scholarly journals Psychological interventions for depression and anxiety: a systematic review and meta-analysis of Iranian chronic pain trials

2020 ◽  
Vol 10 (3) ◽  
pp. 180-191
Author(s):  
Gholamreza Jandaghi ◽  
Manijeh Firoozi ◽  
Ali Zia-Tohidi
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
English Literature ◽  
Meta Analysis ◽  
Random Effect Model ◽  
The United States ◽  
Risk Of Bias ◽  
Psychological Interventions ◽  
Depression And Anxiety ◽  
Methodological Issues

Background: Chronic pain is commonly associated with anxiety and depression, making it more challenging to be managed. Psychological interventions are suggested for such complicated issues which are well evident in the United States and Europe. However, generalizing the evidence to Iranian population – as a Middle Eastern society – might be questionable. We aimed to synthesize our evidence on the effectiveness of these interventions among Iranian populations. Methods: This was a systematic review and meta-analysis. Persian and English literature were searched through Iran-doc, Elm-net, and PubMed until March 2019 using the following terms (or its Persian synonyms): chronic pain; persistent pain; chronic fatigue; fibromyalgia; neuropath*; LBP; irritable bowel; CFS; psycho*; cogniti*; acceptance; meaning; mindfulness; relaxation; biopsychosocial; rehabilitation; educat*. Eligible trials were randomized trials that evaluated the effectiveness of psychological interventions on Iranian adults with chronic pain. No setting restriction was considered. Risk of bias for each trial was assessed, and the random-effect model was used to pool summary effect across trials. Results: In all 30 eligible RCTs, the risk of bias for randomization was low except for one study. The pooled standardized mean difference (SMD) for depression and anxiety were 1.33 (95%CI: -1.42 to -0.68) and 1.25 (95% CI: -1.55 to -0.96), respectively. Conclusion: This study suggests that psychological interventions are highly effective in reducing depression and anxiety in Iranian patients with chronic pain, compared to what observed in theU.S. and European studies. However, there are still some methodological issues to be addressed. Future research should focus on high-quality trials with considerations on the methodological issues reported in the present study.

scholarly journals Psychological interventions for chronic non-specific low back pain: protocol of a systematic review with network meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e034996
Author(s):  
Emma Ho ◽  
Manuela Ferreira ◽  
Lingxiao Chen ◽  
Milena Simic ◽  
Claire Ashton-James ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Psychological Interventions ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Low Back ◽  
Fear Avoidance

IntroductionPsychological factors such as fear avoidance beliefs, depression, anxiety, catastrophic thinking and familial and social stress, have been associated with high disability levels in people with chronic low back pain (LBP). Guidelines endorse the integration of psychological interventions in the management of chronic LBP. However, uncertainty surrounds the comparative effectiveness of different psychological approaches. Network meta-analysis (NMA) allows comparison and ranking of numerous competing interventions for a given outcome of interest. Therefore, we will perform a systematic review with a NMA to determine which type of psychological intervention is most effective for adults with chronic non-specific LBP.Methods and analysisWe will search electronic databases (MEDLINE, Embase, PsycINFO, Cochrane Central Register of Controlled Trials, Web of Science, SCOPUS and CINAHL) from inception until 22 August 2019 for randomised controlled trials comparing psychological interventions to any comparison interventions in adults with chronic non-specific LBP. There will be no restriction on language. The primary outcomes will include physical function and pain intensity, and secondary outcomes will include health-related quality of life, fear avoidance, intervention compliance and safety. Risk of bias will be assessed using the Revised Cochrane risk-of-bias tool for randomised trials (RoB 2) tool and confidence in the evidence will be assessed using the Confidence in NMA (CINeMA) framework. We will conduct a random-effects NMA using a frequentist approach to estimate relative effects for all comparisons between treatments and rank treatments according to the mean rank and surface under the cumulative ranking curve values. All analyses will be performed in Stata.Ethics and disseminationNo ethical approval is required. The research will be published in a peer-reviewed journal.PROSPERO registration numberCRD42019138074.

Prevalence of chronic pain after spinal cord injury: a systematic review and meta-analysis

2021 ◽  
pp. rapm-2020-101960
Author(s):  
Christine Hunt ◽  
Rajat Moman ◽  
Ashley Peterson ◽  
Rachel Wilson ◽  
Stephen Covington ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Chronic Pain ◽  
Classification System ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Pooled Prevalence ◽  
Cord Injury ◽  
Prevalence Estimates

BackgroundThe reported prevalence of chronic pain after spinal cord injury (SCI) varies widely due, in part, to differences in the taxonomy of chronic pain. A widely used classification system is available to describe subcategories of chronic pain in SCI, but the prevalence of chronic pain in SCI based on this system is unknown.ObjectiveThe primary objective of this systematic review and meta-analysis is to determine the prevalence of chronic pain after SCI based on the International Spinal Cord Injury Pain (ISCIP) classification system.Evidence reviewA comprehensive search of databases from January 1980 to August 2019 was conducted. The risk of bias was assessed using a modified tool developed for uncontrolled studies. The Grading of Recommendations, Assessment, Development and Evaluation approach was used to assess certainty in prevalence estimates.FindingsA total of 1305 records were screened, and 37 studies met inclusion criteria. The pooled prevalence of overall chronic pain was 68% (95% CI 63% to 73%). The pooled prevalence of neuropathic pain in 13 studies was 58% (95% CI 49% to 68%); the pooled prevalence of musculoskeletal pain in 11 studies was 56% (95% CI 41% to 70%); the pooled prevalence of visceral pain in 8 studies was 20% (95% CI 11% to 29%) and the pooled prevalence of nociceptive pain in 2 studies was 45% (95% CI 13% to 78%). Meta-regression of risk of bias (p=0.20), traumatic versus non-traumatic etiology of injury (p=0.59), and studies where pain was a primary outcome (p=0.32) demonstrated that these factors were not significant moderators of heterogeneity. Certainty in prevalence estimates was judged to be low due to unexplained heterogeneity.ConclusionThis systematic review and meta-analysis extends the findings of previous studies by reporting the prevalence of chronic pain after SCI based on the ISCIP classification system, thereby reducing clinical heterogeneity in the reporting of pain prevalence related to SCI.

scholarly journals Psychological interventions for depression and anxiety in pregnant Latina and Black women in the United States: A systematic review

2020 ◽  
Vol 27 (2) ◽  
pp. 249-265 ◽  
Author(s):  
Carolyn Ponting ◽  
Nicole E. Mahrer ◽  
Hannah Zelcer ◽  
Christine Dunkel Schetter ◽  
Denise A. Chavira
Keyword(s):  
United States ◽  
Systematic Review ◽  
Black Women ◽  
The United States ◽  
Psychological Interventions ◽  
Depression And Anxiety

scholarly journals Failure of miniscrews installed in maxilla and mandible: a systematic review and meta-analysis

2020 ◽  
Vol 23 (3) ◽  
Author(s):  
Sandro Henrique Batista dos Santos ◽  
Victório Poletto-Neto ◽  
Ana Beatriz Lima de Queiroz ◽  
Rafael Sarkis-Onofre ◽  
Tatiana Pereira-Cenci
Keyword(s):  
Systematic Review ◽  
Failure Rate ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Risk Of Bias ◽  
Selective Reporting ◽  
Risk Of Failure ◽  
Pubmed Database ◽  
Maxilla And Mandible

Objective: The aim of this systematic review was to compare the clinical failure rate of orthodontic miniscrews in maxilla and mandible. Material and Methods: Randomized controlled trials of patients in orthodontic treatment, which required miniscrews for orthodontic intervention reporting the failure rate of miniscrews in the maxilla and mandible were searched in Pubmed database. Two authors independently reviewed all identified titles and abstracts for eligibility. Comparison between failures in maxilla and mandible were estimated using pairwise meta-analysis to calculate the relative risk (RR) of failure and the 95% confidence intervals using a random-effect model. The reports of randomized trials were assessed for bias using the Cochrane risk of bias tool. Results: Four studies fulfilled the eligibility criteria. 299 patients with a total of 628 miniscrews installed were included in the analysis. The analysis showed a 0.55 RR (95% CI 0.23–1.29) and I2 = 85%. All studies had an unclear risk of bias regarding to the two following items: allocation concealment, blinding of participants and personnel. All studies had a low risk of bias with regard to incomplete outcome data and selective reporting. The results did not demonstrate statistical difference between risk of failure of miniscrew between maxilla and mandible. Conclusion: The results of the meta-analysis showed that miniscrews installed in maxilla presents reduced risk of failure. A tendency of higher number of failures in mandible was also demonstrated. However, results should be interpreted with caution because of the very low quality of included studies and the differences among methodologies. KeywordsMeta-analysis; Orthodontic anchorage procedures; Review.

scholarly journals Effects of presurgical interventions on chronic pain after total knee replacement: a systematic review and meta-analysis of randomised controlled trials

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e033248 ◽  
Author(s):  
Jane Dennis ◽  
Vikki Wylde ◽  
Rachael Gooberman-Hill ◽  
AW Blom ◽  
Andrew David Beswick
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Moderate Quality ◽  
Total Knee ◽  
Randomised Controlled ◽  
Quality Evidence

ObjectiveNearly 100 000 primary total knee replacements (TKR) are performed in the UK annually. The primary aim of TKR is pain relief, but 10%–34% of patients report chronic pain. The aim of this systematic review was to evaluate the effectiveness of presurgical interventions in preventing chronic pain after TKR.DesignMEDLINE, Embase, CINAHL,The Cochrane Libraryand PsycINFO were searched from inception to December 2018. Screening and data extraction were performed by two authors. Meta-analysis was conducted using a random effects model. Risk of bias was assessed using the Cochrane tool and quality of evidence was assessed by Grading of Recommendations Assessment, Development and Evaluation.Primary and secondary outcomesPain at 6 months or longer; adverse events.InterventionsPresurgical interventions aimed at improving TKR outcomes.ResultsEight randomised controlled trials (RCTs) with data from 960 participants were included. The studies involved nine eligible comparisons. We found moderate-quality evidence of no effect of exercise programmes on chronic pain after TKR, based on a meta-analysis of 6 interventions with 229 participants (standardised mean difference 0.20, 95% CI −0.06 to 0.47, I2=0%). Sensitivity analysis restricted to studies at overall low risk of bias confirmed findings. Another RCT of exercise with no data available for meta-analysis showed no benefit. Studies evaluating combined exercise and education intervention (n=1) and education alone (n=1) suggested similar findings. Adverse event data were reported by most studies, but events were too few to draw conclusions.ConclusionsWe found low to moderate-quality evidence to suggest that neither preoperative exercise, education nor a combination of both is effective in preventing chronic pain after TKR. This review also identified a lack of evaluations of other preoperative interventions, such as multimodal pain management, which may improve long-term pain outcomes after TKR.PROSPERO registration numberCRD42017041382.

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