scholarly journals Physical Exercise for Patients Undergoing Hematopoietic Stem Cell Transplantation: Systematic Review and Meta-Analyses of Randomized Controlled Trials

2013 ◽  
Vol 93 (4) ◽  
pp. 514-528 ◽  
Author(s):  
Inge E.P.M. van Haren ◽  
Hans Timmerman ◽  
Carin M. Potting ◽  
Nicole M.A. Blijlevens ◽  
J. Bart Staal ◽  
...  
Keyword(s):  
Physical Exercise ◽  
Data Extraction ◽  
Well Being ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Psychological Well Being ◽  
Hematopoietic Stem ◽  
Exercise Interventions ◽  
Randomized Controlled ◽  
Meta Analyses

Background The treatment-related burden for patients undergoing hematopoietic stem cell transplantation (HSCT) may be relieved by physical exercises. Purpose The purpose of this study was to summarize and analyze the evidence provided by randomized controlled trials (RCTs) on physical exercise interventions among patients with cancer undergoing HSCT. Data Sources PubMed, CINAHL, EMBASE, the Cochrane Library, and PEDro were searched for relevant RCTs up to October 1, 2011. Study Selection Two reviewers screened articles on inclusion criteria and indentified relevant RCTs. Data Extraction Two authors assessed the selected articles for risk of bias. Data extraction was performed by 1 reviewer. Meta-analyses were undertaken to estimate the outcomes quality of life (QOL), psychological well-being and distress, and fatigue. Data Synthesis Eleven studies were included, with study populations consisting of recipients undergoing either an allogeneic or autologous HSCT (n=734). Four studies had low risk of bias. The exercise interventions were performed before, during, and after hospitalization for the HSCT. Different exercise programs on endurance, resistance and/or activities of daily living training, progressive relaxation, and stretching were used. Meta-analyses showed that exercise during hospitalization led to a higher QOL (weighted mean difference=8.72, 95% confidence interval=3.13, 14.31) and less fatigue (standardized mean difference=0.53, 95% confidence interval=0.16, 0.91) in patients with an allogeneic HSCT at the moment of discharge from the hospital. No marked effects were found for psychological well-being and distress. Individual study results suggested significant positive effects on QOL, fatigue, psychological well-being and distress, and physical functioning. Limitations Prevalent shortcomings in the included studies were the heterogeneity among studies and the lack of blinding of participants, personnel, and outcome assessment. Conclusions The results suggest that recipients of HSCT may benefit from physical exercise.

scholarly journals Effects of Supervised Multimodal Exercise Interventions on Cancer-Related Fatigue: Systematic Review and Meta-Analysis of Randomized Controlled Trials

2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
José Francisco Meneses-Echávez ◽  
Emilio González-Jiménez ◽  
Robinson Ramírez-Vélez
Keyword(s):  
Systematic Review ◽  
Resistance Training ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Exercise Interventions ◽  
Training Interventions ◽  
Randomized Controlled ◽  
Cancer Related Fatigue

Objective. Cancer-related fatigue (CRF) is the most common and devastating problem in cancer patients even after successful treatment. This study aimed to determine the effects of supervised multimodal exercise interventions on cancer-related fatigue through a systematic review and meta-analysis.Design. A systematic review was conducted to determine the effectiveness of multimodal exercise interventions on CRF. Databases of PubMed, CENTRAL, EMBASE, and OVID were searched between January and March 2014 to retrieve randomized controlled trials. Risk of bias was evaluated using the PEDro scale.Results. Nine studiesn=772were included in both systematic review and meta-analysis. Multimodal interventions including aerobic exercise, resistance training, and stretching improved CRF symptoms (SMD=-0.23; 95% CI: −0.37 to −0.09;P=0.001). These effects were also significant in patients undergoing chemotherapyP<0.0001. Nonsignificant differences were found for resistance training interventionsP=0.30. Slight evidence of publication bias was observedP=0.04. The studies had a low risk of bias (PEDro scale mean score of 6.4 (standard deviation (SD) ± 1.0)).Conclusion. Supervised multimodal exercise interventions including aerobic, resistance, and stretching exercises are effective in controlling CRF. These findings suggest that these exercise protocols should be included as a crucial part of the rehabilitation programs for cancer survivors and patients during anticancer treatments.

scholarly journals Smartphone-Based Self-Monitoring, Treatment, and Automatically Generated Data in Children, Adolescents, and Young Adults With Psychiatric Disorders: Systematic Review (Preprint)

2019 ◽  
Author(s):  
Sigurd Melbye ◽  
Lars Vedel Kessing ◽  
Jakob Eyvind Bardram ◽  
Maria Faurholt-Jepsen
Keyword(s):  
Systematic Review ◽  
Young Adults ◽  
Psychiatric Disorders ◽  
Literature Search ◽  
Risk Of Bias ◽  
Smartphone App ◽  
Controlled Trials ◽  
Self Monitoring ◽  
Randomized Controlled ◽  
Meta Analyses

BACKGROUND Psychiatric disorders often have an onset at an early age, and early identification and intervention help improve prognosis. A fine-grained, unobtrusive, and effective way to monitor symptoms and level of function could help distinguish severe psychiatric health problems from normal behavior and potentially lead to a more efficient use of clinical resources in the current health care system. The use of smartphones to monitor and treat children, adolescents, and young adults with psychiatric disorders has been widely investigated. However, no systematic review concerning smartphone-based monitoring and treatment in this population has been published. OBJECTIVE This systematic review aims at describing the following 4 features of the eligible studies: (1) monitoring features such as self-assessment and automatically generated data, (2) treatment delivered by the app, (3) adherence to self-monitoring, and (4) results of the individual studies. METHODS We conducted a systematic literature search of the PubMed, Embase, and PsycInfo databases. We searched for studies that (1) included a smartphone app to collect self-monitoring data, a smartphone app to collect automatically generated smartphone-based data, or a smartphone-based system for treatment; (2) had participants who were diagnosed with psychiatric disorders or received treatment for a psychiatric disorder, which was verified by an external clinician; (3) had participants who were younger than 25 years; and (4) were published in a peer-reviewed journal. This systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The risk of bias in each individual study was systematically assessed. RESULTS A total of 2546 unique studies were identified through literature search; 15 of these fulfilled the criteria for inclusion. These studies covered 8 different diagnostic groups: psychosis, eating disorders, depression, autism, self-harm, anxiety, substance abuse, and suicidal behavior. Smartphone-based self-monitoring was used in all but 1 study, and 11 of them reported on the participants’ adherence to self-monitoring. Most studies were feasibility/pilot studies, and all studies on feasibility reported positive attitudes toward the use of smartphones for self-monitoring. In 2 studies, automatically generated data were collected. Three studies were randomized controlled trials investigating the effectiveness of smartphone-based monitoring and treatment, with 2 of these showing a positive treatment effect. In 2 randomized controlled trials, the researchers were blinded for randomization, but the participants were not blinded in any of the studies. All studies were determined to be at high risk of bias in several areas. CONCLUSIONS Smartphones hold great potential as a modern, widely available technology platform to help diagnose, monitor, and treat psychiatric disorders in children and adolescents. However, a higher level of homogeneity and rigor among studies regarding their methodology and reporting of adherence would facilitate future reviews and meta-analyses.

scholarly journals The comparative effectiveness of physical exercise interventions in individuals with chronic non-specific neck pain: protocol for a network meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e034846 ◽  
Author(s):  
Rutger MJ de Zoete ◽  
James H McAuley ◽  
Nigel R Armfield ◽  
Michele Sterling
Keyword(s):  
Physical Exercise ◽  
Neck Pain ◽  
Meta Analysis ◽  
Network Effect ◽  
Effect Sizes ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Exercise Interventions ◽  
Meta Analyses

IntroductionNeck pain is a global burdensome problem, with a large proportion of neck pain cases becoming chronic. Although physical exercise is a commonly prescribed treatment, the evidence on the effectiveness of isolated exercise interventions remains limited. Traditional pairwise randomised controlled trials (RCTs) and meta-analyses are limited in only comparing two interventions. This protocol describes the design of a network meta-analysis, which enables a comparative investigation of all physical exercise interventions for which RCTs are available. We aim to systematically compare the effectiveness of different types of physical exercise in people with chronic non-specific neck pain.Methods and analysisNine electronic databases (AMED, CINAHL, Cochrane Central Register of Controlled Trials, Embase, MEDLINE, Physiotherapy Evidence Database, PsycINFO, Scopus and SPORTDiscus) were searched for RCTs from inception to 12 March 2019. Titles and abstract firstly, and full-text papers secondly, will be screened by two reviewers. Data will be extracted by two reviewers. The primary outcome measure is effectiveness of the intervention. Methodological quality of included studies will be assessed by two reviewers using the PEDro scale. The overall quality of evidence will be assessed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework, which has been adapted for network meta-analyses. The available evidence will be summarised using a network diagram. A contribution matrix will be presented to allow assessment of direct and indirect evidence. Forest plots will be constructed to visualise effects of all included exercise interventions. Pairwise effect sizes will be calculated by including all evidence available in the network. Effect measures for treatments that have not been compared in a pairwise RCT can be compared indirectly by contrasting effect sizes of comparisons with a common comparator.Ethics and disseminationThis work synthesises evidence from previously published studies and does not require ethics review or approval. A manuscript describing the findings will be submitted for publication in a peer-reviewed scientific journal.PROSPERO registration numberCRD42019126523.

scholarly journals Son of a Lesser God: The Case of Cell Therapy for Refractory Angina

2021 ◽  
Vol 8 ◽  
Author(s):  
Beatrice Bassetti ◽  
Erica Rurali ◽  
Elisa Gambini ◽  
Giulio Pompilio
Keyword(s):  
Clinical Trials ◽  
Well Being ◽  
Controlled Trials ◽  
Evidence Based ◽  
Refractory Angina ◽  
Level Of Evidence ◽  
Randomized Controlled ◽  
Recommended Treatment ◽  
Meta Analyses ◽  
Current Guidelines

In the last decades, various non-pharmacological solutions have been tested on top of medical therapy for the treatment of patients affected by refractory angina (RA). Among these therapeutics, neuromodulation, external counter-pulsation and coronary sinus constriction have been recently introduced in the guidelines for the management of RA in United States and Europe. Notably and paradoxically, although a consistent body of evidence has proposed cell-based therapies (CT) as safe and salutary for RA outcome, CT has not been conversely incorporated into current international guidelines yet. As a matter of fact, published randomized controlled trials (RCT) and meta-analyses (MTA) cumulatively indicated that CT can effectively increase perfusion, physical function and well-being, thus reducing angina symptoms and drug assumption in RA patients. In this review, we (i) provide an updated overview of novel non-pharmacological therapeutics included in current guidelines for the management of patients with RA, (ii) discuss the Level of Evidence stemmed from available clinical trials for each recommended treatment, and (iii) focus on evidence-based CT application for the management of RA.

scholarly journals Perspectives of People Who Are Overweight and Obese on Using Wearable Technology for Weight Management: Systematic Review

10.2196/12651 ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. e12651 ◽  
Author(s):  
Ruiqi Hu ◽  
Michelle Helena van Velthoven ◽  
Edward Meinert
Keyword(s):  
Randomized Controlled Trials ◽  
Weight Management ◽  
Data Extraction ◽  
Wearable Technology ◽  
Risk Of Bias ◽  
Qualitative Studies ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
The Cochrane Library

Background Obesity is a large contributor to preventable chronic diseases and health care costs. The efficacy of wearable devices for weight management has been researched; however, there is limited knowledge on how these devices are perceived by users. Objective This study aimed to review user perspectives on wearable technology for weight management in people who are overweight and obese. Methods We searched the online databases Pubmed, Scopus, Embase, and the Cochrane library for literature published from 2008 onward. We included all types of studies using a wearable device for delivering weight-loss interventions in adults who are overweight or obese, and qualitative data were collected about participants' perspectives on the device. We performed a quality assessment using criteria relevant to different study types. The Cochrane risk of bias tool was used for randomized controlled trials. The Risk of Bias in Non-randomized Studies - of Interventions (ROBINS-I) was used for nonrandomized studies. The Oxman and Guyatt Criteria were used for systematic reviews. We used the critical appraisal checklist for qualitative studies. Data were extracted into a data extraction sheet and thematically analyzed. Results We included 19 studies: 5 randomized controlled trials, 6 nonrandomized studies, 5 qualitative studies, and 3 reviews. Mixed perceptions existed for different constructs of wearable technologies, which reflects the differences in the suitability of wearable technology interventions for different individuals in different contexts. This also indicates that interventions were not often tailored to participants' motivations. In addition, very few wearable technology interventions included a thorough qualitative analysis of the participants' view on important features of the intervention that made it successful. Conclusions This study highlights the importance of determining the type of intervention most suitable for an individual before the intervention is used. Our findings could help participants find a suitable intervention that is most effective for them. Further research needs to develop a user-centered tool for obtaining comprehensive user feedback. Trial Registration PROSPERO CRD42018096932; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=96932

scholarly journals Assessing the risk of bias in randomized controlled trials in the field of dentistry indexed in the Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde) database

2011 ◽  
Vol 129 (2) ◽  
pp. 85-93 ◽  
Author(s):  
Christiane Alves Ferreira ◽  
Carlos Alfredo Salles Loureiro ◽  
Humberto Saconato ◽  
Álvaro Nagib Atallah
Keyword(s):  
Randomized Controlled Trials ◽  
Research Question ◽  
Allocation Concealment ◽  
Risk Of Bias ◽  
Low Risk ◽  
Controlled Trials ◽  
Level Of Evidence ◽  
Randomized Controlled ◽  
Decision Making Processes ◽  
Meta Analyses

CONTEXT AND OBJECTIVE: Well-conducted randomized controlled trials (RCTs) represent the highest level of evidence when the research question relates to the effect of therapeutic or preventive interventions. However, the degree of control over bias between RCTs presents great variability between studies. For this reason, with the increasing interest in and production of systematic reviews and meta-analyses, it has been necessary to develop methodology supported by empirical evidence, so as to encourage and enhance the production of valid RCTs with low risk of bias. The aim here was to conduct a methodological analysis within the field of dentistry, regarding the risk of bias in open-access RCTs available in the Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde) database. DESIGN AND SETTING: This was a methodology study conducted at Universidade Federal de São Paulo (Unifesp) that assessed the risk of bias in RCTs, using the following dimensions: allocation sequence generation, allocation concealment, blinding, and data on incomplete outcomes. RESULTS: Out of the 4,503 articles classified, only 10 studies (0.22%) were considered to be true RCTs and, of these, only a single study was classified as presenting low risk of bias. The items that the authors of these RCTs most frequently controlled for were blinding and data on incomplete outcomes. CONCLUSION: The effective presence of bias seriously weakened the reliability of the results from the dental studies evaluated, such that they would be of little use for clinicians and administrators as support for decision-making processes.

scholarly journals Efficacy of halofuginone products to prevent or treat cryptosporidiosis in bovine calves: a systematic review and meta-analyses

Parasitology ◽  
2020 ◽  
pp. 1-12
Author(s):  
Julii Brainard ◽  
Charlotte C. Hammer ◽  
Paul R. Hunter ◽  
Frank Katzer ◽  
Georgina Hurle ◽  
...  
Keyword(s):  
Systematic Review ◽  
Weight Gain ◽  
Prophylactic Treatment ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Industry Funding ◽  
Calf Health ◽  
Randomized Controlled ◽  
Meta Analyses ◽  
Design Experiments

Abstract A prior systematic review on the efficacy of halofuginone (HFG) treatment to prevent or treat cryptosporidiosis in bovine calves was inconclusive. We undertook an updated synthesis and meta-analyses on key outcomes for the treatment of calves with HFG. Evaluated outcomes were oocyst shedding, diarrhoea, mortality and weight gain. Experiments had to describe results for same age animals in contemporary arms. Most doses were 100–150 mcg kg−1 day−1. Results were subgrouped by study design, experiments with the lowest risk of bias and lack of industry funding. Eighteen articles were found that described 25 experiments. Most evidence came from randomized controlled trials in Europe. Significantly lower incidence of oocyst shedding, diarrhoea burden and mortality was reported when treatment started before calves were 5 days old. Most studies reported on outcomes for animals up to at least 28 days old. Publication bias was possible in all outcomes and seemed especially likely for diarrhoea outcomes. Beneficial results when HFG treatment was initiated in calves older than 5 days were also found. Prophylactic treatment to prevent cryptosporidiosis is effective in preventing multiple negative outcomes and is beneficial to calf health and will result in a reduction of environmental contamination by Cryptosporidium oocysts.

Outcomes of Surgical Treatment of Migraines: A Systematic Review & Meta-Analysis

2021 ◽  
pp. 229255032110367
Author(s):  
Adam G. Evans ◽  
Dorian S. Hill ◽  
Andrew E. Grush ◽  
Mauricio A. Downer ◽  
Maryo M. Ibrahim ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Migraine Headache ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Headache Frequency ◽  
Randomized Controlled ◽  
Headache Severity ◽  
Meta Analyses ◽  
Migraine Surgery

Background: Migraine surgery at 1 of 6 identified “trigger sites” of a target cranial sensory nerve has rapidly grown in popularity since 2000. This study summarizes the effect of migraine surgery on headache severity, headache frequency, and the migraine headache index score which is derived by multiplying migraine severity, frequency, and duration. Materials and Methods: This is a PRISMA-compliant systematic review of 5 databases searched from inception through May 2020 and is registered under the PROSPERO ID: CRD42020197085. Clinical trials treating headaches with surgery were included. Risk of bias was assessed in randomized controlled trials. Meta-analyses were performed on outcomes using a random effects model to determine the pooled mean change from baseline and when possible, to compare treatment to control. Results: 18 studies met criteria including 6 randomized controlled trials, 1 controlled clinical trial, and 11 uncontrolled clinical trials treated 1143 patients with pathologies including migraine, occipital migraine, frontal migraine, occipital nerve triggered headache, frontal headache, occipital neuralgia, and cervicogenic headache. Migraine surgery reduced headache frequency at 1 year postoperative by 13.0 days per month as compared to baseline ( I2 = 0%), reduced headache severity at 8 weeks to 5 years postoperative by 4.16 points on a 0 to 10 scale as compared to baseline ( I2 = 53%), and reduced migraine headache index at 1 to 5 years postoperative by 83.1 points as compared to baseline ( I2 = 2%). These meta-analyses are limited by a small number of studies that could be analyzed, including studies with high risk of bias. Conclusion: Migraine surgery provided a clinically and statistically significant reduction in headache frequency, severity, and migraine headache index scores. Additional studies, including randomized controlled trials with low risk-of-bias should be performed to improve the precision of the outcome improvements.

scholarly journals Covered versus bare stents for transjugular intrahepatic portosystemic shunt: an updated meta-analysis of randomized controlled trials

2016 ◽  
Vol 10 (1) ◽  
pp. 32-41 ◽  
Author(s):  
Xingshun Qi ◽  
Yulong Tian ◽  
Wei Zhang ◽  
Zhiping Yang ◽  
Xiaozhong Guo
Keyword(s):  
Overall Survival ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Portosystemic Shunt ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Covered Stents ◽  
Randomized Controlled ◽  
Intrahepatic Portosystemic Shunt ◽  
Meta Analyses

Background: Transjugular intrahepatic portosystemic shunt (TIPS) is a standard treatment option for the management of portal hypertension in liver cirrhosis. Since the introduction of covered stents, shunt patency has been greatly improved. However, it remains uncertain about whether covered stents could improve survival. A meta-analysis of randomized controlled trials has been performed to compare the outcomes of covered versus bare stents for TIPS. Methods: PubMed, EMBASE, and Cochrane Library databases were searched to identify the relevant randomized controlled trials. Overall survival, shunt patency, and hepatic encephalopathy were the major endpoints. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated. Heterogeneity was calculated. Cochrane risk of bias tool was employed. Results: Overall, 119 papers were identified. Among them, four randomized controlled trials were eligible. Viatorr covered stents alone, Fluency covered stents alone, and Viatorr plus Fluency covered stents were employed in one, two, and one randomized controlled trials, respectively. Risk of bias was relatively low. Meta-analyses demonstrated that the covered-stents group had significantly higher probabilities of overall survival (HR = 0.67, 95% CI = 0.50–0.90, p = 0.008) and shunt patency (HR = 0.42, 95% CI = 0.29–0.62, p < 0.0001) than the bare-stents group. Additionally, the covered-stents group might have a lower risk of hepatic encephalopathy than the bare-stents group (HR = 0.70, 95% CI = 0.49–1.00, p = 0.05). The heterogeneity among studies was not statistically significant in the meta-analyses. Conclusions: Compared with bare stents, covered stents for TIPS may improve the overall survival. In the era of covered stents, the indications for TIPS may be further expanded.

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