scholarly journals Blinding Measured: A Systematic Review of Randomized Controlled Trials of Acupuncture

2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
Author(s):  
Alex Moroz ◽  
Brian Freed ◽  
Laura Tiedemann ◽  
Heejung Bang ◽  
Melanie Howell ◽  
...  
Keyword(s):  
Systematic Review ◽  
Data Extraction ◽  
Quantitative Measure ◽  
Data Synthesis ◽  
Study Selection ◽  
Potential Association ◽  
Number Of Patients ◽  
Study Characteristics ◽  
The Subject ◽  
Study Participants

Background.There is no agreement among researchers on viable controls for acupuncture treatment, and the assessment of the effectiveness of blinding and its interpretation is rare.Purpose.To systematically assess the effectiveness of blinding (EOB) in reported acupuncture trials; to explore results of RCTs using a quantitative measure of EOB.Data Sources.A systematic review of published sham RCTs that assessed blinding.Study Selection.Five hundred and ninety studies were reviewed, and 54 studies (4783 subjects) were included.Data Extraction.The number of patients who guessed their treatment identity was extracted from each study. Variables with possible influence on blinding were identified.Data Synthesis.The blinding index was calculated for each study. Based on blinding indexes, studies were congregated into one of the nine blinding scenarios. Individual study characteristics were explored for potential association with EOB.Limitations.There is a possibility of publication or reporting bias.Conclusions.The most common scenario was that the subjects believed they received verum acupuncture regardless of the actual treatment received, and overall the subject blinding in the acupuncture studies was satisfactory, with 61% of study participants maintaining ideal blinding. Objectively calculated blinding data may offer meaningful and systematic ways to further interpret the findings of RCTs.

scholarly journals Prioritising recommendations following analyses of adverse events in healthcare: a systematic review

2020 ◽  
Vol 9 (4) ◽  
pp. e000843
Author(s):  
Kelly Bos ◽  
Maarten J van der Laan ◽  
Dave A Dongelmans
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Data Extraction ◽  
Data Sources ◽  
Cochrane Library ◽  
High Quality ◽  
Data Synthesis ◽  
Study Selection ◽  
Personal Opinion ◽  
User Friendly

PurposeThe purpose of this systematic review was to identify an appropriate method—a user-friendly and validated method—that prioritises recommendations following analyses of adverse events (AEs) based on objective features.Data sourcesThe electronic databases PubMed/MEDLINE, Embase (Ovid), Cochrane Library, PsycINFO (Ovid) and ERIC (Ovid) were searched.Study selectionStudies were considered eligible when reporting on methods to prioritise recommendations.Data extractionTwo teams of reviewers performed the data extraction which was defined prior to this phase.Results of data synthesisEleven methods were identified that are designed to prioritise recommendations. After completing the data extraction, none of the methods met all the predefined criteria. Nine methods were considered user-friendly. One study validated the developed method. Five methods prioritised recommendations based on objective features, not affected by personal opinion or knowledge and expected to be reproducible by different users.ConclusionThere are several methods available to prioritise recommendations following analyses of AEs. All these methods can be used to discuss and select recommendations for implementation. None of the methods is a user-friendly and validated method that prioritises recommendations based on objective features. Although there are possibilities to further improve their features, the ‘Typology of safety functions’ by de Dianous and Fiévez, and the ‘Hierarchy of hazard controls’ by McCaughan have the most potential to select high-quality recommendations as they have only a few clearly defined categories in a well-arranged ordinal sequence.

Methodological systematic review of studies on social inequalities in smoking among young adults: A field coming of age?

2018 ◽  
Vol 28 (5) ◽  
pp. 566-573 ◽  
Author(s):  
Thierry Gagné ◽  
Joseph G L Lee ◽  
Madeleine Steinmetz-Wood ◽  
Katherine L Frohlich
Keyword(s):  
Systematic Review ◽  
Young Adults ◽  
Social Inequalities ◽  
Coming Of Age ◽  
Data Extraction ◽  
Life Transitions ◽  
Parental Characteristics ◽  
Study Selection ◽  
Study Characteristics ◽  
Measurement Strategies

ObjectiveSocioeconomic circumstances are critically important to addressing smoking. In young adulthood (ages 18–25), dynamic transitions in education, employment, family and housing complicate the measurement of socioeconomic circumstances. To better understand approaches to capturing these circumstances, this methodological systematic review examined how socioeconomic characteristics used to identify social inequalities in smoking among young adults are measured.Data sourcesWe searched PubMed/MEDLINE, Scopus, EMBASE, ERIC and Sociological Abstracts, and used three prior reviews. We updated the search in March 2018.Study selectionTwo reviewers independently screened peer-reviewed records from OECD countries published in English, French, German or Spanish after 1995 whose samples covered at least 1 year between the ages of 18 and 25. We included 89 of 1320 records.Data extractionOne reviewer extracted study characteristics, indicators used to operationalise socioeconomic circumstances and each indicator’s relation to results on smoking (ie, significance and direction). We found 39 indicators of socioeconomic circumstances related to six broad domains. These indicators were used in 425 results.Data synthesisWe descriptively analysed the extracted data using evidence tables. Educational attainment was most common. Evidence of inequalities varied by indicator used. For example, there was inconsistent evidence regarding the role of parental characteristics and transition stages and insufficient evidence regarding personal income on smoking.ConclusionDespite its importance, studies have disproportionally examined inequalities among young adults using traditional indicators. The mismatch between young adults’ life transitions and measurement strategies may attenuate evidence of inequalities. We suggest strategies to improve future measurement.

scholarly journals A Systematic Review of Ethanol and Fomepizole Use in Toxic Alcohol Ingestions

2013 ◽  
Vol 2013 ◽  
pp. 1-14 ◽  
Author(s):  
Lorri Beatty ◽  
Robert Green ◽  
Kirk Magee ◽  
Peter Zed
Keyword(s):  
Systematic Review ◽  
Ethylene Glycol ◽  
Data Extraction ◽  
Alcohol Ingestion ◽  
Data Synthesis ◽  
Toxic Alcohol ◽  
Study Selection ◽  
Data Source ◽  
Ethylene Glycol Intoxication ◽  
Collection Form

Objectives. The optimal antidote for the treatment of ethylene glycol or methanol intoxication is not known. The objective of this systematic review is to describe all available data on the use of ethanol and fomepizole for methanol and ethylene glycol intoxication.Data Source. A systematic search of MEDLINE and EMBASE was conducted.Study Selection. Published studies involving the use of ethanol or fomepizole, or both, in adults who presented within 72 hours of toxic alcohol ingestion were included. Our search yielded a total of 145 studies for our analysis. There were no randomized controlled trials, and no head-to-head trials.Data Extraction. Variables were evaluated for all publications by one independent author using a standardized data collection form.Data Synthesis. 897 patients with toxic alcohol ingestion were identified. 720 (80.3%) were treated with ethanol (505 Me, 215 EG), 146 (16.3%) with fomepizole (81 Me, 65 EG), and 33 (3.7%) with both antidotes (18 Me, 15 EG). Mortality in patients treated with ethanol was 21.8% for Me and 18.1% for EG. In those administered fomepizole, mortality was 17.1% for Me and 4.1% for EG. Adverse events were uncommon.Conclusion. The data supporting the use of one antidote is inconclusive. Further investigation is warranted.

scholarly journals LO20: Naloxone dosing for suspected opioid and ultra-potent opioid overdoses: A systematic review

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S14
Author(s):  
J. Moe ◽  
J. Godwin ◽  
R. Purssell ◽  
F. O'Sullivan ◽  
J. Hau ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Clinical Response ◽  
Health Care Providers ◽  
Case Reports ◽  
Data Extraction ◽  
Cochrane Central Register ◽  
Care Providers ◽  
Number Of Patients ◽  
Study Characteristics

Introduction: Optimizing naloxone dosing in the context of increasing fentanyl and ultra-potent opioid (UPO) prevalence is an important consideration for emergency health care providers. The goal of this systematic review was to evaluate the association between initial and cumulative naloxone doses on effective reversal and adverse events in undifferentiated and fentanyl/UPO overdoses. Methods: We searched Embase, MEDLINE, Cochrane Central Register of Controlled Trials, DARE, CINAHL, Science Citation Index, reference lists, toxicology websites, and conference proceedings from July to October 2018 and back to 1972. Our search included pertinent indexing terms for UPOs. We included interventional and observational studies reporting on naloxone administration for opioid toxicity reversal in people ≥12 years old. Additionally, we accessed non-traditional evidence sources (case reports and series) given this rapidly changing field. We conducted inclusion screens, data extraction and quality assessments in duplicate. We summarized study characteristics and where reported, analyzed number of patients with clinical response. Response was defined as not receiving further naloxone doses and remaining alive. Results: We included 174 studies (108 case reports and series, 55 observational, 9 interventional) with 26,660 subjects (median age 35.1; 74.2% male). We observed lower response among patients exposed to fentanyl/UPO versus heroin for initial naloxone doses ≤0.4mg (56.8% versus 80.2%) and > 0.4mg (27.0% versus 82.1%). Mean cumulative doses were higher for fentanyl/UPO (2.10 mg, SD 1.80 mg) versus heroin (1.48 mg, SD 1.68 mg) overdoses. In North American studies the median cumulative dose used was higher for fentanyl/UPO versus heroin overdoses. A dose-response curve for fentanyl/UPO studies showed marked variability in doses among responders, indicating heterogeneity. Adverse events reporting was inconsistent; 10% of subjects experienced withdrawal based on studies in which they were reported. Conclusion: This is the first systematic review to summarize proportion of patients with clinical response by naloxone dose provided. While variable reporting, study quality, heterogeneity, and our outcome definitions limit the conclusions we can draw, it appears that higher initial doses and in some cases, higher cumulative naloxone doses were used and may be necessary to reverse toxicity due to fentanyl/UPO compared to other opioids. High-quality prospective studies assessing effectiveness and safety are needed.

Nonsterile Extemporaneous Compounding: A Bibliography for the Pharmacy Practitioner

1994 ◽  
Vol 10 (1) ◽  
pp. 18-22
Author(s):  
Glynn G. Raymond
Keyword(s):  
Chemical Stability ◽  
Degradation Products ◽  
Data Extraction ◽  
Professional Judgment ◽  
Expiration Date ◽  
Alphabetical Order ◽  
Data Synthesis ◽  
Efficient Procedure ◽  
Study Selection ◽  
The Subject

Objective: For the pharmacist to be able to practice good professional and scientific procedures, appropriate literature sources are provided to enable rational, appropriate decisions for extemporaneous compounding. Data Sources: The bibliography consists of articles listed from the key word “compounding” in International Pharmaceutical Abstracts. Study Selection: The list of references are compiled in alphabetical order according to the title of the reference in terms of generic name, the clinical condition, or the subject heading. Data Extraction: Many of the extemporaneous formulations are published in accessible professional pharmacy journals, including American Druggist, American Journal of Hospital Pharmacy, The Annals of Pharmacotherapy, and US Pharmacist. Data Synthesis: The pharmacist must determine if the referenced expiration date was determined either by chemical stability or by successful clinical experience. The assignment of an expiration date by chemical stability is the accepted standard of the pharmaceutical industry. Assigning an expiration date by clinical response does not give the clinician any quantification of chemical potency or an indication of the absence or presence of degradation products in a formulation. Conclusions: With extemporaneous compounding, there must not be any careless formulation of prescription products without adequate scientific and professional judgment. For this reason, pharmacists are encouraged to use the current pharmaceutical literature to enhance their professional judgment. To make pharmacists' searches of the pharmaceutical literature for extemporaneous formulations a time-efficient procedure, a bibliography is presented.

scholarly journals Epidemiology of hepatitis E virus infection in animals in Africa: a systematic review and meta-analysis

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Abdou Fatawou Modiyinji ◽  
Jean Joel Bigna ◽  
Sebastien Kenmoe ◽  
Fredy Brice N. Simo ◽  
Marie A. Amougou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hepatitis E Virus ◽  
Data Extraction ◽  
Meta Analysis ◽  
Hepatitis E ◽  
Epidemiological Studies ◽  
Cross Sectional ◽  
Resource Limited ◽  
Study Selection ◽  
Language Restriction

Abstract Background Hepatitis E virus (HEV) is a major cause of acute hepatitis in humans worldwide and have high burden in the resource-limited countries. Better knowledge of the epidemiology of hepatitis in animals in Africa can help to understand the epidemiology among humans. The objective of this study was to summarize the prevalence of HEV infection and distribution of HEV genotypes among animals in Africa. Methods In this systematic review and meta-analysis, we comprehensively searched PubMed, EMBASE, African Journals Online, and Africa Index Medicus from January 1st, 2000 to March 22th, 2020 without any language restriction. We considered cross-sectional studies of HEV infection in animals in Africa. Study selection, data extraction, and methodological quality of included studies were done independently by two investigators. Prevalence data were pooled using the random-effects meta-analysis. This review was registered in PROSPERO, CRD42018087684. Results Twenty-five studies (13 species and 6983 animals) were included. The prevalence (antibodies or ribonucleic acid [RNA]) of HEV infection in animals varied widely depending on biological markers of HEV infection measured: 23.4% (95% confidence interval; 12.0–37.2) for anti-HEV immunoglobulins G, 13.1% (3.1–28.3) for anti-HEV immunoglobulins M, and 1.8% (0.2–4.3) for RNA; with substantial heterogeneity. In subgroup analysis, the immunoglobulins G seroprevalence was higher among pigs 37.8% (13.9–65.4). The following HEV genotypes were reported in animals: Rat-HEV genotype 1 (rats and horses), HEV-3 (pigs), HEV-7 (dromedaries), and Bat hepeviruses (bats). Conclusions We found a high prevalence of HEV infection in animals in Africa and HEV genotypes close to that of humans. Some animals in Africa could be the reservoir of HEV, highlighting the need of molecular epidemiological studies for investigating zoonotic transmission.

Pegfilgrastim-Induced Bone Pain: A Review on Incidence, Risk Factors, and Evidence-Based Management

2017 ◽  
Vol 51 (9) ◽  
pp. 797-803 ◽  
Author(s):  
Donald C. Moore ◽  
Annie E. Pellegrino
Keyword(s):  
Risk Factors ◽  
Bone Pain ◽  
English Language ◽  
Data Extraction ◽  
Treatment Modalities ◽  
Management Options ◽  
Data Synthesis ◽  
Pharmacological Management ◽  
Study Selection ◽  
Incidence Risk

Objective: To review the incidence, risk factors, and management of pegfilgrastim-induced bone pain (PIBP). Data Sources: PubMed was searched from 1980 to March 31, 2017, using the terms pegfilgrastim and bone pain. Study Selection and Data Extraction: English-language, human studies and reviews assessing the incidence, risk factors, and management of PIBP were incorporated. Data Synthesis: A total of 3 randomized, prospective studies and 2 retrospective studies evaluated pharmacological management of PIBP. Naproxen compared with placebo demonstrated a reduction in the degree, incidence, and duration of bone pain secondary to pegfilgrastim. Loratadine was not effective in reducing the incidence of bone pain prophylactically, but a retrospective study evaluating dual antihistamine blockade with loratadine and famotidine demonstrated a decreased incidence in bone pain when administered before pegfilgrastim. Conclusion: Naproxen is effective at managing PIBP. Although commonly used, antihistamines have a paucity of data supporting their use. Dose reductions of pegfilgrastim and opioids may also be potential management options; however, data supporting these treatment modalities are scarce.

Recovery and Return to Activity Following Exertional Heat Stroke: Considerations for the Sports Medicine Staff

2007 ◽  
Vol 16 (3) ◽  
pp. 163-181 ◽  
Author(s):  
Brendon P. McDermott ◽  
Douglas J. Casa ◽  
Susan W. Yeargin ◽  
Matthew S. Ganio ◽  
Lawrence E. Armstrong ◽  
...  
Keyword(s):  
Data Extraction ◽  
Heat Stroke ◽  
Data Sources ◽  
Exertional Heat Stroke ◽  
Data Synthesis ◽  
Residual Symptoms ◽  
Study Selection ◽  
Initial Care ◽  
Type Data ◽  
Return To Activity

Objective:To describe the current scientific evidence of recovery and return to activity following exertional heat stroke (EHS).Data Sources:Information was collected using MEDLINE and SPORTDiscus databases in English using combinations of key words, exertional heat stroke, recovery, rehabilitation, residual symptoms, heat tolerance, return to activity, and heat illness.Study Selection:Relevant peer-reviewed, military, and published text materials were reviewed.Data Extraction:Inclusion criteria were based on the article’s coverage of return to activity, residual symptoms, or testing for long-term treatment. Fifty-two out of the original 554 sources met these criteria and were included in data synthesis.Data Synthesis:The recovery time following EHS is dependent on numerous factors, and recovery length is individually based and largely dependent on the initial care provided.Conclusion:Future research should focus on developing a structured return-to-activity strategy following EHS.

scholarly journals Aromatherapy for Symptom Relief in Patients with Burn: A Systematic Review and Meta-Analysis

Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 1
Author(s):  
Hye Won Lee ◽  
Lin Ang ◽  
Jung Tae Kim ◽  
Myeong Soo Lee
Keyword(s):  
Systematic Review ◽  
Data Extraction ◽  
Meta Analysis ◽  
Symptom Relief ◽  
Routine Care ◽  
Risk Of Bias ◽  
Review Author ◽  
Beneficial Effects ◽  
Study Selection ◽  
Meta Analyses

Background and Objectives: This review aimed to provide an updated review of evidence regarding the effects of aromatherapy in relieving symptoms of burn injuries, focusing on pain and physiological distress. Materials and Methods: Fifteen databases (including five English databases, four Korean medical databases, and four Iranian databases) and trial registries were searched for studies published between their dates of inception and July 2021. Two review authors individually performed study selection, data extraction, and risk of bias assessment, and any discrepancies were solved by a third review author. Results: Eight RCTs met our inclusion criteria and were analyzed in this updated systematic review. Our meta-analyses revealed that inhaled aromatherapy plus routine care showed beneficial effects in relieving pain after dressing, as compared to placebo plus routine care (p < 0.00001) and routine care alone (p = 0.02). Additionally, inhaled aromatherapy plus routine care (p < 0.00001) and aromatherapy massage plus routine care (p < 0.0001) also showed superior effects in calming anxiety, as compared to routine care alone. None of the included studies reported on AEs. Overall, the risk of bias across the studies was concerning. Conclusions: This updated review and synthesis of the studies had brought a more detailed understanding of the potential application of aromatherapy for easing the pain and anxiety of burn patients.

scholarly journals Effects of Composite Attachments on Orthodontic Clear Aligners Therapy: A Systematic Review

Materials ◽  
2022 ◽  
Vol 15 (2) ◽  
pp. 533
Author(s):  
Riccardo Nucera ◽  
Carolina Dolci ◽  
Angela Mirea Bellocchio ◽  
Stefania Costa ◽  
Serena Barbera ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Data Extraction ◽  
Risk Of Bias ◽  
Bias Assessment ◽  
Bodily Movement ◽  
Study Selection ◽  
Medium Risk ◽  
Clear Aligner ◽  
Anterior Root

This systematic review aims to highlight the differences between different clear aligner therapies that differ in the presence of attachments or in attachment configuration. Eight electronic databases were searched up to March 2020. Two authors independently proceeded to study selection, data extraction, and risk of bias assessment. The analysis of the results was carried out examining six groups of movements (mesio-distal tipping/bodily movement; anterior bucco-lingual tipping/root torque; posterior bucco-lingual tipping/expansion; intrusion; extrusion; rotation). Five clinical trials were selected and all of them showed a medium risk of bias. Literature showed that attachments mostly increase the effectiveness of orthodontic treatment with clear aligners, improving anterior root torque, rotation, and mesio-distal (M-D) movement; they are also important to increase posterior anchorage. However, some articles showed contradictory or not statistically significant results. Attachments also seem to improve intrusion, but the evidence about this movement, as well as extrusion, is lacking. No studies evaluated posterior bucco-lingual tipping/expansion. Further clinical trials are strongly suggested to clarify the influence of attachments and their number, size, shape, and position on each orthodontic movement.

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