scholarly journals Performance and Characteristics of Wearable Sensor Systems Discriminating and Classifying Older Adults According to Fall Risk: A Systematic Review

Sensors ◽  
2021 ◽  
Vol 21 (17) ◽  
pp. 5863 ◽  
Author(s):  
Annica Kristoffersson ◽  
Jiaying Du ◽  
Maria Ehn
Keyword(s):  
Systematic Review ◽  
Risk Assessment ◽  
Model Validation ◽  
Fall Risk ◽  
Small Sample Size ◽  
Classification Performance ◽  
Small Sample ◽  
Risk Of Bias ◽  
Classification Models ◽  
Fall Risk Assessment

Sensor-based fall risk assessment (SFRA) utilizes wearable sensors for monitoring individuals’ motions in fall risk assessment tasks. Previous SFRA reviews recommend methodological improvements to better support the use of SFRA in clinical practice. This systematic review aimed to investigate the existing evidence of SFRA (discriminative capability, classification performance) and methodological factors (study design, samples, sensor features, and model validation) contributing to the risk of bias. The review was conducted according to recommended guidelines and 33 of 389 screened records were eligible for inclusion. Evidence of SFRA was identified: several sensor features and three classification models differed significantly between groups with different fall risk (mostly fallers/non-fallers). Moreover, classification performance corresponding the AUCs of at least 0.74 and/or accuracies of at least 84% were obtained from sensor features in six studies and from classification models in seven studies. Specificity was at least as high as sensitivity among studies reporting both values. Insufficient use of prospective design, small sample size, low in-sample inclusion of participants with elevated fall risk, high amounts and low degree of consensus in used features, and limited use of recommended model validation methods were identified in the included studies. Hence, future SFRA research should further reduce risk of bias by continuously improving methodology.

scholarly journals Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery

SLEEP ◽  
2020 ◽  
Vol 43 (10) ◽  
Author(s):  
Madison Luther ◽  
Katrina M Poppert Cordts ◽  
Cydni N Williams
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Disturbances ◽  
Small Sample Size ◽  
Evaluation Studies ◽  
Small Sample ◽  
Risk Of Bias ◽  
Pediatric Tbi

Abstract Study Objectives Sleep is vital for brain development and healing after injury, placing children with sleep-wake disturbances (SWD) after traumatic brain injury (TBI) at risk for worse outcomes. We conducted a systematic review to quantify SWD after pediatric TBI including prevalence, phenotypes, and risk factors. We also evaluated interventions for SWD and the association between SWD and other posttraumatic outcomes. Methods Systematic searches were conducted in MEDLINE, PsychINFO, and reference lists for English language articles published from 1999 to 2019 evaluating sleep or fatigue in children hospitalized for mild complicated, moderate, or severe TBI. Two independent reviewers assessed eligibility, extracted data, and assessed risk of bias using the Newcastle–Ottowa Score for observational studies. Results Among 966 articles identified in the search, 126 full-text articles were reviewed, and 24 studies were included (11 prospective, 9 cross-sectional, and 4 case studies). Marked heterogeneity was found in study populations, measures defining SWD, and time from injury to evaluation. Studies showed at least 20% of children with TBI had trouble falling or staying asleep, fatigue, daytime sleepiness, and nightmares. SWD are negatively correlated with posttraumatic cognitive, behavioral, and quality of life outcomes. No comparative intervention studies were identified. The risk of bias was moderate–high for all studies often related to lack of validated or objective SWD measures and small sample size. Heterogeneity precluded meta-analyses. Conclusions SWD are important morbidities after pediatric TBI, though current data are limited. SWD have implications for TBI recovery and may represent a modifiable target for improving outcomes after pediatric TBI.

Are antifungal non-inferiority trials at risk of eroding effectiveness because of bio-creep? A secondary analysis of a systematic review

2021 ◽  
Author(s):  
Adam S. Komorowski ◽  
Anthony D. Bai ◽  
Anna Cvetkovic ◽  
Omar Mourad ◽  
Carson K.L. Lo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Small Sample Size ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Small Sample ◽  
Risk Of Bias ◽  
Effective Control ◽  
Erosion Risk ◽  
Randomized Controlled ◽  
Over Time

Non-inferiority randomized controlled trial (RCT) effectiveness may erode when results favour the active control over time, and when a decreasingly effective control arm is used in serial trials. We analyzed 32 antifungal noninferiority RCTs (NI-RCTs) for these scenarios in this secondary analysis of a systematic review. Our exploratory analysis suggests that the erosion risk in the effectiveness of antifungal non-inferiority trials is uncommon. Findings are limited by small sample size, and overall risk of bias.

scholarly journals Surgically accelerated orthodontic techniques and periodontal response: a systematic review

2020 ◽  
Vol 42 (6) ◽  
pp. 635-642 ◽  
Author(s):  
Umar Rekhi ◽  
Raisa Queiroz Catunda ◽  
Monica Prasad Gibson
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Sample Size ◽  
Orthodontic Treatment ◽  
Small Sample Size ◽  
Small Sample ◽  
Risk Of Bias ◽  
Long Term Follow Up

Summary Background Reduction in orthodontic treatment time is gaining popularity due to patient demands. Several new techniques of acceleratory orthodontic treatment have been introduced to effectively treat the malocclusion in a shorter time period with minimal adverse effects. Objective The objective of this systematic review is to critically evaluate the potential effect of accelerated surgically assisted orthodontic techniques on periodontal tissues. Materials and methods Electronic databases used to perform the search were Medline (Ovid), EMBASE, PubMed, Scopus, Cochrane, Google Scholar, and hand searching of the literature was also performed. Selection criteria Only randomized control trials (RCTs) that assessed the relationship between accelerated surgically assisted orthodontic techniques and its effects on periodontium were included. Data collection and analysis The Joanna Briggs Institute (JBI) critical appraisal checklist tool (2016) was used to assess the finally selected studies. Among these studies, five evaluated corticotomy-facilitated orthodontics, two tested accelerated tooth movement with piezocision, one compared corticotomy-facilitated orthodontics with piezocision, and one studied the effects of periodontally accelerated osteogenic orthodontics. The duration of these studies was relatively short and had moderate to high risk of bias. Results Literature search identified 225 records from 5 databases and 50 articles from the partial grey literature (Google scholar) search. Finally, nine eligible RCTs were included in the review. Limitations Most of the included studies were of a high risk of bias due to high experimental heterogeneity and small sample size. Long-term follow-up of the periodontal response to these interventions was also lacking. Conclusions There is an absence of evidence considering the lack of long-term follow-up and small sample size therefore, the results of this review should be carefully interpreted. Implications Due to the need for more studies with less risk of bias, these techniques should be implemented in dental practice with caution. With stronger evidence, the study may be confirmed to provide quicker desired results for orthodontic patients. Registration This study protocol was not registered. Funding No funding was obtained for this systematic review.

Factors included in adult fall risk assessment tools (FRATs): a systematic review

2020 ◽  
pp. 1-25
Author(s):  
Hendrika de Clercq ◽  
Alida Naudé ◽  
Juan Bornman
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Risk Assessment ◽  
Fall Risk ◽  
The Body ◽  
Assessment Tools ◽  
Personal Factors ◽  
Fall Risk Assessment ◽  
Environmental Consequences ◽  
Preventative Measures

Abstract Falls often have severe financial and environmental consequences, not only for those who fall, but also for their families and society at large. Identifying fall risk in older adults can be of great use in preventing or reducing falls and fall risk, and preventative measures that are then introduced can help reduce the incidence and severity of falls in older adults. The overall aim of our systematic review was to provide an analysis of existing mechanisms and measures for evaluating fall risk in older adults. The 43 included FRATs produced a total of 493 FRAT items which, when linked to the ICF, resulted in a total of 952 ICF codes. The ICF domain with the most used codes was body function, with 381 of the 952 codes used (40%), followed by activities and participation with 273 codes (28%), body structure with 238 codes (25%) and, lastly, environmental and personal factors with only 60 codes (7%). This review highlights the fact that current FRATs focus on the body, neglecting environmental and personal factors and, to a lesser extent, activities and participation. This over-reliance on the body as the point of failure in fall risk assessment clearly highlights the need for gathering qualitative data, such as from focus group discussions with older adults, to capture the perspectives and views of the older adults themselves about the factors that increase their risk of falling and comparing these perspectives to the data gathered from published FRATs as described in this review.

scholarly journals Validated Fall Risk Assessment Tools for Use with Older Adults: A Systematic Review

2018 ◽  
Vol 36 (4) ◽  
pp. 331-353 ◽  
Author(s):  
Marcello Ruggieri ◽  
Biagio Palmisano ◽  
Giancarlo Fratocchi ◽  
Valter Santilli ◽  
Roberta Mollica ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Risk Assessment ◽  
Fall Risk ◽  
Assessment Tools ◽  
Fall Risk Assessment ◽  
Risk Assessment Tools

scholarly journals A Systematic Review of the Guidelines and Delphi Study for the Multifactorial Fall Risk Assessment of Community-Dwelling Elderly

2020 ◽  
Vol 17 (17) ◽  
pp. 6097
Author(s):  
Jieun Kim ◽  
Worlsook Lee ◽  
Seon Heui Lee
Keyword(s):  
Systematic Review ◽  
Risk Assessment ◽  
Delphi Study ◽  
Fall Risk ◽  
Assessment Tool ◽  
The Elderly ◽  
Community Dwelling ◽  
Assessment Tools ◽  
Risk Assessment Tool ◽  
Fall Risk Assessment

As falls are among the most common causes of injury for the elderly, the prevention and early intervention are necessary. Fall assessment tools that include a variety of factors are recommended for preventing falls, but there is a lack of such tools. This study developed a multifactorial fall risk assessment tool based on current guidelines and validated it from the perspective of professionals. We followed the Meta-Analysis of Observational Studies in Epidemiology’s guidelines in this systematic review. We used eight international and five Korean databases to search for appropriate guidelines. Based on the review results, we conducted the Delphi survey in three rounds; one open round and two scoring rounds. About nine experts in five professional areas participated in the Delphi study. We included nine guidelines. After conducting the Delphi study, the final version of the “Multifactorial Fall Risk Assessment tool for Community-Dwelling Older People” (MFA-C) has 36 items in six factors; general characteristics, behavior factors, disease history, medication history, physical function, and environmental factors. The validity of the MFA-C tool was largely supported by various academic fields. It is expected to be beneficial to the elderly in the community when it comes to tailored interventions to prevent falls.

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