scholarly journals Accuracy of Ultrasound in Diagnosis of Pneumothorax: A Comparison between Neonates and Adults—A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-16 ◽  
Author(s):  
Hamid Dahmarde ◽  
Fateme Parooie ◽  
Morteza Salarzaei
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Odds Ratio ◽  
English Language ◽  
Meta Analysis ◽  
Diagnostic Odds Ratio ◽  
World Health ◽  
Cochrane Library ◽  
Chest Ultrasonography ◽  
Link Type

Objective. The present systematic review and meta-analysis were conducted to investigate the accuracy of ultrasound in the diagnosis of pneumothorax in neonates and adults. Method. The searches were conducted by two independent researchers (MS and HD) to find the relevant studies published from 01/01/2009 until the end of 01/01/2019. We searched for published literature in the English language in MEDLINE via PubMed, Embase™ via ovid, the Cochrane Library, and Trip database. For literature published in other languages, we searched national databases (Magiran and SID), KoreaMed, and LILACS, and we searched OpenGrey (http://www.opengrey.eu/) and the World Health Organization Clinical Trials Registry (http://who.int/ictrp) for unpublished literature and ongoing studies. The keywords used in the search strategy were pneumothorax or ultrasound or chest ultrasonography or neonate or adult or aerothorax or sensitivity or specificity or diagnostic accuracy. The list of previous study resources and systematic reviews was also searched for identifying the published studies (MS and HD). Analyses were performed using Meta-Disc 1.4. Results. In total, 1,565 patients (255 neonates, 1212 adults, and 101 pediatrics suspected of pneumothorax) were investigated in 10 studies. The overall specificity of chest ultrasound in the diagnosis of pneumothorax in both populations of adults and neonates was 85.1% at the confidence interval of 95 percent (95% CI 81.1%–88.5%). At the confidence interval of 95 percent, the sensitivity was 98.6% (95% CI 97.7%–99.2%). The diagnostic odds ratio was 387.72 (95% CI 76.204–1972.7). For the diagnosis of pneumothorax in neonates, the ultrasound sensitivity was 96.7% at the confidence interval of 95 percent (95% CI 88.3%–99.6%). At the confidence interval of 95 percent, the specificity was 100% (95% CI 97.7%–100%). For the diagnosis of pneumothorax in adults, the ultrasound sensitivity was 82.9% at the confidence interval of 95 percent (95% CI 78.3–86.9%). At the confidence interval of 95 percent, the specificity was 98.2% (95% CI 97.0%–99.0%). The diagnostic odds ratio was 423.13 (95% CI 45.222–3959.1). Analyzing studies indicated that the sensitivity of “absence lung sliding” sign for the diagnosis of pneumothorax was 87.2% (95% CI 77.7–93.7), and specificity was 99.4% (95% CI 96.5%–100%). DOR was 556.74 (95% CI 100.03–3098.7). The sensitivity of “lung point” sign for the diagnosis of pneumothorax was 82.1% (95% CI 71.7%–89.8%), and the specificity was 100% (at the confidence interval of 95% CI 97.6%–100%). DOR was 298.0 (95% CI 58.893–1507.8). Conclusion. The diagnosis of pneumothorax using ultrasound is accurate and reliable; additionally, it can result in timely diagnoses specifically in neonatal pneumothorax. Using this method facilitates the therapy process; lack of ionizing radiation and easy operation are benefits of this imaging technique.

scholarly journals Efficacy of Transparent vs. Pressure Dressing in Prevention of Post-Cardiac Catheterization Pain, Discomfort and Hematoma: A Systematic Review and Meta-analysis of RCTs

2021 ◽  
Vol 10 (2) ◽  
pp. 103-110
Author(s):  
Suresh K Sharma ◽  
Kalpana Thakur ◽  
Shiv K Mudgal ◽  
Barun Kumar
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Cardiac Catheterization ◽  
Odds Ratio ◽  
English Language ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Significant Difference ◽  
Pressure Dressing

ABSTRACT Introduction: There is lack consensus on superiority of transparent vs. pressure dressing for prevention of post-cardiac catheterization pain, discomfort and hematoma. Therefore, we conducted this systematic review and meta-analysis of available RCTs on this subject. Methods: We performed a systematic search of RCTs published between in 2000-2019 in English language using databases including PubMed Medline, EMBASE, CINAHL, Cochrane Library, ERMED Journals, Clinical trials database, DELNET, Google Scholar and Discovery Search. Studies conducted on adult patients with femoral dressing after cardiac catheterization measuring pain, discomfort, hematoma as intended outcomes have been included. Data extraction, critical appraisal, assessment of risk bias was done and decisions on quality were made on mutual consensus. Mantel-Haenszel (MH) and odds ratio for dichotomous variables was calculated by Review Manager 5.3 software. Results: Out of all identified studies, only 5 studies comprising 664 patients fulfilled the inclusion criteria and met the quality assessment. Incidence of discomfort (25, 333) were significantly less in transparent dressing group as compared to pressure dressing group (149, 331); odds ratio 0.10, 95% confidence interval [CI] 0.06-0.15; I2 = 0%, P= 0.00. Four studies reported significantly lower number of pain cases in transparent dressing (17, 203) as compared to pressure dressing (57, 201); odds ratio 0.13, 95% confidence interval [CI] 0.03-0.59; I2 = 47%, P= 0.01). However, incidence of hematoma did not reveal any significant difference between two groups. Conclusion: Transparent dressing is a better option in patients with femoral/groin dressing after cardiac catheterization as it is more effective in prevention of pain and discomfort.

scholarly journals The diagnostic accuracy of B-mode ultrasound in detecting meniscal tears: a systematic review and pooled meta-analysis

2018 ◽  
Vol 20 (2) ◽  
pp. 164 ◽  
Author(s):  
Fajin Dong ◽  
Lei Zhang ◽  
Shuxia Wang ◽  
Duo Dong ◽  
Jinfeng Xu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Diagnostic Odds Ratio ◽  
Cochrane Library ◽  
Meniscal Tears ◽  
Linear Probe ◽  
Sensitivity Specificity

Aim: To evaluate the diagnostic accuracy of meniscal tears using B-mode ultrasound and high-frequency linear probe by conducting a systematic review and pooled meta-analysis. Material and methods: The Cochrane library, Embase, and Pubmed were searched for relevant studies up to 29 July 2017. The arthroscopy was used as the reference standard. The results were estimated by pooled sensitivity, specificity, diagnostic odds ratio, likelihood ratio, and the area under the summary receiver operating characteristic (SROC). Results: Seven prospective studies met the selection criteria, comprising 321meniscal tears from 472 patients. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the SROC curve were 88.80% (95%CI: 82.83-92.87), 84.66% (95%CI: 75.89-90.64), 5.79(95%CI: 3.66-9.15), 0.13 (95%CI: 0.09-0.20), and 43.74 (95%CI: 24.01-79.68), respectively. The area under the SROC curve was 93% (95%CI: 91-95). Conclusions: This meta-analysis indicates that 2-dimensional ultrasound is useful, and could be routinely used for estimating meniscal injuries in the human knee joint

scholarly journals Risk Factors for Perioperative Hemodynamic Instability in Pheochromocytoma: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (19) ◽  
pp. 4531
Author(s):  
Fumihiko Urabe ◽  
Shoji Kimura ◽  
Kosuke Iwatani ◽  
Kazuhiro Takahashi ◽  
Kagenori Ito ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Confidence Interval ◽  
Systematic Reviews ◽  
Tumor Size ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Hemodynamic Instability ◽  
Cochrane Library ◽  
The Cochrane Library

Objective: To evaluate the risk factors of perioperative hemodynamic instability in pheochromocytoma, we conducted a systematic search of the literature using the Preferred Reporting Items for Systematic Reviews and Meta-analysis. Methods: In April 2021, we systematically searched PubMed, the Cochrane library, and Scopus for relevant studies on the risk factors of perioperative hemodynamic instability of adrenalectomy in patients with pheochromocytoma, and we subjected the findings from those studies to formal meta-analysis. Results: Our systematic review identified 14 studies involving 1725 patients, of which nine studies with 967 patients were eligible for meta-analysis. The results of meta-analysis showed that tumor size (odds ratio (OR): 1.14 for each increased cm, 95% confidence interval (CI) 1.03–1.26, z = 2.57) and urinary norepinephrine (OR, 1.51: 95% CI 1.26–1.81; z = 4.50) were most closely associated with the occurrence of perioperative hemodynamic instability. Conclusion: These findings suggest that tumor size and urinary norepinephrine are important predictors and risk factors for perioperative hemodynamic instability in adrenalectomy for pheochromocytoma. Such findings may be of value to surgeons and anesthesiologists when considering or preparing for this procedure.

scholarly journals Impact of interstitial lung disease on mortality in ANCA-associated vasculitis: A systematic literature review and meta-analysis

2021 ◽  
Vol 18 ◽  
pp. 147997312199456
Author(s):  
Peining Zhou ◽  
Jing Ma ◽  
Guangfa Wang
Keyword(s):  
Systematic Review ◽  
Interstitial Lung Disease ◽  
Confidence Interval ◽  
Lung Disease ◽  
Mortality Risk ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Anca Associated Vasculitis ◽  
Retrospective Cohort Studies

Several retrospectivee described the association of interstitial lung disease (ILD) and ANCA-associated vasculitis (AAV). However, the relationship between the ILD and mortality in AAV patients have not been established so far. This study aims to estimate the relevance of AAV-associated-ILD (AAV-ILD) and mortality risk by conducting a systematic review and meta-analysis.A comprehensive systematic review was conducted in accordance with the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses). PubMed, Embase.com and the Cochrane Library (Wiley) were searched for original observational studies. Summary estimates were derived with a random-effects model and reported as risk ratio (RR), tested for publication bias and heterogeneity. Ten retrospective cohort studies were included, comprising 526 AAV-ILD patients enrolled from 1974 to 2018. Meta-analysis yielded a pooled RR of 2.90 (95% confidence interval 1.77–4.74) for death among those with AAV-ILD compared to control group. UIP pattern was associated with an even poorer prognosis in comparison to non-UIP pattern (RR 4.36, 95% confidence interval 1.14–16.78). Sensitivity analysis suggested that the meta-RR result was not skewed by a single dominant study. ILD might be associated with a higher mortality risk in AAV patients.

scholarly journals Adherence to antihypertensive medications and associated factors among hypertensive patients in Ethiopia: Systematic review and meta-analysis

2020 ◽  
Vol 8 ◽  
pp. 205031212098245
Author(s):  
Assefa Tola Gemeda ◽  
Lemma Demissie Regassa ◽  
Adisu Birhanu Weldesenbet ◽  
Bedasa Taye Merga ◽  
Nanti Legesse ◽  
...  
Keyword(s):  
Systematic Review ◽  
Medication Adherence ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Associated Factors ◽  
Antihypertensive Medication ◽  
Meta Analysis ◽  
Group Analysis ◽  
Hypertensive Patients ◽  
Pooled Prevalence

The foundation of controlling hypertension is adherence to antihypertensive medication adherence. This systematic review and meta-analysis aimed to assess the magnitude and associated factors of adherence to antihypertensive medication among adult hypertensive patients in Ethiopia. A comprehensible bibliographic searching was conducted from PubMed, EMBASE, Scopus, and Web of Science core collection. All published and unpublished studies that had been accessible before 31 May 2020, and written in English were eligible. Joanna Briggs Institute assessment tool was used to evaluate the quality of the findings of the included studies. Stata software 16.0 was used to analyze the data. Study-specific estimates were pooled to determine the overall prevalence estimate across studies using a random-effects meta-analysis model. Publication bias and heterogeneity were checked. Fourteen studies with a total of 4938 hypertensive patients were included in the final systematic review and meta-analysis. The pooled prevalence of medication adherence among hypertensive patients in Ethiopia was 65.41% (95% confidence interval: 58.91–71.91). Sub-group analysis shown that the pooled prevalence of medication adherence was the highest (69.07%, 95% confidence interval: 57.83–80.31, I2 = 93.51) among studies using questionnaire technique whereas the lowest in Morisky Medication Adherence Scale eight-items (60.66%, 95% confidence interval: 48.92–72.40, I2 = 97.16). Moreover, medication adherence was associated with the presence of comorbidities (pooled odds ratio = 0.23, 95% confidence interval: 0.07–0.38, p = 0.030, I2 = 54.9%) and knowledge about the disease and its management (pooled odds ratio = 2.98, 95% confidence interval: 1.72–4.24, p = 0.04, I2 = 55.55%) but not with place of residence (pooled odds ratio = 1.22, 95% confidence interval: 0.51–1.93, p = 0.00, I2 = 76.9%). Despite a lack of uniformity among included studies, adherence to antihypertensive medication among the hypertensive population in Ethiopia was moderate. The presence of comorbidities and/or complications reduced the odds of adherence whereas having good knowledge about the disease increased chance of medication adherence among hypertensive patients.

Urgent Carotid Endarterectomy for Patients with Unstable Symptoms: Systematic Review and Meta-Analysis of Outcomes

Vascular ◽  
2009 ◽  
Vol 17 (5) ◽  
pp. 243-252 ◽  
Author(s):  
Benjamin O. Patterson ◽  
Peter J. Holt ◽  
Robert J. Hinchliffe ◽  
Matt M. Thompson ◽  
Ian M. Loftus
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Confidence Interval ◽  
Carotid Endarterectomy ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Long Term Results ◽  
Current Evidence ◽  
Ischemic Attack

Current evidence suggests that carotid endarterectomy (CEA) performed within 2 weeks of symptoms produces better long-term results than if it is delayed. Urgent endarterectomy following unstable presentations such as crescendo transient ischemic attack (cTIA) or progressive stroke has been associated with variable results. The evidence for this treatment strategy required reviewing. A systematic review of articles related to urgent CEA between 1980 and 2008 was performed. For cTIA, there was an odds ratio of 5.6 (95% confidence interval 3.3–9.7, p ≤ .0001) for combined stroke or death compared with surgery for “standard” indications. For unstable stroke, the odds ratio was 5.5 (95% confidence interval 3.1–9.3, p ≤ .0001). Patients with unstable neurologic presentations are at higher risk of complications if operated on urgently. Clearer definitions would help more precise patient selection to avoid inadvertently operating on patients with an unacceptably high risk of poor outcome.

scholarly journals Prognostic Value of N-terminal Probrain Natriuretic Peptide for Patients with Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Qi Ni ◽  
Chaoqian Li ◽  
Hua Lin
Keyword(s):  
Systematic Review ◽  
Acute Respiratory Distress Syndrome ◽  
Likelihood Ratio ◽  
Odds Ratio ◽  
Distress Syndrome ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Sensitivity Specificity

Objectives. The mortality rate of patients with acute respiratory distress syndrome (ARDS) is high. Hence, it is crucial to identify a reliable biomarker with wide clinical applications for predicting the prognosis of patients with ARDS. This systematic review and meta-analysis was conducted to investigate the value of plasma N-terminal probrain natriuretic peptide (NT-proBNP) for predicting mortality in patients with ARDS. Methods. An electronic search of databases including PubMed, Web of Science, Cochrane Library, and Chinese National Knowledge Infrastructure was conducted up to May 31, 2019, without language restrictions. The quality of the included studies was evaluated using QUADAS-2. Data were extracted and analyzed to obtain pooled estimates of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio. A forest graph was used to evaluate heterogeneity. Potential causes of heterogeneity were further explored by subgroup analysis based on the testing day, testing method, observation endpoint, or cut-off points. A summary receiver operating characteristic curve was drawn to obtain the pooled area under the curve. Results. A total of 7 studies involving 581 patients with ARDS were included. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were as follows: 0.79 (95% CI: 0.72–0.84), 0.79 (95% CI: 0.66–0.88), 3.68 (95% CI: 2.16–6.28), 0.27 (95% CI: 0.20–0.38), and 13.58 (95% CI: 6.17–29.90), respectively. The results of subgroup analysis showed that the testing day influenced the summary sensitivity and that the cut-off points influenced the summary sensitivity and specificity. Conclusion. Our results indicate that elevated plasma NT-proBNP levels have a moderate value for predicting the mortality of patients with ARDS.

scholarly journals Duration of palliative care before death in international routine practice: a systematic review and meta-analysis

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Roberta I. Jordan ◽  
Matthew J. Allsop ◽  
Yousuf ElMokhallalati ◽  
Catriona E. Jackson ◽  
Helen L. Edwards ◽  
...  
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
English Language ◽  
Meta Analysis ◽  
Service Evaluation ◽  
Research Literature ◽  
Cochrane Library ◽  
Routine Practice ◽  
Middle Income ◽  
Palliative Care Services

Abstract Background Early provision of palliative care, at least 3–4 months before death, can improve patient quality of life and reduce burdensome treatments and financial costs. However, there is wide variation in the duration of palliative care received before death reported across the research literature. This study aims to determine the duration of time from initiation of palliative care to death for adults receiving palliative care across the international literature. Methods We conducted a systematic review and meta-analysis that was registered with PROSPERO (CRD42018094718). Six databases were searched for articles published between Jan 1, 2013, and Dec 31, 2018: MEDLINE, Embase, CINAHL, Global Health, Web of Science and The Cochrane Library, as well undertaking citation list searches. Following PRISMA guidelines, articles were screened using inclusion (any study design reporting duration from initiation to death in adults palliative care services) and exclusion (paediatric/non-English language studies, trials influencing the timing of palliative care) criteria. Quality appraisal was completed using Hawker’s criteria and the main outcome was the duration of palliative care (median/mean days from initiation to death). Results One hundred sixty-nine studies from 23 countries were included, involving 11,996,479 patients. Prior to death, the median duration from initiation of palliative care to death was 18.9 days (IQR 0.1), weighted by the number of participants. Significant differences between duration were found by disease type (15 days for cancer vs 6 days for non-cancer conditions), service type (19 days for specialist palliative care unit, 20 days for community/home care, and 6 days for general hospital ward) and development index of countries (18.91 days for very high development vs 34 days for all other levels of development). Forty-three per cent of studies were rated as ‘good’ quality. Limitations include a preponderance of data from high-income countries, with unclear implications for low- and middle-income countries. Conclusions Duration of palliative care is much shorter than the 3–4 months of input by a multidisciplinary team necessary in order for the full benefits of palliative care to be realised. Furthermore, the findings highlight inequity in access across patient, service and country characteristics. We welcome more consistent terminology and methodology in the assessment of duration of palliative care from all countries, alongside increased reporting from less-developed settings, to inform benchmarking, service evaluation and quality improvement.

scholarly journals Voluntary medical male circumcision and HIV infection among men who have sex with men: Implications from a systematic review

2019 ◽  
Vol 7 ◽  
pp. 205031211986911 ◽  
Author(s):  
Chen Zhang ◽  
Han-Zhu Qian ◽  
Yu Liu ◽  
Sten H Vermund
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Male Circumcision ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Meta Analysis ◽  
Voluntary Medical Male Circumcision ◽  
Medical Male Circumcision ◽  
Sex With Men ◽  
Meta Analyses

Background: With the rapidly-increased HIV epidemic among men who have sex with men worldwide, the effectiveness of voluntary medical male circumcision as the tool of HIV prevention still remains undetermined. Purpose: In the current study, we conducted a systematic review and meta-analysis to assess the association between voluntary medical male circumcision and HIV risk among men who have sex with men. Methods and Conclusion: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline, we conducted a comprehensive literature search through multiple databases. A total of 37 articles/abstracts were included in the analysis. We employed random-effects models and subgroup analyses based upon key study characteristics derived from empirical studies. A total of 117,293 men who have sex with men were included in the meta-analysis, and no randomized control trials have been identified. The odds of being HIV positive were 7% lower among men who have sex with men who were circumcised than among men who have sex with men who were uncircumcised (adjusted odds ratio, 0.93; 95% confidence interval, 0.88–0.99). The evidence for the potential protective effect of voluntary medical male circumcision was stronger among men who have sex with men in Asia and Africa (adjusted odds ratio, 0.62; 95% confidence interval, 0.53–0.73). Our meta-analyses may suggest a protective effect of voluntary medical male circumcision against HIV infection among men who have sex with men, especially in settings like Asia/Africa.

Association Between Chiropractic Use and Opioid Receipt Among Patients with Spinal Pain: A Systematic Review and Meta-analysis

Pain Medicine ◽  
2019 ◽  
Author(s):  
Kelsey L Corcoran ◽  
Lori A Bastian ◽  
Craig G Gunderson ◽  
Catherine Steffens ◽  
Alexandria Brackett ◽  
...  
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Spinal Pain ◽  
Chiropractic Care ◽  
Current Evidence ◽  
Inverse Association ◽  
Case Control Studies ◽  
Opioid Prescription

Abstract Objective To investigate the current evidence to determine if there is an association between chiropractic use and opioid receipt. Design Systematic review and meta-analysis. Methods The protocol for this review was registered on PROSPERO (CRD42018095128). The MEDLINE, PubMed, EMBASE, AMED, CINAHL, and Web of Science databases were searched for relevant articles from database inception through April 18, 2018. Controlled studies, cohort studies, and case–control studies including adults with noncancer pain were eligible for inclusion. Studies reporting opioid receipt for both subjects who used chiropractic care and nonusers were included. Data extraction and risk of bias assessment were completed independently by pairs of reviewers. Meta-analysis was performed and presented as an odds ratio with 95% confidence interval. Results In all, 874 articles were identified. After detailed selection, 26 articles were reviewed in full, and six met the inclusion criteria. Five studies focused on back pain and one on neck pain. The prevalence of chiropractic care among patients with spinal pain varied between 11.3% and 51.3%. The proportion of patients receiving an opioid prescription was lower for chiropractic users (range = 12.3–57.6%) than nonusers (range = 31.2–65.9%). In a random-effects analysis, chiropractic users had a 64% lower odds of receiving an opioid prescription than nonusers (odds ratio = 0.36, 95% confidence interval = 0.30–0.43, P < 0.001, I2 = 92.8%). Conclusions This review demonstrated an inverse association between chiropractic use and opioid receipt among patients with spinal pain. Further research is warranted to assess this association and the implications it may have for case management strategies to decrease opioid use.

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