scholarly journals Algorithms for Prediction of Clinical Deterioration on the General Wards: A Scoping Review

2021 ◽  
Author(s):  
Roel V Peelen ◽  
Yassin Eddahchouri ◽  
Mats Koeneman ◽  
Tom H van de Belt ◽  
Harry van Goor ◽  
...  
Keyword(s):  
Scoping Review ◽  
Data Extraction ◽  
Vital Signs ◽  
Population Data ◽  
Primary Objective ◽  
General Ward ◽  
Clinical Deterioration ◽  
Predictive Algorithms ◽  
Study Characteristics ◽  
Input Variables

OBJECTIVE: The primary objective of this scoping review was to identify and describe state-of-the-art models that use vital sign monitoring to predict clinical deterioration on the general ward. The secondary objective was to identify facilitators, barriers, and effects of implementing these models. DATA SOURCES: PubMed, Embase, and CINAHL databases until November 2020. STUDY SELECTION: We selected studies that compared vital signs–based automated real-time predictive algorithms to current track-and-trace protocols in regard to the outcome of clinical deterioration in a general ward population. DATA EXTRACTION: Study characteristics, predictive characteristics and barriers, facilitators, and effects. RESULTS: We identified 1,741 publications, 21 of which were included in our review. Two of the these were clinical trials, 2 were prospective observational studies, and the remaining 17 were retrospective studies. All of the studies focused on hospitalized adult patients. The reported area under the receiver operating characteristic curves ranged between 0.65 and 0.95 for the outcome of clinical deterioration. Positive predictive value and sensitivity ranged between 0.223 and 0.773 and 7.2% to 84.0%, respectively. Input variables differed widely, and predicted endpoints were inconsistently defined. We identified 57 facilitators and 48 barriers to the implementation of these models. We found 68 reported effects, 57 of which were positive. CONCLUSION: Predictive algorithms can detect clinical deterioration on the general ward earlier and more accurately than conventional protocols, which in one recent study led to lower mortality. Consensus is needed on input variables, predictive time horizons, and definitions of endpoints to better facilitate comparative research.

scholarly journals Diagnosing Overtraining Syndrome: A Scoping Review

2021 ◽  
pp. 194173812110447
Author(s):  
Justin Carrard ◽  
Anne-Catherine Rigort ◽  
Christian Appenzeller-Herzog ◽  
Flora Colledge ◽  
Karsten Königstein ◽  
...  
Keyword(s):  
Scoping Review ◽  
Sports Medicine ◽  
Female Athletes ◽  
Data Extraction ◽  
Eligibility Criteria ◽  
Level Of Evidence ◽  
Exercise Tests ◽  
Overtraining Syndrome ◽  
Scoping Reviews ◽  
Study Characteristics

Context: Overtraining syndrome (OTS) is a condition characterized by a long-term performance decrement, which occurs after a persisting imbalance between training-related and nontraining-related load and recovery. Because of the lack of a gold standard diagnostic test, OTS remains a diagnosis of exclusion. Objective: To systematically review and map biomarkers and tools reported in the literature as potentially diagnostic for OTS. Data Sources: PubMed, Web of Science, and SPORTDiscus were searched from database inception to February 4, 2021, and results screened for eligibility. Backward and forward citation tracking on eligible records were used to complement results of database searching. Study Selection: Studies including athletes with a likely OTS diagnosis, as defined by the European College of Sport Science and the American College of Sports Medicine, and reporting at least 1 biomarker or tool potentially diagnostic for OTS were deemed eligible. Study Design: Scoping review following the guidelines of the Joanna Briggs Institute and PRISMA Extension for Scoping Reviews (PRISMA-ScR). Level of Evidence: Level 4. Data Extraction: Athletes’ population, criteria used to diagnose OTS, potentially diagnostic biomarkers and tools, as well as miscellaneous study characteristics were extracted. Results: The search yielded 5561 results, of which 39 met the eligibility criteria. Three diagnostic scores, namely the EROS-CLINICAL, EROS-SIMPLIFIED, and EROS-COMPLETE scores (EROS = Endocrine and Metabolic Responses on Overtraining Syndrome study), were identified. Additionally, basal hormone, neurotransmitter and other metabolite levels, hormonal responses to stimuli, psychological questionnaires, exercise tests, heart rate variability, electroencephalography, immunological and redox parameters, muscle structure, and body composition were reported as potentially diagnostic for OTS. Conclusion: Specific hormones, neurotransmitters, and metabolites, as well as psychological, electrocardiographic, electroencephalographic, and immunological patterns were identified as potentially diagnostic for OTS, reflecting its multisystemic nature. As exemplified by the EROS scores, combinations of these variables may be required to diagnose OTS. These scores must now be validated in larger samples and within female athletes.

scholarly journals A protocol for a scoping review of equity measurement in mental health care for children and youth

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
William Gardner ◽  
Stuart G. Nicholls ◽  
Graham J. Reid ◽  
Brian Hutton ◽  
Candyce Hamel ◽  
...  
Keyword(s):  
Mental Health ◽  
Scoping Review ◽  
Full Text ◽  
Data Extraction ◽  
Open Science ◽  
Children And Youth ◽  
Eligibility Criteria ◽  
Study Selection ◽  
Study Characteristics ◽  
Two Stages

Abstract Background Mental health (MH) problems are among the most important causes of morbidity and mortality for children and youth. Problems of lack of equity in child and youth MH services (CYMHS)—including, but not limited to, problems in inaccessibility and quality of services—are widespread. Characterizing the nature of equity in CYMHS is an ongoing challenge because the field lacks a consistent approach to conceptualizing equity. We will conduct a scoping review of how equity in MH services for children and youth has been defined, operationalized, and measured. Our objectives are to discover: (1) What conceptual definitions of equity are used by observational studies of CYMHS?; (2) What service characteristics of CYMHS care do indices of equity cover?; (3) What population dimensions have been used to operationalize equity?; (4) What statistical constructs have been used in indices that measure CYMHS equity?; and (5) What were the numerical values of those indices? Methods The following databases will be searched: Medline, Embase, PsycINFO, Cochrane Controlled Register of Trials, CINAHL, EconLit, and Sociological Abstracts. Searches will be conducted from the date of inception to the end of the last full calendar year (December 2019). Studies will be included if they include an evaluation of a mental health service for children or youth (defined as those under 19 years of age) and which quantify variation in some aspect of child or youth mental health services (e.g., accessibility, volume, duration, or quality) as a function of socio-demographic and/or geographic variables. Study selection will occur over two stages. Stage one will select articles based on title and abstract using the liberal-accelerated method. Stage two will review the full texts of selected titles. Two reviewers will work independently on full-text reviewing, with each study screened twice using pre-specified eligibility criteria. One reviewer will chart study characteristics and indices to be verified by a second reviewer. Reviewers will resolve full-text screening and data extraction disagreements through discussion. Synthesis of the collected data will focus on compiling and mapping the types and characteristics of the indices used to evaluate MH services equity. Discussion The planned, systematic scoping review will survey the literature regarding how equity in MH services for children and youth has been operationalized and help inform future studies of equity in CYMHS. Systematic review registration Open Science Foundation ID SYSR-D-19-00371, https://osf.io/58srv/.

scholarly journals Using theatre as an arts-based knowledge translation strategy for health-related information: a scoping review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e032738 ◽  
Author(s):  
Amanda Hall ◽  
Bradley Furlong ◽  
Andrea Pike ◽  
Gabrielle Logan ◽  
Rebecca Lawrence ◽  
...  
Keyword(s):  
Knowledge Translation ◽  
Scoping Review ◽  
Data Extraction ◽  
Target Population ◽  
Translation Strategy ◽  
Related Information ◽  
Study Results ◽  
Full Text Review ◽  
Health Related ◽  
Study Characteristics

IntroductionSubstantial delays in translating evidence to practice mean that many beneficial and vital advances in medical care are not being used in a timely manner. Traditional knowledge translation (KT) strategies have tended to target academics by disseminating findings in academic journals and at scientific conferences. Alternative strategies, such as theatre-based KT, appear to be effective at targeting broader audiences. The purpose of this scoping review is to collate and understand the current state of science on the use of theatre as a KT strategy. This will allow us to identify gaps in literature, determine the need for a systematic review and develop additional research questions to advance the field.Methods and analysisThis review will follow established scoping review methods outlined by Arksey and O’Malley in conjunction with enhanced recommendations made by Levacet al. The search strategy, guided by an experienced librarian, will be conducted in PubMed, CINHAL and OVID. Study selection will consist of three stages: (1) initial title and abstract scan by one author to remove irrelevant articles and create a shortlist for double screening, (2) title and abstract scan by two authors, and (3) full-text review by two authors. Included studies will report specifically on the use of theatre as means of KT of health-related information to any target population. Two reviewers will independently extract and chart the data using a standardised data extraction form. Descriptive statistics will be used to produce numerical summaries related to study characteristics, KT strategy characteristics and evaluation characteristics. For those studies that included an evaluation of the theatre production as a KT strategy, we will synthesise the data according to outcome.Ethics and disseminationEthical approval was not required for this study. Results will be published in relevant journals, presented at conferences and distributed via social media.

scholarly journals How do children and adolescents experience healthcare professionals? Scoping review and interpretive synthesis

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e054368
Author(s):  
Gail Davison ◽  
Martina Ann Kelly ◽  
Richard Conn ◽  
Andrew Thompson ◽  
Tim Dornan
Keyword(s):  
Scoping Review ◽  
Healthcare Professionals ◽  
Medical Information ◽  
Data Extraction ◽  
Contextual Information ◽  
Evidence Base ◽  
Eligibility Criteria ◽  
Study Characteristics ◽  
Trusting Relationships ◽  
Methodological Principles

ObjectiveExplore children’s and adolescents’ (CADs’) lived experiences of healthcare professionals (HCPs).DesignScoping review methodology provided a six-step framework to, first, identify and organise existing evidence. Interpretive phenomenology provided methodological principles for, second, an interpretive synthesis of the life worlds of CADs receiving healthcare, as represented by verbatim accounts of their experiences.Data sourcesFive key databases (Ovid Medline, Embase, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus, and Web of Science), from inception through to January 2019, reference lists, and opportunistically identified publications.Eligibility criteriaResearch articles containing direct first-person quotations by CADs (aged 0–18 years inclusive) describing how they experienced HCPs.Data extraction and synthesisTabulation of study characteristics, contextual information, and verbatim extraction of all ‘relevant’ (as defined above) direct quotations. Analysis of basic scope of the evidence base. The research team worked reflexively and collaboratively to interpret the qualitative data and construct a synthesis of children’s experiences. To consolidate and elaborate the interpretation, we held two focus groups with inpatient CADs in a children’s hospital.Results669 quotations from 99 studies described CADs’ experiences of HCPs. Favourable experiences were of forming trusting relationships and being involved in healthcare discussions and decisions; less favourable experiences were of not relating to or being unable to trust HCPs and/or being excluded from conversations about them. HCPs fostered trusting relationships by being personable, wise, sincere and relatable. HCPs made CADs feel involved by including them in conversations, explaining medical information, and listening to CADs’ wider needs and preferences.ConclusionThese findings strengthen the case for making CADs partners in healthcare despite their youth. We propose that a criterion for high-quality child-centred healthcare should be that HCPs communicate in ways that engender trust and involvement.

Evaluation of Spin in the Abstracts of Systematic Reviews and Meta-Analyses of Atopic Dermatitis Treatments and Interventions

Dermatology ◽  
2021 ◽  
pp. 1-10
Author(s):  
Vanessa Lin ◽  
Raahi Patel ◽  
Alexis Wirtz ◽  
Deepika Mannem ◽  
Ryan Ottwell ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Systematic Reviews ◽  
Methodological Quality ◽  
Data Extraction ◽  
Included Study ◽  
Primary Objective ◽  
Quality Of Reporting ◽  
Study Characteristics ◽  
Meta Analyses

<b><i>Background:</i></b> Spin – the misrepresentation of a study’s results – has been identified in abstracts of studies focused on a variety of disorders from multiple fields of medicine. <b><i>Objectives:</i></b> This study’s primary objective was to evaluate the abstracts of systematic reviews and meta-analyses focused on the treatment of atopic dermatitis for the nine most severe forms of spin. <b><i>Methods:</i></b> We systematically searched Embase and MEDLINE for systematic reviews of atopic dermatitis therapies. Screening and data extraction occurred in a masked, duplicate fashion. Each included study was evaluated for the nine most severe types of spin and other study characteristics. <b><i>Results:</i></b> Our searches retrieved 2,456 studies, of which 113 were included for data extraction. Spin was found in 74.3% of our included studies (84/113). Spin type 6 occurred most frequently (68/113, 60.2%). Spin types 1, 2, and 9 were not identified. All industry-funded systematic reviews contained spin in their abstract. The presence of spin was not associated with any specific study characteristics, including the methodological quality of the study. <b><i>Conclusions:</i></b> Severe forms of spin were found in the majority of abstracts for systematic reviews of atopic dermatitis treatments. Steps should be taken to prevent spin to improve the quality of reporting in abstracts.

scholarly journals How methodological frameworks are being developed: Evidence from a scoping review

2019 ◽  
Author(s):  
Nicola McMeekin ◽  
Olivia Wu ◽  
Evi Germeni ◽  
A Briggs
Keyword(s):  
Scoping Review ◽  
Data Extraction ◽  
Descriptive Analysis ◽  
Grey Literature ◽  
Methodological Framework ◽  
Data Synthesis ◽  
Wide Range ◽  
Study Characteristics ◽  
Subject Areas ◽  
Definition Of

Abstract Background A methodological framework is a structured guide to completing a process or procedure. Although the benefits of using methodological frameworks are increasingly recognised, to date, there is no formal definition of what constitutes a ‘methodological framework’, nor is there any published guidance on how to develop one. This study sought to: (a) map the existing landscape on the use of methodological frameworks; (b) identify approaches used for the development of methodological frameworks; and (c) recommend guidance for developing future methodological frameworks. We took a broad view and did not limit our study to methodological frameworks in research and academia. Methods A scoping review was conducted, drawing on Arksey and O’Malley’s methodological framework and more recent guidance. We systematically searched two major electronic databases (MEDLINE and Web of Science), as well as grey literature sources and the reference lists of key papers. Study characteristics and approaches used for development of methodological frameworks were extracted from included studies. Descriptive analysis was conducted. Results We included a total of 28 studies, representing a wide range of subject areas. The most commonly reported approach for developing a methodological framework was ‘Based on existing methods and guidelines’ (64.3%), followed by ‘Refined and validated’ (35.7%), ‘Experience and expertise’ (32.1%), ‘Literature review’ (28.6%), ‘Data synthesis and amalgamation’ (25.0%), ‘Data extraction’ (10.7%), ‘Iteratively developed’ (7.1%) and ‘Lab work results’ (3.6%). There was no consistent use of terminology; the studies included a range of terms for ‘methodological framework’, which were also used interchangeably within studies. Conclusions Although no formal guidance exists on how to develop a methodological framework, this scoping review found an overall consensus in approaches used, which can be broadly divided into three phases: (a) identifying data to inform the methodological framework; (b) developing the methodological framework; and (c) validating, testing and refining the methodological framework. Based on these phases, we provide recommendations to facilitate the development of future methodological frameworks.

scholarly journals Epidemiology of childhood injuries in Saudi Arabia: a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hadeel Albedewi ◽  
Nouf Al-Saud ◽  
Abdulhameed Kashkary ◽  
Ada Al-Qunaibet ◽  
Salem M. AlBalawi ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Scoping Review ◽  
Motor Vehicle ◽  
Data Extraction ◽  
Population Based ◽  
Included Study ◽  
Childhood Injuries ◽  
Study Characteristics ◽  
Data Elements ◽  
Injury Burden

Abstract Background Injury is the leading cause of death among Saudi children. Despite that, much remains unknown on the epidemiology and the extent of burden. This scoping review aims to describe previous literature on injury burden, including types, causes, and outcomes. Methods We conducted a scoping literature search of English published articles on injuries among Saudi children between 0 to 18 years old using Scopus, MEDLINE, and Web of Science between January 2000 and December 2020. The primary outcome was the type and the cause of childhood injuries. Data extraction was based on specified data elements that included study characteristics and epidemiological parameters. The STROBE checklist was used to assess the quality of publications. Results The initial review identified 3,384 studies. Of which, 36 studies met the inclusion criteria. A total of 20,136 children were included; of them, 69% were males. Among studies that examined overall injuries, falls represented 31.9%, while 25.1% were due to Motor Vehicle Collision (MVC). The leading cause of fractures was falls (37.9%), followed by MVC (21.5%). The leading cause was flames (52.1%) followed by scald (36.4%) for burns. While for poisoning, medications were the leading cause of (39.9%), followed by toxic household products (25.7%). Weighted mortality rates were 5.2% for overall injuries, 8.3% for fractures of the skull and spine, and 17.4% for burns. Conclusions MVC and falls are associated with the highest share of injuries in the kingdom. These findings can guide prevention efforts to reduce injury burden and improve population health. Further population-based research is warranted to explore the determinants of childhood injuries across all regions of Saudi Arabia.

scholarly journals The effect of cochlear implantation on autonomy, participation and work in postlingually deafened adults: a scoping review

2020 ◽  
Author(s):  
Hugo G. B. Nijmeijer ◽  
Noud M. Keijsers ◽  
Wendy J. Huinck ◽  
Emmanuel A. M. Mylanus
Keyword(s):  
Scoping Review ◽  
Cochlear Implantation ◽  
Data Extraction ◽  
Small Body ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Study Characteristics ◽  
Work Autonomy ◽  
Study Designs

Abstract Purpose This scoping review examines the available evidence on the effect of unilateral cochlear implantation (CI) in adults with postlingual bilateral hearing loss on societal-related outcomes in terms of work, autonomy and participation. Methods Five databases were searched (Pubmed, Web of Science, Embase, PsycINFO and Cochrane Library). Publications were screened in three steps on inclusion criteria. Of the 4230 screened publications, 110 met the inclusion criteria and were assessed for data extraction regarding outcomes “work”, “autonomy”, “participation”. Study characteristics and key findings are presented and narratively described. Results Twenty-seven publications were included and categorized into retrospective (n = 3), cross-sectional (n = 18) or prospective (n = 6) study designs. Measurement or identification of number of outcomes (no) were related to work (no = 20), participation (no = 9) and autonomy or independency (no = 10). Most studies indicated benefits of CI on these outcomes. However, some studies did not or indicated additional barriers for benefits. Eleven publications primarily aimed to study one or more of our primary outcomes. Conclusion In this literature search, scientific databases are reviewed. The results indicate that there is a relatively small body of evidence regarding the effect of CI on the outcomes “work”, “autonomy” and “participation”. Even though there are some limitations of the current study including some overlap in outcome definitions, most included studies indicate a beneficial effect of CI on work, autonomy and participation. The lack of consensus in definitions and the small body of evidence indicates a need for additional prospective studies investigating the societal outcomes of CI in postlingually deafened adults.

scholarly journals How methodological frameworks are being developed: Evidence from a scoping review

2020 ◽  
Author(s):  
Nicola McMeekin ◽  
Olivia Wu ◽  
Evi Germeni ◽  
A Briggs
Keyword(s):  
Scoping Review ◽  
Data Extraction ◽  
Descriptive Analysis ◽  
Grey Literature ◽  
Methodological Framework ◽  
Data Synthesis ◽  
Wide Range ◽  
Study Characteristics ◽  
Subject Areas ◽  
Definition Of

Abstract Background: A methodological framework is a structured guide to completing a process or procedure. Although the benefits of using methodological frameworks are increasingly recognised, to date, there is no formal definition of what constitutes a ‘methodological framework’, nor is there any published guidance on how to develop one. This study’s aims are to: (a) map the existing landscape on the use of methodological frameworks; (b) identify approaches used for the development of methodological frameworks and terminology used; and (c) provide suggestions for developing future methodological frameworks. We took a broad view and did not limit our study to methodological frameworks in research and academia.Methods: A scoping review was conducted, drawing on Arksey and O’Malley’s methods and more recent guidance. We systematically searched two major electronic databases (MEDLINE and Web of Science), as well as grey literature sources and the reference lists and citations of all relevant papers. Study characteristics and approaches used for development of methodological frameworks were extracted from included studies. Descriptive analysis was conducted.Results: We included a total of 30 studies, representing a wide range of subject areas. The most commonly reported approach for developing a methodological framework was ‘Based on existing methods and guidelines’ (66.7%), followed by ‘Refined and validated’ (33.3%), ‘Experience and expertise’ (30.0%), ‘Literature review’ (26.7%), ‘Data synthesis and amalgamation’ (23.3%), ‘Data extraction’ (10.0%), ‘Iteratively developed’ (6.7%) and ‘Lab work results’ (3.3%). There was no consistent use of terminology; the studies included a range of terms for ‘methodological framework’, which were also used interchangeably within studies.Conclusions: Although no formal guidance exists on how to develop a methodological framework, this scoping review found an overall consensus in approaches used, which can be broadly divided into three phases: (a) identifying data to inform the methodological framework; (b) developing the methodological framework; and (c) validating, testing and refining the methodological framework. Based on these phases, we provide suggestions to facilitate the development of future methodological frameworks.Trial registration: Not applicable

scholarly journals Design of the Pilot, Proof of Concept REMOTE-COVID Trial: Remote Monitoring Use in Suspected Cases of COVID-19 (SARS-CoV 2) A Trial Protocol

2020 ◽  
Author(s):  
Fahad Mujtaba Iqbal ◽  
Meera Joshi ◽  
Gary Davies ◽  
Sadia Khan ◽  
Hutan Ashrafian ◽  
...  
Keyword(s):  
Remote Monitoring ◽  
Wearable Sensors ◽  
Healthcare Delivery ◽  
Vital Signs ◽  
World Health Organisation ◽  
Primary Objective ◽  
Clinical Deterioration ◽  
World Health ◽  
Proof Of Concept ◽  
Remote Monitoring Systems

Abstract BackgroundThe outbreak of SARS-CoV-2 (coronavirus, COVID-19), declared a pandemic by the World Health Organisation (WHO) is global health problem with ever-increasing attributed deaths. Vital sign trends are routinely used to monitor patients with changes in these parameters often preceding an adverse event. Wearable sensors can measure vital signs continuously (e.g. heart rate, respiratory rate, temperature) remotely and can be utilised to recognise early clinical deterioration. MethodsWe describe the protocol for a pilot, proof-of-concept, observational study to be conducted in an engineered hotel near London airports, United Kingdom. The study is set to continue for the duration of the pandemic. Individuals arriving to London with mild symptoms suggestive of COVID-19 or returning from high risk areas requiring quarantine, as recommended by Public Health England, or healthcare professionals with symptoms suggestive of COVID-19 unable to isolate at home will be eligible for a wearable patch to be applied for the duration of their stay. Notifications will be generated should deterioration be detected through the sensor and displayed on a central monitoring hub viewed by nursing staff, allowing for trend deterioration to be noted. The primary objective is to determine the feasibility of remote monitoring systems in detecting clinical deterioration for quarantined individuals in a hotel. DiscussionThis trial should prove the feasibility of a rapidly implemented model of healthcare delivery through remote monitoring during a global pandemic at a hotel, acting as an extension to a healthcare trust. Potential benefits would include reducing infection risk of COVID-19 to healthcare staff, with earlier recognition of clinical deterioration through ambulatory, continuous, remote monitoring using a discrete wearable sensor. We hope our results can power future, robust future randomised trials.Trial registrationClinicalTrials.gov Identifier: NCT04337489

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