scholarly journals Searching the evidence: the clinically-effective nutritionist

2003 ◽  
Vol 62 (4) ◽  
pp. 773-776
Author(s):  
Helen Moore ◽  
Carolyn Summerbell
Keyword(s):  
Randomised Controlled Trials ◽  
English Language ◽  
Search Strategy ◽  
Clinical Evidence ◽  
The Internet ◽  
Full Paper ◽  
Publication Type ◽  
Search Terms ◽  
On Line ◽  
Randomised Controlled

As a clinically-effective nutritionist faced with needing to find the answer to a clinical question quickly it is necessary to search the best evidence efficiently. The requirements are to: (1) avoid having lots of papers to read; (2) be able to access this information at one's place of work; (3) restrict reading to trials and systematic reviews of trials. If a decision has to be made while on the ward, the best resource is probably an easy-to-use book, Clinical Evidence. This resource is also available on-line, but there may not be access to the Internet on the ward. If a little more time is available, and access to the Internet, the following plan is suggested: (1) work out what the question is and highlight the search terms; (2) using the best search engine available, search MEDLINE from 1990 for titles and abstracts of papers containing the search terms, this is the search strategy (limit the search by publication type by requesting randomised controlled trials only, English language only and human only); (3) if more or less than approximately ten hits are obtained, alter the limits of the search (not the search strategy); (4) read the abstract, or full paper where available, of the relevant hits and appraise this evidence.

scholarly journals Intralesional injection treatment of hypertrophic scars and keloids: a systematic review regarding outcomes

2015 ◽  
Vol 3 ◽  
pp. 1-10 ◽  
Author(s):  
Aurelia Trisliana Perdanasari ◽  
Matteo Torresetti ◽  
Luca Grassetti ◽  
Fabio Nicoli ◽  
Yi Xin Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Treatment Options ◽  
Intralesional Injection ◽  
Hypertrophic Scars ◽  
Level Of Evidence ◽  
Search Terms ◽  
Injection Treatment ◽  
Full Text Review ◽  
On Line

Abstract Background The aim of this review was to explore the existing body of literature focusing on the intralesional treatments of keloids and hypertrophic scars. Methods A comprehensive systematic review of related articles was conducted across multiple databases. Article selection was limited to those published in the English language between 1950 and 2014. Search terms for the on-line research were “scar(s),” “keloid(s),” “hypertrophic,” “injection,” “intralesional,” and “treatment”. Results The initial search returned 2548 published articles. After full text review, the final search yielded 11 articles that met inclusion criteria. A total of 14 patient samples in 11 articles were collected. The most frequent intralesional injection treatment studied was triamcinolone (n = 5), followed by bleomycin (n = 3), 5-fluorouracil (n = 2), verapamil (n = 2), cryosurgery, and collagenase. The scar height reduction for all but one study was demonstrated, with acceptable complication and recurrence rate. Only three articles reported a follow-up period longer than 18 months, and only two studies used standardized outcome criteria with a quantitative scale. Conclusions Although many treatment options have already been described in the literature, there is no universally accepted treatment resulting in permanent hypertrophic or keloid scar ablation. The lack of adequately long-term powered randomized controlled trials does not permit to establish definitive conclusions with implications for routine clinical practice. Level of evidence III/Therapeutic

The effectiveness of braces and orthoses for patients with knee osteoarthritis: A systematic review of Japanese-language randomised controlled trials

2016 ◽  
Vol 41 (2) ◽  
pp. 115-126 ◽  
Author(s):  
Koya Mine ◽  
Takashi Nakayama ◽  
Steve Milanese ◽  
Karen Grimmer
Keyword(s):  
Systematic Review ◽  
Knee Osteoarthritis ◽  
Randomised Controlled Trials ◽  
English Language ◽  
Japanese Language ◽  
Controlled Trials ◽  
Foot Orthoses ◽  
Language Studies ◽  
Knee Braces ◽  
Randomised Controlled

Background:Knee osteoarthritis is common. The evidence regarding the effectiveness of braces and orthoses for patients with knee osteoarthritis is inconclusive according to English-language literature. English-language reviews to date have not included Japanese-language studies.Objectives:This study aimed to collect and synthesise Japanese-language randomised controlled trials investigating the effectiveness of braces and orthoses for patients with knee osteoarthritis.Study design:Systematic review.Methods:Eight databases were systematically searched from inception to 29 July 2015. Only Japanese-language randomised controlled trials were included. Risk of bias was assessed using Physiotherapy Evidence Database scale. A meta-analysis was not appropriate due to the heterogeneity in the included studies.Results:Seven randomised controlled trials with low to high risks of bias were included. Six of seven included studies were conducted by the same author group. Limited evidence supported the positive effects of short-lever elastic knee braces to improve pain and functional disability in specific outcomes. No evidence was found to support the use of foot orthoses, such as laterally wedged insoles, medial arch support and metatarsal arch pad.Conclusion:Our systematic review found no conclusive evidence about the effectiveness of any braces and orthoses for patients with medial knee osteoarthritis. Future Japanese-language studies should address methodological flaws exposed in this review and strengthen the international evidence base.Clinical relevanceThis is the first systematic review of Japanese-language randomised controlled trials investigating orthoses for patients with knee osteoarthritis. Clinicians can consider the use of short-lever elastic knee braces to improve specifically pain on squat or walking. Evidence found in this review does not support the use of foot orthoses.

scholarly journals A Systematic Review to Assess the Effectiveness of Technology-Based Interventions to Address Obesity in Children

2019 ◽  
Author(s):  
Megan McMullan ◽  
Rachel Millar ◽  
Jayne Woodside
Keyword(s):  
Systematic Review ◽  
Childhood Obesity ◽  
Secondary Prevention ◽  
Randomised Controlled Trials ◽  
English Language ◽  
Evidence Base ◽  
Controlled Trials ◽  
Obese Children ◽  
Active Video ◽  
Randomised Controlled

Abstract Background: Childhood obesity is associated with a multitude of co-morbidities, including hypertension, hyperlipidaemia, cardiovascular disease and type 2 diabetes. Childhood obesity can also affect a young person’s social, emotional and mental health if they encounter negative prejudice and social marginalisation. Given the prevalence of overweight and obese children globally, it is imperative that effective interventions are developed. Children are receptive to information conveyed via digital means, therefore, the use of technology may play a crucial role in interventions to reduce childhood obesity. This systematic review aimed to review and critically appraise the literature published to date in relation to the effectiveness of technology-based interventions, employed as secondary prevention, in addressing childhood obesity. Methods: An electronic search strategy was undertaken in Medline and Embase, covering publications up to and including 12th July 2018. Randomised controlled trials assessing the effectiveness of technology-based interventions on weight-related outcomes in children, aged 8 to 18, published only in the English language, were included. Results: From an initial search total of 1,012 studies, 11 met the inclusion criteria. They were assessed for methodological quality using the Cochrane Risk of Bias Tool for Randomised Controlled Trials and were analysed using a narrative approach. The findings of this review showed a weak evidence base regarding the role of technology-based interventions, employed as secondary prevention, to address childhood obesity. Of the eleven studies reviewed, three (27%) showed a positive relationship between technology-based interventions and weight-related outcomes in overweight or obese children. Conclusions: This review suggests that technology-based interventions, primarily active video games, as well as internet or web-based interventions and mobile phone communications, may, with further research, have the potential to impact positively on weight-related outcomes. It is difficult to determine the degree of efficacy of these technology-based interventions, as only two databases were searched, selecting only English language articles. Moreover, the included studies demonstrated a lack of high-quality evidence. The lack and heterogeneity of studies with technology-based interventions is a further limitation.

scholarly journals Evidence Supporting the Use of Recombinant Activated Factor VII in Congenital Bleeding Disorders

2011 ◽  
Vol 07 (01) ◽  
pp. 71
Author(s):  
Pär I Johansson ◽  
Sisse R Ostrowski ◽  
◽  
Keyword(s):  
Randomised Controlled Trials ◽  
Thrombin Generation ◽  
English Language ◽  
Factor Vii ◽  
Controlled Trials ◽  
Bleeding Disorders ◽  
Recombinant Activated Factor Vii ◽  
Activated Factor Vii ◽  
Number Of Patients ◽  
Randomised Controlled

Recombinant activated factor VII ([rFVIIa] NovoSeven) was introduced in 1996 for the treatment of haemophilia patients with inhibitors (HPIs) to factor VIII or IX. This article reviews the evidence for the use of rFVIIa in congenital bleeding disorders. English-language databases were searched in September 2009 for reports of randomised controlled trials (RCTs) evaluating the effect of rFVIIa on haemostasis in congenital bleeding disorders. Eight RCTs comprising 256 HPIs were identified. The evidence for the use of rFVIIa in HPIs in terms of dose, clinical setting, modes of administration, efficacy and adverse events was weak, given the limited number of patients included and the heterogeneity of the RCTs. Overall, the haemostatic efficacy of rFVIIa varied from 25 to 100% in the studies reviewed; <1% of the patients receiving rFVIIa developed a thromboembolic adverse event. The authors suggest that the addition FVIIa therapy to HPIs should be based on the patient’s ability to generate thrombin and form a clot, rather than being based on weight alone. Assays reflecting thrombin generation, such as whole-blood thrombelastography, have the potential to significantly improve the treatment of these patients.

scholarly journals A Systematic Review to Assess the Effectiveness of Technology-Based Interventions to Address Obesity in Children

2019 ◽  
Author(s):  
Megan McMullan ◽  
Rachel Millar ◽  
Jayne Woodside
Keyword(s):  
Systematic Review ◽  
Childhood Obesity ◽  
Secondary Prevention ◽  
Randomised Controlled Trials ◽  
English Language ◽  
Controlled Trials ◽  
Effective Interventions ◽  
Use Of Technology ◽  
Active Video ◽  
Randomised Controlled

Abstract Background Childhood obesity is associated with a multitude of co-morbidities, including hypertension, hyperlipidaemia, cardiovascular disease and type 2 diabetes. Childhood obesity can also affect a young person’s social, emotional and mental health if they encounter negative prejudice and social marginalisation. Given the prevalence of overweight and obese children globally, it is imperative that effective interventions are developed. Children are receptive to information conveyed via digital means, therefore, the use of technology may play a crucial role in interventions to reduce childhood obesity. This systematic review aimed to review and critically appraise the literature published to date in relation to the effectiveness of technology-based interventions, employed as secondary prevention, in addressing childhood obesity.Methods An electronic search strategy was undertaken in Medline and Embase, covering publications up to and including 12th July 2018. Randomised controlled trials assessing the effectiveness of technology-based interventions on weight-related outcomes in children, aged 8 to 18, published only in the English language, were included.Results From an initial search total of 1,012 studies, 11 met the inclusion criteria. They were assessed for methodological quality using the Cochrane Risk of Bias Tool for Randomised Controlled Trials and were analysed using a narrative approach. The findings of this review showed a limited potential of technology-based interventions, employed as secondary prevention, to address childhood obesity. Of the eleven studies reviewed, three (27%) showed a positive relationship between technology-based interventions and weight-related outcomes in overweight or obese children.Conclusions This review suggests that technology-based interventions, primarily active video games, as well as internet or web-based interventions and mobile phone communications, may, with further research, have the potential to impact positively on weight-related outcomes. It is difficult to determine the degree of efficacy of these technology-based interventions, as only two databases were searched, selecting only English language articles. Moreover, the included studies demonstrated a lack of high-quality evidence. The lack and heterogeneity of studies with technology-based interventions is a further limitation.

scholarly journals A Systematic Review to Assess the Effectiveness of Technology-Based Interventions to Address Obesity in Children

2020 ◽  
Author(s):  
Megan McMullan ◽  
Rachel Millar ◽  
Jayne Woodside
Keyword(s):  
Systematic Review ◽  
Childhood Obesity ◽  
Secondary Prevention ◽  
Randomised Controlled Trials ◽  
English Language ◽  
Controlled Trials ◽  
Obese Children ◽  
Effective Interventions ◽  
Active Video ◽  
Randomised Controlled

Abstract Background: Childhood obesity is associated with a multitude of co-morbidities, including hypertension, hyperlipidaemia, cardiovascular disease and type 2 diabetes. Childhood obesity can also affect a young person’s social, emotional and mental health if they encounter negative prejudice and social marginalisation. Given the prevalence of overweight and obese children globally, it is imperative that effective interventions are developed. Children are receptive to information conveyed via digital means, therefore, the use of technology may play a crucial role in interventions to reduce childhood obesity. This systematic review aimed to review and critically appraise the literature published to date in relation to the effectiveness of technology-based interventions, employed as secondary prevention, in addressing childhood obesity.Methods: An electronic search strategy was undertaken in Medline and Embase, covering publications up to and including 12th July 2018. Randomised controlled trials assessing the effectiveness of technology-based interventions on weight-related outcomes in children, aged 8 to 18, published only in the English language, were included. Results: From an initial search total of 1,012 studies, 11 met the inclusion criteria. They were assessed for methodological quality using the Cochrane Risk of Bias Tool for Randomised Controlled Trials and were analysed using a narrative approach. The findings of this review showed a limited potential of technology-based interventions, employed as secondary prevention, to address childhood obesity. Of the eleven studies reviewed, three (27%) showed a positive relationship between technology-based interventions and weight-related outcomes in overweight or obese children. Conclusions: This review suggests that technology-based interventions, primarily active video games, as well as internet or web-based interventions and mobile phone communications, may, with further research, have the potential to impact positively on weight-related outcomes. It is difficult to determine the degree of efficacy of these technology-based interventions, as only two databases were searched, selecting only English language articles. Moreover, the included studies demonstrated a lack of high-quality evidence. The lack and heterogeneity of studies with technology-based interventions is a further limitation.

scholarly journals Acupuncture for Infantile Colic: A Systematic Review of Randomised Controlled Trials

2018 ◽  
Vol 2018 ◽  
pp. 1-11
Author(s):  
Dabin Lee ◽  
Hojung Lee ◽  
Jiwon Kim ◽  
Taehun Kim ◽  
Siyun Sung ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Randomised Controlled Trials ◽  
Clinical Evidence ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Clinical Heterogeneity ◽  
Infantile Colic ◽  
Safety And Efficacy ◽  
Randomized Controlled ◽  
Randomised Controlled

Introduction. Infantile colic is a common condition causing considerable deterioration in the quality of life of both infants and their parents. Minimal acupuncture, a gentle needling technique without strong muscle stimulation, has primarily been used to treat this condition, but the clinical evidence of its efficacy and safety is yet to be established. The objective of this review was to assess clinical evidence of the safety and efficacy of acupuncture for infantile colic. Methods. To identify studies for inclusion, PubMed, Cochrane Library, Google Scholar, China Knowledge Resource Integrated Database, Wanfang, and Oriental Medicine Advanced Searching Integrated System were searched until January 2017. Only randomised controlled trials of infantile colic in patients aged 0 to 25 weeks, who were treated with acupuncture, were included. To assess the quality, the risk of bias was determined for each study by two authors. The intention was to perform a meta-analysis, but this was not possible in this study due to considerable clinical heterogeneity among the included studies. Results. Of the 601 studies identified, only four randomized controlled trials were included in this review. All included studies were conducted in northern European countries. Most studies showed a low risk of bias in most domains. Minimal acupuncture on LI4 or ST36 without strong stimulation was used in all studies. From the narrative analysis, acupuncture appears to be effective in alleviating the symptoms of colic, including crying and feeding and stooling problems, and may have only minor adverse effects. However, clinical evidence could not be confirmed owing to considerable clinical heterogeneity and the small sample sizes of the included studies. Conclusion. There is currently no conclusive evidence on the safety and efficacy of acupuncture for infantile colic. Rigorous full-scale randomized controlled trials will be necessary in future.

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