Effectiveness of Mobile Health Interventions on Management of Patients with Hypertension: Systematic Review of Systematic Reviews (Preprint)

2021 ◽  
Author(s):  
Sisi Wu ◽  
Chunhua Long ◽  
Shasha Li ◽  
Xuemei Tu
Keyword(s):  
Systematic Reviews ◽  
Mobile Health ◽  
Chronic Disease Management ◽  
Meta Analysis ◽  
Self Management ◽  
Cochrane Library ◽  
Measurement Tool ◽  
Hypertension Management ◽  
Management Behaviors

BACKGROUND Mobile health (mHealth) has provided a powerful platform for chronic disease management recent years. Although some previous systematic reviews evaluated the effectiveness of mHealth on hypertension management, there were inconsistent findings. OBJECTIVE To systematically evaluate the effectiveness of mHealth interventions on the management of patients with hypertension and to provide recommendations for the clinic and future researches. METHODS Databases including Embase, Cochrane Library, CINAHL, CNKI, SinoMed, WanFang and VIP Database were searched to collect systematic reviews and meta-analysis on mHealth interventions for hypertension management. Two researchers independently screened the articles and extracted data, and the Measurement Tool to Assess Systematic Reviews (AMSTAR 2) was used to evaluate the methodological quality of the included reviews. RESULTS A total of 11 systematic reviews were included. Three reviews were rated as high quality, four moderate quality, three low quality, one critically low quality. Mobile phone was the most common intervention type, followed by the internet. Seven reviews performed meta-analysis and showed that mHealth was associated with significant reduction in SBP from 2.28mmHg(95%CI 0.66-3.90; I2=100%) to 14.77 mmHg(95%CI 11.76-17.77; I2=90%) and DBP from 1.50mmHg(95%CI 0.80-2.20; I2=62%) to 8.17 mmHg(95%CI 5.67-10.67; I2=86%). Self-management behaviors included medication adherence, diet, smoking, alcohol drinking, exercise and BP monitoring, there were inconsistent results on the effectiveness of mHealth interventions. CONCLUSIONS The mHealth interventions can improve BP control in patients with hypertension, but its impact on self-management behaviors is not confirmed.

scholarly journals Effectiveness and Safety of Acupuncture for Migraine: An Overview of Systematic Reviews

2020 ◽  
Vol 2020 ◽  
pp. 1-14 ◽  
Author(s):  
Yu-Xi Li ◽  
Xi-li Xiao ◽  
Dong-Ling Zhong ◽  
Liao-Jun Luo ◽  
Han Yang ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Western Medicine ◽  
Data Extraction ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Measurement Tool ◽  
High Quality ◽  
Quality Of Evidence

Background. Migraine is a common neurological disease, which burdens individuals and society all over the world. Acupuncture, an important method in Traditional Chinese Medicine, is widely used in clinical practice as a treatment for migraine. Several systematic reviews (SRs) have investigated the effectiveness and safety of acupuncture for migraine. Objective. To summarize and critically assess the quality of relevant SRs and present an objective and comprehensive evidence on the effectiveness and safety of acupuncture for migraine. Data Sources. MEDLINE, Embase, Cochrane Library, PROSPERO database, Chinese National Knowledge Infrastructure (CNKI), Chinese Biological Medicine (CBM), China Science and Technology Journal (SCTJ), and WanFang database (WF) were searched from inception to December 2019 and grey literatures were manually searched. Selection Criteria. SRs which meet the criteria were independently selected by 2 reviewers according to a predetermined protocol. Data Extraction. Characteristics of included SRs were independently extracted by 2 reviewers following a predefined data extraction form. Review Appraisal. The methodological quality, risk of bias, and reporting quality of included SRs were assessed, respectively, by a Measurement Tool to Assess Systematic Reviews (AMSTAR) 2, the Risk of Bias in Systematic reviews (ROBIS) tool, and the Preferred Reporting Item for Systematic Review and Meta-analysis-Acupuncture (PRISMA-A) statement. The quality of outcomes was evaluated by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results. A total of 15 SRs were included. All the SRs were published between 2011–2019. Based on AMSTAR 2, 14 out of 15 SRs were rated critically low quality and 1 was rated low quality. According to ROBIS tool, 9 SRs (60%) were low risk of bias. With the PRISMA-A checklist, we found 11 out of 15 SRs were found adequately reported over 70%. With the GRADE tool, we found high quality of evidence indicated that the effective rate of acupuncture was superior to western medicine in treatment of migraine. Besides, acupuncture reduced more headache days and the times of using painkiller and was more effective in reducing the frequency and degree of headache than western medicine and sham acupuncture. Limitations. There might be some missing information. The accuracy of the conclusions may be decreased reduced since we were unable to synthesis all the evidence. Conclusions. Based on high quality of evidence, we concluded that acupuncture may be an effective and safe therapy for migraine. However, the quality of SRs in acupuncture for migraine still needs more improvement.

scholarly journals Systematic Reviews and Meta-analysis Published in Indexed Portuguese Medical Journals: Time Trends and Critical Appraisal.

2021 ◽  
Author(s):  
Luísa Prada ◽  
Ana Prada ◽  
Miguel Antunes ◽  
Ricardo Fernandes ◽  
João Costa ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Critical Appraisal ◽  
Data Extraction ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Measurement Tool ◽  
Medical Journals ◽  
Electronic Search ◽  
Potential Impact

Abstract Introduction:Over the last years, the number of systematic reviews published is steadily increasing due to the global interest in this type of evidence synthesis. However, little is known about the characteristics of this research published in Portuguese medical journals. This study aims to evaluate the publication trends and overall quality of these systematic reviews.Material and Methods:Systematic reviews were identified through an electronic search up to August 2020, targeting Portuguese Medical journals indexed in MEDLINE. Systematic reviews selection and data extraction were done independently by three authors. The overall quality critical appraisal using the A MeaSurement Tool to Assess systematic Reviews (AMSTAR II) was independently assessed by three authors. Disagreements were solved by consensus.Results:Seventy systematic reviews published in 5 Portuguese medical journals were included. Most (n=57; 81,4%) were systematic reviews without meta-analysis. Until 2010, the number of systematic reviews per year increased. Since then, the number of reviews published has not remained stable and no less than 3 SRs were published per year. According to the systematic reviews’ typology, most have been predominantly conducted to assess the effectiveness of health interventions (n=28; 40,0%). General and Internal Medicine (n=26; 37,1%) was the most addressed field. Most systematic reviews (n=45; 64,3%) were rated as being of “critically low-quality”.Conclusions:There were consistent flaws in the methodological quality report of the systematic reviews included, particularly in establishing a prior protocol and not assessing the potential impact of the risk of bias on the results.Through the years, the number of systematic reviews published increased, yet their quality is suboptimal. There is a need to improve the reporting of systematic reviews in Portuguese medical journals, which can be achieved by better adherence to quality checklists/tools.Systematic review registration: INPLASY202090105

Outcomes of digital biomarker-based interventions: protocol for a systematic review of systematic reviews (Preprint)

2021 ◽  
Author(s):  
Hossein Motahari-Nezhad ◽  
Márta Péntek ◽  
László Gulácsi ◽  
Zsombor Zrubka
Keyword(s):  
Clinical Outcomes ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Level Of Evidence ◽  
Clinical Benefits ◽  
The Cochrane Library ◽  
The Impact ◽  
Digital Biomarkers

BACKGROUND Digital biomarkers are defined as objective, quantifiable physiological and behavioral data that are collected and measured by means of digital devices such as portables, wearables, implantables or digestibles. For their widespread adoption in publicly financed healthcare systems, it is important to understand how their benefits translate into improved patient outcomes, which is essential for demonstrating their value. OBJECTIVE To assess the quality and strength of evidence of the impact of digital biomarkers on clinical outcomes compared to interventions without digital biomarkers, reported in systematic reviews. METHODS A comprehensive search for 2019-2020 will be conducted in the PubMed and the Cochrane Library using keywords related to digital biomarkers and a filter for systematic reviews. Original full-text English publications of systematic reviews comparing clinical outcomes of interventions with and without digital biomarkers via meta-analysis will be included. The AMSTAR-2 tool will be used to assess the methodological quality of reviews. To assess the quality of evidence, we will evaluate systematic reviews using the GRADE tool. To detect the possible presence of reporting bias, we will record whether the protocol of the systematic reviews was published before the start of the study. A qualitative summary of results by digital biomarker technology and outcome will be provided. RESULTS This protocol was submitted before data collection. The next steps in this review will be initiated after the protocol is accepted for publication. CONCLUSIONS Our study will provide a comprehensive summary of the highest level of evidence available on digital biomarker interventions. Our results will help identify clinical areas where the use of digital biomarkers leads to favorable clinical outcomes. In addition, our findings will highlight areas of evidence gaps where the clinical benefits of digital biomarkers have not yet been demonstrated.

scholarly journals Reporting quality of systematic review abstracts in articles hand and wrist pathology: a review

2019 ◽  
Vol 2 (2) ◽  
pp. 50-57
Author(s):  
Amanda Yang Shen ◽  
Robert S Ware ◽  
Tom J O'Donohoe ◽  
Jason Wasiak
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
English Language ◽  
Meta Analysis ◽  
Reporting Quality ◽  
Cochrane Library ◽  
Annual Basis ◽  
Cochrane Reviews ◽  
Abstract Reporting

Background: An increasing number of systematic reviews are published on an annual basis. Although perusal of the full text of articles is preferable, abstracts are sometimes relied upon to guide clinical decisions. Despite this, the abstracts of systematic reviews have historically been poorly reported. We evaluated the reporting quality of systematic review abstracts within hand and wrist pathology literature. Methods: We searched MEDLINE®, EMBASE and Cochrane Library from inception to December 2017 for systematic reviews in hand and wrist pathology using the 12-item PRISMA-A checklist to assess abstract reporting quality. Results: A total of 114 abstracts were included. Most related to fracture (38%) or arthritis (17%) management. Forty-seven systematic reviews (41%) included meta-analysis. Mean PRISMA-A score was 3.6/12 with Cochrane reviews having the highest mean score and hand-specific journals having the lowest. Abstracts longer than 300 words (mean difference [MD]: 1.43, 95% CI [0.74, 2.13]; p <0.001) and systematic reviews with meta-analysis (MD: 0.64, 95% CI [0.05, 1.22]; p = 0.034) were associated with higher scores. Unstructured abstracts were associated with lower scores (MD: –0.65, 95% CI [–1.28, –0.02]; p = 0.044). A limitation of this study is the possible exclusion of relevant studies that were not published in the English language. Conclusion: Abstracts of systematic reviews pertaining to hand and wrist pathology have been suboptimally reported as assessed by the PRISMA-A checklist. Improvements in reporting quality could be achieved by endorsement of PRISMA-A guidelines by authors and journals, and reducing constraints on abstract length.

Reasons and factors associated with inconclusiveness of systematic reviews about interventions for neuropathic pain

2020 ◽  
Author(s):  
Svjetlana Dosenovic ◽  
Andria Dujmic ◽  
Danijela Nujic ◽  
Ivana Vuka ◽  
Goran Tintor ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Systematic Reviews ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Measurement Tool ◽  
Efficacy And Safety ◽  
Factors Associated ◽  
Explicit Statement ◽  
Cochrane Database

Aim: Systematic reviews (SRs) are frequently inconclusive. The aim of this study was to analyze factors associated with conclusiveness of SRs about efficacy and safety of interventions for neuropathic pain (NeuP). Materials & methods: The study protocol was registered in the PROSPERO database (No. CRD42015025831). Five electronic databases (Medical Literature Analysis and Retrieval System Online, Cochrane Database of Systematic Reviews, Cumulative Index for Nursing and Allied Health Literature, Database of Abstracts of Reviews of Effects and Psychological Information Database) were searched until July 2018 for SRs about NeuP management. Conclusion statements for efficacy and safety, and characteristics of SRs were analyzed. Conclusiveness was defined as explicit statement by the SR authors that one intervention is better/similar to the other in terms of efficacy and safety. Methodological quality of SRs was assessed with the AMSTAR (A MeaSurement Tool to Assess systematic Reviews) tool. Results: Of 160 SRs, 37 (23%) were conclusive for efficacy and/or safety. In the SRs, conclusions about safety were missing in half of the analyzed abstracts, and a third of the full texts. Conclusive SRs included significantly more trials and participants, searched more databases, had more authors, conducted meta-analysis, analyzed quality of evidence, and had lower methodological quality than inconclusive SRs. The most common reasons for the lack of conclusiveness indicated by the SR authors were the small number of participants and trials, and the high heterogeneity of included studies. Conclusion: Most SRs about NeuP treatment were inconclusive. Sources of inconclusiveness of NeuP reviews need to be further studied, and SR authors need to provide conclusions about both safety and efficacy of interventions.

P14.71 An assessment of the reporting and methodological quality of meningioma systematic reviews and meta-analyses

2021 ◽  
Vol 23 (Supplement_2) ◽  
pp. ii51-ii52
Author(s):  
A M George ◽  
S Gupta ◽  
S M Keshwara ◽  
M A Mustafa ◽  
C S Gillespie ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Neurofibromatosis Type ◽  
Risk Of Bias ◽  
Measurement Tool ◽  
High Quality ◽  
Meta Analyses

Abstract BACKGROUND Systematic reviews and meta-analyses constitute the highest level of research evidence and for a disease with limited clinical trial activity, are often relied upon to help inform clinical practice. This review of reviews evaluates both the reporting & methodological quality of meningioma evidence syntheses. MATERIAL AND METHODS Potentially eligible meningioma reviews published between 1st January 1990 and 31st December 2020 were identified from eight electronic databases. Inclusion required the study to meet the Cochrane guideline definition of a systematic review or meta-analysis. Reviews concerning neurofibromatosis type 2, spinal and pediatric meningiomas were excluded. The reporting and methodological quality of articles were assessed against the following modified guidelines: Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), A MeaSurement Tool to Assess Systematic Reviews (AMSTAR2) and the Risk of Bias in Systematic Reviews (ROBIS) guidelines. RESULTS 117 systematic reviews were identified, 57 of which included meta-analysis (48.7%). The number of meningioma systematic reviews published each year has increased with 63 studies (53.9%) published between 01/2018 and 12/2020. A median of 17 studies (IQR 9–29) were included per review. Impact factor of journals publishing a systematic review with or without a meta-analysis was similar (median 2.3 vs 1.8, P=0.397). The mean PRISMA scores for systematic reviews with a meta-analysis was 21.11 (SD 4.1, 78% adherence) and without was 13.89 (SD 3.4, 63% adherence). Twenty-nine systematic reviews with meta-analysis (51%) and 11 without meta-analysis (18%) achieved greater than 80% adherence to PRISMA recommendations. Methodological quality assessment using AMSTAR2 revealed one study (0.9%) as high quality whilst 111 (94.8%) studies were graded as critically low. One hundred and two articles (87.2%) did not utilize a comprehensive search strategy as defined by the AMSTAR2 tool. Ninety-nine studies (84.6%) obtained a high level of concern for potential bias as per the ROBIS assessment. One hundred and eight articles (92.3%) failed to present information that a protocol had been established prior to study commencement and 76 articles (65.0%) did not conduct a risk of bias assessment. Across the three tools, domains relating to the establishment of a protocol prior to review commencement and conducting appropriate risk of bias assessments were frequently low scoring. CONCLUSION Overall reporting and methodological quality of meningioma systematic reviews was sub-optimal. Established critical appraisal tools and reporting guidelines should be utilized a priori to assist in producing high-quality systematic reviews.

scholarly journals Scoping review of COVID-19-related systematic reviews and meta-analyses: can we really have confidence in their results?

2021 ◽  
pp. postgradmedj-2020-139392
Author(s):  
Rachel Wurth ◽  
Michelle Hajdenberg ◽  
Francisco J Barrera ◽  
Skand Shekhar ◽  
Caroline E Copacino ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Scoping Review ◽  
Meta Analysis ◽  
Internal Validity ◽  
Reporting Quality ◽  
Measurement Tool ◽  
Literature Search Strategy ◽  
Definition Of ◽  
Meta Analyses

AimThe aim of this study was to systematically appraise the quality of a sample of COVID-19-related systematic reviews (SRs) and discuss internal validity threats affecting the COVID-19 body of evidence.DesignWe conducted a scoping review of the literature. SRs with or without meta-analysis (MA) that evaluated clinical data, outcomes or treatments for patients with COVID-19 were included.Main outcome measuresWe extracted quality characteristics guided by A Measurement Tool to Assess Systematic Reviews-2 to calculate a qualitative score. Complementary evaluation of the most prominent published limitations affecting the COVID-19 body of evidence was performed.ResultsA total of 63 SRs were included. The majority were judged as a critically low methodological quality. Most of the studies were not guided by a pre-established protocol (39, 62%). More than half (39, 62%) failed to address risk of bias when interpreting their results. A comprehensive literature search strategy was reported in most SRs (54, 86%). Appropriate use of statistical methods was evident in nearly all SRs with MAs (39, 95%). Only 16 (33%) studies recognised heterogeneity in the definition of severe COVID-19 as a limitation of the study, and 15 (24%) recognised repeated patient populations as a limitation.ConclusionThe methodological and reporting quality of current COVID-19 SR is far from optimal. In addition, most of the current SRs fail to address relevant threats to their internal validity, including repeated patients and heterogeneity in the definition of severe COVID-19. Adherence to proper study design and peer-review practices must remain to mitigate current limitations.

scholarly journals The Effect of a Combined Gluten- and Casein-Free Diet on Children and Adolescents with Autism Spectrum Disorders: A Systematic Review and Meta-Analysis

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 470
Author(s):  
Amélie Keller ◽  
Marie Louise Rimestad ◽  
Jeanett Friis Rohde ◽  
Birgitte Holm Petersen ◽  
Christoffer Bruun Korfitsen ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Random Effect ◽  
Random Effect Model ◽  
Autism Spectrum ◽  
Risk Of Bias ◽  
Mean Difference ◽  
Cochrane Library ◽  
Measurement Tool ◽  
Quality Of Evidence

There has been a growing interest in the gastrointestinal system and its significance for autism spectrum disorder (ASD), including the significance of adopting a gluten-free and casein-free (GFCF) diet. The objective was to investigate beneficial and safety of a GFCF diet among children with a diagnosis of ASD. We performed a systematic literature search in Medline, Embase, Cinahl, and the Cochrane Library up to January 2020 for existing systematic reviews and individual randomized controlled trials (RCTs). Studies were included if they investigated a GFCF diet compared to a regular diet in children aged 3 to 17 years diagnosed with ASD, with or without comorbidities. The quality of the identified existing reviews was assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR). The risk of bias in RCTs was assessed using the Cochrane Risk of Bias Tool, and overall quality of evidence was evaluated using Grades of Recommendation, Assessment, Development, and Evaluation (GRADE). We identified six relevant RCTs, which included 143 participants. The results from a random effect model showed no effect of a GFCF diet on clinician-reported autism core symptoms (standardized mean difference (SMD) −0.31 (95% Cl. −0.89, 0.27)), parent-reported functional level (mean difference (MD) 0.61 (95% Cl −5.92, 7.14)) or behavioral difficulties (MD 0.80 (95% Cl −6.56, 10.16)). On the contrary, a GFCF diet might trigger gastrointestinal adverse effects (relative risk (RR) 2.33 (95% Cl 0.69, 7.90)). The quality of evidence ranged from low to very low due to serious risk of bias, serious risk of inconsistency, and serious risk of imprecision. Clinical implications of the present findings may be careful consideration of introducing a GFCF diet to children with ASD. However, the limitations of the current literature hinder the possibility of drawing any solid conclusion, and more high-quality RCTs are needed. The protocol is registered at the Danish Health Authority website.

scholarly journals Effect of High-intensity Interval Training on patients with Type 2 Diabetes Mellitus: An Overview of Systematic Reviews

2021 ◽  
Author(s):  
Tan Jun ◽  
Jin-Hui Tian ◽  
Fei Yu ◽  
Xing Wang ◽  
lan Zheng
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Reviews ◽  
High Intensity ◽  
Interval Training ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Measurement Tool ◽  
High Intensity Interval Training ◽  
High Intensity Interval

Abstract BackgroundType 2 Diabetes Mellitus (T2DM) is a serious disease. The intervention of High Intensity Interval Training (HIIT) on T2DM is widely concerned but controversial, which also exists in the current Systematic Reviews/Meta-Analysis (SRs/MAs). The objective of this study is to evaluate the methodology, evidence and reporting quality of SRs/MAs of the effects of HIIT on patients with T2DM. MethodsPubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Data, SinoMed and VIP were searched. A MeaSurement Tool to Assess Systemic Reviews 2 （AMSTAR2）, Risk of Bias in Systematic Review（ROBIS）,Grading of Recommendations Assessment, Development and Evaluation（GRADE）were used to evaluate the included studies.ResultsSix SRs/MAs studies were included, with 79 outcomes from 21 original studies. Methodological quality of AMSTAR2 evaluation was extremely low. ROBIS evaluation showed high risk of bias. There are 39 outcomes of 3 included SRs/MAs used GRADE, of which 29 items are low, 8 items are very low, and 2 items are intermediate quality. Low quality and very low quality evidence bodies account for 95% of the total.ConclusionsSRs/MAs on the effect of HIIT intervention on patients with T2DM included a small number of original studies and the overlapping feature is obvious, outcomes are diverse and overlapping, and there is a lack of key and ending outcomes; From original study, outcomes to system reviews, quality of evaluation is low. Evidence from a large samples, long periods, better protocols, and reflecting ending outcomes and critical outcomes are needed to promote the application of HIIT in T2DM.

scholarly journals Interventions for Treating Tennis Elbow: An Overview of Systematic Reviews in the Past Ten Years

2020 ◽  
Author(s):  
Xue Wang ◽  
Jun Xiong ◽  
Jun Yang ◽  
Ting Yuan
Keyword(s):  
Systematic Reviews ◽  
Comparative Studies ◽  
Methodological Quality ◽  
Tennis Elbow ◽  
Meta Analysis ◽  
Reporting Quality ◽  
Research Process ◽  
Cochrane Library ◽  
Different Types

Abstract purpose: Tennis elbow is a common orthopedic disease, and there are many ways to treat it. This overview aimed to summarize the evidence of different treatments for tennis elbows, so as to provide the best guidance for clinical treatment.Methods: Use computer to search CNKI, WanFang database, WeiPu database, CBM database, PubMed, Cochrane Library and Embase from the time of establishment to May 31, 2019.Te Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and latest Assessment of Multiple Systematic Reviews 2 (AMSTAR2) checklists were used to assess reporting characteristics and methodological quality, respectively.Results: A total of 37 references were included. Methodological quality and reporting quality were unsatisfactory. Methodological quality was generally low and many key items were not reported. Some research reports are of high quality, but there is no trial registration and protocol written in advance, which may lead to some bias in the research process. The most frequent problems included non-registration of study protocol, absence of a list of excluded studies, and unclear acknowledgment of conflicts of interests. The different types of interventions included have been shown to relieve pain, improve quality of life, and restore elbow function, but there has been a lack of comparative studies.Conclusion: The reporting and methodological quality of systematic reviews and meta-analysis studies were sub-optimal, which demands further improvement. Comparative studies of different types of interventions are needed to determine unclear.PROSPERO registration number: CRD42015017071

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