Industry sponsorship bias in clinical trials in implant dentistry: Systematic review and meta‐regression

2019 ◽  
Vol 46 (4) ◽  
pp. 510-519 ◽  
Author(s):  
Mateus Bertolini Fernandes dos Santos ◽  
Bernardo Antônio Agostini ◽  
Rafael Ratto Moraes ◽  
Falk Schwendicke ◽  
Rafael Sarkis‐Onofre
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Industry Sponsorship ◽  
Meta Regression ◽  
Implant Dentistry

scholarly journals The impact of inclusion, dose and duration of pyrazinamide (PZA) on efficacy and safety outcomes in tuberculosis: systematic review and meta-analysis protocol

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
James D. Millard ◽  
Elizabeth A. Mackay ◽  
Laura J. Bonnett ◽  
Geraint R. Davies
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Meta Analysis ◽  
World Health ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Efficacy And Safety ◽  
Safety Outcomes ◽  
Meta Regression ◽  
Indirect Comparisons

Abstract Background Pyrazinamide (PZA) is a key component of current and future regimens for tuberculosis (TB). Inclusion of PZA at higher doses and for longer durations may improve efficacy outcomes but must be balanced against the potential for worse safety outcomes. Methods We will search for randomised and quasi-randomised clinical trials in adult participants with and without the inclusion of PZA in TB treatment regimens in the Cochrane infectious diseases group’s trials register, Cochrane central register of controlled trials (CENTRAL), MEDLINE, EMBASE, LILACS, the metaRegister of Controlled Trials (mRCT) and the World Health Organization (WHO) international clinical trials registry platform. One author will screen abstracts and remove ineligible studies (10% of which will be double-screened by a second author). Two authors will review full texts for inclusion. Safety and efficacy data will be extracted to pre-piloted forms by one author (10% of which will be double-extracted by a second author). The Cochrane risk of bias tool will be used to assess study quality. The study has three objectives: the association of (1) inclusion, (2) dose and (3) duration of PZA with efficacy and safety outcomes. Risk ratios as relative measures of effect for direct comparisons within trials (all objectives) and proportions as absolute measures of effect for indirect comparisons across trials (for objectives 2 and 3) will be calculated. If there is insufficient data for direct comparisons within trials for objective 1, indirect comparisons between trials will be performed. Measures of effect will be pooled, with corresponding 95% confidence intervals and p values. Meta-analysis will be performed using the generalised inverse variance method for fixed effects models (FEM) or the DerSimonian-Laird method for random effects models (REM). For indirect comparisons, meta-regression for absolute measures against dose and duration data will be performed. Heterogeneity will be quantified through the I2-statistic for direct comparisons and the τ2 statistic for indirect comparisons using meta-regression. Discussion The current use of PZA for TB is based on over 60 years of clinical trial data, but this has never been synthesised to guide rationale use in future regimens and clinical trials. Systematic review registration: International Prospective Register of Systematic Reviews (PROSPERO) CRD42019138735

scholarly journals Effects of Aerobic Training Progression on Blood Pressure in Individuals With Hypertension: A Systematic Review With Meta-Analysis and Meta-Regression

2021 ◽  
Author(s):  
Guilherme Tadeu de Barcelos¹ ◽  
Isabel Heberle¹ ◽  
Juliana Cavestré Coneglian¹ ◽  
Bruno Allan Vieira¹ ◽  
Rodrigo Sudatti Delevatti¹ ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Clinical Trials ◽  
Systolic Blood Pressure ◽  
Aerobic Training ◽  
Data Extraction ◽  
Meta Analysis ◽  
Control Group ◽  
Meta Regression ◽  
Selection Of

Abstract Objective: To analyze, through a systematic review with meta-analysis, the effects of aerobic training with and without progression on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in hypertensive adults.Method: The search for the studies was carried out in the PubMed, Cochrane Central, SPORTDiscus and LILACS databases. Clinical trials that analyzed the effect of aerobic training, lasting at least six weeks, on blood pressure in hypertensive individuals comparing with a control group without intervention were selected. The selection of studies and data extraction were carried out independently by two pairs of researchers. Results: Of the 13028 studies found, 24 were selected and included in this review. There was a reduction in SBP after aerobic training with progression (-10.67 mmHg; 95% CI -15.421, -5.926; p <0.001) and without progression (-10.17 mmHg; CI -12.213, -8.120; p <0.001). DBP also decreased after aerobic training with progression (-5.49 mmHg; 95% CI -8.663, -2.310; p <0.001) and without progression (-6.51 mmHg; 95% CI -9.147, -3.868; p < 0.001). Conclusion: Aerobic training promotes a reduction in the SBP and DBP levels of adults with hypertension, regardless of whether or not the training variables progression.

scholarly journals A systematic review and meta-analysis of nab-paclitaxel mono-chemotherapy for metastatic breast cancer

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Haili Lu ◽  
Siluo Zha ◽  
Wei Zhang ◽  
Qiang Wang ◽  
Daozhen Jiang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Clinical Trials ◽  
Metastatic Breast Cancer ◽  
Meta Analysis ◽  
Metastatic Breast ◽  
First Line ◽  
Line Therapy ◽  
Her 2 ◽  
Meta Regression

Abstract Background Although various clinical trials and real-life studies have tried to explore the value of nab-paclitaxel mono-chemotherapy for metastatic breast cancer (MBC), the safety and efficacy of nab-paclitaxel remain unclear which need to be systematically evaluated. Methods Electronic searches for prospective clinical trials evaluating nab-paclitaxel monotherapy for MBC were performed. Requisite data were extracted, integrated and analysed from the included studies according to the different study designs using systematic review and meta-analysis. Meta-regression and subgroup analysis were further performed to explore the potential risk factors affecting each individual outcome of interest following nab-paclitaxel monotherapy. Results Twenty-two studies with 3287 MBC patients were included. A total of 1685 MBC patients received nab-paclitaxel as first-line therapy, 640 patients as further-line therapy, and 962 patients as mixed-line therapy. A total of 1966 MBC patients (60.40%) received nab-paclitaxel weekly, 1190 patients (36.56%) received nab-paclitaxel triweekly and 99 patients (3.04%) received nab-paclitaxel biweekly. The overall incidence rates of all-grade neutropenia, leukopenia, peripheral sensory neuropathy, and fatigue were 52% (95% CI, 38–66%, I2 = 98.97%), 58% (95% CI, 43–73%, I2 = 97.72%), 58% (95% CI, 48–68%, I2 = 97.17%), and 49% (95% CI, 41–56%, I2 = 94.39%), respectively. The overall response rate (ORR) was 40% (95% CI, 35–45%, I2 = 98.97%), and the clinical benefit rate (CBR) was 66% (95% CI, 59–73%, I2 = 98.97%) following nab-paclitaxel monotherapy. The median progression-free survival (PFS) was 7.64 months (95% CI, 6.89–8.40 months, I2 = 92.3%), and the median overall survival (OS) was 24.51 months (95% CI, 21.25–27.78 months, I2 = 92.7%). Treatment line, human epidermal growth factor receptor-2(Her-2)-negative status and dosage were found to be sources of heterogeneity among the included studies. According to the meta-regression and subgroup analysis, grade 3/4 neutropenia occurred less frequently in Her-2-negative patients than in the entire population (P = 0.046). Patients who received first-line nab-paclitaxel monotherapy showed a higher ORR (P = 0.006) and longer PFS (P = 0.045). Efficacy outcomes were not affected by the administration schedule. However, within the same schedule, patients appeared to have a superior ORR (P = 0.044) and longer PFS (P = 0.03) with an increasing dosage of nab-paclitaxel administered. Conclusions The benefits brought by nab-paclitaxel mono-chemotherapy in the treatment of MBC are considerable while the harm is generally manageable. Further study and validation are needed to figure out the roles which the dosage, schedule and other factors play actually in nab-paclitaxel chemotherapy.

scholarly journals Efficacy of miltefosine compared with glucantime for the treatment of cutaneous leishmaniasis: a systematic review and meta-analysis

2019 ◽  
Vol 41 ◽  
pp. e2019011 ◽  
Author(s):  
Sohrab Iranpour ◽  
Ali Hosseinzadeh ◽  
Abbas Alipour
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Cutaneous Leishmaniasis ◽  
Publication Bias ◽  
Meta Analysis ◽  
World Health ◽  
Cochrane Central Register ◽  
Significant Difference ◽  
Meta Regression ◽  
Trim And Fill

Cutaneous leishmaniasis (CL) is most common form of leishmaniasis and is characterized by ulcerative skin lesions. The objective of this study was to conduct a systematic review and meta-analysis of clinical trials that compared the efficacy of miltefosine and glucantime for the treatment of CL. We searched the following databases: Cochrane, PubMed, Embase, Scopus, Web of Science, ProQuest, Cochrane Central Register of Controlled Trials, International Clinical Trials Registry Platform search portal of World Health Organization, Sid, Irandoc, Magiran, and clinicaltrials.gov. We used keywords including “miltefosine,” “glucantime,” and “Leishmania.” The quality of studies was assessed using the Cochrane risk of bias tool. A random-effects model was employed for the analysis. We assessed heterogeneity by the chi-square test and the I2 index statistic. When heterogeneity was present, meta-regression analyses were performed. The Egger method was used to assess publication bias; when it was significant, the trim-and-fill method was used to test and adjust for publication bias. A total of 1,570 reports were identified, of which 10 studies were included in the meta-analysis. In the meta-analysis, there was no significant difference between the efficacy of miltefosine and glucantime; however, subgroup analysis showed that, regarding parasite species other than Leishmania braziliensis, miltefosine was significantly superior to glucantime (intention to treat; relative risk, 1.15; 95% confidence interval, 1.01 to 1.32). In the meta-regression, only the glucantime injection type was significant at the p=0.1 level. The Egger test found statistically significant publication bias; however, including the 3 missing studies in the trim-and-fill analysis did not change the results. This meta-analysis found that miltefosine seems to be more effective than glucantime, at least in species other than L. braziliensis, for treating CL.

scholarly journals Decline of COPD exacerbations in clinical trials over two decades – a systematic review and meta-regression

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Stefan Andreas ◽  
Christian Röver ◽  
Judith Heinz ◽  
Sebastian Straube ◽  
Henrik Watz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Copd Exacerbations ◽  
Meta Regression

scholarly journals Ranking videolaryngoscopes and direct laryngoscopes by orotracheal intubation performance in children: protocol of a systematic review and network meta-analysis of randomized clinical trials at patient level

2021 ◽  
Author(s):  
Clístenes C Carvalho ◽  
Stéphanie LPA Regueira ◽  
Ana Beatriz S Souza ◽  
Lucas MLF Medeiros ◽  
Marielle BS Manoel
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
A Priori ◽  
Orotracheal Intubation ◽  
Sensitivity Analyses ◽  
Intubation Attempt ◽  
Cochrane Central Register ◽  
Meta Regression

ABSTRACTBackgroundVideolaryngoscopy was shown to improve glottic visualization in children as compared to direct laryngoscopy, but at the expenses of delayed time for intubation. As little evidence is available regarding the relative performance of different laryngoscopes at present, we designed this systematic review and network meta-analysis to rank the different videolaryngoscopes (VLs) and direct laryngoscopes (DLs) for orotracheal intubation in children.MethodsWe will conduct a search in PubMed, LILACS, Scielo, Embase, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL; 2021, Issue 1) on 27/01/2021. We will include randomized clinical trials fully reported with patients aged ≤ 18 years, making comparisons between different types of laryngoscopes (any of both VLs and DLs) for failed first intubation attempt, intubation time, number of attempts at intubation or number of unsuccessful intubations, failed intubation, glottic view score, or adverse responses to endotracheal intubation. Pooled effects will be estimated by both fixed and random-effects models and presented according to qualitative and quantitative heterogeneity assessment. Sensitivity analyses will be performed as well as a priori subgroup, meta-regression and multiple meta-regression analyses. Additionally, network meta-analyses will be applied to rank the different VLs and DLs. We will also assess the risk of selective publication by funnel plot asymmetry.DiscussionThis systematic review and network meta-analysis aim to understand which laryngoscopes perform better than others for orotracheal intubation.Systematic review registrationThe current protocol was submitted to PROSPERO on 25/01/2021.

scholarly journals Ranking videolaryngoscopes by orotracheal intubation performance: protocol of a systematic review and network meta-analysis of clinical trials at patient level

2021 ◽  
Author(s):  
Clístenes Crístian de Carvalho ◽  
Danielle Melo da Silva ◽  
Victor Macedo Lemos ◽  
Thiago Gadelha Batista dos Santos ◽  
Ikaro Cavalcante Agra ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
A Priori ◽  
Macintosh Laryngoscope ◽  
Orotracheal Intubation ◽  
Sensitivity Analyses ◽  
Cochrane Central Register ◽  
Meta Regression

ABSTRACTBackgroundVideolaryngoscopes (VLs) are regarded to improve glottic visualization as compared to Macintosh laryngoscope (ML). However, we currently do not know which one would be the best choice. We then designed this systematic review and network meta-analysis to rank the different VLs as compared to ML.MethodsWe will conduct a search in PubMed, LILACS, Scielo, Embase, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL; 2020, Issue 6) on 11/01/2021. We will include randomized clinical trials fully reported with patients aged ≥ 16 years, comparing VLs with ML for failed intubation with the device, failed first intubation attempts, number of intubation attempts, time for intubation, difficulty of intubation, and improved visualization of the larynx. Pooled effects will be estimated by both fixed and random-effects models and presented according to qualitative and quantitative heterogeneity assessment. Sensitivity analyses will be performed as well as a priori subgroup, meta-regression and multiple meta-regression analyses. Additionally, network meta-analyses will be applied to rank the different VLs as compared to ML. We will also assess the risk of selective publication by funnel plot asymmetry.DiscussionThis systematic review and network meta-analysis aim at helping health services and clinicians involved in airway manipulation choose the best VLs for orotracheal intubation.Systematic review registrationThe current protocol was submitted to PROSPERO on 07/01/2021.

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