovascular procedures PY - 2018 SP - 809-818 ST - Prophylactic use of resuscitative endovascular balloon occlusion of the aorta in women with abnormal placentation: A systematic review, meta-analysis, and case series T2 - Journal of Trauma and Acute Care Surgery TI - Prophylactic use of resuscitative endovascular balloon occlusion of the aorta in women with abnormal placentation: A systematic review, meta-analysis, and case series VL - 84 ID - 53 ER - TY - JOUR AB - Background: There is a considerable amount of practice variation in managing migraines in emergency settings, and evidence-based therapies are often not used first line. Methods: A peer-reviewed search of databases (MEDLINE, Embase, CENTRAL) was carried out to identify randomized and quasi-randomized controlled trials of interventions for acute pain relief in adults presenting with migraine to emergency settings. Where possible, data were pooled into meta-analyses. Results: Two independent reviewers screened 831 titles and abstracts for eligibility. Three independent reviewers subsequently evaluated 120 full text articles for inclusion, of which 44 were included. Individual studies were then assigned a US Preventive Services Task Force quality rating. The GRADE scheme was used to assign a level of evidence and recommendation strength for each intervention. Interpretation:We strongly recommend the use of prochlorperazine based on a high level of evidence, lysine acetylsalicylic acid, metoclopramide and sumatriptan, based on a moderate level of evidence, and ketorolac, based on a low level of evidence. We weakly recommend the use of chlorpromazine based on a moderate level of evidence, and ergotamine, dihydroergotamine, lidocaine intranasal and meperidine, based on a low level of evidence. We found evidence to recommend strongly against the use of dexamethasone, based on a moderate level of evidence, and granisetron, haloperidol and trimethobenzamide based on a low level of evidence. Based on moderate-quality evidence, we recommend weakly against the use of acetaminophen and magnesium sulfate. Based on low-quality evidence, we recommend weakly against the use of diclofenac, droperidol, lidocaine intravenous, lysine clonixinate, morphine, propofol, sodium valproate and tramadol. © International Headache Society 2014. AU - Orr, S. L. AU - Aubé, M. AU - Becker, W. J. AU - Davenport, W. J. AU - Dilli, E. AU - Dodick, D. AU - Giammarco, R. AU - Gladstone, J. AU - Leroux, E. AU - Pim, H. AU - Dickinson, G. AU - Christie, S. N. DA - 2015-1-1 IS - 3 KW - Meta-Analysis as Topic Emergencies Lysine Lidocaine Treatment Outcome Societies, Medical Randomized Controlled Trials as Topic Prospective Studies Practice Guidelines as Topic Pain Management Migraine Disorders Humans Emergency Medical Services Canada standards prospective study procedures practice guideline emergency health service analgesia systematic review Review randomized controlled trial (topic) migraine medical society human evidence based medicine drug indication valproic acid trimethobenzamide tramadol sumatriptan propofol prochlorperazine pethidine paracetamol octreotide morphine metoclopramide magnesium sulfate lysine acetylsalicylate ketorolac haloperidol granisetron ergotamine droperidol dihydroergotamine diclofenac dexamethasone clonixin lysine chlorpromazine management headache emergency acute pain PY - 2015 SP - 271-284 ST - Canadian Headache Society systematic review and recommendations on the treatment of migraine pain in emergency settings T2 - Cephalalgia TI - Canadian Headache Society systematic review and recommendations on the treatment of migraine pain in emergency settings VL - 35 ID - 36 ER - TY - JOUR AB - Background: The majority of the global population cannot afford existing asthma pharmacotherapy. Physical training as an airway anti-inflammatory therapy for asthma could potentially be a non-invasive, easily available, affordable, and healthy treatment modality. However, effects of physical training on airway inflammation in asthma are currently inconclusive. The main objective of this review is to summarize the effects of physical training on airway inflammation in asthmatics.Methods: A peer reviewed search was applied to Medline, Embase, Web of Science, Cochrane, and DARE databases. We included all observational epidemiological research studies and RCTs. Studies evaluating at least one marker of airway inflammation in asthmatics after a period of physical training were selected. Data extraction was performed in a blinded fashion. We decided a priori to avoid pooling of the data in anticipation of heterogeneity of the studies, specifically heterogeneity of airway inflammatory markers studied as outcome measures.Results: From the initial 2635 studies; 23 studies (16 RCTs and 7 prospective cohort studies) were included. Study sizes were generally small (median sample size = 30). There was a reduction in C-reactive protein, malondialdehyde, nitric oxide, sputum cell counts and IgE in asthmatics with physical training. Mixed results were observed after training for fractional excretion of nitric oxide and bronchial hyperresponsiveness. The data was not pooled owing to significant heterogeneity between studies, and a funnel plot tests for publication bias were not performed because there were less than 10 studies for almost all outcome measures. Physical training intervention type, duration, intensity, frequency, primary outcome measures, methods of assessing outcome measures, and study designs were heterogeneous.Conclusion: Due to reporting issues, lack of information and heterogeneity there was no definite conclusion; however, some findings suggest physical training may reduce airway inflammation in asthmatics. © 2013 Pakhale et al.; licensee BioMed Central Ltd. AU - Pakhale, S. AU - Luks, V. AU - Burkett, A. AU - Turner, L. DA - 2013-1-1 IS - 1 KW - Meta-Analysis as Topic Inflammation Young Adult Pneumonia Nitric Oxide Middle Aged Malondialdehyde Male Immunoglobulin E Humans Female Exercise Child, Preschool Child C-Reactive Protein Asthma Aged Adult Adolescent physiology pathophysiology complication review preschool child metabolism training systematic review sputum respiratory tract inflammation human cell heterogeneity cell count article malonaldehyde C reactive protein superoxide dismutase glutathione peroxidase Physical exercise Meta-analysis Chronic airway inflammation Asthma therapy Adherence PY - 2013 ST - Effect of physical training on airway inflammation in bronchial asthma: A systematic review T2 - BMC Pulmonary Medicine TI - Effect of physical training on airway inflammation in bronchial asthma: A systematic review VL - 13 ID - 42 ER - TY - JOUR AB - Mental health conditions such as depression and anxiety represent a growing health concern among post-secondary students. Mental health and sleep problems tend to co-occur and circadian preference may have implications for mental health outcomes. We conducted a systematic review of the literature to synthesize the existing evidence on the association between circadian typology and mental health symptomatology in students pursuing higher education. We systematically searched three databases from inception to November 2017 to identify potentially relevant articles. A total of 3097 articles were screened, 75 were critically appraised, and 3 had low or moderate risk of bias. Preliminary evidence suggests that sleep preference is associated with depressive and/or anxiety symptomatology in undergraduate university students. The role of sleep preference as a risk factor for depressive and/or anxiety symptomatology needs to be evaluated in cohort studies. © 2018, Springer Science+Business Media, LLC, part of Springer Nature. AU - Papaconstantinou, E. A. AU - Shearer, H. AU - Fynn-Sackey, N. AU - Smith, K. AU - Taylor-Vaisey, A. AU - Côté, P. DA - 2018-1-1 %J International Journal of Mental Health and Addiction KW - Anxiety PY - 2018 SN - 1557-1874 1557-1882 ST - The Association Between Chronotype and Mental Health Problems in a University Population: a Systematic Review of the Literature T2 - International Journal of Mental Health and Addiction TI - The Association Between Chronotype and Mental Health Problems in a University Population: a Systematic Review of the Literature ID - 281 ER - TY - JOUR AB - Background: The benefits of trauma registries have been well described. The crucial data they provide may guide injury prevention strategies, inform resource allocation, and support advocacy and policy. This has been shown to reduce trauma-related mortality in various settings. Trauma remains a leading cause of mortality in low- and middle-income countries (LMICs). However, the implementation of trauma registries in LMICs can be challenging due to lack of funding, specialized personnel, and infrastructure. This study explores strategies for successful trauma registry implementation in LMICs. Methods: The protocol was registered a priori (CRD42017058586). A peer-reviewed search strategy of multiple databases will be developed with a senior librarian. As per PRISMA guidelines, first screen of references based on abstract and title and subsequent full-text review will be conducted by two independent reviewers. Disagreements that cannot be resolved by discussion between reviewers shall be arbitrated by the principal investigator. Data extraction will be performed using a pre-defined data extraction sheet. Finally, bibliographies of included articles will be hand-searched. Studies of any design will be included if they describe or review development and implementation of a trauma registry in LMICs. No language or period restrictions will be applied. Summary statistics and qualitative meta-narrative analyses will be performed. Discussion: The significant burden of trauma in LMIC environments presents unique challenges and limitations. Adapted strategies for deployment and maintenance of sustainable trauma registries are needed. Our methodology will systematically identify recommendations and strategies for successful trauma registry implementation in LMICs and describe threats and barriers to this endeavor. Systematic review registration: The protocol was registered on the PROSPERO international prospective register of systematic reviews (CRD42017058586). © 2018 The Author(s). AU - Paradis, T. AU - St-Louis, E. AU - Landry, T. AU - Poenaru, D. DA - 2018-1-1 IS - 1 KW - Registries systematic review questionnaire priority journal injury human disease registry Article Trauma registries Trauma information Trauma Resource-limited setting Low-middle-income countries Database Acute injury data PY - 2018 SN - 2046-4053 ST - Strategies for successful trauma registry implementation in low- and middle-income countries-protocol for a systematic review T2 - Systematic Reviews TI - Strategies for successful trauma registry implementation in low- and middle-income countries-protocol for a systematic review VL - 7 ID - 30 ER - TY - JOUR AB - Aim: The aim of this study was to identify interventions associated with peripheral intravenous catheterization first attempt success in pediatric inpatients and emergency department patients who require vascular access for therapeutic interventions. Background: Unsuccessful peripheral intravenous catheterization puts children at risk for increased pain and treatment delays. Effective interventions to increase peripheral intravenous catheterization first attempt success are unclear. Design: Systematic review of randomized controlled trials according to the Cochrane Handbook for the Systematic Review of Interventions. Data sources: Through November and December 2014, we searched 10 databases including MEDLINE (OVID), EMBASE (OVID) and CINAHL (EBSCO) without date limits. The references of articles were also reviewed. We included full text reports of randomized controlled trials testing intervention first attempt success rates vs. standard of care. Review methods: According to inclusion and exclusion criteria set a priori, data were extracted using a standardized tool. We assessed for risk of bias with the Cochrane Collaboration Risk of Bias Tool. Due to unclear reporting narrative synthesis was used to report results. Results: Four cluster randomized control trials and ten randomized control trials involving 4539 participants ranging from 15·6 days to 16 years of age met our inclusion criteria. We excluded the four cluster trials from meta-analysis due to unclear reporting. Interventions did not increase first attempt success rate compared with standard of care. Conclusions: There was insufficient evidence to support the use of ultrasound, infrared light or transillumination. Interventions to reduce children's pain did not decrease first attempt success. Research examining between-clinician proficiency and persistence differences is absent. © 2016 John Wiley & Sons Ltd AU - Parker, S. I. A. AU - Benzies, K. M. AU - Hayden, K. A. DA - 2017-1-1 %J Journal of Advanced Nursing IS - 7 KW - Only Child Child Catheterization PY - 2017 SP - 1570-1582 ST - A systematic review: effectiveness of pediatric peripheral intravenous catheterization strategies T2 - Journal of Advanced Nursing TI - A systematic review: effectiveness of pediatric peripheral intravenous catheterization strategies VL - 73 ID - 285 ER - TY - JOUR AB - Background Peripheral intravenous catheterization (PIVC) is commonly performed on emergency departments and inpatient units. Unsuccessful PIVC first attempts increase pain, and lead to treatment and diagnostic delays. Objective To determine strategies associated with PIVC first attempt success in adult emergency department patients and inpatients. Methods We searched MEDLINE, EMBASE, CINAHL, TRIP, Cochrane Central Register of Controlled Trials (OVID), and grey literatures databases such as Proquest Dissertation and Theses Global, and Open Grey databases between November and December, 2014. The search was updated on January 28, 2016. We included full text reports of randomized controlled trials testing PIVC interventions versus standard of care. Risk of bias was assessed using the Cochrane Collaboration's tool. Results We included 14 randomized controlled trials involving 3201 participants. Interventions included the AccuVein™, AccuCath™ catheter system, ultrasound, safety catheters, and topical anesthetics. Three studies compared AutoGuard and Insyte catheters and were suitable for meta-analysis. There was no difference in first attempt success with a relative risk of 0.0 (95% CI, −0.04, 0.04). There was limited evidence to support the use of ultrasound to increase first attempt success. Conclusions Well-designed and reported randomized controlled trials examining the effectiveness of ultrasound compared to standard of care are warranted. Registration PROSPERO registration: CRD42014015428. © 2016 Elsevier Ltd AU - Parker, S. I. A. AU - Benzies, K. M. AU - Hayden, K. A. AU - Lang, E. S. DA - 2017-1-1 %J International Emergency Nursing KW - Emergency Service, Hospital Catheterization Adult PY - 2017 SN - 1755-599X SP - 15-21 ST - Effectiveness of interventions for adult peripheral intravenous catheterization: A systematic review and meta-analysis of randomized controlled trials T2 - International Emergency Nursing TI - Effectiveness of interventions for adult peripheral intravenous catheterization: A systematic review and meta-analysis of randomized controlled trials VL - 31 ID - 289 ER - TY - JOUR AB - Purpose: Tuberculosis (TB) remains a common cause of death globally. A regimen of 12 doses of isoniazid (INH) and rifapentine given once weekly (INH/RPT-3) has recently been recommended by the World Health Organization for the treatment of latent TB infection (LTBI). We aimed to determine whether the INH/RPT-3 regimen had similar or lesser rates of adverse events compared to other LTBI regimens, namely INH for 9 months, INH for 6 months, rifampin for 3 to 4 months, and rifampin plus INH for 3 to 4 months. Methods: We searched MEDLINE, Embase, CENTRAL, PubMed, ICTRP, clinicaltrials.gov, and Canadian Agency for Drugs and Technologies in Health's Gray Matters Light for randomized, postmarketing, and comparative nonrandomized studies of patients with confirmed LTBI that reported the frequency of at least 1 adverse event of relevance for a regimen of interest. The search included studies published until March 2017. The frequencies of adverse events were extracted and are presented descriptively. Results: Data from 23 randomized and 55 nonrandomized studies were included. Although inconsistent event reporting and high heterogeneity limited comparisons, the adverse event profile of INH/RPT-3 appeared generally favorable. Flu-like reactions were reported with an increased frequency and hepatotoxicity with a lower frequency than standard treatment. Conclusions: While INH/RPT-3 had an overall low frequency of adverse events compared to INH monotherapy, reporting of adverse events for many regimens was limited meaning results should be interpreted cautiously. Future studies of LTBI treatment would benefit from more complete collection and reporting of adverse events and more consistent definitions of hepatotoxicity. Copyright © 2018 John Wiley & Sons, Ltd. AU - Pease, C. AU - Hutton, B. AU - Yazdi, F. AU - Wolfe, D. AU - Hamel, C. AU - Barbeau, P. AU - Skidmore, B. AU - Alvarez, G. G. DA - 2018-1-1 IS - 6 KW - Rifampin world health organization treatment duration systematic review risk factor Review priority journal pregnancy complication postmarketing surveillance nonhuman mortality rate mortality monotherapy meta analysis liver toxicity latent tuberculosis human hospitalization flu like syndrome comparative study childhood disease cause of death bibliographic database angioneurotic edema anaphylaxis allergic reaction adverse event rifapentine rifampicin isoniazid pharmacoepidemiology latent tuberculosis infection adverse events PY - 2018 SP - 557-566 ST - A systematic review of adverse events of rifapentine and isoniazid compared to other treatments for latent tuberculosis infection T2 - Pharmacoepidemiology and Drug Safety TI - A systematic review of adverse events of rifapentine and isoniazid compared to other treatments for latent tuberculosis infection VL - 27 ID - 123 ER - TY - JOUR AB - Background: We conducted a systematic review and network meta-analysis (NMA) to examine the efficacy and completion rates of treatments for latent tuberculosis infection (LTBI). While a previous review found newer, short-duration regimens to be effective, several included studies did not confirm LTBI, and analyses did not account for variable follow-up or assess completion. Methods: We searched MEDLINE, Embase, CENTRAL, PubMed, and additional sources to identify RCTs in patients with confirmed LTBI that involved a regimen of interest and reported on efficacy or completion. Regimens of interest included isoniazid (INH) with rifapentine once weekly for 12 weeks (INH/RPT-3), 6 and 9 months of daily INH (INH-6; INH-9), 3-4 months daily INH plus rifampicin (INH/RFMP 3-4), and 4 months daily rifampicin alone (RFMP-4). NMAs were performed to compare regimens for both endpoints. Results: Sixteen RCTs (n = 44,149) and 14 RCTs (n = 44,128) were included in analyses of efficacy and completion. Studies were published between 1968 and 2015, and there was diversity in patient age and comorbidities. All regimens of interest except INH-9 showed significant benefits in preventing active TB compared to placebo. Comparisons between active regimens did not reveal significant differences. While definitions of regimen completion varied across studies, regimens of 3-4 months were associated with a greater likelihood of adequate completion. Conclusions: Most of the active regimens showed an ability to reduce the risk of active TB relative to no treatment, however important differences between active regimens were not found. Shorter rifamycin-based regimens may offer comparable benefits to longer INH regimens. Regimens of 3-4 months duration are more likely to be completed than longer regimens. © 2017 The Author(s). AU - Pease, C. AU - Hutton, B. AU - Yazdi, F. AU - Wolfe, D. AU - Hamel, C. AU - Quach, P. AU - Skidmore, B. AU - Moher, D. AU - Alvarez, G. G. DA - 2017-1-1 IS - 1 KW - Time Factors Rifampin Network Meta-Analysis Male Latent Tuberculosis Isoniazid Humans Drug Therapy, Combination Antitubercular Agents time factor comparative study combination drug therapy analogs and derivatives treatment duration systematic review randomized controlled trial (topic) meta analysis medication compliance human drug efficacy drug dose regimen Article tuberculostatic agent rifapentine rifampicin pyrazinamide isoniazid plus rifampicin isoniazid plus pyrazinamide plus rifampicin Latent tuberculosis infection PY - 2017 ST - Efficacy and completion rates of rifapentine and isoniazid (3HP) compared to other treatment regimens for latent tuberculosis infection: A systematic review with network meta-analyses T2 - BMC Infectious Diseases TI - Efficacy and completion rates of rifapentine and isoniazid (3HP) compared to other treatment regimens for latent tuberculosis infection: A systematic review with network meta-analyses VL - 17 ID - 152 ER - TY - JOUR AB - Objective: The purpose of this study is to describe the volume, topics, and methodological nature of the existing research literature on research data management in academic institutions. Materials and methods: We conducted a scoping review by searching forty literature databases encompassing a broad range of disciplines from inception to April 2016. We included all study types and data extracted on study design, discipline, data collection tools, and phase of the research data lifecycle. Results: We included 301 articles plus 10 companion reports after screening 13,002 titles and abstracts and 654 full-text articles. Most articles (85%) were published from 2010 onwards and conducted within the sciences (86%). More than three-quarters of the articles (78%) reported methods that included interviews, cross-sectional, or case studies. Most articles (68%) included the Giving Access to Data phase of the UK Data Archive Research Data Lifecycle that examines activities such as sharing data. When studies were grouped into five dominant groupings (Stakeholder, Data, Library, Tool/Device, and Publication), data quality emerged as an integral element. Conclusion: Most studies relied on self-reports (interviews, surveys) or accounts from an observer (case studies) and we found few studies that collected empirical evidence on activities amongst data producers, particularly those examining the impact of research data management interventions. As well, fewer studies examined research data management at the early phases of research projects. The quality of all research outputs needs attention, from the application of best practices in research data management studies, to data producers depositing data in repositories for long-term use. © 2017 Perrier et al.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. AU - Perrier, L. AU - Blondal, E. AU - Ayala, A. P. AU - Dearborn, D. AU - Kenny, T. AU - Lightfoot, D. AU - Reka, R. AU - Thuna, M. AU - Trimble, L. AU - MacDonald, H. C7 - e0178261 DB - Scopus DO - 10.1371/journal.pone.0178261 IS - 5 M3 - Review PY - 2017 ST - Research data management in academic institutions: A scoping review T2 - PLoS ONE TI - Research data management in academic institutions: A scoping review VL - 12 ID - 331 ER - TY - JOUR AB - Taking on responsibilities in research data management (RDM) has proven to be a significant challenge as libraries have adopted new roles within higher education institutions. A qualitative review using the meta-ethnographic approach was conducted that examined the experiences of academic libraries and provided clarity on contextual influences associated with achievements, as well as illuminating the reasons for deficiencies. Libraries experienced uncertainty around roles and relationships related to RDM yet were recognized positively as a neutral, centralized space within academic institutions. This perception, combined with the current approach of fostering partnerships and collaborations, may prove to be useful for libraries as they strategically consider how best to provide continued support and services in RDM. Understanding the perspectives of academic libraries on how they respond and support the demands related to RDM offers a fuller, more robust insight that is essential for planning and decision-making. © 2018 Elsevier Inc. AU - Perrier, L. AU - Blondal, E. AU - MacDonald, H. DB - Scopus DO - 10.1016/j.lisr.2018.08.002 IS - 3-4 M3 - Article PY - 2018 SP - 173-183 ST - Exploring the experiences of academic libraries with research data management: A meta-ethnographic analysis of qualitative studies T2 - Library and Information Science Research TI - Exploring the experiences of academic libraries with research data management: A meta-ethnographic analysis of qualitative studies VL - 40 ID - 326 ER - TY - JOUR AB - Objective To assess the effects of librarian-provided services in healthcare settings on patient, healthcare provider, and researcher outcomes. Materials and methods Medline, CINAHL, ERIC, LISA (Library and Information Science Abstracts), and the Cochrane Central Register of Controlled Trials were searched from inception to June 2013. Studies involving librarian-provided services for patients encountering the healthcare system, healthcare providers, or researchers were eligible for inclusion. All librarian-provided services in healthcare settings were considered as an intervention, including hospitals, primary care settings, or public health clinics. Results Twenty-five articles fulfilled our eligibility criteria, including 22 primary publications and three companion reports. The majority of studies (15/22 primary publications) examined librarians providing instruction in literature searching to healthcare trainees, and measured literature searching proficiency. Other studies analyzed librarian-provided literature searching services and instruction in question formulation as well as the impact of librarian-provided services on patient length of stay in hospital. No studies were found that investigated librarians providing direct services to researchers or patients in healthcare settings. Conclusions Librarian-provided services directed to participants in training programs (eg, students, residents) improve skills in searching the literature to facilitate the integration of research evidence into clinical decisionmaking. Services provided to clinicians were shown to be effective in saving time for health professionals and providing relevant information for decision-making. Two studies indicated patient length of stay was reduced when clinicians requested literature searches related to a patient's case. AU - Perrier, L. AU - Farrell, A. AU - Ayala, A. P. AU - Lightfoot, D. AU - Kenny, T. AU - Aaronson, E. AU - Allee, N. AU - Brigham, T. AU - Connor, E. AU - Constantinescu, T. AU - Muellenbach, J. AU - Epstein, H. A. B. AU - Weiss, A. DA - 2014-1-1 IS - 6 KW - Length of Stay Patient Care Outcome and Process Assessment (Health Care) Librarians Information Storage and Retrieval Humans Health Facilities treatment outcome information retrieval health care facility training systematic review student skill scientist resident publication primary medical care Medline librarian information science human health care system health care personnel doctor patient relation decision making Cochrane Library Cinahl PY - 2014 SP - 1118-1124 ST - Effects of librarian-provided services in healthcare settings: A systematic review T2 - Journal of the American Medical Informatics Association TI - Effects of librarian-provided services in healthcare settings: A systematic review VL - 21 ID - 238 ER - TY - JOUR AB - Background: Systematic reviews are important for decision makers. They offer many potential benefits but are often written in technical language, are too long, and do not contain contextual details which make them hard to use for decision-making. There are many organizations that develop and disseminate derivative products, such as evidence summaries, from systematic reviews for different populations or subsets of decision makers. This systematic review aimed to (1) assess the effectiveness of evidence summaries on policymakers' use of the evidence and (2) identify the most effective summary components for increasing policymakers' use of the evidence. We present an overview of the available evidence on systematic review derivative products. Methods: We included studies of policymakers at all levels as well as health system managers. We included studies examining any type of "evidence summary," "policy brief," or other products derived from systematic reviews that presented evidence in a summarized form. The primary outcomes were the (1) use of systematic review summaries in decision-making (e.g., self-reported use of the evidence in policymaking and decision-making) and (2) policymakers' understanding, knowledge, and/or beliefs (e.g., changes in knowledge scores about the topic included in the summary). We also assessed perceived relevance, credibility, usefulness, understandability, and desirability (e.g., format) of the summaries. Results: Our database search combined with our gray literature search yielded 10,113 references after removal of duplicates. From these, 54 were reviewed in full text, and we included six studies (reported in seven papers) as well as protocols from two ongoing studies. Two studies assessed the use of evidence summaries in decision-making and found little to no difference in effect. There was also little to no difference in effect for knowledge, understanding or beliefs (four studies), and perceived usefulness or usability (three studies). Summary of findings tables and graded entry summaries were perceived as slightly easier to understand compared to complete systematic reviews. Two studies assessed formatting changes and found that for summary of findings tables, certain elements, such as reporting study event rates and absolute differences, were preferred as well as avoiding the use of footnotes. Conclusions: Evidence summaries are likely easier to understand than complete systematic reviews. However, their ability to increase the use of systematic review evidence in policymaking is unclear. Trial registration: The protocol was published in the journal Systematic Reviews (2015;4:122) © 2016 The Author(s). AU - Petkovic, J. AU - Welch, V. AU - Jacob, M. H. AU - Yoganathan, M. AU - Ayala, A. P. AU - Cunningham, H. AU - Tugwell, P. C2 - 27938409 C7 - 162 DB - Scopus DO - 10.1186/s13012-016-0530-3 IS - 1 KW - Evidence summaries Policymakers Systematic reviews comparative effectiveness controlled study data base human language manager organization registration systematic review administrative personnel health care policy literature management Health Policy Humans Policy Making Review Literature as Topic M3 - Review PY - 2016 ST - The effectiveness of evidence summaries on health policymakers and health system managers use of evidence from systematic reviews: A systematic review T2 - Implementation Science TI - The effectiveness of evidence summaries on health policymakers and health system managers use of evidence from systematic reviews: A systematic review VL - 11 ID - 312 ER - TY - JOUR AB - This is a protocol for a Cochrane Review (Methodology). The objectives are as follows: We aim to assess methods used to assess health equity considerations, and how they are reported, in studies that have assessed cohorts of RCTs. © 2017 The Cochrane Collaboration. AU - Petkovic, J. AU - Welch, V. AU - Jull, J. AU - Petticrew, M. AU - Kristjansson, E. AU - Rader, T. AU - Yoganathan, M. AU - McGowan, J. AU - Lyddiatt, A. AU - Grimshaw, J. M. AU - Volmink, J. AU - Moher, D. AU - Shea, B. AU - Pottie, K. AU - Pantoja, T. AU - Wells, G. A. AU - Tugwell, P. DA - 2017-1-1 %J Cochrane Database of Systematic Reviews IS - 8 PY - 2017 ST - How health equity is reported and analyzed in randomized trials T2 - Cochrane Database of Systematic Reviews TI - How health equity is reported and analyzed in randomized trials VL - 2017 ID - 284 ER - TY - JOUR AB - Objectives To assess the characteristics and core statistical methodology specific to network meta-analyses (NMAs) in clinical research articles. Study Design and Setting We searched MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews from inception until April 14, 2015, for NMAs of randomized controlled trials including at least four different interventions. Two reviewers independently screened potential studies, whereas data abstraction was performed by a single reviewer and verified by a second. Results A total of 456 NMAs, which included a median (interquartile range) of 21 (13–40) studies and 7 (5–9) treatment nodes, were assessed. A total of 125 NMAs (27%) were star networks; this proportion declined from 100% in 2005 to 19% in 2015 (P = 0.01 by test of trend). An increasing number of NMAs discussed transitivity or inconsistency (0% in 2005, 86% in 2015, P < 0.01) and 150 (45%) used appropriate methods to test for inconsistency (14% in 2006, 74% in 2015, P < 0.01). Heterogeneity was explored in 256 NMAs (56%), with no change over time (P = 0.10). All pairwise effects were reported in 234 NMAs (51%), with some increase over time (P = 0.02). The hierarchy of treatments was presented in 195 NMAs (43%), the probability of being best was most commonly reported (137 NMAs, 70%), but use of surface under the cumulative ranking curves increased steeply (0% in 2005, 33% in 2015, P < 0.01). Conclusion Many NMAs published in the medical literature have significant limitations in both the conduct and reporting of the statistical analysis and numerical results. The situation has, however, improved in recent years, in particular with respect to the evaluation of the underlying assumptions, but considerable room for further improvements remains. © 2016 Elsevier Inc. AU - Petropoulou, M. AU - Nikolakopoulou, A. AU - Veroniki, A. A. AU - Rios, P. AU - Vafaei, A. AU - Zarin, W. AU - Giannatsi, M. AU - Sullivan, S. AU - Tricco, A. C. AU - Chaimani, A. AU - Egger, M. AU - Salanti, G. DA - 2017-1-1 KW - Network Meta-Analysis Humans Databases, Bibliographic Biometry statistics and numerical data procedures human bibliographic database systematic review (topic) Review randomized controlled trial (topic) publishing publication priority journal medical research medical literature drug therapy clinical research Reporting Multiple interventions Mixed-treatment comparisons Meta-epidemiology Indirect evidence Inconsistency PY - 2017 SP - 20-28 ST - Bibliographic study showed improving statistical methodology of network meta-analyses published between 1999 and 2015 T2 - Journal of Clinical Epidemiology TI - Bibliographic study showed improving statistical methodology of network meta-analyses published between 1999 and 2015 VL - 82 ID - 102 ER - TY - JOUR AB - Background: The concept of early health technology assessment, discussed well over a decade, has now been collaboratively implemented by industry, government, and academia to select and expedite the development of emerging technologies that may address the needs of patients and health systems. Early economic evaluation is essential to assess the value of emerging technologies, but empirical data to inform the current practice of early evaluation is limited. We propose a systematic review of early economic evaluation studies in order to better understand the current practice. Methods/design: This protocol describes a systematic review of economic evaluation studies of regulated health technologies in which the evaluation is conducted prior to regulatory approval and when the technology effectiveness is not well established. Included studies must report an economic evaluation, defined as the comparative analysis of alternatives with respect to their associated costs and health consequences, and must evaluate some regulated health technology such as pharmaceuticals, biologics, high-risk medical devices, or biomarkers. We will conduct the literature search on multiple databases, including MEDLINE, EMBASE, the Centre for Reviews and Dissemination Databases, and EconLit. Additional citations will be identified via scanning reference lists and author searching. We suspect that many early economic evaluation studies are unpublished, especially those conducted for internal use only. Additionally, we use a chain-referral sampling approach to identify authors of unpublished studies who work in technology discovery and development, starting out with our contact lists and authors who published relevant studies. Citation screening and full-text review will be conducted by pairs of reviewers. Abstracted data will include those related to the decision context and decision problem of the early evaluation, evaluation methods (e.g., data sources, methods, and assumptions used to identify, measure, and value the likely effectiveness and the costs and consequences of the new technology, handling of uncertainty), and whether the study results adequately address the main study question or objective. Data will be summarized overall and stratified by publication status. Discussion: This study is timely to inform early economic evaluation practice, given the international trend in early health technology assessment initiatives. © 2014 Pham et al.; licensee BioMed Central Ltd. AU - Pham, B. AU - Tu, H. A. T. AU - Han, D. AU - Pechlivanoglou, P. AU - Miller, F. AU - Rac, V. AU - Chin, W. AU - Tricco, A. C. AU - Paulden, M. AU - Bielecki, J. AU - Krahn, M. DA - 2014-1-1 IS - 1 KW - Technology Assessment, Biomedical Review Literature as Topic Information Storage and Retrieval Cost-Benefit Analysis Biomedical Technology procedures medical technology literature information retrieval economics cost benefit analysis systematic review priority journal Medical Subject Headings medical informatics human health care quality economic evaluation decision making data extraction clinical practice Article biological marker PY - 2014 SN - 2046-4053 ST - Early economic evaluation of emerging health technologies: Protocol of a systematic review T2 - Systematic Reviews TI - Early economic evaluation of emerging health technologies: Protocol of a systematic review VL - 3 ID - 237 ER - TY - JOUR AB - Background: There are an increasing number of studies reporting the efficacy of educational strategies to facilitate the development of knowledge and skills underpinning evidence based practice (EBP). To date there is no standardised guideline for describing the teaching, evaluation, context or content of EBP educational strategies. The heterogeneity in the reporting of EBP educational interventions makes comparisons between studies difficult. The aim of this program of research is to develop the Guideline for Reporting EBP Educational interventions and Teaching (GREET) statement and an accompanying explanation and elaboration (E&E) paper. Methods/design. Three stages are planned for the development process. Stage one will comprise a systematic review to identify features commonly reported in descriptions of EBP educational interventions. In stage two, corresponding authors of articles included in the systematic review and the editors of the journals in which these studies were published will be invited to participate in a Delphi process to reach consensus on items to be considered when reporting EBP educational interventions. The final stage of the project will include the development and pilot testing of the GREET statement and E&E paper. Outcome. The final outcome will be the creation of a Guideline for Reporting EBP Educational interventions and Teaching (GREET) statement and E&E paper. Discussion. The reporting of health research including EBP educational research interventions, have been criticised for a lack of transparency and completeness. The development of the GREET statement will enable the standardised reporting of EBP educational research. This will provide a guide for researchers, reviewers and publishers for reporting EBP educational interventions. © 2013 Phillips et al; licensee BioMed Central Ltd. AU - Phillips, A. C. AU - Lewis, L. K. AU - McEvoy, M. P. AU - Galipeau, J. AU - Glasziou, P. AU - Hammick, M. AU - Moher, D. AU - Tilson, J. AU - Williams, M. T. DA - 2013-1-1 IS - 1 KW - Teaching Practice Guidelines as Topic Humans Evidence-Based Medicine Delphi Technique standard practice guideline organization and management methodology human evidence based medicine education Delphi study article Reporting guideline Evidence based practice PY - 2013 ST - Protocol for development of the guideline for reporting evidence based practice educational interventions and teaching (GREET) statement T2 - BMC Medical Education TI - Protocol for development of the guideline for reporting evidence based practice educational interventions and teaching (GREET) statement VL - 13 ID - 255 ER - TY - JOUR AB - Background: Surgical site infection describes an infectious complication of surgical wounds. This single complication is thought to occur in close to 20% of surgical cases. This complication has been described in all kinds of surgical procedure including minimally invasive procedures. Wound irrigation is frequently used as a means of reducing surgical site infection. However, there is lack of solid evidence to support routine wound irrigation. The aim of this review is to provide evidence for the efficacy of routine wound irrigation with normal saline in preventing surgical site infection. The rate of surgical site infection in cases with and without wound irrigation will be analyzed. Methods/design: Systematic literature searches will be conducted to identify all published and unpublished studies. The following databases will be searched for citations from inception to present: MEDLINE (via PubMed), Embase (via Embase), and CENTRAL (via the Cochrane library). The search strategy will be developed by the research team in collaboration with an experienced librarian and checked by a referee according to the Peer Review of Electronic Search Strategies (PRESS) guideline. A draft of the PubMed search strategy could be (irrigation[tiab] OR "Therapeutic Irrigation"[mesh] OR lavage[tiab]) AND (saline[tiab] OR "Sodium Chloride"[mesh] OR sodium chloride[tiab]) NOT ("Comment" [Publication Type] OR "Letter" [Publication Type] OR "Editorial" [Publication Type]). No time limits will be set. The reference lists of eligible articles will be hand searched. Relevant data will be extracted from eligible studies using a previously designed data extraction sheet. Relative risks will be calculated for binary outcomes and mean differences or standardized mean differences, if necessary, for continuous outcomes. For all measures, 95% confidence levels will be calculated. Both arms would be compared with regard to the rate of surgical site infection within 30 days following surgery. We will report the review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Discussion: This review aims at investigating the value of routine wound irrigation using normal saline in preventing surgical site infection. Systematic review registration: PROSPERO: CRD42018082287 © 2018 The Author(s). AD - Institute for Research in Operative Medicine, Department of Surgical Research, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany Department of Surgery, Helios University Hospital Wuppertal, Witten/Herdecke University, Heusnerstr. 40, Wuppertal, 42283, Germany Department of Visceral, Minimal Invasive and Oncologic Surgery, Marienhospital Düsseldorf, Rochusstr. 2, Düsseldorf, 40479, Germany AU - Pieper, D. AU - Rombey, T. AU - Doerner, J. AU - Rembe, J. D. AU - Zirngibl, H. AU - Zarras, K. AU - Ambe, P. C. C2 - 30286812 C7 - 152 DB - Scopus DO - 10.1186/s13643-018-0813-7 IS - 1 KW - sodium chloride abdominal surgery Article clinical protocol data extraction hospital readmission human information processing laparotomy length of stay lifestyle meta analysis morbidity mortality priority journal quality of life surgical infection systematic review wound closure wound irrigation administration and dosage lavage procedures wound healing Humans Saline Solution Surgical Wound Infection Therapeutic Irrigation M3 - Article PY - 2018 ST - The role of saline irrigation prior to wound closure in the reduction of surgical site infection: Protocol for a systematic review and meta-analysis T2 - Systematic Reviews TI - The role of saline irrigation prior to wound closure in the reduction of surgical site infection: Protocol for a systematic review and meta-analysis VL - 7 ID - 395 ER - TY - JOUR AB - Background: Chlamydia trachomatis and Neisseria gonorrhoeae are the most commonly reported sexually transmitted infections in Canada. Existing national guidance on screening for these infections was not based on a systematic review, and recommendations as well as implementation considerations (e.g., population groups, testing and case management) should be explicit and reflect the quality of evidence. The aim of this systematic review is to synthesize research on screening for these infections in sexually active individuals within primary care. We will also review evidence on how people weigh the relative importance of the potential outcomes from screening, rated as most important by the Canadian Task Force on Preventive Health Care (CTFPHC) with input from patients and stakeholders. Methods: We have developed a peer-reviewed strategy to comprehensively search MEDLINE, Embase, Cochrane Library, CINAHL, and PsycINFO for English and French literature published 1996 onwards. We will also search trial registries and conference proceedings, and mine references lists. Screening, study selection, risk of bias assessments, and quality of findings across studies (for each outcome) will be independently undertaken by two reviewers with consensus for final decisions. Data extraction will be conducted by one reviewer and checked by another for accuracy and completeness. The CTFPHC and content experts will provide input for decisions on study design (i.e., when and whether to include uncontrolled studies for screening effectiveness) and for interpretation of the findings. Discussion: The results section of the review will include a description of all studies, results of all analyses, including planned subgroup and sensitivity analyses, and evidence profiles and summary of findings tables incorporating assessment based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods to communicate our confidence in the estimates of effect. We will compare our findings to others and discuss limitations of the review and available literature. The findings will be used by the CTFPHC - supplemented by consultations with patients and stakeholders and from other sources on issues of feasibility, acceptability, costs/resources, and equity - to inform recommendations on screening to support primary health care providers in delivering preventive care. Systematic review registration: International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42018100733. © 2018 Crown. AD - Alberta Research Centre for Health Evidence, University of Alberta, 11405 87 Avenue, Edmonton, AB T6G 1C9, Canada Department of Family Medicine, McMaster University, Hamilton, Canada Global Health and Guidelines Division, Public Health Agency of Canada, Edmonton, Canada Department of Family Medicine, University of Ottawa, Ottawa, Canada Department of Family and Community Medicine, University of Toronto, Toronto, Canada Department of Family Medicine, McGill University, Montreal, Canada Faculty of Medicine, McGill University, Montreal, Canada Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Canada Division of Infectious Diseases, Department of Pediatrics, University of Alberta, Edmonton, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, Canada Department of Microbiology and Immunology, University of Saskatchewan, Saskatoon, Canada Division of Infectious Diseases, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada Public Health Agency of Canada, Edmonton, Canada Ottawa Public Health, Ottawa, Canada AU - Pillay, J. AU - Moore, A. AU - Rahman, P. AU - Lewin, G. AU - Reynolds, D. AU - Riva, J. AU - Thériault, G. AU - Thombs, B. AU - Wilson, B. AU - Robinson, J. AU - Ramdyal, A. AU - Cadieux, G. AU - Featherstone, R. AU - Burchell, A. N. AU - Dillon, J. A. AU - Singh, A. AU - Wong, T. AU - Doull, M. AU - Traversy, G. AU - Courage, S. AU - MacGregor, T. AU - Johnson, C. AU - Vandermeer, B. AU - Hartling, L. C2 - 30587234 C7 - 248 DB - Scopus DO - 10.1186/s13643-018-0904-5 IS - 1 KW - Chlamydia Gonorrhea Guideline Screening Sexually transmitted infections Systematic review azithromycin chlamydiasis clinical protocol decision making disease transmission follow up health care personnel high risk population human Human immunodeficiency virus infection morbidity prevalence primary health care primary medical care priority journal public health quality control quality of life randomized controlled trial (topic) Review risk factor sexuality sexually transmitted disease Canada Chlamydia trachomatis isolation and purification mass screening Neisseria gonorrhoeae procedures Chlamydia Infections Humans LA - English M3 - Review PY - 2018 ST - Screening for chlamydia and/or gonorrhea in primary health care: Protocol for systematic review T2 - Systematic Reviews TI - Screening for chlamydia and/or gonorrhea in primary health care: Protocol for systematic review VL - 7 ID - 396 ER - TY - JOUR AB - Background: Soft-tissue therapy is commonly used to manage musculoskeletal injuries. Objective: To determine the effectiveness of soft-tissue therapy for the management of musculoskeletal disorders and injuries of the upper and lower extremities. Design: Systematic Review. Methods: We searched six databases from 1990 to 2015 and critically appraised eligible articles using Scottish Intercollegiate Guidelines Network (SIGN) criteria. Evidence from studies with low risk of bias was synthesized using best-evidence synthesis methodology. Results: We screened 9869 articles and critically appraised seven; six had low risk of bias. Localized relaxation massage provides added benefits to multimodal care immediately post-intervention for carpal tunnel syndrome. Movement re-education (contraction/passive stretching) provides better long-term benefit than one corticosteroid injection for lateral epicondylitis. Myofascial release improves outcomes compared to sham ultrasound for lateral epicondylitis. Diacutaneous fibrolysis (DF) or sham DF leads to similar outcomes in pain intensity for subacromial impingement syndrome. Trigger point therapy may provide limited or no additional benefit when combined with self-stretching for plantar fasciitis; however, myofascial release to the gastrocnemius, soleus and plantar fascia is effective. Conclusion: Our review clarifies the role of soft-tissue therapy for the management of upper and lower extremity musculoskeletal disorders and injuries. Myofascial release therapy was effective for treating lateral epicondylitis and plantar fasciitis. Movement re-education was also effective for managing lateral epicondylitis. Localized relaxation massage combined with multimodal care may provide short-term benefit for treating carpal tunnel syndrome. More high quality research is needed to study the appropriateness and comparative effectiveness of this widely utilized form of treatment. © 2015 Elsevier Ltd. AU - Piper, S. AU - Shearer, H. M. AU - Côté, P. AU - Wong, J. J. AU - Yu, H. AU - Varatharajan, S. AU - Southerst, D. AU - Randhawa, K. A. AU - Sutton, D. A. AU - Stupar, M. AU - Nordin, M. C. AU - Mior, S. A. AU - van der Velde, G. M. AU - Taylor-Vaisey, A. L. DA - 2016-1-1 %J Manual Therapy KW - Fasciitis Carpal Tunnel Syndrome Therapy, Soft Tissue Systematic review Soft-tissue therapy Musculoskeletal injuries Massage PY - 2016 SN - 1356-689X DO - http://dx.doi.org/10.1016/j.math.2010.08.005 SP - 18-34 ST - The effectiveness of soft-tissue therapy for the management of musculoskeletal disorders and injuries of the upper and lower extremities: A systematic review by the Ontario Protocol for Traffic Injury management (OPTIMa) collaboration T2 - Manual Therapy TI - The effectiveness of soft-tissue therapy for the management of musculoskeletal disorders and injuries of the upper and lower extremities: A systematic review by the Ontario Protocol for Traffic Injury management (OPTIMa) collaboration VL - 21 ID - 266 ER - TY - JOUR AB - Introduction: Hip fractures are a significant cause of morbidity and mortality and care of hip fracture patients places a heavy burden on healthcare systems due to prolonged recovery time. Measuring quality of care delivered to hip fracture patients is important to help target efforts to improve care for patients and efficiency of the health system. The purpose of this study is to synthesise the evidence surrounding quality of care indicators for patients who have sustained a hip fracture. Using a scoping review methodology, the research question that will be addressed is: "What patient, institutional, and system-level indicators are currently in use or proposed for measuring quality of care across the continuum for individuals following a hip fracture?". Methods and analysis: We will employ the methodological frameworks used by Arksey and O'Malley and Levac et al. The synthesis will be limited to quality of care indicators for individuals who suffered low trauma hip fracture. All English peerreviewed studies published from the year 2000-most recent will be included. Literature search strategies will be developed using medical subject headings and text words related to hip fracture quality indicators and the search will be peer-reviewed. Numerous electronic databases will be searched. Two reviewers will independently screen titles and abstracts for inclusion, followed by screening of the full text of potentially relevant articles to determine final inclusion. Abstracted data will include study characteristics and indicator definitions. Dissemination: To improve quality of care for patients and create a more efficient healthcare system, mechanisms for the measurement of quality of care are required. The implementation of quality of care indicators enables stakeholders to target areas for improvement in service delivery. Knowledge translation activities will occur throughout the review with dissemination of the project goals and findings to local, national, and international stakeholders. AU - Pitzul, K. B. AU - Munce, S. E. P. AU - Perrier, L. AU - Beaupre, L. AU - Morin, S. N. AU - McGlasson, R. AU - Jaglal, S. B. DA - 2014-1-1 IS - 10 KW - Hip Quality Indicators, Health Care Outcome Assessment (Health Care) Humans Hip Fractures outcome assessment systematic review (topic) randomized controlled trial (topic) peer review methodology medical ethics information retrieval information dissemination human hip fracture health care quality Article PY - 2014 SN - 2044-6055 ST - Quality indicators for hip fracture patients: A scoping review protocol T2 - BMJ Open TI - Quality indicators for hip fracture patients: A scoping review protocol VL - 4 ID - 38 ER - TY - JOUR AB - Objective The purpose of this study is to identify existing or potential quality of care indicators (ie, current indicators as well as process and outcome measures) in the acute or postacute period, or across the continuum of care for older adults with hip fracture. Design Scoping review. Setting All care settings. Search strategy English peer-reviewed studies published from January 2000 to January 2016 were included. Literature search strategies were developed, and the search was peer-reviewed. Two reviewers independently piloted all forms, and all articles were screened in duplicate. Results The search yielded 2729 unique articles, of which 302 articles were included (11.1%). When indicators (eg, in-hospital mortality, acute care length of stay) and potential indicators (eg, comorbidities developed in hospital, walking ability) were grouped by the outcome or process construct they were trying to measure, the most common constructs were measures of mortality (outcome), length of stay (process) and time-sensitive measures (process). There was heterogeneity in definitions within constructs between studies. There was also a paucity of indicators and potential indicators in the postacute period. Conclusions To improve quality of care for patients with hip fracture and create a more efficient healthcare system, mechanisms for the measurement of quality of care across the entire continuum, not just during the acute period, are required. Future research should focus on decreasing the heterogeneity in definitions of quality indicators and the development and implementation of quality indicators for the postacute period. © 2017 Published by the BMJ Publishing Group Limited. AU - Pitzul, K. B. AU - Munce, S. E. P. AU - Perrier, L. AU - Beaupre, L. AU - Morin, S. N. AU - McGlasson, R. AU - Jaglal, S. B. DA - 2017-1-1 IS - 3 KW - Quality of Health Care Quality Indicators, Health Care Patient Care Outcome and Process Assessment (Health Care) Length of Stay Humans Hospital Mortality Hip Fractures Continuity of Patient Care treatment outcome standards hip fracture walking visual analog scale Review quality of life pilot study patient satisfaction patient safety outcome assessment human hospital readmission health care utilization health care system health care quality emergency care comorbidity PY - 2017 SN - 2044-6055 ST - Scoping review of potential quality indicators for hip fracture patient care T2 - BMJ Open TI - Scoping review of potential quality indicators for hip fracture patient care VL - 7 ID - 33 ER - TY - JOUR AB - Fatigue is a frequent and distressing symptom in patients with multiple sclerosis (MS). In contrast, sleepiness, characterized by difficulties to stay awake and alert during the day, seems to be less prevalent in MS; however, exact studies are lacking. In addition, there is a semantic confusion of the concepts of “fatigue” and “sleepiness”, which are often used interchangeably. We conducted a systematic review of studies using the Epworth sleepiness scale (ESS) for the assessment of daytime sleepiness in patients with MS. The summarized results of 48 studies demonstrate that sleepiness, as indicated by elevated ESS scores, is less prevalent and less severe than fatigue but is present in a significant proportion of patients with MS. In most cross-sectional and longitudinal studies, there was a moderate association between ESS scores and various fatigue rating scales. Longitudinal studies on the effect of wakefulness-promoting agents failed to show a consistent improvement of sleepiness or fatigue as compared to placebo. It has also been shown that daytime sleepiness is frequently associated with comorbid sleep disorders that are often underrecognized and undertreated in MS. Sleepiness and potential sleep disorders may also precipitate and perpetuate fatigue in patients with MS and should be part of the differential diagnostic assessment. To support an appropriate decision-making process, we propose a stepwise evaluation of sleepiness as compared to fatigue in patients with MS. © 2016 Elsevier Ltd AU - Popp, R. F. J. AU - Fierlbeck, A. K. AU - Knüttel, H. AU - König, N. AU - Rupprecht, R. AU - Weissert, R. AU - Wetter, T. C. DA - 2017-1-1 %J Sleep Medicine Reviews KW - Sleep Disorders Longitudinal Studies Fatigue Multiple Sclerosis PY - 2017 SP - 95-108 ST - Daytime sleepiness versus fatigue in patients with multiple sclerosis: A systematic review on the Epworth sleepiness scale as an assessment tool T2 - Sleep Medicine Reviews TI - Daytime sleepiness versus fatigue in patients with multiple sclerosis: A systematic review on the Epworth sleepiness scale as an assessment tool VL - 32 ID - 288 ER - TY - JOUR AB - Objective: There is increasing concern that mental health may be deteriorating in recent generations of adolescents. It is unclear whether this is the case for self-reported psychosomatic health complaints (PSHC). Method: We conducted a systematic review and meta-analysis of published primary studies on PSHC in the general adolescent population over time. The primary databases were MEDLINE, Embase and PsycINFO, which were searched from inception to November 2016. Studies were included if they involved an observational design, presented self-reported data from participants aged 10–19 years and included data from at least two time points, five years apart. Inclusion and study quality were assessed by two independent reviewers. Results: Twenty-one studies were included; 18 reported trends on the prevalence of PSHC in a single country, while three studies reported on multiple countries. In total, over seven million adolescents from 36 countries in Europe, North America, Israel and New Zealand were represented, covering the period 1982–2013. In the descriptive analysis, 10 studies indicated a trend of increasing PSHC, eight showed a stable trend and three showed a decreasing trend at certain points in time. The results from the meta-analysis showed a mean odds ratio (OR) of 1.04 (K = 139, 95% CI 1.01–1.08) for PSHC from 1982 to 2013, thus indicating a minor increase in general. In the subgroup analysis, this minor increase was observed mainly between the 1980s and 2000s, while the trend appeared to be more stable between the 2000s and 2010s. Some differences were also found between multinational subregions. Findings from subgroup analysis, however, only supported a significant increasing trend in Northern Europe. Conclusion: There may have been a minor increasing trend in adolescent self-rated PSHC between the 1980 and 2000s, but has become more stable since the 2010s, from a multinational perspective. Northern Europe was the only region to show a clearly significant minor increasing trend, without being the region with the highest total prevalence of PSHC at the present time. The discrepant trends regarding PSHC between regions and the reliance on self-reported data may reflect true changes in the occurrence of PSHC in the adolescent population. However, they may also reflect changes in how adolescents perceive and report health complaints. Other: PROSPERO registration 2016: CRD42016048300. © 2017 Potrebny et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. AU - Potrebny, T. AU - Wiium, N. AU - Lundegård, M. M. I. DA - 2017-1-1 IS - 11 KW - Prevalence Research Design Psychophysiologic Disorders Male Humans History, 21st Century History, 20th Century Female Animals Adolescent Health Adolescent psychosomatic disorder history animal systematic review registration PsycINFO North America New Zealand meta analysis Medline Israel human Europe Embase PY - 2017 ST - Temporal trends in adolescents’ self-reported psychosomatic health complaints from 1980-2016: A systematic review and meta-analysis T2 - PLoS ONE TI - Temporal trends in adolescents’ self-reported psychosomatic health complaints from 1980-2016: A systematic review and meta-analysis VL - 12 ID - 75 ER - TY - JOUR AB - Background: Inherited metabolic diseases (IMD) are a large group of rare single-gene disorders that are typically diagnosed early in life. There are important evidence gaps related to the comparative effectiveness of therapies for IMD, which are in part due to challenges in conducting randomized controlled trials (RCTs) for rare diseases. Registry-based RCTs present a unique opportunity to address these challenges provided the registries implement standardized collection of outcomes that are important to patients and their caregivers and to clinical providers and healthcare systems. Currently there is no core outcome set (COS) for studies evaluating interventions for paediatric IMD. This protocol outlines a study that will establish COS for each of two relatively common IMD in children, phenylketonuria (PKU) and medium-chain acyl-CoA dehydrogenase (MCAD) deficiency. Methods: This two-part study is registered with the Core Outcome Measures in Effectiveness Trials (COMET) initiative. Part 1 includes a rapid review and development of an evidence map to identify a comprehensive listing of outcomes reported in past studies of PKU and MCAD deficiency. The review follows established methods for knowledge synthesis, including a comprehensive search strategy, two stages of screening citations against inclusion/exclusion criteria by two reviewers working independently, and extraction of important data elements from eligible studies, including details of the outcomes collected and outcome measurement instruments. The review findings will inform part 2 of our study, a set of Delphi surveys to establish consensus on the highest priority outcomes for each condition. Healthcare providers, families of children with PKU or MCAD deficiency, and health system decision-makers will be invited to participate in two to three rounds of Delphi surveys. The design of the surveys will involve parents of children with IMD who are part of a family advisory forum. Discussion: This protocol is a crucial step in developing the capacity to launch RCTs with meaningful outcomes that address comparative effectiveness questions in the field of paediatric IMD. Such trials will contribute high-quality evidence to inform decision-making by patients and their family members, clinicians, and policy-makers. © 2017 The Author(s). AU - Potter, B. K. AU - Hutton, B. AU - Clifford, T. J. AU - Pallone, N. AU - Smith, M. AU - Stockler, S. AU - Chakraborty, P. AU - Barbeau, P. AU - Garritty, C. M. AU - Pugliese, M. AU - Rahman, A. AU - Skidmore, B. AU - Tessier, L. AU - Tingley, K. AU - Coyle, D. AU - Greenberg, C. R. AU - Korngut, L. AU - MacKenzie, A. AU - Mitchell, J. J. AU - Nicholls, S. AU - Offringa, M. AU - Schulze, A. AU - Taljaard, M. DA - 2017-1-1 IS - 1 KW - Child Metabolic Diseases Acyl-CoA Dehydrogenase Butyryl-CoA Dehydrogenase Only Child Phenylketonurias Acyl Coenzyme A systematic review (topic) study design phenylketonuria patient decision making outcome assessment medium chain acyl coenzyme A dehydrogenase deficiency human health care policy family decision making evidence based practice Delphi study comparative effectiveness clinical decision making childhood disease Article Registry-based randomized trials PKU MCAD deficiency Inherited metabolic diseases Delphi Core outcome set PY - 2017 ST - Establishing core outcome sets for phenylketonuria (PKU) and medium-chain Acyl-CoA dehydrogenase (MCAD) deficiency in children: Study protocol for systematic reviews and Delphi surveys T2 - Trials TI - Establishing core outcome sets for phenylketonuria (PKU) and medium-chain Acyl-CoA dehydrogenase (MCAD) deficiency in children: Study protocol for systematic reviews and Delphi surveys VL - 18 ID - 135 ER - TY - JOUR AB - This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: The aim of our review is to assess effects of rapid HIV testing strategies on HIV screening outcomes: (i) uptake; (ii) transport and costs, (iii) tradeoffs/possible harmful effects/false positives compared to traditional laboratory testing approaches. HIV screening outcomes also include completion of risk reduction counselling, and uptake of ARV treatment for people living with HIV, including pregnant women, and other HIV/AIDS treatments to reduce morbidity and mortality. The specific objectives of this review are to: 1) critically review and synthesize effectiveness evidence on rapid compared to conventional laboratory HIV testing approaches for community and facility-based testing. 2) conduct sensitivity analysis to explore the effect modifiers (e.g. location of testing, population, link to treatment etc.) on HIV testing and treatment outcomes. The populations that are considered at high risk for HIV infection include people from HIV concentrated epidemic countries, ethnic minority groups, Aboriginal peoples, men who have sex with men (MSM), intravenous drug users, truckers, factory workers and sex workers (UNAIDS 2011). © 2018 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. AU - Pottie, K. AU - Dahal, G. AU - Logie, C. AU - Welch, V. C7 - Cd003507 DB - Scopus DO - 10.1002/14651858.CD003507.pub3 IS - 1 M3 - Article PY - 2018 ST - Rapid testing for improving uptake of HIV/AIDS services in people with HIV infection T2 - Cochrane Database of Systematic Reviews TI - Rapid testing for improving uptake of HIV/AIDS services in people with HIV infection VL - 2018 ID - 343 ER - TY - JOUR AB - Background: The rate of caesarean sections increased in the last decades to about 30% of births in western populations. Many caesarean sections are electively planned without an urgent medical reason for mother or child. Especially in women with a foregoing caesarean section, the procedure is planned early. An early caesarean section though may harm the newborn. Our aim is to evaluate the gestational time point after the 37th gestational week (after prematurity = term) of performing an elective caesarean section with the lowest morbidity for mother and child. Methods: This is an update of a systematic review previously carried out on behalf of the German Federal Ministry of Health. We will perform a systematic literature search in MEDLINE, EMBASE, CENTRAL and CINAHL. Our primary outcome is the rate of admissions to the neonatal intensive care unit in early versus late term neonates. We will include (quasi) randomized controlled trials and cohort studies. The studies should include pregnant women who have an elective caesarean section at term. We will screen titles and abstracts and the identified full texts of studies for eligibility. Risk of bias will be assessed with the Cochrane Risk of Bias Tool for Randomized Trials or with the Risk of Bias Tool for Non-Randomized Studies of Interventions (ROBINS-I). These tasks will be performed independently by two reviewers. Data will be extracted in beforehand piloted extraction tables. A dose-response meta-analysis will be performed. Discussion: Our aim is to reach a higher validity in the assessment of the time point of elective caesarean sections by performing a meta-analysis to support recommendations for clinical practice. We assume to identify less randomized controlled trials but a large number of cohort studies analyzing the given question. We will discuss similarities and differences in included studies as well as methodological strengths and weaknesses. © 2018 The Author(s). AD - Witten/Herdecke University, Institute for Research in Operative Medicine, Ostmerheimer Str. 200, Haus 38, Cologne, 51109, Germany Goethe-University, Department of Gynecology and Obstetrics, Theodor-Stern-Kai 7, Frankfurt, 60590, Germany Brandenburg Medical School - Theodor Fontane, Faculty of Health, Campus Neuruppin, Fehrbelliner Str.38, Neuruppin, 16816, Germany Witten/Herdecke University, Interdisciplinary Centre for Health Services Research, Alfred-Herrhausen-Straße 50, Witten, 58448, Germany AU - Prediger, B. AU - Polus, S. AU - Mathes, T. AU - Bühn, S. AU - Louwen, F. AU - Neugebauer, E. A. M. AU - Pieper, D. C2 - 30111372 C7 - 119 DB - Scopus DO - 10.1186/s13643-018-0787-5 IS - 1 KW - Elective caesarean section Gestational age Maternal morbidity Neonatal intensive care unit Neonatal morbidity Term birth Article cesarean section cohort analysis elective surgery female hospital admission human maternal death newborn newborn death newborn morbidity pregnant woman randomized controlled trial (topic) systematic review child health maternal mortality pregnancy pregnancy outcome procedures statistics and numerical data Elective Surgical Procedures Humans Infant Health Infant, Newborn LA - English M3 - Article PY - 2018 ST - (Update of a) systematic review on the impact of elective early term (< 39th gestational week) caesarean sections on maternal and neonatal health - a protocol T2 - Systematic Reviews TI - (Update of a) systematic review on the impact of elective early term (< 39th gestational week) caesarean sections on maternal and neonatal health - a protocol VL - 7 ID - 397 ER - TY - JOUR AB - Background: Funders encourage lay-volunteer inclusion in research. There are controversy and resistance, given concerns of role confusion, exploratory methods, and limited evidence about what value lay-volunteers bring to research. This overview explores these areas. Methods: Eleven databases were searched without date or language restrictions for systematic reviews of public and patient involvement (PPI) in clinical trials design. This systematic overview of PPI included 27 reviews from which areas of good and bad practice were identified. Strengths, weaknesses, opportunities, and threats of PPI were explored through use of meta-narrative analysis. Results: Inclusion criteria were met by 27 reviews ranging in quality from high (n = 7), medium (n = 14) to low (n = 6) reviews. Reviews were assessed using CERQUAL NICE, CASP for qualitative research and CASP for systematic reviews. Four reviews report risk of bias. Public involvement roles were primarily in agenda setting, steering committees, ethical review, protocol development, and piloting. Research summaries, follow-up, and dissemination contained PPI, with lesser involvement in data collection, analysis, or manuscript authoring. Trialists report difficulty in finding, retaining, and reimbursing volunteers. Respectful inclusion, role recognition, mutual flexibility, advance planning, and sound methods were reported as facilitating public involvement in research. Public involvement was reported to have increased the quantity and quality of patient relevant priorities and outcomes, enrollment, funding, design, implementation, and dissemination. Challenges identified include lack of clarity within common language, roles, and research boundaries, while logistical needs include extra time, training, and funding. Researchers report struggling to report involvement and avoid tokenism. Conclusions: Involving patients and the public in clinical trials design can be beneficial but requires resources, preparation, training, flexibility, and time. Issues to address include reporting deficits for risk of bias, study quality, and conflicts of interests. We need to address these tensions and improve dissemination strategies to increase PPI and health literacy. © 2017 John Wiley & Sons, Ltd. AU - Price, A. AU - Albarqouni, L. AU - Kirkpatrick, J. AU - Clarke, M. AU - Liew, S. M. AU - Roberts, N. AU - Burls, A. DA - 2018-1-1 %J Journal of Evaluation in Clinical Practice IS - 1 KW - Bias (Epidemiology) PY - 2018 SN - 1356-1294 SP - 240-253 ST - Patient and public involvement in the design of clinical trials: An overview of systematic reviews T2 - Journal of Evaluation in Clinical Practice TI - Patient and public involvement in the design of clinical trials: An overview of systematic reviews VL - 24 ID - 280 ER - TY - JOUR AB - Background Cerebral palsy, a spectrum of neuromuscular conditions caused by abnormal brain development or early damage to the brain, is the most common cause of childhood physical disability. Lumbosacral dorsal rhizotomy is a neurosurgical procedure that permanently decreases spasticity and is always followed by physical therapy. The objectives of this health technology assessment were to evaluate the clinical effectiveness, safety, cost effectiveness, and family perspectives of dorsal rhizotomy. Methods We performed a systematic literature search until December 2015 with auto-alerts until December 2016. Search strategies were developed by medical librarians, and a single reviewer reviewed the abstracts. The health technology assessment included a clinical review based on functional outcomes, safety, and treatment satisfaction; an economic study reviewing cost-effective literature; a budget impact analysis; and interviews with families evaluating the intervention. Results Eighty-four studies (1 meta-analysis, 5 randomized controlled studies [RCTs], 75 observational pre-post studies, and 3 case reports) were reviewed. A meta-analysis of RCTs involving dorsal rhizotomy and physical therapy versus physical therapy confirmed reduced lower-limb spasticity and increased gross motor function (4.5%, P = .002). Observational studies reported statistically significant improvements in gross motor function over 2 years or less (12 studies, GRADE moderate) and over more than 2 years (10 studies, GRADE moderate) as well as improvements in functional independence in the short term (10 studies, GRADE moderate) and long term (4 studies, GRADE low). Major operative complications, were infrequently reported (4 studies). Bony abnormalities and instabilities monitored radiologically in the spine (15 studies) and hip (8 studies) involved minimal or clinically insignificant changes after surgery. No studies evaluated the cost effectiveness of dorsal rhizotomy. The budget impact of funding dorsal rhizotomy for treatment of Ontario children with cerebral palsy was $1.3 million per year. Families reported perceived improvements in their children and expressed satisfaction with treatment. Ontario families reported inadequate medical information on benefits or risk to make an informed decision, enormous financial burdens, and lack rehabilitation support after surgery. Conclusions Lumbrosacral dorsal rhizotomy and physical therapy effectively reduces lower-limb spasticity in children with spastic cerebral palsy and significantly improves their gross motor function and functional independence. Major peri-operative complications were infrequently reported. Families reported perceived improvements with dorsal rhizotomy, and surgery and post-operative rehabilitation were intensive and demanding. © Queen’s Printer for Ontario, 2017. AU - Pron, Gaylene AU - Chan, Brian AU - Tu, Hong Anh AU - Xie, Xuanqian AU - Weir, Mark AU - Wells, David AU - Higgins, Caroline AU - Betsch, Elizabeth Jean AU - Mohamed, Merissa AU - Kaulback, Kellee AU - Laing, Ana AU - Soulodre, Claude AU - Ng, Vivian AU - Mitchell, Andrée AU - Sikich, Nancy AU - Dhalla, Irfan DA - 2017-1-1 IS - 10 KW - Biomedical Technology Disabled Persons Ontario Cost-Benefit Analysis Brain Muscle Spasticity Technology Assessment, Biomedical Cerebral Palsy Rhizotomy systematic review spondylolysis spondylolisthesis spine malformation spasticity spastic cerebral palsy sensory dysfunction scoliosis rehabilitation care randomized controlled trial (topic) physiotherapy patient safety observational study motor performance meta analysis (topic) lumbosacral dorsal rhizotomy lordosis kyphosis human functional status family dorsal rhizotomy cost effectiveness analysis clinical effectiveness bladder dysfunction biomedical technology assessment Article PY - 2017 SN - 1915-7398 SP - 1-186 ST - Ontario health technology assessment series: Lumbosacral dorsal rhizotomy for spastic cerebral palsy: A health technology assessment T2 - Ontario Health Technology Assessment Series TI - Ontario health technology assessment series: Lumbosacral dorsal rhizotomy for spastic cerebral palsy: A health technology assessment VL - 17 ID - 114 ER - TY - JOUR AB - Background: Despite recent improvements, uptake and retention of mothers and infants in prevention of mother-to-child transmission (PMTCT) services remain well below target levels in many low- and middle-income countries (LMICs). Identification of effective interventions to support uptake and retention is the first step towards improvement. We aim to complete a systematic review and meta-analysis to evaluate the effectiveness of interventions at the patient, provider or health system level in improving uptake and retention of HIV-infected mothers and their infants in PMTCT services in LMICs. Methods/Design: We will include studies comparing usual care or no intervention to any type of intervention to improve uptake and retention of HIV-infected pregnant or breastfeeding women and their children from birth to 2 years of age attending PMTCT services in LMICs. We will include randomized controlled trials (RCTs), cluster RCTs, non-randomized controlled trials, and interrupted time series. The primary outcomes of interest are percentage of HIV-infected women receiving/initiated on anti-retroviral prophylaxis or treatment, percentage of infants receiving/initiated on anti-retroviral prophylaxis, and percentage of women and infants completing the anti-retroviral regimen/retained in PMTCT care. The following databases will be searched from inception: Ovid MEDLINE and EMBASE, The WHO Global Health Library, CAB abstracts, EBM Reviews, CINAHL, HealthSTAR and Web of Science databases, Scopus, PsychINFO, POPLINE, Sociological Abstracts, ERIC, AIDS Education Global Information System, NLM Gateway, LILACS, Google Scholar, British Library Catalogue, DARE, ProQuest Dissertation & Theses, the New York Academy of Grey Literature, Open Grey, The Cochrane Library, WHO International Clinical Trials Registry, Controlled Clinical Trials, and clinicaltrials.gov. Reference lists of included articles will be hand searched and study authors and content experts contacted to inquire about eligible unpublished or in progress studies. Screening, data abstraction, and risk of bias appraisal using the Cochrane Effective Practice and Organization of Care criteria will be conducted independently by two team members. Results will be synthesized narratively and a meta-analysis conducted using the DerSimonian Laird random effects method if appropriate based on assessment of clinical and statistical heterogeneity. Discussion: Our findings will be useful to PMTCT implementers, policy makers, and implementation researchers working in LMICs. Systematic review registration: PROSPERO CRD42015020829 © 2015 Puchalski Ritchie et al. AU - Puchalski Ritchie, L. M. AU - van Lettow, M. AU - Hosseinipour, M. C. AU - Rosenberg, N. E. AU - Phiri, S. AU - Landes, M. AU - Cataldo, F. AU - Straus, S. E. DA - 2015-1-1 IS - 1 KW - HIV-1 Child Only Child Review Literature as Topic Research Design Program Evaluation Pregnancy Complications, Infectious Pregnancy Patient Acceptance of Health Care Meta-Analysis as Topic Infectious Disease Transmission, Vertical Infant, Newborn Infant Humans HIV Infections Female Developing Countries Breast Feeding Anti-HIV Agents anti human immunodeficiency virus agent virology vertical transmission transmission prevention and control patient attitude newborn methodology meta analysis (topic) literature developing country systematic review risk assessment priority journal pregnant woman patient education mother child relation meta analysis Human immunodeficiency virus infection human HIV test health service controlled study controlled clinical trial (topic) Article Uptake Retention Prevention of mother-to-child transmission Interventions HIV PY - 2015 SN - 2046-4053 ST - The effectiveness of interventions to improve uptake and retention of HIV-infected pregnant and breastfeeding women and their infants in prevention of mother-to-child transmission care programs in low- and middle-income countries: Protocol for a systematic review and meta-analysis T2 - Systematic Reviews TI - The effectiveness of interventions to improve uptake and retention of HIV-infected pregnant and breastfeeding women and their infants in prevention of mother-to-child transmission care programs in low- and middle-income countries: Protocol for a systematic review and meta-analysis VL - 4 ID - 197 ER - TY - JOUR AB - Aim: Resistances to antibiotics employed for treatment of infectious diseases have increased to alarming numbers making it more and more difficult to treat diseases caused by microorganisms resistant to common antibiotics. Consequently, novel methods for successful inactivation of pathogens are required. In this instance, one alternative could be application of light for treatment of topical infections. Antimicrobial properties of UV light are well documented, but due to its DNA-damaging properties use for medical purposes is limited. In contrast, irradiation with visible light may be more promising. Methods: Literature was systematically screened for research concerning inactivation of main oral bacterial species by means of visible light. Results: Inactivation of bacterial species, especially pigmented ones, in planktonic state showed promising results. There is a lack of research examining the situation when organized as biofilms. Conclusion: More research concerning situation in a biofilm state is required. © 2017 2017 Future Science Ltd. AU - Pummer, A. AU - Knüttel, H. AU - Hiller, K. A. AU - Buchalla, W. AU - Cieplik, F. AU - Maisch, T. DA - 2017-1-1 %J Future Medicinal Chemistry IS - 13 KW - Anti-Bacterial Agents PY - 2017 SN - 17568919 (ISSN) SP - 1557-1574 ST - Antimicrobial efficacy of irradiation with visible light on oral bacteria in vitro: A systematic review T2 - Future Medicinal Chemistry TI - Antimicrobial efficacy of irradiation with visible light on oral bacteria in vitro: A systematic review VL - 9 ID - 283 ER - TY - JOUR AB - Background: Chronic kidney disease affects approximately one in ten North Americans and is associated with a high risk of cardiovascular disease. Chronic kidney disease in women is characterized by an abnormal sex hormone profile and low estradiol levels. Since low estradiol levels are associated with an increased cardiovascular risk in healthy women, our objective is to determine the effect of hormone therapy on all-cause mortality, cardiovascular mortality, and cardiovascular morbidity in women with chronic kidney disease. Methods/design: Studies examining hormone therapy for adult women with chronic kidney disease will be included. The primary outcome is all-cause or cardiovascular mortality and morbidity. We will search electronic bibliographic databases (MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL)) along with relevant conference proceedings, table of contents of journals, and review articles. Two investigators will independently screen identified abstracts and select observational cohort studies, case-control studies, and randomized controlled trials examining hormone therapy in women with chronic kidney disease. These investigators will also independently abstract data from relevant full-text journal articles and assess risk of bias. Where possible, these data will be summarized using pooled or combined estimates for the risk ratio or hazard ratio of all-cause mortality, cardiovascular mortality, and cardiovascular morbidity in women with chronic kidney disease with and without hormone therapy. A random effects model will be used, and meta-regression and subgroup analyses will be used to explore potential source of heterogeneity. Discussion: Given the high burden of cardiovascular disease in women with chronic kidney disease, this study will help guide clinical practice by summarizing current evidence on the use of hormone therapy for prevention of all-cause mortality, cardiovascular mortality, and cardiovascular morbidity in this population. Systematic review registration: The final protocol was registered with PROSPERO (CRD42014014566). © 2015 Ramesh et al.; licensee BioMed Central. AU - Ramesh, S. AU - Mann, M. C. AU - Holroyd-Leduc, J. M. AU - Wilton, S. B. AU - James, M. T. AU - Seely, E. W. AU - Ahmed, S. B. DA - 2015-1-1 IS - 1 KW - Case-Control Studies Kidney Kidney Diseases Risk Factors Research Design Renal Insufficiency, Chronic Incidence Humans Female Estrogen Replacement Therapy Estradiol Clinical Protocols Cause of Death Cardiovascular Diseases risk factor mortality methodology meta analysis estrogen therapy complication clinical protocol chronic kidney failure blood therapy effect systematic review randomized controlled trial (topic) publication priority journal outcome assessment morbidity human hormone substitution hormonal therapy data synthesis data extraction chronic kidney disease cardiovascular mortality cardiovascular disease Article unclassified drug progesterone medroxyprogesterone acetaten gestagen estrogen estriol dydrogesterone conjugated estrogen Hormone therapy Cardiovascular morbidity All-cause mortality PY - 2015 SN - 2046-4053 ST - The effect of hormone therapy on all-cause and cardiovascular mortality in women with chronic kidney disease: Protocol for a systematic review and meta-analysis T2 - Systematic Reviews TI - The effect of hormone therapy on all-cause and cardiovascular mortality in women with chronic kidney disease: Protocol for a systematic review and meta-analysis VL - 4 ID - 211 ER - TY - JOUR AB - Objective: Women with chronic kidney disease (CKD) experience kidney dysfunction-mediated premature menopause. The role of postmenopausal hormone therapy (HT) in this population is unclear. We sought to summarize current knowledge regarding use of postmenopausal HT and cardiovascular (CV) outcomes, and established surrogate measures of CV risk in women with CKD. Methods: This is a systematic review and meta-analysis of adult women with CKD. We searched electronic bibliographic databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials) (inception to 2014 December), relevant conference proceedings, tables of contents of journals, and review articles. Randomized controlled trials and observational studies examining postmenopausal HT compared with either placebo or untreated control groups were included. The intervention of interest was postmenopausal HT, and the outcome measures were all-cause and CV mortality, nonfatal CV event (myocardial infarction, stroke), and surrogate measures of CV risk (serum lipids, blood pressure). Results: Of 12,482 references retrieved, four randomized controlled trials and two cohort studies (N=1,666 participants) were identified. No studies reported on CV outcomes or mortality. Compared with placebo, postmenopausal HT was associated with decreased low-density lipoprotein cholesterol (-13.2 mg/dL [95% CI, -23.32 to -3.00 mg/dL]), and increased high-density lipoprotein (8.73 mg/dL [95% CI, 4.72-12.73 mg/dL]) and total cholesterol (7.96 mg/dL [95% CI, 0.07-15.84 mg/dL]). No associations were observed between postmenopausal HT triglyceride levels and blood pressure. Conclusions: Studies examining the effect of postmenopausal HT on CV outcomes in women with CKD are lacking. Further prospective study of the role of postmenopausal HT in this high-risk group is required. © 2016 by The North American Menopause Society. AU - Ramesh, S. AU - Mann, M. C. AU - Holroyd-Leduc, J. M. AU - Wilton, S. B. AU - James, M. T. AU - Seely, E. W. AU - Ahmed, S. B. DA - 2016-1-1 IS - 9 KW - Cohort Studies Kidney Postmenopause Kidney Diseases Renal Insufficiency, Chronic Middle Aged Menopause, Premature Humans Female Estrogen Replacement Therapy Cardiovascular System Cardiovascular Diseases Biomarkers estrogen therapy early menopause drug effects complication chronic kidney failure cardiovascular disease blood therapy effect systematic review Review randomized controlled trial (topic) outcome assessment observational study meta analysis human hormonal therapy heart infarction disease marker controlled clinical trial (topic) cohort analysis clinical outcome chronic kidney disease cholesterol blood level cerebrovascular accident cardiovascular risk cardiovascular mortality blood pressure biological marker raloxifene norgestrel norethisterone acetate medroxyprogesterone acetate low density lipoprotein cholesterol hormone high density lipoprotein cholesterol estradiol conjugated estrogen Lipids Hormone therapy PY - 2016 SP - 1028-1037 ST - Hormone therapy and clinical and surrogate cardiovascular endpoints in Women with chronic kidney disease: A systematic review and meta-analysis T2 - Menopause TI - Hormone therapy and clinical and surrogate cardiovascular endpoints in Women with chronic kidney disease: A systematic review and meta-analysis VL - 23 ID - 173 ER - TY - JOUR AB - Introduction Survivors of muscle invasive bladder cancer (MIBC) experience physical and psychosocial side effects of cancer diagnosis and treatment. These negative side effects have a crucial impact on their health-related quality of life (HRQoL). To date, there is evidence that rehabilitation interventions such as physical activity and psychosocial support have a positive effect on the HRQoL of cancer survivors. Unfortunately, there are no specific guidelines for rehabilitation or survivorship programmes for MIBC survivors. Therefore, this systematic review aims to assess the effects of exercise-based and psychosocial rehabilitation interventions in MIBC survivors. Methods and analysis The approach of this review is consistent with the Cochrane methodology. Randomized controlled trials and non-randomised studies will be included. The population of interest is patients (≥18 years of age) with diagnosis of MIBC or high-risk non-MIBC for whom a radical cystectomy is indicated. There will be two eligible intervention types for inclusion: Exercise-based and psychosocial rehabilitation interventions. The primary outcome measures are patient-reported outcomes (eg, HRQoL, fatigue and pain) and physical fitness. Studies will be identified independently by two review authors by searching the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Web of Science and the Physiotherapy Evidence Database. A third reviewer will be asked by disagreements. Risk of bias will be assessed using the Cochrane Collaboration tool and the Newcastle-Ottawa Scale. Data will be summarised descriptively. If homogeneity of the studies is sufficient, meta-analysis will be undertaken. The broad scope of this review (ie, different interventions and study designs) is needed to have a comprehensive view on effective rehabilitation interventions. Ethics and dissemination Ethics approval is not required, as no primary data will be collected. Results will be disseminated through a peer-reviewed publication. © 2017 Article author(s). AU - Rammant, E. AU - Bultijnck, R. AU - Sundahl, N. AU - Ost, P. AU - Pauwels, N. S. AU - Deforche, B. AU - Pieters, R. AU - Decaestecker, K. AU - Fonteyne, V. DA - 2017-1-1 IS - 5 KW - Survival Rate Urinary Bladder Neoplasms Survivors Research Design Quality of Life Physical Therapy Modalities Physical Fitness Patient Reported Outcome Measures Humans survivor psychology physiotherapy pathology methodology meta analysis bladder tumor systematic review risk assessment psychosocial rehabilitation practice guideline patient-reported outcome pain muscle invasive bladder cancer human high risk patient fitness fatigue evidence based practice cystectomy Article adult rehabilitation psychosocial intervention exercise Bladder neoplasm PY - 2017 SN - 2044-6055 ST - Rehabilitation interventions to improve patient-reported outcomes and physical fitness in survivors of muscle invasive bladder cancer: A systematic review protocol T2 - BMJ Open TI - Rehabilitation interventions to improve patient-reported outcomes and physical fitness in survivors of muscle invasive bladder cancer: A systematic review protocol VL - 7 ID - 95 ER - TY - JOUR AB - Objective: To determine the effectiveness and cost-effectiveness of noninvasive interventions for temporomandibular disorders (TMD). Methods: We systematically searched MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane Central register from 1990 to 2014 for effectiveness studies and the Cochrane Health Technology Assessment Database, EconLit, NHS Economic Evaluation Database, and Tufts Medical Center Cost-Effectiveness Analysis Register from 1990 to 2014 for cost-effectiveness studies. Random pairs of independent reviewers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria. Evidence from eligible studies was synthesized using best-evidence synthesis methodology. Results: Our search for effectiveness studies yielded 16,995 citations; 31 were relevant and 7 randomized controlled trials (published in 8 articles) had a low risk of bias. We found no relevant cost-effectiveness studies. The evidence suggests that for persistent TMD: (1) cognitive-behavioral therapy and self-care management lead to similar improvements in pain and disability but cognitive-behavioral therapy is more effective for activity interference and depressive symptoms; (2) cognitive-behavioral therapy combined with usual treatment provides short-term benefits in pain and ability to control pain compared with usual treatment alone; (3) intraoral myofascial therapy may reduce pain and improve jaw opening; and (4) structured self-care management may be more effective than usual treatment. The evidence suggests that occlusal devices may not be effective in reducing pain and improving motion for TMD of variable duration. Evidence on the effectiveness of biofeedback is inconclusive. Discussion: The available evidence suggests that cognitive-behavioral therapy, intraoral myofascial therapy, and self-care management are therapeutic options for persistent TMD. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. AU - Randhawa, K. AU - Bohay, R. AU - Côté, P. AU - Van Der Velde, G. AU - Sutton, D. AU - Wong, J. J. AU - Yu, H. AU - Southerst, D. AU - Varatharajan, S. AU - Mior, S. AU - Stupar, M. AU - Shearer, H. M. AU - Jacobs, C. AU - Taylor-Vaisey, A. DA - 2016-1-1 %J Clinical Journal of Pain IS - 3 KW - Cognition Behavior Therapy Cost-Benefit Analysis Managed Care Programs Cognitive Therapy Temporomandibular Joint Disorders PY - 2016 SN - 0749-8047 SP - 260-278 ST - The effectiveness of noninvasive interventions for temporomandibular disorders a systematic review by the Ontario protocol for traffic injury management (OPTIMa) collaboration T2 - Clinical Journal of Pain TI - The effectiveness of noninvasive interventions for temporomandibular disorders a systematic review by the Ontario protocol for traffic injury management (OPTIMa) collaboration VL - 32 ID - 297 ER - TY - JOUR AB - Purpose: To determine the effectiveness of structured patient education for the management of musculoskeletal disorders and injuries of the extremities. Methods: We searched MEDLINE, EMBASE, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials from January 1, 1990 to March 14, 2015. Paired reviewers independently screened titles and abstracts for eligibility. The internal validity of studies was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) criteria. Results from studies with a low risk of bias were synthesized using the bestevidence synthesis methodology. Results: We identified two randomized trials with a low risk of bias. Our review suggests that: 1) multimodal care and corticosteroid injections lead to faster pain relief and improvement than reassurance and advice in the short-term and similar outcomes in the long-term for patients with persistent lateral epicondylitis; and 2) providing health education material alone may be less effective than multimodal care for the management of persistent patellofemoral pain syndrome. Conclusion: Our systematic search of the literature demonstrates that little is known about the effectiveness of structured patient education for the management of musculoskeletal disorders and injuries of the extremities. Two studies suggest that when used alone, structured patient education may be less effective than other interventions used to manage persistent lateral epicondylitis and persistent patellofemoral syndrome. © JCCA 2015. AU - Randhawa, K. AU - Côté, P. AU - Gross, D. P. AU - Wong, J. J. AU - Yu, H. AU - Sutton, D. AU - Southerst, D. AU - Varatharajan, S. AU - Mior, S. AU - Stupar, M. AU - Shearer, H. M. AU - Lindsay, G. M. AU - Jacobs, C. AU - Taylor-Vaisey, A. DA - 2015-1-1 IS - 4 KW - Patient Education as Topic Systematic review Patient education Patellofemoral pain Lateral epicondylitis Injury Extremity Chiropractic PY - 2015 SN - 0008-3194 SP - 349-362 ST - The effectiveness of structured patient education for the management of musculoskeletal disorders and injuries of the extremities: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration T2 - Journal of the Canadian Chiropractic Association TI - The effectiveness of structured patient education for the management of musculoskeletal disorders and injuries of the extremities: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration VL - 59 ID - 220 ER - TY - JOUR AB - Background: Evidence from diverse areas of medicine (e.g., cardiovascular disease, diabetes) indicates that healthcare providers (HCPs) often do not adhere to clinical practice guidelines (CPGs) despite a clear indication to implement recommendations - a phenomenon commonly termed clinical inertia. There are a variety of reasons for clinical inertia, but HCP-related factors (e.g., knowledge, motivation, agreement with guidelines) are the most salient and amenable to intervention aimed to improve adherence. CPGs have been developed to support the safe and effective prescription of opioid medication for the management of chronic non-cancer pain. The extent of physician uptake and adherence to such guidelines is not yet well understood. The purpose of this review is to synthesize the published evidence about knowledge, attitudes, beliefs, and practices that HCPs hold regarding the prescription of opioids for chronic non-cancer pain. Methods: An experienced information specialist will perform searches of CINAHL, Embase, MEDLINE, and PsycINFO bibliographic databases. The Cochrane library, PROSPERO, and the Joanna Briggs Institute will be searched for systematic reviews. Searches will be performed from inception to the present. Quantitative and qualitative study designs that report on HCP knowledge, attitudes, beliefs, or practices in North America will be eligible for inclusion. Studies reporting on interventions to improve HCP adherence to opioid prescribing CPGs will also be eligible for inclusion. Two trained graduate-level research assistants will independently screen articles for inclusion, perform data extraction, and perform risk of bias and quality assessment using recommended tools. Confidence in qualitative evidence will be evaluated using the Grades of Recommendation, Assessment, Development, and Evaluation-Confidence in the Evidence from Qualitative Reviews (GRADE-CERQual) approach. Confidence in quantitative evidence will be assessed using the GRADE approach. Discussion: The ultimate goal of this work is to support interventions aiming to optimize opioid prescribing practices in order to prevent opioid-related morbidity and mortality without restricting a HCP's ability to select the most appropriate treatment for an individual patient. Systematic review registration: PROSPERO CRD42018091640. © 2018 The Author(s). AD - Department of Psychology, Memorial University of Newfoundland, 230 Elizabeth Ave, St. John's, NL A1B 3X9, Canada Department of Anesthesia, McMaster University, Hamilton, ON, Canada Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, ON, Canada Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Hamilton, ON, Canada Department of Psychology, University of Calgary, Calgary, AB, Canada Royal Ottawa Mental Health Centre, Ottawa, ON, Canada Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada University of Ottawa, Institute of Mental Health Research, Ottawa, ON, Canada Canadian Injured Workers Alliance, Thunder Bay, ON, Canada Department of Anesthesia, Memorial University of Newfoundland, St. John's, NL, Canada Department of Psychology, University of Quebec at Montreal, Montreal, QC, Canada Montreal Behavioral Medicine Centre (MBMC), Centre Integree Universitaire de Sante et Services Sociaux de Nord de l'Ile de Montreal, Hopital du Sacre-Coeur de Montreal, Montreal, QC, Canada Ottawa Hospital Research Institute, Ottawa, ON, Canada Ottawa Hospital Pain Clinic, Ottawa, ON, Canada School of Psychology, Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada Independent Information Specialist, Ottawa, ON, Canada AU - Rash, J. A. AU - Buckley, N. AU - Busse, J. W. AU - Campbell, T. S. AU - Corace, K. AU - Cooper, L. AU - Flusk, D. AU - Iorio, A. AU - Lavoie, K. L. AU - Poulin, P. A. AU - Skidmore, B. C2 - 30424800 C7 - 189 DB - Scopus DO - 10.1186/s13643-018-0858-7 IS - 1 KW - Chronic pain Clinical inertia Clinical practice guideline adherence Opioids Systematic review clinical practice dentist health belief health personnel attitude health service human knowledge nurse practitioner pharmacist physician practice guideline prescription priority journal protocol compliance resident Review attitude to health North America standards narcotic analgesic agent Analgesics, Opioid Health Knowledge, Attitudes, Practice Humans Practice Guidelines as Topic Practice Patterns, Physicians' Prescriptions LA - English M3 - Review PY - 2018 ST - Healthcare provider knowledge, attitudes, beliefs, and practices surrounding the prescription of opioids for chronic non-cancer pain in North America: Protocol for a mixed-method systematic review 11 Medical and Health Sciences 1117 Public Health and Health Services T2 - Systematic Reviews TI - Healthcare provider knowledge, attitudes, beliefs, and practices surrounding the prescription of opioids for chronic non-cancer pain in North America: Protocol for a mixed-method systematic review 11 Medical and Health Sciences 1117 Public Health and Health Services VL - 7 ID - 398 ER - TY - JOUR AB - Background: Gaucher disease (GD) is an autosomal recessive lysosomal storage disorder caused by deficiency in acid beta-glucosidase. GD exhibits a wide clinical spectrum of disease severity with an unpredictable natural course. Plasma chitotriosidase activity and CC chemokine ligand 18 (CCL18) have been exchangeably used for monitoring GD activity and response to enzyme replacement therapy in conjunction with clinical assessment. Yet, a large-scale head-to-head comparison of these two biomarkers is currently lacking. We propose a collaborative systematic review with meta-analysis of individual participant data (IPD) to compare the accuracy of plasma chitotriosidase activity and CCL18 in assessing type I (i.e., non-neuropathic) GD severity. Methods: Eligible studies include cross-sectional, cohort, and randomized controlled studies recording both plasma chitotriosidase activity and CCL18 level at baseline and/or at follow-up in consecutive children or adult patients with type I GD. Pre-specified surrogate outcomes reflecting GD activity include liver and spleen volume, hemoglobin concentration, platelet count, and symptomatic bone events with imaging confirmation. Primary studies will be identified by searching Medline (1995 onwards), EMBASE (1995 onwards), and Cochrane Central Register of Controlled Trials (CENTRAL). Electronic search will be complemented by contacting research groups in order to identify unpublished relevant studies. Where possible, IPD will be extracted from published articles. Corresponding authors will be invited to collaborate by supplying IPD. The methodological quality of retrieved studies will be appraised for each study outcome, using a checklist adapted from the Quality Assessment of Diagnostic Accuracy Studies-2 tool. The primary outcome will be a composite of liver volume >1.25 multiple of normal (MN), spleen volume >5 MN, hemoglobin concentration <11 g/dL, or platelet count <100 × 109/L. Effect size estimates for biomarker comparative accuracy in predicting outcomes will be reported as differences in areas under receiver operating characteristic curves along with 95% confidence intervals. Effect size estimates will be reported as (weighted) mean differences along with 95% confidence intervals for each biomarker according to outcomes. IPD meta-analysis will be conducted with both one- and two-stage approaches. Discussion: Valid and precise accuracy estimates will be derived for CCL18 relative to plasma chitotriosidase activity in discriminating patients according to GD severity. Systematic review registration: PROSPERO 2015 CRD42015027243 © 2017 The Author(s). AU - Raskovalova, T. AU - Deegan, P. B. AU - Yang, R. AU - Pavlova, E. AU - Stirnemann, J. AU - Labarère, J. AU - Zimran, A. AU - Mistry, P. K. AU - Berger, M. DA - 2017-1-1 IS - 1 KW - Platelet Count Blood Platelets Hemoglobin A, Glycosylated Liver Biological Markers Thrombocytopenia Splenomegaly Severity of Illness Index Review Literature as Topic Research Design Meta-Analysis as Topic Humans Hexosaminidases Hepatomegaly Gaucher Disease Chemokines, CC Biomarkers Anemia meta analysis (topic) literature enzymology complication comparative study blood treatment outcome thrombocyte count systematic review study design splenectomy spleen weight scientific literature randomized controlled trial (topic) priority journal methodology meta analysis liver weight leukocyte count human gender fracture enzyme replacement enzyme activity disease severity assessment diagnostic test accuracy study diagnostic accuracy data processing controlled study clinical trial (topic) Article chitotriosidase CCL18 protein, human biological marker beta n acetylhexosaminidase beta chemokine unclassified drug chemokine PY - 2017 SN - 2046-4053 ST - Plasma chitotriosidase activity versus CCL18 level for assessing type I Gaucher disease severity: Protocol for a systematic review with meta-analysis of individual participant data T2 - Systematic Reviews TI - Plasma chitotriosidase activity versus CCL18 level for assessing type I Gaucher disease severity: Protocol for a systematic review with meta-analysis of individual participant data VL - 6 ID - 97 ER - TY - JOUR AB - Background: Off periods are a common and disabling symptom of Parkinson's disease. We reviewed published research on understanding, impact, and communication regarding off periods to identify issues warranting further research. Methods: We performed a scoping review, searching MEDLINE, EMBASE, Cochrane Library, CINAHL, and PsycINFO from 2006 to January 2018 for studies examining the impact of, understanding of, or communication about off periods. Results: Twenty-six papers met eligibility criteria. Twenty-three studies evaluated the impact or experience of off periods in patients, three evaluated the impact upon carepartners, two papers addressed understanding of off periods, one study evaluated communication about off periods, and three studies evaluated a facilitator of communication about off periods. The findings indicate that (1) off periods are among the most troublesome symptoms to patients and that their impact on activities is broad; (2) the understanding of off periods by patients, carepartners, and nurses may be suboptimal; and (3) questionnaires hold promise as a mechanism for facilitating communication given the findings that they may enhance the detection of off periods and are rated as useful by physicians. No studies evaluated interventions to promote knowledge about off periods, and no studies identified barriers of communication about off periods. Conclusions: There is a paucity of knowledge regarding the lived experiences of off periods, particularly for carepartners. Additionally, little knowledge exists in the literature regarding understanding of and communication about off periods between patients or carepartners and treating physicians. Further research is required to explore these issues to ultimately improve the treatment of off periods. © 2018 International Parkinson and Movement Disorder Society AD - Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's Research, Toronto Western Hospital, Toronto, ON, Canada Department of Neurology, University of Florida College of Medicine, Gainesville, FL, United States Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada AU - Rastgardani, T. AU - Armstrong, M. J. AU - Gagliardi, A. R. AU - Marras, C. DB - Scopus DO - 10.1002/mdc3.12672 IS - 5 KW - communication impact motor fluctuations Parkinson's disease “off” periods LA - English M3 - Review PY - 2018 SP - 461-470 ST - Understanding, Impact, and Communication of “Off” Periods in Parkinson's Disease: A Scoping Review T2 - Movement Disorders Clinical Practice TI - Understanding, Impact, and Communication of “Off” Periods in Parkinson's Disease: A Scoping Review VL - 5 ID - 399 ER - TY - JOUR AB - Background: Physical rehabilitation (PR) interventions in the intensive care unit (ICU) can improve patients' functional outcomes, yet systematic reviews identified discordant effects and poor reporting. We conducted a scoping review to determine the extent of ICU PR interventions and how they were reported and measured. Methods: We searched five databases from inception to December 2016 for prospective studies evaluating adult ICU PR interventions. Two independent reviewers screened titles, abstracts, and full texts for inclusion. We assessed completeness of reporting using the Consolidated Standards of Reporting Trials, Strengthening the Reporting of Observational Studies in Epidemiology, or Standards for Quality Improvement Reporting Excellence guidelines, as appropriate. For planned PR interventions, we evaluated reporting with the Consensus on Exercise Reporting Template (CERT) and assessed intervention and control groups separately. We calculated completeness of reporting scores for each study; scores represented the proportion of reported items. We compared reporting between groups using Kruskal-Wallis with Bonferroni corrections and t tests, α = 0.05. Results: We screened 61,774 unique citations, reviewed 1429 full-text publications, and included 117: 39 randomized trials, 30 case series, 9 two-group comparison, 14 before-after, and 25 cohort. Interventions included neuromuscular electrical stimulation (NMES) (14.5%), passive/active exercises (15.4%), cycling (6.8%), progressive mobility (32.5%), and multicomponent (29.9%). The median (first,third quartiles) study reporting score was 75.9% (62.5, 86.7) with no significant differences between reporting guidelines. Of 87 planned intervention studies, the median CERT score was 55.6%(44.7,75.0); cycling had the highest (85.0%(62.2,93.8)), and NMES and multicomponent the lowest (50.0% (39.5, 70.3) and 50.0% (41.5, 58.8), respectively) scores. Authors reported intervention groups better than controls (p < 0.001). Conclusions: We identified important reporting deficiencies in ICU PR interventions, limiting clinical implementation and future trial development. © 2018 The Author(s). AD - Faculty of Health Sciences, School of Rehabilitation Science, McMaster University, Institute of Applied Health Sciences, 1400 Main Street West, Hamilton, ON L8S 1C7, Canada Rehabilitation Sciences Institute, University of Toronto, Rehabilitation Sciences Building, 500 University Avenue, Toronto, ON M5G 1V7, Canada Department of Physiotherapy, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, ON L8N 4A6, Canada Department of Pediatrics, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada AU - Reid, J. C. AU - Unger, J. AU - McCaskell, D. AU - Childerhose, L. AU - Zorko, D. J. AU - Kho, M. E. C7 - 80 DB - Scopus DO - 10.1186/s40560-018-0349-x IS - 1 KW - Critical care Critical illness Early ambulation Rehabilitation Respiration, artificial APACHE Article exercise functional disease human intensive care intensive care unit meta analysis mobilization mortality neuromuscular electrical stimulation physical activity priority journal randomized controlled trial (topic) Simplified Acute Physiology Score systematic review LA - English M3 - Article PY - 2018 ST - Physical rehabilitation interventions in the intensive care unit: A scoping review of 117 studies T2 - Journal of Intensive Care TI - Physical rehabilitation interventions in the intensive care unit: A scoping review of 117 studies VL - 6 ID - 400 ER - TY - JOUR AB - Background: Renal replacement therapy is increasingly utilized in the intensive care unit (ICU), of which continuous renal replacement therapy (CRRT) is most common. Despite CRRT being a relatively resource-intensive and expensive technology, there remains wide practice variation in its application. This systematic review will appraise the evidence for quality indicators (QIs) of CRRT care in critically ill patients. Methods: Ovid MEDLINE, Ovid EMBASE, CINAHL, and the Cochrane Library including the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials (CENTRAL), and databases from the National Information Center of Health Services Research and Health Care Technology will be searched for original studies involving QIs in CRRT. Gray literature sources will be searched for technical reports, practice guidelines, and conference proceedings. Websites of relevant organizations will be identified, and industry leaders in the development and marketing of CRRT technology and non-profit organizations that represent key opinion leads in the use of CRRT will be contacted. We will search the Agency of Healthcare Research and Quality National Quality Measures Clearinghouse for CRRT-related QIs. Studies will be included if they contain quality measures, occur in critically ill patients, and are associated with CRRT. Analysis will be primarily descriptive. Each QI will be evaluated for importance, scientific acceptability, usability, and feasibility using the four criteria proposed by the United States Strategic Framework Board for a National Quality Measurement and Reporting System. Finally, QIs will be appraised for their potential operational characteristics, for their potential to be integrated into electronic medical records, and on their affordability, if applicable. Discussion: This systematic review will comprehensively identify and synthesize QIs in CRRT. The results of this study will fuel the development of an inventory of essential QIs to support the appropriate, safe, and efficient delivery of CRRT in critically ill patients. Systematic review registration: PROSPERO CRD42015015530. © 2015 Rewa et al. AU - Rewa, O. AU - Villeneuve, P. M. AU - Eurich, D. T. AU - Stelfox, H. T. AU - Noel Gibney, R. T. AU - Hartling, L. AU - Featherstone, R. AU - Bagshaw, S. M. DA - 2015-1-1 IS - 1 KW - Health Services Research Critical Care United States Research Design Renal Replacement Therapy Quality Indicators, Health Care Intensive Care Units Humans Delivery of Health Care Critical Illness standards methodology intensive care unit health care delivery systematic review randomized controlled trial (topic) priority journal practice guideline multiple organ failure lifespan intensive care human hemofiltration hemodiafiltration health care quality health care cost dialysis critically ill patient continuous renal replacement therapy Article acute kidney failure Quality indicator Effectiveness PY - 2015 SN - 2046-4053 ST - Quality indicators in continuous renal replacement therapy (CRRT) care in critically ill patients: Protocol for a systematic review T2 - Systematic Reviews TI - Quality indicators in continuous renal replacement therapy (CRRT) care in critically ill patients: Protocol for a systematic review VL - 4 ID - 204 ER - TY - JOUR AB - Background: Strained intensive care unit (ICU) capacity represents a fundamental supply-demand mismatch in ICU resources. Strain is likely to be influenced by a range of factors; however, there has been no systematic evaluation of the spectrum of measures that may indicate strain on ICU capacity. Methods: We performed a systematic review to identify indicators of strained capacity. A comprehensive peer-reviewed search of MEDLINE, EMBASE, CINAHL, Cochrane Library, and Web of Science Core Collection was performed along with selected grey literature sources. We included studies published in English after 1990. We included studies that: (1) focused on ICU settings; (2) included description of a quality or performance measure; and (3) described strained capacity. Retrieved studies were screened, selected and extracted in duplicate. Quality was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). Analysis was descriptive. Results: Of 5297 studies identified in our search; 51 fulfilled eligibility. Most were cohort studies (n = 39; 76.5%), five (9.8%) were case-control, three (5.8%) were cross-sectional, two (3.9%) were modeling studies, one (2%) was a correlational study, and one (2%) was a quality improvement project. Most observational studies were high quality. Sixteen measures designed to indicate strain were identified 110 times, and classified as structure (n = 4, 25%), process (n = 7, 44%) and outcome (n = 5, 31%) indicators, respectively. The most commonly identified indicators of strain were ICU acuity (n = 21; 19.1% [process]), ICU readmission (n = 18; 16.4% [outcome]), after-hours discharge (n = 15; 13.6% [process]) and ICU census (n = 13; 11.8% [structure]). There was substantial heterogeneity in the operational definitions used to define strain indicators across studies. Conclusions: We identified and characterized 16 indicators of strained ICU capacity across the spectrum of healthcare quality domains. Future work should aim to evaluate their implementation into practice and assess their value for evaluating strategies to mitigate strain. Systematic review registration: This systematic review was registered at PROSPERO (March 27, 2015; CRD42015017931 ). © 2018 The Author(s). AU - Rewa, O. G. AU - Stelfox, H. T. AU - Ingolfsson, A. AU - Zygun, D. A. AU - Featherstone, R. AU - Opgenorth, D. AU - Bagshaw, S. M. DA - 2018-1-1 IS - 1 KW - Intensive Care Intensive Care Units Strain Safety Quality Performance Organization Intensive care unit Indicator Capacity Adverse event PY - 2018 SN - 1364-8535 ST - Indicators of intensive care unit capacity strain: A systematic review T2 - Critical Care TI - Indicators of intensive care unit capacity strain: A systematic review VL - 22 ID - 29 ER - TY - JOUR AB - Objectives: Renal replacement therapy is increasingly utilized in the intensive care unit (ICU), of which continuous renal replacement therapy (CRRT) is most common. Despite CRRT being a relatively invasive and resource intensive technology, there remains wide practice variation in its application. This systematic review appraised the evidence for quality indicators (QIs) of CRRT care in critically ill patients. Design: A comprehensive search strategy was developed and performed in five citation databases (Medline, Embase, CINAHL, Cochrane Library, and PubMed) and select grey literature sources. Two reviewers independently screened, selected, and extracted data using standardized forms. Each retrieved citation was appraised for quality using the Newcastle–Ottawa Scale (NOS) and Cochrane risk of bias tool. Data were summarized narratively. Measurements and main results: Our search yielded 8374 citations, of which 133 fulfilled eligibility. This included 97 cohort studies, 24 randomized controlled trials, 10 case-control studies, and 2 retrospective medical audits. The quality of retrieved studies was generally good. In total, 18 QIs were identified that were mentioned in 238 instances. Identified QIs were classified as related to structure (n = 4, 22.2 %), care processes (n = 9, 50.0 %), and outcomes (n = 5, 27.8 %). The most commonly mentioned QIs focused on filter lifespan (n = 98), small solute clearance (n = 46), bleeding (n = 30), delivered dose (n = 19), and treatment interruption (n = 5). Across studies, the definitions used for QIs evaluating similar constructs varied considerably. When identified, QIs were most commonly described as important (n = 144, 48.3 %), scientifically acceptable (n = 32, 10.7 %), and useable and/or feasible (n = 17, 5.7 %) by their primary study authors. Conclusions: We identified numerous potential QIs of CRRT care, characterized by heterogeneous definitions, varying quality of derivation, and limited evaluation. Further study is needed to prioritize a concise inventory of QIs to measure, improve, and benchmark CRRT care for critically ill patients. Systematic review registration: PROSPERO CRD42015015530. © 2016, Springer-Verlag Berlin Heidelberg and ESICM. AU - Rewa, O. G. AU - Villeneuve, P. M. AU - Lachance, P. AU - Eurich, D. T. AU - Stelfox, H. T. AU - Gibney, R. T. N. AU - Hartling, L. AU - Featherstone, R. AU - Bagshaw, S. M. DA - 2017-1-1 IS - 6 KW - Retrospective Studies Renal Replacement Therapy Renal Dialysis Quality Indicators, Health Care Intensive Care Units Humans Critical Illness Critical Care Case-Control Studies Acute Kidney Injury standards retrospective study intensive care hemodialysis case control study acute kidney failure treatment interruption systematic review risk factor Review prescription outcome assessment Newcastle-Ottawa scale meta analysis intensive care unit human health services research health care quality critically ill patient continuous renal replacement therapy continuous hemofiltration bibliographic database Quality indicator Effectiveness Dialysis PY - 2017 SP - 750-763 ST - Quality indicators of continuous renal replacement therapy (CRRT) care in critically ill patients: a systematic review T2 - Intensive Care Medicine TI - Quality indicators of continuous renal replacement therapy (CRRT) care in critically ill patients: a systematic review VL - 43 ID - 150 ER - TY - JOUR AB - Introduction The opioid crisis has resulted in increasing rates of death caused by problematic opioid use. Current clinical guidelines recommend that individuals with persons with opioid use disorder (OUD) receive pharmacological (eg, opioid agonist therapy) and psychosocial (eg, cognitive behavioural therapy) therapy; however, the best combination of pharmacologic and psychosocial components is not known. Our objective of the planned study is to conduct a comprehensive systematic review to assess the relative benefits of psychosocial interventions as an adjunct to opioid agonist therapy among persons with OUD. Methods and analysis A comprehensive search for randomised controlled trials published in English or French will be conducted from database inception to March 2018. The search will be conducted in MEDLINE and translated for Embase, PsycINFO and the Cochrane Central Register of Controlled Trials. Two independent reviewers will screen, extract and assess risk of bias of eligible articles. Primary outcomes of interest will be treatment retention and opioid use (based on urinalysis results). Secondary outcomes will include self-reported opioid use, abstinence from illicit drugs, adherence to psychosocial therapy and opioid agonist therapy, risk for sexually transmitted disease, risk for blood borne pathogens, changes in mental health symptoms (eg, depression), measures of craving and changes in patients' quality of life and relevant adverse events. If sufficient data and adequate homogeneity exists, network meta-analyses (NMA) will be performed. Ethics and dissemination This will be the first systematic review to incorporate NMA to compare psychosocial treatments used as an adjunct to opioid agonist therapy for OUD. Results of this review will inform clinical management of persons with OUD. © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. AD - Ottawa Hospital Research Institute, Ottawa, ON, Canada Department of Psychology, McGill University, Montreal, QC, Canada School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada Faculties of Social Sciences and Medicine, University of Ottawa, Ottawa, ON, Canada Pain Clinic, Ottawa Hospital, Ottawa, ON, Canada Department of Pharmacy, Centre for Addiction and Mental Health, Toronto, ON, Canada Leslie Dan Faculty of Pharmacy, Department of Psychiatry, University of Toronto, Toronto, ON, Canada Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada Public Health Ontario, Toronto, ON, Canada Canadian Center on Substance Use and Addiction, Ottawa, ON, Canada Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada Substance Use and Concurrent Disorders Program, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada Department of Psychiatry, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada AU - Rice, D. B. AU - Hutton, B. AU - Poulin, P. AU - Sproule, B. A. AU - Wolfe, D. AU - Moher, D. AU - Thavorn, K. AU - Garber, G. AU - Taha, S. AU - Porath, A. AU - Willows, M. AU - Esmaeilisaraji, L. AU - Yazdi, F. AU - Shea, B. AU - Skidmore, B. AU - Corace, K. C2 - 30341139 C7 - e023902 DB - Scopus DO - 10.1136/bmjopen-2018-023902 IS - 10 KW - addiction medicine network meta-analysis opioid use disorder pharmacological interventions psychosocial interventions systematic review illicit drug opiate agonist narcotic analgesic agent bloodborne bacterium Cochrane Library comorbidity comparative effectiveness craving DSM-5 Embase human Medline opiate addiction psychosocial care PsycINFO quality of life randomized controlled trial (topic) Review sexually transmitted disease aged cognitive behavioral therapy female male methodology middle aged patient compliance psychology Analgesics, Opioid Humans Opioid-Related Disorders Randomized Controlled Trials as Topic Research Design Systematic Reviews as Topic Treatment Adherence and Compliance LA - English M3 - Review PY - 2018 ST - Evaluating comparative effectiveness of psychosocial interventions for persons receiving opioid agonist therapy for opioid use disorder: Protocol for a systematic review T2 - BMJ Open TI - Evaluating comparative effectiveness of psychosocial interventions for persons receiving opioid agonist therapy for opioid use disorder: Protocol for a systematic review VL - 8 ID - 401 ER - TY - JOUR AB - Aim. To describe the development of a systematic review protocol that maps the evidence relating to drug manipulations conducted to obtain the required dose. This process included defining a search strategy and methods to assess the quality and to synthesize the evidence retrieved. Background. Economic constraints mean that marketed formulations may not meet the needs of all patients. Consequently, it is sometimes necessary to manipulate marketed products with the aim of obtaining the required dose. Most clinical practice appears to be guided by ad hoc approaches and informal literature reviews. Methods. This systematic review protocol has been designed to identify the evidence available on drug manipulation. The review aims to identify what evidence is available and where the gaps appear in the current evidence. This report describes the challenges of developing a systematic review in an area that potentially involves many drugs and considers outcomes other than effectiveness. In particular, searches required the use of non-specific terms and the iterative development of a complex search strategy. The development of quality assessment criteria is also described. Funding commenced in April 2009. Discussion. The systematic review described here will capture a broad selection of research about drug manipulations and may also be of interest to those conducting reviews in broad remit subject areas that are not easy to define using accepted terminology. © 2012 Blackwell Publishing Ltd. AU - Richey, R. H. AU - Craig, J. V. AU - Shah, U. U. AU - Ford, J. L. AU - Barker, C. E. AU - Peak, M. AU - Nunn, A. J. AU - Turner, M. A. C2 - 22221111 DB - Scopus DO - 10.1111/j.1365-2648.2011.05916.x IS - 9 KW - Drug administration Medicines manipulation Nursing Protocol Systematic review drug article chemistry cost benefit analysis dose calculation drug formulation drug therapy economics evidence based medicine human information retrieval methodology Chemistry, Pharmaceutical Cost-Benefit Analysis Drug Compounding Drug Dosage Calculations Evidence-Based Medicine Humans Information Storage and Retrieval Pharmaceutical Preparations M3 - Article PY - 2012 SP - 2103-2112 ST - The manipulation of drugs to obtain the required dose: Systematic review T2 - Journal of Advanced Nursing TI - The manipulation of drugs to obtain the required dose: Systematic review VL - 68 ID - 321 ER - TY - JOUR AB - Background: The principal diagnosis/indication for this assessment is chronic diarrhoea due to bile acid malabsorption (BAM). Diarrhoea can be defined as the abnormal passage of loose or liquid stools more than three times daily and/or a daily stool weight > 200 g per day and is considered to be chronic if it persists for more than 4 weeks. The cause of chronic diarrhoea in adults is often difficult to ascertain and patients may undergo several investigations without a definitive cause being identified. BAM is one of several causes of chronic diarrhoea and results from failure to absorb bile acids (which are required for the absorption of dietary fats and sterols in the intestine) in the distal ileum. Objective: For people with chronic diarrhoea with unknown cause and in people with Crohn's disease and chronic diarrhoea with unknown cause (i.e. before resection): (1) What are the effects of selenium-75- homocholic acid taurine (SeHCAT) compared with no SeHCAT in terms of chronic diarrhoea, other health outcomes and costs? (2) What are the effects of bile acid sequestrants (BASs) compared with no BASs in people with a positive or negative SeHCAT test? (3) Does a positive or negative SeHCAT test predict improvement in terms of chronic diarrhoea, other health outcomes and costs? Data sources: A systematic review was conducted to summarise the evidence on the clinical effectiveness of SeHCAT for the assessment of BAM and the measurement of bile acid pool loss. Search strategies were based on target condition and intervention, as recommended in the Centre for Reviews and Dissemination (CRD) guidance for undertaking reviews in health care and the Cochrane Handbook for Diagnostic Test Accuracy Reviews. The following databases were searched up to April 2012: MEDLINE; MEDLINE In-Process & Other Non-Indexed Citations; EMBASE; the Cochrane Databases; Database of Abstracts of Reviews of Effects; Health Technology Assessment (HTA) Database; and Science Citation Index. Research registers and conference proceedings were also searched. Review methods: Systematic review methods followed the principles outlined in the CRD guidance for undertaking reviews in health care and the National Institute for Health and Care Excellence (NICE) Diagnostic Assessment Programme interim methods statement. In the health economic analysis, the cost-effectiveness of SeHCAT for the assessment of BAM, in patients with chronic diarrhoea, was estimated in two different populations. The first is the population of patients with chronic diarrhoea with unknown cause and symptoms suggestive of diarrhoea-predominant irritable bowel syndrome (IBS-D) and the second population concerns patients with Crohn's disease without ileal resection with chronic diarrhoea. For each population, three models were combined: (1) a short-term decision tree that models the diagnostic pathway and initial response to treatment (first 6 months); (2) a long-term Markov model that estimates the lifetime costs and effects for patients initially receiving BAS; and (3) a long-term Markov model that estimates the lifetime costs and effects for patients initially receiving regular treatment (IBS-D treatment in the first population and Crohn's treatment in the second population). Incremental cost-effectiveness ratios were estimated as additional cost per additional responder in the short term (first 6 months) and per additional quality-adjusted life-year (QALY) in the long term (lifetime). Results: We found three studies assessing the relationship between the SeHCAT test and response to treatment with cholestyramine. However, the studies had small numbers of patients with unknown cause chronic diarrhoea, and they used different cut-offs to define BAM. For the short term (first 6 months), when trial of treatment is not considered as a comparator, the optimal choice depends on the willingness to pay for an additional responder. For lower values (between £1500 and £4600) the choice will be no SeHCAT in all scenarios; for higher values either SeHCAT 10% or SeHCAT 15% becomes cost-effective. F r the lifetime perspective, the various scenarios showed widely differing results: in the threshold range of £20,000-30,000 per QALY gained we found as optimal choice either no SeHCAT, SeHCAT 5% (only IBS-D) or SeHCAT 15%. When trial of treatment is considered a comparator, the analysis showed that for the short term, trial of treatment is the optimal choice across a range of scenarios. For the lifetime perspective with trial of treatment, again the various scenarios show widely differing results. Depending on the scenario, in the threshold range of £20,000-30,000 per QALY gained, we found as optimal choice either trial of treatment, no SeHCAT or SeHCAT 15%. Conclusions: In conclusion, the various analyses show that for both populations considerable decision uncertainty exists and that no firm conclusions can be formulated about which strategy is optimal. Standardisation of the definition of a positive SeHCAT test should be the first step in assessing the usefulness of this test. As there is no reference standard for the diagnosis of BAM and SeHCAT testing provides a continuous measure of metabolic function, diagnostic test accuracy (DTA) studies are not the most appropriate study design. However, in studies where all patients are tested with SeHCAT and all patients are treated with BASs, response to treatment can provide a surrogate reference standard; further DTA studies of this type may provide information on the ability of SeHCAT to predict response to BASs. A potentially more informative option would be multivariate regression modelling of treatment response (dependent variable), with SeHCAT result and other candidate clinical predictors as covariates. Such a study design could also inform the definition of a positive SeHCAT result. AU - Riemsma, R. AU - Al, M. AU - Ramos, I. C. AU - Deshpande, S. N. AU - Armstrong, N. AU - Lee, Y. C. AU - Ryder, S. AU - Noake, C. AU - Krol, M. AU - Oppe, M. AU - Kleijnen, J. AU - Severens, H. DA - 2013-1-1 %J Health Technology Assessment IS - 61 KW - Taurine Quality-Adjusted Life Years Dietary Fats Crohn Disease Bile Acids and Salts Selenium Cost-Benefit Analysis PY - 2013 SP - 1-235 ST - SeHCAT [tauroselcholic (selenium-75) acid] for the investigation of bile acid malabsorption and measurement of bile acid pool loss: A systematic review and cost-effectiveness analysis T2 - Health Technology Assessment TI - SeHCAT [tauroselcholic (selenium-75) acid] for the investigation of bile acid malabsorption and measurement of bile acid pool loss: A systematic review and cost-effectiveness analysis VL - 17 ID - 305 ER - TY - JOUR AB - Background: In recent years, meters for continuous monitoring of interstitial fluid glucose have been introduced to help people with type 1 diabetes mellitus (T1DM) to achieve better control of their disease. Objective: The objective of this project was to summarise the evidence on the clinical effectiveness and cost-effectiveness of the MiniMed® Paradigm™ Veo system (Medtronic Inc., Northridge, CA, USA) and the Vibe™ (Animas® Corporation, West Chester, PA, USA) and G4® PLATINUM CGM (continuous glucose monitoring) system (Dexcom Inc., San Diego, CA, USA) in comparison with multiple daily insulin injections (MDIs) or continuous subcutaneous insulin infusion (CSII), both with either self-monitoring of blood glucose (SMBG) or CGM, for the management of T1DM in adults and children. Data sources: A systematic review was conducted in accordance with the principles of the Centre for Reviews and Dissemination guidance and the National Institute for Health and Care Excellence Diagnostic Assessment Programme manual. We searched 14 databases, three trial registries and two conference proceedings from study inception up to September 2014. In addition, reference lists of relevant systematic reviews were checked. In the absence of randomised controlled trials directly comparing Veo or an integrated CSII + CGM system, such as Vibe, with comparator interventions, indirect treatment comparisons were performed if possible. Methods: A commercially available cost-effectiveness model, the IMS Centre for Outcomes Research and Effectiveness diabetes model version 8.5 (IMS Health, Danbury, CT, USA), was used for this assessment. This model is an internet-based, interactive simulation model that predicts the long-term health outcomes and costs associated with the management of T1DM and type 2 diabetes. The model consists of 15 submodels designed to simulate diabetes-related complications, non-specific mortality and costs over time. As the model simulates individual patients over time, it updates risk factors and complications to account for disease progression. Results: Fifty-four publications resulting from 19 studies were included in the review. Overall, the evidence suggests that the Veo system reduces hypoglycaemic events more than other treatments, without any differences in other outcomes, including glycated haemoglobin (HbA1c) levels. We also found significant results in favour of the integrated CSII + CGM system over MDIs with SMBG with regard to HbA1c levels and quality of life. However, the evidence base was poor. The quality of the included studies was generally low, often with only one study comparing treatments in a specific population at a specific follow-up time. In particular, there was only one study comparing Veo with an integrated CSII + CGM system and only one study comparing Veo with a CSII + SMBG system in a mixed population. Cost-effectiveness analyses indicated that MDI + SMBG is the option most likely to be cost-effective, given the current threshold of £30,000 per quality-adjusted life-year gained, whereas integrated CSII + CGM systems and Veo are dominated and extendedly dominated, respectively, by stand-alone, non-integrated CSII with CGM. Scenario analyses did not alter these conclusions. No cost-effectiveness modelling was conducted for children or pregnant women. Conclusions: The Veo system does appear to be better than the other systems considered at reducing hypoglycaemic events. However, in adults, it is unlikely to be cost-effective. Integrated systems are also generally unlikely to be cost-effective given that stand-alone systems are cheaper and, possibly, no less effective. However, evidence in this regard is generally lacking, in particular for children. Future trials in specific child, adolescent and adult populations should include longer term follow-up and ratings on the European Quality of Life-5 Dimensions scale at various time points with a view to informing improved cost-effectiveness modelling. © Queen’s Printer and Controller of HMSO 2016. AU - Riemsma, R. AU - Ramos, I. C. AU - Birnie, R. AU - Büyükkaramikli, N. AU - Armstrong, N. AU - Ryder, S. AU - Duffy, S. AU - Worthy, G. AU - Al, M. AU - Severens, J. AU - Kleijnen, J. DB - Scopus DO - 10.3310/hta20170 IS - 17 M3 - Article PY - 2016 ST - Integrated sensor-augmented pump therapy systems [the MiniMed® Paradigm™ Veo system and the Vibe™ and G4® PLATINUM CGM (continuous glucose monitoring) system] for managing blood glucose levels in type 1 diabetes: A systematic review and economic evaluation T2 - Health Technology Assessment TI - Integrated sensor-augmented pump therapy systems [the MiniMed® Paradigm™ Veo system and the Vibe™ and G4® PLATINUM CGM (continuous glucose monitoring) system] for managing blood glucose levels in type 1 diabetes: A systematic review and economic evaluation VL - 20 ID - 341 ER - TY - JOUR AB - Guidelines and recommendations developed and/or endorsed by the American College of Rheumatology (ACR) are intended to provide guidance for particular patterns of practice and not to dictate the care of a particular patient. The ACR considers adherence to these guidelines and recommendations to be voluntary, with the ultimate determination regarding their application to be made by the physician in light of each patient's individual circumstances. Guidelines and recommendations are intended to promote beneficial or desirable outcomes but cannot guarantee any specific outcome. Guidelines and recommendations developed or endorsed by the ACR are subject to periodic revision as warranted by the evolution of medical knowledge, technology, and practice. The American College of Rheumatology is an independent, professional, medical and scientific society which does not guarantee, warrant, or endorse any commercial product or service. © Published 2013. This article is a U.S. Government work and is in the public domain in the USA. AU - Ringold, S. AU - Weiss, P. F. AU - Beukelman, T. AU - Dewitt, E. M. AU - Ilowite, N. T. AU - Kimura, Y. AU - Laxer, R. M. AU - Lovell, D. J. AU - Nigrovic, P. A. AU - Robinson, A. B. AU - Vehe, R. K. C2 - 24092554 DB - Scopus DO - 10.1002/art.38092 IS - 10 KW - abatacept adalimumab calcineurin inhibitor canakinumab cyclosporin disease modifying antirheumatic drug etanercept glucocorticoid immunoglobulin infliximab interleukin 1 antibody interleukin 6 antibody leflunomide methotrexate nonsteroid antiinflammatory agent recombinant interleukin 1 receptor blocking agent rilonacept rituximab tacrolimus tocilizumab tumor necrosis factor alpha inhibitor American College of Rheumatology article clinical feature disease activity human juvenile rheumatoid arthritis knowledge macrophage activation syndrome medical practice medical society outcome assessment patient care priority journal screening test synovitis systematic review treatment duration tuberculosis Adolescent Antirheumatic Agents Arthritis, Juvenile Biological Products Child Child, Preschool Humans Mass Screening M3 - Article PY - 2013 SP - 2499-2512 ST - 2013 Update of the 2011 American College of Rheumatology Recommendations for the treatment of juvenile idiopathic arthritis: Recommendations for the medical therapy of children with systemic juvenile idiopathic arthritis and tuberculosis screening among children receiving biologic medications T2 - Arthritis and Rheumatism TI - 2013 Update of the 2011 American College of Rheumatology Recommendations for the treatment of juvenile idiopathic arthritis: Recommendations for the medical therapy of children with systemic juvenile idiopathic arthritis and tuberculosis screening among children receiving biologic medications VL - 65 ID - 318 ER - TY - JOUR AB - Importance: Systemic chemotherapy can be administered either through a peripheral vein (IV), or centrally through peripherally inserted central catheter (PICC), totally implanted vascular access devices (PORTs) or tunnelled cuffed catheters. Despite the widespread use of systemic chemotherapy in patients with breast cancer, the optimal choice of vascular access is unknown. Objective: This systematic review evaluated complication rates and patient satisfaction with different access strategies for administering neo/adjuvant chemotherapy for breast cancer. Evidence reviewed: Ovid Medline, EMBASE and the Cochrane Central Register of Controlled Trials were searched from 1946 to September 2017. Two reviewers independently assessed each citation. The Newcastle–Ottawa scale was used to assess the quality of cohort and case–control studies. Findings: Of 1584 citations identified, 15 unique studies met the pre-specified eligibility criteria. There were no randomised studies comparing types of vascular access. Reports included six single-institution retrospective cohort studies, one retrospective multi-institution cohort, one retrospective cohort database study, five prospective single-institution studies, one prospective multi-institution study and one nested case–control study. Median complication rates were infection: 6.0% PICC (2 studies) versus 2.1% PORT (8 studies); thrombosis: 8.9% PICC (2 studies) versus 2.6% PORT (9 studies); extravasation: 0 PICC (1 study) versus 0.4% PORT (4 studies) and mechanical issues: PICC 3.8% (1 study) versus 1.8% PORT (9 studies). Satisfaction/quality of life appeared high with each device. Conclusion: In the absence of high-quality data comparing vascular access strategies, randomised, adequately powered, prospective studies would be required to help inform clinical practice and reduce variation. © 2018, Springer Science+Business Media, LLC, part of Springer Nature. AD - Division of Medical Oncology, Cancer Centre of Southeastern Ontario, Kingston, Canada Ottawa Hospital Research Institute and University of Ottawa, Ottawa, Canada Department of Medicine, Division of Medical Oncology, The Ottawa Hospital and University of Ottawa, Ottawa, Canada Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada Division of Medical Oncology, Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, Canada Department of Nursing, Ottawa Hospital, Ottawa, ON, Canada Department of Radiology, The Ottawa Hospital Research Institute Clinical Epidemiology Program, The University of Ottawa, Ottawa, Canada The Ottawa Hospital, Ottawa, Canada AU - Robinson, A. AU - Souied, O. AU - Bota, A. B. AU - Levasseur, N. AU - Stober, C. AU - Hilton, J. AU - Kamel, D. AU - Hutton, B. AU - Vandermeer, L. AU - Mazzarello, S. AU - Joy, A. A. AU - Fergusson, D. AU - McDiarmid, S. AU - McInnes, M. AU - Shorr, R. AU - Clemons, M. C2 - 29974358 DB - Scopus DO - 10.1007/s10549-018-4868-x IS - 3 KW - Breast cancer Chemotherapy PICC PORT Vascular access anthracycline fluorouracil taxane derivative trastuzumab Article cancer chemotherapy cancer patient cancer staging device infection extravasation human meta analysis Newcastle-Ottawa scale patient satisfaction priority journal prosthesis thrombosis quality of life systematic review adverse device effect breast tumor catheterization complication female intravenous drug administration microbiology neoadjuvant therapy pathology vascular access device Administration, Intravenous Breast Neoplasms Catheterization, Peripheral Humans Vascular Access Devices LA - English M3 - Article PY - 2018 SP - 607-620 ST - Optimal vascular access strategies for patients receiving chemotherapy for early-stage breast cancer: a systematic review T2 - Breast Cancer Research and Treatment TI - Optimal vascular access strategies for patients receiving chemotherapy for early-stage breast cancer: a systematic review VL - 171 ID - 402 ER - TY - JOUR AB - Background: Placenta-mediated pregnancy complications include pre-eclampsia, late pregnancy loss, placental abruption, and the small-for-gestational age newborn. They are leading causes of maternal, fetal, and neonatal morbidity and mortality in developed nations. Women who have experienced these complications are at an elevated risk of recurrence in subsequent pregnancies. However, despite decades of research no effective strategies to prevent recurrence have been identified, until recently. We completed a pooled summary-based meta-analysis that strongly suggests that low-molecular-weight heparin reduces the risk of recurrent placenta-mediated complications. The proposed individual patient data meta-analysis builds on this successful collaboration. The project is called AFFIRM, An individual patient data meta-analysis oF low-molecular-weight heparin For prevention of placenta-medIated pRegnancy coMplications. Methods/Design: We conducted a systematic review to identify randomized controlled trials with a low-molecular-weight heparin intervention for the prevention of recurrent placenta-mediated pregnancy complications. Investigators and statisticians representing eight trials met to discuss the outcomes and analysis plan for an individual patient data meta-analysis. An additional trial has since been added for a total of nine eligible trials. The primary analyses from the original trials will be replicated for quality assurance prior to recoding the data from each trial and combining it into a common dataset for analysis. Using the anonymized combined data we will conduct logistic regression and subgroup analyses aimed at identifying which women with previous pregnancy complications benefit most from treatment with low-molecular-weight heparin during pregnancy. Discussion: The goal of the proposed individual patient data meta-analysis is a thorough estimation of treatment effects in patients with prior individual placenta-mediated pregnancy complications and exploration of which complications are specifically prevented by low-molecular-weight heparin. Systematic review registration: PROSPERO (International Prospective Registry of Systematic Reviews) 23 December 2013, CRD42013006249. © 2014 Rodger et al.; licensee BioMed Central Ltd. AU - Rodger, M. A. AU - Langlois, N. J. AU - de Vries, J. I. P. AU - Rey, É AU - Gris, J. C. AU - Martinelli, I. AU - Schleussner, E. AU - Ramsay, T. AU - Mallick, R. AU - Skidmore, B. AU - Middeldorp, S. AU - Bates, S. AU - Petroff, D. AU - Bezemer, D. AU - van Hoorn, M. E. AU - Abheiden, C. N. H. AU - Perna, A. AU - de Jong, P. AU - Kaaja, R. DA - 2015-1-1 IS - 1 KW - Infant, Newborn Heparin Developing Countries Placenta Review Literature as Topic Randomized Controlled Trials as Topic Pregnancy Complications Pregnancy Placenta Diseases Information Storage and Retrieval Humans Heparin, Low-Molecular-Weight Guidelines as Topic Female practice guideline literature information retrieval thrombocytopenia systematic review spontaneous abortion solutio placentae small for date infant rash randomized controlled trial (topic) quality control priority journal pregnancy outcome pregnancy complication preeclampsia outcome assessment meta analysis lung embolism knowledge base human HELLP syndrome fetus wastage fetus death deep vein thrombosis Article antepartum hemorrhage anaphylaxis allergic reaction low molecular weight heparin nadroparin enoxaparin dalteparin acetylsalicylic acid Small-for-gestational age Pregnancy loss Pre-eclampsia Placental abruption Placenta-mediated pregnancy complications Meta-analysis Low-molecular-weight heparin Individual patient data meta-analysis PY - 2015 SN - 2046-4053 ST - Low-molecular-weight heparin for prevention of placenta-mediated pregnancy complications: Protocol for a systematic review and individual patient data meta-analysis (AFFIRM) T2 - Systematic Reviews TI - Low-molecular-weight heparin for prevention of placenta-mediated pregnancy complications: Protocol for a systematic review and individual patient data meta-analysis (AFFIRM) VL - 3 ID - 207 ER - TY - JOUR AB - Context: Although unanimity exists on using palliative sedation (PS) for controlling refractory physical suffering in end-of-life situations, using it for controlling refractory existential suffering (PS-ES) is controversial. Complicating the debate is that definitions and terminology for existential suffering are unclear, ambiguous, and imprecise, leading to a lack of consensus for clinical practice. Objectives: To systematically identify, describe, analyze, and discuss ethical arguments and concepts underpinning the argument-based bioethics literature on PS-ES. Methods: We conducted a systematic search of the argument-based bioethics literature in PubMed, CINAHL, Embase®, The Philosopher's Index, PsycINFO®, PsycARTICLES®, Scopus, ScienceDirect, Web of Science, Pascal-Francis, and Cairn. We included articles published in peer-reviewed journals till December 31, 2016, written in English or French, which focused on ethical arguments related to PS-ES. We used Peer Review of Electronic Search Strategies protocol, Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and The Qualitative Analysis Guide of Leuven for data extraction and synthesis of themes. Results: We identified 18 articles that met the inclusion criteria. Our analysis revealed mind-body dualism, existential suffering, refractoriness, terminal condition, and imminent death as relevant concepts in the ethical debate on PS-ES. The ethical principles of double effect, proportionality, and the four principles of biomedical ethics were used in argumentations in the PS-ES debate. Conclusion: There is a clear need to better define the terminology used in discussions of PS-ES and to ground ethical arguments in a more effective way. Anthropological presuppositions such as mind-body dualism underpin the debate and need to be more clearly elucidated using an interdisciplinary approach. © 2018 American Academy of Hospice and Palliative Medicine AU - Rodrigues, P. AU - Crokaert, J. AU - Gastmans, C. DA - 2018-1-1 IS - 6 KW - Bioethics Existentialism Web of Science terminal care systematic review synthesis Scopus ScienceDirect qualitative analysis peer review nomenclature Medline medical ethics human deep sedation death data extraction Cinahl article palliative sedation existential suffering ethics end-of-life care PY - 2018 SN - 0885-3924 SP - 1577-1590 ST - Palliative Sedation for Existential Suffering: A Systematic Review of Argument-Based Ethics Literature T2 - Journal of Pain and Symptom Management TI - Palliative Sedation for Existential Suffering: A Systematic Review of Argument-Based Ethics Literature VL - 55 ID - 28 ER - TY - JOUR AB - Background: Antimicrobial resistance (AMR) is a recognized threat to global public health. Increasing AMR and a dry pipeline of novel antimicrobial drugs have put AMR in the international spotlight. One strategy to combat AMR is to reduce antimicrobial drug consumption. Governments around the world have been experimenting with different policy interventions, such as regulating where antimicrobials can be sold, restricting the use of last-resort antimicrobials, funding AMR stewardship programs, and launching public awareness campaigns. To inform future action, governments should have access to synthesized data on the effectiveness of large-scale AMR interventions. This planned systematic review will (1) identify and describe previously evaluated government policy interventions to reduce human antimicrobial use and (2) estimate the effectiveness of these different strategies. Methods: An electronic search strategy has been developed in consultation with two research librarians. Seven databases (MEDLINE, CINAHL, EMBASE, CENTRAL, PAIS Index, Web of Science, and PubMed excluding MEDLINE) will be searched, and additional studies will be identified using several gray literature search strategies. To be included, a study must (1) clearly describe the government policy and (2) use a rigorous design to quantitatively measure the impact of the policy on human antibiotic use. The intervention of interest is any policy intervention enacted by a government or government agency in any country to change human antimicrobial use. Two independent reviewers will screen for eligibility using criteria defined a priori. Data will be extracted with Covidence software using a customized extraction form. If sufficient data exists, a meta-analysis by intervention type will be conducted as part of the effectiveness review. However, if there are too few studies or if the interventions are too heterogeneous, data will be tabulated and a narrative synthesis strategy will be used. Discussion: This evidence synthesis is intended for use by policymakers, public health practitioners, and researchers to inform future government policies aiming to address antimicrobial resistance. This review will also identify gaps in the evidence about the effectiveness of different policy interventions to inform future research priorities. Systematic review registration: PROSPERO CRD42017067514. © 2017 The Author(s). AU - Rogers Van Katwyk, S. AU - Grimshaw, J. M. AU - Mendelson, M. AU - Taljaard, M. AU - Hoffman, S. J. DA - 2017-1-1 IS - 1 KW - Humanities Humanism Humans systematic review salt intake research randomized controlled trial (topic) quality control public policy public health priority journal population phase 2 clinical trial (topic) phase 1 clinical trial (topic) nonhuman meta analysis health care system education Article antibiotic resistance antivirus agent antiparasitic agent antiinfective agent antifungal agent antibiotic agent Protocol Policy Government Antimicrobial resistance AMR PY - 2017 SN - 2046-4053 ST - Government policy interventions to reduce human antimicrobial use: Protocol for a systematic review and meta-analysis T2 - Systematic Reviews TI - Government policy interventions to reduce human antimicrobial use: Protocol for a systematic review and meta-analysis VL - 6 ID - 68 ER - TY - JOUR AB - Background: There are various reasons why weaning and extubation failure occur, but ineffective cough and secretion retention can play a significant role. Cough augmentation techniques, such as lung volume recruitment or manually- and mechanically-assisted cough, are used to prevent and manage respiratory complications associated with chronic conditions, particularly neuromuscular disease, and may improve short- and long-term outcomes for people with acute respiratory failure. However, the role of cough augmentation to facilitate extubation and prevent post-extubation respiratory failure is unclear. Objectives: Our primary objective was to determine extubation success using cough augmentation techniques compared to no cough augmentation for critically-ill adults and children with acute respiratory failure admitted to a high-intensity care setting capable of managing mechanically-ventilated people (such as an intensive care unit, specialized weaning centre, respiratory intermediate care unit, or high-dependency unit). Secondary objectives were to determine the effect of cough augmentation techniques on reintubation, weaning success, mechanical ventilation and weaning duration, length of stay (high-intensity care setting and hospital), pneumonia, tracheostomy placement and tracheostomy decannulation, and mortality (high-intensity care setting, hospital, and after hospital discharge). We evaluated harms associated with use of cough augmentation techniques when applied via an artificial airway (or non-invasive mask once extubated/decannulated), including haemodynamic compromise, arrhythmias, pneumothorax, haemoptysis, and mucus plugging requiring airway change and the type of person (such as those with neuromuscular disorders or weakness and spinal cord injury) for whom these techniques may be efficacious. Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL; Issue 4, 2016), MEDLINE (OvidSP) (1946 to April 2016), Embase (OvidSP) (1980 to April 2016), CINAHL (EBSCOhost) (1982 to April 2016), and ISI Web of Science and Conference Proceedings. We searched the PROSPERO and Joanna Briggs Institute databases, websites of relevant professional societies, and conference abstracts from five professional society annual congresses (2011 to 2015). We did not impose language or other restrictions. We performed a citation search using PubMed and examined reference lists of relevant studies and reviews. We contacted corresponding authors for details of additional published or unpublished work. We searched for unpublished studies and ongoing trials on the International Clinical Trials Registry Platform (apps.who.int/trialsearch) (April 2016). Selection criteria: We included randomized and quasi-randomized controlled trials that evaluated cough augmentation compared to a control group without this intervention. We included non-randomized studies for assessment of harms. We included studies of adults and of children aged four weeks or older, receiving invasive mechanical ventilation in a high-intensity care setting. Data collection and analysis: Two review authors independently screened titles and abstracts identified by our search methods. Two review authors independently evaluated full-text versions, independently extracted data and assessed risks of bias. Main results: We screened 2686 citations and included two trials enrolling 95 participants and one cohort study enrolling 17 participants. We assessed one randomized controlled trial as being at unclear risk of bias, and the other at high risk of bias; we assessed the non-randomized study as being at high risk of bias. We were unable to pool data due to the small number of studies meeting our inclusion criteria and therefore present narrative results rather than meta-analyses. One trial of 75 participants reported that extubation success (defined as no need for reintubation within 48 hours) was higher in the mechanical insufflation-exsufflation (MI-E) group (82.9% versus 52.5%, P < 0.05) (risk ratio (RR) 1.58, 95% confidence interval (CI) 1.13 to 2 20, v ry low-quality evidence). No study reported weaning success or reintubation as distinct from extubation success. One trial reported a statistically significant reduction in mechanical ventilation duration favouring MI-E (mean difference -6.1 days, 95% CI -8.4 to -3.8, very low-quality evidence). One trial reported mortality, with no participant dying in either study group. Adverse events (reported by two trials) included one participant receiving the MI-E protocol experiencing haemodynamic compromise. Nine (22.5%) of the control group compared to two (6%) MI-E participants experienced secretion encumbrance with severe hypoxaemia requiring reintubation (RR 0.25, 95% CI 0.06 to 1.10). In the lung volume recruitment trial, one participant experienced an elevated blood pressure for more than 30 minutes. No participant experienced new-onset arrhythmias, heart rate increased by more than 25%, or a pneumothorax. For outcomes assessed using GRADE, we based our downgrading decisions on unclear risk of bias, inability to assess consistency or publication bias, and uncertainty about the estimate of effect due to the limited number of studies contributing outcome data. Authors' conclusions: The overall quality of evidence on the efficacy of cough augmentation techniques for critically-ill people is very low. Cough augmentation techniques when used in mechanically-ventilated critically-ill people appear to result in few adverse events. © 2017 The Cochrane Collaboration. AU - Rose, L. AU - Adhikari, N. K. J. AU - Leasa, D. AU - Fergusson, D. A. AU - McKim, D. DA - 2017-1-1 %J Cochrane Database of Systematic Reviews IS - 1 KW - Only Child Length of Stay Meta-Analysis as Topic Ventilator Weaning Bias (Epidemiology) Respiration, Artificial Spinal Cord Injuries Lung Ventilators, Mechanical Critical Illness Cough PY - 2017 ST - Cough augmentation techniques for extubation or weaning critically ill patients from mechanical ventilation T2 - Cochrane Database of Systematic Reviews TI - Cough augmentation techniques for extubation or weaning critically ill patients from mechanical ventilation VL - 2017 ID - 291 ER - TY - JOUR AB - Introduction Delirium is a common, serious and potentially preventable condition with devastating impact on the quality of life prompting a proliferation of interventional trials. Core outcome sets aim to standardise outcome reporting by identifying outcomes perceived fundamental for measurement in trials of a specific interest area. Our aim is to develop international consensus on two core outcome sets for trials of interventions to prevent and/or treat delirium, irrespective of study population. We aim to identify additional core outcomes specific to the critically ill, acutely hospitalised patients, palliative care and older adults. Methods and analysis We will conduct a systematic review of published and ongoing delirium trials (1980 onwards) and one-on-one interviews of patients who have experienced delirium and family members. These data will inform Delphi round 1 of a two-stage consensus process. In round 2, we will provide participants their own response, summarised group responses and those of patient/family participants for rescoring. We will randomise participants to receive feedback as proportion scoring the outcome as critical or as group mean responses. We will hold a consensus meeting using nominal group technique to finalise outcomes for inclusion. We will repeat the Delphi process and consensus meeting to select measures for each core outcome. We will recruit 240 Delphi participants giving us 80% power to detect a 1.0-1.5 point (9-point scale) difference by feedback method between rounds. We will analyse differences for subsequent scores, magnitude of opinion change, items retained and level of agreement. Ethics and dissemination We are obtaining research ethics approvals according to local governance. Participation will be voluntary and data deidentified. Support from three international delirium organisations will be instrumental in dissemination and core outcome set uptake. We will disseminate through peer-reviewed open access publications and present at conferences selected to reach a wide range of knowledge users. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. AU - Rose, L. AU - Agar, M. AU - Burry, L. D. AU - Campbell, N. AU - Clarke, M. AU - Lee, J. AU - Siddiqi, N. AU - Page, V. J. DA - 2017-1-1 IS - 9 KW - Critical Illness Research Design Random Allocation Patient Outcome Assessment Palliative Care Humans Hospitalization Feedback Delphi Technique Delirium Critical Care Consensus Development Conferences as Topic Consensus randomization outcome assessment methodology intensive care consensus development systematic review residential care personal experience palliative therapy nursing home intervention study human hospitalized child high dependency unit feedback system family emergency ward emergency care Delphi study critically ill patient Article research methods core outcome set PY - 2017 SN - 2044-6055 ST - Development of core outcome sets for effectiveness trials of interventions to prevent and/or treat delirium (Del-COrS): Study protocol T2 - BMJ Open TI - Development of core outcome sets for effectiveness trials of interventions to prevent and/or treat delirium (Del-COrS): Study protocol VL - 7 ID - 82 ER - TY - JOUR AB - Background: Critically ill patients frequently experience severe agitation placing them at risk of harm. Physical restraint is common in intensive care units (ICUs) for clinician concerns about safety. However, physical restraint may not prevent medical device removal and has been associated with negative physical and psychological consequences. While professional society guidelines, legislation, and accreditation standards recommend physical restraint minimization, guidelines for critically ill patients are over a decade old, with recommendations that are non-specific. Our systematic review will synthesize evidence on physical restraint in critically ill adults with the primary objective of identifying effective minimization strategies. Methods: Two authors will independently search from inception to July 2016 the following: Ovid MEDLINE, CINAHL, Embase, Web of Science, Cochrane Library, PROSPERO, Joanna Briggs Institute, grey literature, professional society websites, and the International Clinical Trials Registry Platform. We will include quantitative and qualitative study designs, clinical practice guidelines, policy documents, and professional society recommendations relevant to physical restraint of critically ill adults. Authors will independently perform data extraction in duplicate and complete risk of bias and quality assessment using recommended tools. We will assess evidence quality for quantitative studies using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and for qualitative studies using the Confidence in the Evidence from Reviews of Qualitative Research (CERQual) guidelines. Outcomes of interest include (1) efficacy/effectiveness of physical restraint minimization strategies; (2) adverse events (unintentional device removal, psychological impact, physical injury) and associated benefits including harm prevention; (3) ICU outcomes (ventilation duration, length of stay, and mortality); (4) prevalence, incidence, patterns of use including patient and treatment characteristics and chemical restraint (5) barriers and facilitators to minimization; (6) patient, family, and healthcare professional perspectives (7) professional society-endorsed recommendations; and (8) evidence gaps and research priorities. Discussion: We will use our systematic review findings to produce updated guidelines on physical restraint use for critically ill adults and to develop a professional society-endorsed position statement. This will foster patient and clinician safety by providing clinicians, administrators, and policy makers with a tool to promote minimal and safe use of physical restraint for critically ill adults. Systematic review registration: PROSPERO CRD42015027860. © 2016 The Author(s). AU - Rose, L. AU - Dale, C. AU - Smith, O. M. AU - Burry, L. AU - Enright, G. AU - Fergusson, D. AU - Sinha, S. AU - Wiesenfeld, L. AU - Sinuff, T. AU - Mehta, S. DA - 2016-1-1 IS - 1 KW - Device Removal Adult Time Factors Restraint, Physical Respiration, Artificial Qualitative Research Patient Outcome Assessment Length of Stay Intensive Care Units Humans Critical Illness utilization time factor outcome assessment exercise artificial ventilation systematic review sensitivity analysis quality control publishing priority journal physical activity patient safety intensive care unit human device safety critically ill patient Article sedative agent neuromuscular blocking agent Physical restraint Mechanical ventilation Intensive care PY - 2016 SN - 2046-4053 ST - A mixed-methods systematic review protocol to examine the use of physical restraint with critically ill adults and strategies for minimizing their use T2 - Systematic Reviews TI - A mixed-methods systematic review protocol to examine the use of physical restraint with critically ill adults and strategies for minimizing their use VL - 5 ID - 117 ER - TY - JOUR AB - Background: Approximately 5 to 10% of critically ill patients transition from acute critical illness to a state of persistent and in some cases chronic critical illness. These patients have unique and complex needs that require a change in the clinical management plan and overall goals of care to a focus on rehabilitation, symptom relief, discharge planning, and in some cases, end-of-life care. However, existing indicators and measures of care quality, and tools such as checklists, that foster implementation of best practices, may not be sufficiently inclusive in terms of actionable processes of care relevant to these patients. Therefore, the aim of this systematic review is to identify the processes of care, performance measures, quality indicators, and outcomes including reports of patient/family experience described in the current evidence base relevant to patients with persistent or chronic critical illness and their family members. Methods: Two authors will independently search from inception to November 2016: MEDLINE, Embase, CINAHL, Web of Science, the Cochrane Library, PROSPERO, the Joanna Briggs Institute and the International Clinical Trials Registry Platform. We will include all study designs except case series/reports of <10 patients describing their study population (aged 18years and older) using terms such as persistent critical illness, chronic critical illness, and prolonged mechanical ventilation. Two authors will independently perform data extraction and complete risk of bias assessment. Our primary outcome is to determine actionable processes of care and interventions deemed relevant to patients experiencing persistent or chronic critical illness and their family members. Secondary outcomes include (1) performance measures and quality indicators considered relevant to our population of interest and (2) themes related to patient and family experience. Discussion: We will use our systematic review findings, with data from patient, family member and clinician interviews, and a subsequent consensus building process to inform the development of quality metrics and tools to measure processes of care, outcomes and experience for patients experiencing persistent or chronic critical illness and their family members. © 2017 The Author(s). AN - rayyan-16877189 AU - Rose, L. AU - Istanboulian, L. AU - Allum, L. AU - Burry, L. AU - Dale, C. AU - Hart, N. AU - Kydonaki, C. AU - Ramsay, P. AU - Pattison, N. AU - Connolly, B. DA - 2017-1-1 IS - 1 KW - Patient Care Planning Terminal Care Critical Illness Review Literature as Topic Quality of Health Care Quality Indicators, Health Care Patient-Centered Care Humans standards procedures literature health care quality family chronic disease Web of Science ventilator weaning systematic review quality control priority journal population physical performance patient risk patient care length of stay human hospital care family centered care data base crisis intervention Cochrane Library clinical outcome artificial ventilation Article Quality indicator Process of care Persistent critical illness Intensive care Chronic critical illness PY - 2017 SN - 2046-4053 ST - Patient- and family-centered performance measures focused on actionable processes of care for persistent and chronic critical illness: Protocol for a systematic review T2 - Systematic Reviews TI - Patient- and family-centered performance measures focused on actionable processes of care for persistent and chronic critical illness: Protocol for a systematic review VL - 6 ID - 26 ER - TY - JOUR AB - Background: This paper describes the methods, strategies and insights gained from a scoping study using a "Two-Eyed Seeing" approach. An evolving technique, Two-Eyed Seeing respects and integrates the strengths of Indigenous knowledge and Western sciences, often "weaving back and forth" between the two worldviews. The scoping study was used to inform a tool for measuring the impact of culturally based addictions treatment services on wellness in Indigenous populations. It formed part of a three-year study, Honouring Our Strengths: Indigenous Culture as Intervention in Addictions Treatment. The scoping study identified and mapped literature on cultural interventions in addictions treatment, and described the nature, extent and gaps in literature. Methods: Using a Two-Eyed Seeing approach, we adapted, applied and enhanced a common framework of scoping studies. In the end stage of the scoping review process, an Ad Hoc Review Group, led by our project Elder, reviewed and interpreted Indigenous and Western understandings within the mapped information. Elements of the scoping study were joined with results from community focus groups with staff at treatment centres. Results: Two-Eyed Seeing contributed differently at each stage of the scoping study. In early stages, it clarified team expertise and potential contributions. At the mid-point, it influenced our shift from a systematic to a scoping review. Near the end, it incorporated Western and Indigenous knowledge to interpret and synthesize evidence from multiple sources. Conclusions: This paper adds to the collective work on augmenting the methodology of scoping studies. Despite the challenges of a Two-Eyed Seeing approach, it enables researchers using scoping studies to develop knowledge that is better able to translate into meaningful findings for Indigenous communities. © 2015 Rowan et al. AU - Rowan, M. AU - Poole, N. AU - Shea, B. AU - Mykota, D. AU - Farag, M. AU - Hopkins, C. AU - Hall, L. AU - Mushquash, C. AU - Fornssler, B. AU - Dell, C. A. DA - 2015-1-1 %J Substance Abuse: Treatment, Prevention, and Policy IS - 1 KW - Poverty Two-Eyed Seeing Treatment interventions Systematic review Scoping study Indigenous First Nations Cultural interventions Addictions PY - 2015 SN - 1747597X (ISSN) ST - A scoping study of cultural interventions to treat addictions in Indigenous populations: Methods, strategies and insights from a Two-Eyed Seeing approach T2 - Substance Abuse: Treatment, Prevention, and Policy TI - A scoping study of cultural interventions to treat addictions in Indigenous populations: Methods, strategies and insights from a Two-Eyed Seeing approach VL - 10 ID - 268 ER - TY - JOUR AB - Background: Bipolar Disorder (BD) is a mental disorder usually diagnosed between 18 and 30 years of age; this coincides with the period when many women experience pregnancy and childbirth. As specific problems have been reported in pregnancy and childbirth when the mother has BD, a systematic review was carried out to summarise the outcomes of pregnancy and childbirth, in mother and child, when the mother has BD diagnosed before pregnancy. Methods: An a priori protocol was designed and a systematic search conducted in PubMed, CINAHL, Scopus, PsycINFO and Cochrane databases in March 2015. Studies of all designs were included if they involved women with a diagnosis of bipolar disorder prior to pregnancy, who were pregnant and/or followed up to one year postpartum. All stages of inclusion, quality assessment and data extraction were done by two people. All maternal or infant outcomes were examined, and narrative synthesis was used for most outcomes. Meta-analysis was used to achieve a combined prevalence for some outcomes and, where possible, case and control groups were combined and compared. Results: The search identified 2809 papers. After screening and quality assessement (using the EPHPP and AMSTAR tools), nine papers were included. Adverse pregnancy outcomes such as gestational hypertension and antepartum haemorrhage occur more frequently in women with BD. They also have increased rates of induction of labour and caesarean section, and have an increased risk of mood disorders in the postnatal period. Women with BD are more likely to have babies that are severely small for gestational age (<2nd-3rd percentile), and it appears that those women not being treated with mood stabilisers in pregnancy might not have an increased risk of having a baby with congenital abnormalities. Discussion: Due to heterogeneity of data, particularly the use of differing definitions of bipolar disorder, narrative synthesis was used for most outcomes, rather than a meta-analysis. Conclusions: It is evident that adverse outcomes are more common in women with BD and their babies. Large cohort studies examining fetal abnormality outcomes for women with BD who are not on mood stabilisers in pregnancy are required, as are studies on maternal-infant interaction. © 2016 The Author(s). AU - Rusner, M. AU - Berg, M. AU - Begley, C. DA - 2016-1-1 IS - 1 KW - Infant Mental Disorders Pregnancy Outcome Bipolar Disorder Pregnancy Postpartum Parturition Mania Delivery Childbirth Affective disorders LA - English PY - 2016 ST - Bipolar disorder in pregnancy and childbirth: A systematic review of outcomes T2 - BMC Pregnancy and Childbirth TI - Bipolar disorder in pregnancy and childbirth: A systematic review of outcomes VL - 16 ID - 12 ER - TY - JOUR AB - Background: Duchenne Muscular Dystrophy (DMD) is a rapidly progressive, lethal neuromuscular disorder, present from birth, which occurs almost exclusively in males. We have reviewed contemporary evidence of burden, epidemiology, illness costs and treatment patterns of DMD. This systematic review adhered to published methods with information also sought from the web and contacting registries. Searches were carried out from 2005 to June 2015. The population of interest was individuals with clearly defined DMD or their carers. Results: Nine thousand eight hundred fifty titles were retrieved from searches. Fifty-eight studies were reviewed with three assessed as high, 33 as medium and 22 as low quality. We found two studies reporting birth and four reporting point prevalence, three reporting mortality, 41 reporting severity and/or progression, 18 reporting treatment patterns, 12 reporting quality of life, two reporting utility measures, three reporting costs of illness and three treatment guidelines. Birth prevalence ranged from 15.9 to 19.5 per 100,000 live births. Point prevalence per 100,000 males was for France, USA, UK and Canada, 10.9, 1.9, 2.2 and 6.1 respectively. A study of adult DMD patients at a centre in France found median survival for those born between 1970 and 1994 was 40.95 years compared to 25.77 years for those born between 1955 and 1969. Loss of ambulation occurred at a median age of 12 and ventilation starts at about 20 years. There was international variation in use of corticosteroids, scoliosis surgery, ventilation and physiotherapy. The economic cost of DMD climbs dramatically with disease progression - rising as much as 5.7 fold from the early ambulatory phase to the non-ambulatory phase in Germany. Conclusions: This is the first systematic review of treatment, progression, severity and quality of life in DMD. It also provides the most recent description of the burden, epidemiology, illness costs and treatment patterns in DMD. There are evidence gaps, particularly in prevalence and mortality. People with DMD seem to be living longer, possibly due to corticosteroid use, cardiac medical management and ventilation. Future research should incorporate registry data to improve comparability across time and between countries and to investigate the quality of life impact as the condition progresses. © 2017 The Author(s). AU - Ryder, S. AU - Leadley, R. M. AU - Armstrong, N. AU - Westwood, M. AU - De Kock, S. AU - Butt, T. AU - Jain, M. AU - Kleijnen, J. C7 - 79 DB - Scopus DO - 10.1186/s13023-017-0631-3 IS - 1 M3 - Review PY - 2017 ST - The burden, epidemiology, costs and treatment for Duchenne muscular dystrophy: An evidence review T2 - Orphanet Journal of Rare Diseases TI - The burden, epidemiology, costs and treatment for Duchenne muscular dystrophy: An evidence review VL - 12 ID - 337 ER - TY - JOUR AB - Background: This systematic review is the first step in a study investigating the resilience methods and processes in families of children with juvenile idiopathic arthritis. In particular, this review will focus on chronic or persistent pain, as a common symptom of juvenile idiopathic arthritis, which is the most common rheumatic disease in childhood. The experience of persistent pain can add to the functional disability associated with juvenile idiopathic arthritis. Resilience has relevance to all areas of paediatric psychology, and targeted attention to child, sibling, and parent strengths within the context of paediatric chronic pain and juvenile idiopathic arthritis in particular will augment the field on numerous levels. The objective is to determine which resilience processes are associated with a favourable quality of life in terms of academic, communication, emotional, interpersonal, physical, psychological, and social well-being in families of children with chronic pain associated with JIA. Methods/design: This systematic review will be conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and the PRESS (Peer Review of Electronic Search Strategies) guideline. Longitudinal, cross-sectional, and treatment studies written in English will be included, as will grey literature (i.e. conference abstracts and dissertations). Studies involving participants who are 6-18years of age, have been diagnosed with juvenile idiopathic arthritis, are experiencing chronic pain, and are currently undergoing treatment will be included regardless of sex, arthritis type, and type of treatment. Studies including siblings who are 6-18years of age and the patient's parents will be included. Discussion: Research exploring resilience within the adult population is accruing. Shifting our focus to protective factors of resilience in the context of paediatric chronic pain, specifically juvenile idiopathic arthritis, is a novel and promising pursuit that has the potential to optimize and inform future clinical practice and interventions. A better understanding of the role of reliance in family adaptation will facilitate the development of more effective treatment approaches and lay the foundation for more effective self-management in paediatric chronic pain. Systematic review registration: This protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO) database (registration: CRD42016047226). © 2017 The Author(s). AU - Saetes, S. AU - Hynes, L. AU - McGuire, B. E. AU - Caes, L. DA - 2017-1-1 IS - 1 KW - Child Arthritis Only Child treatment duration systematic review scientific literature quality of life publication psychological adjustment psoriatic arthritis priority journal practice guideline meta analysis (topic) juvenile rheumatoid arthritis human ecosystem resilience coping behavior chronic pain Article PY - 2017 SN - 2046-4053 ST - Family resilience and adaptive coping in children with juvenile idiopathic arthritis: Protocol for a systematic review T2 - Systematic Reviews TI - Family resilience and adaptive coping in children with juvenile idiopathic arthritis: Protocol for a systematic review VL - 6 ID - 31 ER - TY - JOUR AB - Background: Cognitive pharmaceutical services (CPSs) encompass a variety of pharmacists' interventions to optimise pharmacotherapy. The clinical effectiveness of CPSs for aged patients remains controversial. Objective: To analyse and describe the evidence of theclinical effectiveness of CPSs in aged patients by means of performing a systematic review of systematic reviews. Methods: Using the recommended methodology by Cochrane, a searchwas undertaken for systematic reviews of the clinical effectiveness of CPSs in MEDLINE, EMBASE, DOAJ, SCIELO and COCHRANE LIBRARY. Reviews were assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) instrument. Quality of the evidence in the reviews was ranked using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Results: A total of 14 systematic reviews and one meta-analysis were analysed. The overall quality of the reviews was moderate. High and moderate strength of evidencewas found for the positive effect of certain CPSs on reducing the number and improving the appropriateness of medicines. There was conflicting evidence of the effect on adherence. There was limited evidence of high and moderate strength on clinical outcomes. No positive evidence was found on mortality, hospitalisations, functional capacity and cognitive function. No systematic reviews reported the effect on the level of control of health problems. Conclusions: certain types of CPSs reduce the number of medicines and improve the appropriateness of prescriptions. Longer follow-up periods and/or the use of surrogate clinical variables measuring the short-term impact are required to demonstrate the effect on clinical outcomes. © The Author 2013. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. AU - Sáez-Benito, L. AU - Fernandez-Llimos, F. AU - Feletto, E. AU - Gastelurrutia, M. A. AU - Martinez-Martinez, F. AU - Benrimoj, S. I. DA - 2013-1-1 IS - 4 KW - Pharmaceutical Services Treatment Outcome Medication Therapy Management Medication Adherence Inappropriate Prescribing Humans Health Services for the Aged Health Knowledge, Attitudes, Practice Evidence-Based Medicine Drug-Related Side Effects and Adverse Reactions Comparative Effectiveness Research Cognition Aging Aged, 80 and over Aged Age Factors systematic review pharmacists medication review cognitive services aged patients priority journal prescription pharmacy patient compliance mortality meta analysis (topic) human hospitalization geriatric patient functional status follow up elderly care depression cognitive defect clinical effectiveness article drug PY - 2013 SN - 0002-0729 SP - 442-449 ST - Evidence of the clinical effectiveness of cognitive pharmaceutical services for aged patients T2 - Age and Ageing TI - Evidence of the clinical effectiveness of cognitive pharmaceutical services for aged patients VL - 42 ID - 251 ER - TY - JOUR AB - Introduction Numerous factors may influence the survival/success of post-retained restorations of endodontically treated teeth (ETT). The aim of this review was to assess the influence of the number of remaining coronal walls, the use or disuse of posts, and their type on the clinical performance of these restorations. Methods Randomized controlled trials and controlled clinical trials for ETT restored with a combination of post/crown or no post/crown were searched for in MEDLINE, Embase, and the Cochrane Library. Two authors independently reviewed all identified titles and abstracts for eligibility. Tables were generated to summarize the included studies, and reports of randomized trials were assessed for bias using the Cochrane risk of bias tool. Results Nine articles were identified as meeting the inclusion criteria. Teeth without ferrule presented the highest values of variation of success/survival (0%–97%), whereas teeth with remaining coronal walls (1, 2, 3, or 4 walls with ferrule) presented lower variation. The use of posts with a high elastic modulus success/survival ranged between 71.8% and 100%, whereas posts with a low elastic modulus ranged between 28.5% and 100%. The survival of crowns without posts varied between 0% and 100%. The poor performance of posts with a low elastic modulus and without posts was associated with the absence of ferrule and the preservation of only 1 coronal wall. Conclusions The restoration of ETT should focus on the maintenance of the coronal structure. Until more studies with longer follow-up periods are available, posts with a high elastic modulus appear to present with better performance when restoring ETT with no ferrule. © 2016 American Association of Endodontists AU - Sarkis-Onofre, R. AU - Fergusson, D. AU - Cenci, M. S. AU - Moher, D. AU - Pereira-Cenci, T. DA - 2017-1-1 IS - 2 KW - Elasticity Risk Factors Post and Core Technique Humans Dental Restoration Failure Dental Prosthesis Retention Crowns tooth prosthesis tooth crown risk factor human dental restoration systematic review glass fiber posts Coronal walls PY - 2017 SP - 175-183 ST - Performance of Post-retained Single Crowns: A Systematic Review of Related Risk Factors T2 - Journal of Endodontics TI - Performance of Post-retained Single Crowns: A Systematic Review of Related Risk Factors VL - 43 ID - 157 ER - TY - JOUR AB - Background The standard treatment option for medication-refractory essential tremor is invasive neurosurgery. A new, noninvasive alternative is magnetic resonance-guided focused ultrasound (MRgFUS) neurosurgery. We aimed to determine the effectiveness, safety, and cost-effectiveness of MRgFUS neurosurgery for the treatment of moderate to severe, medication-refractory essential tremor in Ontario. We also spoke with people with essential tremor to gain an understanding of their experiences and thoughts regarding treatment options, including MRgFUS neurosurgery. Methods We performed a systematic review of the clinical literature published up to April 11, 2017, that examined MRgFUS neurosurgery alone or compared with other interventions for the treatment of moderate to severe, medication-refractory essential tremor. We assessed the risk of bias of each study and the quality of the body of evidence according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. We performed a systematic review of the economic literature and created Markov cohort models to assess the cost-effectiveness of MRgFUS neurosurgery compared with other treatment options, including no surgery. We also estimated the budget impact of publicly funding MRgFUS neurosurgery in Ontario for the next 5 years. To contextualize the potential value of MRgFUS neurosurgery as a treatment option for essential tremor, we spoke with people with essential tremor and their families. Results Nine studies met our inclusion criteria for the clinical evidence review. In noncomparative studies, MRgFUS neurosurgery was found to significantly improve tremor severity and quality of life and to significantly reduce functional disability (GRADE: very low). It was also found to be significantly more effective than a sham procedure (GRADE: high). We found no significant difference in improvements in tremor severity, functional disability, or quality of life between MRgFUS neurosurgery and deep brain stimulation (GRADE: very low). We found no significant difference in improvement in tremor severity compared with radiofrequency thalamotomy (GRADE: low). MRgFUS neurosurgery has a favourable safety profile. We estimated that MRgFUS neurosurgery has a mean cost of $23,507 and a mean quality-adjusted survival of 3.69 quality-adjusted life-years (QALYs). We also estimated that the mean costs and QALYs of radiofrequency thalamotomy and deep brain stimulation are $14,978 and 3.61 QALYs, and $57,535 and 3.94 QALYs, respectively. For people ineligible for invasive neurosurgery, we estimated the incremental cost-effectiveness ratio (ICER) of MRgFUS neurosurgery compared with no surgery as $43,075 per QALY gained. In people eligible for invasive neurosurgery, the ICER of MRgFUS neurosurgery compared with radiofrequency thalamotomy is $109,795 per QALY gained; when deep brain stimulation is compared with MRgFUS neurosurgery, the ICER is $134,259 per QALY gained. Of note however, radiofrequency thalamotomy is performed very infrequently in Ontario. We also estimated that the budget impact of publicly funding MRgFUS neurosurgery in Ontario at the current case load (i.e., 48 cases/year) would be about $1 million per year for the next 5 years. People with essential tremor who had undergone MRgFUS neurosurgery reported positive experiences with the procedure. The tremor reduction they experienced improved their ability to perform activities of daily living and improved their quality of life. Conclusions MRgFUS neurosurgery is an effective and generally safe treatment option for moderate to severe, medication-refractory essential tremor. It provides a treatment option for people ineligible for invasive neurosurgery and offers a noninvasive option for all people considering neurosurgery. For people ineligible for invasive neurosurgery, MRgFUS neurosurgery is cost-effective compared with no surgery. In people eligible for invasive neurosurgery, MRgFUS neurosurgery may be one of several reasonable options. Publicly funding MRgFUS neurosurgery for t e tre tment of moderate to severe, medication-refractory essential tremor in Ontario at the current case load would have a net budget impact of about $1 million per year for the next 5 years. People with essential tremor who had undergone MRgFUS neurosurgery reported positive experiences. They liked that it was a noninvasive procedure and reported a substantial reduction in tremor that resulted in an improvement in their quality of life. © Queen’s Printer for Ontario, 2018. AU - Schaink, Alexis AU - Li, Chunmei AU - Gajic-Veljanoski, Olga AU - Wells, David AU - Higgins, Caroline AU - Stahl, Kara AU - Kolodziej, Paul AU - Kaulback, Kellee AU - Laing, Ana AU - Soulodre, Claude AU - McDowell, Sarah AU - Mitchell, Andrée AU - Ng, Vivian AU - Thota, Anil AU - Sikich, Nancy AU - Dhalla, Irfan DA - 2018-1-1 IS - 4 KW - Quality of Life Technology Assessment, Biomedical Magnetic Resonance Spectroscopy Quality-Adjusted Life Years Brain Essential Tremor Cost-Benefit Analysis Tremor Neurosurgery thalamotomy systematic review surgical risk radiosurgery radiofrequency thalamotomy personal experience patient preference PY - 2018 SN - 1915-7398 SP - 1-141 ST - Magnetic resonance-guided focused ultrasound neurosurgery for essential tremor: A health technology assessment T2 - Ontario Health Technology Assessment Series TI - Magnetic resonance-guided focused ultrasound neurosurgery for essential tremor: A health technology assessment VL - 18 ID - 57 ER - TY - JOUR AB - Background Prostate cancer is very common and many localized tumours are non-aggressive. Determining which cancers are aggressive is important for choosing the most appropriate treatment (e.g., surgery, radiation, active surveillance). Current clinical risk stratification is reliable in forecasting the prognosis of groups of men with similar clinical and pathologic characteristics, but there is residual uncertainty at the individual level. The Prolaris cell cycle progression (CCP) test, a genomic test that estimates how fast tumour cells are proliferating, could potentially be used to improve the accuracy of individual risk assessment. This health technology assessment sought to determine the clinical utility, economic impact, and patients’ perceptions of the value of the CCP test in low-and intermediate-risk localized prostate cancer. Methods We conducted a systematic review of the clinical and economic evidence of the CCP test in low-and intermediate-risk, localized prostate cancer. Medical and health economic databases were searched from 2010 to June or July 2016. The critical appraisal of the clinical evidence included risk of bias and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. We also analyzed the potential budget impact of adding the CCP test into current practice, from the perspective the Ontario Ministry of Health and Long-Term Care. Finally, we conducted qualitative interviews with men with prostate cancer, on the factors that influenced their treatment decision-making. Results For the review of clinical effectiveness, we screened 3,021 citations, and two before-after studies met our inclusion criteria. In one study, the results of the CCP test appeared to change the treatment plan (from initial to final plan) in 64.9% of cases overall (GRADE rating of the quality of evidence: Very low). In the other study, the CCP test changed the treatment received in nearly half of cases overall, compared with the initial plan (GRADE: Very low). No evidence was available on clinical outcomes of patients whose treatment was informed by CCP results. For the review of cost-effectiveness, 100 citations were identified and screened. No studies met the inclusion criteria. In our economic evaluation, we estimated that publicly funding the CCP test would result in a total net budget impact of $41.3 million in the first 5 years, mostly due to the cost of the CCP test. In our model, the relatively small cost savings ($7.3 million) due to treatment change (increased use of active surveillance and decreased use of interventional treatment) was not large enough to offset the high cost of the test. Patients viewed the test as potentially helpful but, due to the complexity of treatment decision-making, were unsure the test would ultimately change their treatment choices. Conclusions We found no evidence to demonstrate the impact of the Prolaris CCP test on patient-important clinical outcomes. The limited evidence available shows that the test appears to provide information that, when considered in addition to clinical risk stratification, may change the treatment plan or actual treatment for some low-and intermediate-risk prostate cancer patients. As a result, there is insufficient data to inform the cost-effectiveness of the CCP test. Publicly funding the CCP test would result in a large incremental cost to the provincial budget. © Queen’s Printer for Ontario, 2017. AU - Schaink, Alexis AU - Li, Chunmei AU - Wells, David AU - Holubowich, Corinne AU - Zierler, Amy AU - Mohammed, Merissa AU - Soulodre, Claude AU - Laing, Ana AU - Kaulback, Kellee AU - Mitchell, Andrée AU - Thota, Anil AU - Ng, Vivian AU - Sikich, Nancy AU - Dhalla, Irfan DA - 2017-1-1 IS - 6 KW - Biomedical Technology Decision Making Ontario Cost-Benefit Analysis Prostatitis Prostatism Prostate Technology Assessment, Biomedical Cell Cycle Prostatic Neoplasms treatment planning systematic review risk benefit analysis prostate cancer low risk patient intermediate risk patient human funding disease course cost of illness cost effectiveness analysis cost control consultation cell cycle progression cancer risk cancer localization budget biomedical technology assessment Article PY - 2017 SN - 1915-7398 SP - 1-75 ST - Ontario health technology assessment series: Prolaris cell cycle progression test for localized prostate cancer: A health technology assessment T2 - Ontario Health Technology Assessment Series TI - Ontario health technology assessment series: Prolaris cell cycle progression test for localized prostate cancer: A health technology assessment VL - 17 ID - 110 ER - TY - JOUR AB - Aim or objective The objective of this systematic review was to evaluate the evidence regarding rest and active treatment/rehabilitation following sport-related concussion (SRC). Design Systematic review. Data sources MEDLINE (OVID), CINAHL (EbscoHost), PsycInfo (OVID), Cochrane Central Register of Controlled Trials (OVID), SPORTDiscus (EbscoHost), EMBASE (OVID) and Proquest DissertationsandTheses Global (Proquest) were searched systematically. Eligibility criteria for selecting studies Studies were included if they met the following criteria: (1) original research; (2) reported SRC as the diagnosis; and (3) evaluated the effect of rest or active treatment/rehabilitation. Review articles were excluded. Results Twenty-eight studies met the inclusion criteria (9 regarding the effects of rest and 19 evaluating active treatment). The methodological quality of the literature was limited; only five randomised controlled trials (RCTs) met the eligibility criteria. Those RCTs included rest, cervical and vestibular rehabilitation, subsymptom threshold aerobic exercise and multifaceted collaborative care. Summary/conclusions A brief period (24-48 hours) of cognitive and physical rest is appropriate for most patients. Following this, patients should be encouraged to gradually increase activity. The exact amount and duration of rest are not yet well defined and require further investigation. The data support interventions including cervical and vestibular rehabilitation and multifaceted collaborative care. Closely monitored subsymptom threshold, submaximal exercise may be of benefit. Systematic review registration PROSPERO 2016:CRD42016039570 © © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. AU - Schneider, K. J. AU - Leddy, J. J. AU - Guskiewicz, K. M. AU - Seifert, T. AU - McCrea, M. AU - Silverberg, N. D. AU - Feddermann-Demont, N. AU - Iverson, G. L. AU - Hayden, A. AU - Makdissi, M. DA - 2017-1-1 IS - 12 KW - Sports Rest Randomized Controlled Trials as Topic Humans Brain Concussion Athletic Injuries sport randomized controlled trial (topic) human treatment rehabilitation mild traumatic brain injury Concussion PY - 2017 SN - 0306-3674 SP - 930-934 ST - Rest and treatment/rehabilitation following sport-related concussion: A systematic review T2 - British Journal of Sports Medicine TI - Rest and treatment/rehabilitation following sport-related concussion: A systematic review VL - 51 ID - 92 ER - TY - JOUR AB - Objective To synthesise research findings regarding the efficacy and safety of normal saline instillation (NSI) during endotracheal suction in the paediatric intensive care unit. Data sources The Cochrane Library, PROSPERO, the National Health Service Centre for Reviews and Dissemination, PubMed and Cumulative Index to Nursing and Allied Health (CINAHL) databases were systematically searched. Subject headings included “suctioning, endotracheal” “suction” “sodium chloride” “normal saline” and “paediatrics”. Additional references were sourced from hand searches of journal article reference lists and Google Scholar. Method An integrative, systematic approach was used to qualitatively synthesise study results in the context of paediatric intensive care nursing practice. Data were extracted using a standardised data extraction form. Quality assessment was performed independently by two reviewers. Results Three studies met pre-defined inclusion criteria. Quality of all study methods was 75% on the Mixed Method Appraisal Tool, although reporting quality varied. Overall, there was a scarcity of high quality evidence examining NSI and paediatric endotracheal suction. Outcome measures included oxygen saturation (SpO2), serious adverse events (author/s defined) and ventilation parameters (author/s defined). Endotracheal suction with NSI was associated with a transient decrease in blood oxygen saturation; research protocols did not include interventions to mitigate alveolar derecruitment. Studies were not powered to detect differences in endotracheal tube (ETT) occlusion or ventilator associated pneumonia (VAP). Conclusion NSI was associated with a transient decrease in oxygen saturation. In children with obstructive mucous, NSI may have a positive effect. Practices which maximise secretion removal and mitigate the negative physiological interactions of ETS have been poorly evaluated in the paediatric population. High quality, powered, clinical trials are needed to determine the safety and efficacy of normal saline instillation and to inform clinical practice. © 2017 Australian College of Critical Care Nurses Ltd AU - Schults, J. AU - Mitchell, M. L. AU - Cooke, M. AU - Schibler, A. DB - Scopus DO - 10.1016/j.aucc.2017.02.069 IS - 1 M3 - Review PY - 2018 SP - 3-9 ST - Efficacy and safety of normal saline instillation and paediatric endotracheal suction: An integrative review T2 - Australian Critical Care TI - Efficacy and safety of normal saline instillation and paediatric endotracheal suction: An integrative review VL - 31 ID - 328 ER - TY - JOUR AB - Background There are currently two methods used to administer immunoglobulin: Intravenous (IV) infusion, the conventional method, and subcutaneous (SC) infusion, a newer alternative. The aim of this assessment was to compare administration of SC immunoglobulin at home with IV immunoglobulin in hospital with respect to benefits, harm, and costs. We also investigated the lived experiences of patients, looking at their quality of life, satisfaction, opinions, and preferences. Methods We searched the literature for studies that compared home-based SC infusion with hospital- or clinic-based IV infusion of immunoglobulin in the treatment of primary and secondary immunodeficiency in adults and children. Two review authors reviewed the abstracts and full text of the relevant studies, and abstracted the data. We also performed a review of the economic literature comparing SC infusion at home versus IV infusion of immunoglobulin in a hospital or outpatient clinic in patients with primary or secondary immunodeficiency disorders. We also performed a budget impact analysis to estimate the 5-year cost burden of funding home-based SC infusion programs. All costs were reported in 2017 Canadian dollars. This health technology assessment followed a consultation plan for public engagement. We focused on interviews to examine the lived experience of patients with immunodeficiency, including those having experience of intravenous and/or subcutaneous immunoglobulin treatment. Results Sixteen studies met the inclusion criteria. The annual rate of serious bacterial infection per patient did not differ. The annual rate of all infections per patient was relatively lower with home-based SC infusion than with hospital-based IV infusion. Both methods provided an adequate blood (serum) level of immunoglobulin and the pooled mean difference in immunoglobulin level favoured home-based SC infusion. Severe adverse reactions were rare with either method. The risk of adverse events such as fever or headache were higher with IV, while SC infusion sometimes caused infusion site reactions such as swelling, redness, or pain. Where reported, incidence of hospitalization, antibiotic use, and missed days from work or school either did not differ or were lower for SC infusion. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) of evidence for these outcomes was determined to be low. The scores for quality of life and treatment satisfaction either did not differ between the two methods or were significantly higher for some domains with home-based SC infusion. The three important concerns of patients in Ontario regarding home-based programs are loss of supervision, cost, and frequent injections. We identified four economic studies with six analyses (five cost-minimization and one cost-utility). All six analyses suggested that home-based infusion has lower costs, with one also showing greater effectiveness. Results of the budget impact analysis suggest that funding home-based SC infusion program would yield savings of about $0.4 million in the first year, and about $1.6 million by year 5. The total savings from funding home-based SC infusion are approximately $5.0 million over 5 years. Greater savings are indicated when the analysis is conducted from the societal perspective. In speaking directly with patients and their caregivers we found that immunodeficiency reduces quality of life. Intravenous treatment was said to be effective but consumed time and induced side-effects. Conclusions The best available evidence suggests that home-based SC infusion is safe and effective, with clinical outcomes that are comparable to the clinical outcomes of hospital IV infusion. The quality of evidence is low, however, meaning that we cannot be certain about these findings. The shift from hospital-based IV to home-based SC has the potential to reduce the health care costs due to savings in nursing time in Ontario. Patients and caregivers expressed preference for home-based SC treatment as it reduces treatment burden and improves overall quality of ife. © 2017, Health Quality Ontario. All rights reserved. AU - Sehatzadeh, Shayan AU - Xie, Xuanqian AU - Ali, Arshia AU - Walter, Melissa AU - Maguire, Tim AU - Mohamed, Merissa AU - Laing, Ana AU - Soulodre, Claude AU - Kaulback, Kellee AU - Mitchell, Andrée AU - Ng, Vivian AU - Thota, Anil AU - McDowell, Sarah AU - Lang, Amy AU - Sikich, Nancy AU - Dhalla, Irfan DA - 2017-1-1 IS - 16 KW - Biomedical Technology Quality of Life Technology Assessment, Biomedical Immunoglobulin G Immunoglobulin Variable Region Immunoglobulin E Immunoglobulin A Immunoglobulin M Immunoglobulin D Immunoglobulins vomiting treatment withdrawal swelling skin redness skin induration skin bruising rash pruritus premedication personal experience patient satisfaction patient safety patient preference patient harm pain outcome assessment Ontario Note nausea malaise immune deficiency human hospitalization hospital care home care health program headache funding fever drug use dizziness disease burden diarrhea cost utility analysis cost minimization analysis cost benefit analysis clinical supervision chill blood level biomedical technology assessment allergic reaction immunoglobulin PY - 2017 SN - 1915-7398 ST - Home-based subcutaneous infusion of immunoglobulin for primary and secondary immunodeficiencies: A health technology assessment T2 - Ontario Health Technology Assessment Series TI - Home-based subcutaneous infusion of immunoglobulin for primary and secondary immunodeficiencies: A health technology assessment VL - 17 ID - 74 ER - TY - JOUR AB - PURPOSE: Cataract is the leading cause of blindness and the second cause of low vision in the world. In the world, Asia has the highest number of blind population. The aim of the present systematic review and meta-analysis was to assess the frequency of clinical cataracts in Iran. MATERIALS AND METHODS: The frequency of clinical cataract was defined based on the international criteria and the measured outcome of the disease. Study selection, data extraction, and quality assessment were performed by two independent reviewers. We explored PubMed, Google Scholar, ISI Web of Science, and national databases (scientific information database, Magiran) to evaluate the clinical cataract of cataract in the Iranian populations from 1995 to July 2017. Statistical analysis was performed using STATA 14.0 software. RESULTS: Of 283 studies, 27 studies utilized meta-analysis. In 2017, the pooled overall frequency of clinical cataract in 59668 people was 9.27% (95% confidence interval [CI]: 8.09, 10.45, I2 = 98.82%). Based on subgroup analysis, in the random effect method, the frequency of clinical cataract in males and females were 8.03% (CI: 6.78, 9.28) and 8.32% (CI: 7.08, 9.55), respectively. CONCLUSION: Regarding the high frequency of clinical cataract in Iran, it seems that paying attention to the results of the current study and the application of international policy plans may contribute to better cataract control in Iran. © 2018 Middle East African Journal of Ophthalmology. AU - Shahdadi, H. AU - Aminifard, M. AU - Balouchi, A. AU - Rafiemanesh, H. AU - Allahyari, J. DA - 2018-1-1 IS - 1 KW - systematic review Review quality control priority journal prevalence population research Iran incidence human data extraction cataract systematic reviews meta-analysis PY - 2018 SP - 40-46 ST - Frequency of cataract in Iran: A meta-analysis and systematic review T2 - Middle East African Journal of Ophthalmology TI - Frequency of cataract in Iran: A meta-analysis and systematic review VL - 25 ID - 62 ER - TY - JOUR AB - Background: Reporting of health research is often inadequate and incomplete. Complete and transparent reporting is imperative to enable readers to assess the validity of research findings for use in healthcare and policy decision-making. To this end, many guidelines, aimed at improving the quality of health research reports, have been developed for reporting a variety of research types. Despite efforts, many reporting guidelines are underused. In order to increase their uptake, evidence of their effectiveness is important and will provide authors, peer reviewers and editors with an important resource for use and implementation of pertinent guidance. The objective of this study was to assess whether endorsement of reporting guidelines by journals influences the completeness of reporting of health studies.Methods: Guidelines providing a minimum set of items to guide authors in reporting a specific type of research, developed with explicit methodology, and using a consensus process will be identified from an earlier systematic review and from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network's reporting guidelines library. MEDLINE, EMBASE, the Cochrane Methodology Register and Scopus will be searched for evaluations of those reporting guidelines; relevant evaluations from the recently conducted CONSORT systematic review will also be included. Single data extraction with 10% verification of study characteristics, 20% of outcomes and complete verification of aspects of study validity will be carried out. We will include evaluations of reporting guidelines that assess the completeness of reporting: (1) before and after journal endorsement, and/or (2) between endorsing and non-endorsing journals. For a given guideline, analyses will be conducted for individual and the total sum of items. When possible, standard, pooled effects with 99% confidence intervals using random effects models will be calculated.Discussion: Evidence on which guidelines have been evaluated and which are associated with improved completeness of reporting is important for various stakeholders, including editors who consider which guidelines to endorse in their journal editorial policies. © 2012 Shamseer et al.; licensee BioMed Central Ltd. AU - Shamseer, L. AU - Stevens, A. AU - Skidmore, B. AU - Turner, L. AU - Altman, D. G. AU - Hirst, A. AU - Hoey, J. AU - Palepu, A. AU - Simera, I. AU - Schulz, K. AU - Moher, D. DA - 2012-1-1 IS - 1 KW - Review Literature as Topic Research Report Research Design Quality Control Publishing Periodicals as Topic Peer Review, Research Humans Health Services Research Guidelines as Topic Evidence-Based Medicine Editorial Policies research publication practice guideline peer review methodology literature human evidence based medicine article Systematic review Reporting guidelines Evaluation Completeness of reporting PY - 2012 SN - 2046-4053 ST - Does journal endorsement of reporting guidelines influence the completeness of reporting of health research? A systematic review protocol T2 - Systematic Reviews TI - Does journal endorsement of reporting guidelines influence the completeness of reporting of health research? A systematic review protocol VL - 1 ID - 259 ER - TY - JOUR AB - Patients and caregivers play a central role in health care safety in the hospital, ambulatory care setting, and community. Despite this, interventions to promote patient engagement in safety are still underexplored. We conducted an overview of review articles on patient engagement interventions in safety to examine the current state of the evidence. Of the 2,795 references we evaluated, 52 articles met our full-text inclusion criteria for synthesis in 2018. We identified robust evidence supporting patients’ self-management of anticoagulation medications and mixed-quality evidence supporting patient engagement in medication and chronic disease self-management, adverse event reporting, and medical record accuracy. Promising modes of patient engagement in safety, such as anticoagulation management and patient portal access, are not widely implemented. We discuss major implementation priorities and propose directions for future research and policy to enhance patient partnership within safety efforts. © 2018 Project HOPE— The People-to-People Health Foundation, Inc. AD - University of California San Francisco (UCSF), Zuckerberg San Francisco General Hospital’s Family Health Center, United States Center for Vulnerable Populations, UCSF Division of General Internal Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, United States Zuckerberg San Francisco General Hospital and Trauma Center and UCSF, United States UCSF, Zuckerberg San Francisco General Hospital and Trauma Center, United States NYC Health+ Hospitals, New York City, United States Division of General Internal Medicine, UCSF, Zuckerberg San Francisco General Hospital’s Richard H. Fine People’s Clinic, United States AU - Sharma, A. E. AU - Rivadeneira, N. A. AU - Barr-Walker, J. AU - Stern, R. J. AU - Johnson, A. K. AU - Sarkar, U. C2 - 30395509 DB - Scopus DO - 10.1377/hlthaff.2018.0716 IS - 11 KW - accuracy adverse event anticoagulant therapy Article bleeding chronic disease decubitus diabetes mellitus diagnostic error drug safety drug surveillance program error health care health care planning health care policy healthcare associated infection hospital readmission human hypoglycemia law suit malpractice medical record medication compliance mortality patient participation patient safety self care thromboembolism voluntary reporting ambulatory care hospital literature medication error organization and management prevention and control safety Hospitals Humans Medication Errors Review Literature as Topic Safety Management LA - English M3 - Article PY - 2018 SP - 1813-1820 ST - Patient engagement in health care safety: An overview of mixed-quality evidence T2 - Health Affairs TI - Patient engagement in health care safety: An overview of mixed-quality evidence VL - 37 ID - 403 ER - TY - JOUR AB - Background Context In 2008, the lack of published evidence prevented the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders (Neck Pain Task Force [NPTF]) from commenting on the effectiveness of psychological interventions for the management of neck pain. Purpose This study aimed to update findings of the NPTF and evaluate the effectiveness of psychological interventions for the management of neck pain and associated disorders (NAD) or whiplash-associated disorders (WAD). Study Design/setting This study used systematic review and best-evidence synthesis. Sample Randomized controlled trials, cohort studies, and case-control studies comparing psychological interventions to other non-invasive interventions or no intervention were the samples used in this study. Outcome measures The outcome measures are (1) self-rated recovery; (2) functional recovery; (3) clinical outcomes; (4) administrative outcomes; and (5) adverse effects. Methods We searched six databases from 1990 to 2015. Randomized controlled trials, cohort studies, and case-control studies meeting our selection criteria were eligible for critical appraisal. Random pairs of independent reviewers used the Scottish Intercollegiate Guidelines Network criteria to critically appraise eligible studies. Studies with a low risk of bias were synthesized following best evidence synthesis principles. This study was funded by the Ontario Ministry of Finance. Results We screened 1,919 articles, 19 were eligible for critical appraisal and 10 were judged to have low risk of bias. We found no clear evidence supporting relaxation training or cognitive behavioral therapy (CBT) for persistent grades I–III NAD for reducing pain intensity or disability. Similarly, we did not find evidence to support the effectiveness of biofeedback or relaxation training for persistent grade II WAD, and there is conflicting evidence for the use of CBT in this population. However, adding a progressive goal attainment program to functional restoration physiotherapy may benefit patients with persistent grades I–III WAD. Furthermore, Jyoti meditation may help reduce neck pain intensity and bothersomeness in patients with persistent NAD. Conclusions We did not find evidence for or against the use of psychological interventions in patients with recent onset NAD or WAD. We found evidence that a progressive goal attainment program may be helpful for the management of persistent WAD and that Jyoti meditation may benefit patients with persistent NAD. The limited evidence of effectiveness for psychological interventions may be due to several factors, such as interventions that are ineffective, poorly conceptualized, or poorly implemented. Further methodologically rigorous research is needed. © 2015 Elsevier Inc. AU - Shearer, H. M. AU - Carroll, L. J. AU - Wong, J. J. AU - Côté, P. AU - Varatharajan, S. AU - Southerst, D. AU - Sutton, D. A. AU - Randhawa, K. A. AU - Yu, H. AU - Mior, S. A. AU - van der Velde, G. M. AU - Nordin, M. C. AU - Stupar, M. AU - Taylor-Vaisey, A. L. DA - 2016-1-1 IS - 12 KW - Physical Therapy Modalities Ontario NADPH Oxidase Bias (Epidemiology) Cohort Studies Behavior Therapy Cognitive Therapy Nitrate Reductase (NAD(P)H) FMN Reductase Case-Control Studies Neck Pain Whiplash-associated disorders Systematic review Recovery Psychological intervention Outcome Neck pain and associated disorders PY - 2016 SP - 1566-1581 ST - Are psychological interventions effective for the management of neck pain and whiplash-associated disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration T2 - Spine Journal TI - Are psychological interventions effective for the management of neck pain and whiplash-associated disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration VL - 16 ID - 6 ER - TY - JOUR AB - Background: Population aging is increasing and this process together with its characteristics influence the prevalence and incidence of chronic conditions and musculoskeletal-functional outcomes such as frailty, functional disability and sarcopenia. Nutritional strategies focused on dietary patterns, such as a Mediterranean diet, can be protective from these outcomes. Purpose: To investigate the association between adherence to a Mediterranean diet and frailty, functional disability and sarcopenia in community-dwelling older people. Methods: We systematically reviewed electronic databases (MEDLINE, EMBASE, and others) and grey literature for articles investigating the relationship between adherence to a Mediterranean diet and frailty, functional disability and sarcopenia in community-dwelling people aged 60 and over. Study selection, quality of study assessment and data extraction were conducted independently by two authors. Random effects meta-analyses were performed, and pooled Odds Ratios (OR) were obtained. Results: After the literature search, screening and eligibility investigation, we included 12studies, with a total of 20,518 subjects. A higher adherence to a Mediterranean diet was found to be inversely associated with frailty (OR 0.42, 95% CI: 0.28-0.65, I2=24.9%, p=0.262) and functional disability (OR 0.75, 95% CI: 0.61-0.93, I2=0.0%, p=0.78). Highly different study characteristics prevented us from performing a meta-analysis for sarcopenia. Cohort data indicated no association between adherence to a Mediterranean diet and sarcopenia; however, cross-sectional results showed a positive relationship. Conclusion: A Mediterranean diet is protective of frailty and functional disability, but not of sarcopenia. More longitudinal studies are needed to understand the relationship between a Mediterranean diet and sarcopenia. © 2017, Serdi and Springer-Verlag France SAS, part of Springer Nature. AU - Silva, R. AU - Pizato, N. AU - da Mata, F. AU - Figueiredo, A. AU - Ito, M. AU - Pereira, M. G. DA - 2018-1-1 IS - 6 KW - Diet, Mediterranean Aging Longitudinal Studies Aged systematic review sarcopenia priority journal musculoskeletal function meta analysis Mediterranean diet human geriatric nutrition frailty disease association disability dietary compliance Article functional disability elderly PY - 2018 SP - 655-663 ST - Mediterranean Diet and Musculoskeletal-Functional Outcomes in Community-Dwelling Older People: A Systematic Review and Meta-Analysis T2 - Journal of Nutrition, Health and Aging TI - Mediterranean Diet and Musculoskeletal-Functional Outcomes in Community-Dwelling Older People: A Systematic Review and Meta-Analysis VL - 22 ID - 49 ER - TY - JOUR AB - Background & Aims Tests to measure serum endomysial antibodies (EMA) and antibodies to tissue transglutaminase (tTG) were developed to screen for celiac disease in patients consuming gluten. However, they are commonly used to monitor patients on a gluten-free diet (GFD). We conducted a meta-analysis to assess the sensitivity and specificity of tTG IgA and EMA IgA assays in identifying patients with celiac disease who have persistent villous atrophy despite a GFD. Methods We searched PUBMED, EMBASE, BIOSIS, SCOPUS, clinicaltrials.gov, Science Citation Index, and Cochrane Library databases through November 2016. Inclusion criteria were studies of subjects with biopsy-confirmed celiac disease, follow-up biopsies, and measurement of serum antibodies on a GFD, biopsy performed on subjects regardless of symptoms, or antibody test results. Our analysis excluded subjects with refractory celiac disease, undergoing gluten challenge, or consuming a prescribed oats-containing GFD. Tests were considered to have positive or negative findings based on manufacturer cut-off values. Villous atrophy was defined as a Marsh 3 lesion or villous height:crypt depth ratio below 3.0. We constructed forest plots to determine the sensitivity and specificity of detection for individual studies. For the meta-analysis, a bivariate random effects model was used to jointly model sensitivity and specificity. Results Our search identified 5408 unique citations. Following review of abstracts, 442 articles were reviewed in detail. Only 26 studies (6 of tTG assays, 15 of EMA assays, and 5 of tTG and EMA assays) met our inclusion criteria. The most common reason studies were excluded from our analysis was inability to cross-tabulate histologic and serologic findings. The serum assays identified patients with persistent villous atrophy with high levels of specificity: 0.83 for the tTG IgA assay (95% CI, 0.79–0.87) and 0.91 for the EMA IgA assay (95% CI, 0.87–0.94). However, they detected villous atrophy with low levels of sensitivity: 0.50 for the tTG IgA assay (95% CI, 0.41–0.60) and 0.45 for the EMA IgA assay (95% CI, 0.34-0.57). The tests had similar levels of performance in pediatric and adult patients. Conclusions In a meta-analysis of patients with biopsy-confirmed celiac disease undergoing follow-up biopsy on a GFD, we found that tests for serum tTG IgA and EMA IgA levels had low sensitivity (below 50%) in detection of persistent villous atrophy. We need more-accurate non-invasive markers of mucosal damage in children and adults with celiac disease who are following a GFD. © 2017 AGA Institute AU - Silvester, J. A. AU - Kurada, S. AU - Szwajcer, A. AU - Kelly, C. P. AU - Leffler, D. A. AU - Duerksen, D. R. DA - 2017-1-1 IS - 3 KW - Antibodies, Heterophile Diet, Gluten-Free Biopsy Glutens Transglutaminases Sensitivity and Specificity Intestinal Mucosa Immunoglobulin A Humans GTP-Binding Proteins Celiac Disease Autoantibodies Atrophy pathology intestine mucosa immunology diet therapy blood villous height crypt depth ratio systematic review Scopus SciSearch reference value priority journal plots and curves patient identification oat meta analysis Medline intestine villus atrophy intestine parameters intestine biopsy immunoassay human gluten free diet forest plot follow up enzyme blood level Embase diagnostic value diagnostic test accuracy study diagnostic accuracy Cochrane Library Biosis Article antibody blood level protein glutamine gamma glutamyltransferase 2 protein glutamine gamma glutamyltransferase guanine nucleotide binding protein autoantibody immunoglobulin A antibody gluten endomysium antibody Tissue Transglutaminase Antibody Monitoring and Follow-up Diagnostics Endomysial Antibody PY - 2017 SP - 689-701.e1 ST - Tests for Serum Transglutaminase and Endomysial Antibodies Do Not Detect Most Patients With Celiac Disease and Persistent Villous Atrophy on Gluten-free Diets: a Meta-analysis T2 - Gastroenterology TI - Tests for Serum Transglutaminase and Endomysial Antibodies Do Not Detect Most Patients With Celiac Disease and Persistent Villous Atrophy on Gluten-free Diets: a Meta-analysis VL - 153 ID - 143 ER - TY - JOUR AB - Purpose. The comparative efficacy, safety, and cost-effectiveness of rapid and longacting insulin analogs compared with regular or neutral protamine Hagedorn nonanalog insulins or with oral antidiabetic agents in hospitalized adults were evaluated. Methods. A literature search was conducted to identify studies that compared the effects of rapid-acting, long-acting, or mixed insulin analogs with short-or intermediateacting insulin or any other oral antidiabetic medication. Results. Twenty-three primary studies were included in the review. Rapid-acting analogs and basal-bolus analog regimens were found to reduce the duration of hospital stay by approximately one day compared with regular insulin and basal-bolus nonanalog regimens. One large cohort study found an adjusted 48% relative risk reduction in mortality with rapid-acting analogs versus regular insulin in a heterogeneous hospitalized hyperglycemic population. A randomized controlled trial found a significant reduction in postoperative complications with basal-bolus analogs compared with basal-bolus nonanalog insulin. When compared with regular sliding-scale insulin (SSI), fixed-dose insulin glargine with or without insulin glulisine was found to reduce the blood glucose concentration in patients with type 2 diabetes and reduce postoperative complications in surgical patients with diabetes. The quality of evidence was primarily very low or low for most outcomes. Conclusion. A systematic literature review revealed a very low or low quality of evidence, suggesting that, compared with nonanalog regimens, rapid-acting insulin analogs reduce the duration of hospital stay and mortality rates and that basal-bolus analog regimens may reduce the duration of hospital stay and postoperative complications. There is also a low quality of evidence to suggest that a fixed-dose analog regimen of insulin glargine with or without insulin glulisine is more effective than regular SSI for reducing blood glucose concentrations and postoperative complications. Copyright © 2015, American Society of Health-System Pharmacists, Inc. Inc. AU - Singh, K. AU - Ansari, M. T. AU - Patel, R. V. AU - Bedard, M. AU - Keely, E. AU - Tierney, M. AU - Moher, D. DA - 2015-1-1 IS - 7 KW - Adult Blood Glucose Length of Stay Postoperative Complications Hypoglycemic Agents Insulin Humans Hospitalization Cost-Benefit Analysis meta analysis analogs and derivatives treatment duration systematic review risk factor Review randomized controlled trial (topic) priority journal postoperative complication population outcome assessment mortality rate meta analysis (topic) hyperglycemia human glucose blood level drug safety drug efficacy diabetes mellitus cost utility analysis cost effectiveness analysis cost benefit analysis controlled clinical trial (topic) comparative study cohort analysis clinical evaluation bolus injection short acting insulin pig insulin oral antidiabetic agent long acting insulin isophane insulin insulin lispro insulin glulisine insulin glargine insulin detemir insulin aspart glucose PY - 2015 SP - 525-535 ST - Comparative efficacy and safety of insulin analogs in hospitalized adults T2 - American Journal of Health-System Pharmacy TI - Comparative efficacy and safety of insulin analogs in hospitalized adults VL - 72 ID - 212 ER - TY - JOUR AB - Background: The matching of critical care service supply with demand is fundamental for the efficient delivery of advanced life support to patients in urgent need. Mismatch in this supply/demand relationship contributes to "intensive care unit (ICU) capacity strain," defined as a time-varying disruption in the ability of an ICU to provide well-timed and high-quality intensive care support to any and all patients who are or may become critically ill. ICU capacity strain leads to suboptimal quality of care and may directly contribute to heightened risk of adverse events, premature discharges, unplanned readmissions, and avoidable death. Unrelenting strain on ICU capacity contributes to inefficient health resource utilization and may negatively impact the satisfaction of patients, their families, and frontline providers. It is unknown how to optimally quantify the instantaneous and temporal "stress" an ICU experiences due to capacity strain. Methods: We will perform a systematic review to identify, appraise, and evaluate quality and performance measures of strain on ICU capacity and their association with relevant patient-centered, ICU-level, and health system-level outcomes. Electronic databases (i.e., MEDLINE, EMBASE, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Web of Science, and the Agency of Healthcare Research and Quality (AHRQ)-National Quality Measures Clearinghouse (NQMC)) will be searched for original studies of measures of ICU capacity strain. Selected gray literature sources will be searched. Search themes will focus on intensive care, quality, operations management, and capacity. Analysis will be primarily narrative. Each identified measure will be defined, characterized, and evaluated using the criteria proposed by the US Strategic Framework Board for a National Quality Measurement and Reporting System (i.e., importance, scientific acceptability, usability, feasibility). Discussion: Our systematic review will comprehensively identify, define, and evaluate quality and performance measures of ICU capacity strain. This is a necessary step towards understanding the impact of capacity strain on quality and performance in intensive care and to develop innovative interventions aimed to improve efficiency, avoid waste, and better anticipate impending capacity shortfalls. Systematic review registration: PROSPERO, CRD42015017931 © 2015 Soltani et al. AU - Soltani, S. A. AU - Ingolfsson, A. AU - Zygun, D. A. AU - Stelfox, H. T. AU - Hartling, L. AU - Featherstone, R. AU - Opgenorth, D. AU - Bagshaw, S. M. DA - 2015-1-1 IS - 1 KW - Intensive Care Patient Satisfaction Research Design Intensive Care Units Humans Health Services Needs and Demand Critical Illness Critical Care standards intensive care unit health service systematic review qualitative research public health priority journal outcome assessment methodology information processing human evidence based practice electronic medical record clinical protocol clinical evaluation bibliographic database Article Quality indicator Performance measure Health services Capacity PY - 2015 SN - 2046-4053 SP - 1 ST - Quality and performance measures of strain on intensive care capacity: A protocol for a systematic review T2 - Systematic Reviews TI - Quality and performance measures of strain on intensive care capacity: A protocol for a systematic review VL - 4 ID - 196 ER - TY - JOUR AB - Background Transitions in care can increase patients’ vulnerability to adverse events. In particular, patients admitted for heart failure or chronic obstructive pulmonary disorder (COPD) have high rates of readmission and return emergency department visits. Heart failure patients have the highest 30-day readmission rates in Canada, and COPD patients comprise the highest volume of readmissions. Combined, these two conditions account for the largest number of emergency department returns. Prompt follow-up of discharged patients has been linked with reduced rates of readmission, emergency department use, and death. This systematic review evaluated the clinical effectiveness of early follow-up, within either 7 days or 30 days after hospital discharge, compared with usual care or a different time to follow-up, in reducing readmissions, emergency department visits, and mortality in patients with heart failure or COPD. Methods We performed a literature search to identify studies published in English up to May 25, 2016, on early follow-up after discharge from hospital in patients with heart failure or COPD. A single reviewer screened the titles and abstracts and obtained full-text articles for studies meeting the eligibility criteria. The risk of bias in the studies was evaluated according to ROBINS-I and EPOC criteria, and the quality of the body of evidence for each outcome was examined according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. Results From a total of 3,228 unique citations, we identified 10 eligible studies: one randomized controlled trial, two nonrandomized controlled trials, and seven observational studies. Four studies were specifically on 7-day follow-up and 30-day health outcomes. The other six studies were on 30-day follow-up and more variable time to health outcomes. Follow-up was conducted by general and specialist physicians, nurses, and pharmacists in clinics, by telephone, and by home visit. Risk of bias was moderate for most of the studies. Having follow-up within either 7 days or 30 days after hospitalization for heart failure or COPD was associated with lower all-cause readmissions, emergency department visits, and mortality, even after accounting for confounders such as age, sex, socioeconomic status, and disease severity (GRADE: Very low to low). However, the evidence was inconsistent. We did not find a difference in effectiveness between studies using a 7-day versus a 30-day follow-up. Conclusions Based on low-and very low-quality evidence, follow-up within 7 days and within 30 days of discharge from hospitalization for heart failure or COPD—compared with usual care or no follow-up—were both associated with a reduced risk of all-cause readmission, emergency department visits, and mortality. Overall, there is a lack of large, methodologically robust studies specifically focusing on the effectiveness of 7-day follow-up after discharge in improving patient outcomes. © 2017, Health Quality Ontario. All rights reserved. AU - Song, Jasmine AU - Walter, Melissa AU - Zierler, Amy AU - Mohamed, Merissa AU - Kabali, Conrad AU - Kaulback, Kellee AU - Millward, Margaret AU - Monte, Ryan AU - Soulodre, Claude AU - Wells, David AU - Weir, Mark AU - Mitchell, Andrée AU - Degani, Naushaba AU - Martin, Danyal AU - Thota, Anil AU - Sikich, Nancy AU - Dhalla, Irfan DA - 2017-1-1 IS - 8 KW - Ontario Lung Diseases, Obstructive Emergencies Patient Discharge Pulmonary Disease, Chronic Obstructive Bias (Epidemiology) Technology Assessment, Biomedical Emergency Service, Hospital treatment outcome systematic review social status sex randomized controlled trial (topic) observational study mortality human hospital readmission hospital discharge heart failure follow up emergency ward disease severity confounding variable clinical effectiveness chronic obstructive lung disease Canada biomedical technology assessment Article age PY - 2017 SN - 1915-7398 SP - 1-37 ST - Ontario health technology assessment series: Effect of early follow-up after hospital discharge on outcomes in patients with heart failure or chronic obstructive pulmonary disease: A systematic review T2 - Ontario Health Technology Assessment Series TI - Ontario health technology assessment series: Effect of early follow-up after hospital discharge on outcomes in patients with heart failure or chronic obstructive pulmonary disease: A systematic review VL - 17 ID - 106 ER - TY - JOUR AB - Background: Comprehensive geriatric assessment (CGA) is an integrated model of care involving a geriatrician and an interdisciplinary team and can prioritize and manage complex health needs of older adults with multimorbidity. CGAs differ across healthcare settings, ranging from shared care conducted in primary care settings to specialized inpatient units in acute care. Models of care involving geriatricians vary across healthcare settings, and it is unclear which CGA model is most effective. Our objective is to conduct a systematic review and network meta-analysis (NMA) to examine the comparative effectiveness of various geriatrician-led CGAs and to identify which models improve patient and healthcare system level outcomes. Methods: An integrated knowledge translation approach will be used and knowledge users (KUs) including patients, caregivers, geriatricians, and healthcare policymakers will be involved throughout the review. Electronic databases including MEDLINE, EMBASE, Cochrane library, and Ageline will be searched from inception to November 2016 to identify relevant studies. Randomized controlled trials of older adults (≥65 years of age) that examine geriatrician-led CGAs compared to any intervention will be included. Primary and secondary outcomes will be selected by KUs to ensure the results are relevant to their decision-making. Two reviewers will independently screen the search results, extract data, and assess risk of bias. Data will be synthesized using an NMA to allow for multiple comparisons using direct (head-to-head) as well as indirect evidence. Interventions will be ranked according to their effectiveness using surface under the cumulative ranking curve (SUCRA). Discussion: As the proportion of older adults grows worldwide, the demand for specialized geriatric services that help manage complex health needs of older adults with multimorbidity will increase in many countries. Results from this systematic review and NMA will enhance decision-making and the efficient allocation of scarce geriatric resources. Moreover, active involvement of KUs throughout the review process will ensure the results are relevant to different levels of decision-making. Systematic review registration: PROSPERO CRD42014014008 © 2017 The Author(s). AU - Soobiah, C. AU - Daly, C. AU - Blondal, E. AU - Ewusie, J. AU - Ho, J. AU - Elliott, M. J. AU - Yue, R. AU - Holroyd-Leduc, J. AU - Liu, B. AU - Marr, S. AU - Basran, J. AU - Tricco, A. C. AU - Hamid, J. AU - Straus, S. E. DA - 2017-1-1 IS - 1 KW - Decision Making Geriatrics Adult Review Literature as Topic Research Design Quality of Health Care Quality Improvement Outcome Assessment (Health Care) Network Meta-Analysis Humans Geriatricians Geriatric Assessment Comparative Effectiveness Research Aged total quality management procedures outcome assessment methodology literature health care quality comparative effectiveness systematic review study design scientific literature randomized controlled trial (topic) priority journal meta analysis integrated health care system information processing human geriatrician geriatric patient Delphi study data base clinical outcome Article Integrated knowledge translation Geriatric care Comprehensive geriatric assessment PY - 2017 SN - 2046-4053 ST - An evaluation of the comparative effectiveness of geriatrician-led comprehensive geriatric assessment for improving patient and healthcare system outcomes for older adults: A protocol for a systematic review and network meta-analysis T2 - Systematic Reviews TI - An evaluation of the comparative effectiveness of geriatrician-led comprehensive geriatric assessment for improving patient and healthcare system outcomes for older adults: A protocol for a systematic review and network meta-analysis VL - 6 ID - 99 ER - TY - JOUR AB - Objective The purpose of this study was to critically appraise and synthesize evidence on the effectiveness of noninvasive interventions, excluding pharmacological treatments, for musculoskeletal thoracic pain. Methods Randomized controlled trials (RCTs), cohort studies, and case-control studies evaluating the effectiveness of noninvasive interventions were eligible. We searched MEDLINE, EMBASE, PsycINFO, and the Cochrane Central Register of Controlled Trials accessed through Ovid Technologies, Inc, and CINAHL Plus with Full Text accessed through EBSCOhost from 1990 to 2015. Our search strategies combined controlled vocabulary relevant to each database (eg, MeSH for MEDLINE) and text words relevant to our research question and the inclusion criteria. Random pairs of independent reviewers screened studies for relevance and critically appraised relevant studies using the Scottish Intercollegiate Guidelines Network criteria. Studies with a low risk of bias were synthesized following best evidence synthesis principles. Results We screened 6988 articles and critically appraised 2 studies. Both studies had a low risk of bias and were included in our synthesis. One RCT compared thoracic spinal manipulation, needle acupuncture, and placebo electrotherapy for recent thoracic spine pain. There were statistically significant but clinically nonimportant short-term reductions in pain favoring manipulation. There were no differences between acupuncture and placebo electrotherapy. Another RCT compared a multimodal program of care and a session of education for recent musculoskeletal chest wall pain. The multimodal care resulted in statistically significant but clinically nonimportant short-term reductions in pain over education. However, participants receiving multimodal care were more likely to report important improvements in chest pain. Conclusions Quality evidence on the management of musculoskeletal thoracic pain is sparse. The current evidence suggests that compared to placebo, spinal manipulation is associated with a small and clinically nonimportant reduction in pain intensity and that acupuncture leads to similar outcomes as placebo. Furthermore, a multimodal program of care (ie, manual therapy, soft tissue therapy, exercises, heat/ice, and advice) and a single education session lead to similar pain reduction for recent-onset musculoskeletal chest wall pain. However, patients who receive multimodal care are more likely to report pain improvements. © 2015 National University of Health Sciences. AU - Southerst, D. AU - Marchand, A. A. AU - Côté, P. AU - Shearer, H. M. AU - Wong, J. J. AU - Varatharajan, S. AU - Randhawa, K. AU - Sutton, D. AU - Yu, H. AU - Gross, D. P. AU - Jacobs, C. AU - Goldgrub, R. AU - Stupar, M. AU - Mior, S. AU - Carroll, L. J. AU - Taylor-Vaisey, A. DA - 2015-1-1 IS - 7 KW - Electric Stimulation Therapy Manipulation, Spinal Spine Treatment Outcome Thoracic Wall Thoracic Vertebrae Spinal Diseases Severity of Illness Index Randomized Controlled Trials as Topic Practice Guidelines as Topic Physical Therapy Modalities Pain Measurement Pain Management Ontario Musculoskeletal Pain Musculoskeletal Manipulations Middle Aged Male Humans Female Exercise Therapy Cooperative Behavior Cohort Studies Case-Control Studies Aged Adult Acupuncture Therapy thorax wall thoracic vertebra procedures practice guideline physiotherapy pathophysiology kinesiotherapy cooperation comparative study cohort analysis case control study analgesia acupuncture thorax pain thoracic spine systematic review spinal pain soft tissue therapy Review randomized controlled trial (topic) PsycINFO musculoskeletal chest pain Medline manipulative medicine human Embase electrostimulation therapy Cochrane Library Cinahl acupuncture needle Review Literature as Topic Patient Education as Topic PY - 2015 SN - 0161-4754 DO - http://dx.doi.org/10.1016/j.jmpt.2012.01.001 SP - 521-531 ST - The effectiveness of noninvasive interventions for musculoskeletal thoracic spine and chest wall pain: A systematic review by the Ontario protocol for traffic injury management (OPTIMa) Collaboration T2 - Journal of Manipulative and Physiological Therapeutics TI - The effectiveness of noninvasive interventions for musculoskeletal thoracic spine and chest wall pain: A systematic review by the Ontario protocol for traffic injury management (OPTIMa) Collaboration VL - 38 ID - 201 ER - TY - JOUR AB - Background context In 2008, the Neck Pain Task Force (NPTF) recommended exercise for the management of neck pain and whiplash-associated disorders (WAD). However, no evidence was available on the effectiveness of exercise for Grade III neck pain or WAD. Moreover, limited evidence was available to contrast the effectiveness of various types of exercises. Purpose To update the findings of the NPTF on the effectiveness of exercise for the management of neck pain and WAD grades I to III. Study design/setting Systematic review and best evidence synthesis. Sample Studies comparing the effectiveness of exercise to other conservative interventions or no intervention. Outcome measures Outcomes of interest included self-rated recovery, functional recovery, pain intensity, health-related quality of life, psychological outcomes, and/or adverse events. Methods We searched eight electronic databases from 2000 to 2013. Eligible studies were critically appraised using the Scottish Intercollegiate Guidelines Network criteria. The results of scientifically admissible studies were synthesized following best-evidence synthesis principles. Results We retrieved 4,761 articles, and 21 randomized controlled trials (RCTs) were critically appraised. Ten RCTs were scientifically admissible: nine investigated neck pain and one addressed WAD. For the management of recent neck pain Grade I/II, unsupervised range-of-motion exercises, nonsteroidal anti-inflammatory drugs and acetaminophen, or manual therapy lead to similar outcomes. For recent neck pain Grade III, supervised graded strengthening is more effective than advice but leads to similar short-term outcomes as a cervical collar. For persistent neck pain and WAD Grade I/II, supervised qigong and combined strengthening, range-of-motion, and flexibility exercises are more effective than wait list. Additionally, supervised Iyengar yoga is more effective than home exercise. Finally, supervised high-dose strengthening is not superior to home exercises or advice. Conclusions We found evidence that supervised qigong, Iyengar yoga, and combined programs including strengthening, range of motion, and flexibility are effective for the management of persistent neck pain. We did not find evidence that one supervised exercise program is superior to another. Overall, most studies reported small effect sizes suggesting that a small clinical effect can be expected with the use of exercise alone. © 2014 Elsevier Inc. AU - Southerst, D. AU - Nordin, M. C. AU - Côté, P. AU - Shearer, H. M. AU - Varatharajan, S. AU - Yu, H. AU - Wong, J. J. AU - Sutton, D. A. AU - Randhawa, K. A. AU - van der Velde, G. M. AU - Mior, S. A. AU - Carroll, L. J. AU - Jacobs, C. L. AU - Taylor-Vaisey, A. L. DA - 2016-1-1 IS - 12 KW - Recovery of Function Neck Pain Whiplash-associated disorders Treatment Systematic review Rehabilitation Exercise PY - 2016 SP - 1503-1523 ST - Is exercise effective for the management of neck pain and associated disorders or whiplash-associated disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration T2 - Spine Journal TI - Is exercise effective for the management of neck pain and associated disorders or whiplash-associated disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration VL - 16 ID - 4 ER - TY - JOUR AB - Background: Musculoskeletal disorders (MSDs) of the upper and lower extremities are common in the general population and place a significant burden on the health care system. Manual therapy is recommended by clinical practice guidelines for the management of these injuries; however, there is limited evidence to support its effectiveness. The purpose of our review was to investigate the effectiveness of manual therapy in adults or children with MSDs of the upper or lower extremity. Methods: Randomized controlled trials (RCTs), cohort studies, and case-control studies evaluating the effectiveness of manual therapy were eligible. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials from 1990 to 2015. Paired reviewers screened studies for relevance and critically appraised relevant studies using the Scottish Intercollegiate Guidelines Network criteria. Studies with low risk of bias were synthesized following best-evidence synthesis principles. Where available, we computed mean changes between groups, relative risks and 95 % CI. Results: We screened 6047 articles. Seven RCTs were critically appraised and three had low risk of bias. For adults with nonspecific shoulder pain of variable duration, cervicothoracic spinal manipulation and mobilization in addition to usual care may improve self-perceived recovery compared to usual care alone. For adults with subacromial impingement syndrome of variable duration, neck mobilization in addition to a multimodal shoulder program of care provides no added benefit. Finally, for adults with grade I-II ankle sprains of variable duration, lower extremity mobilization in addition to home exercise and advice provides greater short-term improvements in activities and function over home exercise and advice alone. No studies were included that evaluated the effectiveness of manual therapy in children or for the management of other extremity injuries in adults. Conclusions: The current evidence on the effectiveness of manual therapy for MSDs of the upper and lower extremities is limited. The available evidence supports the use of manual therapy for non-specific shoulder pain and ankle sprains, but not for subacromial impingement syndrome in adults. Future research is needed to determine the effectiveness of manual therapy and guide clinical practice. Systematic review registration number:CRD42014009899 © 2015 Southerst et al. AU - Southerst, D. AU - Yu, H. AU - Randhawa, K. AU - Côté, P. AU - D'Angelo, K. AU - Shearer, H. M. AU - Wong, J. J. AU - Sutton, D. AU - Varatharajan, S. AU - Goldgrub, R. AU - Dion, S. AU - Cox, J. AU - Menta, R. AU - Brown, C. K. AU - Stern, P. J. AU - Stupar, M. AU - Carroll, L. J. AU - Taylor-Vaisey, A. DA - 2015-1-1 IS - 1 KW - Bias (Epidemiology) Shoulder Pain Musculoskeletal Manipulations Only Child Case-Control Studies Upper and lower extremities Treatment Systematic review Rehabilitation Recovery Outcome Musculoskeletal disorders Manual therapy PY - 2015 SN - --- - 2045-709X - 2045-709X ST - The effectiveness of manual therapy for the management of musculoskeletal disorders of the upper and lower extremities: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration T2 - Chiropractic and Manual Therapies TI - The effectiveness of manual therapy for the management of musculoskeletal disorders of the upper and lower extremities: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration VL - 23 ID - 10 ER - TY - JOUR AB - Background: Cardiovascular disease and type 2 diabetes are examples of chronic diseases that impose significant morbidity and mortality in the general population worldwide. Most chronic diseases are associated with underlying preventable risk factors, such as elevated blood pressure, high blood glucose or glucose intolerance, high lipid levels, physical inactivity, excessive sedentary behaviours, and overweight/obesity. The occurrence of intermediate outcomes during childhood increases the risk of disease in adulthood. Sugar-sweetened beverages are known to be significant sources of additional caloric intake, and given recent attention to their contribution in the development of chronic diseases, a systematic review is warranted. We will assess whether the consumption of sugar-sweetened beverages in children is associated with adverse health outcomes and what the potential moderating factors are. Methods/Design: Of interest are studies addressing sugar-sweetened beverage consumption, taking a broad perspective. Both direct consumption studies as well as those evaluating interventions that influence consumption (e.g. school policy, educational) will be relevant. Non-specific or multi-faceted behavioural, educational, or policy interventions may also be included subject to the level of evidence that exists for the other interventions/exposures. Comparisons of interest and endpoints of interest are pre-specified. We will include randomized controlled trials, controlled clinical trials, interrupted time series studies, controlled before-after studies, prospective and retrospective comparative cohort studies, case-control studies, and nested case-control designs. The MEDLINE®, Embase, The Cochrane Library, CINAHL, ERIC, and PsycINFO® databases and grey literature sources will be searched. The processes for selecting studies, abstracting data, and resolving conflicts are described. We will assess risk of bias using design-specific tools. To determine sets of confounding variables that should be adjusted for, we have developed causal directed acyclic graphs and will use those to inform our risk of bias assessments. Meta-analysis will be conducted where appropriate; parameters for exploring statistical heterogeneity and effect modifiers are pre-specified. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach will be used to determine the quality of evidence for outcomes. Systematic review registration: PROSPERO CRD42014009641. © 2014 Stevens et al.; licensee BioMed Central Ltd. AU - Stevens, A. AU - Hamel, C. AU - Singh, K. AU - Ansari, M. T. AU - Myers, E. AU - Ziegler, P. AU - Hutton, B. AU - Sharma, A. AU - Bjerre, L. M. AU - Fenton, S. AU - Gow, R. AU - Hadjiyannakis, S. AU - O'Hara, K. AU - Pound, C. AU - Salewski, E. AU - Shrier, I. AU - Willows, N. AU - Moher, D. AU - Tremblay, M. DA - 2014-1-1 IS - 1 KW - Bias (Epidemiology) Cardiovascular Diseases Case-Control Studies Only Child Chronic Disease Sweetening Agents Schools Research Design Prediabetic State Obesity Hypertension Humans Health Policy Health Education Fractures, Bone Dyslipidemias Dietary Sucrose Dental Caries Child, Preschool Child Beverages Adolescent sweetening agent sugar intake school preschool child methodology health care policy beverage adverse effects sugar sweetened beverage sensitivity analysis risk assessment randomized controlled trial (topic) quality control priority journal intervention study information processing human honey fruit juice food intake data extraction data analysis Article adverse outcome Type 2 diabetes Systematic review Sugar-sweetened beverage Paediatric Academic achievement PY - 2014 SN - 2046-4053 ST - Do sugar-sweetened beverages cause adverse health outcomes in children? A systematic review protocol T2 - Systematic Reviews TI - Do sugar-sweetened beverages cause adverse health outcomes in children? A systematic review protocol VL - 3 ID - 236 ER - TY - JOUR AB - Introduction: Over the past 10 years, a number of systematic reviews have evaluated the validity of multisource feedback (MSF) to assess and quality-assure medical practice. The purpose of this study is to synthesize the results from existing reviews to provide a holistic overview of the validity evidence. Methods: This review identified eight systematic reviews evaluating the validity of MSF published between January 2006 and October 2016. Using a standardized data extraction form, two independent reviewers extracted study characteristics. A framework of validation developed by the American Psychological Association was used to appraise the validity evidence within each systematic review. Results: In terms of validity evidence, each of the eight reviews demonstrated evidence across at least one domain of the American Psychological Association's validity framework. Evidence of assessment validity within the domains of "internal structure" and "relationship to other variables" has been well established. However, the domains of content validity (ie, ensuring that MSF tools measure what they are intended to measure); consequential validity (ie, evidence of the intended or unintended consequences MSF assessments may have on participants or wider society), and response process validity (ie, the process of standardization and quality control in the delivery and completion of assessments) remain limited. Discussion: Evidence for the validity of MSF has, across a number of domains, been well established. However, the size and quality of the existing evidence remains variable. To determine the extent to which MSF is considered a valid instrument to assess medical performance, future research is required to determine the following: (1) how best to design and deliver MSF assessments that address the identified limitations of existing tools and (2) how to ensure that involvement within MSF supports positive changes in practice. Such research is integral if MSF is to continue to inform medical performance and subsequent improvements in the quality and safety of patient care. © 2018 The Alliance for Continuing Education in the Health Professions, the Association for Hospital Medical Education, and the Society for Academic Continuing Medical Education. AD - Collaboration for the Advancement of Medical Education Research and Assessment, Plymouth University Peninsula, Schools of Medicine and Dentistry, University of Plymouth, Portland Square, Plymouth, PL48AA, United Kingdom AU - Stevens, S. AU - Read, J. AU - Baines, R. AU - Chatterjee, A. AU - Archer, J. C2 - 30157152 DB - Scopus DO - 10.1097/CEH.0000000000000219 IS - 4 KW - Medical Education Msf Multisource Feedback Physician Systematic Review Validity adult article content validity controlled study data extraction drug safety female human male medical practice patient care standardization validation process clinical competence devices feedback system health care personnel procedures psychometry total quality management Feedback Health Personnel Humans Psychometrics Quality Improvement LA - English M3 - Article PY - 2018 SP - 262-268 ST - Validation of multisource feedback in assessing medical performance: A systematic review T2 - Journal of Continuing Education in the Health Professions TI - Validation of multisource feedback in assessing medical performance: A systematic review VL - 38 ID - 404 ER - TY - JOUR AB - Objectives: To conduct a scoping review of knowledge translation (KT) theories, models, and frameworks that have been used to guide dissemination or implementation of evidence-based interventions targeted to prevention and/or management of cancer or other chronic diseases. Study Design and Setting: We used a comprehensive multistage search process from 2000 to 2016, which included traditional bibliographic database searching, searching using names of theories, models and frameworks, and cited reference searching. Two reviewers independently screened the literature and abstracted the data. Results: We found 596 studies reporting on the use of 159 KT theories, models, or frameworks. A majority (87%) of the identified theories, models, or frameworks were used in five or fewer studies, with 60% used once. The theories, models, and frameworks were most commonly used to inform planning/design, implementation and evaluation activities, and least commonly used to inform dissemination and sustainability/scalability activities. Twenty-six were used across the full implementation spectrum (from planning/design to sustainability/scalability) either within or across studies. All were used for at least individual-level behavior change, whereas 48% were used for organization-level, 33% for community-level, and 17% for system-level change. Conclusion: We found a significant number of KT theories, models, and frameworks with a limited evidence base describing their use. © 2018 Elsevier Inc. AD - Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, East Building, Toronto, Ontario M5B 1W8, Canada Institute of Health Policy Management & Evaluation, University of Toronto, 4th Floor, 155 College Street, Toronto, Ontario M5T 3M6, Canada School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, 600 Peter Morand Crescent, Ottawa, Ontario K1G 5Z3, Canada Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 6th Floor, 155 College Street, Toronto, Ontario M5T 3M7, Canada Department of Geriatric Medicine, University of Toronto, 27 King's College Circle, Toronto, Ontario M5S 1A1, Canada AU - Strifler, L. AU - Cardoso, R. AU - McGowan, J. AU - Cogo, E. AU - Nincic, V. AU - Khan, P. A. AU - Scott, A. AU - Ghassemi, M. AU - MacDonald, H. AU - Lai, Y. AU - Treister, V. AU - Tricco, A. C. AU - Straus, S. E. C2 - 29660481 DB - Scopus DO - 10.1016/j.jclinepi.2018.04.008 KW - Framework Implementation Knowledge synthesis Knowledge translation Model Theory behavior change bibliographic database cancer control cancer prevention cardiovascular disease chronic disease community conceptual framework diabetes mellitus funding human knowledge translation theory long term care malignant neoplasm obesity planning priority journal Review evidence based medicine female male procedures theoretical model translational research Databases, Bibliographic Evidence-Based Medicine Humans Models, Theoretical Translational Medical Research LA - English M3 - Review PY - 2018 SP - 92-102 ST - Scoping review identifies significant number of knowledge translation theories, models, and frameworks with limited use T2 - Journal of Clinical Epidemiology TI - Scoping review identifies significant number of knowledge translation theories, models, and frameworks with limited use VL - 100 ID - 405 ER - TY - JOUR AB - Background: Short-stay units are hospital units that provide short-term care for selected patients. Studies have indicated that short-stay units might reduce admission rates, time of hospital stays, hospital readmissions and expenditure without compromising the quality of care. Short-stay units are often defined by a target patient category, a target function, and a target time frame. Hypothetically, short-stay units could be established as part of any department, but this review focuses on short-stay units that provide care for participants with internal medicine diseases and conditions. Objectives: To assess beneficial and harmful effects of short-stay unit hospitalisation compared with usual care in people with internal medicine diseases and conditions. Search methods: We searched CENTRAL, MEDLINE, Embase, three other databases and two trials registers up to 13 December 2017 together with reference checking, citation searching and contact with study authors to identify additional studies. We also searched several grey literature sources and performed a forward citation search for included studies. Selection criteria: We included randomised trials and cluster-randomised trials, comparing hospitalisation in a short-stay unit with usual care (hospitalisation in a traditional hospital ward or other services). We defined a short-stay unit to be a hospital ward where the targeted length of stay in hospital for patients was five days or less. We included both multipurpose and specialised short-stay units. Participants were adults admitted to hospital with an internal medicine disease or condition. We excluded surgical, obstetric, psychiatric, gynaecological, and ambulatory participants. Trials were included irrespective of publication status, date, and language. Data collection and analysis: We used standard methodological procedures expected by Cochrane. Two review authors independently extracted data and assessed the risk of bias of each included trial. We measured intervention effect sizes by meta-analyses for two primary outcomes, mortality and serious adverse events, and one secondary outcome, hospital readmission. We narratively reported the following important outcomes: quality of life, activities of daily living, non-serious adverse events, and costs. We used risk ratio differences of 15% for mortality and of 20% for serious adverse events for minimal relevant clinical consideration. We rated the certainty of the evidence and the strength of recommendations of the outcomes using the GRADE approach. Main results: We included 19 records reporting on 14 randomised trials with a total of 2872 participants. One trial was ongoing. Thirteen trials evaluated short-stay unit hospitalisation for six specific conditions (acute decompensated heart failure (one trial), asthma (one trial), atrial fibrillation (one trial), chest pain (seven trials), syncope (two trials), and transient ischaemic attack (one trial)) and one trial investigated participants presenting with miscellaneous internal medicine disease and conditions. The components of the intervention differed among the trials as dictated by the trial participants' condition. All included trials were at high risk of bias. The certainty of the evidence for all outcomes was very low. Consequently, it is uncertain whether hospitalisation in short-stay units compared with usual care reduces mortality (risk ratio (RR) 0.73, 95% confidence interval (CI) 0.47 to 1.15) 5 trials (seven additional trials reporting on 1299 participants reported no deaths in either group)); serious adverse events (RR 0.95, 95% CI 0.59 to 1.54; 7 trials (one additional trial with 108 participants reported no serious adverse events in either group)), and hospital readmission (RR 0.80, 95% CI 0.54 to 1.19, 8 trials (one additional trial with 424 participants did not report results for participants)). There was not enough information to confirm or refute that short-stay unit hospitalisation had relevant effects on quality of life, activities of daily living, non-serious adverse events, and costs. Auth rs' conclusions: Overall, the quantity and the certainty of the evidence was very low. Consequently, it is uncertain whether there are any beneficial or harmful effects of short-stay unit hospitalisation for adults with internal medicine diseases and conditions - more trials comparing the effects of short-stay units with usual care are needed. Such trials ought to be conducted with low risk of bias and low risks of random errors to improve the overall confidence in the evidence. © 2018 The Cochrane Collaboration. AD - Holbaek Hospital, University of Copenhagen, Department of Emergency Medicine, Holbaek, 4300, Denmark Rigshospitalet, University of Copenhagen, Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen, Denmark Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University Hospital, Cochrane Hepato-Biliary Group, Blegdamsvej 9, Copenhagen, Sjælland, DK-2100, Denmark Holbaek Hospital, Department of Cardiology, Holbaek, 4300, Denmark AU - Strøm, C. AU - Stefansson, J. S. AU - Fabritius, M. L. AU - Rasmussen, L. S. AU - Schmidt, T. A. AU - Jakobsen, J. C. C2 - 30102428 C7 - Cd012370 DB - Scopus DO - 10.1002/14651858.CD012370.pub2 IS - 8 KW - acute heart failure asthma atrial fibrillation daily life activity emergency ward evidence based medicine faintness health care cost health hazard hospital admission hospital readmission hospitalization human length of stay mortality outcome assessment priority journal quality of life Review short course therapy thorax pain transient ischemic attack adult classification heart failure hospital mortality hospital subdivisions and components internal medicine meta analysis randomized controlled trial (topic) time factor Activities of Daily Living Chest Pain Hospital Units Humans Ischemic Attack, Transient Patient Readmission Randomized Controlled Trials as Topic Syncope Time Factors LA - English M3 - Review PY - 2018 ST - Hospitalisation in short-stay units for adults with internal medicine diseases and conditions T2 - Cochrane Database of Systematic Reviews TI - Hospitalisation in short-stay units for adults with internal medicine diseases and conditions VL - 2018 ID - 406 ER - TY - JOUR AB - Background: Pulmonary arterial hypertension (PAH) is a rare disease (15 cases per million) that is characterized by widespread loss of the pulmonary microcirculation and elevated pulmonary vascular resistance leading to pathological right ventricular remodeling and ultimately right heart failure. Regenerative cell therapies (i.e., therapies involving cells with stem or progenitor-like properties) could potentially restore the effective lung microcirculation and provide a curative therapy for PAH. Preclinical evidence suggests that regenerative cell therapy using endothelial progenitor cells or mesenchymal stem cells may be beneficial in the treatment of PAH. These findings have led to the completion of a small number of human clinical trials, albeit with modest effect compared to animal studies. The objective of this systematic review is to compare the efficacy and safety of regenerative cell therapies in preclinical models of PAH as well as assess study quality to inform future clinical studies. Methods: We will include preclinical studies of PAH in which a regenerative cell type was administered and outcomes compared to a disease control. The primary outcome will be pulmonary hemodynamics as assessed by measurement of right ventricular systolic pressure and/or mean pulmonary arterial pressure. Secondary outcomes will include mortality, survival, right ventricular remodeling, pulmonary vascular resistance, cardiac output, cardiac index, pulmonary acceleration time, tricuspid annular systolic excursion, and right ventricular wall thickness. Electronic searches of MEDLINE and EMBASE databases will be constructed and reviewed by the Peer Review of Electronic Search Strategies (PRESS) process. Search results will be screened independently in duplicate. Data from eligible studies will be extracted, pooled, and analyzed using random effects models. Risk of bias will be assessed using the SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE) risk of bias tool, and individual study reporting will be assessed according to an itemized checklist based on the Animal Research: Reporting of In vivo Experiments (ARRIVE) guidelines. Discussion: This systematic review will examine the efficacy and safety of regenerative cell therapy in preclinical models of PAH. As well, the literature will be assessed for study quality and risk of bias. The results will guide the design of future clinical trials and preclinical animal studies. Systematic review registration: CAMARADES (http://www.dcn.ed.ac.uk/camarades/SyRF/Protocols.htm ). © 2016 Suen et al. AU - Suen, C. M. AU - Zhai, A. AU - Lalu, M. M. AU - Welsh, C. AU - Levac, B. M. AU - Fergusson, D. AU - McIntyre, L. AU - Stewart, D. J. DA - 2016-1-1 IS - 1 KW - Pulmonary Artery Microcirculation Bias (Epidemiology) Ventricular Remodeling Animals Humanism Humanities Animal Shells Humans Systematic review Stem cells Risk of bias Pulmonary arterial hypertension Preclinical Mesenchymal stem cells Endothelial progenitor cells Cell therapy Animal models PY - 2016 SN - 2046-4053 ST - Efficacy and safety of regenerative cell therapy for pulmonary arterial hypertension in animal models: A preclinical systematic review protocol T2 - Systematic Reviews TI - Efficacy and safety of regenerative cell therapy for pulmonary arterial hypertension in animal models: A preclinical systematic review protocol VL - 5 ID - 19 ER - TY - JOUR AB - Background Patient-reported outcomes have the potential to provide invaluable information for evaluation of hypospadias patients, aid in decision-making, performance assessment, and improvement in quality of care. To appropriately measure patient-relevant outcomes, well-developed and validated patient-reported outcome (PRO) instruments are essential. Objective To identify and evaluate existing PRO instruments designed to measure quality of life and/or satisfaction of individuals with hypospadias that have been developed and validated in a hypospadias population. Methods A systematic search of MEDLINE, EMBASE, PsycINFO, CINAHL and Health and Psychosocial Instruments was conducted in April 2016. Two reviewers independently assessed studies and identified PRO instruments for inclusion. Data were extracted on study characteristics, instrument development and validation, and content domains. Results A total of 32 studies were included that used or described five PRO instruments: Hypospadias Objective Scoring Evaluation (HOSE), Pediatric Penile Perception Score (PPPS), Penile Perception Score (PPS), Genital Perception Scale (GPS) for adults, and GPS for children/adolescents. Instrument development and validation was limited. The majority of identified instruments focused on postoperative cosmetic satisfaction, with only one instrument considering urinary function, and no instruments evaluating sexual function and psychosocial sequelae. Conclusions While many hypospadias studies have acknowledged the necessity of a patient-reported element, few have used validated PRO instruments developed in a hypospadias population. Existing instruments to measure patient-reported outcomes in hypospadias require improvement in both the breadth of content and in their development and validation methodology. © 2016 Journal of Pediatric Urology Company AU - Sullivan, K. J. AU - Hunter, Z. AU - Andrioli, V. AU - Guerra, L. AU - Leonard, M. AU - Klassen, A. AU - Keays, M. A. DA - 2017-1-1 %J Journal of Pediatric Urology IS - 1 KW - Hypospadias Quality of Life PY - 2017 SP - 19-27 ST - Assessing quality of life of patients with hypospadias: A systematic review of validated patient-reported outcome instruments T2 - Journal of Pediatric Urology TI - Assessing quality of life of patients with hypospadias: A systematic review of validated patient-reported outcome instruments VL - 13 ID - 290 ER - TY - JOUR AB - Objective: Although the effectiveness of integrated mental health care has been demonstrated, its implementation in real-world settings is highly variable, may not conform to evidence-based practice, and has rarely been evaluated. Quality indicators can guide improvements in integrated care implementation. However, the literature on indicators for this purpose is limited. This article reports findings from a systematic review of existing measures by which to evaluate integrated care models in primary care settings. Methods: Bibliographic databases and gray literature sources, including academic conference proceedings, were searched to July 2014. Measures used or proposed to evaluate integrated care implementation or outcomes were extracted and critically appraised. A qualitative synthesis was conducted to generate a panel of unique measures and to group these measures into broad domains and specific dimensions of integrated care program performance. Results: From 172 literature sources, 1,255 measures were extracted, which were distilled into 148 unique measures. Existing literature frequently reports integrated care program effectiveness vis-à-vis evidence-based care processes and individual clinical outcomes, as well as efficiency (costeffectiveness) and client satisfaction. No measures of safety of care and few measures of equitability, accessibility, or timeliness of care were located, despite the known benefits of integrated care in several of these areas. Conclusions: To realize the potential for quality measurement to improve integrated care implementation, future measures will need to incorporate domains of quality that are presently unaddressed; microprocesses of care that influence effectiveness, sustainability, and transferability of models of care; and client and health care provider perspectives on meaningful measures of quality. AU - Sunderji, N. AU - Ion, A. AU - Ghavam-Rassoul, A. AU - Abate, A. DA - 2017-1-1 IS - 9 KW - Quality Indicators, Health Care Mental Health Services Humans Delivery of Health Care, Integrated standards mental health service integrated health care system health care quality systematic review synthesis satisfaction program effectiveness primary medical care outcome assessment mental health care human health care personnel clinical outcome bibliographic database PY - 2017 SN - 1075-2730 SP - 891-898 ST - Evaluating the implementation of integrated mental health care: A systematic review to guide the development of quality measures T2 - Psychiatric Services TI - Evaluating the implementation of integrated mental health care: A systematic review to guide the development of quality measures VL - 68 ID - 142 ER - TY - JOUR AB - Background: Musculoskeletal disorders of the elbow, forearm, wrist and hand are associated with pain, functional impairment and decreased productivity in the general population. Combining several interventions in a multimodal program of care is reflective of current clinical practice; however there is limited evidence to support its effectiveness. The purpose of our review was to investigate the effectiveness of multimodal care for the management of musculoskeletal disorders of the elbow, forearm, wrist and hand on self-rated recovery, functional recovery, or clinical outcomes in adults or children. Methods: We conducted a systematic review of the literature and best evidence synthesis. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials from January 1990 to March 2015. Randomized controlled trials, cohort studies, and case-control studies were eligible. Random pairs of independent reviewers screened studies for relevance and critically appraised relevant studies using the Scottish Intercollegiate Guidelines Network criteria. Studies with a low risk of bias were synthesized following best evidence synthesis principles. Results: We screened 5989 articles, and critically appraised eleven articles. Of those, seven had a low risk of bias; one addressed carpal tunnel syndrome and six addressed lateral epicondylitis. Our search did not identify any low risk of bias studies examining the effectiveness of multimodal care for the management of other musculoskeletal disorders of the elbow, forearm, wrist or hand. The evidence suggests that multimodal care for the management of lateral epicondylitis may include education, exercise (strengthening, stretching, occupational exercise), manual therapy (manipulation) and soft tissue therapy (massage). The evidence does not support the use of multimodal care for the management of carpal tunnel syndrome. Conclusions: The current evidence on the effectiveness of multimodal care for musculoskeletal disorders of the elbow, forearm, wrist and hand is limited. The available evidence suggests that there may be a role for multimodal care in the management of patients with persistent lateral epicondylitis. Future research is needed to examine the effectiveness of multimodal care and guide clinical practice. Systematic review registration number:CRD42014009093 © 2016 Sutton et al. AU - Sutton, D. AU - Gross, D. P. AU - Côté, P. AU - Randhawa, K. AU - Yu, H. AU - Wong, J. J. AU - Stern, P. AU - Varatharajan, S. AU - Southerst, D. AU - Shearer, H. M. AU - Stupar, M. AU - Goldgrub, R. AU - van der Velde, G. AU - Nordin, M. AU - Carroll, L. J. AU - Taylor-Vaisey, A. DA - 2016-1-1 IS - 1 KW - Bias (Epidemiology) Elbow Carpal Tunnel Syndrome Case-Control Studies Managed Care Programs Forearm wrist disease tennis elbow systematic review splinting soft tissue therapy Review randomized controlled trial (topic) priority journal patient safety patient care manipulative medicine intermethod comparison human hand disease follow up exercise elbow disease educational status disease duration corticosteroid therapy compression therapy cohort analysis clinical protocol clinical effectiveness case control study arm injury acupuncture Wrist injuries Review literature as topic Multimodal treatment Hand injuries Epicondylitis PY - 2016 SN - --- - 2045-709X - 2045-709X ST - Multimodal care for the management of musculoskeletal disorders of the elbow, forearm, wrist and hand: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration T2 - Chiropractic and Manual Therapies TI - Multimodal care for the management of musculoskeletal disorders of the elbow, forearm, wrist and hand: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration VL - 24 ID - 182 ER - TY - JOUR AB - Background context Little is known about the effectiveness of multimodal care for individuals with whiplash-associated disorders (WAD) and neck pain and associated disorders (NAD). Purpose To update findings of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders and evaluate the effectiveness of multimodal care for the management of patients with WAD or NAD. Study design/setting Systematic review and best-evidence synthesis. Patient sample We included randomized controlled trials (RCTs), cohort studies, and case-control studies. Outcome measures Self-rated recovery, functional recovery (eg, disability, return to activities, work, or school), pain intensity, health-related quality of life, psychological outcomes (eg, depression, fear), or adverse events. Methods We systematically searched five electronic databases (MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane Central Register of Controlled Trials) from 2000 to 2013. RCTs, cohort, and case-control studies meeting our selection criteria were eligible for critical appraisal. Random pairs of independent reviewers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria. Scientifically admissible studies were summarized using evidence tables and synthesized following best-evidence synthesis principles. Results We retrieved 2,187 articles, and 23 articles were eligible for critical appraisal. Of those, 18 articles from 14 different RCTs were scientifically admissible. There were a total of 31 treatment arms, including 27 unique multimodal programs of care. Overall, the evidence suggests that multimodal care that includes manual therapy, education, and exercise may benefit patients with grades I and II WAD and NAD. General practitioner care that includes reassurance, advice to stay active, and resumption of regular activities may be an option for the early management of WAD grades I and II. Our synthesis suggests that patients receiving high-intensity health care tend to experience poorer outcomes than those who receive fewer treatments for WAD and NAD. Conclusions Multimodal care can benefit patients with WAD and NAD with early or persistent symptoms. The evidence does not indicate that one multimodal care package is superior to another. Clinicians should avoid high utilization of care for patients with WAD and NAD. © 2014 Elsevier Inc. AU - Sutton, D. A. AU - Côté, P. AU - Wong, J. J. AU - Varatharajan, S. AU - Randhawa, K. A. AU - Yu, H. AU - Southerst, D. AU - Shearer, H. M. AU - van der Velde, G. M. AU - Nordin, M. C. AU - Carroll, L. J. AU - Mior, S. A. AU - Taylor-Vaisey, A. L. AU - Stupar, M. DA - 2016-1-1 IS - 12 KW - NADPH Oxidase Case-Control Studies Nitrate Reductase (NAD(P)H) FMN Reductase Neck Pain Whiplash-associated disorders Systematic review Recovery Outcome Neck pain and associated disorders Multimodal care PY - 2016 SP - 1541-1565 ST - Is multimodal care effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration T2 - Spine Journal TI - Is multimodal care effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration VL - 16 ID - 8 ER - TY - JOUR AB - Objective The purpose of this systematic review was to evaluate the effectiveness of multimodal care for the management of soft tissue injuries of the lower extremity. Methods We systematically searched MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials from 1990 to 2015. Random pairs of independent reviewers screened studies for relevance and critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria. We included studies with a low risk of bias in our best evidence synthesis. Results We screened 6794 articles. Six studies had a low risk of bias and addressed the following: plantar heel pain (n = 2), adductor-related groin pain (n = 1), and patellofemoral pain (n = 3). The evidence suggests that multimodal care for the management of persistent plantar heel pain may include mobilization and stretching exercise. An intensive, clinic-based, group exercise program (strengthening, stretching, balance, agility) is more effective than multimodal care for the management of adductor-related groin pain in male athletes. There is inconclusive evidence to support the use of multimodal care for the management of persistent patellofemoral pain. Our search did not identify any low risk of bias studies examining multimodal care for the management of other soft tissue injuries of the lower extremity. Conclusion A multimodal program of care for the management of persistent plantar heel pain may include mobilization and stretching exercise. Multimodal care for adductor-related groin pain is not recommended based on the current evidence. There is inconclusive evidence to support the use of multimodal care for the management of persistent patellofemoral pain. © 2016 National University of Health Sciences. AU - Sutton, D. A. AU - Nordin, M. AU - Côté, P. AU - Randhawa, K. AU - Yu, H. AU - Wong, J. J. AU - Stern, P. AU - Varatharajan, S. AU - Southerst, D. AU - Shearer, H. M. AU - Stupar, M. AU - Chung, C. AU - Goldgrub, R. AU - Carroll, L. J. AU - Taylor-Vaisey, A. DA - 2016-1-1 IS - 2 KW - Bias (Epidemiology) Managed Care Programs Soft Tissue Injuries Physical Therapy Modalities Patient Outcome Assessment Lower Extremity Humans Combined Modality Therapy physiotherapy outcome assessment multimodality cancer therapy lower limb injuries traffic accident systematic review stretching exercise soft tissue injury Review plantar heel pain patient care patellofemoral pain syndrome multimodal care mobilization leg injury human groin pain clinical protocol Canada Sprains and Strains Review Literature as Topic Plantar Pain Fasciitis PY - 2016 SN - 0161-4754 DO - http://dx.doi.org/10.1016/j.jmpt.2012.01.001 SP - 95-109.e2 ST - The Effectiveness of Multimodal Care for Soft Tissue Injuries of the Lower Extremity: A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration T2 - Journal of Manipulative and Physiological Therapeutics TI - The Effectiveness of Multimodal Care for Soft Tissue Injuries of the Lower Extremity: A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration VL - 39 ID - 184 ER - TY - JOUR AB - Background-The proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors evolocumab and alirocumab substantially reduce low-density lipoprotein cholesterol (LDL-C) when added to statin therapy in patients who need additional LDL-C reduction. Methods and Results-We conducted a systematic review and network meta-analysis of randomized trials of lipid-lowering therapies from database inception through August 2016 (45 058 records retrieved). We found 69 trials of lipid-lowering therapies that enrolled patients requiring further LDL-C reduction while on maximally tolerated medium- or high-intensity statin, of which 15 could be relevant for inclusion in LDL-C reduction networks with evolocumab, alirocumab, ezetimibe, and placebo as treatment arms. PCSK9 inhibitors significantly reduced LDL-C by 54% to 74% versus placebo and 26% to 46% versus ezetimibe. There were significant treatment differences for evolocumab 140 mg every 2 weeks at the mean of weeks 10 and 12 versus placebo (-74.1%; 95% credible interval -79.81% to -68.58%), alirocumab 75 mg (-20.03%; 95% credible interval -27.32% to -12.96%), and alirocumab 150 mg (-13.63%; 95% credible interval -22.43% to -5.33%) at ≥12 weeks. Treatment differences were similar in direction and magnitude for PCSK9 inhibitor monthly dosing. Adverse events were similar between PCSK9 inhibitors and control. Rates of adverse events were similar between PCSK9 inhibitors versus placebo or ezetimibe. Conclusions-PCSK9 inhibitors added to medium- to high-intensity statin therapy significantly reduce LDL-C in patients requiring further LDL-C reduction. The network meta-analysis showed a significant treatment difference in LDL-C reduction for evolocumab versus alirocumab. © 2017 The Authors. AU - Toth, P. P. AU - Worthy, G. AU - Gandra, S. R. AU - Sattar, N. AU - Bray, S. AU - Cheng, L. I. AU - Bridges, I. AU - Worth, G. M. AU - Dent, R. AU - Forbes, C. A. AU - Deshpande, S. AU - Ross, J. AU - Kleijnen, J. AU - Stroes, E. S. G. DA - 2017-1-1 IS - 10 KW - Hyperlipidemias unspecified side effect systematic review randomized controlled trial (topic) priority journal network meta-analysis meta analysis hyperlipidemia hypercholesterolemia human familial hypercholesterolemia dyslipidemia drug safety drug megadose drug efficacy drug dose comparison dosage schedule comparison Article simvastatin rosuvastatin placebo low density lipoprotein cholesterol hydroxymethylglutaryl coenzyme A reductase inhibitor ezetimibe evolocumab atorvastatin plus ezetimibe atorvastatin alirocumab Statin therapy Proprotein convertase subtilisin/kexin type 9 inhibitor Meta-analysis Low-density lipoprotein cholesterol Lipids Evidence-based medicine PY - 2017 SN - 2047-9980 ST - Systematic review and network meta-analysis on the efficacy of evolocumab and other therapies for the management of lipid levels in hyperlipidemia T2 - Journal of the American Heart Association TI - Systematic review and network meta-analysis on the efficacy of evolocumab and other therapies for the management of lipid levels in hyperlipidemia VL - 6 ID - 81 ER - TY - JOUR AB - Objective: Complementary and alternative medicine (CAM) is commonly used by children, but estimates of that use vary widely partly due to the range of questionnaires used to assess CAM use. However, no studies have attempted to appraise measurement properties of these questionnaires. The aim of this systematic review was to critically appraise and summarize measurement properties of questionnaires of CAM use in pediatrics. Study design: A search strategy was implemented in major electronic databases in March 2011 and conference websites, scientific journals and experts were consulted. Studies were included if they mentioned a questionnaire assessing the prevalence of CAM use in pediatrics. Members of the team independently rated the methodological quality of the studies (using the COSMIN checklist) and measurement properties of the questionnaires (using the Terwee and Cohen criteria). Results: A total of 96 CAM questionnaires were found in 104 publications. The COSMIN checklist showed that no studies reported adequate methodological quality. The Terwee criteria showed that all included CAM questionnaires had indeterminate measurement properties. According to the Cohen score, none were considered to be a well-established assessment, two approached the level of a well-established assessment, seven were promising assessments and the remainder (n = 87) did not reach the score's minimum standards. Conclusion: None of the identified CAM questionnaires have been thoroughly validated. This systematic review highlights the need for proper validation of CAM questionnaires in pediatrics, which may in turn lead to improved research and knowledge translation about CAM in clinical practice. © 2012 Toupin April et al. AU - Toupin April, K. AU - Moher, D. AU - Stinson, J. AU - Byrne, A. AU - White, M. AU - Boon, H. AU - Duffy, C. M. AU - Rader, T. AU - Vohra, S. AU - Tugwell, P. DA - 2012-1-1 IS - 6 KW - Questionnaires Pediatrics Humans Complementary Therapies Child systematic review scientific literature questionnaire publication prevalence methodology interrater reliability human data extraction data base content validity construct validity clinical practice article alternative medicine PY - 2012 ST - Measurement properties of questionnaires assessing complementary and alternative medicine use in pediatrics: A systematic review T2 - PLoS ONE TI - Measurement properties of questionnaires assessing complementary and alternative medicine use in pediatrics: A systematic review VL - 7 ID - 258 ER - TY - JOUR AB - Background: Antiretroviral therapy reduces mother-to-child transmission of human immunodeficiency virus (HIV) during pregnancy, delivery, and breastfeeding. However, these agents have been associated with preterm birth, anemia and low birth weight. We aim to evaluate the comparative safety and effectiveness of the use of antiretroviral drugs among HIV-infected women and the effects on their infants and children through a systematic review and network meta-analysis. Methods/Design: Studies examining the effects of six antiretroviral drug classes (nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, protease inhibitors, integrase inhibitors, fusion inhibitors, co-receptor inhibitors) administered to HIV-infected pregnant women will be included. We will include randomized clinical trials (RCTs), quasi-RCTs, non-RCTs, controlled before-after, interrupted time series, cohort, registry, and case-control studies. No limitations will be imposed on publication status (that is, unpublished studies are eligible for inclusion), duration of follow-up, study conduct period, and language of dissemination. Comprehensive literature searches will be conducted in major electronic databases, including MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. Gray literature will be identified through searching dissertation databases, trial protocol registries, and conference abstracts. Two team members will independently screen all citations, full-text articles, and abstract data; conflicts will be resolved through discussion. The risk of bias and methodological quality will be appraised using appropriate tools (for example, Cochrane Collaboration's tool for assessing risk of bias, Newcastle-Ottawa Scale, and McMaster Quality Assessment Scale of Harms). If feasible and appropriate, we will conduct random effects meta-analysis. Network meta-analysis will be considered for outcomes with the greatest number of treatment comparisons available that fulfill network meta-analysis assumptions (for example, consistency of evidence between direct and indirect data, and low statistical heterogeneity between included studies). The primary effectiveness outcome is mother-to-child transmission of HIV, and the primary safety outcome is major congenital malformation (overall and specific types) among newborns of HIV-infected women. Secondary safety outcomes include stillbirths, infant/child death, preterm delivery, overall and specific minor congenital malformations, and small for gestational age infants. Discussion: Our systematic review will be of utility to healthcare providers, policy-makers, and HIV-positive women regarding the use of antiretroviral drugs. � 2014 Tricco et al. AU - Tricco, A. C. AU - Antony, J. AU - Angeliki, V. A. AU - Ashoor, H. AU - Hutton, B. AU - Hemmelgarn, B. R. AU - Moher, D. AU - Finkelstein, Y. AU - Gough, K. AU - Straus, S. E. DA - 2014-1-1 IS - 1 KW - Registries Case-Control Studies Only Child Humanities Humanism Prenatal Exposure Delayed Effects Pregnancy Complications, Infectious Pregnancy Male Infectious Disease Transmission, Vertical Infant Humans HIV-1 HIV Infections Female Child Anti-HIV Agents vertical transmission review prenatal exposure pregnancy complication Human immunodeficiency virus 1 chemically induced disorder systematic review stillbirth randomized controlled trial (topic) priority journal prenatal drug exposure premature labor pregnant woman outcome assessment meta analysis Human immunodeficiency virus infection Human immunodeficiency virus human highly active antiretroviral therapy gestational age follow up drug safety drug efficacy disease transmission congenital malformation comparative study child death Article anti human immunodeficiency virus agent RNA directed DNA polymerase inhibitor nonnucleoside reverse transcriptase inhibitor integrase inhibitor Human immunodeficiency virus proteinase inhibitor Human immunodeficiency virus fusion inhibitor antiretrovirus agent Mother-to-child-transmission Fetus Breastfeeding Antiretroviral therapy PY - 2014 SN - 2046-4053 ST - Safety and effectiveness of antiretroviral therapies for HIV-infected women and their infants and children: Protocol for a systematic review and network meta-analysis T2 - Systematic Reviews TI - Safety and effectiveness of antiretroviral therapies for HIV-infected women and their infants and children: Protocol for a systematic review and network meta-analysis VL - 3 ID - 244 ER - TY - JOUR AB - Background: Frequent users of health care services are a relatively small group of patients who account for a disproportionately large amount of health care utilization. We conducted a meta-analysis of the effectiveness of interventions to improve the coordination of care to reduce health care utilization in this patient group. Methods: We searched MEDLINE, Embase and the Cochrane Library from inception until May 2014 for randomized clinical trials (RCTs) assessing quality improvement strategies for the coordination of care of frequent users of the health care system. Articles were screened, and data abstracted and appraised for quality by 2 reviewers, independently. Random effects meta-analyses were conducted. Results: We identified 36 RCTs and 14 companion reports (total 7494 patients). Significantly fewer patients in the intervention group than in the control group were admitted to hospital (relative risk [RR] 0.81, 95% confidence interval [CI] 0.72-0.91). In subgroup analyses, a similar effect was observed among patients with chronic medical conditions other than mental illness, but not among patients with mental illness. In addition, significantly fewer patients 65 years and older in the intervention group than in the control group visited emergency departments (RR 0.69, 95% CI 0.54-0.89). Interpretation: We found that quality improvement strategies for coordination of care reduced hospital admissions among patients with chronic conditions other than mental illness and reduced emergency department visits among older patients. Our results may help clinicians and policy-makers reduce utilization through the use of strategies that target the system (team changes, case management) and the patient (promotion of self-management). © 2014 Canadian Medical Association or its licensors. AU - Tricco, A. C. AU - Antony, J. AU - Ivers, N. M. AU - Ashoor, H. M. AU - Khan, P. A. AU - Blondal, E. AU - Ghassemi, M. AU - MacDonald, H. AU - Chen, M. H. AU - Ezer, L. K. AU - Straus, S. E. DA - 2014-1-1 IS - 15 KW - Emergencies Quality Improvement Humans Health Services Delivery of Health Care, Integrated utilization organization and management integrated health care system health service total quality management systematic review substance abuse South Africa self care schizophrenia risk factor Review reimbursement practice guideline patient education North America meta analysis mental disease medical information system length of stay Israel intervention study human hospital admission health care utilization health care system health care policy health care management health care disparity Europe emergency ward decision support system comorbidity chronic disease care coordination Australia PY - 2014 SP - E568-E578 ST - Effectiveness of quality improvement strategies for coordination of care to reduce use of health care services: A systematic review and meta-analysis T2 - CMAJ TI - Effectiveness of quality improvement strategies for coordination of care to reduce use of health care services: A systematic review and meta-analysis VL - 186 ID - 233 ER - TY - JOUR AB - Objective: To evaluate the effectiveness and safety of dipeptidyl peptidase-4 (DPP-4) inhibitors versus intermediate-acting insulin for adults with type 2 diabetes mellitus (T2DM) and poor glycaemic control despite treatment with two oral agents. Setting: Studies were multicentre and multinational. Participants: Ten studies including 2967 patients with T2DM. Interventions: Studies that examined DPP-4 inhibitors compared with each other, intermediate-acting insulin, no treatment or placebo in patients with T2DM. Primary and secondary outcome measures: Primary outcome was glycosylated haemoglobin (HbA1c). Secondary outcomes were healthcare utilisation, body weight, fractures, quality of life, microvascular complications, macrovascular complications, all-cause mortality, harms, cost and cost-effectiveness. Results: 10 randomised clinical trials with 2967 patients were included after screening 5831 titles and abstracts, and 180 full-text articles. DPP-4 inhibitors significantly reduced HbA1c versus placebo in network meta-analysis (NMA; mean difference (MD) -0.62%, 95% CI -0.93% to -0.33%) and meta-analysis (MD -0.61%, 95% CI -0.81% to -0.41%), respectively. Significant differences in HbA1c were not observed for neutral protamine Hagedorn (NPH) insulin versus placebo and DPP-4 inhibitors versus NPH insulin in NMA. In meta-analysis, no significant differences were observed between DPP-4 inhibitors and placebo for severe hypoglycaemia, weight gain, cardiovascular disease, overall harms, treatment-related harms and mortality, although patients receiving DPP-4 inhibitors experienced less infections (relative risk 0.72, 95% CI 0.57 to 0.91). Conclusions: DPP-4 inhibitors were superior to placebo in reducing HbA1c levels in adults with T2DM taking at least two oral agents. Compared with placebo, no safety signals were detected with DPP-4 inhibitors and there was a reduced risk of infection. There was no significant difference in HbA1c observed between NPH and placebo or NPH and DPP-4 inhibitors. Trial registration number: PROSPERO # CRD42013003624. © 2014, BMJ Publishing Group. All rights reserved. AU - Tricco, A. C. AU - Antony, J. AU - Khan, P. A. AU - Ghassemi, M. AU - Hamid, J. S. AU - Ashoor, H. AU - Blondal, E. AU - Soobiah, C. AU - Yu, C. H. AU - Hutton, B. AU - Hemmelgarn, B. R. AU - Moher, D. AU - Majumdar, S. R. AU - Straus, S. E. DA - 2014-1-1 IS - 12 KW - Methionyl Aminopeptidases Leucyl Aminopeptidase Treatment Outcome Insulin, Isophane Insulin Incretins Hypoglycemic Agents Humans Hemoglobin A, Glycosylated Dipeptidyl-Peptidase IV Inhibitors Dipeptidyl Peptidase 4 Diabetes Mellitus, Type 2 metabolism comparative study blood systematic review randomized controlled trial (topic) quality of life outcome assessment non insulin dependent diabetes mellitus multicenter study (topic) mortality meta analysis insulin treatment human hemoglobin blood level health care utilization health care cost drug treatment failure drug safety drug efficacy diabetic microangiopathy cost effectiveness analysis body weight Article isophane insulin incretin glycosylated hemoglobin dipeptidyl peptidase IV inhibitor dipeptidyl peptidase IV antidiabetic agent vildagliptin sulfonylurea sitagliptin saxagliptin placebo oral antidiabetic agent metformin plus vildagliptin metformin plus sitagliptin linagliptin hemoglobin A1c PY - 2014 SN - 2044-6055 ST - Safety and effectiveness of dipeptidyl peptidase-4 inhibitors versus intermediate-acting insulin or placebo for patients with type 2 diabetes failing two oral antihyperglycaemic agents: A systematic review and network meta-analysis T2 - BMJ Open TI - Safety and effectiveness of dipeptidyl peptidase-4 inhibitors versus intermediate-acting insulin or placebo for patients with type 2 diabetes failing two oral antihyperglycaemic agents: A systematic review and network meta-analysis VL - 4 ID - 243 ER - TY - JOUR AB - Background: Numerous, often multi-faceted regimens are available for treating complex wounds, yet the evidence of these interventions is recondite across the literature. We aimed to identify effective interventions to treat complex wounds through an overview of systematic reviews. Methods: MEDLINE (OVID interface, 1946 until October 26, 2012), EMBASE (OVID interface, 1947 until October 26, 2012), and the Cochrane Database of Systematic Reviews (Issue 10 of 12, 2012) were searched on October 26, 2012. Systematic reviews that examined adults receiving care for their complex wounds were included. Two reviewers independently screened the literature, abstracted data, and assessed study quality using the Assessment of Multiple Systematic Reviews (AMSTAR) tool. Results: Overall, 99 systematic reviews were included after screening 6,200 titles and abstracts and 422 full-texts; 54 were systematic reviews with a meta-analysis (including data on over 54,000 patients) and 45 were systematic reviews without a meta-analysis. Overall, 44% of included reviews were rated as being of high quality (AMSTAR score ≥8). Based on data from systematic reviews including a meta-analysis with an AMSTAR score ≥8, promising interventions for complex wounds were identified. These included bandages or stockings (multi-layer, high compression) and wound cleansing for venous leg ulcers; four-layer bandages for mixed arterial/venous leg ulcers; biologics, ultrasound, and hydrogel dressings for diabetic leg/foot ulcers; hydrocolloid dressings, electrotherapy, air-fluidized beds, and alternate foam mattresses for pressure ulcers; and silver dressings and ultrasound for unspecified mixed complex wounds. For surgical wound infections, topical negative pressure and vacuum-assisted closure were promising interventions, but this was based on evidence from moderate to low quality systematic reviews. Conclusions: Numerous interventions can be utilized for patients with varying types of complex wounds, yet few treatments were consistently effective across all outcomes throughout the literature. Clinicians and patients can use our results to tailor effective treatment according to type of complex wound. Network meta-analysis will be of benefit to decision-makers, as it will permit multiple treatment comparisons and ranking of the effectiveness of all interventions. © Tricco et al.; licensee BioMed Central. AU - Tricco, A. C. AU - Antony, J. AU - Vafaei, A. AU - Khan, P. A. AU - Harrington, A. AU - Cogo, E. AU - Wilson, C. AU - Perrier, L. AU - Hui, W. AU - Straus, S. E. DA - 2015-1-1 IS - 1 KW - Electric Stimulation Therapy Wounds and Injuries Wound Healing Humans physiology wound care wound vein surgery vacuum assisted closure ulcer healing tissue engineering systematic review surgical infection skin transplantation silver dressing leg ulcer hydrogel dressing hydrocolloid dressing human foam mattress electrostimulation therapy echography diet supplementation diabetic foot decubitus compression therapy compression stocking complex wound biological dressing bibliographic database bed bandage Article air fluidized bed Wounds Ulcer Treatment Effectiveness PY - 2015 ST - Seeking effective interventions to treat complex wounds: An overview of systematic reviews T2 - BMC Medicine TI - Seeking effective interventions to treat complex wounds: An overview of systematic reviews VL - 13 ID - 210 ER - TY - JOUR AB - Objective To examine the safety, effectiveness, and cost effectiveness of long acting insulin for type 1 diabetes. Design Systematic review and network meta-analysis. Data sources Medline, Cochrane Central Register of Controlled Trials, Embase, and grey literature were searched through January 2013. Study selection Randomized controlled trials or non-randomized studies of long acting (glargine, detemir) and intermediate acting (neutral protamine Hagedorn (NPH), lente) insulin for adults with type 1 diabetes were included. Results 39 studies (27 randomized controlled trials including 7496 patients) were included after screening of 6501 titles/abstracts and 190 full text articles. Glargine once daily, detemir once daily, and detemir once/twice daily significantly reduced hemoglobin A1ccompared with NPH once daily in network meta-analysis (26 randomized controlled trials, mean difference-0.39%, 95% confidence interval-0.59% to-0.19%;-0.26%,-0.48% to-0.03%; and-0.36%,-0.65% to-0.08%; respectively). Differences in network meta-analysis were observed between long acting and intermediate acting insulin for severe hypoglycemia (16 randomized controlled trials; detemir once/twice daily versus NPH once/twice daily: odds ratio 0.62, 95% confidence interval 0.42 to 0.91) and weight gain (13 randomized controlled trials; detemir once daily versus NPH once/twice daily: mean difference 4.04 kg, 3.06 to 5.02 kg; detemir once/twice daily versus NPH once daily:-5.51 kg,-6.56 to-4.46 kg; glargine once daily versus NPH once daily:-5.14 kg,-6.07 to-4.21). Compared with NPH, detemir was less costly and more effective in 3/14 cost effectiveness analyses and glargine was less costly and more effective in 2/8 cost effectiveness analyses. The remaining cost effectiveness analyses found that detemir and glargine were more costly but more effective than NPH. Glargine was not cost effective compared with detemir in 2/2 cost effectiveness analyses. Conclusions Long acting insulin analogs are probably superior to intermediate acting insulin analogs, although the difference is small for hemoglobin A1c. Patients and their physicians should tailor their choice of insulin according to preference, cost, and accessibility. Systematic review registration PROSPERO CRD42013003610. AU - Tricco, A. C. AU - Ashoor, H. M. AU - Antony, J. AU - Beyene, J. AU - Veroniki, A. A. AU - Isaranuwatchai, W. AU - Harrington, A. AU - Wilson, C. AU - Tsouros, S. AU - Soobiah, C. AU - Yu, C. H. AU - Hutton, B. AU - Hoch, J. S. AU - Hemmelgarn, B. R. AU - Moher, D. AU - Majumdar, S. R. AU - Straus, S. E. DA - 2014-1-1 KW - Hydrocephalus, Normal Pressure Hemoglobin A, Glycosylated Insulin, Long-Acting Hypoglycemic Agents Humans Diabetes Mellitus, Type 1 Cost-Benefit Analysis economics cost benefit analysis comparative study weight gain uterus cancer transient ischemic attack systematic review randomized controlled trial (topic) quality of life pancreas cancer mortality meta analysis insulin dependent diabetes mellitus hypoglycemia hyperglycemia human heart infarction drug safety drug efficacy drug cost diabetic retinopathy cost effectiveness analysis cardiopulmonary arrest body weight disorder Article long acting insulin antidiabetic agent unclassified drug isophane insulin intermediate acting insulin insulin glargine insulin detemir insulin derivative hemoglobin A1c PY - 2014 ST - Safety, effectiveness, and cost effectiveness of long acting versus intermediate acting insulin for patients with type 1 diabetes: Systematic review and network meta-analysis T2 - BMJ (Online) TI - Safety, effectiveness, and cost effectiveness of long acting versus intermediate acting insulin for patients with type 1 diabetes: Systematic review and network meta-analysis VL - 349 ID - 234 ER - TY - JOUR AB - Background: Knowledge translation (KT, also known as research utilization, and sometimes referring to implementation science) is a dynamic and iterative process that includes the synthesis, dissemination, exchange, and ethically sound application of knowledge to improve health. A KT intervention is one which facilitates the uptake of research. The long-term sustainability of KT interventions is unclear. We aimed to characterize KT interventions to manage chronic diseases that have been used for healthcare outcomes beyond 1 year or beyond the termination of initial grant funding. Methods: We conducted a scoping review by searching MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Campbell from inception until February 2013. We included experimental, quasi-experimental, and observational studies providing information on the sustainability of KT interventions for managing chronic diseases in adults and focusing on end-users including patients, clinicians, public health officials, health service managers, and policy-makers. Articles were screened and abstracted by two reviewers, independently. The data were charted and results described narratively. Results: We included 62 studies reported in 103 publications (total 260,688 patients) plus 41 companion reports after screening 12,328 titles and abstracts and 464 full-text articles. More than half of the studies were randomized controlled trials (RCTs). The duration of the KT intervention ranged from 61 to 522 weeks. Nine chronic conditions were examined across the studies, such as diabetes (34 %), cardiovascular disease (28 %), and hypertension (16 %). Thirteen KT interventions were reported across the studies. Patient education was the most commonly examined (20 %), followed by self-management (17 %). Most studies (61 %) focused on patient-level outcomes (e.g. disease severity), while 31 % included system-level outcomes (e.g. number of eye examinations), and 8 % used both. The interventions were aimed at the patient (58 %), health system (28 %), and healthcare personnel (14 %) levels. Conclusions: We found few studies focusing on the sustainability of KT interventions. Most of the included studies focused on patient-level outcomes and patient-level KT interventions. A future systematic review can be conducted of the RCTs to examine the impact of sustainable KT interventions on health outcomes. © 2016 Tricco et al. AU - Tricco, A. C. AU - Ashoor, H. M. AU - Cardoso, R. AU - MacDonald, H. AU - Cogo, E. AU - Kastner, M. AU - Perrier, L. AU - McKibbon, A. AU - Grimshaw, J. M. AU - Straus, S. E. DA - 2016-1-1 IS - 1 KW - Translational Medical Research Humans Health Plan Implementation Delivery of Health Care Decision Making translational research human health care planning health care delivery Sustainability Self-management Quality improvement Patient education Maintenance Long-term Knowledge translation Implementation Healthcare utilization Adherence PY - 2016 SN - 1748-5908 ST - Sustainability of knowledge translation interventions in healthcare decision-making: A scoping review T2 - Implementation Science TI - Sustainability of knowledge translation interventions in healthcare decision-making: A scoping review VL - 11 ID - 181 ER - TY - JOUR AB - Background: Influenza vaccines are most effective when the antigens in the vaccine match those of circulating influenza strains. The extent to which the vaccine is protective when circulating strains differ from vaccine antigens, or are mismatched, is uncertain. We propose to systematically review the cross-protection offered by influenza vaccines against circulating influenza A or B viruses that are not antigenically well-matched to vaccine strains.Methods/Design: This is a protocol for a systematic review and meta-analysis. Placebo-controlled randomized clinical trials (RCTs) reporting laboratory-confirmed influenza among healthy participants vaccinated with antigens of influenza strains that differed from those circulating will be included. The primary outcome is the incidence of laboratory-confirmed influenza (polymerase chain reaction (PCR) or viral culture). The secondary outcome is the incidence of laboratory-confirmed influenza through antibody assay (a less sensitive test than PCR or viral culture) alone or combined with PCR, and/ or viral culture. The review will be limited to RCTs written in English.We will search MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, previous influenza reviews, and the reference lists of included studies to identify potentially relevant RCTs. Two independent reviewers will conduct all levels of screening, data abstraction, and quality appraisal (using the Cochrane risk of bias tool).If appropriate, random effects meta-analysis of vaccine efficacy will be conducted in SAS (version 9.2) by calculating the relative risk. Vaccine efficacy will be calculated using the following formula: (1 - relative risk × 100). The results will be analyzed by type of vaccine (live attenuated, trivalent inactivated, or other). Subgroup analysis will include the effects of age (children, adults, older participants), and influenza A versus influenza B on the results. For influenza B we will also consider variable degrees of antigenic mismatch (lineage and drift mismatch).Discussion: Our results can be used by researchers and policy-makers to help predict the efficacy of influenza vaccines during mismatched influenza seasons. Furthermore, the review will be of interest to patients and clinicians to determine whether to get immunized or support immunization for a particular influenza season. © 2012 Tricco et al.; licensee BioMed Central Ltd. AU - Tricco, A. C. AU - Chit, A. AU - Hallett, D. AU - Soobiah, C. AU - Meier, G. AU - Chen, M. AU - Tashkandi, M. AU - Bauch, C. AU - Loeb, M. DA - 2007-1-1 IS - 1 KW - Polymerase Chain Reaction Autoantigens Histocompatibility Antigens Class II Antigens, Viral, Tumor O Antigens Vaccination Review Literature as Topic Research Design Randomized Controlled Trials as Topic Orthomyxoviridae Meta-Analysis as Topic Influenza, Human Influenza Vaccines Humans virology randomized controlled trial (topic) Orthomyxovirus methodology meta analysis (topic) literature influenza immunology human article influenza vaccine Vaccines Systematic review Protocol Influenza B virus Influenza A virus Cross protection Antigenic variation PY - 2012 SN - 2046-4053 ST - Effect of influenza vaccines against mismatched strains: A systematic review protocol T2 - Systematic Reviews TI - Effect of influenza vaccines against mismatched strains: A systematic review protocol VL - 1 ID - 263 ER - TY - JOUR AB - Background: Epilepsy affects about 1% of the general population. Anti-epileptic drugs (AEDs) prevent or terminate seizures in individuals with epilepsy. Pregnant women with epilepsy may continue taking AEDs. Many of these agents cross the placenta and increase the risk of major congenital malformations, early cognitive and developmental delays, and infant mortality. We aim to evaluate the comparative safety of AEDs approved for chronic use in Canada when administered to pregnant and breastfeeding women and the effects on their infants and children through a systematic review and network meta-analysis. Methods: Studies examining the effects of AEDs administered to pregnant and breastfeeding women regardless of indication (e.g., epilepsy, migraine, pain, psychiatric disorders) on their infants and children will be included. We will include randomized clinical trials (RCTs), quasi-RCTs, non-RCTs, controlled before-after, interrupted time series, cohort, registry, and case-control studies. The main literature search will be executed in MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. We will seek unpublished literature through searches of trial protocol registries and conference abstracts. The literature search results screening, data abstraction, and risk of bias appraisal will be performed by two individuals, independently. Conflicts will be resolved through discussion. The risk of bias of experimental and quasi-experimental studies will be appraised using the Cochrane Effective Practice and Organization of Care Risk-of-Bias tool, methodological quality of observational studies will be appraised using the Newcastle-Ottawa Scale, and quality of reporting of safety outcomes will be conducted using the McMaster Quality Assessment Scale of Harms (McHarm) tool. If feasible and appropriate, we will conduct random effects meta-analysis. Network meta-analysis will be considered for outcomes that fulfill network meta-analysis assumptions. The primary outcome is major congenital malformations (overall and by specific types), while secondary outcomes include fetal loss/miscarriage, minor congenital malformations (overall and by specific types), cognitive development, psychomotor development, small for gestational age, preterm delivery, and neonatal seizures. Discussion: Our systematic review will address safety concerns regarding the use of AEDs during pregnancy and breastfeeding. Our results will be useful to healthcare providers, policy-makers, and women of childbearing age who are taking anti-epileptic medications. Systematic review registration: PROSPERO CRD42014008925. © 2014 Tricco et al.; licensee BioMed Central Ltd. AU - Tricco, A. C. AU - Cogo, E. AU - Angeliki, V. A. AU - Soobiah, C. AU - Hutton, B. AU - Hemmelgarn, B. R. AU - Moher, D. AU - Finkelstein, Y. AU - Straus, S. E. DA - 2015-1-1 IS - 1 KW - Seizures Registries Case-Control Studies Only Child Prenatal Exposure Delayed Effects Pregnancy Complications Pregnancy Infant Humans Female Epilepsy Child, Preschool Child Breast Feeding Anticonvulsants review preschool child prenatal exposure pregnancy complication chemically induced disorder systematic review spontaneous abortion small for date infant scientific literature randomized controlled trial (topic) psychomotor disorder priority journal prenatal drug exposure premature labor pregnant woman methodology meta analysis infantile spasm infant mortality human growth retardation fetus wastage drug safety congenital malformation cognitive development cognitive defect Canada Article anticonvulsive agent Network meta-analysis Fetus Comparative safety Breastfeeding Anti-epileptic drug PY - 2015 SN - 2046-4053 ST - Comparative safety of anti-epileptic drugs among infants and children exposed in utero or during breastfeeding: Protocol for a systematic review and network meta-analysis T2 - Systematic Reviews TI - Comparative safety of anti-epileptic drugs among infants and children exposed in utero or during breastfeeding: Protocol for a systematic review and network meta-analysis VL - 3 ID - 208 ER - TY - JOUR AB - Introduction: Knowledge translation (KT also known as research utilisation, translational medicine and implementation science) is a dynamic and iterative process that includes the synthesis, dissemination, exchange and ethically sound application of knowledge to improve health. After the implementation of KT interventions, their impact on relevant outcomes should be monitored. The objectives of this scoping review are to: (1) conduct a systematic search of the literature to identify the impact on healthcare outcomes beyond 1 year, or beyond the termination of funding of the initiative of KT interventions targeting chronic disease management for end-users including patients, clinicians, public health officials, health services managers and policy-makers; (2) identify factors that influence sustainability of effective KT interventions; (3) identify how sustained change from KT interventions should be measured; and (4) develop a framework for assessing sustainability of KT interventions. Methods and analysis: Comprehensive searches of relevant electronic databases (eg, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials), websites of funding agencies and websites of healthcare provider organisations will be conducted to identify relevant material. We will include experimental, quasiexperimental and observational studies providing information on the sustainability of KT interventions targeting chronic disease management in adults and focusing on end-users including patients, clinicians, public health officials, health services managers and policy-makers. Two reviewers will pilot-test the screening criteria and data abstraction form. They will then screen all citations, full articles and abstract data in duplicate independently. The results of the scoping review will be synthesised descriptively and used to develop a framework to assess the sustainability of KT interventions. Discussion and dissemination: Our results will help inform end-users (ie, patients, clinicians, public health officials, health services managers and policy-makers) regarding the sustainability of KT interventions. Our dissemination plan includes publications, presentations, website posting and a stakeholder meeting. AU - Tricco, A. C. AU - Cogo, E. AU - Ashoor, H. AU - Perrier, L. AU - McKibbon, K. A. AU - Grimshaw, J. M. AU - Straus, S. E. DA - 2013-1-1 IS - 5 KW - Decision Making Disease Management translational research systematic review sustainable development review quasi experimental study public health pilot study physician patient care outcome assessment observational study Medline medical decision making manager knowledge translation human health service health care utilization health care policy health care personnel health care organization health care Embase conceptual framework Cochrane Library clinical protocol clinical assessment PY - 2013 SN - 2044-6055 ST - Sustainability of knowledge translation interventions in healthcare decision-making: Protocol for a scoping review T2 - BMJ Open TI - Sustainability of knowledge translation interventions in healthcare decision-making: Protocol for a scoping review VL - 3 ID - 252 ER - TY - JOUR AB - Background: Complex wounds present a substantial economic burden on healthcare systems, costing billions of dollars annually in North America alone. The prevalence of complex wounds is a significant patient and societal healthcare concern and cost-effective wound care management remains unclear. This article summarizes the cost-effectiveness of interventions for complex wound care through a systematic review of the evidence base. Methods: We searched multiple databases (MEDLINE, EMBASE, Cochrane Library) for cost-effectiveness studies that examined adults treated for complex wounds. Two reviewers independently screened the literature, abstracted data from full-text articles, and assessed methodological quality using the Drummond 10-item methodological quality tool. Incremental cost-effectiveness ratios were reported, or, if not reported, calculated and converted to United States Dollars for the year 2013. Results: Overall, 59 cost-effectiveness analyses were included; 71% (42 out of 59) of the included studies scored 8 or more points on the Drummond 10-item checklist tool. Based on these, 22 interventions were found to be more effective and less costly (i.e., dominant) compared to the study comparators: 9 for diabetic ulcers, 8 for venous ulcers, 3 for pressure ulcers, 1 for mixed venous and venous/arterial ulcers, and 1 for mixed complex wound types. Conclusions: Our results can be used by decision-makers in maximizing the deployment of clinically effective and resource efficient wound care interventions. Our analysis also highlights specific treatments that are not cost-effective, thereby indicating areas of resource savings. © Tricco et al.; licensee BioMed Central. AU - Tricco, A. C. AU - Cogo, E. AU - Isaranuwatchai, W. AU - Khan, P. A. AU - Sanmugalingham, G. AU - Antony, J. AU - Hoch, J. S. AU - Straus, S. E. DA - 2015-1-1 IS - 1 KW - Wounds and Injuries North America Male Humans Female Cost-Benefit Analysis Adult economics cost benefit analysis wound healing wound care United States ulcer treatment outcome systematic review randomized controlled trial (topic) quality adjusted life year human diabetic foot decubitus cost of illness cost effectiveness analysis cost control Article Skin ulcer Research design Cost-effectiveness analysis Complex wound PY - 2015 ST - A systematic review of cost-effectiveness analyses of complex wound interventions reveals optimal treatments for specific wound types T2 - BMC Medicine TI - A systematic review of cost-effectiveness analyses of complex wound interventions reveals optimal treatments for specific wound types VL - 13 ID - 209 ER - TY - JOUR AB - Background The effectiveness of quality improvement (QI) strategies on diabetes care remains unclear. We aimed to assess the effects of QI strategies on glycated haemoglobin (HbA1c), vascular risk management, microvascular complication monitoring, and smoking cessation in patients with diabetes. Methods We identified studies through Medline, the Cochrane Effective Practice and Organisation of Care database (from inception to July 2010), and references of included randomised clinical trials. We included trials assessing 11 predefined QI strategies or financial incentives targeting health systems, health-care professionals, or patients to improve management of adult outpatients with diabetes. Two reviewers independently abstracted data and appraised risk of bias. Findings We reviewed 48 cluster randomised controlled trials, including 2538 clusters and 84 865 patients, and 94 patient randomised controlled trials, including 38 664 patients. In random effects meta-analysis, the QI strategies reduced HbA1c by a mean difference of 0·37% (95% CI 0·28-0·45; 120 trials), LDL cholesterol by 0·10 mmol/L (0·05-0.14; 47 trials), systolic blood pressure by 3·13 mm Hg (2·19-4·06, 65 trials), and diastolic blood pressure by 1·55 mm Hg (0·95-2·15, 61 trials) versus usual care. We noted larger effects when baseline concentrations were greater than 8·0% for HbA1c, 2·59 mmol/L for LDL cholesterol, and 80 mm Hg for diastolic and 140 mm Hg for systolic blood pressure. The effectiveness of QI strategies varied depending on baseline HbA1c control. QI strategies increased the likelihood that patients received aspirin (11 trials; relative risk [RR] 1·33, 95% CI 1·21-1·45), antihypertensive drugs (ten trials; RR 1·17, 1·01-1·37), and screening for retinopathy (23 trials; RR 1·22, 1·13-1·32), renal function (14 trials; RR 128, 1·13-1·44), and foot abnormalities (22 trials; RR 1·27, 1·16-1·39). However, statin use (ten trials; RR 1·12, 0·99-1·28), hypertension control (18 trials; RR 1·01, 0·96-1·07), and smoking cessation (13 trials; RR 1·13, 0·99-1·29) were not significantly increased. Interpretation: Many trials of QI strategies showed improvements in diabetes care. Interventions targeting the system of chronic disease management along with patient-mediated QI strategies should be an important component of interventions aimed at improving diabetes management. Interventions solely targeting health-care professionals seem to be beneficial only if baseline HbA1c control is poor. AU - Tricco, A. C. AU - Ivers, N. M. AU - Grimshaw, J. M. AU - Moher, D. AU - Turner, L. AU - Galipeau, J. AU - Halperin, I. AU - Vachon, B. AU - Ramsay, T. AU - Manns, B. AU - Tonelli, M. AU - Shojania, K. DA - 2012-1-1 IS - 9833 KW - Smoking Smoking Cessation Qi Smoke total quality management systolic blood pressure systematic review screening risk management review randomized controlled trial (topic) priority journal meta analysis Medline hypertension human diastolic blood pressure diabetic retinopathy diabetes mellitus Cochrane Library clinical effectiveness cardiovascular risk antihypertensive therapy low density lipoprotein cholesterol hydroxymethylglutaryl coenzyme A reductase inhibitor hemoglobin A1c antihypertensive agent acetylsalicylic acid PY - 2012 SP - 2252-2261 ST - Effectiveness of quality improvement strategies on the management of diabetes: A systematic review and meta-analysis T2 - The Lancet TI - Effectiveness of quality improvement strategies on the management of diabetes: A systematic review and meta-analysis VL - 379 ID - 261 ER - TY - JOUR AB - Background: Scoping reviews are used to identify knowledge gaps, set research agendas, and identify implications for decision-making. The conduct and reporting of scoping reviews is inconsistent in the literature. We conducted a scoping review to identify: Papers that utilized and/or described scoping review methods; guidelines for reporting scoping reviews; and studies that assessed the quality of reporting of scoping reviews. Methods: We searched nine electronic databases for published and unpublished literature scoping review papers, scoping review methodology, and reporting guidance for scoping reviews. Two independent reviewers screened citations for inclusion. Data abstraction was performed by one reviewer and verified by a second reviewer. Quantitative (e.g. frequencies of methods) and qualitative (i.e. content analysis of the methods) syntheses were conducted. Results: After searching 1525 citations and 874 full-text papers, 516 articles were included, of which 494 were scoping reviews. The 494 scoping reviews were disseminated between 1999 and 2014, with 45 % published after 2012. Most of the scoping reviews were conducted in North America (53 %) or Europe (38 %), and reported a public source of funding (64 %). The number of studies included in the scoping reviews ranged from 1 to 2600 (mean of 118). Using the Joanna Briggs Institute methodology guidance for scoping reviews, only 13 % of the scoping reviews reported the use of a protocol, 36 % used two reviewers for selecting citations for inclusion, 29 % used two reviewers for full-text screening, 30 % used two reviewers for data charting, and 43 % used a pre-defined charting form. In most cases, the results of the scoping review were used to identify evidence gaps (85 %), provide recommendations for future research (84 %), or identify strengths and limitations (69 %). We did not identify any guidelines for reporting scoping reviews or studies that assessed the quality of scoping review reporting. Conclusion: The number of scoping reviews conducted per year has steadily increased since 2012. Scoping reviews are used to inform research agendas and identify implications for policy or practice. As such, improvements in reporting and conduct are imperative. Further research on scoping review methodology is warranted, and in particular, there is need for a guideline to standardize reporting. © 2016 Tricco et al. AU - Tricco, A. C. AU - Lillie, E. AU - Zarin, W. AU - O'Brien, K. AU - Colquhoun, H. AU - Kastner, M. AU - Levac, D. AU - Ng, C. AU - Sharpe, J. P. AU - Wilson, K. AU - Kenny, M. AU - Warren, R. AU - Wilson, C. AU - Stelfox, H. T. AU - Straus, S. E. DA - 2016-1-1 IS - 1 KW - Systematic review Scoping reviews Reporting Methods Knowledge synthesis PY - 2016 SN - 1471-2288 ST - A scoping review on the conduct and reporting of scoping reviews T2 - BMC Medical Research Methodology TI - A scoping review on the conduct and reporting of scoping reviews VL - 16 ID - 23 ER - TY - JOUR AB - Background: Failure to sustain knowledge translation (KT) interventions impacts patients and health systems, diminishing confidence in future implementation. Sustaining KT interventions used to implement chronic disease management (CDM) interventions is of critical importance given the proportion of older adults with chronic diseases and their need for ongoing care. Our objectives are to (1) complete a systematic review and network meta-analysis of the effectiveness and cost-effectiveness of sustainability of KT interventions that target CDM for end-users including older patients, clinicians, public health officials, health services managers and policy-makers on health care outcomes beyond 1 year after implementation or the termination of initial project funding and (2) use the results of this review to complete an economic analysis of the interventions identified to be effective. Methods: For objective 1, comprehensive searches of relevant electronic databases (e.g. MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials), websites of health care provider organisations and funding agencies will be conducted. We will include randomised controlled trials (RCTs) examining the impact of a KT intervention targeting CDM in adults aged 65 years and older. To examine cost, economic studies (e.g. cost, cost-effectiveness analyses) will be included. Our primary outcome will be the sustainability of the delivery of the KT intervention beyond 1 year after implementation or termination of study funding. Secondary outcomes will include behaviour changes at the level of the patient (e.g. symptom management) and clinician (e.g. physician test ordering) and health system (e.g. cost, hospital admissions). Article screening, data abstraction and risk of bias assessment will be completed independently by two reviewers. Using established methods, if the assumption of transitivity is valid and the evidence forms a connected network, Bayesian random-effects pairwise and network meta-analysis will be conducted. For objective 2, we will build a decision analytic model comparing effective interventions to estimate an incremental cost-effectiveness ratio. Discussion: Our results will inform knowledge users (e.g. patients, clinicians, policy-makers) regarding the sustainability of KT interventions for CDM. Dissemination plan of our results will be tailored to end-users and include passive (e.g. publications, website posting) and interactive (e.g. knowledge exchange events with stakeholders) strategies. © 2018 The Author(s). AD - Li Ka Shing Knowledge Institute, St. Michael's Hospital, Knowledge Translation Program, 209 Victoria Street, Toronto, ON M5B 1W8, Canada Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada Canadian Partnership Against Cancer, 1 University Avenue, Toronto, ON M5J 2P1, Canada Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, MO 63130, United States Department of Surgery, Alvin J. Siteman Cancer Center, Washington University, School of Medicine, Washington University in St. Louis, 660 S. Euclid Avenue, St. Louis, MO 63110, United States National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, United States Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, ON M5S 3M2, Canada Department of Family Medicine, David Braley Health Sciences Centre, McMaster University, 100 Main Street West, Hamilton, ON L8P 1H6, Canada Health Quality Ontario, 130 Bloor Street West, Toronto, ON M5S 1N5, Canada Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, K1G 5Z3, Canada Ottawa Hospital Research Institute, 501 Smyth Road, Box 711, Ottawa, ON K1H 8L6, Canada Departments of Medicine and Community Health Sciences, University of Calgary, TRW Building, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada Michael Smith Foundation for Health Research (MSFHR), 200 - 1285 West Broadway, Vancouver, BC V6H 3X8, Canada Département de Médecine Sociale et Préventive, Faculté de Médecine, Université Laval Pavillon Ferdinand-Vandry, 1050, Avenue de la Médecine, Québec, QC G1V 0A6, Canada Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec, 1050, chemin Sainte-Foy, Québec, QC G1S 4L8, Canada Department of Medicine, University of Alberta, 13-103 Clinical Sciences Building, 11350-83 Avenue, Edmonton, AB T6G 2G3, Canada School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada Departments of Critical Care Medicine, Medicine and Community Health Sciences, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada Department of Family Medicine, Maastricht University, CAPHRI Care, Public Health Research Institute, Universiteitssingel 40, Maastricht, 6229 ER, Netherlands Department of Geriatric Medicine, University of Toronto, 27 Kings College Circle, Toronto, ON M5S 1A1, Canada AU - Tricco, A. C. AU - Moore, J. E. AU - Beben, N. AU - Brownson, R. C. AU - Chambers, D. A. AU - Dolovich, L. R. AU - Edwards, A. AU - Fairclough, L. AU - Glasziou, P. P. AU - Graham, I. D. AU - Hemmelgarn, B. R. AU - Holmes, B. AU - Isaranuwatchai, W. AU - Lachance, C. C. AU - Legare, F. AU - McGowan, J. AU - Majumdar, S. R. AU - Presseau, J. AU - Squires, J. E. AU - Stelfox, H. T. AU - Strifler, L. AU - Thompson, K. AU - Van Der Weijden, T. AU - Veroniki, A. A. AU - Straus, S. E. C2 - 30219107 C7 - 140 DB - Scopus DO - 10.1186/s13643-018-0808-4 IS - 1 KW - Chronic disease management Integrated knowledge translation Knowledge translation Older adults Sustainability artificial neural network Bayes theorem behavior change caregiver chronic disease cluster analysis conceptual framework construct validity cost effectiveness analysis cumulative scale depression diabetes mellitus disease severity assessment evaluation and follow up exercise genetic heterogeneity health care organization health care planning health care policy health service human interpersonal communication intervention study knowledge life sustaining treatment medical personnel medical society meta analysis motivational interviewing priority journal program sustainability protocol compliance public health regression analysis research Review sensitivity analysis stakeholder engagement systematic review taxonomy aged cost benefit analysis disease management network meta-analysis procedures translational research Cost-Benefit Analysis Humans Translational Medical Research LA - English M3 - Review PY - 2018 ST - Sustaining knowledge translation interventions for chronic disease management in older adults: Protocol for a systematic review and network meta-analysis 11 Medical and Health Sciences 1117 Public Health and Health Services 14 Economics 1402 Applied Economics T2 - Systematic Reviews TI - Sustaining knowledge translation interventions for chronic disease management in older adults: Protocol for a systematic review and network meta-analysis 11 Medical and Health Sciences 1117 Public Health and Health Services 14 Economics 1402 Applied Economics VL - 7 ID - 407 ER - TY - JOUR AB - Background: Oncogenic human papillomavirus (HPV) infection prevalence is required to determine optimal vaccination strategies. We systematically reviewed the prevalence of oncogenic cervical HPV infection among Canadian females prior to immunization.Methods: We included studies reporting DNA-confirmed oncogenic HPV prevalence estimates among Canadian females identified through searching electronic databases (e.g., MEDLINE) and public health websites. Two independent reviewers screened literature results, abstracted data and appraised study quality. Prevalence estimates were meta-analyzed among routine screening populations, HPV-positive, and by cytology/histology results.Results: Thirty studies plus 21 companion reports were included after screening 837 citations and 120 full-text articles. Many of the studies did not address non-response bias (74%) or use a representative sampling strategy (53%).Age-specific prevalence was highest among females aged < 20 years and slowly declined with increasing age. Across all populations, the highest prevalence estimates from the meta-analyses were observed for HPV types 16 (routine screening populations, 8 studies: 8.6% [95% confidence interval 6.5-10.7%]; HPV-infected, 9 studies: 43.5% [28.7-58.2%]; confirmed cervical cancer, 3 studies: 48.8% [34.0-63.6%]) and 18 (routine screening populations, 8 studies: 3.3% [1.5-5.1%]; HPV-infected, 9 studies: 13.6% [6.1-21.1%], confirmed cervical cancer, 4 studies: 17.1% [6.4-27.9%].Conclusion: Our results support vaccinating females < 20 years of age, along with targeted vaccination of some groups (e.g., under-screened populations). The highest prevalence occurred among HPV types 16 and 18, contributing a combined cervical cancer prevalence of 65.9%. Further cancer protection is expected from cross-protection of non-vaccine HPV types. Poor study quality and heterogeneity suggests that high-quality studies are needed. © 2011 Tricco et al; licensee BioMed Central Ltd. AU - Tricco, A. C. AU - Ng, C. H. AU - Gilca, V. AU - Anonychuk, A. AU - Pham, B. AU - Berliner, S. C2 - 21892939 C7 - 235 DB - Scopus DO - 10.1186/1471-2334-11-235 KW - Bethesda system Cervical cancer Human papillomavirus Meta-analysis Systematic review age distribution aging article Canada cancer screening human Human papillomavirus type 16 Human papillomavirus type 18 nonhuman oncogenic cervical human papillomavirus infection papillomavirus infection prevalence statistical analysis uterine cervicitis uterine cervix cancer adolescent adult aged classification female genetics genotype immunology isolation and purification meta analysis middle aged Papilloma virus pathogenicity review uterine cervix tumor utilization review vaccination virology virus DNA Wart virus vaccine Aged, 80 and over DNA, Viral Humans Papillomaviridae Papillomavirus Infections Papillomavirus Vaccines Uterine Cervical Neoplasms Young Adult M3 - Article PY - 2011 ST - Canadian oncogenic human papillomavirus cervical infection prevalence: Systematic review and meta-analysis T2 - BMC Infectious Diseases TI - Canadian oncogenic human papillomavirus cervical infection prevalence: Systematic review and meta-analysis VL - 11 ID - 323 ER - TY - JOUR AB - Background Unprofessional behaviour is a challenge in academic medicine. Given that faculty are role models for trainees, it is critical to identify strategies to manage these behaviours. A scoping review was conducted to identify interventions to prevent and manage unprofessional behaviour in any workplace or professional setting. Methods A search of 14 electronic databases was conducted in March 2016, reference lists of relevant systematic reviews were scanned, and grey literature was searched to identify relevant studies. Experimental and quasi-experimental studies that reported on interventions to prevent or manage unprofessional behaviours were included. Studies that reported impact on any outcome were eligible. Two reviewers independently screened articles and completed data abstraction. Qualitative analysis of the definitions of unprofessional behaviour was conducted. Data were charted to describe the study, participant, intervention and outcome characteristics. Results 12,482 citations were retrieved; 23 studies with 11,025 participants were included. The studies were 12 uncontrolled before and after studies, 6 controlled before and after studies, 2 cluster-randomised controlled trials (RCTs), 1 RCT, 1 non-randomised controlled trial and 1 quasi-RCT. Four constructs were identified in the definitions of unprofessional behaviour: verbal and/or non-verbal acts, repeated acts, power imbalance, and unwelcome behaviour. Interventions most commonly targeted individuals (22 studies, 95.7%) rather than organisations (4 studies, 17.4%). Most studies (21 studies, 91.3%) focused on increasing awareness. The most frequently targeted behaviour change was sexual harassment (4 of 7 studies). Discussion Several interventions appear promising in addressing unprofessional behaviour. Most of the studies included single component, in-person education sessions targeting individuals and increasing awareness of unprofessional behaviour. Fewer studies targeted the institutional culture or addressed behaviour change. © 2018 Tricco et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. AD - Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada Department of Medicine, University of Toronto, Toronto, ON, Canada AU - Tricco, A. C. AU - Rios, P. AU - Zarin, W. AU - Cardoso, R. AU - Diaz, S. AU - Nincic, V. AU - Mascarenhas, A. AU - Jassemi, S. AU - Straus, S. E. C2 - 30048512 C7 - e0201187 DB - Scopus DO - 10.1371/journal.pone.0201187 IS - 7 KW - adult article awareness behavior change education female human human experiment male organization qualitative analysis quasi experimental study randomized controlled trial (topic) sexual harassment systematic review workplace human relation professional misconduct Humans Interpersonal Relations LA - English M3 - Article PY - 2018 ST - Prevention and management of unprofessional behaviour among adults in the workplace: A scoping review T2 - PLoS ONE TI - Prevention and management of unprofessional behaviour among adults in the workplace: A scoping review VL - 13 ID - 408 ER - TY - JOUR AB - Background: Cognitive enhancers, including cholinesterase inhibitors and memantine, are used to treat dementia, but their effectiveness for mild cognitive impairment is unclear. We conducted a systematic review to examine the efficacy and safety of cognitive enhancers for mild cognitive impairment. Methods: Our eligibility criteria were studies of the effects of donepezil, rivastigmine, galantamine or memantine on mild cognitive impairment reporting cognition, function, behaviour, global status, and mortality or harms. We identified relevant material by searching electronic databases (e.g., MEDLINE, Embase), the references of included studies, trial registries and conference proceedings, and by contacting experts. Two reviewers independently screened the results of the literature search, abstracted data and appraised risk of bias using the Cochrane risk-of-bias tool. Results: We screened 15 554 titles and ab - stracts and 1384 full-text articles. Eight randomized clinical trials and 3 companion reports met our inclusion criteria. We found no significant effects of cognitive enhancers on cognition (Mini-Mental State Examination: 3 randomized clinical trials [RCTs], mean difference [MD] 0.14, 95% confidence interval [CI] -0.22 to 0.50; Alzheimer's Disease Assessment Scale - cognition subscale: 3 RCTs, standardized MD -0.07, 95% CI-0.16 to 0.01]) or function (Alzheimer's Disease Cooperative Study activities of daily living inventory: 2 RCTs, MD 0.30, 95% CI -0.26 to 0.86). Cognitive enhancers were associated with higher risks of nausea, diarrhea and vomiting than placebo. Interpretation: Cognitive enhancers did not improve cognition or function among patients with mild cognitive impairment and were associated with a greater risk of gastrointestinal harms. Our findings do not support the use of cognitive enhancers for mild cognitive impairment. © 2013 Canadian Medical Association or its licensors. AU - Tricco, A. C. AU - Soobiah, C. AU - Berliner, S. AU - Ho, J. M. AU - Ng, C. H. AU - Ashoor, H. M. AU - Chen, M. H. AU - Hemmelgarn, B. AU - Straus, S. E. DA - 2013-1-1 IS - 16 KW - Alzheimer Disease Memantine Cognition Nootropic Agents PY - 2013 SP - 1393-1401 ST - Efficacy and safety of cognitive enhancers for patients with mild cognitive impairment: A systematic review and meta-analysis T2 - CMAJ TI - Efficacy and safety of cognitive enhancers for patients with mild cognitive impairment: A systematic review and meta-analysis VL - 185 ID - 21 ER - TY - JOUR AB - Background: Patients may experience nausea and vomiting when undergoing chemotherapy or surgery requiring anesthesia. Serotonin 5-hydroxytryptamine 3 (5-HT3) receptor antagonists are effective antiemetics, yet may cause adverse cardiac events, such as arrhythmia. We aimed to identify interventions that mitigate the cardiac risk of 5-HT3 receptor antagonists. Methods: Electronic databases, trial registries, and references were searched. Studies on patients undergoing chemotherapy or surgery examining interventions to monitor cardiac risk of 5-HT3 receptor antagonists were included. Search results were screened and data from relevant studies were abstracted in duplicate. Risk of bias of included studies was assessed using the Cochrane Effective Practice and Organisation of Care (EPOC) group's risk-of-bias tool. Due to a dearth of included studies, meta-analysis was not conducted. Results: Two randomized clinical trials (RCT) and 1 non-randomized clinical trial (NRCT) were included after screening 7,637 titles and abstracts and 1,554 full-text articles. Intravenous administration of different dolasetron doses was examined in the NRCT, while dolasetron versus ondansetron and palonosetron versus ondansetron were examined in the RCT. Electrocardiogram (ECG) was the only intervention examined to mitigate cardiac harm. No differences in ECG evaluations were observed between dolasetron or palonosetron versus ondansetron after 15 minutes, 24 hours, and 1 week post-administration in the 2 RCTs. Four deaths were observed in one RCT, which were deemed unrelated to palonosetron or ondansetron administration. Minor increases in PR and QT intervals were observed in the NRCT for dolasetron dosages greater than 1.2 mg/kg 1-2 hours post-administration, but were deemed not clinically relevant. Conclusions: ECG monitoring of chemotherapy patients administered with 5-HT3 receptor antagonists did not reveal clinically significant differences in arrhythmia between the medications at the examined time periods. The usefulness of ECG to monitor chemotherapy patients administered with 5-HT3 receptor antagonists remains unclear, as all patients received ECG monitoring. © 2015 Tricco et al.; licensee BioMed Central. AU - Tricco, A. C. AU - Soobiah, C. AU - Hui, W. AU - Antony, J. AU - Struchkov, V. AU - Hutton, B. AU - Hemmelgarn, B. AU - Moher, D. AU - Straus, S. E. DA - 2015-1-1 IS - 1 KW - Serotonin 5-HT3 Receptor Antagonists Quinuclidines Quinolizines Ondansetron Isoquinolines Indoles Humans Electrocardiography Drug Therapy, Combination Arrhythmias, Cardiac Antineoplastic Agents Antiemetics drug effects combination drug therapy chemically induced adverse effects systematic review stomach cancer small cell lung cancer risk reduction rectum cancer randomized controlled trial (topic) PY - 2015 SN - 2050-6511 ST - Interventions to decrease the risk of adverse cardiac events for patients receiving chemotherapy and serotonin (5-HT3) receptor antagonists: A systematic review T2 - BMC Pharmacology and Toxicology TI - Interventions to decrease the risk of adverse cardiac events for patients receiving chemotherapy and serotonin (5-HT3) receptor antagonists: A systematic review VL - 16 ID - 216 ER - TY - JOUR AB - Background: Elderly individuals who have memory problems without significant limitations in activities of daily living are often diagnosed as having mild cognitive impairment (MCI). Some of these individuals progress to dementia. Several cognitive enhancers (for example donepezil, galantamine, rivastigmine, memantine) have been approved for use in people with Alzheimer's dementia but their use in patients with MCI is unclear. We aimed to determine the comparative effectiveness, safety, and cost of cognitive enhancers for MCI through a systematic review and network (that is, indirect comparisons) meta-analysis.Design/Methods: We will include studies that examine the use of cognitive enhancers compared to placebo, supportive care, or other cognitive enhancers among patients diagnosed with MCI. Outcomes of interest include cognition and function (primary outcomes), as well as behavior, quality of life, safety, and cost (secondary outcomes). We will include all experimental studies (randomized controlled trials, quasi-randomized controlled trials, controlled clinical trials), quasi-experimental studies (controlled before-after, interrupted time series), and observational studies (cohort, case-control). Studies will be included regardless of publication status (that is, we will include unpublished studies), year, or language of dissemination.To identify potentially relevant material, we will search the following electronic databases from inception onwards: MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, and Ageline. The electronic database search will be supplemented by scanning the reference lists of included studies, searching Google and organization websites for unpublished or difficult to locate material literature, and contacting experts.Two reviewers will independently screen the studies for inclusion using the eligibility criteria established a priori and independently extract data. Risk of bias will be assessed using the Cochrane Risk of Bias tool for experimental and quasi-experimental studies and the Newcastle Ottawa Scale for observational epidemiology studies. Meta-analysis and network meta-analysis are planned, if the studies are deemed statistically, methodologically, and clinically homogenous.Discussion: Our systematic review will provide important information regarding the benefits, costs, and harms of cognitive enhancers for patients with MCI. This information can be used to assist healthcare providers, policy-makers, MCI patients and their family regarding the use of these agents.PROSPERO registry number: CRD42012002234. © 2012 Tricco et al.; licensee BioMed Central Ltd. AU - Tricco, A. C. AU - Soobiah, C. AU - Lillie, E. AU - Perrier, L. AU - Chen, M. H. AU - Hemmelgarn, B. AU - Majumdar, S. R. AU - Straus, S. E. DA - 2012-1-1 IS - 1 KW - Alzheimer Disease Dementia Cognition Nootropic Agents PY - 2012 SN - 2046-4053 ST - Use of cognitive enhancers for mild cognitive impairment: Protocol for a systematic review and network meta-analysis T2 - Systematic Reviews TI - Use of cognitive enhancers for mild cognitive impairment: Protocol for a systematic review and network meta-analysis VL - 1 ID - 22 ER - TY - JOUR AB - Objective: To compare the safety and effectiveness of long-acting β-antagonists (LABA), long-acting antimuscarinic agents (LAMA) and inhaled corticosteroids (ICS) for managing chronic obstructive pulmonary disease (COPD). Setting: Systematic review and network meta-analysis (NMA). Participants: 208 randomised clinical trials (RCTs) including 134 692 adults with COPD. Interventions: LABA, LAMA and/or ICS, alone or in combination, versus each other or placebo. Primary and secondary outcomes: The proportion of patients with moderate-to-severe exacerbations. The number of patients experiencing mortality, pneumonia, serious arrhythmia and cardiovascular-related mortality (CVM) were secondary outcomes. Results: NMA was conducted including 20 RCTs for moderate-to-severe exacerbations for 26 141 patients with an exacerbation in the past year. 32 treatments were effective versus placebo including: tiotropium, budesonide/formoterol, salmeterol, indacaterol, fluticasone/salmeterol, indacaterol/glycopyrronium, tiotropium/fluticasone/salmeterol and tiotropium/budesonide/formoterol. Tiotropium/budesonide/formoterol was most effective (99.2% probability of being the most effective according to the Surface Under the Cumulative RAnking (SUCRA) curve). NMA was conducted on mortality (88 RCTs, 97 526 patients); fluticasone/salmeterol was more effective in reducing mortality than placebo, formoterol and fluticasone alone, and was the most effective (SUCRA=71%). NMA was conducted on CVM (37 RCTs, 55 156 patients) and the following were safest: salmeterol versus each OF placebo, tiotropium and tiotropium (Soft Mist Inhaler (SMR)); fluticasone versus tiotropium (SMR); and salmeterol/fluticasone versus tiotropium and tiotropium (SMR). Triamcinolone acetonide was the most harmful (SUCRA=81%). NMA was conducted on pneumonia occurrence (54 RCTs, 61 551 patients). 24 treatments were more harmful, including 2 that increased risk of pneumonia versus placebo; fluticasone and fluticasone/salmeterol. The most harmful agent was fluticasone/salmeterol (SUCRA=89%). NMA was conducted for arrhythmia; no statistically significant differences between agents were identified. Conclusions: Many inhaled agents are available for COPD, some are safer and more effective than others. Our results can be used by patients and physicians to tailor administration of these agents. AU - Tricco, A. C. AU - Strifler, L. AU - Veroniki, A. A. AU - Yazdi, F. AU - Khan, P. A. AU - Scott, A. AU - Ng, C. AU - Antony, J. AU - Mrklas, K. AU - D'Souza, J. AU - Cardoso, R. AU - Straus, S. E. DA - 2015-1-1 IS - 10 KW - Lung Diseases Lung Diseases, Obstructive Randomized Controlled Trials as Topic Pulmonary Disease, Chronic Obstructive Muscarinic Antagonists Humans Disease Progression Adrenergic beta-2 Receptor Agonists Adrenal Cortex Hormones Administration, Inhalation mortality inhalational drug administration disease course classification systematic review risk factor Review randomized controlled trial (topic) pneumonia outcome assessment meta analysis human heart arrhythmia drug safety drug efficacy disease exacerbation comparative study clinical trial (topic) chronic obstructive lung disease cardiovascular mortality bibliographic database muscarinic receptor blocking agent corticosteroid beta 2 adrenergic receptor stimulating agent triamcinolone acetonide tiotropium bromide salmeterol placebo long acting drug indacaterol glycopyrronium bromide formoterol fluticasone budesonide beta adrenergic receptor blocking agent PY - 2015 SN - 2044-6055 ST - Comparative safety and effectiveness of long-acting inhaled agents for treating chronic obstructive pulmonary disease: A systematic review and network meta-analysis T2 - BMJ Open TI - Comparative safety and effectiveness of long-acting inhaled agents for treating chronic obstructive pulmonary disease: A systematic review and network meta-analysis VL - 5 ID - 223 ER - TY - JOUR AB - Objective To compare the efficacy, effectiveness, and safety of the herpes zoster live attenuated vaccine with the herpes zoster adjuvant recombinant subunit vaccine or placebo for adults aged 50 and older. Design Systematic review with Bayesian meta-analysis and network meta-analysis. Data sources Medline, Embase, and Cochrane Library (inception to January 2017), grey literature, and reference lists of included studies. Eligibility criteria for study selection Experimental, quasi-experimental, and observational studies that compared the live attenuated vaccine with the adjuvant recombinant subunit vaccine, placebo, or no vaccine in adults aged 50 and older. Relevant outcomes were incidence of herpes zoster (primary outcome), herpes zoster ophthalmicus, post-herpetic neuralgia, quality of life, adverse events, and death. Results 27 studies (22 randomised controlled trials) including 2 044 504 patients, along with 18 companion reports, were included after screening 2037 titles and abstracts, followed by 175 full text articles. Network meta-analysis of five randomised controlled trials found no statistically significant differences between the live attenuated vaccine and placebo for incidence of laboratory confirmed herpes zoster. The adjuvant recombinant subunit vaccine, however, was statistically superior to both the live attenuated vaccine (vaccine efficacy 85%, 95% credible interval 31% to 98%) and placebo (94%, 79% to 98%). Network meta-analysis of 11 randomised controlled trials showed the adjuvant recombinant subunit vaccine to be associated with statistically more adverse events at injection sites than the live attenuated vaccine (relative risk 1.79, 95% credible interval 1.05 to 2.34; risk difference 30%, 95% credible interval 2% to 51%) and placebo (5.63, 3.57 to 7.29 and 53%, 30% to 73%, respectively). Network meta-analysis of nine randomised controlled trials showed the adjuvant recombinant subunit vaccine to be associated with statistically more systemic adverse events than placebo (2.28, 1.45 to 3.65 and 20%, 6% to 40%, respectively). Conclusions Using the adjuvant recombinant subunit vaccine might prevent more cases of herpes zoster than using the live attenuated vaccine, but the adjuvant recombinant subunit vaccine also carries a greater risk of adverse events at injection sites. © 2018 Published by the BMJ Publishing Group Limited. AD - Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, 209 Victoria Street, Toronto, ON M5B 1W8, Canada Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada Division of Infectious Diseases, Mount Sinai Hospital, Joseph and Wolf Lebovic Health Complex, Toronto, ON, Canada Department of Medicine, University of Toronto, Toronto, ON, Canada St Michael's Hospital, Toronto, ON, Canada AU - Tricco, A. C. AU - Zarin, W. AU - Cardoso, R. AU - Veroniki, A. A. AU - Khan, P. A. AU - Nincic, V. AU - Ghassemi, M. AU - Warren, R. AU - Sharpe, J. P. AU - Page, A. V. AU - Straus, S. E. C2 - 30361202 C7 - k4029 DB - Scopus DO - 10.1136/bmj.k4029 KW - live vaccine placebo recombinant vaccine subunit vaccine varicella zoster vaccine immunological adjuvant adult Article clinical effectiveness clinical protocol data base drug efficacy drug safety headache herpes zoster herpes zoster ophthalmicus human incidence injection site reaction meta analysis mortality myalgia network meta-analysis postherpetic neuralgia priority journal quality of life randomized controlled trial (topic) risk assessment statistical analysis systematic review treatment outcome vaccination aged chemistry elderly care female male middle aged Adjuvants, Immunologic Health Services for the Aged Herpes Zoster Vaccine Humans Vaccines, Attenuated LA - English M3 - Article PY - 2018 ST - Efficacy, effectiveness, and safety of herpes zoster vaccines in adults aged 50 and older: Systematic review and network meta-analysis T2 - BMJ (Online) TI - Efficacy, effectiveness, and safety of herpes zoster vaccines in adults aged 50 and older: Systematic review and network meta-analysis VL - 363 ID - 409 ER - TY - JOUR AB - Background: A scoping review to characterize the literature on the use of conversations in social media as a potential source of data for detecting adverse events (AEs) related to health products. Methods: Our specific research questions were (1) What social media listening platforms exist to detect adverse events related to health products, and what are their capabilities and characteristics? (2) What is the validity and reliability of data from social media for detecting these adverse events? MEDLINE, EMBASE, Cochrane Library, and relevant websites were searched from inception to May 2016. Any type of document (e.g., manuscripts, reports) that described the use of social media data for detecting health product AEs was included. Two reviewers independently screened citations and full-texts, and one reviewer and one verifier performed data abstraction. Descriptive synthesis was conducted. Results: After screening 3631 citations and 321 full-texts, 70 unique documents with 7 companion reports available from 2001 to 2016 were included. Forty-six documents (66%) described an automated or semi-automated information extraction system to detect health product AEs from social media conversations (in the developmental phase). Seven pre-existing information extraction systems to mine social media data were identified in eight documents. Nineteen documents compared AEs reported in social media data with validated data and found consistent AE discovery in all except two documents. None of the documents reported the validity and reliability of the overall system, but some reported on the performance of individual steps in processing the data. The validity and reliability results were found for the following steps in the data processing pipeline: data de-identification (n = 1), concept identification (n = 3), concept normalization (n = 2), and relation extraction (n = 8). The methods varied widely, and some approaches yielded better results than others. Conclusions: Our results suggest that the use of social media conversations for pharmacovigilance is in its infancy. Although social media data has the potential to supplement data from regulatory agency databases; is able to capture less frequently reported AEs; and can identify AEs earlier than official alerts or regulatory changes, the utility and validity of the data source remains under-studied. Trial registration: Open Science Framework (https://osf.io/kv9hu/). © 2018 The Author(s). AU - Tricco, A. C. AU - Zarin, W. AU - Lillie, E. AU - Jeblee, S. AU - Warren, R. AU - Khan, P. A. AU - Robson, R. AU - Pham, B. AU - Hirst, G. AU - Straus, S. E. DA - 2018-1-1 IS - 1 KW - Social Media Intelligence validity synthesis reliability registration publication pipeline Medline infancy human experiment human extraction Embase drug surveillance program drug safety conversation Cochrane Library clinical article article Surveillance Knowledge synthesis Data analytics Adverse event PY - 2018 ST - Utility of social media and crowd-intelligence data for pharmacovigilance: A scoping review T2 - BMC Medical Informatics and Decision Making TI - Utility of social media and crowd-intelligence data for pharmacovigilance: A scoping review VL - 18 ID - 48 ER - TY - JOUR AB - Introduction Adverse events associated with medications are under-reported in postmarketing surveillance systems. A systematic review of published data from 37 studies worldwide (including Canada) found the median under-reporting rate of adverse events to be 94% in spontaneous reporting systems. This scoping review aims to assess the utility of social media and crowd-sourced data to detect and monitor adverse events related to health products including pharmaceuticals, medical devices, biologics and natural health products. Methods and analysis Our review conduct will follow the Joanna Briggs Institute scoping review methods manual. Literature searches were conducted in MEDLINE, EMBASE and the Cochrane Library from inception to 13 May 2016. Additional sources included searches of study registries, conference abstracts, dissertations, as well as websites of international regulatory authorities (eg, Food and Drug Administration (FDA), the WHO, European Medicines Agency). Search results will be supplemented by scanning the references of relevant reviews. We will include all publication types including published articles, editorials, websites and book sections that describe use of social media and crowd-sourced data for surveillance of adverse events associated with health products. Two reviewers will perform study selection and data abstraction independently, and discrepancies will be resolved through discussion. Data analysis will involve quantitative (eg, frequencies) and qualitative (eg, content analysis) methods. Dissemination The summary of results will be sent to Health Canada, who commissioned the review, and other relevant policymakers involved with the Drug Safety and Effectiveness Network. We will compile and circulate a 1-page policy brief and host a 1-day stakeholder meeting to discuss the implications, key messages and finalise the knowledge translation strategy. Findings from this review will ultimately inform the design and development of a data analytics platform for social media and crowd-sourced data for pharmacovigilance in Canada and internationally. Registration details Our protocol was registered prospectively with the Open Science Framework (https://osf.io/kv9hu/). � 2017 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/. AU - Tricco, A. C. AU - Zarin, W. AU - Lillie, E. AU - Pham, B. AU - Straus, S. E. DA - 2017-1-1 IS - 1 KW - Canada Crowding Social Media Pharmacovigilance Medical Errors Humans Crowdsourcing utilization prevention and control medical error world health organization systematic review (topic) systematic review study design risk assessment register randomized controlled trial (topic) meta analysis (topic) Medline medical device information dissemination human food and drug administration Embase drug surveillance program controlled clinical trial (topic) Cochrane Library clinical trial (topic) authority Article surveillance scoping review data analytics adverse event PY - 2017 SN - 2044-6055 ST - Utility of social media and crowd-sourced data for pharmacovigilance: A scoping review protocol T2 - BMJ Open TI - Utility of social media and crowd-sourced data for pharmacovigilance: A scoping review protocol VL - 7 ID - 107 ER - TY - JOUR AB - Background: It is unclear how to engage a wide range of knowledge users in research. We aimed to map the evidence on engaging knowledge users with an emphasis on policy-makers, health system managers, and policy analysts in the knowledge synthesis process through a scoping review. Methods: We used the Joanna Briggs Institute guidance for scoping reviews. Nine electronic databases (e.g., MEDLINE), two grey literature sources (e.g., OpenSIGLE), and reference lists of relevant systematic reviews were searched from 1996 to August 2016. We included any type ofstudy describing strategies, barriers and facilitators, or assessing the impactofengaging policy-makers, health system managers, and policy analysts in the knowledge synthesis process. Screening and data abstraction were conducted by two reviewers independently with a third reviewer resolving discrepancies. Frequency and thematic analyses were conducted. Results: After screening 8395 titles and abstracts followed by 394 full-texts, 84 unique documents and 7 companion reports fulfilled our eligibility criteria. All 84 documents were published in the last 10years, and half were prepared in North America. The most common type of knowledge synthesis with knowledgeuser engagement was a systematic review (36%). The knowledge synthesismost commonly addressed an issue at the level of national healthcare system (48%) and focused on health services delivery (17%) in high-income countries (86%). Policy-makers were the most common (64%) knowledge users, followed by healthcare professionals (49%) and government agencies as well as patients and caregivers (34%). Knowledge users were engaged in conceptualization and design (49%), literaturesearch and data collection (52%), data synthesis and interpretation (71%), and knowledge dissemination and application (44%). Knowledge users were most commonly engaged as key informants through meetings and workshops as well as surveys, focus groups, and interviews either in-person or by telephone and emails. Knowledgeuser content expertise/awareness was a common facilitator (18%), while lack of time or opportunity to participate was a common barrier (12%). Conclusions: Knowledge users were most commonly engaged during the data synthesis and interpretation phases of theknowledge synthesis conduct. Researchers should document and evaluate knowledgeuser engagement in knowledge synthesis. Registration details: Open Science Framework ( https://osf.io/4dy53/ ). © 2018 The Author(s). AU - Tricco, A. C. AU - Zarin, W. AU - Rios, P. AU - Nincic, V. AU - Khan, P. A. AU - Ghassemi, M. AU - Diaz, S. AU - Pham, B. AU - Straus, S. E. AU - Langlois, E. V. DA - 2018-1-1 IS - 1 KW - Stakeholder Policy-relevant Policy-maker Knowledge user Knowledge translation Knowledge synthesis Health system Health policy Engagement PY - 2018 SN - 1748-5908 ST - Engaging policy-makers, heath system managers, and policy analysts in the knowledge synthesis process: A scoping review T2 - Implementation Science TI - Engaging policy-makers, heath system managers, and policy analysts in the knowledge synthesis process: A scoping review VL - 13 ID - 59 ER - TY - JOUR AB - Introduction: Engaging policymakers, healthcare managers and policy analysts in the conduct of knowledge synthesis can help increase its impact. This is particularly important for knowledge synthesis studies commissioned by decision-makers with limited timelines, as well as reviews of health policy and systems research. A scoping review will be conducted to assess barriers, facilitators, strategies and outcomes of engaging these individuals in the knowledge synthesis process. Methods and analysis: We will follow the Joanna Briggs Institute guidance for scoping reviews. Literature searches of electronic databases (eg, MEDLINE, EMBASE, Cochrane Library, ERIC, PsycINFO) will be conducted from inception onwards. The electronic search will be supplemented by searching for sources that index unpublished/difficult to locate studies (eg, GreyNet International database), as well as through scanning of reference lists of reviews on related topics. All study designs using either qualitative or quantitative methodologies will be eligible if there is a description of the strategies, barriers or facilitators, and outcomes of engaging policymakers, healthcare managers and policy analysts in the knowledge synthesis process. Screening and data abstraction will be conducted by 2 team members independently after a calibration exercise across the team. A third team member will resolve all discrepancies. We will conduct frequency analysis and thematic analysis to chart and characterise the literature, identifying data gaps and opportunities for future research, as well as implications for policy. Ethics and dissemination: This project was commissioned by the Alliance for Health Policy and Systems Research, WHO. The results will be used by Alliance Review Centers of health policy and systems research in low-income and middle-income countries that are conducting knowledge synthesis to inform health policymaking and decision-making. Our results will also be disseminated through conference presentations, train-The-Trainer events, peer-reviewed publication and a 1-page policy brief that will be posted on the authors' websites. AU - Tricco, A. C. AU - Zarin, W. AU - Rios, P. AU - Pham, B. AU - Straus, S. E. AU - Langlois, E. V. DA - 2016-1-1 IS - 12 KW - Stakeholder Participation Research Design Research Policy Making Knowledge Humans Health Services Administration Health Policy Decision Making stakeholder engagement methodology management health service health care policy thematic analysis systematic review synthesis study design screening publication PsycINFO middle income country Medline manager lowest income group human frequency analysis exercise ethics Embase doctor patient relation Cochrane Library calibration PY - 2016 SN - 2044-6055 ST - Barriers, facilitators, strategies and outcomes to engaging policymakers, healthcare managers and policy analysts in knowledge synthesis: A scoping review protocol T2 - BMJ Open TI - Barriers, facilitators, strategies and outcomes to engaging policymakers, healthcare managers and policy analysts in knowledge synthesis: A scoping review protocol VL - 6 ID - 115 ER - TY - JOUR AB - Background: Little is known about the mechanisms that influence the success or failure of programs to facilitate re-engagement with health and social services for formerly incarcerated persons with HIV. This review aims to identify how interventions to address such transitions work, for whom and under what circumstances. Methods: We will use realist review methodology to conduct our analysis. We will systematically search electronic databases and grey literature for English language qualitative and quantitative studies of interventions. Two investigators will independently screen citations and full-text articles, abstract data, appraise study quality and synthesize the literature. Data analysis will include identifying context-mechanism-outcome configurations, exploring and comparing patterns in these configurations, making comparisons across contexts and developing explanatory frameworks. Discussion: This review will identify mechanisms that influence the success or failure of transition interventions for formerly incarcerated individuals with HIV. The findings will be integrated with those from complementary qualitative and quantitative studies to inform future interventions. Systematic review registration: PROSPERO CRD42016040054 � 2017 The Author(s). AU - Tsang, J. AU - Mishra, S. AU - Rowe, J. AU - O'Campo, P. AU - Ziegler, C. AU - Kouyoumdjian, F. G. AU - Matheson, F. I. AU - Bayoumi, A. M. AU - Zahid, S. AU - Antoniou, T. DA - 2017-1-1 IS - 1 KW - HIV-1 Transitional Care Review Literature as Topic Prisoners Humans HIV Infections prisoner organization and management literature Human immunodeficiency virus infection systematic review (topic) social work registration priority journal mental health information processing Human immunodeficiency virus human conceptual framework Article Realist review Post-prison Intervention HIV PY - 2017 SN - 2046-4053 ST - Transitional care for formerly incarcerated persons with HIV: Protocol for a realist review T2 - Systematic Reviews TI - Transitional care for formerly incarcerated persons with HIV: Protocol for a realist review VL - 6 ID - 156 ER - TY - JOUR AB - Background: Overweight and obesity is a major public health concern that includes associations with the development of cardiovascular disease (CVD) risk factors during childhood and adolescence as well as premature mortality in adults. Despite the high prevalence of childhood and adolescent obesity as well as adult CVD, individual studies as well as previous systematic reviews examining the relationship between childhood obesity and adult CVD have yielded conflicting results. The purpose of this study was to use the aggregate data meta-analytic approach to address this gap. Methods: Studies were included if they met the following criteria: (1) longitudinal and cohort studies (including case-cohort), (2) childhood exposure and adult outcomes collected on the same individual over time, (3) childhood obesity, as defined by the original study authors, (4) English-language articles, (5) studies published up to June, 2015, (6) one or more of the following CVD risk factors [systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), non-high-density lipoprotein cholesterol (non-HDL), and triglycerides (TG)], (7) outcome(s) not self-reported, and (8) exposure measurements (child's adiposity) assessed by health professionals, trained investigators, or self-reported. Studies were retrieved by searching three electronic databases as well as citation tracking. Fisher's r to z score was calculated for each study for each outcome. Pooled effect sizes were calculated using random-effects models while risk of bias was assessed using the STROBE instrument. In order to try and identify sources of heterogeneity, random-effects meta-regression was also performed. Results: Of the 4840 citations reviewed, a total of 23 studies were included in the systematic review and 21 in the meta-analysis. The findings suggested that childhood obesity is significantly and positively associated with adult SBP (Zr = 0.11; 95% CI: 0.07, 0.14), DBP (Zr = 0.11; 95% CI: 0.07, 0.14), and TG (Zr =0.08; 95% CI: 0.03, 0.13), and significantly and inversely associated with adult HDL (Zr = -0.06; 95% CI: -0.10, -0.02). For those studies that adjusted for adult body mass index (BMI), associations were reversed, suggesting that adult BMI may be a potential mediator. Nine studies had more than 33% of items that placed them at an increased risk for bias. Conclusions: The results of this study suggest that childhood obesity may be a risk factor for selected adult CVD risk factors. However, a need exists for additional, higher-quality studies that include, but are not limited to, both unadjusted and adjusted measures such as BMI before any definitive conclusions can be reached. Systematic review and meta-analysis: PROSPERO 2015: CRD42015019763. © 2017 The Author(s). AU - Umer, A. AU - Kelley, G. A. AU - Cottrell, L. E. AU - Giacobbi, P., Jr. AU - Innes, K. E. AU - Lilly, C. L. DA - 2017-1-1 IS - 1 KW - Bias (Epidemiology) Triglycerides Risk Factors Pediatric Obesity Overweight Mortality, Premature Humans Cohort Studies Cholesterol, LDL Cholesterol, HDL Child Cardiovascular Diseases Body Mass Index Blood Pressure Adult Adolescent Adiposity risk factor premature mortality obesity mortality meta analysis human complication cohort analysis childhood obesity cardiovascular disease body mass blood triacylglycerol low density lipoprotein cholesterol high density lipoprotein cholesterol Systematic review Meta-analysis Children Adults PY - 2017 ST - Childhood obesity and adult cardiovascular disease risk factors: A systematic review with meta-analysis T2 - BMC Public Health TI - Childhood obesity and adult cardiovascular disease risk factors: A systematic review with meta-analysis VL - 17 ID - 144 ER - TY - JOUR AB - Objectives: To evaluate response-inducing strategies for observational studies using health-related questionnaires or interviews. Study Design and Setting: We searched PubMed, EMBASE, CINAHL, PsycINFO, and Web of Science up to December 28, 2017. Studies evaluating the effect of a response-inducing strategy on participation rates of observational studies were included. For each strategy, we estimated pooled response ratios with 95% confidence intervals (CIs) in a Hartung-Knapp/Sidik-Jonkman random effects model with the final participation rate as outcome, stratified for type of participants and method of data collection. Results: The search yielded 168 eligible studies involving 367,616 potential participants and 33 strategies. Among patients, response-inducing strategies for paper-based questionnaires included unconditional monetary incentives (response ratio 1.15; 95% CI 1.09–1.21) and shorter questionnaires (1.04; 1.02–1.06). Among nonpatients, a personalized mode of delivery (1.47; 1.24–1.74), more expensive mailing type (1.25; 1.00–1.56), unconditional monetary incentives (1.24; 1.12–1.38), prenotification (1.12; 1.03–1.22), unconditional scratch lottery tickets (1.09; 1.01–1.18), and shorter questionnaires (1.06; 1.02–1.11) increased response rates to paper-based questionnaires. For Web-based questionnaires and interviews among nonpatients, response rates were increased by conditional lottery tickets (1.17; 1.02–1.34) and conditional monetary incentives (1.39; 1.01–1.91), respectively. Conclusion: Although the majority of strategies evaluated were unsuccessful, some may increase response rates to observational studies, particularly among nonpatients. © 2018 Elsevier Inc. AU - van Gelder, M. M. H. J. AU - Vlenterie, R. AU - IntHout, J. AU - Engelen, L. J. L. P. G. AU - Vrieling, A. AU - van de Belt, T. H. DA - 2018-1-1 %J Journal of Clinical Epidemiology KW - Questionnaires PY - 2018 SP - 1-13 ST - Most response-inducing strategies do not increase participation in observational studies: a systematic review and meta-analysis T2 - Journal of Clinical Epidemiology TI - Most response-inducing strategies do not increase participation in observational studies: a systematic review and meta-analysis VL - 99 ID - 277 ER - TY - JOUR AB - Summary background data Hepatic sinusoidal dilatation (SD) is a histopathological entity that occurs in up to 75% of patients undergoing oxaliplatin-based chemotherapy for colorectal liver metastases (CRLM). Objective To study the influence of SD on outcome after partial hepatectomy in patients with CRLM. Methods Medline, Embase, CENTRAL, LILACS and CINAHL were searched for studies published between 01.01.2004 and 09.06.2015 with keywords: "sinusoidal obstruction syndrome", "hepatic veno-occlusive disease", and "Stuart-Bras syndrome". Studies comprising adults who underwent partial hepatectomy for CRLM with grading of SD and registration of postoperative morbidity and/or mortality were included. Risk of bias and quality of studies were evaluated with the Quality In Prognosis Studies Instrument (QUIPS) and modified GRADE framework. Results Search strategies produced 2007 hits from which 23 and 13 articles were extracted for qualitative and quantitative analyses, respectively. Meta-analysis on the influence of SD grade 2-3 vs. SD grade 0-1 on postoperative overall morbidity showed an odds ratio (OR) of 1.26 [95% CI 0.74, 2.15](p = 0.40), an OR of 1.03 [0.15, 6.89](p = 0.98) for liver failure, an OR of 1.21 [0.23, 6.35](p = 0.82) for overall mortality, and an OR of 3.52 [0.31, 39.91](p = 0.31) for liver-related morbidity. QUIPS showed a low to high risk of bias for studies, and GRADE showed very low quality of evidence per outcome. Conclusions No significant effect of SD grade 2-3 on short-term outcome after partial hepatectomy was found. However, the data on which this conclusion was based were not very robust and therefore no solid conclusions could be drawn. © 2016 Elsevier Ltd All rights reserved. AU - Van Mierlo, K. M. C. AU - Zhao, J. AU - Kleijnen, J. AU - Rensen, S. S. AU - Schaap, F. G. AU - Dejong, C. H. C. AU - Olde Damink, S. W. M. DB - Scopus DO - 10.1016/j.suronc.2016.05.030 IS - 3 M3 - Article PY - 2016 SP - 298-307 ST - The influence of chemotherapy-associated sinusoidal dilatation on short-term outcome after partial hepatectomy for colorectal liver metastases: A systematic review with meta-analysis T2 - Surgical Oncology TI - The influence of chemotherapy-associated sinusoidal dilatation on short-term outcome after partial hepatectomy for colorectal liver metastases: A systematic review with meta-analysis VL - 25 ID - 339 ER - TY - JOUR AB - Background Type 1 diabetes is a condition in which the pancreas produces little or no insulin. People with type 1 diabetes must manage their blood glucose levels by monitoring the amount of glucose in their blood and administering appropriate amounts of insulin via injection or an insulin pump. Continuous glucose monitoring may be beneficial compared to self-monitoring of blood glucose using a blood glucose meter. It provides insight into a person’s blood glucose levels on a continuous basis, and can identify whether blood glucose levels are trending up or down. Methods We conducted a health technology assessment, which included an evaluation of clinical benefit, value for money, and patient preferences related to continuous glucose monitoring. We compared continuous glucose monitoring with self-monitoring of blood glucose using a finger-prick and a blood glucose meter. We performed a systematic literature search for studies published since January 1, 2010. We created a Markov model projecting the lifetime horizon of adults with type 1 diabetes, and performed a budget impact analysis from the perspective of the health care payer. We also conducted interviews and focus group discussions with people who self-manage their type 1 diabetes or support the management of a child with type 1 diabetes. Results Twenty studies were included in the clinical evidence review. Compared with self-monitoring of blood glucose, continuous glucose monitoring improved the percentage of time patients spent in the target glycemic range by 9.6% (95% confidence interval 8.0–11.2) to 10.0% (95% confidence interval 6.75–13.25) and decreased the number of severe hypoglycemic events. Continuous glucose monitoring was associated with higher costs and small increases in health benefits (quality-adjusted life-years). Incremental cost-effectiveness ratios (ICERs) ranged from $592,206 to $1,108,812 per quality-adjusted life-year gained in analyses comparing four continuous glucose monitoring interventions to usual care. However, the uncertainty around the ICERs was large. The net budget impact of publicly funding continuous glucose monitoring assuming a 20% annual increase in adoption of continuous glucose monitoring would range from $8.5 million in year 1 to $16.2 million in year 5. Patient engagement surrounding the topic of continuous glucose monitoring was robust. Patients perceived that these devices provided important social, emotional, and medical and safety benefits in managing type 1 diabetes, especially in children. Conclusions Continuous glucose monitoring was more effective than self-monitoring of blood glucose in managing type 1 diabetes for some outcomes, such as time spent in the target glucose range and time spent outside the target glucose range (moderate certainty in this evidence). We were less certain that continuous glucose monitoring would reduce the number of severe hypoglycemic events. Compared with self-monitoring of blood glucose, the costs of continuous glucose monitoring were higher, with only small increases in health benefits. Publicly funding continuous glucose monitoring for the type 1 diabetes population in Ontario would result in additional costs to the health system over the next 5 years. Adult patients and parents of children with type 1 diabetes reported very positive experiences with continuous glucose monitoring. The high ongoing cost of continuous glucose monitoring devices was seen as the greatest barrier to their widespread use. © Queen's Printer for Ontario, 2018. All rights reserved. AU - Vandersluis, Stacey AU - Kabali, Conrad AU - Sandjar, Djalalov AU - Gajic-Veljanoski, Olga AU - Wells, David AU - Holubowich, Corinne AU - Harrison, Susan AU - McKane, Jeanne AU - Stahl, Kara AU - Mohamed, Merissa AU - Soulodre, Claude AU - Kaulback, Kellee AU - Clement, Alison AU - Laing, Ana AU - Mitchell, Andrée AU - Ng, Vivian AU - McDowell, Sarah AU - Thota, Anil AU - Sikich, Nancy AU - Dhalla, Irfan DA - 2018-1-1 IS - 2 KW - Biomedical Technology Quality-Adjusted Life Years Ontario Only Child Hypoglycemic Agents Blood Glucose Self-Monitoring Blood Glucose Technology Assessment, Biomedical unconsciousness Short Form 36 sensitivity analysis self monitoring seizure risk reduction reimbursement quality of life assessment quality adjusted life year prick test Pediatric Quality of Life Inventory patient satisfaction occult blood test mortality rate leg amputation insulin dependent diabetes mellitus hypoglycemia human hospitalization hidden Markov model health equity health care cost glucose blood level glomerulus filtration rate funding end stage renal disease economic evaluation diabetic retinopathy diabetic neuropathy diabetic nephropathy cost utility analysis cost effectiveness analysis continuous glucose monitoring cardiovascular disease Canada budget blood glucose monitoring blindness biomedical technology assessment Article area under the curve insulin glucose LA - English PY - 2018 SN - 1915-7398 SP - 1-160 ST - Ontario health technology assessment series: Continuous monitoring of glucose for type 1 diabetes: A health technology assessment T2 - Ontario Health Technology Assessment Series TI - Ontario health technology assessment series: Continuous monitoring of glucose for type 1 diabetes: A health technology assessment VL - 18 ID - 27 ER - TY - JOUR AB - Purpose We conducted a systematic review to critically appraise and synthesize literature on the effectiveness of work disability prevention (WDP) interventions in workers with neck pain, whiplash-associated disorders (WAD), or upper extremity disorders. Methods We searched electronic databases from 1990 to 2012. Random pairs of independent reviewers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria. Scientifically admissible studies were summarized and synthesized following best-evidence synthesis methodology. Results Of the 6,359 articles retrieved, 16 randomized controlled trials were eligible for critical appraisal and five were admissible. We found that a return-to-work coordination program (including workplace-based work hardening) was superior to clinic-based work hardening for persistent rotator cuff tendinitis. Workplace high-intensity strength training and workplace advice had similar outcomes for neck and shoulder pain. Mensendieck/Cesar postural exercises and strength and fitness exercises had similar outcomes for non-specific work-related upper limb complaints. Adding a brief job stress education program to a workplace ergonomic intervention was not beneficial for persistent upper extremity symptoms. Adding computer-prompted work breaks to ergonomic adjustments and workplace education benefited workers’ recovery from recent work-related neck and upper extremity complaints. Conclusions At present, no firm conclusions can be drawn regarding the effectiveness of WDP interventions for managing neck pain, WAD, and upper extremity disorders. Our review suggests a return-to-work coordination program is more effective than clinic-based work hardening. Also, adding computer-prompted breaks to ergonomic and workplace interventions benefits workers’ recovery. The current quality of evidence does not allow for a definitive evaluation of the effectiveness of ergonomic interventions. © 2014, Springer Science+Business Media New York. AU - Varatharajan, S. AU - Côté, P. AU - Shearer, H. M. AU - Loisel, P. AU - Wong, J. J. AU - Southerst, D. AU - Yu, H. AU - Randhawa, K. AU - Sutton, D. AU - van der Velde, G. AU - Mior, S. AU - Carroll, L. J. AU - Jacobs, C. AU - Taylor-Vaisey, A. DA - 2014-1-1 IS - 4 KW - Whiplash Injuries Upper Extremity Shoulder Pain Return to Work Resistance Training Randomized Controlled Trials as Topic Occupational Health Occupational Diseases Neck Pain Humans randomized controlled trial (topic) human complication arm Work disability prevention interventions Whiplash-associated disorders Upper extremity disorders Treatment Systematic review Neck pain and associated disorders PY - 2014 SN - 1053-0487 1573-3688 SP - 692-708 ST - Are Work Disability Prevention Interventions Effective for the Management of Neck Pain or Upper Extremity Disorders? A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration T2 - Journal of Occupational Rehabilitation TI - Are Work Disability Prevention Interventions Effective for the Management of Neck Pain or Upper Extremity Disorders? A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration VL - 24 ID - 248 ER - TY - JOUR AB - Purpose: To update findings of the 2000–2010 Bone and Joint Decade Task Force on Neck Pain and its Associated Disorders and evaluate the effectiveness of non-invasive and non-pharmacological interventions for the management of patients with headaches associated with neck pain (i.e., tension-type, cervicogenic, or whiplash-related headaches). Methods: We searched five databases from 1990 to 2015 for randomized controlled trials (RCTs), cohort studies, and case–control studies comparing non-invasive interventions with other interventions, placebo/sham, or no interventions. Random pairs of independent reviewers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria to determine scientific admissibility. Studies with a low risk of bias were synthesized following best evidence synthesis principles. Results: We screened 17,236 citations, 15 studies were relevant, and 10 had a low risk of bias. The evidence suggests that episodic tension-type headaches should be managed with low load endurance craniocervical and cervicoscapular exercises. Patients with chronic tension-type headaches may also benefit from low load endurance craniocervical and cervicoscapular exercises; relaxation training with stress coping therapy; or multimodal care that includes spinal mobilization, craniocervical exercises, and postural correction. For cervicogenic headaches, low load endurance craniocervical and cervicoscapular exercises; or manual therapy (manipulation with or without mobilization) to the cervical and thoracic spine may also be helpful. Conclusions: The management of headaches associated with neck pain should include exercise. Patients who suffer from chronic tension-type headaches may also benefit from relaxation training with stress coping therapy or multimodal care. Patients with cervicogenic headache may also benefit from a course of manual therapy. © 2016, Springer-Verlag Berlin Heidelberg. AU - Varatharajan, S. AU - Ferguson, B. AU - Chrobak, K. AU - Shergill, Y. AU - Côté, P. AU - Wong, J. J. AU - Yu, H. AU - Shearer, H. M. AU - Southerst, D. AU - Sutton, D. AU - Randhawa, K. AU - Jacobs, C. AU - Abdulla, S. AU - Woitzik, E. AU - Marchand, A. A. AU - van der Velde, G. AU - Carroll, L. J. AU - Nordin, M. AU - Ammendolia, C. AU - Mior, S. AU - Ameis, A. AU - Stupar, M. AU - Taylor-Vaisey, A. DA - 2016-1-1 IS - 7 KW - Tension-Type Headache Neck Pain Systematic review Non-invasive interventions Headache attributed to whiplash injury Cervicogenic headache PY - 2016 SP - 1971-1999 ST - Are non-invasive interventions effective for the management of headaches associated with neck pain? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration T2 - European Spine Journal TI - Are non-invasive interventions effective for the management of headaches associated with neck pain? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration VL - 25 ID - 9 ER - TY - JOUR AB - Background: Insight into the quality of health care is important for any stakeholder including patients, professionals, and governments. In light of a patient-centered approach, it is essential to assess the quality of health care from a patient's perspective, which is commonly done with surveys or focus groups. Unfortunately, these "traditional" methods have significant limitations that include social desirability bias, a time lag between experience and measurement, and difficulty reaching large groups of people. Information on social media could be of value to overcoming these limitations, since these new media are easy to use and are used by the majority of the population. Furthermore, an increasing number of people share health care experiences online or rate the quality of their health care provider on physician rating sites. The question is whether this information is relevant to determining or predicting the quality of health care. Objective: The goal of our research was to systematically analyze the relation between information shared on social media and quality of care. Methods: We performed a scoping review with the following goals: (1) to map the literature on the association between social media and quality of care, (2) to identify different mechanisms of this relationship, and (3) to determine a more detailed agenda for this relatively new research area. A recognized scoping review methodology was used. We developed a search strategy based on four themes: social media, patient experience, quality, and health care. Four online scientific databases were searched, articles were screened, and data extracted. Results related to the research question were described and categorized according to type of social media. Furthermore, national and international stakeholders were consulted throughout the study, to discuss and interpret results. Results: Twenty-nine articles were included, of which 21 were concerned with health care rating sites. Several studies indicate a relationship between information on social media and quality of health care. However, some drawbacks exist, especially regarding the use of rating sites. For example, since rating is anonymous, rating values are not risk adjusted and therefore vulnerable to fraud. Also, ratings are often based on only a few reviews and are predominantly positive. Furthermore, people providing feedback on health care via social media are presumably not always representative for the patient population. Conclusions: Social media and particularly rating sites are an interesting new source of information about quality of care from the patient's perspective. This new source should be used to complement traditional methods, since measuring quality of care via social media has other, but not less serious, limitations. Future research should explore whether social media are suitable in practice for patients, health insurers, and governments to help them judge the quality performance of professionals and organizations. AU - Verhoef, L. M. AU - Van De Belt, T. H. AU - Engelen, L. AU - Schoonhoven, L. AU - Kool, R. B. DA - 2014-1-1 %J Journal of Medical Internet Research IS - 2 KW - Social Media Quality of Health Care PY - 2014 ST - Social media and rating sites as tools to understanding quality of care: A scoping review T2 - Journal of Medical Internet Research TI - Social media and rating sites as tools to understanding quality of care: A scoping review VL - 16 ID - 302 ER - TY - JOUR AB - Background Nearly all newly infected children acquire Human Immunodeficiency virus (HIV) via mother-to-child transmission (MTCT) during pregnancy, labour or breastfeeding from untreated HIV-positive mothers. Antiretroviral therapy (ART) is the standard care for pregnant women with HIV. However, evidence of ART effectiveness and harms in infants and children of HIV-positive pregnant women exposed to ART has been largely inconclusive. The aim of our systematic review and network meta-analysis (NMA) was to evaluate the comparative safety and effectiveness of ART drugs in children exposed to maternal HIV and ART (or no ART/placebo) across different study designs. Methods We searched MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (inception until December 7, 2015). Primary outcomes were any congenital malformations (CMs; safety), including overall major and minor CMs, and mother-to-child transmission (MTCT; effectiveness). Random-effects Bayesian pairwise meta-analyses and NMAs were conducted. After screening 6,468 citations and 1,373 full-text articles, 90 studies of various study designs and 90,563 patients were included. Results The NMA on CMs (20 studies, 7,503 children, 16 drugs) found that none of the ART drugs examined here were associated with a significant increase in CMs. However, zidovudine administered with lamivudine and indinavir was associated with increased risk of preterm births, zidovudine administered with nevirapine was associated with increased risk of stillbirths, and lamivudine administered with stavudine and efavirenz was associated with increased risk of low birth weight. A NMA on MTCT (11 studies, 10,786 patients, 6 drugs) found that zidovudine administered once (odds ratio [OR] = 0.39, 95% credible interval [CrI]: 0.19–0.83) or twice (OR = 0.43, 95% CrI: 0.21–0.68) was associated with significantly reduced risk of MTCT. Conclusions Our findings suggest that ART drugs are not associated with an increased risk of CMs, yet some may increase adverse birth events. Some ART drugs (e.g., zidovudine) effectively reduce MTCT. © 2018 Veroniki et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. AD - Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada Department of Medicine, University of Toronto, Toronto, ON, Canada Hospital for Sick Children, Toronto, ON, Canada Department of Paediatrics, University of Toronto, Toronto, ON, Canada Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada Ottawa Hospital Research Institute, Center for Practice Changing Research, Ottawa Hospital, General Campus, Ottawa, ON, Canada Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, AB, Canada Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada AU - Veroniki, A. A. AU - Antony, J. AU - Straus, S. E. AU - Ashoor, H. M. AU - Finkelstein, Y. AU - Khan, P. A. AU - Ghassemi, M. AU - Blondal, E. AU - Ivory, J. D. AU - Hutton, B. AU - Gough, K. AU - Hemmelgarn, B. R. AU - Lillie, E. AU - Vafaei, A. AU - Tricco, A. C. C2 - 29912896 C7 - e0198447. DB - Scopus DO - 10.1371/journal.pone.0198447 IS - 6 KW - antiretrovirus agent efavirenz indinavir lamivudine nevirapine stavudine zidovudine anti human immunodeficiency virus agent benzoxazine derivative Article Bayes theorem comparative effectiveness disease association drug efficacy drug safety human Human immunodeficiency virus infection low birth weight meta analysis perinatal drug exposure premature labor systematic review treatment outcome virus transmission child combination drug therapy comparative study congenital disorder drug induced malformation economics female infant network meta-analysis newborn perinatal care pregnancy pregnancy complication prevention and control statistics and numerical data stillbirth vertical transmission Abnormalities, Drug-Induced Anti-HIV Agents Benzoxazines Congenital Abnormalities Drug Therapy, Combination HIV Infections Humans Infant, Low Birth Weight Infant, Newborn Infectious Disease Transmission, Vertical Pregnancy Complications, Infectious LA - English M3 - Article PY - 2018 ST - Comparative safety and effectiveness of perinatal antiretroviral therapies for HIV-infected women and their children: Systematic review and network meta-analysis including different study designs T2 - PLoS ONE TI - Comparative safety and effectiveness of perinatal antiretroviral therapies for HIV-infected women and their children: Systematic review and network meta-analysis including different study designs VL - 13 ID - 410 ER - TY - JOUR AB - Background: Pregnant women with epilepsy frequently experience seizures related to pregnancy complications and are often prescribed anti-epileptic drugs (AEDs) to manage their symptoms. However, less is known about the comparative safety of AED exposure in utero. We aimed to compare the risk of congenital malformations (CMs) and prenatal outcomes of AEDs in infants/children who were exposed to AEDs in utero through a systematic review and Bayesian random-effects network meta-analysis. Methods: MEDLINE, EMBASE, and Cochrane CENTRAL were searched from inception to December 15, 2015. Two reviewers independently screened titles/abstracts and full-text papers for experimental and observational studies comparing mono- or poly-therapy AEDs versus control (no AED exposure) or other AEDs, then abstracted data and appraised the risk of bias. The primary outcome was incidence of major CMs, overall and by specific type (cardiac malformations, hypospadias, cleft lip and/or palate, club foot, inguinal hernia, and undescended testes). Results: After screening 5305 titles and abstracts, 642 potentially relevant full-text articles, and 17 studies from scanning reference lists, 96 studies were eligible (n = 58,461 patients). Across all major CMs, many AEDs were associated with higher risk compared to control. For major CMs, ethosuximide (OR, 3.04; 95% CrI, 1.23-7.07), valproate (OR, 2.93; 95% CrI, 2.36-3.69), topiramate (OR, 1.90; 95% CrI, 1.17-2.97), phenobarbital (OR, 1.83; 95% CrI, 1.35-2.47), phenytoin (OR, 1.67; 95% CrI, 1.30-2.17), carbamazepine (OR, 1.37; 95% CrI, 1.10-1.71), and 11 polytherapies were significantly more harmful than control, but lamotrigine (OR, 0.96; 95% CrI, 0.72-1.25) and levetiracetam (OR, 0.72; 95% CrI, 0.43-1.16) were not. Conclusion: The newer generation AEDs, lamotrigine and levetiracetam, were not associated with significant increased risks of CMs compared to control, and were significantly less likely to be associated with children experiencing cardiac malformations than control. However, this does not mean that these agents are not harmful to infants/children exposed in utero. Counselling is advised concerning teratogenic risks when the prescription is written for a woman of childbearing age and before women continue with these agents when considering pregnancy, such as switching from polytherapy to monotherapy with evidence of lower risk and avoiding AEDs, such as valproate, that are consistently associated with CMs. These decisions must be balanced against the need for seizure control. Systematic Review Registration: PROSPERO CRD42014008925 © 2017 The Author(s). AU - Veroniki, A. A. AU - Cogo, E. AU - Rios, P. AU - Straus, S. E. AU - Finkelstein, Y. AU - Kealey, R. AU - Reynen, E. AU - Soobiah, C. AU - Thavorn, K. AU - Hutton, B. AU - Hemmelgarn, B. R. AU - Yazdi, F. AU - D'Souza, J. AU - MacDonald, H. AU - Tricco, A. C. DA - 2017-1-1 IS - 1 KW - Poly(A)-Binding Protein II Polyglactin 910 Valproic Acid Seizures Young Adult Pregnancy Outcome Pregnancy Complications Pregnancy Network Meta-Analysis Infant Humans Female Epilepsy Child Bayes Theorem Anticonvulsants Adult Abnormalities, Drug-Induced drug induced malformation systematic review prenatal period premature labor pregnant woman population risk outcome assessment observational study meta analysis intrauterine growth retardation inguinal hernia incidence hypospadias human fetus wastage drug safety cryptorchism congenital malformation congenital heart malformation comparative study clubfoot cleft palate cleft lip Article anticonvulsive agent topiramate phenytoin phenobarbital levetiracetam lamotrigine ethosuximide carbamazepine Miscarriage Knowledge synthesis Fetus Congenital malformations Antiepileptic drugs Adverse effects PY - 2017 ST - Comparative safety of anti-epileptic drugs during pregnancy: A systematic review and network meta-analysis of congenital malformations and prenatal outcomes T2 - BMC Medicine TI - Comparative safety of anti-epileptic drugs during pregnancy: A systematic review and network meta-analysis of congenital malformations and prenatal outcomes VL - 15 ID - 151 ER - TY - JOUR AB - Objectives Compare the safety of antiepileptic drugs (AEDs) on neurodevelopment of infants/children exposed in utero or during breast feeding. Design and setting Systematic review and Bayesian random-effects network meta-analysis (NMA). MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were searched until 27 April 2017. Screening, data abstraction and quality appraisal were completed in duplicate by independent reviewers. Participants 29 cohort studies including 5100 infants/children. Interventions Monotherapy and polytherapy AEDs including first-generation (carbamazepine, clobazam, clonazepam, ethosuximide, phenobarbital, phenytoin, primidone, valproate) and newer-generation (gabapentin, lamotrigine, levetiracetam, oxcarbazepine, topiramate, vigabatrin) AEDs. Epileptic women who did not receive AEDs during pregnancy or breast feeding served as the control group. Primary and secondary outcome measures Cognitive developmental delay and autism/dyspraxia were primary outcomes. Attention-deficit hyperactivity disorder, language delay, neonatal seizures, psychomotor developmental delay and social impairment were secondary outcomes. Results The NMA on cognitive developmental delay (11 cohort studies, 933 children, 18 treatments) suggested that among all AEDs only valproate was statistically significantly associated with more children experiencing cognitive developmental delay compared with control (OR=7.40, 95% credible interval (CrI) 3.00 to 18.46). The NMA on autism (5 cohort studies, 2551 children, 12 treatments) suggested that oxcarbazepine (OR 13.51, CrI 1.28 to 221.40), valproate (OR 17.29, 95% CrI 2.40 to 217.60), lamotrigine (OR 8.88, CrI 1.28 to 112.00) and lamotrigine+valproate (OR 132.70, CrI 7.41 to 3851.00) were associated with significantly greater odds of developing autism compared with control. The NMA on psychomotor developmental delay (11 cohort studies, 1145 children, 18 treatments) found that valproate (OR 4.16, CrI 2.04 to 8.75) and carbamazepine+phenobarbital+valproate (OR 19.12, CrI 1.49 to 337.50) were associated with significantly greater odds of psychomotor delay compared with control. Conclusions Valproate alone or combined with another AED is associated with the greatest odds of adverse neurodevelopmental outcomes compared with control. Oxcarbazepine and lamotrigine were associated with increased occurrence of autism. Counselling is advised for women considering pregnancy to tailor the safest regimen. Trial registration number PROSPERO database (CRD42014008925). © 2017 Article author(s) (or their employer(s) unless otherwise stated in the text of the article). All rights reserved. No commercial use is permitted unless otherwise expressly granted. AU - Veroniki, A. A. AU - Rios, P. AU - Cogo, E. AU - Straus, S. E. AU - Finkelstein, Y. AU - Kealey, R. AU - Reynen, E. AU - Soobiah, C. AU - Thavorn, K. AU - Hutton, B. AU - Hemmelgarn, B. R. AU - Yazdi, F. AU - D'Souza, J. AU - Macdonald, H. AU - Tricco, A. C. DA - 2017-1-1 IS - 7 KW - Only Child Cohort Studies Attention Deficit Disorder with Hyperactivity Infant Valproic Acid Triazines Prenatal Exposure Delayed Effects Pregnancy Complications Pregnancy Observational Studies as Topic Humans Female Epilepsy Child Carbamazepine Breast Feeding Bayes Theorem Autistic Disorder Anticonvulsants prenatal exposure pregnancy complication observational study chemically induced autism analogs and derivatives therapy systematic review nervous system development meta analysis language delay infantile spasm human drug safety developmental delay attention deficit disorder Article apraxia anticonvulsant therapy triazine derivative oxcarbazepine lamotrigine anticonvulsive agent vigabatrin topiramate primidone phenytoin phenobarbital levetiracetam gabapentin ethosuximide clonazepam clobazam multiple treatment meta-analysis knowledge synthesis infants PY - 2017 SN - 2044-6055 ST - Comparative safety of antiepileptic drugs for neurological development in children exposed during pregnancy and breast feeding: A systematic review and network meta-analysis T2 - BMJ Open TI - Comparative safety of antiepileptic drugs for neurological development in children exposed during pregnancy and breast feeding: A systematic review and network meta-analysis VL - 7 ID - 87 ER - TY - JOUR AB - Introduction: Alzheimer's dementia (AD) is the most common cause of dementia, and several organisations, such as the National Institute for Health and Care Excellence, suggest that management of patients with AD should be tailored to their needs. To date, little research has been conducted on the treatment effect in different subgroups of patients with AD. The aim of this study is to examine the comparative effectiveness and safety of cognitive enhancers for different patient characteristics. Methods and analysis: We will update our previous literature search from January 2015 forward, using the same terms and electronic databases (eg, MEDLINE) from our previous review. We will additionally search grey literature and scan the reference lists of the included studies. Randomised clinical trials of any duration conducted at any time comparing cognitive enhancers alone or in any combination against other cognitive enhancers, or placebo in adults with AD will be eligible. The outcomes of interest are cognition according to the Mini-Mental State Examination, and overall serious adverse events. For each outcome and treatment comparison, we will perform a Bayesian hierarchical random-effects meta-analysis combining the individual patient data (IPD) from each eligible study. If the identified treatment comparisons form a connected network diagram, we will perform an IPD network meta-analysis (NMA) to estimate subgroup effects for patients with different characteristics, such as AD severity and sex. We will combine aggregated data from studies that we will not be able to obtain IPD, with the IPD provided by the original authors, in a single model. We will use the PRISMA-IPD and PRISMA-NMA statements to report our findings. Ethics and dissemination: The findings of this study will be of interest to stakeholders, including decision makers, guideline developers, clinicians, methodologists and patients, and they will help to improve guidelines for the management of patients with AD. AU - Veroniki, A. A. AU - Straus, S. E. AU - Ashoor, H. M. AU - Hamid, J. S. AU - Hemmelgarn, B. R. AU - Holroyd-Leduc, J. AU - Majumdar, S. R. AU - McAuley, G. AU - Tricco, A. C. DA - 2016-1-1 IS - 1 KW - Cognition Dementia Young Adult Treatment Outcome Randomized Controlled Trials as Topic Nootropic Agents Middle Aged Male Humans Female Clinical Protocols Alzheimer Disease Aged Adult Adolescent comparative study systematic review randomized controlled trial (topic) outcome assessment Mini Mental State Examination meta analysis human drug safety disease severity comparative effectiveness clinical protocol Article nootropic agent rivastigmine memantine galantamine donepezil PY - 2016 SN - 2044-6055 ST - Comparative safety and effectiveness of cognitive enhancers for Alzheimer's dementia: Protocol for a systematic review and individual patient data network meta-analysis T2 - BMJ Open TI - Comparative safety and effectiveness of cognitive enhancers for Alzheimer's dementia: Protocol for a systematic review and individual patient data network meta-analysis VL - 6 ID - 190 ER - TY - JOUR AB - Background: Several indirect comparison methods, including network meta-analyses (NMAs), using individual patient data (IPD) have been developed to synthesize evidence from a network of trials. Although IPD indirect comparisons are published with increasing frequency in health care literature, there is no guidance on selecting the appropriate methodology and on reporting the methods and results. Methods: In this paper we examine the methods and reporting of indirect comparison methods using IPD. We searched MEDLINE, Embase, the Cochrane Library, and CINAHL from inception until October 2014. We included published and unpublished studies reporting a method, application, or review of indirect comparisons using IPD and at least three interventions. Results: We identified 37 papers, including a total of 33 empirical networks. Of these, only 9 (27 %) IPD-NMAs reported the existence of a study protocol, whereas 3 (9 %) studies mentioned that protocols existed without providing a reference. The 33 empirical networks included 24 (73 %) IPD-NMAs and 9 (27 %) matching adjusted indirect comparisons (MAICs). Of the 21 (64 %) networks with at least one closed loop, 19 (90 %) were IPD-NMAs, 13 (68 %) of which evaluated the prerequisite consistency assumption, and only 5 (38 %) of the 13 IPD-NMAs used statistical approaches. The median number of trials included per network was 10 (IQR 4-19) (IPD-NMA: 15 [IQR 8-20]; MAIC: 2 [IQR 3-5]), and the median number of IPD trials included in a network was 3 (IQR 1-9) (IPD-NMA: 6 [IQR 2-11]; MAIC: 2 [IQR 1-2]). Half of the networks (17; 52 %) applied Bayesian hierarchical models (14 one-stage, 1 two-stage, 1 used IPD as an informative prior, 1 unclear-stage), including either IPD alone or with aggregated data (AD). Models for dichotomous and continuous outcomes were available (IPD alone or combined with AD), as were models for time-to-event data (IPD combined with AD). Conclusions: One in three indirect comparison methods modeling IPD adjusted results from different trials to estimate effects as if they had come from the same, randomized, population. Key methodological and reporting elements (e.g., evaluation of consistency, existence of study protocol) were often missing from an indirect comparison paper. © 2016 Veroniki et al. AU - Veroniki, A. A. AU - Straus, S. E. AU - Soobiah, C. AU - Elliott, M. J. AU - Tricco, A. C. DA - 2016-1-1 IS - 1 KW - Research Report Research Design Reproducibility of Results Patient Identification Systems Meta-Analysis as Topic Information Dissemination Humans Hospital Records Biomedical Research statistics and numerical data research reproducibility procedures patient identification methodology meta analysis (topic) medical research medical record human comparative study Scoping review Research methods Patient-level data Network meta-analysis Multiple treatments meta-analysis Knowledge synthesis Individual participant data PY - 2016 SN - 1471-2288 ST - A scoping review of indirect comparison methods and applications using individual patient data T2 - BMC Medical Research Methodology TI - A scoping review of indirect comparison methods and applications using individual patient data VL - 16 ID - 180 ER - TY - JOUR AB - Background and purpose: Auriculotherapy is a therapeutic technique used for a wide variety of conditions. Nevertheless, similarly to any health related intervention, the clinical use of this therapy requires scientific evidence of effectiveness in order to support its rational use. The main goal of this article is to critically analyze published literature on auriculotherapy and to provide an overview of the effectiveness of this technique in the management of health disorders. Methods: The inventory of published reviews on this subject was carried out in November 2017, by assessing the following computerized databases: PubMed, MEDLINE, PsycINFO, EBMR, Cochrane Database of Systematic Reviews, CINAHL Plus NRC and Science Direct. Were only considered the systematic reviews based on meta-analysis with high methodological quality described according to AMSTAR (Assessment of Multiple Systematic Reviews). The eligible articles were systematically reviewed to find out in which health conditions auriculotherapy can be used with effectiveness. Results: A total of 14 reviews were eligible according to the inclusion and exclusion criterions. Those reviews were focused on the management of insomnia, smoking cessation and pain, within the clinical scope of Neurology, Orthopaedics and Rheumatology. Conclusions: Auriculotherapy has shown to have positive effects while associated to conventional treatments of insomnia, chronic and acute pain. Further well designed studies are required to evaluate the effectiveness of this technique in the treatment of other health conditions. © 2018 AD - ICBAS - Institute of Biomedical Sciences, University of Porto, Porto, 4099-030, Portugal Santa Maria Health School, Porto, 4049-024, Portugal Laboratory of Applied Physiology, ICBAS - Institute of Biomedical Sciences, University of Porto, Porto, 4099-030, Portugal Faculdade de Engenharia da Universidade do Porto, Rua Dr. Roberto Frias, s/n, Porto, 4200-465, Portugal Sport Sciences School of Rio Maior, Rio Maior, 2040-413, Portugal AU - Vieira, A. AU - Reis, A. M. AU - Matos, L. C. AU - Machado, J. AU - Moreira, A. C2 - 30396628 DB - Scopus DO - 10.1016/j.ctcp.2018.08.005 KW - Acupressure Auricular acupuncture Auriculotherapy Insomnia Pain Smoking cessation acupuncture human procedures treatment outcome Humans Sleep Initiation and Maintenance Disorders LA - English M3 - Review PY - 2018 SP - 61-70 ST - Does auriculotherapy have therapeutic effectiveness? An overview of systematic reviews T2 - Complementary Therapies in Clinical Practice TI - Does auriculotherapy have therapeutic effectiveness? An overview of systematic reviews VL - 33 ID - 411 ER - TY - JOUR AB - Objectives: This article seeks to identify neuroanatomical differences in ADHD through an overview of systematic reviews that report encephalic differences compared to a control group in volume, area, activation likelihood or chemical composition. Methods: We conducted a systematic search using Cochrane guidelines and PRISMA criteria in PubMed, Scopus, Web of Science, Cochrane Database of Systematic Reviews and Database of Abstracts of Reviews of Effects. Results: Results revealed broad encephalic involvement that includes a functional frontal and cingulate hypoactivation and structural differences in corpus callosum, cerebellum and basal nuclei. Conclusions: ADHD symptoms might be due to a multi-network unbalanced functioning hypothesis. © 2017 Taylor & Francis. AU - Vieira de Melo, B. B. AU - Trigueiro, M. J. AU - Rodrigues, P. P. DA - 2018-1-1 IS - 1 KW - France Corpus Callosum Cerebellum Neuroanatomy Humans Attention Deficit Disorder with Hyperactivity procedures human diagnostic imaging attention deficit disorder PY - 2018 SN - 8756-5641 SP - 52-68 ST - Systematic overview of neuroanatomical differences in ADHD: Definitive evidence T2 - Developmental Neuropsychology TI - Systematic overview of neuroanatomical differences in ADHD: Definitive evidence VL - 43 ID - 132 ER - TY - JOUR AB - Background Prostate cancer is the second most common type of cancer in Canadian men. Radical prostatectomy is one of the treatment options available, and involves removing the prostate gland and surrounding tissues. In recent years, surgeons have begun to use robot-assisted radical prostatectomy more frequently. We aimed to determine the clinical benefits and harms of the robotic surgical system for radical prostatectomy (robot-assisted radical prostatectomy) compared with the open and laparoscopic surgical methods. We also assessed the cost-effectiveness of robot-assisted versus open radical prostatectomy in patients with clinically localized prostate cancer in Ontario. Methods We performed a literature search and included prospective comparative studies that examined robot-assisted versus open or laparoscopic radical prostatectomy for prostate cancer. The outcomes of interest were perioperative, functional, and oncological. The quality of the body of evidence was examined according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Working Group criteria. We also conducted a cost–utility analysis with a 1-year time horizon. The potential long-term benefits of robot-assisted radical prostatectomy for functional and oncological outcomes were also evaluated in a 10-year Markov model in scenario analyses. In addition, we conducted a budget impact analysis to estimate the additional costs to the provincial budget if the adoption of robot-assisted radical prostatectomy were to increase in the next 5 years. A needs assessment determined that the published literature on patient perspectives was relatively well developed, and that direct patient engagement would add relatively little new information. Results Compared with the open approach, we found robot-assisted radical prostatectomy reduced length of stay and blood loss (moderate quality evidence) but had no difference or inconclusive results for functional and oncological outcomes (low to moderate quality evidence). Compared with laparoscopic radical prostatectomy, robot-assisted radical prostatectomy had no difference in perioperative, functional, and oncological outcomes (low to moderate quality evidence). Compared with open radical prostatectomy, our best estimates suggested that robot-assisted prostatectomy was associated with higher costs ($6,234) and a small gain in quality-adjusted life-years (QALYs) (0.0012). The best estimate of the incremental cost-effectiveness ratio (ICER) was $5.2 million per QALY gained. However, if robot-assisted radical prostatectomy were assumed to have substantially better long-term functional and oncological outcomes, the ICER might be as low as $83,921 per QALY gained. We estimated the annual budget impact to be $0.8 million to $3.4 million over the next 5 years. Conclusions There is no high-quality evidence that robot-assisted radical prostatectomy improves functional and oncological outcomes compared with open and laparoscopic approaches. However, compared with open radical prostatectomy, the costs of using the robotic system are relatively large while the health benefits are relatively small. © Queen’s Printer for Ontario, 2017. AU - Wang, Myra AU - Xie, Xuanqian AU - Wells, David AU - Higgins, Caroline AU - Harrison, Susan AU - Ali, Arshia AU - Singh, Tanveer AU - Kaulback, Kellee AU - Laing, Ana AU - Soulodre, Claude AU - Mitchell, Andrée AU - Ng, Vivian AU - Thota, Anil AU - Sikich, Nancy AU - Dhalla, Irfan DA - 2017-1-1 IS - 11 KW - Quality-Adjusted Life Years Cost-Benefit Analysis Length of Stay Prostatitis Prostatism Prostate Technology Assessment, Biomedical Prostatic Neoplasms Robotics Prostatectomy systematic review surgical technology surgical approach robot-assisted prostatectomy risk benefit analysis quality control quality adjusted life year prostate cancer prospective study practice guideline perioperative period outcome assessment operative blood loss open surgery Ontario oncological parameters medical expert laparoscopic surgery intermethod comparison human functional status evidence based medicine cost utility analysis cost effectiveness analysis cost benefit analysis consultation comparative study clinical outcome budget Article PY - 2017 SN - 1915-7398 SP - 1-172 ST - Ontario health technology assessment series: Robotic surgical system for radical prostatectomy: A health technology assessment T2 - Ontario Health Technology Assessment Series TI - Ontario health technology assessment series: Robotic surgical system for radical prostatectomy: A health technology assessment VL - 17 ID - 113 ER - TY - JOUR AB - Synopsis: This is the first systematic review to investigate the risk of recurrence in breast cancer survivors <50 years old who have used hormone replacement therapy (HRT). Background: The risk of HRT in premenopausal breast cancer survivors is unclear. Due to the higher incidence of estrogen receptor negative tumours in women <50, the potential for HRT to promote breast cancer recurrence may differ from older age groups. Methods: We performed a search of Medline, EMBASE and CINAHL through June 2016. For the observational studies relative risk (RR) and 95% confidence interval (CI) were calculated for the recurrence rate among HRT users and nonusers. A random effects model was used to estimate the combined RR using the Mantel-Haenszel method. Results: Four papers satisfied our inclusion criteria. 3477 subjects were analyzed. On pooled meta-analysis of breast cancer recurrence in the observational studies, no significant association was found between HRT and risk of recurrence (RR 1.04 [95% CI 0.45, 2.41]). The randomized controlled trial (RCT) included found an increased risk of recurrence with HRT among women <50 (HR 1.56 [95% CI 1.1–2.2]). However, among women of all ages with an estrogen receptor negative tumour there was no significant difference in recurrence when compared to hormone receptor positive tumours (HR 1.15 [95% CI 0.7–1.8, p = 0.55]). Discussion: This review on HRT in breast cancer survivors <50 revealed conflicting results between randomized and observational study data. Further studies are warranted to investigate the association between HRT and recurrence rates in younger breast cancer survivors. © 2018 AU - Wang, Y. AU - Lewin, N. AU - Qaoud, Y. AU - Rajaee, A. N. AU - Scheer, A. S. DA - 2018-1-1 KW - Recurrence Survivors Premenopause Breast Neoplasms Survivor Premenopausal Hormone replacement therapy Breast cancer recurrence Breast cancer PY - 2018 SP - 123-130 ST - The oncologic impact of hormone replacement therapy in premenopausal breast cancer survivors: A systematic review T2 - Breast TI - The oncologic impact of hormone replacement therapy in premenopausal breast cancer survivors: A systematic review VL - 40 ID - 45 ER - TY - JOUR AB - Background: Behavioral and psychological symptoms of dementia (BPSD) are highly prevalent in patients with dementia. Both pharmacological and non-pharmacological strategies are commonly used to treat these symptoms, but their comparative safety and efficacy is unknown. Methods: We will conduct a systematic review of the published and unpublished literature to retrieve all articles pertaining to outcomes of safety and efficacy associated with pharmacological and non-pharmacological treatments of BPSD for patients living in the community and institutionalized care settings. Our primary outcome of efficacy is a change in aggression. Our primary outcome of safety will be risk of fracture. These primary outcomes were chosen by stakeholders involved in the care of patients experiencing BPSD. Possible secondary outcomes of efficacy will include a change in agitation, depressive symptoms, and night-time behaviors. Possible secondary outcomes of safety will include the risk of stroke, falls, and mortality. All article screening, data abstraction, and risk of bias appraisal will be completed independently by two reviewers. If the assumption of transitivity is valid and the evidence forms a connected network, Bayesian random-effects pairwise and network meta-analyses (NMAs) will be conducted. Relative treatment rankings will be reported with mean ranks and the surface under the cumulative ranking curve. Discussion: We will identify the safest and most efficacious treatment strategies for patients with BPSD from among our most highly ranked treatments. The results of this study will be used to guide decision-making and improve patient care. Systematic review registration: PROSPERO registry number CRD42017050130. © 2017 The Author(s). AU - Watt, J. AU - Goodarzi, Z. AU - Tricco, A. C. AU - Veroniki, A. A. AU - Straus, S. E. C7 - 182 DB - Scopus DO - 10.1186/s13643-017-0572-x IS - 1 M3 - Article PY - 2017 ST - Comparative safety and efficacy of pharmacological and non-pharmacological interventions for the behavioral and psychological symptoms of dementia: Protocol for a systematic review and network meta-analysis T2 - Systematic Reviews TI - Comparative safety and efficacy of pharmacological and non-pharmacological interventions for the behavioral and psychological symptoms of dementia: Protocol for a systematic review and network meta-analysis VL - 6 ID - 330 ER - TY - JOUR AB - Background: Multiple sclerosis (MS) is a chronic disabling, inflammatory, and degenerative disease of the central nervous system that, in most cases, requires long-term disease-modifying treatment (DMT). The drugs used vary in efficacy and adverse effect profiles. Several studies have used attribute-based stated-preference methods, primarily to investigate patient preferences for initiating or escalating DMT. Objectives: To conduct a systematic review of attribute-based stated-preference studies in people with MS to identify common methods employed and to assess study quality, with reference to the specific challenges of this disease area. Methods: We conducted a systematic search for studies related to attribute-based stated-preference and MS in multiple databases, including Cochrane and MEDLINE. Studies were included if they were published in a peer-reviewed journal, were on the topic of MS, and used a survey methodology that measured stated preferences for attributes of a whole. Analysis was conducted using narrative synthesis and summary statistics. Study quality was judged against the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) conjoint analysis checklist. Results: We identified 16 relevant articles reporting 17 separate studies, all but one focusing on DMTs. Most studies were discrete-choice experiments. Study quality was generally high, but we recommend the following: (1) that consideration of sample sizes be improved, (2) that survey design choices be justified and documented, (3) that qualitative approaches for attribute and level selection be incorporated to better involve patients, and (4) that reporting of experimental practice be improved. The effects of DMTs on reproduction and the impact of how risk and uncertainty are presented were identified as neglected research topics. The ISPOR conjoint analysis checklist was found to be unsuitable for the assessment of study quality. Conclusion: Attribute-based stated preference is a useful method with which to examine the preferences of people with MS in their choice of DMT. However, further research embracing the methodological recommendations identified, particularly greater use of qualitative methods in attribute development, is needed. © 2018, Springer International Publishing AG, part of Springer Nature. AD - Leeds Institute for Health Sciences, University of Leeds, Leeds, United Kingdom School of Dentistry, University of Leeds, Leeds, United Kingdom Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London, United Kingdom Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom Institute of Social and Preventive Medicine (IUMSP), Centre Hospitalier Universitaire Vaudois, Université de Lausanne, Lausanne, Switzerland Dental Translational and Clinical Research Unit, School of Dentistry, University of Leeds, Leeds, United Kingdom Blizard Institute (Neuroscience) Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom Clinical Board Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom School of Sociology and Social Policy, University of Leeds, Leeds, United Kingdom AU - Webb, E. J. D. AU - Meads, D. AU - Eskyte, I. AU - King, N. AU - Dracup, N. AU - Chataway, J. AU - Ford, H. L. AU - Marti, J. AU - Pavitt, S. H. AU - Schmierer, K. AU - Manzano, A. C2 - 29313265 DB - Scopus DO - 10.1007/s40271-017-0296-y IS - 4 KW - checklist Cinahl Cochrane Library Embase human Medline multiple sclerosis patient preference peer review priority journal PsycINFO Review systematic review Web of Science decision making decision support system drug administration drug administration route methodology qualitative research quality of life immunosuppressive agent Choice Behavior Decision Support Techniques Drug Administration Routes Drug Administration Schedule Humans Immunosuppressive Agents Research Design LA - English M3 - Review PY - 2018 SP - 391-402 ST - A Systematic Review of Discrete-Choice Experiments and Conjoint Analysis Studies in People with Multiple Sclerosis T2 - Patient TI - A Systematic Review of Discrete-Choice Experiments and Conjoint Analysis Studies in People with Multiple Sclerosis VL - 11 ID - 412 ER - TY - JOUR AU - Welch, V. AU - Tugwell, P. AU - Wells, G. A. AU - Kristjansson, B. AU - Petticrew, M. AU - McGowan, J. L. AU - De Montigny, J. AU - Benkhalti, M. AU - Ueffing, E. C7 - Mr000028 DB - Scopus DO - 10.1002/14651858.MR000028 IS - 3 KW - health care policy health care quality health service health status human lowest income group review socioeconomics M3 - Review PY - 2009 ST - How effects on health equity are assessed in systematic reviews of interventions T2 - Cochrane Database of Systematic Reviews TI - How effects on health equity are assessed in systematic reviews of interventions ID - 325 ER - TY - JOUR AB - Background Soil-transmitted helminthiasis and schistosomiasis, considered among the neglected tropical diseases by WHO, affect more than a third of the world's population, with varying intensity of infection. We aimed to evaluate the effects of mass deworming for soil-transmitted helminths (with or without deworming for schistosomiasis or co-interventions) on growth, educational achievement, cognition, school attendance, quality of life, and adverse effects in children in endemic helminth areas. Methods We searched 11 databases up to Jan 14, 2016, websites and trial registers, contacted authors, and reviewed reference lists. We included studies published in any language of children aged 6 months to 16 years, with mass deworming for soil-transmitted helminths or schistosomiasis (alone or in combination with other interventions) for 4 months or longer, that reported the primary outcomes of interest. We included randomised and quasi-randomised trials, controlled before–after studies, interrupted time series, and quasi-experimental studies. We screened in duplicate, then extracted data and appraised risk of bias in duplicate with a pre-tested form. We conducted random-effects meta-analysis and Bayesian network meta-analysis. Findings We included 52 studies of duration 5 years or less with 1 108 541 children, and four long-term studies 8–10 years after mass deworming programmes with more than 160 000 children. Overall risk of bias was moderate. Mass deworming for soil-transmitted helminths compared with controls led to little to no improvement in weight over a period of about 12 months (0·99 kg, 95% credible interval [CrI] −0·09 to 0·28; moderate certainty evidence) or height (0·07 cm, 95% CrI −0·10 to 0·24; moderate certainty evidence), little to no difference in proportion stunted (eight fewer per 1000 children, 95% CrI −48 to 32; high certainty evidence), cognition measured by short-term attention (−0·23 points on a 100 point scale, 95% CI −0·56 to 0·14; high certainty evidence), school attendance (1% higher, 95% CI −1 to 3; high certainty evidence), or mortality (one fewer per 1000 children, 95% CI −3 to 1; high certainty evidence). We found no data on quality of life and little evidence of adverse effects. Mass deworming for schistosomiasis might slightly increase weight (0·41 kg, 95% CrI −0·20 to 0·91) and has little to no effect on height (low certainty evidence) and cognition (moderate certainty evidence). Our analyses do not suggest indirect benefits for untreated children from being exposed to treated children in the community. We are uncertain about effects on long-term economic productivity (hours worked), cognition, literacy, and school enrolment owing to very low certainty evidence. Results were consistent across sensitivity and subgroup analyses by age, worm prevalence, baseline nutritional status, infection status, impact on worms, infection intensity, types of worms (ascaris, hookworm, or trichuris), risk of bias, cluster versus individual trials, compliance, and attrition. Interpretation Mass deworming for soil-transmitted helminths with or without deworming for schistosomiasis had little effect. For schistosomiasis, mass deworming might be effective for weight but is probably ineffective for height, cognition, and attendance. Future research should assess which subset of children do benefit from mass deworming, if any, using individual participant data meta-analysis. Funding Canadian Institutes of Health Research and WHO. © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license AU - Welch, V. A. AU - Ghogomu, E. AU - Hossain, A. AU - Awasthi, S. AU - Bhutta, Z. A. AU - Cumberbatch, C. AU - Fletcher, R. AU - McGowan, J. AU - Krishnaratne, S. AU - Kristjansson, E. AU - Sohani, S. AU - Suresh, S. AU - Tugwell, P. AU - White, H. AU - Wells, G. A. C2 - 27955788 DB - Scopus DO - 10.1016/S2214-109X(16)30242-X IS - 1 KW - albendazole diethylcarbamazine folic acid iron ivermectin levamisole mebendazole palm oil piperazine placebo praziquantel pyrantel retinol secnidazole tetrachloroethylene tetramisole tiabendazole anthelmintic agent academic achievement antihelminthic therapy Article child child growth cognition controlled study helminthiasis human low income country meta analysis (topic) middle income country mortality rate priority journal quality of life randomized controlled trial (topic) schistosomiasis school attendance soil pollution systematic review wellbeing body weight gain growth intestine infection meta analysis network meta-analysis soil Anthelmintics Humans Intestinal Diseases, Parasitic Weight Gain M3 - Article PY - 2017 SP - e40-e50 ST - Mass deworming to improve developmental health and wellbeing of children in low-income and middle-income countries: a systematic review and network meta-analysis T2 - The Lancet Global Health TI - Mass deworming to improve developmental health and wellbeing of children in low-income and middle-income countries: a systematic review and network meta-analysis VL - 5 ID - 311 ER - TY - JOUR AB - Human faces are under a constant state of change throughout the entirety of one's lifetime. Photogrammetry has been advocated for use in large epidemiological studies investigating facial characteristics. This study aimed to review existing longitudinal photogrammetric studies in terms of the measurements selected and the observed facial changes overtime.Acomprehensive literature search was performed in 4 databases, PubMed, ISI Web of Science, EMBASE, and Scopus, which was supplemented by hand search. No limitations were set as to the language, dates, or status of publication. The records were assessed for the eligibility and rated for the risk of bias by 2 independent reviewers.Data regarding study characteristics, measurements selected and the outcomes reported, were extracted for analysis. An initial search identified 5127 studies. After 2 rounds of study screening, 6 eligible studies informed this review. The risk of bias of the studies ranged from 41.7% to 80.8%. Only 1 study performed sample size calculation, and only 17% of the studies had a sample size of over 30 subjects. Confidence interval was reported by none of the studies. The facial features assessed varied among the studies, and some studies focused on only specific regions of the face. Photogrammetry has been used by a limited number of studies in the analysis of longitudinal soft tissue facial changes. Moreover, these studies are heterogeneous with respect to their levels of risk of bias and the facial features assessed. Recommendations are provided to improve the qualities of future photogrammetric studies. Copyright © 2015 by Mutaz B. Habal, MD. AU - Wen, Y. F. AU - Wong, H. M. AU - McGrath, C. P. DA - 2015-1-1 IS - 6 KW - Humanities Humanism Photogrammetry Maxillofacial Development Longitudinal Studies Humans Face Cephalometry Bias (Epidemiology) statistics and numerical data statistical bias physiology photography longitudinal study human anatomy and histology Systematic review Facial changes PY - 2015 SP - 1830-1834 ST - Longitudinal Photogrammetric Analysis of Soft Tissue Facial Changes: A Systematic Review of the Literature and a Summary of Recommendations T2 - Journal of Craniofacial Surgery TI - Longitudinal Photogrammetric Analysis of Soft Tissue Facial Changes: A Systematic Review of the Literature and a Summary of Recommendations VL - 26 ID - 227 ER - TY - JOUR AB - Background: Case definitions of medication-overuse headache (MOH) in population-based research have changed over time. This study aims to review MOH prevalence reports with respect to these changes, and to propose a practical case definition for future studies based on the ICHD-3 beta. Methods: A systematic literature search was conducted to identify MOH prevalence studies. Findings were summarized according to diagnostic criteria. Results: Twenty-seven studies were included. The commonly used case definition for MOH was headache ≥15 days/ month with concurrent medication overuse ≥3 months. There were varying definitions for what was considered as overuse. Studies that all used ICHD-2 criteria showed a wide range of prevalence among adults: 0.5%-7.2%. Conclusions: There are limits to comparing prevalence of MOH across studies and over time. The wide range of reported prevalence might not only be due to changing criteria, but also the diversity of countries now publishing data. The criterion "headache occurring on ≥15 days per month with concurrent medication overuse can be applied in population- based studies. However, the new requirement that a respondent must have "a preexisting headache disorder has not been previously validated. Exclusion of other headache diagnoses by expert evaluation and ancillary examinations is not feasible in large population-based studies. © 2013 International Headache Society. AU - Westergaard, M. L. AU - Hansen, E. H. AU - Glümer, C. AU - Olesen, J. AU - Jensen, R. H. DA - 2014-1-1 IS - 6 KW - Prevalence Humans Headache Disorders, Secondary Epidemiologic Research Design Cross-Sectional Studies standards epidemiology cross-sectional study classification chemically induced systematic review review population research nomenclature human headache drug induced headache disease classification cultural anthropology comparative study chronic daily headache medication-overuse headache International Classification of Headache Disorders Chronic headache PY - 2014 SP - 409-425 ST - Definitions of medication-overuse headache in population-based studies and their implications on prevalence estimates: A systematic review T2 - Cephalalgia TI - Definitions of medication-overuse headache in population-based studies and their implications on prevalence estimates: A systematic review VL - 34 ID - 250 ER - TY - JOUR AB - Background: Medical imaging techniques are important in the management of many patients with liver disease. Unenhanced ultrasound examinations sometimes identify focal abnormalities in the liver that may require further investigation, primarily to distinguish liver cancers from benign abnormalities. One important factor in selecting an imaging test is the ability to provide a rapid diagnosis. Options for additional imaging investigations include computed tomography (CT) and/or magnetic resonance imaging (MRI) and biopsy when the diagnosis remains uncertain. CT and MRI usually require referral with associated waiting time and are sometimes contraindicated. The use of contrast agents may improve the ability of ultrasound to distinguish between liver cancer and benign abnormalities and, because it can be performed at the same appointment as unenhanced ultrasound, more rapid diagnoses may be possible. Objective: To compare the clinical effectiveness and cost-effectiveness of contrast-enhanced ultrasound (CEUS) using SonoVue® with that of contrast-enhanced computed tomography (CECT) and contrast-enhanced magnetic resonance imaging (CEMRI) for the assessment of adults with focal liver lesions (FLLs) in whom previous liver imaging is inconclusive. Data sources: Eight bibliographic databases including MEDLINE, EMBASE, Cochrane Database of Systematic Reviews and Database of Abstracts of Reviews of Effects were searched from 2000 to September/October 2011. Research registers and conference proceedings were also searched. Review methods: Systematic review methods followed published guidance. Risk of bias was assessed using a modified version of the QUADAS-2 tool. Results were stratified by clinical indication for imaging (characterisation of FLLs detected on ultrasound surveillance of cirrhosis patients, detection of liver metastases, characterisation of incidentally detected FLLs, assessment of treatment response). For incidental FLLs, pooled estimates of sensitivity and specificity, with 95% CIs, were calculated using a random-effects model. For other clinical indications a narrative summary was used. The cost-effectiveness of CEUS was modelled separately for the three main clinical applications considered [characterisation of FLLs detected on ultrasound surveillance of cirrhosis patients, detection of liver metastases in patients with colorectal cancer (CRC), characterisation of incidentally detected FLLs]. Results: Of the 854 references identified, 19 (describing 18 studies) were included in the review. Hand searching of conference proceedings identified a further three studies. Twenty of the 21 studies included in the systematic review were diagnostic test accuracy studies. Studies in cirrhosis patients reported varying estimates of test performance. There was no consistent evidence of a significant difference in performance between imaging modalities. It was unclear whether or not CEUS alone is adequate to rule out hepatocellular carcinoma (HCC) for FLLs of < 30 mm; one study indicated that CEUS may be better at ruling out HCC for FLLs of 11-30 mm [very small FLLs (< 10 mm) excluded]. There was no consistent evidence of a difference in test performance between imaging modalities for the detection of metastases; CEUS alone may be adequate to rule out liver metastases in colorectal cancer. In patients with incidentally detected FLLs, the pooled estimates of sensitivity for any malignancy using CEUS and CECT were 95.1% and 94.6%, respectively, and the corresponding specificity estimates were 93.8% and 93.1% respectively. One study comparing CEUS with CEMRI reported similar sensitivity and lower specificity for both modalities. In the surveillance of cirrhosis, CEUS was as effective as but £379 less costly than CECT. CEMRI was £1063 more costly than CEUS and gained 0.022 QALYs. In the detection of liver metastases from CRC, CEUS cost £1 more than CECT, and at a lifetime time horizon they yielded equal QALYs. CEMRI was dominated by CECT. In the characterisation of incidentally detected FLLs, CEUS was slightly more effect ve th n CECT and CEMRI (by 0.0002 QALYs and 0.0026 QALYs respectively) and less costly (by £52 and £131 respectively). Limitations: There were a number of methodological issues specific to the studies included in this review. The main indication for liver imaging in the populations considered is likely to be to rule out primary liver cancer or metastases. Therefore, patient-level analyses of test performance are of particular interest. Some of the studies included in this review reported per-patient analyses; however, no study clearly stated how results were defined (e.g. was the presence of any positive lesion regarded as a positive test for the whole patient). In addition, a number of studies reported data for one lesion per patient (treated as per-patient data in this assessment). These studies generally selected the largest lesion or the lesion 'most suspicious for malignancy' for inclusion in analyses, with the consequence that estimates of test performance may have been exaggerated. The applicability of studies included in this review may be limited, as the majority of imaging studies were interpreted by multiple, experienced operators and the prevalence of malignancy in included studies appeared higher than might be expected in clinical practice. The cost-effectiveness analyses did not take into account the potential benefits of reduced anxiety that may arise from potentially shorter waiting times associated with SonoVue CEUS. Conclusions: SonoVue CEUS could provide similar diagnostic performance to other imaging modalities (CECT and CEMRI) for the assessment of FLLs. Economic analyses indicated that CEUS was a cost-effective replacement for CEMRI. The use of CEUS instead of CECT was considered cost-effective in the surveillance of cirrhosis and the characterisation of incidentally detected FLLs, with similar costs and effects for the detection of liver metastases from CRC. Further research is needed to compare the effects of different imaging modalities (SonoVue CEUS, CECT, CEMRI) on therapeutic planning, treatment and clinical outcomes. Future test accuracy studies should provide standardised definitions of a positive imaging test, and compare all three imaging modalities in the same patient group. © Queen's Printer and Controller of HMSO 2013. AU - Westwood, M. AU - Joore, M. AU - Grutters, J. AU - Redekop, K. AU - Armstrong, N. AU - Lee, K. AU - Gloy, V. AU - Raatz, H. AU - Misso, K. AU - Severens, J. AU - Kleijnen, J. DA - 2013-1-1 %J Health Technology Assessment IS - 16 KW - Magnetic Resonance Spectroscopy Liver Diseases Colorectal Neoplasms Diagnostic Imaging Ultrasonography Tomography, X-Ray Computed Technology Assessment, Biomedical Sulfur Hexafluoride Quality-Adjusted Life Years Phospholipids Neoplasm Metastasis Microbubbles Magnetic Resonance Imaging Liver Neoplasms Liver Cirrhosis Liver Humans Cost-Benefit Analysis Contrast Media radiography pathology nuclear magnetic resonance imaging microbubble metastasis economics echography diagnostic use cost benefit analysis computer assisted tomography biomedical technology assessment ultrasound scanner treatment planning systematic review spiral computer assisted tomography sensitivity and specificity radiofrequency ablation quality adjusted life year progression free survival nuclear magnetic resonance scanner multidetector computed tomography liver nodule liver metastasis liver disease liver cell carcinoma intermethod comparison incidental finding human focal liver lesion false positive result false negative result disease surveillance disease free survival differential diagnosis diagnostic value diagnostic test accuracy study diagnostic accuracy cryosurgery cost effectiveness analysis contrast enhancement computed tomography scanner colorectal cancer clinical effectiveness cancer prognosis article phospholipid contrast medium contrast agent BR1 superparamagnetic iron oxide sonovue iopromide iopamidol iomeprol iohexol gadoxetic acid gadolinium gadodiamide gadobenate dimeglumine ferucarbotran LA - English PY - 2013 SP - 7-243 ST - Contrast-enhanced ultrasound using SonoVue® (sulphur hexafluoride microbubbles) compared with contrast- enhanced computed tomography and contrast-enhanced magnetic resonance imaging for the characterisation of focal liver lesions and detection of liver metastases: A systematic review and cost-effectiveness analysis T2 - Health Technology Assessment TI - Contrast-enhanced ultrasound using SonoVue® (sulphur hexafluoride microbubbles) compared with contrast- enhanced computed tomography and contrast-enhanced magnetic resonance imaging for the characterisation of focal liver lesions and detection of liver metastases: A systematic review and cost-effectiveness analysis VL - 17 ID - 267 ER - TY - JOUR AB - Background: Non-small cell lung cancer (NSCLC) is the most common form of lung cancer. Some epidermal growth factor receptor tyrosine kinase (EGFR-TK) mutations make tumours responsive to treatment with EGFR-TK inhibitors (EGFR-TKIs) but less responsive to treatment with standard chemotherapy. Patients with NSCLC are therefore tested for EGFR-TK tumour gene mutations to inform treatment decisions. There are a variety of tests available to detect these mutations. The different tests vary in the specific mutations that they attempt to detect, the amount of tumour cells needed for the test to work, the time that it takes to give a result, the error rate of the test, and the cost of the test. Objective: To compare the performance and cost-effectiveness of EGFR-TK mutation tests used to identify previously untreated adults with locally advanced or metastatic NSCLC, who may benefit from first-line treatment with TKIs. Data sources: Twelve databases to August 2012 [including MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations and Daily Update (OvidSP), EMBASE, Cochrane Database of Systematic Reviews (CDSR), Cochrane Central Register of Controlled Trials (CENTRAL), Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment database (HTA), Science Citation Index (SCI), Latin American and Caribbean Health Sciences Literature (LILACS), BIOSIS Previews, NIHR Health Technology Assessment programme, PROSPERO (International Prospective Register of Systematic Reviews)], research registers and conference proceedings. A web-based survey gathered data on technical performance of EGFR-TK mutation tests. Methods: Randomised controlled trials were assessed for methodological quality using the Cochrane risk of bias tool. Diagnostic accuracy studies were assessed using QUADAS-2. There were insufficient data for meta-analysis. For accuracy studies, we calculated sensitivity and specificity together with 95% confidence intervals (CIs). Survival data were summarised as hazard ratios and tumour response data as relative risks, with 95% CIs. The health-economic analysis considered the long-term costs and quality-adjusted life-years (QALYs) associated with different tests followed by treatment with either standard chemotherapy or a TKI. Direct sequencing was taken as the comparator. The de novo model consisted of a decision tree and a Markov model. Results: The survey indicated no differences between tests in batch size, turnaround time, number of failed samples or cost. Six studies provided data on the accuracy of EGFR-TK mutation testing for predicting response to treatment with TKIs. Estimates of accuracy were similar across studies. Six analyses provided data on the clinical effectiveness of TKIs compared with standard chemotherapy. There were no clear differences in the treatment effects reported by different studies, regardless of which EGFR mutation test was used to select patients. Cost-effectiveness analysis using 'Evidence on comparative effectiveness available' and 'Linked evidence' approaches: Therascreen® EGFR polymerase chain reaction (PCR) Kit (Qiagen, Venlo, the Netherlands) was both less effective and less costly than direct sequencing of all exon 19-21 mutations at an incremental cost-effectiveness ratio of £32,167 (comparative) and £32,190 (linked) per QALY lost. 'Assumption of equal prognostic value' approach: the lowest total strategy cost was [commercial-in-confidence (CiC) information has been removed] [Sanger sequencing or Roche cobas EGFR Mutation Testing Kit® (Roche Molecular Systems, Inc., Branchburg, NJ, USA)] compared with (CiC information has been removed) for the most expensive strategy (fragment length analysis combined with pyrosequencing). Limitations: The cost-effectiveness analysis assumed that the differences in outcomes between the results of the trials were solely attributable to the different mutation tests used to distinguish between patients; this assumption ignores other factors that might explain this variation. Conclusion: There was no strong evidence that any one EGFR mutat on test had greater accuracy than any other test. Re-testing of stored samples from previous studies, where patient outcomes are already known, could be used to provide information on the relative effectiveness of TKIs and standard chemotherapy in patients with EGFR mutation-positive and mutation-negative tumours, where mutation status is determined using tests for which adequate data are currently unavailable. © Queen's Printer and Controller of HMSO 2014. AD - M. Westwood, Kleijnen Systematic Reviews Ltd, York, United Kingdom AN - rayyan-13126514 AU - Westwood, M. AU - Joore, M. AU - Whiting, P. AU - van Asselt, T. AU - Ramaekers, B. AU - Armstrong, N. AU - Misso, K. AU - Severens, J. AU - Kleijnen, J. DA - 2014-1-1 %J Health Technology Assessment IS - 32 KW - Receptor, Epidermal Growth Factor Carcinoma, Non-Small-Cell Lung Small Cell Lung Carcinoma Adult Lung Quality-Adjusted Life Years Tyrosine Epidermal Growth Factor Protein-Tyrosine Kinases Receptor Protein-Tyrosine Kinases Lung Neoplasms Mutation Cost-Benefit Analysis Therascreen Roche cobas EGFR Mutation Testing Kit treatment response systematic review statistical model sensitivity and specificity randomized controlled trial quality control quality adjusted life year pyrosequencing predictive value polymerase chain reaction mutational analysis metastasis potential male non small cell lung cancer intermethod comparison human health survey gene sequence gene mutation female exon drug effect drug cost diagnostic kit diagnostic accuracy decision tree cost effectiveness analysis cost benefit analysis controlled study confidence interval clinical effectiveness cancer survival cancer prognosis cancer diagnosis cancer chemotherapy article advanced cancer protein tyrosine kinase inhibitor epidermal growth factor receptor PY - 2014 SP - 1-165 ST - Epidermal growth factor receptor tyrosine kinase (EGFR-TK) mutation testing in adults with locally advanced or metastatic non-small cell lung cancer: A systematic review and cost-effectiveness analysis T2 - Health Technology Assessment TI - Epidermal growth factor receptor tyrosine kinase (EGFR-TK) mutation testing in adults with locally advanced or metastatic non-small cell lung cancer: A systematic review and cost-effectiveness analysis VL - 18 ID - 264 ER - TY - JOUR AB - Background Allergy is a form of immune-mediated exaggerated sensitivity (hypersensitivity) to a substance that is either inhaled, swallowed, injected or comes into contact with the skin. Foreign substances that provoke allergies are called allergens. It has been claimed that multiplex allergen testing may help in diagnosing the cause of symptoms in patients with an unclear cause of allergy or who are allergic to more than one substance. Objectives To evaluate multiplex allergen testing [devices that can measure the presence of multiple immunoglobulin E (IgE) antibodies in a patient’s blood at the same time], by assessing (1) clinical effectiveness (allergy symptoms, incidence of acute exacerbations, mortality, adverse events of testing and treatment, health-care presentations or admissions, health-related quality of life); (2) effects on treatment (diet, immunotherapy medications, other potential testing); (3) any additional diagnostic information provided by multiplex allergen testing; and (4) cost-effectiveness (cost of different assessment strategies). Methods Fifteen databases were searched from 2005 to April 2015, including MEDLINE (via OvidSp), MEDLINE In-Process Citations, MEDLINE Daily Update, PubMed (National Library of Medicine), EMBASE, Cochrane Database of Systematic Reviews (CDSR), Cochrane Central Register of Controlled Trials (CENTRAL), Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment (HTA) database, Science Citation Index (SCI), Conference Proceedings Citation Index-Science (CPCI-S), BIOSIS Previews, Latin American and Caribbean Health Sciences Literature (LILACS), National Institute for Health Research (NIHR) HTA programme, and the US Food and Drug Administration (FDA); supplementary searches of conference proceedings and trials registries were performed. Review methods followed published guidance from the Cochrane Collaboration and the Centre for Reviews and Dissemination, University of York, UK. The methodological quality of included studies was assessed using appropriate published tools or a review-specific tool designed by the project team. Studies were summarised in a narrative synthesis. Owing to a lack of data on the clinical effectiveness of multiplex allergen testing, no long-term cost-effectiveness model was developed. A conceptual model structure was developed and cost analyses were performed to examine the short-term costs of various possible diagnostic pathways. Results Fifteen studies were included in the review. The very limited available data indicated that the addition of multiplex allergen testing [ImmunoCAP® Immuno Solid-phase Allergen Chip (ISAC), Thermo Fisher Scientific/Phadia AB, Uppsala, Sweden] to standard diagnostic work-up can change the clinicians’ views on the diagnosis, management and treatment of patients. There was some indication that the use of ImmunoCAP ISAC testing may be useful to guide decisions on the discontinuation of restrictive diets, the content of allergen-specific immunotherapy (SIT) prescriptions, and whether or not patients should receive SIT. However, none of the studies that we identified reported any information on clinical outcomes subsequent to changes in treatment or management. There was some evidence that ImmunoCAP ISAC may be useful for discriminating allergens that are structurally similar and are recognised by the same IgE antibody (cross-immunoreactive). No data were available for Microtest (Microtest Matrices Ltd, London, UK). Detailed cost analyses suggested that multiplex allergen testing would have to result in a substantial reduction of the proportions of patients receiving single IgE testing and oral food challenge tests in order to be cost-saving in the short term. Conclusions No recommendations for service provision can be made based on the analyses included in this report. It is suggested that a consensus-based protocol for the use of multiplex allergen testing be developed. The clinical effectiveness and cost-effectiveness of the proposed protocol should then be assessed by comparing long-term clinical and quality of life outcomes and resource use in patients managed using the protocol with those managed using a standard diagnostic pathway. © Queen’s Printer and Controller of HMSO 2016. AU - Westwood, M. AU - Ramaekers, B. AU - Lang, S. AU - Armstrong, N. AU - Noake, C. AU - De Kock, S. AU - Joore, M. AU - Severens, J. AU - Kleijnen, J. DB - Scopus DO - 10.3310/hta20670 IS - 67 M3 - Review PY - 2016 ST - Immunocap® ISAC and microtest for multiplex allergen testing in people with difficult to manage allergic disease: A systematic review and cost analysis T2 - Health Technology Assessment TI - Immunocap® ISAC and microtest for multiplex allergen testing in people with difficult to manage allergic disease: A systematic review and cost analysis VL - 20 ID - 340 ER - TY - JOUR AB - Background: Ovarian cancer is the sixth most common cancer in UK women and can be difficult to diagnose, particularly in the early stages. Risk-scoring can help to guide referral to specialist centres. Objectives: To assess the clinical and cost-effectiveness of risk scores to guide referral decisions for women with suspected ovarian cancer in secondary care. Methods: Twenty-one databases, including MEDLINE and EMBASE, were searched from inception to November 2016. Review methods followed published guidelines. The meta-analysis using weighted averages and random-effects modelling was used to estimate summary sensitivity and specificity with 95% confidence intervals (CIs). The cost-effectiveness analysis considered the long-term costs and quality-adjusted life-years (QALYs) associated with different risk-scoring methods, and subsequent care pathways. Modelling comprised a decision tree and a Markov model. The decision tree was used to model short-term outcomes and the Markov model was used to estimate the long-term costs and QALYs associated with treatment and progression. Results: Fifty-one diagnostic cohort studies were included in the systematic review. The Risk of Ovarian Malignancy Algorithm (ROMA) score did not offer any advantage over the Risk of Malignancy Index 1 (RMI 1). Patients with borderline tumours or non-ovarian primaries appeared to account for disproportionately high numbers of false-negative, low-risk ROMA scores. (Confidential information has been removed.) To achieve similar levels of sensitivity to the Assessment of Different NEoplasias in the adneXa (ADNEX) model and the International Ovarian Tumour Analysis (IOTA) group’s simple ultrasound rules, a very low RMI 1 decision threshold (25) would be needed; the summary sensitivity and specificity estimates for the RMI 1 at this threshold were 94.9% (95% CI 91.5% to 97.2%) and 51.1% (95% CI 47.0% to 55.2%), respectively. In the base-case analysis, RMI 1 (threshold of 250) was the least effective [16.926 life-years (LYs), 13.820 QALYs] and the second cheapest (£5669). The IOTA group’s simple ultrasound rules (inconclusive, assumed to be malignant) were the cheapest (£5667) and the second most effective [16.954 LYs, 13.841 QALYs], dominating RMI 1. The ADNEX model (threshold of 10%), costing £5699, was the most effective (16.957 LYs, 13.843 QALYs), and compared with the IOTA group’s simple ultrasound rules, resulted in an incremental cost-effectiveness ratio of £15,304 per QALY gained. At thresholds of up to £15,304 per QALY gained, the IOTA group’s simple ultrasound rules are cost-effective; the ADNEX model (threshold of 10%) is cost-effective for higher thresholds. Limitations: Information on the downstream clinical consequences of risk-scoring was limited. Conclusions: Both the ADNEX model and the IOTA group’s simple ultrasound rules may offer increased sensitivity relative to current practice (RMI 1); that is, more women with malignant tumours would be referred to a specialist multidisciplinary team, although more women with benign tumours would also be referred. The cost-effectiveness model supports prioritisation of sensitivity over specificity. Further research is needed on the clinical consequences of risk-scoring. © Queen’s Printer and Controller of HMSO 2018. AU - Westwood, M. AU - Ramaekers, B. AU - Lang, S. AU - Grimm, S. AU - Deshpande, S. AU - de Kock, S. AU - Armstrong, N. AU - Joore, M. AU - Kleijnen, J. DB - Scopus DO - 10.3310/hta22440 IS - 44 M3 - Article PY - 2018 SP - V-264 ST - Risk scores to guide referral decisions for people with suspected ovarian cancer in secondary care: A systematic review and cost-effectiveness analysis T2 - Health Technology Assessment TI - Risk scores to guide referral decisions for people with suspected ovarian cancer in secondary care: A systematic review and cost-effectiveness analysis VL - 22 ID - 334 ER - TY - JOUR AB - Background: Colorectal cancer (CRC) is the third most common cancer in the UK. Presenting symptoms that can be associated with CRC usually have another explanation. Faecal immunochemical tests (FITs) detect blood that is not visible to the naked eye and may help to select patients who are likely to benefit from further investigation. Objectives: To assess the effectiveness of FITs [OC-Sensor (Eiken Chemical Co./MAST Diagnostics, Tokyo, Japan), HM-JACKarc (Kyowa Medex/Alpha Laboratories Ltd, Tokyo, Japan), FOB Gold (Sentinel/Sysmex, Sentinel Diagnostics, Milan, Italy), RIDASCREEN Hb or RIDASCREEN Hb/Hp complex (R-Biopharm, Darmstadt, Germany)] for primary care triage of people with low-risk symptoms. Methods: Twenty-four resources were searched to March 2016. Review methods followed published guidelines. Summary estimates were calculated using a bivariate model or a random-effects logistic regression model. The cost-effectiveness analysis considered long-term costs and quality-adjusted life-years (QALYs) that were associated with different faecal occult blood tests and direct colonoscopy referral. Modelling comprised a diagnostic decision model, a Markov model for long-term costs and QALYs that were associated with CRC treatment and progression, and a Markov model for QALYs that were associated with no CRC. Results: We included 10 studies. Using a single sample and 10 μg Hb/g faeces threshold, sensitivity estimates for OC-Sensor [92.1%, 95% confidence interval (CI) 86.9% to 95.3%] and HM-JACKarc (100%, 95% CI 71.5% to 100%) indicated that both may be useful to rule out CRC. Specificity estimates were 85.8% (95% CI 78.3% to 91.0%) and 76.6% (95% CI 72.6% to 80.3%). Triage using FITs could rule out CRC and avoid colonoscopy in approximately 75% of symptomatic patients. Data from our systematic review suggest that 22.5–93% of patients with a positive FIT and no CRC have other significant bowel pathologies. The results of the base-case analysis suggested minimal difference in QALYs between all of the strategies; no triage (referral straight to colonoscopy) is the most expensive. Faecal immunochemical testing was cost-effective (cheaper and more, or only slightly less, effective) compared with no triage. Faecal immunochemical testing was more effective and costly than guaiac faecal occult blood testing, but remained cost-effective at a threshold incremental cost-effectiveness ratio of £30,000. The results of scenario analyses did not differ substantively from the base-case. Results were better for faecal immunochemical testing when accuracy of the guaiac faecal occult blood test (gFOBT) was based on studies that were more representative of the correct population. Limitations: Only one included study evaluated faecal immunochemical testing in primary care; however, all of the other studies evaluated faecal immunochemical testing at the point of referral. Further, validation data for the Faecal haemoglobin, Age and Sex Test (FAST) score, which includes faecal immunochemical testing, showed no significant difference in performance between primary and secondary care. There were insufficient data to adequately assess FOB Gold, RIDASCREEN Hb or RIDASCREEN Hb/Hp complex. No study compared FIT assays, or FIT assays versus gFOBT; all of the data included in this assessment refer to the clinical effectiveness of individual FIT methods and not their comparative effectiveness. Conclusions: Faecal immunochemical testing is likely to be a clinically effective and cost-effective strategy for triaging people who are presenting, in primary care settings, with lower abdominal symptoms and who are at low risk for CRC. Further research is required to confirm the effectiveness of faecal immunochemical testing in primary care practice and to compare the performance of different FIT assays. © Queen’s Printer and Controller of HMSO 2017. AU - Westwood, M. AU - Ramos, I. C. AU - Lang, S. AU - Luyendijk, M. AU - Zaim, R. AU - Stirk, L. AU - Al, M. AU - Armstrong, N. AU - Kleijnen, J. DB - Scopus DO - 10.3310/hta21330 IS - 33 M3 - Review PY - 2017 ST - Faecal immunochemical tests to triage patients with lower abdominal symptoms for suspected colorectal cancer referrals in primary care: A systematic review and cost-effectiveness analysis T2 - Health Technology Assessment TI - Faecal immunochemical tests to triage patients with lower abdominal symptoms for suspected colorectal cancer referrals in primary care: A systematic review and cost-effectiveness analysis VL - 21 ID - 338 ER - TY - JOUR AB - Methods: A systematic review of the evidence was carried out using standard methods. Randomised controlled trials were assessed for quality using the Cochrane risk of bias tool. Diagnostic accuracy studies were assessed using the QUADAS-2 tool. There were insufficient data for meta-analysis. For accuracy studies we calculated sensitivity and specificity together with 95% confidence intervals (CIs). Survival data were summarised as hazard ratios and tumour response data were summarised as relative risks, with 95% CIs. The health economic analysis considered the long-term costs and quality-adjusted life-years associated with different tests followed by treatment with standard chemotherapy or cetuximab plus standard chemotherapy. The analysis took a 'no comparator' approach, which implies that the cost-effectiveness of each strategy will be presented only compared with the next most cost-effective strategy. The de novo model consisted of a decision tree and Markov model. Results: The online survey indicated no differences between tests in batch size, turnaround time, number of failed samples or cost. The literature searches identified 7903 references, of which seven publications of five studies were included in the review. Two studies provided data on the accuracy of KRAS mutation testing for predicting response to treatment in patients treated with cetuximab plus standard chemotherapy. Four RCTs provided data on the clinical effectiveness of cetuximab plus standard chemotherapy compared with that of standard chemotherapy in patients with KRAS wild-type tumours. There were no clear differences in the treatment effects reported by different studies, regardless of which KRAS mutation test was used to select patients. In the 'linked evidence' analysis the Therascreen(®) KRAS RGQ PCR Kit (QIAGEN) was more expensive but also more effective than pyrosequencing or direct sequencing, with an incremental cost-effectiveness ratio of £17,019 per quality-adjusted life-year gained. In the 'assumption of equal prognostic value' analysis the total costs associated with the various testing strategies were similar. Limitations: The results assume that the differences in outcomes between the trials were solely the result of the different mutation tests used to distinguish between patients; this assumption ignores other factors that might explain this variation. Conclusions: There was no strong evidence that any one KRAS mutation test was more effective or cost-effective than any other test. Background: Bowel cancer is the third most common cancer in the UK. Most bowel cancers are initially treated with surgery, but around 17% spread to the liver. When this happens, sometimes the liver tumour can be treated surgically, or chemotherapy may be used to shrink the tumour to make surgery possible. Kirsten rat sarcoma viral oncogene (KRAS) mutations make some tumours less responsive to treatment with biological therapies such as cetuximab. There are a variety of tests available to detect these mutations. These vary in the specific mutations that they detect, the amount of mutation they detect, the amount of tumour cells needed, the time to give a result, the error rate and cost. Objectives: To compare the performance and cost-effectiveness of KRAS mutation tests in differentiating adults with metastatic colorectal cancer whose metastases are confined to the liver and are unresectable and who may benefit from first-line treatment with cetuximab in combination with standard chemotherapy from those who should receive standard chemotherapy alone. Data sources: Thirteen databases, including MEDLINE and EMBASE, research registers and conference proceedings were searched to January 2013. Additional data were obtained from an online survey of laboratories participating in the UK National External Quality Assurance Scheme pilot for KRAS mutation testing. © Queen’s Printer and Controller of HMSO 2014. AU - Westwood, M. AU - van Asselt, T. AU - Ramaekers, B. AU - Whiting, P. AU - Joore, M. AU - Armstrong, N. AU - Noake, C. AU - Ross, J. AU - Severens, J. AU - Kleijnen, J. DA - 2014-1-1 %J Health Technology Assessment IS - 62 KW - Adult Colorectal Neoplasms Quality-Adjusted Life Years Mutation Cost-Benefit Analysis PY - 2014 SP - i-xxii+1-131 ST - KRAS mutation testing of tumours in adults with metastatic colorectal cancer: A systematic review and cost-effectiveness analysis T2 - Health Technology Assessment TI - KRAS mutation testing of tumours in adults with metastatic colorectal cancer: A systematic review and cost-effectiveness analysis VL - 18 ID - 304 ER - TY - JOUR AB - Background: Ivacaftor (Kalydeco®, Vertex Pharmaceuticals) is the first of a new class of drugs that target the underlying protein defect in cystic fibrosis (CF). It is aimed at patients with the G551D (glycine to aspartate change in nucleotide 1784 in exon 11) mutation; 5.7% of patients with CF in the UK have this mutation. Objectives: To review the clinical effectiveness and cost-effectiveness of ivacaftor for the treatment of CF in patients aged ≥ 6 years who have the G551D mutation. Methods: Ten databases, including MEDLINE and EMBASE, were searched from inception to July 2012. Studies that evaluated ivacaftor for the treatment of adults and children (≥ 6 years) with at least one G551D mutation were eligible. There were insufficient data to conduct a formal meta-analysis. The manufacturer of ivacaftor, Vertex Pharmaceuticals, submitted a deterministic patient-level simulation model for the assessment of the lifetime cost-effectiveness of ivacaftor. We modified the model where values were not UK-specific or not recent, or where better estimates could be found. The only change to the model structure was the addition of lung transplantations. We changed utility values, annual decline in percentage predicted forced expiratory volume in 1 second (FEV1), and the baseline exacerbation rate, and used data from the CF Registry to estimate the relation between costs, age and percentage predicted FEV1. Estimates of treatment effect of ivacaftor came from the clinical effectiveness review. We modelled three scenarios for the longer-term effects of ivacaftor. We also modelled an 'optimistic' scenario for patients aged < 12 years with little lung damage. We conducted a budget impact analysis to estimate the total cost to the NHS of introducing ivacaftor in England. Results: Three studies were included: a randomised controlled trial (RCT) in adults (n = 167) (≥ 12 years), a RCT in children (n = 26) (6-11 years), and an open-label extension study of the two RCTs. Both RCTs reported significantly greater changes from baseline in all measures of lung function in patients receiving ivacaftor than in those receiving placebo. The mean difference in change in percentage predicted FEV1 was 10.5 [95% confidence interval (CI) 8.5 to 12.5] percentage points in the adults' study and 10.0 (95% CI 4.5 to 15.5) percentage points in the children's study at 48 weeks. Improvements in lung function were seen across all subgroups investigated (age, sex, study region and lung function). There were significantly greater improvements in the ivacaftor group than in the placebo group for all outcomes assessed (exacerbations, quality of life, sweat chloride and weight) with the exception of quality of life in children Improvements were maintained in the open-label trial. Adverse events were mainly minor and comparable across treatment groups. Both RCTs reported more withdrawals in the placebo group than in the ivacaftor group. The incremental cost-effectiveness ratio varied between £335,000 and £1,274,000 per quality-adjusted life-year gained. The total additional lifetime costs for all eligible CF patients in England ranged from £438M to £479M; the lifetime cost for standard care only was £72M. Conclusions: The available evidence suggests that ivacaftor is a clinically effective treatment for patients with CF and the G551D mutation; the high cost of ivacaftor may prove an obstacle in the uptake of this treatment. The main priority for further research is the long-term effectiveness of ivacaftor © Queen's Printer and Controller of HMSO 2014. AU - Whiting, P. AU - Maiwenn, Al AU - Burgers, L. AU - Westwood, M. AU - Ryder, S. AU - Hoogendoorn, M. AU - Armstrong, N. AU - Allen, A. AU - Severens, H. AU - Kleijnen, J. DA - 2014-1-1 %J Health Technology Assessment IS - 18 KW - Cystic Fibrosis Only Child Child Lung England Mutation Cost-Benefit Analysis PY - 2014 SP - 1-106 ST - Ivacaftor for the treatment of patients with cystic fibrosis and the G551D mutation: A systematic review and cost-effectiveness analysis T2 - Health Technology Assessment TI - Ivacaftor for the treatment of patients with cystic fibrosis and the G551D mutation: A systematic review and cost-effectiveness analysis VL - 18 ID - 303 ER - TY - JOUR AB - IMPORTANCE: Cannabis and cannabinoid drugs are widely used to treat disease or alleviate symptoms, but their efficacy for specific indications is not clear. OBJECTIVE: To conduct a systematic review of the benefits and adverse events (AEs) of cannabinoids. DATA SOURCES: Twenty-eight databases from inception to April 2015. STUDY SELECTION: Randomized clinical trials of cannabinoids for the following indications: nausea and vomiting due to chemotherapy, appetite stimulation in HIV/AIDS, chronic pain, spasticity due to multiple sclerosis or paraplegia, depression, anxiety disorder, sleep disorder, psychosis, glaucoma, or Tourette syndrome. DATA EXTRACTION AND SYNTHESIS: Study quality was assessed using the Cochrane risk of bias tool. All review stages were conducted independently by 2 reviewers. Where possible, data were pooled using random-effects meta-analysis. MAIN OUTCOMES AND MEASURES: Patient-relevant/disease-specific outcomes, activities of daily living, quality of life, global impression of change, and AEs. RESULTS: A total of 79 trials (6462 participants) were included; 4 were judged at low risk of bias. Most trials showed improvement in symptoms associated with cannabinoids but these associations did not reach statistical significance in all trials. Compared with placebo, cannabinoids were associated with a greater average number of patients showing a complete nausea and vomiting response (47% vs 20%; odds ratio [OR], 3.82 [95% CI, 1.55-9.42]; 3 trials), reduction in pain (37% vs 31%; OR, 1.41 [95% CI, 0.99-2.00]; 8 trials), a greater average reduction in numerical rating scale pain assessment (on a 0-10-point scale; weighted mean difference [WMD], -0.46 [95% CI, -0.80 to -0.11]; 6 trials), and average reduction in the Ashworth spasticity scale (WMD, -0.36 [95% CI, -0.69 to -0.05]; 7 trials). There was an increased risk of short-term AEs with cannabinoids, including serious AEs. Common AEs included dizziness, dry mouth, nausea, fatigue, somnolence, euphoria, vomiting, disorientation, drowsiness, confusion, loss of balance, and hallucination. CONCLUSIONS AND RELEVANCE: There was moderate-quality evidence to support the use of cannabinoids for the treatment of chronic pain and spasticity. There was low-quality evidence suggesting that cannabinoids were associated with improvements in nausea and vomiting due to chemotherapy, weight gain in HIV infection, sleep disorders, and Tourette syndrome. Cannabinoids were associated with an increased risk of short-term AEs. Copyright 2015 American Medical Association. All rights reserved. AU - Whiting, P. F. AU - Wolff, R. F. AU - Deshpande, S. AU - Di Nisio, M. AU - Duffy, S. AU - Hernandez, A. V. AU - Keurentjes, J. C. AU - Lang, S. AU - Misso, K. AU - Ryder, S. AU - Schmidlkofer, S. AU - Westwood, M. AU - Kleijnen, J. DA - 2015-1-1 %J JAMA - Journal of the American Medical Association IS - 24 KW - Bias (Epidemiology) Muscle Spasticity Sleep Disorders Tourette Syndrome Cannabinoids PY - 2015 SN - 0098-7484 SP - 2456-2473 ST - Cannabinoids for medical use: A systematic review and meta-analysis T2 - JAMA - Journal of the American Medical Association TI - Cannabinoids for medical use: A systematic review and meta-analysis VL - 313 ID - 299 ER - TY - JOUR AB - Previous systematic reviews have confirmed the benefits of both exercise training and psychological interventions in people with chronic obstructive pulmonary disease (COPD). The objective of this systematic review was to examine the effect of interventions which combine exercise training and psychological interventions for a range of health outcomes in people with COPD. Database searches identified randomized controlled trials of people with COPD participating in interventions that combined exercise training with a psychological strategy compared with control (usual care, waiting list) or active comparators (education, exercise, psychological interventions alone). Health outcomes included dyspnoea, anxiety, depression, quality of life or functional exercise capacity. Standardized mean differences (SMD) were calculated for each intervention arm/control comparison. Across the 12 included studies (738 participants), compared with control conditions, SMD consistently favoured interventions which included both exercise-+-psychological components (SMD range dyspnoea -1.63 to -0.25; anxiety -0.50 to -0.20; depression -0.46 to -0.18; quality of life 0.09 to 1.16; functional exercise capacity 0.22 to 1.23). When compared with active comparators, SMD consistently favoured interventions that included exercise training-+-psychological component for dyspnoea (SMD range -0.35 to -0.97), anxiety (SMD range -0.13 to -1.00) and exercise capacity (SMD range 0.64 to 0.71) but were inconsistent for depression (-0.11 to 1.27) and quality of life (0.02 to -2.00). The magnitude of effect for most interventions was greater than the minimum required for clinical significance (i.e.->-0.32) in behavioural medicine. While interventions, outcomes and effect sizes differed substantially between studies, combining exercise training with a psychological intervention may provide a means of optimizing rehabilitation in people with COPD. © 2014 Asian Pacific Society of Respirology. AU - Wiles, L. AU - Cafarella, P. AU - Williams, M. T. DA - 2015-1-1 IS - 1 KW - Lung Diseases Lung Diseases, Obstructive Randomized Controlled Trials as Topic Quality of Life Pulmonary Disease, Chronic Obstructive Humans Exercise Tolerance Exercise Therapy Dyspnea Depression Behavior Therapy Anxiety psychology kinesiotherapy complication systematic review risk assessment Review randomized controlled trial (topic) psychological aspect outcome assessment intervention study human exercise chronic obstructive lung disease pulmonary rehabilitation psychological intervention exercise training chronic obstructive pulmonary disease PY - 2015 SP - 46-55 ST - Exercise training combined with psychological interventions for people with chronic obstructive pulmonary disease T2 - Respirology TI - Exercise training combined with psychological interventions for people with chronic obstructive pulmonary disease VL - 20 ID - 225 ER - TY - JOUR AB - Abstract: Counseling has been suggested as a promising approach for facilitating changes in health behavior. The aim of this systematic review of counseling interventions for people with COPD was to describe: 1) counseling definitions, 2) targeted health behaviors, 3) counseling techniques and 4) whether commonalities in counseling techniques were associated with improved health behaviors. Ten databases were searched for original randomized controlled trials which included adults with COPD, used the term “counseling” as a sole or component of a multifaceted intervention and were published in the previous 10 years. Data extraction, study appraisal and coding for behavior change techniques (BCTs) were completed by two independent reviewers. Data were synthesized descriptively, with meta-analysis conducted where possible. Of the 182 studies reviewed as full-text, 22 were included. A single study provided a definition for counseling. Two key behaviors were the main foci of counseling: physical activity (n=9) and smoking cessation (n=8). Six studies (27%) reported underlying models and/or theoretical frameworks. Counseling was the sole intervention in 10 studies and part of a multicomponent intervention in 12. Interventions targeting physical activity included a mean of 6.3 (±3.1) BCTs, smoking cessation 4.9 (±2.9) BCTs and other behaviors 6.5 (±3.9) BCTs. The most frequent BCTs were social support unspecified (n=22; 100%), goal setting behavior (n=11), problem-solving (n=11) and instructions on how to perform the behavior (n=10). No studies shared identical BCT profiles. Counseling had a significant positive effect for smoking cessation and positive but not significant effect for physical activity. Counseling for health behavior change was rarely defined and effectiveness varied by target behavior. Provision of specific details when reporting studies of counseling interventions (definition, BCTs, dosage) would allow clarification of the effectiveness of counseling as an approach to health behavior change in people with COPD. © 2017 Williams et al. AU - Williams, M. T. AU - Effing, T. W. AU - Paquet, C. AU - Gibbs, C. A. AU - Lewthwaite, H. AU - Katrina Li, L. S. AU - Phillips, A. C. AU - Johnston, K. N. DA - 2017-1-1 KW - Smoking Smoke Treatment Outcome Smoking Cessation Risk Reduction Behavior Pulmonary Disease, Chronic Obstructive Motivation Middle Aged Male Lung Humans Healthy Lifestyle Health Knowledge, Attitudes, Practice Health Behavior Female Exercise Counseling Behavior Therapy Aged risk reduction psychology procedures pathophysiology meta analysis chronic obstructive lung disease attitude to health systematic review social support problem solving physical activity patient counseling human goal attainment behavior change Article Health behavior counseling COPD Behavior change techniques PY - 2017 SP - 2165-2178 ST - Counseling for health behavior change in people with COPD: Systematic review T2 - International Journal of COPD TI - Counseling for health behavior change in people with COPD: Systematic review VL - 12 ID - 145 ER - TY - JOUR AB - Background: Traumatic brain injury (TBI) is a worldwide leading cause of mortality and disability. Among TBI complications, agitation is a frequent behavioural problem. Agitation causes potential harm to patients and caregivers, interferes with treatments, leads to unnecessary chemical and physical restraints, increases hospital length of stay, delays rehabilitation, and impedes functional independence. Pharmacological treatments are often considered for agitation management following TBI. Several types of agents have been proposed for the treatment of agitation. However, the benefit and safety of these agents in TBI patients as well as their differential effects and interactions are uncertain. In addition, animal studies and observational studies have suggested impaired cognitive function with the use of certain antipsychotics and benzodiazepines. Hence, a safe and effective treatment for agitation, which does not interfere with neurological recovery, remains to be identified. Methods/design: With the help of Health Sciences librarian, we will design a search strategy in the following databases: PubMed, Ovid MEDLINE®, EMBASE, CINAHL, PsycINFO, Cochrane Library, Google Scholar, Directory of Open Access Journals, LILACS, Web of Science, and Prospero. A grey literature search will be performed using the resources suggested in CADTH's Grey Matters. We will include all randomized controlled, quasi-experimental, and observational studies with control groups. The population of interest is all patients, including children and adults, who have suffered a TBI. We will include studies in which agitation, not further defined, was the presenting symptom or one of the presenting symptoms. We will also include studies where agitation was not the presenting symptom but was measured as an outcome variable and studies assessing the safety of these pharmacological interventions in TBI patients. We will include studies evaluating all pharmacological interventions including beta-adrenergic blockers, typical and atypical antipsychotics, anticonvulsants, dopamine agonists, psychostimulants, antidepressants, alpha-2-adrenergic agonists, hypnotics, and anxiolytics. Discussion: Although agitation is frequent following TBI and pharmacological agents that are often used, there is no consensus on the most efficacious and safest strategy to treat these complications. There is a need for an updated systematic review to summarize the evidence in order to inform practice and future research. Systematic review registration: PROSPERO CRD42016033140 © 2016 The Author(s). AU - Williamson, D. R. AU - Frenette, A. J. AU - Burry, L. AU - Perreault, M. M. AU - Charbonney, E. AU - Lamontagne, F. AU - Potvin, M. J. AU - Giguère, J. F. AU - Mehta, S. AU - Bernard, F. DA - 2016-1-1 IS - 1 KW - Length of Stay Adrenergic beta-Antagonists Brain Brain Injuries Research Design Psychomotor Agitation Problem Behavior Mental Disorders Male Infant, Newborn Infant Humans Female Cognition Child, Preschool Child Central Nervous System Agents Brain Injuries, Traumatic Adult Adolescent traumatic brain injury restlessness preschool child newborn methodology mental disease drug effects complication urine retention tremor tachycardia systematic review speech disorder sexual dysfunction seizure respiration depression randomized controlled trial (topic) priority journal observational study mood disorder meta analysis insomnia human heart arrhythmia hallucination follow up drowsiness dizziness disorientation depression constipation confusion breathing rate body temperature disorder blood pressure Article agitation aggressiveness valproic acid serotonin uptake inhibitor serotonin noradrenalin reuptake inhibitor psychostimulant agent oxcarbazepine noradrenalin uptake inhibitor neuroleptic agent methylphenidate levetiracetam hypnotic agent gabapentin dopamine uptake inhibitor dexmedetomidine clonidine carbamazepine beta adrenergic receptor blocking agent benzodiazepine antidepressant agent amantadine Pharmacological intervention PY - 2016 SN - 2046-4053 ST - Pharmacological interventions for agitation in patients with traumatic brain injury: Protocol for a systematic review and meta-analysis T2 - Systematic Reviews TI - Pharmacological interventions for agitation in patients with traumatic brain injury: Protocol for a systematic review and meta-analysis VL - 5 ID - 118 ER - TY - JOUR AB - Background: Human epidermal growth factor receptor 2-positive (HER2+) breast cancer is an aggressive disease that makes up about 20% of all invasive breast cancers. HER2+ breast cancer is associated with poor prognosis and high mortality rates, but the development of HER2-targeted therapies, such as originator trastuzumab (Herceptin®), has substantially improved patient survival. Numerous clinical trials and reviews have investigated the efficacy of HER2-targeted therapies over the past few decades; however, no study has specifically investigated the vast body of evidence on trastuzumab in comparison to chemotherapy regimens, endocrine therapies, and other targeted therapies. This systematic review and cumulative network meta-analysis (NMA) will synthesize available evidence to evaluate the survival benefit conferred by the addition of originator trastuzumab to standard chemotherapy and to compare the most widely used trastuzumab regimens in patients with HER2+ early breast cancer, based on results from randomized controlled trials (RCTs) and comparative observational studies. Methods/design: A systematic search of Embase, MEDLINE®, and the Cochrane Library has been designed by an experienced medical information specialist and peer reviewed by another senior information specialist. RCTs and comparative observational studies of patients with HER2+ early breast cancer indexed from 1990 onwards will be eligible for inclusion. Two investigators will independently assess studies for inclusion and use standardized data extraction templates to collect data on study and patient characteristics. The primary outcome of interest is overall survival. Bayesian cumulative NMA methods will be used to quantify the evolution of publicly available evidence using both fixed and random effects models. Discussion: This study will evaluate survival trends associated with originator trastuzumab in patients with HER2+ early breast cancer. As originator trastuzumab has been researched in both clinical and real-world settings for close to 20 years, a cumulative NMA is likely to show improved precision around the parameter estimates for trastuzumab now compared with when the drug was initially launched in the USA in 1998. A better understanding of the evolution of publicly available comparative evidence for originator trastuzumab will further inform treatment for patients with HER2+ early breast cancer, providing benefit to patients, health professionals, and researchers. Systematic review registration: PROSPERO CRD42017055763 https://www.crd.york.ac.uk/PROSPERO © 2017 The Author(s). AU - Wilson, F. R. AU - Coombes, M. E. AU - Wylie, Q. AU - Yurchenko, M. AU - Brezden-Masley, C. AU - Hutton, B. AU - Skidmore, B. AU - Cameron, C. DA - 2017-1-1 IS - 1 KW - Receptor, Epidermal Growth Factor Epidermal Growth Factor Breast Neoplasms Humans Humanism Humanities systematic review randomized controlled trial (topic) priority journal overall survival outcome assessment neoadjuvant therapy molecularly targeted therapy meta analysis human epidermal growth factor receptor 2 positive breast cancer human health practitioner cancer survival bibliographic database Article adjuvant therapy trastuzumab emtansine trastuzumab tamoxifen lapatinib fulvestrant epirubicin docetaxel carboplatin bevacizumab anastrozole Targeted therapy Survival Network meta-analysis Herceptin® HER2-positive breast cancer Early breast cancer PY - 2017 SN - 2046-4053 ST - Herceptin® (trastuzumab) in HER2-positive early breast cancer: Protocol for a systematic review and cumulative network meta-analysis T2 - Systematic Reviews TI - Herceptin® (trastuzumab) in HER2-positive early breast cancer: Protocol for a systematic review and cumulative network meta-analysis VL - 6 ID - 79 ER - TY - JOUR AB - Background: Many systematic reviews have evaluated the effectiveness of interventions to prevent, delay, or decrease frailty symptoms, but no effort has been made to identify, map, and synthesize the findings from reviews across the full spectrum of interventions. Our objectives are to (1) synthesize findings from all existing systematic reviews evaluating interventions for preventing, delaying the onset, or decreasing the burden of frailty symptoms; (2) examine different conceptualizations of frailty that have been used in the development and implementation of interventions; and (3) inform policy by convening a stakeholder dialogue with Canadian health-system leaders. Methods/design: We will conduct an overview of systematic reviews to identify and synthesize all of the systematic reviews addressing interventions to preventing, delaying the onset, or decreasing the burden of frailty symptoms. To identify relevant systematic reviews, we will conduct database searches for published and grey literature as well as contact key experts and search reference lists of included reviews. Two reviewers will independently review all search results for inclusion and then conceptually map, extract key findings (including the conceptualization/definition of frailty used) and assess the methodological quality of all included reviews. We will then synthesize the findings by producing a 'gap map' (i.e. mapping reviews in a matrix according to the interventions and outcomes assessed), and narratively synthesize the key messages across reviews related to type of interventions. Discussion: Following the completion of the synthesis, we will use the findings to develop an evidence brief that mobilizes the best available evidence about the problem related to preventing, delaying the onset, or decreasing the burden of frailty symptoms in older adults, policy and programmatic options to address the problem and implementation considerations. The evidence brief will then be used as the input into a stakeholder dialogue, which will engage 18-22 Canadian health-system leaders (including policymakers, health providers, researchers, and other stakeholders) in 'off-the-record' deliberations to inform future actions and policymaking. Systematic review registration: PROSPERO CRD42015022082 © 2015 Wilson et al. AU - Wilson, M. G. AU - Béland, F. AU - Julien, D. AU - Gauvin, L. AU - Guindon, G. E. AU - Roy, D. AU - Campbell, K. AU - Comeau, D. G. AU - Davidson, H. AU - Raina, P. AU - Sattler, D. AU - Vrkljan, B. C2 - 26419226 C7 - 128 DB - Scopus DO - 10.1186/s13643-015-0110-7 IS - 1 KW - Ageing Frailty Interventions Older adults Overview of systematic reviews Seniors Stakeholder dialogue aging anthropometry Article bibliographic database clinical evaluation clinical feature disease course electronic medical record evidence based practice human information processing intervention study methodology outcome assessment priority journal qualitative research randomized controlled trial (topic) systematic review aged cost of illness frail elderly geriatrics literature medical research procedures translational research Biomedical Research Humans Review Literature as Topic Translational Medical Research M3 - Article PY - 2015 ST - Interventions for preventing, delaying the onset, or decreasing the burden of frailty: An overview of systematic reviews T2 - Systematic Reviews TI - Interventions for preventing, delaying the onset, or decreasing the burden of frailty: An overview of systematic reviews VL - 4 ID - 315 ER - TY - JOUR AB - Background: Providing patient-centered care requires that patients partner in their personal health-care decisions to the full extent desired. Patient decision aids facilitate processes of shared decision-making between patients and their clinicians by presenting relevant scientific information in balanced, understandable ways, helping clarify patients' goals, and guiding decision-making processes. Although international standards stipulate that patients and clinicians should be involved in decision aid development, little is known about how such involvement currently occurs, let alone best practices. This systematic review consisting of three interlinked subreviews seeks to describe current practices of user involvement in the development of patient decision aids, compare these to practices of user-centered design, and identify promising strategies. Methods/design: A research team that includes patient and clinician representatives, decision aid developers, and systematic review method experts will guide this review according to the Cochrane Handbook and PRISMA reporting guidelines. A medical librarian will hand search key references and use a peer-reviewed search strategy to search MEDLINE, EMBASE, PubMed, Web of Science, the Cochrane Library, the ACM library, IEEE Xplore, and Google Scholar. We will identify articles across all languages and years describing the development or evaluation of a patient decision aid, or the application of user-centered design or human-centered design to tools intended for patient use. Two independent reviewers will assess article eligibility and extract data into a matrix using a structured pilot-tested form based on a conceptual framework of user-centered design. We will synthesize evidence to describe how research teams have included users in their development process and compare these practices to user-centered design methods. If data permit, we will develop a measure of the user-centeredness of development processes and identify practices that are likely to be optimal. Discussion: This systematic review will provide evidence of current practices to inform approaches for involving patients and other stakeholders in the development of patient decision aids. We anticipate that the results will help move towards the establishment of best practices for the development of patient-centered tools and, in turn, help improve the experiences of people who face difficult health decisions. Systematic review registration: PROSPERO CRD42014013241. © 2015 Witteman et al.; licensee BioMed Central. AU - Witteman, H. O. AU - Dansokho, S. C. AU - Colquhoun, H. AU - Coulter, A. AU - Dugas, M. AU - Fagerlin, A. AU - Giguere, A. M. C. AU - Glouberman, S. AU - Haslett, L. AU - Hoffman, A. AU - Ivers, N. AU - Légaré, F. AU - Légaré, J. AU - Levin, C. AU - Lopez, K. AU - Montori, V. M. AU - Provencher, T. AU - Renaud, J. S. AU - Sparling, K. AU - Stacey, D. AU - Vaisson, G. AU - Volk, R. J. AU - Witteman, W. DA - 2015-1-1 IS - 1 KW - Acquired Immunodeficiency Syndrome Humanism Humanities Patient-Centered Care Patient Participation Patient Education as Topic Humans Health Services Research Decision Support Techniques Decision Making statistics and numerical data patient education patient care organization and management decision support system validation process systematic review social support randomized controlled trial (topic) quality control priority journal peer review patient decision making human health care management data extraction conceptual framework Cochrane Library Article User-centered design Stakeholder engagement Shared decision-making Patient partnership Patient decision aids Knowledge translation Implementation Human-centered design Decision support Counseling PY - 2015 SN - 2046-4053 ST - User-centered design and the development of patient decision aids: Protocol for a systematic review T2 - Systematic Reviews TI - User-centered design and the development of patient decision aids: Protocol for a systematic review VL - 4 ID - 37 ER - TY - JOUR AB - Introduction: Soft tissue injuries of the leg, ankle, or foot are common and often treated by exercise. The purpose of this study was to determine the effectiveness of exercise for the management of soft tissue injuries of the leg, ankle, or foot. Methods: A systematic review of the literature was conducted. We searched five databases from 1990 to 2015. Relevant articles were critically appraised using Scottish Intercollegiate Guidelines Network (SIGN) criteria. The evidence from studies with low risk of bias was synthesized using the best-evidence synthesis methodology. Results: We screened 7946 articles. We critically appraised ten randomized trials and six had a low risk of bias. The evidence suggests that for recent lateral ankle sprain: 1) rehabilitation exercises initiated immediately post-injury are as effective as a similar program initiated one week post-injury; and 2) supervised progressive exercise plus education/advice and home exercise lead to similar outcomes as education/advice and home exercise. Eccentric exercises may be more effective than an AirHeel brace but less effective than acupuncture for Achilles tendinopathy of more than two months duration. Finally, for plantar heel pain, static stretching of the calf muscles and sham ultrasound lead to similar outcomes, while static plantar fascia stretching provides short-term benefits compared to shockwave therapy. Conclusions: We found little evidence to support the use of early or supervised exercise interventions for lateral ankle sprains. Eccentric exercises may provide short-term benefits over a brace for persistent Achilles tendinopathy and plantar fascia stretching provides short-term benefits for plantar heel pain. © 2015 Elsevier Ltd. AU - Woitzik, E. AU - Jacobs, C. AU - Wong, J. J. AU - Côté, P. AU - Shearer, H. M. AU - Randhawa, K. AU - Sutton, D. AU - Southerst, D. AU - Varatharajan, S. AU - Brison, R. J. AU - Yu, H. AU - van der Velde, G. AU - Stern, P. J. AU - Taylor-Vaisey, A. AU - Stupar, M. AU - Mior, S. AU - Carroll, L. J. DA - 2015-1-1 IS - 5 KW - Ankle Leg Treatment Outcome Soft Tissue Injuries Recovery of Function Practice Guidelines as Topic Pain Measurement Ontario Male Leg Injuries Injury Severity Score Humans Foot Injuries Female Exercise Therapy Ankle Injuries Accidents, Traffic traffic accident statistics and numerical data procedures practice guideline physiology kinesiotherapy injury scale treatment planning therapy effect systematic review soft tissue injury rehabilitation care priority journal outcome assessment low risk patient human home care heel pain foot injury convalescence clinical evaluation clinical effectiveness Article ankle sprain ankle injury achilles tendinitis Plantar fasciitis Exercise Achilles tendinopathy PY - 2015 SN - 1356-689X DO - http://dx.doi.org/10.1016/j.math.2010.08.005 SP - 633-645 ST - The effectiveness of exercise on recovery and clinical outcomes of soft tissue injuries of the leg, ankle, and foot: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration T2 - Manual Therapy TI - The effectiveness of exercise on recovery and clinical outcomes of soft tissue injuries of the leg, ankle, and foot: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration VL - 20 ID - 200 ER - TY - JOUR AB - Background Preventable adverse drug reactions (PADRs) in inpatients are associated with harm, including increased length of stay and potential loss of life, and result in elevated costs of care. We conducted an overview of reviews (i.e., a systematic review of systematic reviews) to determine the incidence of PADRs experienced by inpatients. Secondary review objectives were related to assessment of the effects of patient age, setting, and clinical specialty on PADR incidence. Methods The protocol was registered in PROSPERO (CRD42016043220). We performed a search of Medline, Embase, and the Cochrane Library, limiting languages of publication to English and French. We included published systematic reviews that reported quantitative data on the incidence of PADRs in patients receiving acute or ambulatory care in a hospital setting. The full texts of all primary studies for which PADR data were reported in the included reviews were obtained and data relevant to review objectives were extracted. Quality of the included reviews was assessed using the AMSTAR-2 tool. Both narrative summaries of findings and meta-analyses of primary study data were undertaken. Results Thirteen systematic reviews encompassing 37 unique primary studies were included. Across primary studies, the PADR incidence was highly varied, ranging from 0.006 to 13.3 PADRs per 100 patients, with a pooled incidence estimate of 0.59 PADRs per 100 patients. Substantial heterogeneity was present across both reviews and primary studies with respect to review/study objectives, patient age, hospital setting, medical discipline, definitions and assessment tools used, event detection methods, endpoints of interest, and units of measure. Thirteen primary studies used prospective event detection methods and had a pooled PADR incidence of 3.13 (2.87-3.38) PADRs per 100 patients; however, extreme statistical heterogeneity (I 2 = 97%) indicated this finding should be considered with caution. Subgroup meta-analyses demonstrated that PADR incidence varied significantly with event detection method (prospective > retrospective > voluntary reporting methods), hospital setting (ICU > wards), and medical discipline (medical > surgical). High statistical heterogeneity (I 2 > 80%) was present across all analyses, indicating results should be interpreted with caution. Effects of patient age could not be assessed due to poor reporting of age groups used in primary studies. © 2018 Wolfe et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. AD - Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada Department of Pharmacy, Ottawa Hospital, Ottawa, ON, Canada Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada AU - Wolfe, D. AU - Yazdi, F. AU - Kanji, S. AU - Burry, L. AU - Beck, A. AU - Butler, C. AU - Esmaeilisaraji, L. AU - Hamel, C. AU - Hersi, M. AU - Skidmore, B. AU - Moher, D. AU - Hutton, B. C2 - 30308067 C7 - e0205426 DB - Scopus DO - 10.1371/journal.pone.0205426 IS - 10 KW - adverse drug reaction age ambulatory care Canada hospital patient human incidence intensive care unit medication error meta analysis (topic) preventable adverse drug reaction quality control Review staff training systematic review systematic review (topic) treatment outcome ward drug surveillance program prospective study retrospective study statistics and numerical data Drug-Related Side Effects and Adverse Reactions Humans Inpatients Pharmacovigilance Prospective Studies Retrospective Studies Systematic Reviews as Topic LA - English M3 - Review PY - 2018 ST - Incidence, causes, and consequences of preventable adverse drug reactions occurring in inpatients: A systematic review of systematic reviews T2 - PLoS ONE TI - Incidence, causes, and consequences of preventable adverse drug reactions occurring in inpatients: A systematic review of systematic reviews VL - 13 ID - 413 ER - TY - JOUR AB - Purpose: To evaluate the effectiveness of non-steroidal anti-inflammatory drugs (NSAIDs) for the management of neck pain and associated disorders (NAD), whiplash-associated disorders, and non-specific low back pain (LBP) with or without radiculopathy. Methods: We systematically searched six databases from 2000 to 2014. Random pairs of independent reviewers critically appraised eligible systematic reviews using the Scottish Intercollegiate Guidelines Network criteria. We included systematic reviews with a low risk of bias in our best evidence synthesis. Results: We screened 706 citations and 14 systematic reviews were eligible for critical appraisal. Eight systematic reviews had a low risk of bias. For recent-onset NAD, evidence suggests that intramuscular NSAIDs lead to similar outcomes as combined manipulation and soft tissue therapy. For NAD (duration not specified), oral NSAIDs may be more effective than placebo. For recent-onset LBP, evidence suggests that: (1) oral NSAIDs lead to similar outcomes to placebo or a muscle relaxant; and (2) oral NSAIDs with bed rest lead to similar outcomes as placebo with bed rest. For persistent LBP, evidence suggests that: (1) oral NSAIDs are more effective than placebo; and (2) oral NSAIDs may be more effective than acetaminophen. For recent-onset LBP with radiculopathy, there is inconsistent evidence on the effectiveness of oral NSAIDs versus placebo. Finally, different oral NSAIDs lead to similar outcomes for neck and LBP with or without radiculopathy. Conclusions: For NAD, oral NSAIDs may be more effective than placebo. Oral NSAIDs are more effective than placebo for persistent LBP, but not for recent-onset LBP. Different oral NSAIDs lead to similar outcomes for neck pain and LBP. © 2015, Springer-Verlag Berlin Heidelberg. AU - Wong, J. J. AU - Côté, P. AU - Ameis, A. AU - Varatharajan, S. AU - Varatharajan, T. AU - Shearer, H. M. AU - Brison, R. J. AU - Sutton, D. AU - Randhawa, K. AU - Yu, H. AU - Southerst, D. AU - Goldgrub, R. AU - Mior, S. AU - Stupar, M. AU - Carroll, L. J. AU - Taylor-Vaisey, A. DA - 2016-1-1 %J European Spine Journal IS - 1 KW - NADPH Oxidase Bias (Epidemiology) FMN Reductase Nitrate Reductase (NAD(P)H) Low Back Pain Radiculopathy Anti-Inflammatory Agents, Non-Steroidal Neck Pain PY - 2016 SP - 34-61 ST - Are non-steroidal anti-inflammatory drugs effective for the management of neck pain and associated disorders, whiplash-associated disorders, or non-specific low back pain? A systematic review of systematic reviews by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration T2 - European Spine Journal TI - Are non-steroidal anti-inflammatory drugs effective for the management of neck pain and associated disorders, whiplash-associated disorders, or non-specific low back pain? A systematic review of systematic reviews by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration VL - 25 ID - 298 ER - TY - JOUR AB - Objective: To evaluate the methodological quality and synthesize recommendations of evidence-based guidelines for the management of common traffic injuries. Study design: We conducted a systematic review and best evidence synthesis of guidelines on musculoskeletal injuries, psychological disorders and mild traumatic brain injuries (MTBI) from 1995 to 2012. Independent reviewers critically appraised eligible guidelines using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) criteria. Results: We retrieved 9863 citations. Of those, 16 guidelines were eligible for critical appraisal and eight were scientifically admissible (four targeting whiplash-associated disorders (WAD), one addressing anxiety and three addressing MTBI). The inadmissible guidelines had inadequate literature searches, inexplicit links between evidence and recommendations, and ambiguous recommendations. The literature used to develop most of the admissible guidelines was outdated. Major recommendations included: (1) Advice, education and reassurance for all conditions; (2) Exercise, return-to-activity, mobilization/manipulation, analgesics and avoiding collars for WAD; (3) Psychological first aid, pharmacotherapy and cognitive behavioral therapy as first-line interventions for anxiety; and (4) Monitoring for complications, discharge criteria, advice upon discharge from the emergency room and post-discharge care for MTBI. Conclusion: Fifty percent of appraised guidelines were scientifically admissible, but most need updating. Most guidelines focus on WAD and MTBI. Few guidelines make comprehensive recommendations on a wide range of consequences from traffic collisions.Implications for RehabilitationThe core components of a program of care designed to manage common traffic injuries (whiplash-associated disorders-WAD, anxiety and mild traumatic brain injuries) should include advice, education and reassurance.Depending on the condition, the following specific interventions should be considered: (1) WAD: exercise, early return to activity, mobilization/manipulation, analgesics and avoidance of collars; (2) Anxiety: psychological first aid, pharmacotherapy and cognitive behavioral therapy; and (3) Mild traumatic brain injuries: use of specific discharge criteria (including no factors warranting hospital admission and support structures for subsequent care), education upon discharge from emergency room and post-discharge care (e.g. monitoring for complications, gradual return to normal activity based on tolerance of individual).The methodological quality of guidelines varies greatly; therefore, guideline developers need to adhere to established methodological standards and conform to the evaluation criteria outlined in the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. © 2014 Informa UK Ltd. All rights reserved. AU - Wong, J. J. AU - Côté, P. AU - Shearer, H. M. AU - Carroll, L. J. AU - Yu, H. AU - Varatharajan, S. AU - Southerst, D. AU - Van Der Velde, G. AU - Jacobs, C. AU - Taylor-Vaisey, A. DA - 2015-1-1 IS - 6 KW - Emergency Service, Hospital Behavior Therapy Cognitive Therapy Brain Whiplash Injuries Prognosis Practice Guidelines as Topic Humans Exercise Disease Management Brain Injuries Anxiety Accidents, Traffic traffic accident practice guideline human Wounds Whiplash Traumatic brain injury Traffic Injuries Accidents PY - 2015 SN - 0963-8288 SP - 471-489 ST - Clinical practice guidelines for the management of conditions related to traffic collisions: A systematic review by the OPTIMa Collaboration T2 - Disability and Rehabilitation TI - Clinical practice guidelines for the management of conditions related to traffic collisions: A systematic review by the OPTIMa Collaboration VL - 37 ID - 214 ER - TY - JOUR AB - We conducted a systematic review of guidelines on the management of low back pain (LBP) to assess their methodological quality and guide care. We synthesized guidelines on the management of LBP published from 2005 to 2014 following best evidence synthesis principles. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane, DARE, National Health Services Economic Evaluation Database, Health Technology Assessment Database, Index to Chiropractic Literature and grey literature. Independent reviewers critically appraised eligible guidelines using AGREE II criteria. We screened 2504 citations; 13 guidelines were eligible for critical appraisal, and 10 had a low risk of bias. According to high-quality guidelines: (1) all patients with acute or chronic LBP should receive education, reassurance and instruction on self-management options; (2) patients with acute LBP should be encouraged to return to activity and may benefit from paracetamol, nonsteroidal anti-inflammatory drugs (NSAIDs), or spinal manipulation; (3) the management of chronic LBP may include exercise, paracetamol or NSAIDs, manual therapy, acupuncture, and multimodal rehabilitation (combined physical and psychological treatment); and (4) patients with lumbar disc herniation with radiculopathy may benefit from spinal manipulation. Ten guidelines were of high methodological quality, but updating and some methodological improvements are needed. Overall, most guidelines target nonspecific LBP and recommend education, staying active/exercise, manual therapy, and paracetamol or NSAIDs as first-line treatments. The recommendation to use paracetamol for acute LBP is challenged by recent evidence and needs to be revisited. Significance: Most high-quality guidelines recommend education, staying active/exercise, manual therapy and paracetamol/NSAIDs as first-line treatments for LBP. Recommendation of paracetamol for acute LBP is challenged by recent evidence and needs updating. � 2016 European Pain Federation - EFIC� AU - Wong, J. J. AU - Côté, P. AU - Sutton, D. A. AU - Randhawa, K. AU - Yu, H. AU - Varatharajan, S. AU - Goldgrub, R. AU - Nordin, M. AU - Gross, D. P. AU - Shearer, H. M. AU - Carroll, L. J. AU - Stern, P. J. AU - Ameis, A. AU - Southerst, D. AU - Mior, S. AU - Stupar, M. AU - Varatharajan, T. AU - Taylor-Vaisey, A. DA - 2017-1-1 IS - 2 KW - Acetaminophen Ontario Musculoskeletal Manipulations Low Back Pain Humans Exercise Therapy Anti-Inflammatory Agents, Non-Steroidal Acupuncture Therapy procedures practice guideline musculoskeletal manipulation kinesiotherapy acupuncture systematic review spine manipulation self care risk assessment Review rehabilitation reassurance radiculopathy PsycINFO psychological aspect priority journal physical activity patient education patient care non invasive procedure national health service Medline manipulative medicine managed care lumbar disk hernia human exercise evidence based medicine Embase economic evaluation data base daily life activity Cochrane Library clinical assessment Cinahl acupuncture analgesia paracetamol nonsteroid antiinflammatory agent muscle relaxant agent gabapentin antidepressant agent PY - 2017 SN - 10903801 (ISSN) SP - 201-216 ST - Clinical practice guidelines for the noninvasive management of low back pain: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration T2 - European Journal of Pain (United Kingdom) TI - Clinical practice guidelines for the noninvasive management of low back pain: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration VL - 21 ID - 159 ER - TY - JOUR AB - Background Context In 2008, the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders (Neck Pain Task Force) found limited evidence on the effectiveness of manual therapies, passive physical modalities, or acupuncture for the management of whiplash-associated disorders (WAD) or neck pain and associated disorders (NAD). Purpose This review aimed to update the findings of the Neck Pain Task Force, which examined the effectiveness of manual therapies, passive physical modalities, and acupuncture for the management of WAD or NAD. Study Design/Setting This is a systematic review and best evidence synthesis. Sample The sample includes randomized controlled trials, cohort studies, and case-control studies comparing manual therapies, passive physical modalities, or acupuncture with other interventions, placebo or sham, or no intervention. Outcome Measures The outcome measures were self-rated or functional recovery, pain intensity, health-related quality of life, psychological outcomes, or adverse events. Methods We systematically searched five databases from 2000 to 2014. Random pairs of independent reviewers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria. Studies with a low risk of bias were stratified by the intervention's stage of development (exploratory vs. evaluation) and synthesized following best evidence synthesis principles. Funding was provided by the Ministry of Finance. Results We screened 8,551 citations, and 38 studies were relevant and 22 had a low risk of bias. Evidence from seven exploratory studies suggests that (1) for recent but not persistent NAD grades I–II, thoracic manipulation offers short-term benefits; (2) for persistent NAD grades I–II, technical parameters of cervical mobilization (eg, direction or site of manual contact) do not impact outcomes, whereas one session of cervical manipulation is similar to Kinesio Taping; and (3) for NAD grades I–II, strain-counterstrain treatment is no better than placebo. Evidence from 15 evaluation studies suggests that (1) for recent NAD grades I–II, cervical and thoracic manipulation provides no additional benefit to high-dose supervised exercises, and Swedish or clinical massage adds benefit to self-care advice; (2) for persistent NAD grades I–II, home-based cupping massage has similar outcomes to home-based muscle relaxation, low-level laser therapy (LLLT) does not offer benefits, Western acupuncture provides similar outcomes to non-penetrating placebo electroacupuncture, and needle acupuncture provides similar outcomes to sham-penetrating acupuncture; (3) for WAD grades I–II, needle electroacupuncture offers similar outcomes as simulated electroacupuncture; and (4) for recent NAD grades III, a semi-rigid cervical collar with rest and graded strengthening exercises lead to similar outcomes, and LLLT does not offer benefits. Conclusions Our review adds new evidence to the Neck Pain Task Force and suggests that mobilization, manipulation, and clinical massage are effective interventions for the management of neck pain. It also suggests that electroacupuncture, strain-counterstrain, relaxation massage, and some passive physical modalities (heat, cold, diathermy, hydrotherapy, and ultrasound) are not effective and should not be used to manage neck pain. © 2015 Elsevier Inc. AU - Wong, J. J. AU - Shearer, H. M. AU - Mior, S. AU - Jacobs, C. AU - Côté, P. AU - Randhawa, K. AU - Yu, H. AU - Southerst, D. AU - Varatharajan, S. AU - Sutton, D. AU - van der Velde, G. AU - Carroll, L. J. AU - Ameis, A. AU - Ammendolia, C. AU - Brison, R. AU - Nordin, M. AU - Stupar, M. AU - Taylor-Vaisey, A. DA - 2016-1-1 IS - 12 KW - NADPH Oxidase Laser Therapy Hydrotherapy Musculoskeletal Manipulations Case-Control Studies Nitrate Reductase (NAD(P)H) FMN Reductase Neck Pain Whiplash-associated disorders Systematic review Passive physical modalities Neck pain and associated disorders Manual therapy Acupuncture PY - 2016 SP - 1598-1630 ST - Are manual therapies, passive physical modalities, or acupuncture effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the OPTIMa collaboration T2 - Spine Journal TI - Are manual therapies, passive physical modalities, or acupuncture effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the OPTIMa collaboration VL - 16 ID - 5 ER - TY - JOUR AB - Background: With the accumulation of evidence regarding potential harms of cancer screening in recent years, researchers, policy-makers, and the public are becoming more critical of population-based cancer screening. Consequently, a high-quality cancer screening program should consider individuals' values and preferences when determining recommendations. In cervical cancer screening, offering women autonomy is considered a "person-centered" approach to health care services; however, it may impact the effectiveness of the program should women choose to not participate. As part of a larger project to investigate women's cervical screening preferences and correlates of these preferences, this systematic review will capture quantitative and qualitative investigations of women's cervical screening preferences and the methods used to elicit them. Design and methods: This mixed methods synthesis will use a thematic analysis approach to synthesize qualitative, quantitative, and mixed methods evidence. This protocol describes the methods that will be used in this investigation. A search strategy has been developed with a health librarian and peer reviewed using PRESS. Based on this strategy, five databases and the gray literature will be searched for studies that meet the inclusion criteria. The quality of the included individual studies will be examined using the Mixed Methods Appraisal Tool. Three reviewers will extract data from the primary studies on the tools or instruments used to elicit women's preferences regarding cervical cancer screening, theoretical frameworks used, outcomes measured, the outstanding themes from quantitative and qualitative evidence, and the identified preferences for cervical cancer screening. We will describe the relationships between study results and the study population, "intervention" (e.g., tool or instrument), and context. We will follow the PRISMA reporting guideline. We will compare findings across studies and between study methods (e.g., qualitative versus quantitative study designs). The strength of the synthesized findings will be assessed using the validated GRADE and CERQual tool. Discussion: This review will inform the development of a tool to elicit women's cervical screening preferences. Understanding the methods used to elicit women's preferences and what is known about women's cervical screening preferences will be useful for guideline developers who wish to incorporate a woman-centered approach specifically for cervical screening guidelines. Systematic review registration: PROSPERO CRD42016035737 © 2016 The Author(s). AU - Wood, B. AU - Van Katwyk, S. R. AU - El-Khatib, Z. AU - McFaul, S. AU - Taljaard, M. AU - Wright, E. AU - Graham, I. D. AU - Little, J. DA - 2016-1-1 %J Systematic Reviews IS - 1 KW - Mass Screening Uterine Cervical Neoplasms PY - 2016 SN - 2046-4053 ST - Eliciting women's cervical screening preferences: A mixed methods systematic review protocol T2 - Systematic Reviews TI - Eliciting women's cervical screening preferences: A mixed methods systematic review protocol VL - 5 ID - 294 ER - TY - JOUR AB - Background: The purpose of this systematic review is to assess the effectiveness of brief interventions (BIs) as part of the Screening, Brief Intervention, and Referral to Treatment (SBIRT) model for reducing the nonmedical use of psychoactive substances. Methods: Bibliographic databases (including MEDLINE, Embase, The Cochrane Library, CINAHL, and PsycINFO to April 2012) and gray literature sources were searched. We included randomized controlled trials that opportunistically screened adolescents or adults and then provided a one-to-one, verbal BI to those at risk of substance-use harm. Of interest was the nonmedical use of psychoactive substances (for example, drugs prohibited by international law), excluding alcohol, nicotine, and caffeine. Interventions comprised four or fewer sessions and were compared with no/delayed intervention or provision of information only. Studies were assessed for bias using the Cochrane risk of bias tool. Results were synthesized narratively. Evidence was interpreted according to the GRADE framework. Results: We identified 8,836 records. Of these, five studies met our inclusion criteria. Two studies compared BI with no BI, and three studies compared BI with information only. Studies varied in characteristics such as substances targeted, screening procedures, and BI administered. Outcomes were mostly reported by a single study, leading to limited or uncertain confidence in effect estimates. Conclusions: Insufficient evidence exists as to whether BIs, as part of SBIRT, are effective or ineffective for reducing the use of, or harms associated with nonmedical use of, psychoactive substances when these interventions are administered to nontreatment-seeking, screen-detected populations. Updating this review with emerging evidence will be important. © 2014 Young et al. AU - Young, M. M. AU - Stevens, A. AU - Galipeau, J. AU - Pirie, T. AU - Garritty, C. AU - Singh, K. AU - Yazdi, F. AU - Golfam, M. AU - Pratt, M. AU - Turner, L. AU - Porath-Waller, A. AU - Arratoon, C. AU - Haley, N. AU - Leslie, K. AU - Reardon, R. AU - Sproule, B. AU - Grimshaw, J. AU - Moher, D. C2 - 24887418 C7 - 50 DB - Scopus DO - 10.1186/2046-4053-3-50 IS - 1 KW - Brief intervention Drug use Psychoactive substance SBIRT Screening Substance use Systematic review cannabis psychotropic agent Article behavior clinical effectiveness early intervention health care system health program human off label drug use outcome assessment priority journal randomized controlled trial (topic) risk assessment Screening, Brief Intervention, and Referral to Treatment model addiction adolescent adult mass screening patient referral review treatment outcome Humans Psychotropic Drugs Referral and Consultation Substance-Related Disorders M3 - Article PY - 2014 ST - Effectiveness of brief interventions as part of the Screening, Brief Intervention and Referral to Treatment (SBIRT) model for reducing the nonmedical use of psychoactive substances: A systematic review T2 - Systematic Reviews TI - Effectiveness of brief interventions as part of the Screening, Brief Intervention and Referral to Treatment (SBIRT) model for reducing the nonmedical use of psychoactive substances: A systematic review VL - 3 ID - 317 ER - TY - JOUR AB - Background: There is a significant public health burden associated with substance use in Canada. The early detection and/or treatment of risky substance use has the potential to dramatically improve outcomes for those who experience harms from the non-medical use of psychoactive substances, particularly adolescents whose brains are still undergoing development. The Screening, Brief Intervention, and Referral to Treatment model is a comprehensive, integrated approach for the delivery of early intervention and treatment services for individuals experiencing substance use-related harms, as well as those who are at risk of experiencing such harm.Methods: This article describes the protocol for a systematic review of the effectiveness of brief interventions as part of the Screening, Brief Intervention, and Referral to Treatment model for reducing the non-medical use of psychoactive substances. Studies will be selected in which brief interventions target non-medical psychoactive substance use (excluding alcohol, nicotine, or caffeine) among those 12 years and older who are opportunistically screened and deemed at risk of harms related to psychoactive substance use. We will include one-on-one verbal interventions and exclude non-verbal brief interventions (for example, the provision of information such as a pamphlet or online interventions) and group interventions. Primary, secondary and adverse outcomes of interest are prespecified. Randomized controlled trials will be included; non-randomized controlled trials, controlled before-after studies and interrupted time series designs will be considered in the absence of randomized controlled trials. We will search several bibliographic databases (for example, MEDLINE, EMBASE, CINAHL, PsycINFO, CORK) and search sources for grey literature. We will meta-analyze studies where possible. We will conduct subgroup analyses, if possible, according to drug class and intervention setting.Discussion: This review will provide evidence on the effectiveness of brief interventions as part of the Screening, Brief Intervention, and Referral to Treatment protocol aimed at the non-medical use of psychoactive substances and may provide guidance as to where future research might be most beneficial. © 2012 Young et al.; licensee BioMed Central Ltd. AU - Young, M. M. AU - Stevens, A. AU - Porath-Waller, A. AU - Pirie, T. AU - Garritty, C. AU - Skidmore, B. AU - Turner, L. AU - Arratoon, C. AU - Haley, N. AU - Leslie, K. AU - Reardon, R. AU - Sproule, B. AU - Grimshaw, J. AU - Moher, D. C2 - 22587894 C7 - 22 DB - Scopus DO - 10.1186/2046-4053-1-22 IS - 1 KW - Brief intervention Drug use Psychoactive substance Referral to treatment SBIRT Screening Substance use Systematic review 3, 4 methylenedioxymethamphetamine acetone alcohol amphetamine benzodiazepine caffeine cannabis cocaine dextromethorphan diamorphine gasoline illicit drug nicotine opiate psychotropic agent unclassified drug article human psychotherapy screening brief intervention and referral to treatment sensitivity analysis substance abuse systematic review (topic) addiction adolescent adult Canada child clinical trial (topic) early intervention female harm reduction integrated health care system intervention study literature male mass screening methodology organization and management Clinical Trials as Topic Delivery of Health Care, Integrated Early Medical Intervention Humans Intervention Studies Research Design Review Literature as Topic Substance-Related Disorders M3 - Article PY - 2012 ST - Effectiveness of brief interventions as part of the screening, brief intervention and referral to treatment (SBIRT) model for reducing the non-medical use of psychoactive substances: A systematic review protocol T2 - Systematic Reviews TI - Effectiveness of brief interventions as part of the screening, brief intervention and referral to treatment (SBIRT) model for reducing the non-medical use of psychoactive substances: A systematic review protocol VL - 1 ID - 322 ER - TY - JOUR AB - The implementation of electronic health records (EHRs) or electronic medical records (EMRs) is well documented in health informatics literature yet, very few studies focus primarily on how health professionals in direct clinical care are trained for EHR or EMR use. Purpose: To investigate how health professionals in direct clinical care are trained to prepare them for EHR or EMR use. Methods: Systematic searches were conducted in CINAHL, EMBASE, Ovid MEDLINE, PsycINFO, PubMed and ISI WoS and, the Arksey and O'Malley scoping methodological framework was used to collect the data and analyze the results. Results: Training was done at implementation, orientation and post-implementation. Implementation and orientation training had a broader scope while post-implementation training focused on proficiency, efficiency and improvement. The multiplicity of training methods, types and levels of training identified appear to suggest that training is more effective when a combination of training methods are used. AU - Younge, V. L. AU - Borycki, E. M. AU - Kushniruk, A. W. DB - Scopus IS - 3 M3 - Article PY - 2015 SP - 436-469 ST - On-the-job training of health professionals for electronic health record and electronic medical record use: A scoping review T2 - Knowledge Management & E-Learning TI - On-the-job training of health professionals for electronic health record and electronic medical record use: A scoping review VL - 7 ID - 342 ER - TY - JOUR AB - Background. Shoulder pain is a common musculoskeletal condition in the general population. Passive physical modalities are commonly used to treat shoulder pain. However, previous systematic reviews reported conflicting results. Purpose. The aim of this study was to evaluate the effectiveness of passive physical modalities for the management of soft tissue injuries of the shoulder. Data Sources. MEDLINE, EMBASE, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials were searched from January 1, 1990, to April 18, 2013. Study Selection. Randomized controlled trials (RCTs) and cohort and casecontrol studies were eligible. Random pairs of independent reviewers screened 1,470 of 1,760 retrieved articles after removing 290 duplicates. Twenty-two articles were eligible for critical appraisal. Eligible studies were critically appraised using the Scottish Intercollegiate Guidelines Network criteria. Of those, 11 studies had a low risk of bias. Data Extraction. The lead author extracted data from low risk of bias studies and built evidence tables. A second reviewer independently checked the extracted data. Data Synthesis. The findings of studies with a low risk of bias were synthesized according to principles of best evidence synthesis. Pretensioned tape, ultrasound, and interferential current were found to be noneffective for managing shoulder pain. However, diathermy and corticosteroid injections led to similar outcomes. Low-level laser therapy provided short-term pain reduction for subacromial impingement syndrome. Extracorporeal shock-wave therapy was not effective for subacromial impingement syndrome but provided benefits for persistent shoulder calcific tendinitis. Limitations. Non-English studies were excluded. Conclusions. Most passive physical modalities do not benefit patients with subacromial impingement syndrome. However, low-level laser therapy is more effective than placebo or ultrasound for subacromial impingement syndrome. Similarly, shockwave therapy is more effective than sham therapy for persistent shoulder calcific tendinitis. © 2015 American Physical Therapy Association. AU - Yu, H. AU - Côté, P. AU - Shearer, H. M. AU - Wong, J. J. AU - Sutton, D. A. AU - Randhawa, K. A. AU - Varatharajan, S. AU - Southerst, D. AU - Mior, S. A. AU - Ameis, A. AU - Stupar, M. AU - Nordin, M. AU - Van Der Velde, G. M. AU - Carroll, L. AU - Jacobs, C. L. AU - Taylor-Vaisey, A. L. AU - Abdulla, S. AU - Shergill, Y. DA - 2015-1-1 IS - 3 KW - Laser Therapy Treatment Outcome Soft Tissue Injuries Shoulder Pain Shoulder Impingement Syndrome Shoulder Recovery of Function Physical Therapy Modalities Humans physiotherapy injuries human convalescence complication PY - 2015 SN - 0031-9023 U2 - PMID: 2813518 SP - 306-318 ST - Effectiveness of passive physical modalities for shoulder pain: Systematic review by the Ontario protocol for traffic injury management collaboration T2 - Physical Therapy TI - Effectiveness of passive physical modalities for shoulder pain: Systematic review by the Ontario protocol for traffic injury management collaboration VL - 95 ID - 228 ER - TY - JOUR AB - Background context In 2008, the Bone and Joint Decade 2000 to 2010 Task Force on Neck Pain and Its Associated Disorders recommended patient education for the management of neck pain. However, the effectiveness of education interventions has recently been challenged. Purpose To update the findings of the Bone and Joint Decade 2000 to 2010 Task Force on Neck Pain and Its Associated Disorders and evaluate the effectiveness of structured patient education for the management of patients with whiplash-associated disorders (WAD) or neck pain and associated disorders (NAD). Study design/setting Systematic review of the literature and best-evidence synthesis. Patient sample Randomized controlled trials that compared structured patient education with other conservative interventions. Outcome measures Self-rated recovery, functional recovery (eg, disability, return to activities, work, or school), pain intensity, health-related quality of life, psychological outcomes such as depression or fear, or adverse effects. Methods We systematically searched eight electronic databases (MEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Central Register of Controlled Trials, DARE, PubMed, and ICL) from 2000 to 2012. Randomized controlled trials, cohort studies, and case-control studies meeting our selection criteria were eligible for critical appraisal. Random pairs of independent reviewers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria. Scientifically admissible studies were summarized in evidence tables and synthesized following best-evidence synthesis principles. Results We retrieved 4,477 articles. Of those, nine were eligible for critical appraisal and six were scientifically admissible. Four admissible articles investigated patients with WAD and two targeted patients with NAD. All structured patient education interventions included advice on activation or exercises delivered orally combined with written information or as written information alone. Overall, as a therapeutic intervention, structured patient education was equal or less effective than other conservative treatments including massage, supervised exercise, and physiotherapy. However, structured patient education may provide small benefits when combined with physiotherapy. Either mode of delivery (ie, oral or written education) provides similar results in patients with recent WAD. Conclusions This review adds to the Bone and Joint Decade 2000 to 2010 Task Force on Neck Pain and Its Associated Disorders by defining more specifically the role of structured patient education in the management of WAD and NAD. Results suggest that structured patient education alone cannot be expected to yield large benefits in clinical effectiveness compared with other conservative interventions for patients with WAD or NAD. Moreover, structured patient education may be of benefit during the recovery of patients with WAD when used as an adjunct therapy to physiotherapy or emergency room care. These benefits are small and short lived. © 2014 Elsevier Inc. AU - Yu, H. AU - Côté, P. AU - Southerst, D. AU - Wong, J. J. AU - Varatharajan, S. AU - Shearer, H. M. AU - Gross, D. P. AU - van der Velde, G. M. AU - Carroll, L. J. AU - Mior, S. A. AU - Ameis, A. AU - Jacobs, C. L. AU - Taylor-Vaisey, A. L. DA - 2016-1-1 IS - 12 KW - NADPH Oxidase Physical Therapy Modalities Nitrate Reductase (NAD(P)H) FMN Reductase Case-Control Studies Neck Pain Patient Education as Topic Whiplash-associated disorders Systematic review Recovery Patient education Outcome Neck pain and associated disorders PY - 2016 SP - 1524-1540 ST - Does structured patient education improve the recovery and clinical outcomes of patients with neck pain? A systematic review from the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration T2 - Spine Journal TI - Does structured patient education improve the recovery and clinical outcomes of patients with neck pain? A systematic review from the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration VL - 16 ID - 7 ER - TY - JOUR AB - Fisheye STUDY DESIGN: Systematic review. Fisheye BACKGROUND: Soft tissue injuries to the lower limb bring a substantial health and economic burden to society. Physical agents are commonly used to treat these injuries. However, the effectiveness of many such physical agents is not clearly established in the literature. Fisheye OBJECTIVE: To evaluate the effectiveness and safety of physical agents for soft tissue injuries of the lower limb. Fisheye METHODS: We searched 5 databases from 1990 to 2015 for randomized controlled trials (RCTs), cohort studies, and case-control studies. Paired reviewers independently screened the retrieved literature and appraised relevant studies using the Scottish Intercollegiate Guidelines Network criteria. Studies with a high risk of bias were excluded. We synthesized low-risk-of-bias studies according to principles of best-evidence synthesis. Fisheye RESULTS: We screened 10 261 articles. Of 43 RCTs identified, 20 had a high risk of bias and were excluded from the analysis, and 23 RCTs had a low risk of bias and were included in the analysis. The available higher-quality evidence suggests that patients with persistent plantar fasciitis may benefit from ultrasound or foot orthoses, while those with persistent midportion Achilles tendinopathy may benefit from shockwave therapy. However, the current evidence does not support the use of shockwave therapy for recent plantar fasciitis, low-Dye taping for persistent plantar fasciitis, low-level laser therapy for recent ankle sprains, or splints for persistent midportion Achilles tendinopathy. Finally, evidence on the effectiveness of the following interventions is not established in the current literature: (1) shockwave therapy for persistent plantar fasciitis, (2) cryotherapy or assistive devices for recent ankle sprains, (3) braces for persistent midportion Achilles tendinopathy, and (4) taping or electric muscle stimulation for patellofemoral pain syndrome. Fisheye CONCLUSION: Almost half the identified RCTs that evaluated the effectiveness of physical agents for the management of lower-limb soft tissue injuries had a high risk of bias. High-quality RCTs are still needed to assess the effectiveness of physical agents for managing the broad range of lower-limb soft tissue injuries. The effectiveness of most interventions remains unclear. Fisheye LEVEL OF EVIDENCE: Therapy, 1a. Protocol registered July 10, 2014 with PROSPERO (CRD42014010621). Copyright ©2016 Journal of Orthopaedic & Sports Physical Therapy®. AU - Yu, H. AU - Randhawa, K. AU - Côté, P. AU - Carroll, L. J. AU - Sutton, D. AU - Wong, J. J. AU - Varatharajan, S. AU - Southerst, D. AU - Stern, P. J. AU - Bohay, R. AU - Shearer, H. M. AU - Mior, S. AU - Lindsay, G. M. AU - Goldgrub, R. AU - Chung, C. L. AU - Ameis, A. AU - Nordin, M. AU - Stupar, M. AU - Taylor-Vaisey, A. DA - 2016-1-1 IS - 7 KW - Orthotic Devices Case-Control Studies Bias (Epidemiology) Soft Tissue Injuries Randomized Controlled Trials as Topic Physical Therapy Modalities Lower Extremity Humans Child randomized controlled trial (topic) physiotherapy meta analysis lower limb injuries human Recovery Physical agents Assistive devices PY - 2016 SP - 523-554 ST - The effectiveness of physical agents for lower-limb soft tissue injuries: A systematic review T2 - Journal of Orthopaedic and Sports Physical Therapy TI - The effectiveness of physical agents for lower-limb soft tissue injuries: A systematic review VL - 46 ID - 177 ER - TY - JOUR AB - Background: Network meta-analysis (NMA) has become a popular method to compare more than two treatments. This scoping review aimed to explore the characteristics and methodological quality of knowledge synthesis approaches underlying the NMA process. We also aimed to assess the statistical methods applied using the Analysis subdomain of the ISPOR checklist. Methods: Comprehensive literature searches were conducted in MEDLINE, PubMed, EMBASE, and Cochrane Database of Systematic Reviews from inception until April 14, 2015. References of relevant reviews were scanned. Eligible studies compared at least four different interventions from randomised controlled trials with an appropriate NMA approach. Two reviewers independently performed study selection and data abstraction of included articles. All discrepancies between reviewers were resolved by a third reviewer. Data analysis involved quantitative (frequencies) and qualitative (content analysis) methods. Quality was evaluated using the AMSTAR tool for the conduct of knowledge synthesis and the ISPOR tool for statistical analysis. Results: After screening 3538 citations and 877 full-text papers, 456 NMAs were included. These were published between 1997 and 2015, with 95% published after 2006. Most were conducted in Europe (51%) or North America (31%), and approximately one-third reported public sources of funding. Overall, 84% searched two or more electronic databases, 62% searched for grey literature, 58% performed duplicate study selection and data abstraction (independently), and 62% assessed risk of bias. Seventy-eight (17%) NMAs relied on previously conducted systematic reviews to obtain studies for inclusion in their NMA. Based on the AMSTAR tool, almost half of the NMAs incorporated quality appraisal results to formulate conclusions, 36% assessed publication bias, and 16% reported the source of funding. Based on the ISPOR tool, half of the NMAs did not report if an assessment for consistency was conducted or whether they accounted for inconsistency when present. Only 13% reported heterogeneity assumptions for the random-effects model. Conclusions: The knowledge synthesis methods and analytical process for NMAs are poorly reported and need improvement. © 2016 The Author(s). AU - Zarin, W. AU - Veroniki, A. A. AU - Nincic, V. AU - Vafaei, A. AU - Reynen, E. AU - Motiwala, S. S. AU - Antony, J. AU - Sullivan, S. M. AU - Rios, P. AU - Daly, C. AU - Ewusie, J. AU - Petropoulou, M. AU - Nikolakopoulou, A. AU - Chaimani, A. AU - Salanti, G. AU - Straus, S. E. AU - Tricco, A. C. DA - 2017-1-1 IS - 1 KW - Research Report North America Network Meta-Analysis Humans Europe Bias (Epidemiology) statistical bias research systematic review synthesis statistical analysis screening publishing model meta analysis Medline human funding Embase data analysis content analysis Cochrane Library checklist Research reporting Multiple treatments Mixed-treatment ISPOR AMSTAR PY - 2017 ST - Characteristics and knowledge synthesis approach for 456 network meta-analyses: A scoping review T2 - BMC Medicine TI - Characteristics and knowledge synthesis approach for 456 network meta-analyses: A scoping review VL - 15 ID - 103 ER - TY - JOUR AB - Objective: To identify predictors of persistent concussion symptoms (PCS) in children following concussion. Data Sources: We searched MEDLINE, Embase, and the Cochrane Library to April 2012. Study Selection: A systematic review of the literature to identify prognosticators of PCS following pediatric concussion was conducted. Studies evaluating patients aged 2 years to 18 years with PCS were eligible. Main Outcome Measures: The association of clinically available factors with PCS development. Results: A literature search yielded 824 records; 561 remained after removal of duplicates. Fifteen studies were included in descriptive analysis; heterogeneity precluded a meta-analysis. Larger prospective studies concluded that the risk for PCS was increased in older children with loss of consciousness, headache, and/or nausea/ vomiting. Smaller studies noted that initial dizziness may predict PCS. Patients with premorbid conditions (eg, previous head injury, learning difficulties, or behavioral problems) may also have increased risk. Conclusions: Minimal, and at times contradictory, evidence exists to associate clinically available factors with eventual development of PCS in children. Future trials must be adequately powered to determine which variables best predict the time to full symptom resolution. Expert consensus should delineate which postconcussion assessment measures are preferred to reduce heterogeneity going forward. Research to improve care for the epidemic of pediatric concussion depends on early identification of those most in need of intervention. © 2013 American Medical Association. All rights reserved. AU - Zemek, R. L. AU - Farion, K. J. AU - Sampson, M. AU - McGahern, C. C2 - 23303474 DB - Scopus DO - 10.1001/2013.jamapediatrics.216 IS - 3 KW - anxiety balance disorder behavior disorder blurred vision childhood injury concussion confusion dizziness drowsiness fatigue grief head injury headache human irritability learning disorder medical history memory disorder meta analysis nausea neck pain nervousness persistent concussion symptom predictive value priority journal prognosis review sleep disorder symptom systematic review unconsciousness Adolescent Brain Concussion Child Child, Preschool Female Humans Male Post-Concussion Syndrome Risk Factors M3 - Review PY - 2013 SP - 259-265 ST - Prognosticators of persistent symptoms following pediatric concussion: A systematic review T2 - JAMA Pediatrics TI - Prognosticators of persistent symptoms following pediatric concussion: A systematic review VL - 167 ID - 320 ER - TY - JOUR AB - Introduction: Chronic pain is a public health problem of epidemic proportion in most countries with important physical, psychological, social and economic consequences. The management of chronic pain is complex and requires an integrated network approach between all levels of the healthcare system and the involvement of several health professionals from different disciplines. Measuring the performance of organisations that provide care to individuals with chronic pain is essential to improve quality of care and requires the use of relevant performance and quality indicators. A scoping review methodology will be used to synthesise the evidence on performance and quality indicators developed for non-cancer chronic pain management across the continuum of care. Methods and analysis: The following electronic databases will be searched from 2000 onwards: Cochrane Effective Practice and Organisation of Care (EPOC) Review Group Specialised Register; Cochrane Library; EMBASE; PubMed; CINAHL; PsycINFO; ProQuest Dissertations and Theses. All types of studies will be included if these are concerned with performance or quality indicators in adults with chronic non-cancer pain. In addition, searches will be conducted on provincial, national and international health organisations as well as health professional and scientific associations' websites. A qualitative descriptive approach will be used to describe characteristics of each indicator. All identified indicators will be classified according to dimensions covered by Donabedian and the Triple Aim frameworks. Ethics and dissemination: The scoping review findings will inform the development of a performance measurement system comprising a list of performance indicators with their level of evidence which can be used by stakeholders to evaluate the quality of care for individuals with chronic non-cancer pain at the patient, institutional and system level. The results will be disseminated via several knowledge translation strategies, including 2 stakeholder meetings, publication and presentation at conferences. AU - Zidarov, D. AU - Visca, R. AU - Gogovor, A. AU - Ahmed, S. DA - 2016-1-1 IS - 2 KW - Quality Indicators, Health Care Humans Disease Management Chronic Pain health care quality total quality management Review publication PsycINFO performance measurement system patient care Medline information dissemination human health practitioner health care system health care organization ethics Embase conceptual framework Cochrane Library Cinahl chronic non cancer pain analgesia PY - 2016 SN - 2044-6055 ST - Performance and quality indicators for the management of non-cancer chronic pain: A scoping review protocol T2 - BMJ Open TI - Performance and quality indicators for the management of non-cancer chronic pain: A scoping review protocol VL - 6 ID - 188 ER - TY - JOUR AB - Introduction Group practices have potential benefits for patients, physicians and healthcare systems. Although group practices have been around for many years, research in this area is lacking and generally is centred around the economic benefits that may be realised from group practice. The aim of this scoping review is to identify the impact that group practices have on patients, physicians and healthcare systems to guide further research in this area. Methods and analysis A scoping review will be performed based on the methodology proposed by Arksey and O'Malley and refined by Levac and colleagues. MEDLINE, EMBASE, Cochrane Central and Cochrane Economic Database will be searched from inception to present day to identify relevant studies that assess the impact of group practices on patient care, satisfaction and outcomes; physician quality of life, satisfaction and income and healthcare systems. Titles and abstracts will be screened by two members and the abstraction results charted and verified. Qualitative and quantitative analyses will be performed to identify key themes. Ethics and dissemination Research ethics board approval is not required for this scoping review. A consultation phase will be used to discuss the results with key stakeholders followed by dissemination at local and national levels. We will also publish the results in a peer-reviewed journal. © Author(s) (or their employer(s)) 2018. AD - Department of Surgery, Ottawa Hospital, Ottawa, ON, Canada Department of Anesthesiology and Pain Medicine, Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada Ottawa Hospital Research Institute, Ottawa, ON, Canada AU - Zwiep, T. M. AU - Greenberg, J. A. AU - Balaa, F. AU - McIsaac, D. I. AU - Musselman, R. P. AU - Raiche, I. AU - Williams, L. AU - Moloo, H. C2 - 30244212 C7 - e022164 DB - Scopus DO - 10.1136/bmjopen-2018-022164 IS - 9 KW - adult article Cochrane Library Embase female group practice health care system human male Medline outcome assessment patient care physician quality of life quantitative analysis research ethics satisfaction systematic review economics health care delivery organization and management patient procedures psychology Delivery of Health Care Humans Patients Personal Satisfaction Physicians LA - English M3 - Article PY - 2018 ST - Impact of group practices on patients, physicians and healthcare systems: Protocol for a scoping review T2 - BMJ Open TI - Impact of group practices on patients, physicians and healthcare systems: Protocol for a scoping review VL - 8 ID - 414 ER -