scholarly journals A Critical Review of the Scientific Evidence and Recommendations in COVID-19 Management Guidelines

2021 ◽  
Author(s):  
Jiaxing Xie ◽  
Zhufeng Wang ◽  
Jingyi Liang ◽  
Huimin Lin ◽  
Zhaowei Yang ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Web Sites ◽  
Critical Review ◽  
Web Of Science ◽  
Scientific Evidence ◽  
Cochrane Library ◽  
Level Of Evidence ◽  
Management Guidelines ◽  
Specialty Society

Abstract Background Little is known about the quality and potential impacts of the guidelines for COVID-19 management. Methods We systematically searched PubMed, Web of Science, Cochrane Library, guideline databases and specialty society Web sites to evaluate the quality of the retrieved guidelines using the Appraisal of Guidelines for Research and Evaluation II. Results A total of 66 guidelines were identified. Only 24% were categorized as “recommended” for clinical practice. The 211 identified recommendations for COVID-19 management were classified into four topics: respiratory support(27), ARDS management(31), anti-viral or immunomodulatory therapy(95), or other medicines(58). Only 63% and 56% recommendations were supported by, respectively, assessment of the strength of recommendation or level of evidence. There were notable discrepancies between the different guidelines regarding the recommendations on COVID-19 management. Conclusions The quality of the guidelines for COVID-19 management is heterogeneous, and the recommendations are rarely supported by evidence.

scholarly journals Atividades da intervenção de enfermagem “cuidados com a ostomia”

2017 ◽  
Vol 11 (12) ◽  
pp. 5417
Author(s):  
Lays Pinheiro de Medeiros ◽  
Isabelle Pereira da Silva ◽  
Silvia Kalyma Paiva Lucena ◽  
Julliana Fernandes de Sena ◽  
Emily Kathiene Silva de Mesquita ◽  
...  
Keyword(s):  
Web Of Science ◽  
Scientific Evidence ◽  
Integrative Review ◽  
Level Of Evidence ◽  
Management Guidelines ◽  
Levels Of Evidence ◽  
Intervention Method

RESUMOObjetivo: avaliar as evidências sobre as atividades propostas pela intervenção da NIC “Cuidados com a ostomia”. Método: revisão integrativa, realizada em março de 2016 nas bases de dados MEDLINE, CINAHL, Web of Science, SCOPUS e LILACS. Os estudos foram categorizados a partir da identificação das intervenções condizentes com a taxonomia da intervenção na NIC <<Cuidados com a ostomia>>, bem como as atividades propostas. Resultados: a coleta resultou em 23 artigos, de maioria qualitativos (52%), com nível de evidência IV (60,9%), identificando-se, nestes, 23 das 25 atividades de Enfermagem propostas na NIC, sendo a atividade “Orientar o paciente/pessoa importante quanto ao uso de dispositivo/cuidados de ostomia” a mais frequente (60,9%). Conclusão: verificou-se, portanto, que as ações mais frequentes realizadas pelos enfermeiros se referem às orientações de manejo do ostoma com a inclusão do cuidador e que há necessidade de mais estudos com melhores níveis de evidência nessa temática. Descritores: Ostomia; Enfermagem; Assistência.  ABSTRACTObjective: to evaluate the scientific evidence about the activities proposed by the NIC "Care with ostomy" intervention. Method: integrative review, conducted in March 2016 in the MEDLINE, CINAHL, Web of Science, SCOPUS and LILACS databases. The studies were categorized from the identification of the interventions according to the taxonomy of the intervention in the NIC << Care for the ostomy >>, as well as the proposed activities. Results: collection resulted in 23 articles, mostly qualitative (52%), with level of evidence IV (60.9%), identifying, in these, 23 of the 25 Nursing activities proposed in the NIC, and the activity "Orient the patient / important person regarding the use of ostomy device / care "the most frequent (60.9%). Conclusion: it was verified, therefore, that the most frequent actions performed by the nurses refer to the management guidelines of the ostoma with the inclusion of the caregiver and that there is a need for more studies with better levels of evidence in this subject. Descriptors: Ostomy; Nursing; Assistance.RESUMENObjetivo: evaluar la evidencia científica sobre las actividades propuestas por la intervención de la NIC "Cuidados con la ostomía". Método: revisión integrativa, realizada en marzo de 2016 en las bases de datos MEDLINE, CINAHL, Web of Science, SCOPUS y LILACS. Los estudios fueron categorizados a partir de la identificación de las intervenciones concordantes con la taxonomía de la intervención en la NIC << Cuidados con la ostomía >>, así como las actividades propuestas. Resultados: la recolección resultó en 23 artículos, de mayoría cualitativos (52%), con nivel de evidencia IV (60,9%), identificándose, en estos, 23 de las 25 actividades de Enfermería propuestas en la NIC, siendo la actividad "Orientar al paciente / persona importante en cuanto al uso de dispositivo / cuidados de ostomía "la más frecuente (60,9%). Conclusión: se verificó, por lo tanto, que las acciones más frecuentes realizadas por los enfermeros se refieren a las orientaciones de manejo del ostoma con la inclusión del cuidador y que hay necesidad de más estudios con mejores niveles de evidencia en esa temática. Descriptores: Estomía; Enfermería; Asistencia.

scholarly journals Objective Measures to Assess Active Commuting Physical Activity to School in Young People: A Systematic Review Protocol and Practical Considerations

2020 ◽  
Vol 17 (16) ◽  
pp. 5936
Author(s):  
Pablo Campos-Garzón ◽  
Javier Sevil-Serrano ◽  
Yaira Barranco-Ruíz ◽  
Palma Chillón
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Young People ◽  
Web Of Science ◽  
Cochrane Library ◽  
Objective Measures ◽  
Active Commuting ◽  
School Based ◽  
Review Protocol

There are no systematic reviews that have identified the existing studies assessing active commuting physical activity (PA) to and from (to/from) school using objective measures, as well as the contribution of both walking and cycling to/from school to PA levels. To fill this gap in the literature, this systematic review will aim (a) to identify existing studies that assess active commuting PA to/from school with objective measures in young people and to examine the contribution of walking and cycling to/from school to PA levels, and (b) to propose an appropriate methodology and practical considerations to assess active commuting PA to/from school based on the studies identified. The review protocol was registered in PROSPERO (CRD42020162004). We will conduct a systematic search up to 2020 in five databases: PubMed, Web of Science, SPORTdiscuss, Cochrane Library, and National Transportation Library. Both the risk of bias and the quality of the identified studies will be evaluated through different instruments according to the design of each study. This systematic review will help to choose the most appropriate objective measures to assess active commuting PA to/from school and to promote walking and cycling to/from school to increase PA levels.

scholarly journals Safety and Efficacy of Therapeutic Taping in Primary Dysmenorrhea: a Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Bandara EMIA ◽  
Kularathne WNI ◽  
K Brain ◽  
Weerasekara I
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Adult Women ◽  
Primary Dysmenorrhea ◽  
Level Of Evidence ◽  
Effective Measure ◽  
Safety And Efficacy ◽  
Pain Anxiety

Abstract Primary dysmenorrhea (PD) is a common gynecological complaint among adolescents and adult women. Various pharmacological and alternative therapies such as therapeutic taping have been used as a treatment of PD. Although several studies have been conducted to evaluate the safety and efficacy of therapeutic taping in PD, these studies have not provided adequate level of evidence related to the safety and efficacy of therapeutic taping in PD. Hence, a systematic review and meta-analysis was performed to evaluate the safety and efficacy of therapeutic taping in PD. The following databases; Medline, Cochrane Library, Embase, PEDro, CINAHL and any other gray literature sources were searched for randomized controlled trials (RCTs) that used therapeutic taping to treat PD from inception to June 2021 with the language restricted to English. Independently screened articles by two reviewers were extracted according to the study objectives. A total of nine studies were included in the systematic review, involving 577 participants. Three studies were eligible for meta-analysis to find the pooled effect of taping on pain intensity. The review indicates that therapeutic taping is an effective measure in improving pain, anxiety and quality of life of women with PD. Meta-analysis conducted to compare the effect of elastic therapeutic taping (ETT) to sham taping showed that the ETT is an effective measure in improving pain among women with PD (MD = -3.12 (95% CI -5.64, -0.60); p=0.02; I2=95 %). The quality of the studies was assessed using the PEDro scale and the included RCTs indicated a fair to good level of quality. Our systematic review and meta-analysis demonstrated that therapeutic taping is an effective intervention for PD. However, RCTs with higher quality and larger sample sizes are necessary to verify the current results of the review.

Outcomes of digital biomarker-based interventions: protocol for a systematic review of systematic reviews (Preprint)

2021 ◽  
Author(s):  
Hossein Motahari-Nezhad ◽  
Márta Péntek ◽  
László Gulácsi ◽  
Zsombor Zrubka
Keyword(s):  
Clinical Outcomes ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Level Of Evidence ◽  
Clinical Benefits ◽  
The Cochrane Library ◽  
The Impact ◽  
Digital Biomarkers

BACKGROUND Digital biomarkers are defined as objective, quantifiable physiological and behavioral data that are collected and measured by means of digital devices such as portables, wearables, implantables or digestibles. For their widespread adoption in publicly financed healthcare systems, it is important to understand how their benefits translate into improved patient outcomes, which is essential for demonstrating their value. OBJECTIVE To assess the quality and strength of evidence of the impact of digital biomarkers on clinical outcomes compared to interventions without digital biomarkers, reported in systematic reviews. METHODS A comprehensive search for 2019-2020 will be conducted in the PubMed and the Cochrane Library using keywords related to digital biomarkers and a filter for systematic reviews. Original full-text English publications of systematic reviews comparing clinical outcomes of interventions with and without digital biomarkers via meta-analysis will be included. The AMSTAR-2 tool will be used to assess the methodological quality of reviews. To assess the quality of evidence, we will evaluate systematic reviews using the GRADE tool. To detect the possible presence of reporting bias, we will record whether the protocol of the systematic reviews was published before the start of the study. A qualitative summary of results by digital biomarker technology and outcome will be provided. RESULTS This protocol was submitted before data collection. The next steps in this review will be initiated after the protocol is accepted for publication. CONCLUSIONS Our study will provide a comprehensive summary of the highest level of evidence available on digital biomarker interventions. Our results will help identify clinical areas where the use of digital biomarkers leads to favorable clinical outcomes. In addition, our findings will highlight areas of evidence gaps where the clinical benefits of digital biomarkers have not yet been demonstrated.

Level of Scientific Evidence Underlying Recommendations from the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines for Hematologic Malignancies: Are We Moving Forward?

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 32-32
Author(s):  
Aakash Desai ◽  
Harry E Fuentes ◽  
Sri Harsha Tella ◽  
Caleb J Scheckel ◽  
Thejaswi Poonacha ◽  
...  
Keyword(s):  
Clinical Practice ◽  
National Comprehensive Cancer Network ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Scientific Evidence ◽  
Hematologic Malignancies ◽  
Level Of Evidence ◽  
Nccn Guidelines ◽  
Therapeutic Recommendations ◽  
Cancer Network

Background: National Comprehensive Cancer Network (NCCN) guidelines are the most comprehensive and widely used standard for clinical care in malignant hematology by clinicians and payers in the US. The level of scientific evidence in NCCN guidelines for malignant hematological conditions has not been recently investigated. We describe the distribution of categories of evidence and consensus (EC) among the 10 most common hematologic malignancies with regard to recommendations for staging, initial and salvage therapy, and surveillance. Methods: NCCN uses a system of guideline development distinct from other major professional organizations. The NCCN definitions for EC are: category I, high level of evidence such as randomized controlled trials with uniform consensus; category IIA, lower level of evidence with uniform consensus; category IIB, lower level of evidence without a uniform consensus but with no major disagreement; and category III, any level of evidence but with major disagreement. We compared our results with previously published results from 2011 guidelines. Results: Total recommendations increased by 16.6% from 1160 (2011) to 1353 (2020). Of the 1353 recommendations, Category 1, 2A, 2B and 3 EC were 5%, 91%, 4%, 1% while in 2011 they were 3%, 93%, 4% and 0% respectively. Recommendations with category 1 EC were found in all guidelines, except for Burkitt's Lymphoma. 6.3% of therapeutic recommendations were category 1 EC with the majority (56.4%) pertaining to initial therapy. Guidelines with highest proportions of therapeutic recommendations with category 1 EC were Multiple Myeloma (12.4%), CLL/SLL (6.9%) and AML (5.6%). Between 2011 and 2020, the proportion of category I recommendations increased significantly only in Follicular lymphoma and CLL/SLL. No category 1 EC recommendations existed in staging or surveillance. Conclusion: Recommendations issued in the 2020 NCCN guidelines are largely developed from lower levels of evidence but with uniform expert opinion. Despite the major advances in hematology in the past decade, this is largely unchanged. Our study underscores the urgent need and available opportunities to expand the current evidence base in malignant hematological disorders which forms the platform for clinical practice guidelines. Figure Disclosures No relevant conflicts of interest to declare.

scholarly journals Obesity and dental caries: systematic review

2013 ◽  
Vol 47 (4) ◽  
pp. 799-812 ◽  
Author(s):  
Alexandre Emidio Ribeiro Silva ◽  
Ana Maria Baptista Menezes ◽  
Flavio Fernando Demarco ◽  
Fabiana Vargas-Ferreira ◽  
Marco Aurelio Peres
Keyword(s):  
Systematic Review ◽  
Dental Caries ◽  
Observational Studies ◽  
Web Of Science ◽  
Scientific Evidence ◽  
Positive Association ◽  
Sufficient Evidence ◽  
Inverse Association

OBJECTIVE Identifying, through a systematic literature review, evidence of a possible association between obesity and dental caries. METHODS A search of articles published between 2005 and January 2012 was performed in the Medline/PubMed, LILACS and Web of Science databases. The quality of scientific evidence of the selected articles was assessed by the items proposed for observational studies in the Downs & Black instrument. RESULTS Initially, 537 references were found; after checking the titles and abstracts by two independent researchers, twenty-eight articles were selected for complete reading. Ten of them that assessed the primary and/or permanent dentition observed a positive association between obesity and dental caries and one study found an inverse association. According to the Downs & Black classification, thirteen articles with good scientific evidence were found. CONCLUSIONS The present review did not find sufficient evidence regarding the association between obesity and dental caries, and it did not clarify the possible role of diet and other possible effect modifiers on this association.

scholarly journals Tuberculosis/HIV coinfection from the perspective of quality of life: scope review

2021 ◽  
Vol 74 (3) ◽  
Author(s):  
Marcos Vinícius de Freitas Carvalho ◽  
Mônica Taminato ◽  
Maria Rita Bertolozzi ◽  
Lúcia Yasuko Izumi Nichiata ◽  
Hugo Fernandes ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Factors ◽  
Scientific Evidence ◽  
Cochrane Collaboration ◽  
Level Of Evidence ◽  
Underdeveloped Countries ◽  
Hiv Coinfection ◽  
The Subject ◽  
The Cochrane Collaboration

ABSTRACT Objectives: to analyze evidence on the quality of life of people with tuberculosis/HIV coinfection. Methods: review that followed steps of the Cochrane Collaboration, with the search of publications in the bases Embase, LILACS, PubMed, and Cochrane, through the descriptors “HIV,” “Tuberculosis,” and “Quality of Life,” without a temporal cut. Results: the results include 15 studies, published between 2009 and 2019, with the level of evidence V, in its majority. It was observed that there is no uniformity in the instrument used. Psychological support to this group and strengthening of actions to manage both infections are necessary. This segment’s quality of life is associated with social factors and scientific production on the subject concentrated in underdeveloped countries. Conclusions: the articles found have a low level of scientific evidence and indicate that people who experience coinfection have a more compromised quality of life when compared to those who experience tuberculosis or HIV separately.

scholarly journals Overview of evidence-based clinical practice guidelines for preoperative care: a systematic review.

2020 ◽  
Author(s):  
Agustín Ciapponi ◽  
Tapia-López Elena ◽  
Virgilio Sacha ◽  
Ariel Bardach
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Cochrane Library ◽  
Evidence Based ◽  
Agree Ii ◽  
Quality Of Evidence ◽  
Moderate Quality

Abstract Background Our aim was to summarize and compare relevant recommendations from evidence-based CPGs (EB-CPGs). Methods Systematic review of clinical practice guidelines. Data sources: PubMed, EMBase, Cochrane Library, LILACS, Tripdatabase and additional sources. In July 2017, we searched CPGs that were published in the last 10 years, without language restrictions, in electronic databases, and also searched specific CPG sources, reference lists and consulted experts. Pairs of independent reviewers selected EB-CPGs and rated their methodological quality using the AGREE-II instrument. We summarized recommendations, its supporting evidence and strength of recommendations according to the GRADE methodology. Results We included 16 EB-CPGs out of 2262 references identified. Only nine of them had searches within the last five years and seven used GRADE. The median (percentile 25-75) AGREE-II scores for rigor of development was 49% (35-76%) and the domain ‘applicability’ obtained the worst score: 16% (9-31%). We summarized 31 risk stratification recommendations, 21.6% of which were supported by high/moderate quality of evidence (41% of them were strong recommendations), and 16 therapeutic/preventive recommendations, 59% of which were supported by high/moderate quality of evidence (75.7% strong). We found inconsistency in ratings of evidence level. ‘Guidelines’ applicability’ and ‘monitoring’ were the most deficient domains. Only half of the EB-CPGs were updated in the past five years. Conclusions We present many strong recommendations that are ready to be considered for implementation as well as others to be interrupted, and we reveal opportunities to improve guidelines’ quality.

scholarly journals The Role of Physiotherapy in Pediatric Palliative Care: A Systematic Review

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1043
Author(s):  
Silvia Ortiz-Campoy ◽  
Cristina Lirio-Romero ◽  
Helena Romay-Barrero ◽  
David Martín-Caro Álvarez ◽  
Purificación López-Muñoz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Palliative Care ◽  
Scientific Evidence ◽  
Pediatric Palliative Care ◽  
Cochrane Library ◽  
Her Family ◽  
Life Threatening ◽  
Respiratory Physiotherapy

Pediatric palliative care (PPC) is a set of actions aimed at children who suffer from a severe or life-threatening disease to alleviate the symptoms of the disease and improve the quality of life of both the child and his/her family. One of the tools used to control symptoms is physiotherapy; however, its application in the child population has not been thoroughly studied. The main objective of this study was to gather, analyze, and critically evaluate the available scientific evidence on physiotherapy in children who require palliative care through a systematic review of the studies published in the last 10 years in the following databases: PubMed, Cochrane Library, PEDro, CINAHL, and Scopus. Of a total of 622 studies, the inclusion criteria were only met by seven articles, which were focused on the relationship between physiotherapy and PPC. This study analyzed: (1) the main pathologies treated, with a predominance of cerebral palsy and cancer; (2) the interventions applied, such as respiratory physiotherapy, neurological physiotherapy, therapeutic massage, and virtual reality; (3) the effects achieved in the child and his/her family, highlighting the control of symptoms and the improvement of the quality of life; and (4) the knowledge of the physiotherapists on PPC, observing that most of the professionals had not received training in this scope. The findings of this review indicate a lack of an adequate evidence foundation for physiotherapy in PPC.

scholarly journals Evaluación de la calidad de vida según el estado nutricional del paciente paliativo adulto: revisión sistemática

2017 ◽  
Vol 1 (4) ◽  
pp. 199 ◽  
Author(s):  
Ester Aracil-Lavado ◽  
Carmina Wanden-Berghe ◽  
Javier Sanz-Valero
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Palliative Care ◽  
Web Of Science ◽  
Cochrane Library ◽  
Calidad De Vida ◽  
Revisión Sistemática ◽  
Literatura Latinoamericana ◽  
The Cochrane Library

Objetivo: Revisar la literatura científica relacionada con la calidad de vida según el estado nutricional del paciente paliativo adulto.Método: Análisis crítico de los trabajos recuperados mediante revisión sistemática. Los datos se obtuvieron de la consulta directa y acceso, vía Internet, a las siguientes bases de datos bibliográficas del ámbito de las ciencias de la salud: MEDLINE (vía PubMed), The Cochrane Library, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINHAL), Web of Science y la Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS). Se consideró adecuado el uso de los Descriptores “Quality of life”, “Nutritional Status” y “Palliative care”, utilizando los filtros: «Humans», «Adult» y «Comparative Study» o «Clinical Trial». Fecha de la búsqueda: noviembre de 2016.Resultados: Tras aplicar los criterios de inclusión y exclusión se aceptaron 4 estudios para su revisión y análisis crítico. Al evaluar la calidad de los artículos seleccionados para la revisión mediante el cuestionario CONSORT, las puntuaciones oscilaron entre 11 y 20 sobre una puntuación máxima de 25.Conclusiones: El seguimiento nutricional de los enfermos estaba relacionado directamente con la mejora del estado nutricional, y se correspondía con el incremento de la calidad de vida. Sería deseable utilizar cuestionarios específicos y validados para evaluar la calidad de vida según el estado nutricional que permitirán minimizar cualquier tipo de subjetividad del paciente. Serían necesarios futuros estudios, con una adecuada población, que aclaren la relación directa entre el estado nutricional y la calidad de vida en los enfermos paliativos.

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