scholarly journals Systematic review: the quality of the scientific evidence and conflicts of interest in international inflammatory bowel disease practice guidelines

2013 ◽  
Vol 37 (10) ◽  
pp. 937-946 ◽  
Author(s):  
J. D. Feuerstein ◽  
M. Akbari ◽  
A. E. Gifford ◽  
G. Cullen ◽  
D. A. Leffler ◽  
...  
Keyword(s):  
Systematic Review ◽  
Inflammatory Bowel Disease ◽  
Practice Guidelines ◽  
Bowel Disease ◽  
Conflicts Of Interest ◽  
Scientific Evidence ◽  
Inflammatory Bowel

Are Quality Metrics in Inflammatory Bowel Disease Rooted in Substantial Quality Evidence? A Systematic Review

2020 ◽  
Author(s):  
Simcha Weissman ◽  
Alexander Goldowsky ◽  
Tej I Mehta ◽  
Michael A Sciarra ◽  
Joseph D Feuerstein
Keyword(s):  
Systematic Review ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Conflicts Of Interest ◽  
Quality Metrics ◽  
High Quality ◽  
Quality Of Evidence ◽  
Inflammatory Bowel ◽  
Quality Evidence

Abstract Background and Aims Quality metrics were established to develop standards to help assess quality of care, yet variation in inflammatory bowel disease [IBD] clinical practice exists. We performed a systematic review to assess the overall quality of evidence cited in formulating IBD quality metrics. Methods A systematic search was performed on PubMed, MEDLINE, and EMBASE. All major national and international IBD societies were included. Quality metrics were assessed for evidence quality and categorised as category A [guideline based], category B [primarily retrospective and observational studies], or category C [expert opinion]. Quality metrics were examined for the type of metric, and the quality, measurability, review, existing conflicts of interest [COI], and patient participation of the metric. Statistical analysis was conducted in R. Results A total of 143 distinct, and an aggregate total of 217 quality metrics were included and analysed; 68%, 3.2%, and 28.6% of IBD quality metrics were based on low, moderate, and high quality of evidence, respectively. The proportion of high-quality evidence across societies was significantly different [p <0.01]. Five organisations included patients in quality metric development, three reported external review, not all reported measurable outcomes or stated the presence of a COI. Finally, 43% of quality metrics were published more than 5 years ago. Conclusions Quality metrics are important to standardise practice. As more than two-thirds of the quality metrics in IBD are based on low-quality evidence, further studies are needed to improve the overall quality of evidence supporting the development of quality measures.

scholarly journals Body image dissatisfaction in patients with inflammatory bowel disease: a systematic review

2019 ◽  
Vol 6 (1) ◽  
pp. e000255 ◽  
Author(s):  
Sophie Elizabeth Beese ◽  
Isobel Marion Harris ◽  
Janine Dretzke ◽  
David Moore
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Inflammatory Bowel Disease ◽  
Body Image ◽  
Narrative Analysis ◽  
Bowel Disease ◽  
Female Gender ◽  
Body Image Dissatisfaction ◽  
Inflammatory Bowel

Background and aimsLittle is known about the relationship between inflammatory bowel disease (IBD) and body image. The aim of this systematic review was to summarise the evidence on body image dissatisfaction in patients with IBD across four areas: (1) body image tools, (2) prevalence, (3) factors associated with body image dissatisfaction in IBD and (4) association between IBD and quality of life.MethodsTwo reviewers screened, selected, quality assessed and extracted data from studies in duplicate. EMBASE, MEDLINE, PsycINFO and Cochrane CENTRAL were searched to April 2018. Study design–specific critical appraisal tools were used to assess risk of bias. Narrative analysis was undertaken due to heterogeneity.ResultsFifty-seven studies using a body image tool were included; 31 for prevalence and 16 and 8 for associated factors and association with quality of life, respectively. Studies reported mainly mean or median scores. Evidence suggested female gender, age, fatigue, disease activity and steroid use were associated with increased body image dissatisfaction, which was also associated with decreased quality of life.ConclusionThis is the first systematic review on body image in patients with IBD. The evidence suggests that body image dissatisfaction can negatively impact patients, and certain factors are associated with increased body image dissatisfaction. Greater body image dissatisfaction was also associated with poorer quality of life. However, the methodological and reporting quality of studies was in some cases poor with considerable heterogeneity. Future IBD research should incorporate measurement of body image dissatisfaction using validated tools.

Is Therapeutic Drug Monitoring for Anti-tumour Necrosis Factor Agents in Adults With Inflammatory Bowel Disease Ready for Standard of Care? A Systematic Review and Meta-analysis

2020 ◽  
Vol 14 (8) ◽  
pp. 1057-1065 ◽  
Author(s):  
Raj Shah ◽  
Gila R Hoffman ◽  
Mohammed El-Dallal ◽  
Alexander M Goldowsky ◽  
Ye Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Inflammatory Bowel Disease ◽  
Therapeutic Drug Monitoring ◽  
Bowel Disease ◽  
Drug Monitoring ◽  
Meta Analysis ◽  
Therapeutic Drug ◽  
Quality Of Evidence ◽  
Inflammatory Bowel

Abstract Introduction Using therapeutic drug monitoring [TDM] in adult patients with inflammatory bowel disease [IBD] remains controversial. We conducted a systematic review and meta-analysis to answer four clinical PICO [Population, Intervention, Comparator, Outcome] questions. Methods We searched MEDLINE, Embase, Web of Science, and Cochrane Central from inception to June 30, 2019. Remission was defined by the manuscripts’ definitions of clinical remission. Data were analysed using RevMan 5.3. Quality of evidence was assessed with GRADE methodology. Results We identified and screened 3365 abstracts and 11 articles. PICO 1 Reactive vs No TDM: six studies pooled showed 57.1% [257/450] failed to achieve remission following reactive TDM vs 44.7% [268/600] in the no TDM group (risk ratio [RR]: 1.14; 95% confidence interval [CI] 0.88–1.47). PICO 2 Proactive vs no TDM: five studies pooled showed 19.5% [75/384] failed to maintain remission in the proactive TDM group vs 33.4% [248/742] in the no TDM group [RR: 0.60; 95% CI 0.35–1.04]. PICO 3 Proactive vs Reactive TDM: two retrospective studies pooled showed 14.2% [26/183] failure to maintain remission in the proactive TDM group and 64.7% [119/184] in the reactive TDM group [RR: 0.22; 95% CI 0.15–0.32]. PICO 4 TDM [proactive/reactive] vs No TDM: we pooled 10 studies showing 39.7% [332/837] failed to achieve remission in the TDM [proactive/reactive] cohort vs 40.3% [428/1063] in the no TDM cohort [RR: 0.94; 95% CI 0.77–1.14]. Overall, the quality of evidence in each PICO was very low when using GRADE. Conclusions This meta-analysis shows that data supporting use of TDM in adults are limited and of very low quality. Further well-designed randomized controlled trials are needed to determine the place of TDM in clinical practice.

scholarly journals Quality of Life in Inflammatory Bowel Disease: A Systematic Review and Meta-analyses—Part I

2018 ◽  
Vol 24 (4) ◽  
pp. 742-751 ◽  
Author(s):  
Simon R Knowles ◽  
Lesley A Graff ◽  
Helen Wilding ◽  
Catherine Hewitt ◽  
Laurie Keefer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Inflammatory Bowel ◽  
Meta Analyses

scholarly journals Systematic Review of Health-related Quality of Life Measures for Inflammatory Bowel Disease

2015 ◽  
Vol 9 (3) ◽  
pp. 284-292 ◽  
Author(s):  
Laith Alrubaiy ◽  
Ibtihal Rikaby ◽  
Phedra Dodds ◽  
Hayley Anne Hutchings ◽  
John Gordon Williams
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Health Related Quality ◽  
Quality Of Life Measures ◽  
Related Quality ◽  
Health Related ◽  
Inflammatory Bowel

Systematic Review of the Quality of Patient Information on the Internet Regarding Inflammatory Bowel Disease Treatments

2010 ◽  
Vol 8 (4) ◽  
pp. 322-328 ◽  
Author(s):  
Morgan Langille ◽  
André Bernard ◽  
Chris Rodgers ◽  
Stephanie Hughes ◽  
Des Leddin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Inflammatory Bowel Disease ◽  
Patient Information ◽  
Bowel Disease ◽  
The Internet ◽  
Inflammatory Bowel

scholarly journals A174 PATIENT PERSPECTIVES AND EXPECTATIONS IN INFLAMMATORY BOWEL DISEASE: A SYSTEMATIC REVIEW

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 185-186
Author(s):  
B Balram ◽  
A Al Khoury ◽  
T Bessissow ◽  
W Afif ◽  
l gonczi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Inflammatory Bowel Disease ◽  
Shared Decision Making ◽  
Bowel Disease ◽  
Disease Process ◽  
Disease Diagnosis ◽  
Shared Decision ◽  
Inflammatory Bowel

Abstract Background Shared decision making is gaining favour in clinical practice and increasingly patients want to be involved in their disease process. Aims In this systematic review, our objective was to assess inflammatory bowel disease (IBD) patient preferences and perspectives relating to their disease diagnosis, treatment, knowledge needs and telemedicine. Methods This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). Four databases and conference proceedings were searched between January 1, 1980, and May 1, 2020. The methodological quality of the included studies was assessed using the Standards for reporting qualitative research (SRQR) checklist. Results Our search identified 240 citations and 51 studies met the inclusion criteria. The major expectations of the patients are symptomatic and pain control, quality of life and normal endoscopy. Patients’ main concerns are access to information and healthcare, and shared decision making. At the time of diagnosis, patients expressed a greater need for knowledge about their IBD, preferentially by their treating gastroenterologist. The main treatment expectations in active disease are efficacy, safety and convenience. Patients are willing to accept relatively high risks of complications from medical therapy to avoid a permanent ostomy and to achieve durable remission. Patients are more interested in disease monitoring, research and development during the time of remission. Telemedicine and self-management with supervised e-health tools are feasible and acceptable amongst IBD patients. Conclusions This systematic review demonstrates that IBD patients expect more information about their disease process, shared decision making and symptom control. Further research is needed to help align patient and physician expectations in order to improve the quality of care provided to IBD patients. Funding Agencies None

Colorectal Cancer Prevention in Inflammatory Bowel Disease: A Systematic Analysis of the Overall Quality of Guideline Recommendations

2021 ◽  
Author(s):  
Simcha Weissman ◽  
Hannah K Systrom ◽  
Muhammad Aziz ◽  
Mohammed El-Dallal ◽  
Wade Lee-Smith ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Conflicts Of Interest ◽  
Institute Of Medicine ◽  
Industry Funding ◽  
Increased Risk ◽  
Inflammatory Bowel ◽  
Quality Evidence

Abstract Background Owing to the increased risk of colorectal cancer (CRC) in patients with inflammatory bowel disease (IBD), numerous societies developed preventative guidelines. We aimed to assess the overall quality of CRC prevention guidelines in IBD. Methods A systematic search was performed in multiple databases to identify all guidelines pertaining to CRC prevention in IBD in September 2020. All guidelines were reviewed for conflicts of interest (COIs)/funding, recommendation quality/strength, external guideline review, use of patient representation, and plans for update—as per Institute of Medicine standards. In addition, recommendations were compared amongst societies. Results One hundred forty-nine recommendations from 14 different guidelines/societies were included. Not all guidelines provided recommendations on key elements surrounding (1) screening initiation and surveillance, (2) screening modality, (3) pharmacological chemoprevention, (4) dysplasia management and follow-up, and (5) molecular marker use. Only 71% of guidelines disclosed COIs, 43% reported industry funding, 14% were externally reviewed, 7% included patient representation, and 36% had plans for update. Of the total recommendations, 7.4%, 23.5%, and 69.1% were based on high,- moderate-, and low-quality evidence, respectively. Additionally, 20.1% of recommendations were strong, 14.1%, were weak/conditional, and 65.8% did not provide a strength. The proportion of high-quality evidence (P = 0.34) and strong recommendations (P = 0.57) did not significantly differ across societies. Conclusions Many guidelines do not provide recommendations on key aspects of CRC prevention in IBD. Over 90% of recommendations are based on low- to moderate-quality evidence; therefore, further studies on CRC prevention in IBD are needed to improve the overall quality of evidence.

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