scholarly journals Mobile Apps to Support the Self-Management of Hypertension: Systematic Review of Effectiveness, Usability, and User Satisfaction (Preprint)

2018 ◽  
Author(s):  
Tourkiah Alessa ◽  
Sarah Abdi ◽  
Mark S Hawley ◽  
Luc de Witte
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
User Satisfaction ◽  
Large Scale ◽  
Public Health Problem ◽  
Risk Of Bias ◽  
The Self ◽  
Self Management ◽  
Cochrane Library ◽  
Cochrane Central Register

BACKGROUND Hypertension is a chronic disease that is considered to be a public health problem and requires efforts by patients to manage themselves. The global growth in the use of mobile phones and tablets has been accompanied by the increased use of health apps. Many of these apps support the self-management of hypertension and, therefore, they have the potential benefits of lowering blood pressure. Despite this, there is currently a lack of evidence for their effectiveness, usability, and patient satisfaction with their use. OBJECTIVE A systematic review was conducted to assess the effectiveness of apps in lowering blood pressure, as well as their usability and patients’ satisfaction with their use. METHODS We conducted searches in the following databases: MEDLINE (OVID), EMBASE (OVID), PsycINFO (OVID), CINAHL, the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), IEEE Xplore ASSIAN, Google Scholar and the main Arabic databases Al Manhal, AskZad, and Mandumah. We looked for studies that used apps in the self-management of hypertension from 2008-2016. We also checked the reference lists of the review papers and all the primary studies for additional references. RESULTS A total of 21 studies with a total of 3112 participants were included in the review. Of the 14 studies that assessed the effectiveness of the apps in lowering blood pressure, 10 (71.4%) studies (6 RCTs and 4 nonrandomized studies) reported that using the apps led to significant decreases in blood pressure and seemed to be effective in the self-management of hypertension. Of these 10, only 2 (20%) RCTs and 3 (30%) nonrandomized studies had a low–moderate risk of bias. The results of this review are inconclusive regarding which combinations of functionalities would be most effective in lowering blood pressure because of variation in the studies’ quality, but the data suggest that apps incorporating more comprehensive functionalities are likely to be more effective. In all the studies that assessed the usability of the apps and users’ acceptance of them, all the apps seemed to be accepted and easy to use. CONCLUSIONS Most of the studies reported that apps might be effective in lowering blood pressure and are accepted by users. However, these findings should be interpreted with caution, as most of the studies had a high risk of bias. More well-designed, large-scale studies are required to evaluate the real effect of using apps in lowering blood pressure and to identify the most effective functionality combinations for lowering blood pressure.

The Effectiveness of Dietary Approaches to Stop Hypertension (DASH) Mobile Applications in Supporting a Healthy Diet and Controlling Hypertension in Adults: Systematic Review (Preprint)

2022 ◽  
Author(s):  
Ghadah Alnooh ◽  
Tourkiah Alessa ◽  
Mark Hawley ◽  
Luc de Witte
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
High Risk ◽  
Mobile Applications ◽  
Risk Of Bias ◽  
Self Management ◽  
Cochrane Library ◽  
Smartphone Apps ◽  
Dash Diet ◽  
Diet Adherence

BACKGROUND Uncontrolled hypertension is a public health issue, with increasing prevalence worldwide. The Dietary Approach to Stop Hypertension (DASH) diet is one of the most effective dietary approaches for lowering blood pressure (BP). Dietary mobile applications (apps) have gained popularity and are being used to support DASH diet self-management, aiming to improve DASH diet adherence and thus lower BP OBJECTIVE This systematic review aimed to assess the effectiveness of smartphone apps that support self-management to improve DASH diet adherence and, consequently, reduce BP. A secondary aim was to assess user engagement, satisfaction and acceptance, and usability related to DASH mobile app use. METHODS EMBASE (OVID), Cochrane Library, CINAHL, Web of Science, Scopus, and Google Scholar electronic databases were used to conduct systematic searches for studies conducted between 2008 and 2021 that used DASH smartphone apps to support self-management. The included articles’ reference lists were also checked. RESULTS Five studies (three RCTs and two pre-post studies) including 334 participants altogether examined DASH mobile apps. All studies found a positive trend related to the use of DASH smartphone apps, but the three RCTs had a high risk of bias. One pre-post study had a high risk of bias, the other had a low risk. As a consequence, no firm conclusions can be drawn regarding DASH smartphone apps’ effectiveness in increasing DASH diet adherence and lowering blood pressure. All the apps appeared to be accepted and easy to use. CONCLUSIONS There is weak emerging evidence of a positive effect of using DASH smartphone apps supporting self-management to improve DASH diet adherence and, consequently, lower BP. Further research is needed to provide high-quality evidence that can determine the effectiveness of DASH smartphone apps. CLINICALTRIAL Review article

What Types of Exercise Are More Effective in Reducing Obesity and Blood Pressure for Middle-Aged Women? A Systematic Review With Meta-Analysis

2021 ◽  
pp. 109980042110154
Author(s):  
Seong-Hi Park ◽  
Chul-Gyu Kim
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Body Weight ◽  
Waist Circumference ◽  
Meta Analysis ◽  
Physical Activities ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Middle Aged

Background: A systematic review was performed to identify the types of physical activities effective as interventions in preventing metabolic syndrome in middle-aged women. Methods: Electronic databases (MEDLINE, EMBASE, the Cochrane Library, and CINAHL) served as the data sources. Cochrane’s Risk of Bias 2 was applied to assess the risk of bias of the randomized controlled trials. Meta-analyses were performed on selected studies using Review Manager 5.3. Thirty-one trials enrolling 2,202 participants were included. Results: Compared to controls, the effects of physical activity were indicated by pooled mean differences, which were −0.57 kg for body weight, −0.43 kg/m2 for body mass index, −1.63 cm for waist circumference, −4.89 mmHg for systolic blood pressure (BP), and −2.71 mmHg for diastolic BP. The effects were greater on the measurements of waist circumference and BP than on body weight and BMI. The types of physical activities were further analyzed according to sub-groups. Only aerobic exercise did not affect body weight and resistance exercise did not significantly change any results. Contrarily, combined exercises significantly reduced measurements of waist circumference and BP. Conclusion: This review can provide valuable information for research and implementation of measures to prevent metabolic syndrome in middle-aged women.

Patient education for preventing recurrence of venous leg ulcers: a systematic review

2020 ◽  
Vol 29 (2) ◽  
pp. 79-91 ◽  
Author(s):  
Emer Shanley ◽  
Zena Moore ◽  
Declan Patton ◽  
Tom O’Connor ◽  
Linda Nugent ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Education ◽  
Small Sample ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Leg Ulcers ◽  
Venous Leg Ulcers ◽  
The Impact

Objective: To investigate the impact of patient education interventions on preventing the recurrence of venous leg ulcers (VLU). Method: A systematic review was undertaken using the following databases: Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library); Ovid; Ovid (In-process and Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL. Trial registries and reference lists of relevant publications for published and ongoing trials were also searched. There were no language or publication date restrictions. Randomised controlled trials (RCTs) and cluster RCTs of patient educational interventions for preventing VLU recurrence were included. Review authors working independently assessed trials for their appropriateness for inclusion and for their risk of bias, using pre-determined inclusion and quality criteria. Results: A total of four studies met the inclusion criteria (274 participants). Each trial explored different interventions as follows: the Lively legs programme; education delivered via a video compared with education delivered via a pamphlet; the Leg Ulcer Prevention Programme and the Lindsay Leg Club. Only one study reported the primary outcome of incidence of VLU recurrence. All studies reported at least one of the secondary outcomes: patient behaviours, patient knowledge and patient quality of life (QoL). It is uncertain whether patient education programmes make any difference to VLU recurrence at 18 months (risk ratio [RR]: 0.82; 95% confidence interval: [CI] 0.59 to 1.14) or to patient behaviours (walked at least 10 minutes/five days a week RR: 1.48; 95%CI: 0.99 to 2.21; walked at least 30 minutes/five days a week: RR 1.14; 95%CI: 0.66 to 1.98; performed leg exercises: RR: 1.47; 95%CI: 1.04 to 2.09); to knowledge scores (MD (mean difference) 5.12, 95% CI –1.54 to 11.78); or to QoL (MD: 0.85, 95% CI –0.13 to 1.83), as the certainty of evidence has been assessed as very low. It is also uncertain whether different types of education delivery make any difference to knowledge scores (MD: 12.40; 95%CI: –5.68 to 30.48). Overall, GRADE assessments of the evidence resulted predominantly in judgments of very low certainty. The studies were at high risk of bias and outcome measures were imprecise due to wide CIs and small sample sizes. Conclusion: It is uncertain whether education makes any difference to the prevention of VLU recurrence. Therefore, further well-designed trials, addressing important clinical, QoL and economic outcomes are justified, based on the incidence of the problem and the high costs associated with VLU management.

scholarly journals Effectiveness of Self-Monitoring Approach Using Fitness Trackers to Improve Walking Ability in Rehabilitation Settings: A Systematic Review

2021 ◽  
Vol 2 ◽  
Author(s):  
Eri Otaka ◽  
Kazuyo Oguchi ◽  
Izumi Kondo ◽  
Yohei Otaka
Keyword(s):  
Systematic Review ◽  
Risk Of Bias ◽  
The Self ◽  
Walking Distance ◽  
Cochrane Library ◽  
Walking Ability ◽  
Self Monitoring ◽  
Quantitative Synthesis ◽  
Rehabilitative Intervention ◽  
Fitness Trackers

Background: A self-monitoring approach utilizing fitness trackers that provide feedback regarding physical activities has been recently applied to rehabilitation patients to promote voluntary walking activities. Although this approach has been proven to increase physical activity, it is uncertain whether the intervention improves walking ability.Aim: This review investigated whether the additional self-monitoring approach using activity trackers would improve walking ability in any type of rehabilitation setting.Methods: A systematic search was performed in four databases [PubMed (MEDLINE), The Cochrane Library, SPORTDiscus, and Cumulative Index to Nursing and Allied Health Literature] to identify studies that examined the self-monitoring approach combined with rehabilitative intervention vs. the same rehabilitative intervention only in participants with any unhealthy conditions. Two review authors independently assessed the eligibility of all the retrieved English literature published from 2009 to 2019, then discussed the final inclusion. The risk of bias was assessed referring to the criteria of the Cochrane Risk of Bias tool. The key findings were synthesized using narrative synthesis. In addition, a quantitative synthesis was conducted when more than two studies investigating the same disease were identified.Results: Eleven randomized controlled trials satisfied the eligibility criteria, nine of which had a lower risk of bias. The types of diseases included stroke, chronic obstructive pulmonary disease (COPD), cancer, Parkinson's disease, hemophilia, peripheral artery disease, post-total knee arthroplasty, and geriatric rehabilitation. Eight studies reported measures of walking endurance and four reported measures of gait speed. In the quantitative synthesis of two studies investigating COPD, there was a significant between-group difference in terms of changes in the 6-min walking distance from the baseline, which was favorable to the additional self-monitoring intervention group (mean difference: 13.1 m; 95% confidence interval, 1.8–24.5; 2 studies, 124 participants; p = 0.02; I2 = 0%). Other available data revealed no consistent evidence regarding effectiveness of the intervention.Conclusions: The findings indicate that there is little evidence suggesting the effectiveness of the self-monitoring approach in improving walking ability in rehabilitation settings. However, a weak recommendation for patients with stable COPD was implicated in the quantitative synthesis. Further research would be required to explore the best indications for this self-monitoring approach.Systematic Review Registration: CRD 42020157695.

scholarly journals Mobile Apps to Support the Self-Management of Hypertension: Systematic Review of Effectiveness, Usability, and User Satisfaction

10.2196/10723 ◽  
2018 ◽  
Vol 6 (7) ◽  
pp. e10723 ◽  
Author(s):  
Tourkiah Alessa ◽  
Sarah Abdi ◽  
Mark S Hawley ◽  
Luc de Witte
Keyword(s):  
Systematic Review ◽  
User Satisfaction ◽  
Mobile Apps ◽  
The Self ◽  
Self Management

Reconstruction versus no reconstruction of iliac crest defects following harvest for spinal fusion: a systematic review

2012 ◽  
Vol 16 (6) ◽  
pp. 565-572 ◽  
Author(s):  
Anthony M. T. Chau ◽  
Lileane L. Xu ◽  
Rhys van der Rijt ◽  
Johnny H. Y. Wong ◽  
Cristian Gragnaniello ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postoperative Pain ◽  
Spinal Fusion ◽  
Functional Disability ◽  
Iliac Crest ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Reconstructive Procedures

Object Autologous bone from the iliac crest is commonly used for spinal fusion. However, its use is associated with significant donor site morbidity, especially pain. Reconstructive procedures of the iatrogenic defect have been investigated as a technique to alleviate these symptoms. The goal of this study was to assess the effects of reconstruction versus no reconstruction following iliac crest harvest in adults undergoing spine surgery. Methods The authors searched the Cochrane Central Register of Controlled Trials (The Cochrane Library 2011, Issue 4); MEDLINE (1948–Oct 2011); EMBASE (1947–Oct 2011); and the reference lists of articles. Randomized controlled trials (RCTs) or nonrandomized controlled trials (NRCTs) were included in the study. Two independent reviewers selected the studies, extracted data using a standardized collection form, and assessed for risk of bias. Results Three RCTs (96 patients) and 2 NRCTs (82 patients) were included. These had a moderate to high risk of bias. The results suggest that iliac crest reconstruction may be useful in reducing postoperative pain, minimizing functional disability, and improving cosmesis. No pattern of other clinical, radiological, or resource outcomes was identified. Conclusions Although the available evidence is suboptimal, this systematic review supports the notion that iliac crest reconstruction following harvest for spinal fusion may reduce postoperative pain, minimize functional disability, and improve cosmesis.

scholarly journals Using Machine Learning Technologies in Pressure Injury Management: Systematic Review (Preprint)

2020 ◽  
Author(s):  
Mengyao Jiang ◽  
Yuxia Ma ◽  
Siyi Guo ◽  
Liuqi Jin ◽  
Lin Lv ◽  
...  
Keyword(s):  
Machine Learning ◽  
Systematic Review ◽  
Large Scale ◽  
Assessment Tool ◽  
Risk Of Bias ◽  
Biomedical Literature ◽  
Cochrane Library ◽  
Future Research ◽  
Great Promise ◽  
Pressure Injury

BACKGROUND Pressure injury (PI) is a common and preventable problem, yet it is a challenge for at least two reasons. First, the nurse shortage is a worldwide phenomenon. Second, the majority of nurses have insufficient PI-related knowledge. Machine learning (ML) technologies can contribute to lessening the burden on medical staff by improving the prognosis and diagnostic accuracy of PI. To the best of our knowledge, there is no existing systematic review that evaluates how the current ML technologies are being used in PI management. OBJECTIVE The objective of this review was to synthesize and evaluate the literature regarding the use of ML technologies in PI management, and identify their strengths and weaknesses, as well as to identify improvement opportunities for future research and practice. METHODS We conducted an extensive search on PubMed, EMBASE, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, China National Knowledge Infrastructure (CNKI), the Wanfang database, the VIP database, and the China Biomedical Literature Database (CBM) to identify relevant articles. Searches were performed in June 2020. Two independent investigators conducted study selection, data extraction, and quality appraisal. Risk of bias was assessed using the Prediction model Risk Of Bias ASsessment Tool (PROBAST). RESULTS A total of 32 articles met the inclusion criteria. Twelve of those articles (38%) reported using ML technologies to develop predictive models to identify risk factors, 11 (34%) reported using them in posture detection and recognition, and 9 (28%) reported using them in image analysis for tissue classification and measurement of PI wounds. These articles presented various algorithms and measured outcomes. The overall risk of bias was judged as high. CONCLUSIONS There is an array of emerging ML technologies being used in PI management, and their results in the laboratory show great promise. Future research should apply these technologies on a large scale with clinical data to further verify and improve their effectiveness, as well as to improve the methodological quality.

scholarly journals Effectiveness of XP-Endo Finisher and Passive Ultrasonic Irrigation on Intracanal Medicament Removal From Root Canals: a Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Jiani Zhou ◽  
Tingjun Liu ◽  
Lihong Guo
Keyword(s):  
Systematic Review ◽  
Large Scale ◽  
Ethylenediaminetetraacetic Acid ◽  
Data Extraction ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Passive Ultrasonic Irrigation ◽  
Significant Difference ◽  
Ultrasonic Irrigation

Abstract Background: XP-Endo finisher (XPF) and passive ultrasonic irrigation (PUI) are commonly used in intracanal medicament removal. The effectiveness of these two techniques needs to be compared, and evidence-based research should be conducted. Methods: A comprehensive literature search was conducted in PubMed, Web of Science, Embase, Cochrane Library, and Google Scholar up to December 20th, 2020. The outcomes of the included trials were pooled into the Cochrane Collaboration’s Review Manager 5.3 software. Cochrane’s risk-of-bias tool 2.0 was applied to assess the risk of bias.Results: Nine articles were included in this systematic review and processed for data extraction, and eight studies were identified for meta-analysis. In general, the use of PUI showed better medicament removal effectiveness than XPF (odds ratio [OR]: 3.09; 95% confidence interval [CI], 1.96-4.86; P < 0.001). In subgroup analysis, when anatomical areas were focused on the apical third region of the canal, PUI was also significantly more effective than XPF (OR: 3.42; 95% CI, 1.32-8.84; P = 0.01). For trials using sodium hypochlorite (NaOCl) alone, PUI was also significantly more effective than XPF on intracanal medicaments removal (OR: 5.23; 95% CI, 2.79-9.82; P < 0.001). However, there was no significant difference between PUI and XPF when NaOCl and ethylenediaminetetraacetic acid (EDTA) were used in combination (OR: 1.51; 95% CI, 0.74-3.09; P = 0.26). In addition, for studies whose intracanal medicament periods were two weeks, the effectiveness of PUI was statistically better than the XPF (OR: 7.73; 95% CI, 3.71-16.07; P < 0.001). Nevertheless, for trials whose intracanal medicament time was one week or over two weeks, no differences between the XPF and PUI were found (OR: 1.54; 95% CI, 0.74-3.22; P = 0.25) (OR: 1.42; 95% CI, 0.44-4.61; P = 0.56). Conclusions: PUI might be superior over XPF techniques for removing intracanal medicaments from artificial standardized grooves and cavities in the root canal system. The anatomical areas, irrigation protocol, and intracanal medicaments time may influence the cleaning efficacy. More large-scale and high-quality trials are warranted to validate the conclusions.

scholarly journals The effectiveness of manual therapy applied to craniomandibular structures in the treatment of temporomandibular disorders: protocol for a systematic review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Giacomo Asquini ◽  
Alison Rushton ◽  
Laurent Pitance ◽  
Nicola Heneghan ◽  
Deborah Falla
Keyword(s):  
Systematic Review ◽  
Range Of Motion ◽  
Manual Therapy ◽  
Temporomandibular Disorder ◽  
Meta Analysis ◽  
Grey Literature ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Cochrane Central Register

Abstract Background The term temporomandibular disorder (TMD) includes disorders of the temporomandibular joints (TMJ), masticatory muscles and adjacent tissues. Several studies have examined the effectiveness of manual therapy (MT) for TMDs by evaluating changes in pain and maximum mouth opening (MMO). Nevertheless, the effectiveness of MT exclusively applied to the craniomandibular structures (craniomandibular manual therapy (CMMT)) on pain and TMJ range of motion remains unclear. This review aims to evaluate the effectiveness of CMMT on pain and TMJ range of motion in people with TMDs. Methods This protocol is reported in line with the preferred reporting items for systematic reviews and meta-analysis protocols (PRISMA-P). Databases including MEDLINE, Embase, CINAHL, ZETOC, Web of Science, SCOPUS, PEDro, PubMed, Cochrane Library and Best Evidence, EBM reviews–Cochrane Central Register of Controlled Trials, Index to Chiropractic Literature ChiroAccess and Google Scholar will be searched from inception as well as key journals and grey literature. Randomised controlled trials involving adults with TMD that compare the effect of any type of CMMT (e.g. mobilisation) on pain and range of motion with a placebo intervention, controlled care intervention or other types of treatment will be included. Two reviewers will independently screen articles for inclusion, extract data, assess risk of bias (revised Cochrane risk of bias tool) for included studies and evaluate overall quality of evidence (Grading of Recommendations Assessment, Development and Evaluation). A meta-analysis will be conducted if possible. If not, a narrative synthesis will be conducted reporting the effectiveness of CMMT according to disorder type (TMJ disorders, masticatory muscle disorders and mixed disorders). Discussion In this review, the effectiveness of MT applied to craniomandibular structures for the treatment of TMD will be evaluated. Results will be submitted for publication in a peer-reviewed journal and presented at conferences. We expect our findings will facilitate treatment planning for manual therapists managing patients with TMD and provide future clinical research implications. Systematic review registration PROSPERO CRD42019160213

scholarly journals Non-pharmacological interventions for treating sexual dysfunction in postpartum women: a systematic review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e028660
Author(s):  
Michelly Nóbrega Monteiro ◽  
Kleyton Santos Medeiros ◽  
Iaponira Vidal ◽  
Ivete Matias ◽  
Ricardo Ney Cobucci ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sexual Dysfunction ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Sexual Problems ◽  
Cochrane Library ◽  
Published Data ◽  
Postpartum Women ◽  
Cochrane Central Register ◽  
Pharmacological Interventions

IntroductionSexual dysfunction in the postpartum period is a very common and relevant clinical problem, which has a significant adverse impact on the health of women. We aim to analyse the efficacy and safety of non-pharmacological interventions for treating sexual dysfunction in postpartum women. Our review aims to provide accurate data for effective policy-making and improve our understanding of the treatment of postpartum sexual dysfunction with non-pharmacological therapies.Methods and analysisThe Cochrane Central Register of Controlled Trials in The Cochrane Library, clinicaltrials.gov, Medline/PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), LILACS (Literatura Latino-americana e do Caribe em Ciências da Saúde) and Embase will be used to search for articles dated from database inception to July 2019. Randomised controlled clinical trials and large prospective cohorts with control groups using non-pharmacological treatments for sexual dysfunction in postpartum women will be included. Sexual problems are directly linked to sexual dysfunction; thus, the primary outcome will be the absolute number or percentage of sexual issues in each treatment group. The secondary outcomes will be assessed by decreased sexual problems, such as lack of lubrication, decreased libido and difficulty reaching orgasm. Three reviewers will independently select trials and extract data from the original publications. The citations will be screened independently by reviewers in duplicate. The risk of bias of the included studies will be assessed according to the Cochrane risk of bias tool. Data synthesis will be performed using Review Manager (RevMan) software V.5.2.3. In the event that a meta-analysis is possible, we will assess the heterogeneity across the studies by computing the I2statistic.Ethics and disseminationAs the design of this study includes a review of published data, the need to obtain ethical approval was waived by our institutional review committee. We intend to publish the findings of this systematic review in a peer-reviewed journal.PROSPERO registration numberCRD42018103077.

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